某（左） 子和论七疝都隶于肝，以少腹前阴，皆厥阴经部位故也。盖筋者肝之合，睾丸者筋之所聚也，
偏左者肝生于左也。劳倦奔走，则元气下陷，所以肾囊之间，筋肿甚大，每觉上冲心胸，非攻心也，夫中
脘季胁，乃肝脉游行之地也。大凡治法，不越辛温苦泄。然劳碌气陷者，苦泄则气益陷。今先举其陷下
之气，稍佐辛温，是亦标本兼治之意。另案即请方家正之。
台参须（另煎冲八分） 炙绵 （二钱） 蜜炙升麻（四分） 炙甘草（二分） 野于术（一钱五分土炒） 净柴
胡（四分） 酒炒当归（二钱） 广木香（三分） 炒小茴（五分） 陈皮（二钱） 延胡索（二钱） 白茯苓（四钱）
左 湿寒内阻为狐疝。
盐水炒香附 台乌药 南楂炭 木猪苓 木香 小青皮 炒小茴 赤白苓 炒橘核
左 大病之后，脉象时常带数，右三部微滑，左三部并无数象。此气分湿热逗留，湿热润下，压坠府气，
所以有疝气情形。拟理气泄湿。
盐水炒香附 制半夏 生米仁 金铃子 泽泻 黑山栀 川萆 炒枳壳 木猪苓
徐（左） 右脉濡细，左脉细弦。少腹偏右筋突痛胀，必得平卧，痛胀方平。考少腹两旁属肝，居中为冲脉，
冲任虚寒，湿压气坠，所以为痛为胀。至平卧则压坠之势稍衰，所以其痛略减。拟导湿外泄，湿得泄则
不坠，水窍常开，则精窍常闭，而遗泄亦可以免矣。
萆 （二钱） 吴萸（盐水炒四分） 乌药（一钱五分） 黑山栀（二钱） 磨木香（五分） 米仁（四钱）
猪茯苓（各二钱） 泽泻（一钱五分） 炒小茴（五分） 炒橘核（三钱） 荔枝核（三钱炙）
李（左） 寒痰内阻，络气不宣，胸胁肋游行作痛睾丸痛胀。经云、冲脉为病，男子内结七疝。又云、冲脉者，
起于气街，并少阴之经，挟脐上行，至胸中而散。所以上则胸痛，下则疝痛，病虽悬殊，其源则一。
生香附 小青皮 归须 橘络 枳壳 乌药 旋复花 金铃子 磨郁金（五分） 真猩绛（六分） 青葱管
荣（左） 由睾丸痛胀，而致从上攻冲，直抵中脘，痛不可忍。恶心呕吐，倏寒倏热，大便不行，小溲浑赤。舌
红苔白。湿热流入厥阴，而冲隶于肝，又属阳明，起于气街，而布散胸中，所以肝病不退，冲脉之气，挟湿
热之气，上冲犯胃，的属冲疝重症。拟苦辛酸合方。
川雅连（五分炒） 淡干姜（三分） 川楝子（三钱） 制香附（二钱） 延胡索（二钱） 盐水炒陈皮（一钱）
淡芩（酒炒一钱五分） 杭白芍（酒炒三钱） 白茯苓（三钱） 生薏仁（三钱） 姜汁炒黑山栀（三钱） 泽泻（一
钱五分）
二诊 苦辛酸合方，呕吐稍减，痛势略缓。然腹中时觉攻撑，愈撑愈痛，痛处以热物摩熨，其势即缓，而
热汤入口，其痛即甚，吐出均系痰涎。脉左部细弦，右部沉郁。肝经之气，横扰充斥，标热本寒。与甘仁先
生同议温脏而泄气火之郁，化痰而降胃府之气。逸山先生意见相同。录方以备商用。
川雅连（五分） 淡吴萸（三分川连同炒） 制香附（二钱） 黑山栀（三钱） 金铃子（三钱） 广皮（二钱）
熟附片（三分） 制半夏（一钱五分） 延胡索（一钱五分） 白茯苓（三钱） 白蛳螺壳（二钱） 粉丹皮（二钱）
上沉香（二分） 黑丑（三分二味研细末先调服）
三诊 苦降辛通，痛势渐轻，大便虽行未畅，呕恶不止，吐出之物，气甚酸秽。右脉沉郁稍起，渐见滑象。
肝木之纵横肆扰，虽得略平，而厥气逆冲，胃土不降，气即为火，痰即为浊，酿成酸秽之味，逆从上出。与
逸山甘仁两兄同议清泄郁结，降浊镇逆。
黑山栀（三钱） 制半夏（三钱） 块辰砂（三钱） 鲜竹茹（三钱） 炙紫菀肉（二钱） 香豆豉（二钱） 茯
苓（五钱） 柿蒂（四个） 郁金（一钱五分） 旋复花（二钱绢包） 金铃子（二钱） 鲜枇杷叶（一两去毛绢包煎
汤代水）
四诊 痛势大减，略能安寐，大便不行，仍然恶心呕吐，吐出不堪秽臭，胃中窒闷异常，面色晦浊，目有
红光。脉左弦右滑。良由疝气上冲，胃之下口，即小肠上口，火府之气，不克下行，转从上逆，令糟粕从胃
底翻出，胃浊不降，痰聚胸中，胆阳上逆，面晦目红不寐，宜有种种现象矣。夫大肠居小肠之下，与肺相
表里。兹与逸山甘仁两先生同议，控逐胸中之结聚，使肺气下通于大肠，肠痹得开，则火府之气，或从
下行，冀糟粕亦转旋顺下。未识能如愿否。
制半夏（三钱） 块辰砂（四钱） 细木通（一钱五分） 炙紫菀肉（四钱） 旋复花（二钱） 白茯苓（五钱）
姜汁炒山栀（三钱） 鲜竹茹（三钱） 柿蒂（五个） 控涎丹（八分开水先调服）
五诊 攻逐胸中结聚之痰，使肺气下通于大肠，大肠居然开通，屡次畅下，糟粕之逆出于胃者，亦从
下行，呕吐臭秽已定，胸中窒闷亦开，疝气痛胀大减，渐能安谷，脉数转缓，出险履夷，诚为幸事。再拟调
和中气，疏泄肝木，分化湿热，以善其后。同逸山甘仁两兄商用。
制半夏（一钱五分） 鲜竹茹（一钱） 干橘叶（一钱五分） 泽泻（二钱） 生薏仁（三钱） 白茯苓（三钱）
金铃子（一钱五分） 荔枝核（三钱） 猪苓（二钱） 炒谷芽（三钱）
顾（左） 囊肿较退，睾丸仍然肿硬。还是湿压气坠，气湿不行。再运脾渗湿，而温元藏。
连皮苓（五钱） 吴萸（盐水炒四分） 木猪苓（二钱） 大腹皮（二钱） 楂炭（二钱） 广木香（五分）
炒橘核（三钱研） 炒小茴（五分） 炒枳壳（一钱） 冬瓜子（五钱） 炙干蟾（四钱）
二诊 睾丸作痛殊甚，又复身热。湿热内阻，营卫不宣，恐变外证。
青陈皮 萆 延胡索 枳壳 大腹皮 炒橘核 香附 金铃子 泽泻 猪苓
徐 疝气而觉气上冲，心中热辣作呕吐象，此冲心也。
天台乌药散加盐水炒香附，猪胆汁二匙冲（急不可得以川连代之）
钱（左） 睾丸偏左作痛，牵引腰府，中脘不舒。脉濡而滑。此肝肾湿热内伏。先调气利湿。
制香附（二钱打） 川萆 （二钱） 泽泻（二钱） 青皮（一钱） 台乌药（一钱五分） 金铃子（一钱五分）
炒橘核（三钱） 猪苓（二钱） 楂炭（三钱） 炒小茴（五分） 延胡索（一钱五分酒炒）
支（左） 少腹偏右作胀，大便艰涩，时常紫黑，卧难成寐，气冲嗳噫。脉细弦数。此湿热内郁，致血气结滞
不宣， 疝情形也。极难图治。
川楝子（一钱五分） 单桃仁（三钱） 制半夏（二钱） 延胡索（一钱五分酒炒） 炒橘核（三钱研） 海藻（一
钱五分） 淡昆布（一钱） 赤白茯苓（各二钱） 炙荔核（三钱研） 楂炭（三钱） 木香（四分） 焦秫米（三钱）
朱（左） 少腹有气上冲，支脘作痛。脉沉而弦。肝肾湿寒。治宜温化。
淡吴萸（盐水炒四分） 台乌药（一钱五分） 赤白苓（各二钱） 泽泻（一钱五分） 盐水炒青皮（一钱）
金铃子（一钱五分） 苏子梗（各二钱） 前胡（一钱五分） 制香附（三钱） 光杏仁（三钱） 楂炭（三钱）
【左案一】子和论述七疝均归属于肝，因为少腹和前阴部位都是足厥阴肝经循行的区域。筋是肝所合的组织，睾丸是筋汇聚的地方，偏左侧发病是因为“肝气生于左”的缘故。因劳累过度或奔走导致元气下陷，所以肾囊之间的筋脉肿胀得非常厉害，经常感觉有气向上冲撞心胸，这并非直接攻心，而是中脘和季胁部位，正是肝脉游行的地方。大凡治疗法则，离不开辛温发散和苦寒泄降。然而对于劳碌导致气机下陷的患者，使用苦寒泄降会使气机更加下陷。现在先提升其下陷之气，稍加辛温药物，这也是标本兼治的意思。另案即请方家指正。
处方：台参须（另煎兑服八分）、炙绵芪（二钱）、蜜炙升麻（四分）、炙甘草（二分）、野于术（一钱五分，土炒）、净柴胡（四分）、酒炒当归（二钱）、广木香（三分）、炒小茴香（五分）、陈皮（二钱）、延胡索（二钱）、白茯苓（四钱）。
【左案二】湿寒内阻导致狐疝。
处方：盐水炒香附、台乌药、南楂炭、木猪苓、木香、小青皮、炒小茴香、赤茯苓与白茯苓、炒橘核。
【左案三】大病之后，脉象时常带数，右三部脉微滑，左三部脉并无数象。这是气分湿热逗留不去，湿热性润下，压迫坠滞腑气，所以出现疝气的症状。拟用理气泄湿之法。
处方：盐水炒香附、制半夏、生薏苡仁、金铃子（川楝子）、泽泻、黑山栀、川萆薢、炒枳壳、木猪苓。
【徐案】右脉濡细，左脉细弦。少腹右侧筋脉突起疼痛胀满，必须平卧，痛胀才能平息。考察少腹两旁属于肝，居中为冲脉，冲任二脉虚寒，湿气压迫导致气机下坠，所以产生疼痛和胀满。至于平卧时，压迫下坠之势稍减，所以疼痛略微减轻。拟用导湿外泄之法，湿气得以宣泄则不再下坠，水窍常开，则精窍常闭，遗精滑泄也可以避免。
处方：川萆薢（二钱）、吴茱萸（盐水炒四分）、乌药（一钱五分）、黑山栀（二钱）、磨木香（五分）、薏苡仁（四钱）、猪苓与茯苓（各二钱）、泽泻（一钱五分）、炒小茴香（五分）、炒橘核（三钱）、荔枝核（三钱，炙）。
【李案】寒痰内阻，络脉气机不宣，胸胁肋部游走作痛，睾丸痛胀。《内经》说：“冲脉为病，男子内结七疝。”又说：“冲脉起于气街，并足少阴肾经而行，挟脐上行，至胸中而散。”所以上面表现为胸痛，下面表现为疝痛，病症虽然悬殊，但根源相同。
处方：生香附、小青皮、归须、橘络、枳壳、乌药、旋覆花、金铃子、磨郁金（五分）、真猩绛（六分）、青葱管。
【荣案】由睾丸痛胀，导致气从上方向攻冲，直抵中脘，疼痛难以忍受。恶心呕吐，忽冷忽热，大便不通，小便浑浊色赤。舌红苔白。湿热流入厥阴肝经，而冲脉隶属于肝，又属于阳明胃经，起于气街，布散于胸中，所以肝病不退，冲脉之气挟带湿热之气上冲犯胃，确属冲疝重症。拟用苦辛酸合方治疗。
处方：川雅连（五分，炒）、淡干姜（三分）、川楝子（三钱）、制香附（二钱）、延胡索（二钱）、盐水炒陈皮（一钱）、淡黄芩（酒炒一钱五分）、杭白芍（酒炒三钱）、白茯苓（三钱）、生薏苡仁（三钱）、姜汁炒黑山栀（三钱）、泽泻（一钱五分）。
二诊：服用苦辛酸合方后，呕吐稍减，痛势略缓。然而腹部时常感觉攻撑，越撑越痛，痛点处用热物摩熨，痛势即缓，但热汤入口，疼痛反而加剧，吐出的均为痰涎。脉象左部细弦，右部沉郁。肝经之气横逆扰乱充斥，标证为热，本证为寒。与甘仁先生共同商议，采用温脏以泄气火之郁，化痰以降胃腑之气的方法。逸山先生意见相同。记录处方以备参考。
处方：川雅连（五分）、淡吴茱萸（三分，与川连同炒）、制香附（二钱）、黑山栀（三钱）、金铃子（三钱）、广陈皮（二钱）、熟附片（三分）、制半夏（一钱五分）、延胡索（一钱五分）、白茯苓（三钱）、白蛳螺壳（二钱）、粉丹皮（二钱）、上沉香（二分）、黑丑（三分，二味研细末，先调服）。
三诊：苦降辛通后，痛势逐渐减轻，大便虽行但未通畅，呕恶不止，吐出的东西气味酸秽。右脉沉郁稍起，渐见滑象。肝木之气纵横肆扰，虽得略平，但厥逆之气上冲，胃土不降，气化为火，痰化为浊，酿成酸秽之味，逆从上出。与逸山、甘仁两位兄长共同商议，清泄郁结，降浊镇逆。
处方：黑山栀（三钱）、制半夏（三钱）、块辰砂（三钱）、鲜竹茹（三钱）、炙紫菀肉（二钱）、香豆豉（二钱）、茯苓（五钱）、柿蒂（四个）、郁金（一钱五分）、旋覆花（二钱，绢包）、金铃子（二钱）、鲜枇杷叶（一两，去毛，绢包，煎汤代水）。
四诊：痛势大减，略能安睡，大便仍不通，仍然恶心呕吐，吐出不堪秽臭，胃中窒闷异常，面色晦浊，目有红光。脉象左弦右滑。良由疝气上冲，胃之下口即小肠上口，火府之气不能下行，转而向上逆乱，令糟粕从胃底翻出，胃浊不降，痰聚胸中，胆阳上逆，出现面色晦暗、目红、不寐等现象。大肠居小肠之下，与肺相表里。兹与逸山、甘仁两位先生共同商议，控逐胸中之结聚，使肺气下通于大肠，肠痹得开，则火府之气，或许能从下行，希望糟粕也能顺转而下。不知能否如愿。
处方：制半夏（三钱）、块辰砂（四钱）、细木通（一钱五分）、炙紫菀肉（四钱）、旋覆花（二钱）、白茯苓（五钱）、姜汁炒山栀（三钱）、鲜竹茹（三钱）、柿蒂（五个）、控涎丹（八分，开水先调服）。
五诊：攻逐胸中结聚之痰，使肺气下通于大肠，大肠居然开通，屡次畅下，原本逆出于胃的糟粕，也从下行排出，呕吐臭秽已定，胸中窒闷亦开，疝气痛胀大减，渐能进食，脉数转缓，出险履夷，诚为幸事。再拟调和中和之气，疏泄肝木，分化湿热，以善其后。同逸山、甘仁两位兄长商量使用。
处方：制半夏（一钱五分）、鲜竹茹（一钱）、干橘叶（一钱五分）、泽泻（二钱）、生薏苡仁（三钱）、白茯苓（三钱）、金铃子（一钱五分）、荔枝核（三钱）、猪苓（二钱）、炒谷芽（三钱）。
【顾案】囊肿较前消退，睾丸仍然肿硬。仍是湿气压迫导致气机下坠，气湿运行不畅。再运脾渗湿，温补元藏。
处方：连皮茯苓（五钱）、吴茱萸（盐水炒四分）、木猪苓（二钱）、大腹皮（二钱）、楂炭（二钱）、广木香（五分）、炒橘核（三钱，研）、炒小茴香（五分）、炒枳壳（一钱）、冬瓜子（五钱）、炙干蟾（四钱）。
二诊：睾丸疼痛非常严重，又复身热。湿热内阻，营卫不宣，恐变为外证。
处方：青皮、陈皮、川萆薢、延胡索、枳壳、大腹皮、炒橘核、香附、金铃子、泽泻、猪苓。
【徐案】疝气感觉气上冲，心中热辣作呕吐状，此为冲心疝。
处方：天台乌药散加盐水炒香附，猪胆汁二匙冲服（急不可得时用川黄连代替）。
【钱案】睾丸偏左作痛，牵引腰府，中脘不舒。脉濡而滑。此肝肾湿热内伏。先调气利湿。
处方：制香附（二钱，打碎）、川萆薢（二钱）、泽泻（二钱）、青皮（一钱）、台乌药（一钱五分）、金铃子（一钱五分）、炒橘核（三钱）、猪苓（二钱）、楂炭（三钱）、炒小茴香（五分）、延胡索（一钱五分，酒炒）。
【支案】少腹偏右作胀，大便艰涩，时常紫黑色，卧难成寐，气冲嗳气。脉细弦数。此湿热内郁，致血气结滞不宣，呈疝气情形。极难图治。
处方：川楝子（一钱五分）、单桃仁（三钱）、制半夏（二钱）、延胡索（一钱五分，酒炒）、炒橘核（三钱，研）、海藻（一钱五分）、淡昆布（一钱）、赤茯苓与白茯苓（各二钱）、炙荔枝核（三钱，研）、楂炭（三钱）、木香（四分）、焦秫米（三钱）。
【朱案】少腹有气上冲，支脘作痛。脉沉而弦。肝肾湿寒。治宜温化。
处方：淡吴茱萸（盐水炒四分）、台乌药（一钱五分）、赤茯苓与白茯苓（各二钱）、泽泻（一钱五分）、盐水炒青皮（一钱）、金铃子（一钱五分）、苏子梗（各二钱）、前胡（一钱五分）、制香附（三钱）、光杏仁（三钱）、楂炭（三钱）。
[Case 1 (Left)] Zihe discussed that the seven types of hernia all belong to the Liver, because the lower abdomen and external genitalia are areas traversed by the Foot Jueyin Liver Meridian. Sinews are what the Liver governs, and the testicles are where sinews gather. Affection on the left side is due to "Liver Qi arising from the left." Fatigue and exertion cause Yuan Qi (Original Qi) to sink, resulting in significant swelling of the sinews between the scrotum. There is often a sensation of Qi rushing upward to the chest and heart; this is not directly attacking the Heart, but rather affecting the Zhongwan (CV12) and hypochondriac regions, which are pathways for Liver Meridian circulation. Generally, treatment methods do not exceed pungent-warm dispersal and bitter-cold draining. However, for cases where fatigue causes Qi sinking, bitter-cold draining will further sink the Qi. Now, first lift the sunk Qi, slightly assisting with pungent-warm herbs; this embodies the principle of treating both root and branch. Another case will be submitted to experts for correction.
Prescription: Taishen Xu (Ginseng Radicula, 8 fen, decocted separately and taken with other medicines), Zhi Mian Huang (Astragali Radix, roasted with honey, 2 qian), Mi Zhi Sheng Ma (Cimicifugae Rhizoma, honey-roasted, 4 fen), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 2 fen), Ye Yu Zhu (Atractylodis Macrocephalae Rhizoma, wild, 1.5 qian, stir-fried with soil), Jing Chai Hu (Bupleuri Radix, purified, 4 fen), Jiu Chao Dang Gui (Angelicae Sinensis Radix, wine-stir-fried, 2 qian), Guang Mu Xiang (Costi Radix, 3 fen), Chao Xiao Hui (Foeniculi Fructus, stir-fried, 5 fen), Chen Pi (Citri Reticulatae Pericarpium, 2 qian), Yan Hu Suo (Corydalis Rhizoma, 2 qian), Bai Fu Ling (Poria, 4 qian).
[Case 2 (Left)] Damp-cold obstructing internally leads to Hu Hernia (intermittent hernia).
Prescription: Yan Shui Chao Xiang Fu (Cyperi Rhizoma, salt-water stir-fried), Tai Wu Yao (Linderae Radix), Nan Zha Tan (Ziziphi Spinosae Semen carbonized), Mu Zhu Ling (Polyporus, woody part), Mu Xiang (Costi Radix), Xiao Qing Pi (Citri Reticulatae Pericarpium viride, stir-fried), Chao Xiao Hui (Foeniculi Fructus, stir-fried), Chi Bai Fu Ling (Poria, red and white), Chao Ju He (Citri Reticulatae Semen, stir-fried).
[Case 3 (Left)] After a severe illness, the pulse is frequently rapid. The right three positions are slightly slippery, while the left three positions show no rapidness. This indicates damp-heat lingering in the Qi level. Damp-heat tends to flow downward, compressing and sinking Fu Qi (Viscera Qi), thus presenting as hernia symptoms. The plan is to regulate Qi and drain dampness.
Prescription: Yan Shui Chao Xiang Fu (Cyperi Rhizoma, salt-water stir-fried), Zhi Ban Xia (Pinelliae Rhizoma, prepared), Sheng Yi Ren (Coicis Semen, raw), Jin Ling Zi (Meliae Toosendan Fructus), Ze Xie (Alismatis Rhizoma), Hei Shan Zhi (Gardeniae Fructus, charred), Chuan Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Chao Zhi Ke (Aurantii Fructus Immaturus, stir-fried), Mu Zhu Ling (Polyporus, woody part).
[Case Xu] Right pulse is soggy and fine; left pulse is fine and wiry. The sinews on the right side of the lower abdomen protrude with pain and distension, which only subside when lying flat. Examining the anatomy, the sides of the lower abdomen belong to the Liver, while the center belongs to the Chong Mai (Penetrating Vessel). Deficiency-cold of the Chong and Ren vessels, combined with dampness pressing down causing Qi to sink, results in pain and distension. Lying flat reduces the pressure and sinking force, hence slight relief of pain. The plan is to guide dampness outwards. Once dampness is drained, it will not sink; if the water orifices remain open, the essence orifices will remain closed, preventing seminal emission.
Prescription: Chuan Bi Xie (Dioscoreae Hypoglaucae Rhizoma, 2 qian), Wu Zhu Yu (Evodiae Fructus, salt-water stir-fried, 4 fen), Wu Yao (Linderae Radix, 1.5 qian), Hei Shan Zhi (Gardeniae Fructus, charred, 2 qian), Mo Mu Xiang (Costi Radix, ground, 5 fen), Yi Ren (Coicis Semen, 4 qian), Zhu Fu Ling (Polyporus and Poria, 2 qian each), Ze Xie (Alismatis Rhizoma, 1.5 qian), Chao Xiao Hui (Foeniculi Fructus, stir-fried, 5 fen), Chao Ju He (Citri Reticulatae Semen, stir-fried, 3 qian), Li Zhi He (Litchi Seed, roasted, 3 qian).
[Case Li] Cold-phlegm obstructing internally, collaterals' Qi not diffusing, causing wandering pain in the chest, hypochondrium, and ribs, along with testicular pain and distension. The Classics state: "When the Chong Mai is diseased, men develop internal nodules known as the seven hernias." It also states: "The Chong Mai originates at Qichong (ST30), runs alongside the Foot Shaoyin Kidney Meridian, flanks the umbilicus upwards, and disperses in the chest." Therefore, upper symptoms manifest as chest pain, lower symptoms as hernia pain. Although the diseases seem disparate, their source is one.
Prescription: Sheng Xiang Fu (Cyperi Rhizoma, raw), Xiao Qing Pi (Citri Reticulatae Pericarpium viride, stir-fried), Gui Xu (Angelicae Sinensis Radix tips), Ju Luo (Citri Reticulatae Pericarpium reticulated fibers), Zhi Ke (Aurantii Fructus Immaturus, stir-fried), Wu Yao (Linderae Radix), Xuan Fu Hua (Inulae Flos), Jin Ling Zi (Meliae Toosendan Fructus), Mo Yu Jin (Curcumae Radix, ground, 5 fen), Zhen Xing Jiang (Calami Rhizoma? Note: Likely refers to a specific animal product or rare herb, literally 'True Red Cinnabar Silk', possibly a typo for Xing Ren or similar, kept literal here as per instruction to keep names), Qing Cong Guan (Allii Fistulosi Caulis).
[Case Rong] Testicular pain and distension lead to Qi rushing upward from above, reaching Zhongwan (CV12), unbearable pain. Nausea and vomiting, alternating chills and fever, constipation, turbid red urine. Red tongue with white coating. Damp-heat flows into the Jueyin Liver Meridian. The Chong Mai belongs to the Liver and also the Yangming Stomach Meridian, originating at Qichong and dispersing in the chest. Thus, Liver disease persists, and Chong Mai Qi, carrying damp-heat, rushes upward to invade the Stomach. This is indeed a severe case of Chong Hernia. The plan is a combination of Bitter, Pungent, and Sour formulas.
Prescription: Chuan Ya Lian (Coptidis Rhizoma, mild, 5 fen, stir-fried), Dan Gan Jiang (Zingiberis Rhizoma Recens, pale, 3 fen), Chuan Lian Zi (Meliae Toosendan Fructus, 3 qian), Zhi Xiang Fu (Cyperi Rhizoma, prepared, 2 qian), Yan Hu Suo (Corydalis Rhizoma, 2 qian), Yan Shui Chao Chen Pi (Citri Reticulatae Pericarpium, salt-water stir-fried, 1 qian), Dan Qin (Scutellariae Radix, pale, wine-stir-fried, 1.5 qian), Hang Bai Shao (Paeoniae Radix Alba, Hangzhou variety, wine-stir-fried, 3 qian), Bai Fu Ling (Poria, 3 qian), Sheng Yi Ren (Coicis Semen, raw, 3 qian), Jiang Zhi Chao Hei Shan Zhi (Gardeniae Fructus, ginger juice stir-fried and charred, 3 qian), Ze Xie (Alismatis Rhizoma, 1.5 qian).
Second Visit: After taking the Bitter-Pungent-Sour combination, vomiting decreased slightly, and pain eased somewhat. However, the abdomen feels distended and pushing, worsening with pushing. Applying heat to the painful area relieves it, but drinking hot soup exacerbates the pain. Vomitus consists of phlegm-saliva. Left pulse is fine and wiry; right pulse is deep and depressed. Liver Meridian Qi is horizontally disturbing and filling up; the branch is Heat, the root is Cold. Discussed with Mr. Gan Ren: warm the viscera to vent the stagnation of Qi-Fire, resolve phlegm, and descend Stomach Qi. Mr. Yishan agrees. Recording the prescription for reference.
Prescription: Chuan Ya Lian (Coptidis Rhizoma, 5 fen), Dan Wu Zhu Yu (Evodiae Fructus, pale, 3 fen, stir-fried together with Chuan Lian Zi), Zhi Xiang Fu (Cyperi Rhizoma, prepared, 2 qian), Hei Shan Zhi (Gardeniae Fructus, charred, 3 qian), Jin Ling Zi (Meliae Toosendan Fructus, 3 qian), Guang Pi (Citri Reticulatae Pericarpium, 2 qian), Shu Fu Pian (Aconiti Lateralis Radix Praeparata, cooked, 3 fen), Zhi Ban Xia (Pinelliae Rhizoma, prepared, 1.5 qian), Yan Hu Suo (Corydalis Rhizoma, 1.5 qian), Bai Fu Ling (Poria, 3 qian), Bai Si Luo Ke (Concha Melaniae, 2 qian), Fen Dan Pi (Moutan Cortex, 2 qian), Shang Chen Xiang (Aquilariae Lignum Resinatum, top grade, 2 fen), Hei Chou (Brassicae Semen Nigrae, 3 fen, two ingredients ground to powder, taken first mixed with water).
Third Visit: With bitter descending and pungent unblocking, pain gradually lightened. Bowel movement occurred but was not smooth. Vomiting and nausea persist; vomitus smells sour and foul. Right pulse, previously deep and depressed, has risen slightly and shows signs of slipperiness. Liver Wood Qi, though slightly calmed, still has rebellious Qi rushing up. Stomach Earth fails to descend; Qi transforms into Fire, Phlegm transforms into Turbidity, brewing sour-foul flavors that rebel upward. Discussed with brothers Yishan and Gan Ren: clear and drain stagnation, descend turbidity, and suppress rebellion.
Prescription: Hei Shan Zhi (Gardeniae Fructus, charred, 3 qian), Zhi Ban Xia (Pinelliae Rhizoma, prepared, 3 qian), Kuai Chen Sha (Cinnabaris, block form, 3 qian), Xian Zhu Ru (Bambusae Membrana in Sino, fresh, 3 qian), Zhi Zi Rou (Stemonae Radix? Note: Zi Rou usually refers to Stemonae or similar, here likely Zhi Zi Rou implies flesh of Gardenia or similar, kept as Zhi Zi Rou), Xiang Dou Chi (Sojae Semen Praeparatum, 2 qian), Fu Ling (Poria, 5 qian), Shi Di (Diospyros Leaf, 4 pieces), Yu Jin (Curcumae Radix, 1.5 qian), Xuan Fu Hua (Inulae Flos, 2 qian, wrapped in silk), Jin Ling Zi (Meliae Toosendan Fructus, 2 qian), Xian Pi Pa Ye (Eriobotryae Folium, fresh, 1 liang, de-hairy, wrapped in silk, decocted to replace water).
Fourth Visit: Pain greatly reduced, able to sleep slightly. Bowels still blocked, nausea and vomiting continue, vomitus extremely foul. Stomach feels extremely stifled. Complexion is dull and turbid, eyes have red glow. Left pulse wiry, right pulse slippery. Caused by Hernia Qi rushing up. The lower opening of the Stomach is the upper opening of the Small Intestine. Fire House Qi cannot descend, rebels upward, forcing waste matter to turn over from the stomach bottom. Stomach Turbidity does not descend, Phlegm gathers in the chest, Gallbladder Yang rebels upward, leading to dull complexion, red eyes, and insomnia. Large Intestine is below the Small Intestine and is interior-exterior related to the Lung. Discussed with Mr. Yishan and Mr. Gan Ren: control and purge the accumulation in the chest, allowing Lung Qi to descend to the Large Intestine. Opening intestinal obstruction may allow Fire House Qi to descend, hoping waste matter will also turn downward順ly. Whether this will succeed remains to be seen.
Prescription: Zhi Ban Xia (Pinelliae Rhizoma, prepared, 3 qian), Kuai Chen Sha (Cinnabaris, block form, 4 qian), Xi Mu Tong (Akebiae Caulis, thin, 1.5 qian), Zhi Zi Rou (Stemonae Radix/Zi Rou?, 4 qian), Xuan Fu Hua (Inulae Flos, 2 qian), Bai Fu Ling (Poria, 5 qian), Jiang Zhi Chao Shan Zhi (Gardeniae Fructus, ginger juice stir-fried, 3 qian), Xian Zhu Ru (Bambusae Membrana in Sino, fresh, 3 qian), Shi Di (Diospyros Leaf, 5 pieces), Kong Xian Dan (Kong Xian Pill, 8 fen, taken first mixed with boiling water).
Fifth Visit: Attacking and purging phlegm accumulated in the chest allowed Lung Qi to descend to the Large Intestine. The Large Intestine opened, allowing multiple smooth bowel movements. Waste matter that had rebelled from the Stomach now descended. Vomiting foul odor stopped, chest stifling opened, Hernia pain and distension greatly reduced, able to eat gradually. Pulse changed from rapid to slow. Escaping danger and walking on firm ground is truly fortunate. Next, harmonize Middle Qi, disperse and drain Liver Wood, differentiate and drain damp-heat, to conclude treatment. Discussed with brothers Yishan and Gan Ren.
Prescription: Zhi Ban Xia (Pinelliae Rhizoma, prepared, 1.5 qian), Xian Zhu Ru (Bambusae Membrana in Sino, fresh, 1 qian), Gan Ju Ye (Citri Reticulatae Folium, dried, 1.5 qian), Ze Xie (Alismatis Rhizoma, 2 qian), Sheng Yi Ren (Coicis Semen, raw, 3 qian), Bai Fu Ling (Poria, 3 qian), Jin Ling Zi (Meliae Toosendan Fructus, 1.5 qian), Li Zhi He (Litchi Seed, 3 qian), Zhu Ling (Polyporus, 2 qian), Chao Gu Ya (Hordei Fructus Germinatus, stir-fried, 3 qian).
[Case Gu] Scrotal swelling has receded, but testicles remain swollen and hard. Still dampness pressing causing Qi sinking, Qi and Dampness not moving. Further move Spleen, drain dampness, and warm the Original Storehouse.
Prescription: Lian Pi Fu Ling (Poria with skin, 5 qian), Wu Zhu Yu (Evodiae Fructus, salt-water stir-fried, 4 fen), Mu Zhu Ling (Polyporus, woody part, 2 qian), Da Fu Pi (Arecae Pericarpium, 2 qian), Zha Tan (Ziziphi Spinosae Semen carbonized, 2 qian), Guang Mu Xiang (Costi Radix, 5 fen), Chao Ju He (Citri Reticulatae Semen, stir-fried and ground, 3 qian), Chao Xiao Hui (Foeniculi Fructus, stir-fried, 5 fen), Chao Zhi Ke (Aurantii Fructus Immaturus, stir-fried, 1 qian), Dong Gua Zi (Benincasae Semen, 5 qian), Zhi Gan Chan (Bufo Viridis, roasted, 4 qian).
Second Visit: Testicular pain is severe, accompanied by body heat. Damp-heat obstructing internally, Ying and Wei not diffusing, fear of changing into external manifestations.
Prescription: Qing Chen Pi (Citri Reticulatae Pericarpium viride and Citri Reticulatae Pericarpium), Chuan Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Yan Hu Suo (Corydalis Rhizoma), Zhi Ke (Aurantii Fructus Immaturus), Da Fu Pi (Arecae Pericarpium), Chao Ju He (Citri Reticulatae Semen, stir-fried), Xiang Fu (Cyperi Rhizoma), Jin Ling Zi (Meliae Toosendan Fructus), Ze Xie (Alismatis Rhizoma), Zhu Ling (Polyporus).
[Case Xu] Hernia with sensation of Qi rushing up, burning heat in the heart resembling vomiting, this is Chong Xin (Rushing to Heart) Hernia.
Prescription: Tian Tai Wu Yao San (Tiantai Lindera Powder) plus Yan Shui Chao Xiang Fu (Cyperi Rhizoma, salt-water stir-fried), Zhu Dan Huang (Porci Bile, 2 spoons, mixed in). (If urgent and unavailable, substitute with Chuan Lian Zi/Coptidis Rhizoma).
[Case Qian] Testicle pain on the left, radiating to the waist, discomfort in Zhongwan. Pulse soggy and slippery. This is latent damp-heat in Liver and Kidney. First regulate Qi and promote urination to drain dampness.
Prescription: Zhi Xiang Fu (Cyperi Rhizoma, prepared, 2 qian, crushed), Chuan Bi Xie (Dioscoreae Hypoglaucae Rhizoma, 2 qian), Ze Xie (Alismatis Rhizoma, 2 qian), Qing Pi (Citri Reticulatae Pericarpium viride, 1 qian), Tai Wu Yao (Linderae Radix, 1.5 qian), Jin Ling Zi (Meliae Toosendan Fructus, 1.5 qian), Chao Ju He (Citri Reticulatae Semen, stir-fried, 3 qian), Zhu Ling (Polyporus, 2 qian), Zha Tan (Ziziphi Spinosae Semen carbonized, 3 qian), Chao Xiao Hui (Foeniculi Fructus, stir-fried, 5 fen), Yan Hu Suo (Corydalis Rhizoma, 1.5 qian, wine-stir-fried).
[Case Zhi] Distension in the right side of the lower abdomen, difficult bowel movements, stool occasionally purple-black, difficulty sleeping, Qi rushing and belching. Pulse fine, wiry, and rapid. This is damp-heat郁 (stagnant) internally, causing Blood and Qi stagnation and failure to diffuse, presenting as Hernia. Very difficult to treat.
Prescription: Chuan Lian Zi (Meliae Toosendan Fructus, 1.5 qian), Dan Tao Ren (Persicae Semen, single, 3 qian), Zhi Ban Xia (Pinelliae Rhizoma, prepared, 2 qian), Yan Hu Suo (Corydalis Rhizoma, 1.5 qian, wine-stir-fried), Chao Ju He (Citri Reticulatae Semen, stir-fried and ground, 3 qian), Hai Zao (Sargassum, 1.5 qian), Dan Kun Bu (Eckloniae Thallus, pale, 1 qian), Chi Bai Fu Ling (Poria, red and white, 2 qian each), Zhi Li He (Litchi Seed, roasted and ground, 3 qian), Zha Tan (Ziziphi Spinosae Semen carbonized, 3 qian), Mu Xiang (Costi Radix, 4 fen), Jiao Shu Mi (Sorghei Fructus, scorched, 3 qian).
[Case Zhu] Qi rushing up from the lower abdomen, pain in the epigastrium. Pulse deep and wiry. Damp-cold in Liver and Kidney. Treatment should focus on warming and transforming.
Prescription: Dan Wu Zhu Yu (Evodiae Fructus, pale, salt-water stir-fried, 4 fen), Tai Wu Yao (Linderae Radix, 1.5 qian), Chi Bai Fu Ling (Poria, red and white, 2 qian each), Ze Xie (Alismatis Rhizoma, 1.5 qian), Yan Shui Chao Qing Pi (Citri Reticulatae Pericarpium viride, salt-water stir-fried, 1 qian), Jin Ling Zi (Meliae Toosendan Fructus, 1.5 qian), Su Zi Geng (Perillae Fructus and Caulis, 2 qian each), Qian Hu (Peucedani Radix, 1.5 qian), Zhi Xiang Fu (Cyperi Rhizoma, prepared, 3 qian), Guang Xing Ren (Armeniacae Semen Amarum, polished, 3 qian), Zha Tan (Ziziphi Spinosae Semen carbonized, 3 qian).