先哲云∶水火即人身熟腐水谷之气，得其平谓之水火，失其宜谓之湿热，湿热相搏，气
不得达
而生黄，是固然矣。然王海藏云∶伤寒病遇太阳太阴司天，若下之太过，往往变成阴黄。
一则寒水太过，水来犯土；一则土气不及，水来侵之，用茵陈汤，次第加姜、附、茱萸治之
。夫伤寒热病而有阴黄，则杂病黄胆亦有阴黄矣。故身冷畏寒，阴黄也；湿胜脾虚，阴黄也
；二便清利，阴黄也；脉沉而微，阴黄也。凡遇此等，非温补不愈。设以黄色为土邪有余，
而过行朱伐，饮食必减，胃气必亏。由脾传肾，变为黑疸而不可治，良可悲矣！
疝、隐疾也，古称七疝，寒、水、筋、血、气、狐、 也。寒疝者，腰痛牵引睾丸，屈
而不
伸，其脉沉迟，得此之由，必是寒客下体，如坐于卑湿，涉于寒水之所起也，寒气自外入内
，束其少火，郁其肝气，故令腰痛，痛而牵引睾丸者，肝之经络环阴器故也；寒主收引，故
令屈而不伸；尺内主腰，脉沉迟，皆阴象也，宜吴茱萸加附子汤主之。水疝者，肾囊肿大，
阴汗不绝，得之饮水，醉后劳于使内。盖饮水醉酒，则湿气胜。劳于使内，则肾气虚，肾虚
则湿胜而流攻者，势也，故令阴囊肿大如水晶，阴汗不绝，如罅漏也。经云∶下者举之。又
云∶风能胜湿，宜升阳除湿汤主之。筋疝者，茎筋掣痛，挺胀不堪。此得之房劳邪术，所使
春方，多热毒之剂，故令胀满不堪，宜甘草梢黑豆汤主之。血疝者，外肾因扑损而伤，睾丸
偏大，有时疼痛者，中有瘀血，名曰血疝，宜于夜分之时，自以一手托其下，一手按其上，
由轻至重，揉摩百遍，弥月之间，瘀血尽散，陈气皆行，诚妙法也。气疝者遇有拂郁，则
睾丸
肿大，遇有悲哀，则不药而消，盖邪之所凑，常垂其虚拂郁，而睾丸肿大者，肝气垂肾之也
，悲哀则不药而消者，气有所泄也。先哲云∶肝肾之病同一法，治宜虎潜丸主之。或曰∶何
以不用橘核、川楝、枳实、青皮之类？余曰∶皆破气之药，昔人多用之，然治标云尔，况蹈
重虚之戒乎？气实用之可也，狐疝者∶昼则气出而肾囊肿大，令人不堪，夜则气入而肿胀皆
消，如无其疾。狐之为物，昼则出穴而溺，夜则入穴而不溺，以斯证肖之，故名狐疝。昼阳
也，夜阴也，昼病而夜否，气病而血不病也。宜补中益气汤，升举下陷之阳，加黄柏、知母
，以益夫不足之坎。或曰∶何不用子和辛香流气之品？余曰∶此气虚所致，若更流藏，非惟
无益，而又害之也。 疝者，颓大也，睾丸虽大而无疾。此系父子相传，得于有生之初，非
有生以后，外因所致之疾也，故不必主治。或先有 疝，后来疼痛疾苦者，必兼前六证之法
治之。
先哲曾说：水火之气即人体内消化水谷的能量，平衡时称为“水火”，失调时则转化为湿热。湿热相互搏结，气机阻滞不通而发黄，这确实是常理。然而王海藏指出：伤寒病若逢太阳、太阴司天之年，如果误用攻下法太过，往往会转变为阴黄（寒湿郁滞所致的黄疸）。一种是寒水之气过盛，水邪侵犯脾土；另一种是脾土之气虚弱，被水邪侵袭。治疗应用茵陈汤，依次加入干姜、附子、吴茱萸来调理。既然伤寒热病中会出现阴黄，那么杂病中的黄疸也有阴黄之分。因此，身体发冷、畏寒，属于阴黄；湿气偏胜、脾气虚弱，属于阴黄；大小便清长通畅，属于阴黄；脉象沉而微弱，属于阴黄。凡是遇到这些情况，非用温补之法不能痊愈。假如认为黄色代表土邪有余，而过重地使用苦寒攻伐药物，必然导致饮食减少，胃气亏损。病邪由脾传至肾，演变为黑疸（一种难治的黄疸变证）而无法治愈，实在令人悲哀！
疝气，是一种隐蔽的疾病，古称“七疝”，包括寒疝、水疝、筋疝、血疝、气疝、狐疝和㿗疝。寒疝的症状是腰痛并牵引睾丸，腿部弯曲无法伸直，脉象沉迟。得此病的原因，必定是寒邪客居下部，如坐于低洼潮湿之地，或涉入寒冷水中所致。寒气从外侵入体内，束缚了体内的少火（命门之火），郁滞了肝气，所以导致腰痛，且疼痛牵引睾丸，这是因为肝的经络环绕生殖器；寒性主收引，所以导致腿部弯曲无法伸直；尺部脉候腰，脉象沉迟均为阴寒之象，适宜用吴茱萸加附子汤主治。水疝的症状是肾囊肿大，阴部汗出不止。得此病是因为饮水过多，醉酒后进行房事。饮水醉酒会导致湿气偏胜，房劳过度则导致肾气虚弱，肾虚则湿气偏胜并流注攻冲，这是必然的趋势，所以导致阴囊肿大如水晶透明状，阴汗不止，如同缝隙漏水。医经说：“下陷者宜升举。”又说：“风能胜湿。”适宜用升阳除湿汤主治。筋疝的症状是阴茎筋脉抽搐疼痛，勃起胀满难以忍受。此病得自房劳过度或服用邪术春药，其中多含有热毒成分，所以导致胀满不堪，适宜用甘草梢黑豆汤主治。血疝的症状是外肾因跌打损伤而受伤，睾丸一侧偏大，有时疼痛，这是因为里面有瘀血，名叫血疝。适宜在半夜时分，自己用一只手托住下方，另一只手按压上方，由轻到重，揉摩一百遍，一个月之间，瘀血即可散尽，陈旧的积气也能运行，这确实是个妙法。气疝的症状是遇到情绪抑郁时，睾丸肿大；遇到悲伤时，不用吃药也会消退。大概是因为邪气聚集之处，往往是因为该处正气虚弱。情绪抑郁导致睾丸肿大，是肝气下坠影响肾脏所致；悲伤时不用药而消退，是因为气机得以宣泄。先哲曾说：肝肾之病治疗方法相同，适宜用虎潜丸主治。有人问：为什么不用橘核、川楝子、枳实、青皮这类药物？我说：这些都是破气的药物，过去的人多用它们，但这只是治标罢了，况且还要触犯“虚虚”（使虚者更虚）的大忌吗？只有气实证才可使用。狐疝的症状是：白天阳气出表，肾囊肿大，令人难受；夜晚阳气入里，肿胀全部消失，好像没有生病一样。狐狸这种动物，白天出洞排尿，晚上进洞不排尿，用这个症状来比喻，所以叫狐疝。白天属阳，夜晚属阴，白天发病而夜晚正常，说明是气病而血未病。适宜用补中益气汤，升举下陷的阳气，加入黄柏、知母，以滋补肾阴（坎水）。有人问：为什么不用张子和那种辛香行气的药物？我说：这是气虚导致的，如果再使用流通耗散的药物，不仅无益，反而有害。㿗疝的症状是睾丸肿大，但并无其他病痛。这是由于父子遗传，在生命形成之初就有的，并非出生后由外因引起的疾病，所以不必专门治疗。或者原本有㿗疝，后来出现疼痛痛苦的，必须兼用前六种疝气的方法进行治疗。
The sages once said: The qi of water and fire refers to the energy responsible for digesting food and fluids in the human body. When balanced, it is called "water and fire"; when imbalanced, it transforms into damp-heat. When damp-heat struggles with each other, the qi fails to circulate freely, leading to jaundice; this is indeed the general principle. However, Wang Haizang stated: In cases of Shanghan (Cold Damage) disease, if occurring during years governed by the Taiyang or Taiyin celestial stems/earthly branches, excessive use of purgatives often leads to Yin Jaundice (jaundice caused by cold-dampness stagnation). One scenario involves excessive cold-water qi, where water evil attacks the spleen-earth; another involves deficiency of spleen-earth qi, allowing water evil to invade. Treatment should employ Yinchen Decoction (Artemisia Capillaris Decoction), sequentially adding Shengjiang (Dried Ginger), Fuzi (Prepared Aconite Root), and Wuzhuyu (Evodia Fruit). Since Yin Jaundice can occur in Shanghan febrile diseases, it follows that miscellaneous disease jaundice also includes Yin Jaundice. Therefore, a cold body and aversion to cold indicate Yin Jaundice; excess dampness with spleen deficiency indicates Yin Jaundice; clear and profuse urination and defecation indicate Yin Jaundice; a deep and faint pulse indicates Yin Jaundice. In all such cases, only warming and tonifying methods can effect a cure. If one assumes the yellow color represents an excess of earth-pathogen and employs overly harsh bitter-cold purging drugs, dietary intake will inevitably decrease, and stomach qi will be depleted. The pathogen may transmit from the spleen to the kidney, transforming into Black Jaundice (a refractory variant of jaundice) which becomes incurable, truly a sorrowful outcome!
Shan (Hernia) is a concealed ailment. Ancient texts refer to "Seven Types of Shan," including Cold Shan, Water Shan, Sinew Shan, Blood Shan, Qi Shan, Fox Shan, and Tui Shan.
Cold Shan presents with lower back pain radiating to the testicles, with legs bent and unable to extend. The pulse is deep and slow. The etiology is certainly cold evil lodging in the lower body, akin to sitting in low, damp places or wading in cold water. Cold qi enters from the exterior into the interior, binding the Shaohuo (Mingmen Fire/Life Gate Fire) and stagnating Liver qi, thus causing lower back pain radiating to the testicles, as the Liver meridian encircles the genitalia. Cold governs contraction and drawing-in, hence the inability to extend the legs. The chi position governs the lower back; a deep and slow pulse are both yin manifestations. Wu Zhu Yu Jia Fu Zi Tang (Evodia and Prepared Aconite Decoction) is indicated.
Water Shan presents with scrotal swelling and continuous sweating in the genital region. It arises from excessive drinking of water and sexual activity after intoxication. Drinking excessively and becoming drunk lead to dampness predominance. Sexual exertion depletes Kidney qi. With Kidney deficiency, dampness predominates and flows downward, which is the natural tendency, resulting in the scrotum swelling like crystal-clear glass and continuous leakage-like sweating. The Classics state: "What has sunk should be raised." And again: "Wind can overcome dampness." Sheng Yang Chu Shi Tang (Raise Yang and Dispel Dampness Decoction) is indicated.
Sinew Shan presents with spasmodic pain in the penile tendons and unbearable distension during erection. This results from sexual exhaustion or the use of aphrodisiacs containing many heat-toxic ingredients, causing unbearable distension. Gan Cao Shao Hei Dou Tang (Licorice Tip and Black Soybean Decoction) is indicated.
Blood Shan occurs when the external genitals are injured by falls or blows, causing unilateral testicular enlargement and occasional pain due to internal blood stasis. This is named Blood Shan. It is advisable to perform self-massage at midnight: support the lower part with one hand and press the upper part with the other, rubbing gently to firmly for one hundred repetitions. Within a month, the blood stasis will dissipate completely, and stagnant qi will circulate. This is indeed a wonderful method.
Qi Shan manifests as testicular swelling upon emotional depression, which resolves spontaneously without medication upon experiencing grief. Generally, where evil gathers, there is often underlying deficiency. Depression causes testicular swelling due to Liver qi sinking affecting the Kidneys. Grief allows the qi to vent, resolving the swelling. The sages said: Diseases of the Liver and Kidney share similar treatment principles. Hu Huan Wan (Tiger Hidden Pill) is indicated. Some ask: Why not use Ju He (Tangerine Seed), Chuan Lian Zi (Sichuan Chinaberry Seed), Zhi Shi (Immature Bitter Orange), or Qing Pi (Green Tangerine Peel)? I reply: These are all qi-breaking herbs. Although widely used in the past, they only treat the branch/symptoms. Moreover, do they not violate the prohibition against "making the deficient more deficient"? They are suitable only for excess conditions.
Fox Shan presents with daytime scrotal swelling and discomfort as yang qi emerges, while nighttime sees the resolution of swelling as yang qi enters, appearing as if no disease exists. The fox exits its burrow to urinate during the day and does not urinate at night. This symptom resembles the fox's behavior, hence the name Fox Shan. Day is yang, night is yin. Daytime illness with nighttime remission indicates a qi disorder rather than a blood disorder. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is indicated to raise the sunken yang, supplemented by Huang Bai (Phellodendron Bark) and Zhi Mu (Anemarrhena Rhizome) to nourish the deficient Kan (Kidney/Water). Some ask: Why not use Zhang Hezi’s pungent-aromatic qi-moving agents? I reply: This is caused by qi deficiency. Using dispersing agents would not only be unhelpful but harmful.
Tui Shan refers to massive enlargement of the testicles without other ailments. This is hereditary, present from conception, not acquired through external factors after birth, so specific treatment is unnecessary. If Tui Shan is initially present but later develops pain and distress, it must be treated using the methods applicable to the previous six types of Shan.