脉
疝脉弦急,积聚在里,牢急者生,弱息者死。沉迟浮涩,疝瘕寒痛,痛甚则伏,或细,或动。
病
夫疝者,小腹引卵,肿急绞痛也。有痛在睾丸者,有痛在五枢穴者,皆是厥阴肝之经也。或无形无声,
或形如瓜,有声如蛙。自《素问》而下,皆以为寒,盖寒主收引,经络得寒,则引而不行,所以作痛,理
固然也,亦有踢水涉水,终身不病此者,无执在内故也。大抵此症始于湿热,在经郁遏至久,又得寒气外来,
不得疏散而作痛。若只作寒论,恐为未备,或曰厥阴一经,郁积湿热,何由而致?予曰∶大劳则火起于筋,
醉饱则火起于胃,房劳则火起于肾,大怒则火起于肝。本经火积之久,母能令子虚,湿气便盛,浊液凝聚,
并入血队流于厥阴。厥阴属木,系于肝,为将军之官,其性急速,火性又暴,为寒所束,宜其痛之太暴也。
有以乌头、栀子作汤饮之,其效亦敏,后因此方随病加减与之,无有不验。但湿热又须分多少而治,
湿则多肿, 病是也。又有挟虚而发者,当以
参、术为君,而以疏导药佐之。脉甚沉紧而豁大无力者也,其痛亦轻,惟觉重坠牵引耳。
经有七疝∶寒、水、筋、血、气、狐、 。
治
一、寒疝者,囊冷结硬如石,阴茎不举,或控引睾丸而痛,得于寒湿也,使内过劳也,宜以温剂下之,禹
功散、加味五苓散、下清木香丸,或五积蟠葱之类。
一、水疝者,肾囊肿痛,阴汗时出,囊或肿如水晶,或痒而搔出黄水,或小腹按之作水声,得于饮食
醉饱,使内过劳也,汗出而遇风寒湿气聚于囊中,故多水也,宜禹功散、三花神佑丸、导水丸逐中之剂下之。
一、筋疝者,阴茎肿痛,或浓或痛,里急筋缩,或茎中痛,痛极则痒,或挺纵不收,或白物如精,随
溲而下,得于房室劳倦,及邪术所使,以降心火之剂下之,泻心汤主之。
一、血疝者,状如黄瓜,在小腹两旁,横骨两端纹中,俗云便痈也。得于春夏,重感大燠劳于内,气
流溢渗入脬囊,留而不去,结成痈肿,脓少血多。又或强制情欲,当泄不泄,亦成此疾。宜玉
烛散和血之剂下之。
一、气疝者,上连肾区,下及阴囊,或因号哭忿怒,则气郁而胀,以针出气而愈,然针有得失,宜散
气药下之,宜荡疝丸,或蟠葱散主之。或小儿亦有此疾,俗云偏坠,气得于其父,阴痿精怯,
强力入房,因而有子,胎中病也。此疝不治,惟宜灸筑宾一穴,在内上五寸、 分肉中,灸五壮。
一、狐疝者,状如仰瓦,卧则入小腹,行立则出小腹,入囊中,狐则昼出穴而溺,夜则
入穴而不溺,此疝与狐相类,亦与气疝大同小异,令人带钩铃是也,宜以逐气流经之剂下之。
一、 疝者,阴囊肿坠如升斗,不痒不痛,得之地气卑湿,故
江淮人多有之,宜去湿之剂下之,三花神佑丸之类。如女子阴户突
出,虽亦此类,乃热不禁故也,不可便认为虚寒,而温之补之,名曰瘕。
一、元神虚弱,受寒作小肠疝气滚痛,以蟠葱散加故纸、小茴、川楝子、木香之类。
一、体壮实,小肠气痛,或小便不通,以八正散加破故纸、小茴、川楝子。
一、小腹下毛际边,或左或右,生气核如桃状,按之则散,时伏时见,以五苓散加川楝子、小茴香、
葱白、灯心煎汤,下青木香丸五十七粒。
一、治阳明受湿热,传入太阳,恶寒发热,小腹连毛际结核,
闷痛不可忍者,以栀子炒、枳壳炒、桃仁炒、山楂各等分,生姜三片,水煎服。
方
禹功散 治寒疝。
黑牵牛(头末,一钱) 小茴香(二钱五分) 加木香(一钱)
上共为末,每服三钱,姜汁调下。
五积散 治醉饱后色欲过度,触伤小腹,致成疝气。其症自小腹痛连两胁下,心头吊痛,额上汗出。
根据本方加玄胡索。
蟠葱散 治脾胃虚寒,气滞不行,攻刺心腹,痛连胁胸,及膀胱、小肠疝气,又治妇人血气痛。
丁皮(一两) 砂仁(一两) 莪术(一两五钱) 三棱(一两五钱) 槟榔(一两) 玄
胡索(七钱五分) 苍术(一两) 青皮(一两五钱) 干姜(五钱) 肉桂(五钱) 茯苓(一两
五钱) 甘草(一两)
上锉一剂,生姜、枣子、葱白,水煎热服。脐下极冷痛,加
吴茱萸、木香、小茴香等味。
加味五苓散
根据本方加木香、小茴香、川楝子、槟榔、黑牵牛、故纸、木通、青皮、三棱、莪术等味。
上锉一剂,水煎服。
橘核丸 治四积 疝,卵核肿胀,偏有大小,或坚硬如石,或
引脐腹绞痛,肾囊肿胀,或成疮毒,轻则时出黄水,甚则成痈溃烂。
橘核(炒) 海藻(盐酒炒) 昆布(盐酒炒) 桃仁(面炒,去皮尖) 桂心(五钱) 川楝肉(炒
)海带(盐水洗,一两) 枳实(面炒) 浓朴(姜汁炒) 玄胡索(炒) 木香(五钱) 木通(五钱)
上为末,酒糊为丸,如梧桐子大。每服六七十丸,空心陈酒、盐汤下。如虚寒甚,脉沉细,手足冷者,
加川乌一两。如坚胀久不消,加 砂二钱,醋煮旋入。
荡疝丸
黑牵牛(取头末) 破故纸(炒) 小茴香(炒) 川楝子(去核,炒,各一两) 青
皮(三钱) 陈皮(三钱) 莪术(四钱) 木香(四钱)
上为末,酒糊为丸,如梧桐子大。每服五十丸,空心温酒送下。
青木香丸
黑牵牛(炒,取头末,二两) 槟榔(二两,粟米饭裹煨,去饭) 青木香(一两五钱)
破故纸(二两,炒) 荜澄茄(二两)
上为末,水煮稀糊为丸,如梧桐子大。每服三十丸,滚汤送下。
行气香苏散 治偏坠气初起疼痛,憎寒壮热,根据本方加小茴香,木香、三棱、莪术、木通。
加减香苓散 治偏坠气初起,憎寒壮热,发表分利药,轻者,
一服而愈。
枳壳 陈皮 香附 苍术 麻黄 香薷 猪苓 泽泻 木通
滑石 车前子 三棱 莪术 川楝子 玄胡索 甘草
上锉一剂,生姜、葱白,水煎热服。
文蛤散 治偏坠气神效。
五倍子(五、六个,烧存性)
上为末,陈酒调服,以醉为度。
神消散(秘方) 治诸般疝气,外肾肿胀疼痛。
山栀子(盐水炒黑色,一两) 益智仁(炒,七钱) 橘核(炒,一两) 青皮(香油
炒,六钱) 槟榔(一钱) 荔枝核(八钱) 小茴香(盐水炒,一两)
上为细末,每服二钱,烧酒调服。如不用酒,以灯心草煎汤,加盐少许,调服立效。
茴香安肾汤(太医院传) 治左边偏坠,丸如鸡、鸭子。
人参(一钱) 白术(一钱) 白茯苓(去皮,一钱) 泽泻(七分) 茴香(一钱,炒)
破故纸(一钱) 黄柏(八分) 木香(五分) 槟榔(一钱) 乌药(一钱) 香附(一钱,童
便浸经宿) 砂仁(一钱) 玄胡索(五分) 升麻(三分) 甘草(炙,五分) 荔枝核(一钱)
上锉一剂,饥时服。
三香酒(秘方) 治偏坠气。
南木香(三钱) 小茴香(三钱) 八角茴香(三钱) 川楝肉(三钱)
上合一服,锅内炒四味,入葱白、莲须五根,水一碗,淬入锅,将碗罩住,候煎至半碗,取出去渣,加
陈酒半碗,合和入炒盐一茶匙,空心热服,神效。
四圣散(秘方) 治疝气,外肾肿胀。
小茴香(炒) 穿山甲(炒) 全蝎(炒) 南木香(各等分)
上为末,每服二钱,陈酒调,一服痛止。
木香金铃丸(严宪副传) 治外肾肿痛,诸般疝气,一服立效。
木香 乳香 没药 大附子(面裹火煨) 小茴香(盐炒) 川楝肉 玄
胡索 全蝎 人参(各等分)
上为末,陈酒打糊为丸,如梧桐子大。每服百丸,空心陈酒送
下。
大小茴香丸(长葛李大尹传) 治疝气如神。
大茴香(一两) 小茴香(一两) 吴茱萸(一两) 川楝子(一两) 川椒(一两)
上共为末,连须葱头八两,同药捣成饼子,晒干,用粘米五合,同药饼研碎,微火炒黄为末,
酒糊为丸,如梧子大。每服八九十丸,空心盐汤,或酒下,忌发气物。
茴香丸 治疝气神效。
茯苓(二两,炒) 白术(二两,炒) 山楂(二两,炒) 枳实(八钱) 八角茴香
(一两,炒) 吴茱萸(一两,炒) 橘核(三两,炒) 荔枝核(一两)
上为细末,炼蜜为丸。每服重一钱五分大,空心细嚼,姜汤送下。
灸法 治一偏坠气痛。
用蓖麻子,一岁一粒,去皮研烂,贴头顶囟上,却令患人仰卧,将两脚掌相对,以带子绑住二中指,于
两指合缝处,艾麦粒大灸七壮,实时上去。
脉象
疝气的脉象表现为弦而急,病邪积聚在体内。若脉象牢而急,预后良好(可生);若脉象微弱欲绝,则预后不良(主死)。若脉象沉迟或浮涩,多为疝瘕及寒性疼痛;疼痛剧烈时,脉象可能伏匿不见,或者呈现细脉、动脉。
病症
所谓疝气,是指小腹牵引睾丸,出现肿胀、紧急、绞痛的症状。有的疼痛位于睾丸,有的疼痛位于五枢穴处,这些都属于足厥阴肝经的病变。有的疝气无形无声,有的形状像瓜,有的发出如青蛙般的叫声。自《素问》以来,医家多认为疝气由寒邪引起,因为寒性主收敛牵引,经络受寒后气血运行不畅,所以产生疼痛,这在道理上是成立的。但也有的人踢水涉水,终身不患此病,这是因为体内没有寒邪滞留的缘故。大抵来说,这种病症起始于湿热,在经络中郁结阻滞日久,又受到外来寒气的侵袭,导致无法疏散而引发疼痛。如果只从寒证来论述,恐怕不够全面。有人问:厥阴一经郁积湿热,是如何形成的呢?我说:过度劳累则火起于筋,醉酒饱食则火起于胃,房事过度则火起于肾,大怒则火起于肝。本经火热积聚日久,母脏(肝木)虚弱不能制约子脏(心火/脾土等,此处指五行相生关系中的虚损),湿气便旺盛,浊液凝聚,并入血分流注于厥阴经。厥阴属木,联系肝脏,被称为“将军之官”,其性质急速,火性又猛烈,被寒气束缚,所以疼痛非常剧烈。有用乌头、栀子煮汤饮用的,效果也很迅速,后来根据这个方子随病情加减使用,没有不灵验的。但是湿热又需要区分湿重还是热重来治疗,湿重的话往往肿胀明显,这就是上述提到的症状。又有夹杂虚证而发作的,应当以人参、白术为君药,辅以疏导的药物。脉象非常沉紧但按之豁大无力的,疼痛也较轻,只觉得沉重下坠和牵引感。
经典记载有七种疝:寒疝、水疝、筋疝、血疝、气疝、狐疝、㿗疝。
治疗
一、寒疝:阴囊寒冷结硬如石头,阴茎不能勃起,或者牵引睾丸疼痛,这是由于寒湿所致,或因房事过劳引起。适宜用温里剂攻下,可用禹功散、加味五苓散、下清木香丸,或者五积蟠葱散之类。
二、水疝:肾囊肿痛,阴部出汗时常流出,阴囊有时肿得像水晶一样,或者瘙痒搔抓后流出黄水,或者按压小腹有水声,这是由于饮食醉饱、房事过劳,汗出后遭遇风寒湿气聚积于阴囊中,所以水分多。适宜用禹功散、三花神佑丸、导水丸等逐水剂攻下。
三、筋疝:阴茎肿痛,或者流脓或者疼痛,里急筋缩,或者尿道内疼痛,痛极则痒,或者阴茎挺纵不收,或者有白色分泌物像精液一样,随小便排出,这是由于房室劳倦及邪术所致。适宜用清降心火的剂型攻下,以泻心汤为主治。
四、血疝:形状像黄瓜,位于小腹两旁,横骨两端纹中,俗称便痈。这是由于春夏季节,内部感受大热且劳累,气流溢渗入膀胱囊袋,停留不去,结成痈肿,脓少血多。或者是强行抑制情欲,该泄而不泄,也会形成此疾。适宜用玉烛散等调和血液的剂型攻下。
五、气疝:上连肾区,下及阴囊,或者因号哭愤怒,导致气机郁滞而胀满,可以用针刺放气而痊愈,然而针刺有得失之分,适宜用散气药攻下,可用荡疝丸,或者蟠葱散为主治。小儿也有此病,俗称偏坠,是得自父亲的气,父亲阴痿精怯,强力入房因而有子,属于胎中病。此疝难以治愈,只适宜灸筑宾穴,位置在内踝上五寸,分肉之中,灸五壮。
六、狐疝:形状像仰放的瓦片,躺下时进入小腹,站立行走时从小腹出来进入阴囊。狐狸白天出穴排尿,夜晚回穴不排尿,此疝与狐狸习性相似,也与气疝大同小异,让人身上带有钩铃响声。适宜用逐气流经的剂型攻下。
七、㿗疝:阴囊肿坠如升斗大小,不痒不痛,是由于地气卑湿所致,所以江淮地区人多有此病。适宜用祛湿剂攻下,如三花神佑丸之类。如果是女子阴户突出,虽然也是此类,但这是因为热邪不能固禁所致,不可就认为是虚寒而用温补法,名为瘕。
八、元神虚弱,受寒引起小肠疝气滚动剧痛,用蟠葱散加破故纸、小茴香、川楝子、木香之类。
九、体质壮实,小肠气痛,或者小便不通,用八正散加破故纸、小茴香、川楝子。
十、小腹下方毛际边缘,或左或右,生气核如桃状,按压则散开,时而潜伏时而显现,用五苓散加川楝子、小茴香、葱白、灯心煎汤,送服青木香丸五十七粒。
十一、治疗阳明经受湿热,传入太阳经,恶寒发热,小腹连接毛际处结核闷痛不可忍受,用炒栀子、炒枳壳、炒桃仁、山楂各等分,生姜三片,水煎服。
方剂
禹功散 治疗寒疝。
黑牵牛(取头末,一钱) 小茴香(二钱五分) 加木香(一钱)
以上共研为末,每次服用三钱,姜汁调服。
五积散 治疗醉饱后色欲过度,触伤小腹,导致疝气。症状是小腹痛连两胁下,心头吊痛,额头出汗。
根据本方加玄胡索。
蟠葱散 治疗脾胃虚寒,气滞不行,攻刺心腹,痛连胁胸,以及膀胱、小肠疝气,又治疗妇人血气痛。
丁皮(一两) 砂仁(一两) 莪术(一两五钱) 三棱(一两五钱) 槟榔(一两) 玄胡索(七钱五分) 苍术(一两) 青皮(一两五钱) 干姜(五钱) 肉桂(五钱) 茯苓(一两五钱) 甘草(一两)
以上锉成一剂,加生姜、枣子、葱白,水煎热服。脐下极冷痛,加吴茱萸、木香、小茴香等味。
加味五苓散
根据本方加木香、小茴香、川楝子、槟榔、黑牵牛、破故纸、木通、青皮、三棱、莪术等味。
以上锉成一剂,水煎服。
橘核丸 治疗四种积疝,卵核肿胀,偏有大小,或者坚硬如石,或者牵引脐腹绞痛,肾囊肿胀,或者成疮毒,轻则时而流出黄水,重则成痈溃烂。
橘核(炒) 海藻(盐酒炒) 昆布(盐酒炒) 桃仁(面炒,去皮尖) 桂心(五钱) 川楝肉(炒) 海带(盐水洗,一两) 枳实(面炒) 浓朴(姜汁炒) 玄胡索(炒) 木香(五钱) 木通(五钱)
以上研为末,酒糊为丸,如梧桐子大。每次服用六七十丸,空腹时用陈酒、盐汤送服。如果虚寒严重,脉沉细,手足冷者,加川乌一两。如果坚胀久不消,加荜澄茄二钱,醋煮后随时加入。
荡疝丸
黑牵牛(取头末) 破故纸(炒) 小茴香(炒) 川楝子(去核,炒,各一两) 青皮(三钱) 陈皮(三钱) 莪术(四钱) 木香(四钱)
以上研为末,酒糊为丸,如梧桐子大。每次服用五十丸,空腹用温酒送下。
青木香丸
黑牵牛(炒,取头末,二两) 槟榔(二两,粟米饭裹煨,去饭) 青木香(一两五钱) 破故纸(二两,炒) 荜澄茄(二两)
以上研为末,水煮稀糊为丸,如梧桐子大。每次服用三十丸,滚汤送下。
行气香苏散 治疗偏坠气初起疼痛,憎寒壮热,根据本方加小茴香,木香、三棱、莪术、木通。
加减香苓散 治疗偏坠气初起,憎寒壮热,发表分利药,轻者,一服而愈。
枳壳 陈皮 香附 苍术 麻黄 香薷 猪苓 泽泻 木通 滑石 车前子 三棱 莪术 川楝子 玄胡索 甘草
以上锉成一剂,加生姜、葱白,水煎热服。
文蛤散 治疗偏坠气神效。
五倍子(五、六个,烧存性)
以上研为末,陈酒调服,以醉为度。
神消散(秘方) 治疗诸般疝气,外肾肿胀疼痛。
山栀子(盐水炒黑色,一两) 益智仁(炒,七钱) 橘核(炒,一两) 青皮(香油炒,六钱) 槟榔(一钱) 荔枝核(八钱) 小茴香(盐水炒,一两)
以上为细末,每次服用二钱,烧酒调服。如不用酒,以灯心草煎汤,加盐少许,调服立效。
茴香安肾汤(太医院传) 治疗左边偏坠,丸如鸡、鸭子。
人参(一钱) 白术(一钱) 白茯苓(去皮,一钱) 泽泻(七分) 茴香(一钱,炒) 破故纸(一钱) 黄柏(八分) 木香(五分) 槟榔(一钱) 乌药(一钱) 香附(一钱,童便浸经宿) 砂仁(一钱) 玄胡索(五分) 升麻(三分) 甘草(炙,五分) 荔枝核(一钱)
以上锉成一剂,饥时服。
三香酒(秘方) 治疗偏坠气。
南木香(三钱) 小茴香(三钱) 八角茴香(三钱) 川楝肉(三钱)
以上合一服,锅内炒四味,入葱白、莲须五根,水一碗,淬入锅,将碗罩住,候煎至半碗,取出去渣,加陈酒半碗,合和入炒盐一茶匙,空心热服,神效。
四圣散(秘方) 治疗疝气,外肾肿胀。
小茴香(炒) 穿山甲(炒) 全蝎(炒) 南木香(各等分)
以上研为末,每次服用二钱,陈酒调服,一服痛止。
木香金铃丸(严宪副传) 治疗外肾肿痛,诸般疝气,一服立效。
木香 乳香 没药 大附子(面裹火煨) 小茴香(盐炒) 川楝肉 玄胡索 全蝎 人参(各等分)
以上研为末,陈酒打糊为丸,如梧桐子大。每次服用百丸,空腹陈酒送下。
大小茴香丸(长葛李大尹传) 治疗疝气如神。
大茴香(一两) 小茴香(一两) 吴茱萸(一两) 川楝子(一两) 川椒(一两)
以上共研为末,连须葱头八两,同药捣成饼子,晒干,用粘米五合,同药饼研碎,微火炒黄为末,酒糊为丸,如梧子大。每次服用八九十丸,空腹盐汤,或酒下,忌发气物。
茴香丸 治疗疝气神效。
茯苓(二两,炒) 白术(二两,炒) 山楂(二两,炒) 枳实(八钱) 八角茴香(一两,炒) 吴茱萸(一两,炒) 橘核(三两,炒) 荔枝核(一两)
以上为细末,炼蜜为丸。每次服用重一钱五分大,空腹细嚼,姜汤送下。
灸法 治疗一侧偏坠气痛。
用蓖麻子,一岁一粒,去皮研烂,贴头顶囟门上,却让患者仰卧,将两脚掌相对,用带子绑住二中指,在两指合缝处,艾麦粒大灸七壮,实时去掉。
Pulse
The pulse of Shan (hernia) is wiry and rapid, with pathogenic factors accumulating inside. If the pulse is firm and rapid, survival is indicated; if it is weak and fading, death is indicated. A deep and slow or floating and choppy pulse indicates Shan masses and cold pain; when pain is severe, the pulse may become hidden, thready, or moving.
Disease
Shan refers to a condition where the lower abdomen draws pain to the testicles, accompanied by swelling, tension, and colicky pain. Some pain is located in the testicles, some at the Wushu acupoint (GB29), all belonging to the Jueyin Liver meridian. Some Shan are formless and soundless, while others resemble melons or make sounds like frogs. Since the *Suwen*, it has been considered caused by cold, because cold governs contraction and pulling; when meridians receive cold, qi and blood fail to flow smoothly, causing pain, which is theoretically sound. However, some people wade in water or kick water yet never suffer from this disease, as there is no internal retention of cold. Generally, this condition originates from damp-heat stagnating in the meridians for a long time, compounded by external cold invasion, preventing dispersion and causing pain. Relying solely on a cold pattern theory is insufficient. One might ask: How does damp-heat accumulate in the Jueyin channel? I say: Excessive labor generates fire in the sinews; drunkenness and overeating generate fire in the stomach; sexual exhaustion generates fire in the Kidneys; extreme anger generates fire in the Liver. When fire accumulates in the primary channel for a long time, the mother organ becomes deficient, allowing dampness to flourish. Turbid fluids condense, merge with the blood, and flow into the Jueyin. Jueyin belongs to Wood, connects to the Liver, known as the "General," possessing a swift nature. Fire is also violent. Constrained by cold, the pain becomes extremely acute. Using Aconite (*Fuzi*) and Gardenia (*Zhizi*) decoction yields quick results; subsequently modifying this formula based on symptoms has proven effective without exception. However, damp-heat must be treated according to their respective proportions. Dampness predominance often causes significant swelling, as described above. Cases complicated by deficiency should use Ginseng (*Renshen*) and Atractylodes Macrocephala (*Baizhu*) as sovereign herbs, assisted by herbs that promote circulation. If the pulse is deeply tight yet hollow and powerless upon pressure, the pain is mild, characterized mainly by heaviness, dragging, and traction.
Classics describe seven types of Shan: Cold Shan, Water Shan, Sinew Shan, Blood Shan, Qi Shan, Fox Shan, and Scrotal Shan.
Treatment
1. Cold Shan: The scrotum is cold, hard, and stone-like; the penis fails to erect; pain radiates to the testicles. Caused by cold-dampness or excessive sexual activity/labor. Treat with warming purgatives such as Yugong San, Modified Wuling San, Xia Qingmuxiang Wan, or Wuji Pancun San.
2. Water Shan: Swollen and painful kidneys/scrotum; frequent sweating in the genital area; scrotum may swell like crystal or ooze yellow fluid when scratched; pressing the lower abdomen produces a water sound. Caused by drunkenness, overeating, sexual exhaustion, and subsequent exposure to wind-cold-dampness after sweating, leading to fluid accumulation in the scrotum. Treat with water-draining purgatives such as Yugong San, Sanhua Shenyao Wan, or Daoshui Wan.
3. Sinew Shan: Swollen and painful penis; pus or pain; tenesmus and tendon retraction; pain in the urethra; extreme pain leads to itching; priapism or inability to retract; white discharge resembling semen during urination. Caused by sexual fatigue and evil influences. Treat with formulas that descend Heart fire, primarily Xie Xin Tang.
4. Blood Shan: Resembles a cucumber, located on both sides of the lower abdomen in the creases at the ends of the transverse bone, commonly called "pian tong" (groin abscess). Caused by summer-heat and internal exertion in spring/summer, causing qi overflow into the bladder sac, stagnating and forming an abscess with little pus and much blood. Or caused by suppressing sexual desire without emission. Treat with blood-nourishing purgatives such as Yuzhu San.
5. Qi Shan: Extends from the kidney region to the scrotum. Distension due to qi stagnation caused by crying or anger can be relieved by acupuncture to release qi, though acupuncture outcomes vary. Preferably treat with qi-dispersing purgatives such as Dangshan Wan or Pancun San. Children may also suffer from this,俗称 "pianzhui" (one-sided descent), inherited from the father's weak essence due to forced intercourse while impotent. This type is difficult to cure; moxibustion at Zhubin (KI9), 5 cun above the medial malleolus in the muscle gap, 5 moxa cones, is recommended.
6. Fox Shan: Resembles an inverted tile; enters the lower abdomen when lying down, exits into the scrotum when standing/walking. Similar to the fox's behavior of exiting to urinate by day and hiding by night. Closely related to Qi Shan, often associated with a clicking sensation (like a hook/bell). Treat with formulas that expel qi and unblock meridians.
7. Scrotal Shan (*Tui* Shan): Scrotum hangs heavily like a measuring cup, non-itchy and non-painful, caused by low-lying damp earth qi, common in Jianghuai regions. Treat with damp-resolving purgatives like Sanhua Shenyao Wan. In women, vaginal prolapse is similar but caused by heat failing to secure; do not mistake it for deficiency-cold requiring warming/nourishing; it is termed *Jia*.
8. For Yuan Shen (Primordial Spirit) deficiency with cold invading causing rolling colic in Small Intestine Qi Shan: Use Pancun San plus Psoralea (*Guzhi*), Fennel (*Xiaohui*), Sichuan Chinaberry (*Chuanlianzi*), and Costus (*Muxiang*).
9. For robust constitution with Small Intestine Qi pain or urinary obstruction: Use Bazheng San plus Psoralea (*Guzhi*), Fennel (*Xiaohui*), and Sichuan Chinaberry (*Chuanlianzi*).
10. For nodules like peaches appearing near the pubic hairline (left or right), dispersible on pressure, intermittent: Decoct Wuling San with Sichuan Chinaberry (*Chuanlianzi*), Fennel (*Xiaohui*), White Onion (*Congbai*), and Centipede Grass (*Dengxincao*), take 57 pills of Qingmuxiang Wan.
11. For Yangming channel affected by damp-heat transmitting to Taiyang, with aversion to cold, fever, tender knots connecting lower abdomen to pubis, unbearable stifling pain: Decoct equal parts of fried Gardenia (*Zhizi*), fried Bitter Orange (*Zhiqiao*), fried Peach Kernel (*Taoren*), and Hawthorn (*Shanzha*) with 3 slices of Ginger (*Shengjiang*).
Formulas
Yugong San treats Cold Shan.
Black Morning Glory Seed (*Hei Qianniu*, head powder, 1 qian), Fennel (*Xiaohui*, 2.5 qian), plus Costus (*Muxiang*, 1 qian).
Grind to powder. Take 3 qian per dose, mixed with Ginger Juice (*Jiangzhi*).
Wuji San treats Shan caused by sexual excess after drunkenness/overeating, injuring the lower abdomen. Symptoms include lower abdominal pain radiating to hypochondrium, heart-tethering pain, and forehead sweating.
Add Corydalis (*Yanhusuo*) to this formula.
Pancun San treats Spleen/Stomach deficiency-cold, qi stagnation stabbing heart/abdomen, pain radiating to hypochondrium/chest, Bladder/Small Intestine Shan, and women's blood/qi pain.
Phellodendron Bark (*Dingpi*, 1 liang), Amomum (*Sharen*, 1 liang), Curcuma (*Ezhu*, 1.5 liang), Burreed Tuber (*Sanleng*, 1.5 liang), Areca Nut (*Binglang*, 1 liang), Corydalis (*Yanhusuo*, 0.75 liang), Atractylodes (*Cangzhu*, 1 liang), Green Tangerine Peel (*Qingpi*, 1.5 liang), Dried Ginger (*Ganjiang*, 0.5 liang), Cinnamon Twig (*Rougui*, 0.5 liang), Poria (*Fuling*, 1.5 liang), Licorice (*Gancao*, 1 liang).
Cut into one dose. Decoct with Fresh Ginger (*Shengjiang*), Jujube (*Zaozi*), and White Onion (*Congbai*). Take hot. For extreme cold pain below navel, add Evodia (*Wuzhuyu*), Costus (*Muxiang*), and Fennel (*Xiaohui*).
Modified Wuling San
Based on the base formula, add Costus (*Muxiang*), Fennel (*Xiaohui*), Sichuan Chinaberry (*Chuanlianzi*), Areca Nut (*Binglang*), Black Morning Glory Seed (*Hei Qianniu*), Psoralea (*Guzhi*), Akebia (*Mutong*), Green Tangerine Peel (*Qingpi*), Burreed Tuber (*Sanleng*), and Curcuma (*Ezhu*).
Cut into one dose. Decoct in water.
Juhe Wan treats four types of accumulated Shan, swollen testicles of unequal size, hardness like stone, traction pain to umbilicus/abdomen, kidney/scrotal swelling, sores/toxins, oozing yellow fluid, or abscess ulceration.
Tangerine Seed (*Juhe*, fried), Seaweed (*Haizao*, salt-wine fried), Kelp (*Kunbu*, salt-wine fried), Peach Kernel (*Taoren*, flour-fried, skin removed), Cinnamon Heart (*Guixin*, 0.5 liang), Sichuan Chinaberry Flesh (*Chuanlianrou*, fried), Kelp (*Haidai*, salt-water washed, 1 liang), Immature Bitter Orange (*Zhishi*, flour-fried), Magnolia Bark (*Houpo*, ginger-juice fried), Corydalis (*Yanhusuo*, fried), Costus (*Muxiang*, 0.5 liang), Akebia (*Mutong*, 0.5 liang).
Grind to powder, make pills with wine paste, size of Sophora seeds. Take 60-70 pills fasting with aged wine and salt water. For severe deficiency-cold, deep/thready pulse, cold limbs, add Aconite (*Chuanwu*, 1 liang). For chronic hardness/swelling, add Galangal (*Bichengqie*, 2 qian), boiled in vinegar and added fresh.
Dangshan Wan
Black Morning Glory Seed (*Hei Qianniu*, head powder), Psoralea (*Poguozhi*, fried), Fennel (*Xiaohui*, fried), Sichuan Chinaberry (*Chuanlianzi*, pitted, fried, each 1 liang), Green Tangerine Peel (*Qingpi*, 3 qian), Tangerine Peel (*Chenpi*, 3 qian), Curcuma (*Ezhu*, 4 qian), Costus (*Muxiang*, 4 qian).
Grind to powder, make pills with wine paste, size of Sophora seeds. Take 50 pills fasting with warm wine.
Qingmuxiang Wan
Black Morning Glory Seed (*Hei Qianniu*, fried, head powder, 2 liang), Areca Nut (*Binglang*, 2 liang, baked in millet rice, remove rice), Costus (*Qingmuxiang*, 1.5 liang), Psoralea (*Poguozhi*, 2 liang, fried), Galangal (*Bichengqie*, 2 liang).
Grind to powder, make pills with water-boiled thin paste, size of Sophora seeds. Take 30 pills with boiling water.
Xingqi Xiangsu San treats early-stage unilateral descent pain with aversion to cold and high fever. Based on base formula, add Fennel (*Xiaohui*), Costus (*Muxiang*), Burreed Tuber (*Sanleng*), Curcuma (*Ezhu*), Akebia (*Mutong*).
Jiajian Xiangling San treats early-stage unilateral descent pain with aversion to cold and high fever. Release exterior and separate clear/turbid herbs. Mild cases cured in one dose.
Bitter Orange (*Zhiqiao*), Tangerine Peel (*Chenpi*), Cyperus (*Xiangfu*), Atractylodes (*Cangzhu*), Ephedra (*Mahuang*), Mosla (*Xiangru*), Polyporus (*Zhuling*), Alisma (*Zexie*), Akebia (*Mutong*), Talc (*Huashi*), Plantago Seed (*Cheqianzi*), Burreed Tuber (*Sanleng*), Curcuma (*Ezhu*), Sichuan Chinaberry (*Chuanlianzi*), Corydalis (*Yanhusuo*), Licorice (*Gancao*).
Cut into one dose. Decoct with Fresh Ginger (*Shengjiang*) and White Onion (*Congbai*). Take hot.
Wenge San treats unilateral descent pain with miraculous effect.
Chinese Gall (*Wubeizi*, 5-6 pieces, burned to retain charred nature).
Grind to powder. Mix with aged wine until drunk.
Shenxiao San (Secret Recipe) treats various Shan with external testicular swelling/pain.
Gardenia (*Shanzhizi*, salt-water fried black, 1 liang), Alpinia Oxyphylla (*Yizhiren*, fried, 0.7 qian), Tangerine Seed (*Juhe*, fried, 1 liang), Green Tangerine Peel (*Qingpi*, sesame-oil fried, 0.6 liang), Areca Nut (*Binglang*, 0.1 liang), Lychee Seed (*Lizhihe*, 0.8 liang), Fennel (*Xiaohui*, salt-water fried, 1 liang).
Grind to fine powder. Take 2 qian mixed with burning wine. If no wine, use Centipede Grass (*Dengxincao*) decoction with a pinch of salt; effective immediately.
Huixiang Anshen Tang (Imperial Hospital Transmission) treats left-sided unilateral descent, pills sized like chicken/duck eggs.
Ginseng (*Renshen*, 0.1 liang), Atractylodes Macrocephala (*Baizhu*, 0.1 liang), Poria (*Baifuling*, peeled, 0.1 liang), Alisma (*Zexie*, 0.07 liang), Fennel (*Huixiang*, fried, 0.1 liang), Psoralea (*Poguozhi*, 0.1 liang), Phellodendron (*Huangbai*, 0.08 liang), Costus (*Muxiang*, 0.05 liang), Areca Nut (*Binglang*, 0.1 liang), Lindera (*Wuyao*, 0.1 liang), Cyperus (*Xiangfu*, 0.1 liang, soaked in child's urine overnight), Amomum (*Sharen*, 0.1 liang), Corydalis (*Yanhusuo*, 0.05 liang), Cimicifuga (*Shengma*, 0.03 liang), Licorice (*Gancao*, roasted, 0.05 liang), Lychee Seed (*Lizhihe*, 0.1 liang).
Cut into one dose. Take when hungry.
Sanxiang Jiu (Secret Recipe) treats unilateral descent.
Southern Costus (*Nanmuxiang*, 3 qian), Fennel (*Xiaohui*, 3 qian), Star Anise (*Bajiao Huixiang*, 3 qian), Sichuan Chinaberry Flesh (*Chuanlianrou*, 3 qian).
Stir-fry the four ingredients in a pot. Add White Onion (*Congbai*) and 5 Lotus Stamen (*Lianxu*). Add 1 bowl of water, cover with a bowl, simmer until half remains. Remove dregs, add half bowl of aged wine, mix with 1 teaspoon of roasted salt. Take hot fasting. Miraculous effect.
Sisheng San (Secret Recipe) treats Shan with external testicular swelling.
Fennel (*Xiaohui*, fried), Pangolin Scale (*Chuanshanjia*, fried), Whole Scorpion (*Quanxie*, fried), Southern Costus (*Nanmuxiang*, equal parts).
Grind to powder. Take 2 qian mixed with aged wine. Pain stops after one dose.
Muxiang Jinling Wan (Transmitted by Yan Xianfu) treats external testicular swelling/pain, various Shan, effective after one dose.
Costus (*Muxiang*), Frankincense (*Ruxiang*), Myrrh (*Moyao*), Large Aconite (*Da Fuzi*, wrapped in flour, fire-roasted), Fennel (*Xiaohui*, salt-fried), Sichuan Chinaberry Flesh (*Chuanlianrou*), Corydalis (*Yanhusuo*), Whole Scorpion (*Quanxie*), Ginseng (*Renshen*, equal parts).
Grind to powder, make pills with aged wine paste, size of Sophora seeds. Take 100 pills fasting with aged wine.
Daxiao Huixiang Wan (Transmitted by Li Dayin of Changge) treats Shan miraculously.
Star Anise (*Da Huixiang*, 1 liang), Fennel (*Xiao Huixiang*, 1 liang), Evodia (*Wuzhuyu*, 1 liang), Sichuan Chinaberry (*Chuanlianzi*, 1 liang), Sichuan Pepper (*Chuanjiao*, 1 liang).
Grind to powder. Mix with 8 liang of green onion heads (with roots), pound into cakes, dry. Grind 0.5 he of glutinous rice with the dried cakes, stir-fry lightly until yellow, grind to powder. Make pills with wine paste, size of Sophora seeds. Take 80-90 pills fasting with salt water or wine. Avoid foods that provoke qi.
Huixiang Wan treats Shan miraculously.
Poria (*Fuling*, 2 liang, fried), Atractylodes Macrocephala (*Baizhu*, 2 liang, fried), Hawthorn (*Shanzha*, 2 liang, fried), Immature Bitter Orange (*Zhishi*, 0.8 qian), Star Anise (*Bajiao Huixiang*, 1 liang, fried), Evodia (*Wuzhuyu*, 1 liang, fried), Tangerine Seed (*Juhe*, 3 liang, fried), Lychee Seed (*Lizhihe*, 1 liang).
Grind to fine powder. Make pills with refined honey. Each pill weighs 1.5 qian. Chew thoroughly fasting, swallow with Ginger Soup (*Jiangtang*).
Moxibustion Method treats unilateral descent pain.
Use Castor Seeds (*Bimazi*). One seed per year of age. Peel and grind to paste. Apply to the fontanelle (*Xin*) on the top of the head. Have the patient lie supine. Press soles together. Tie middle fingers together with a strap. At the seam between the two middle fingers, apply moxa cone the size of wheat grain, 7 cones. Remove immediately after burning.