疝气之甚者，睾丸连小腹急痛也。有痛在睾丸者，有痛在五枢穴边者，皆足厥阴之经也。或有形，或无形；或有声，
或无声。有形如瓜，有声如蛙。自《素问》以下，历代名医，皆以为寒。盖寒主收引，经络得寒，故引不行，所以作痛，
理固然也。有得寒而无疝者，又必有说以通之可也。予尝屡因门户雪上有霜，没膝之水，踢冰徒涉，不曾病此，以予素
无热在内也。因而思之，此证始于湿热在经，郁而至久，又得寒气外束，湿热之邪不得疏散，所以作痛。若只作寒论，
恐为未备。或曰∶厥阴一经，其道远，其位卑，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，母能生子，虚，湿气便盛。厥阴属木，系于肝，为将军之官，其性急速，
火性且又暴，为寒所束，宜其痛之大暴也。愚见有用乌头、栀子等分作汤，用之其效亦敏。后因此方随证与形加减用之，
无有不应。然湿热又须分多少而始治，但湿者肿多 病是也。又有挟虚而发者，当以参、术为用，而以疏导药佐之，诊
其脉有甚沉紧而大豁无力者是也。其痛亦轻，惟觉重坠牵引耳！
无子之因，多起于妇人。医者不求其因起于何处，遍阅古方，惟秦桂丸其辞确，其意专，用药温热，近乎人情，欣
然授之，锐然服之，甘受燔灼之祸，犹且懵然不悔。何者？阳精之施也，阴血能摄之，精成其子，血成其胞，胎孕乃成。
今妇人之无子者，率由血少不足以摄精也。血之少也，固非一端。然欲得子者，必须补其阴血，使无亏欠乃可。推其有
余以成胎孕，何乃轻用热剂，煎熬脏腑，血气沸腾，祸不旋踵矣！或曰∶春气温和，则万物发生，冬气寒凛，则万物消
殒，非秦桂丸之温热，何由得子脏温暖而成胎耶？予曰∶《诗》言妇人和平，则乐有子。和则气血不乖，平则阴阳不争。
今得此药，经血转紫黑，渐成衰少，或先或后，始则饮食骤进，久则口苦而干，阴阳不平，血气不和，疾病蜂起，焉能
成胎？纵使成胎，生子亦多病而不寿。以秦桂丸之耗损矣天真之阴也，戒之慎之！
郑廉使之子，年十六，求医曰∶我生七个月患淋病，五日、七日必一发。其发也大痛，扪地叫天，水道方行，状如
漆和粟者，约一盏许，然后定。诊其脉轻则涩，重则弦。视其形瘦而稍长，其色青而苍。意其父必因多服下部药，遗热
在胎，留于子之命门而然。遂以紫雪和黄柏细末，丸梧子大，晒十分干，而与二百丸作一服，率以热汤下，以食物压之，
又经半日，痛大作，连腰腹，水道乃行，下如漆和粟者一大碗许，其病减十分之八。后张子忠以陈皮一两，桔梗、木通
各半两，作一帖与之，又下漆粟者一合许遂安。父得燥热且能病子，况母得之者乎？余书此以证东垣红丝瘤之事。
疝气严重的，表现为睾丸与小腹拘急疼痛。有的疼痛位于睾丸，有的疼痛位于五枢穴附近，这些都属于足厥阴肝经的循行部位。有的有形可见，有的无形；有的有声响，有的无声响。有形的像瓜一样肿大，有声响的像青蛙鸣叫。自从《素问》以来，历代名医都认为是寒邪所致。大概因为寒性主收敛牵引，经络受到寒邪侵袭，所以气血运行受阻而作痛，道理确实如此。但是也有感受寒邪而没有患疝气的情况，对此必须有解释来阐明其机理。我曾经多次在门前的雪地上行走，踩着没膝的深水，赤脚趟过冰水，却从未因此患病，这是因为我的体内本来就没有热邪。由此思考，这种病症起始于湿热蕴结在经脉之中，郁积日久，再加上外感寒气束缚体表，导致湿热之邪无法疏散，所以才产生疼痛。如果只从寒邪角度论述，恐怕不够全面。有人问：厥阴一经，其道遥远，其位卑下，湿热是如何积聚而成的呢？我说：过度劳累则火起于筋脉，醉酒饱食则火起于胃腑，房事过度则火起于肾脏，大怒则火起于肝脏。本经之火积存久了，母脏（肝）虚而不能生子脏（胆/筋等），湿气便旺盛起来。厥阴属木，隶属于肝，被称为将军之官，其性质急速，火性又暴烈，被寒邪所束缚，所以疼痛发作得非常剧烈且突然。我见解认为可用乌头、栀子各等分煎汤服用，效果也很迅速。后来根据这个方子随证候和形体变化进行加减使用，没有不奏效的。然而治疗湿热还必须区分湿与热的多少来施治，如果是湿重于热，多表现为肿胀，这就是所谓的“病是也”（指湿盛之象）。又有夹杂虚证而发作的，应当用人参、白术为主药，并用疏导药作为辅助，诊察其脉搏沉紧而大豁无力的就是这种情况。这种疼痛也比较轻微，只觉得沉重坠胀和牵引不适罢了！
不孕的原因，大多起因于妇人。医生不探究病因究竟起于何处，遍阅古方，只有秦桂丸的言辞确切，用意专一，用药温热，合乎人情，于是欣然接受它，果断服用它，甘愿承受火热灼烧的灾祸，仍然懵懂不觉后悔。为什么呢？阳精施泄时，需要阴血来摄纳，精形成胎儿，血形成胞宫，胎孕才能成功。现在妇女不孕的，大多是因为血少不足以摄纳精液。血的减少，固然不止一个原因。然而想要怀孕的人，必须补益阴血，使其没有亏欠才可以。推究有余的部分来促成胎孕，为何轻易使用热剂，煎熬脏腑，使血气沸腾，灾祸随即而至呢！有人问：春天气候温和，万物发生；冬天气候寒冷凛冽，万物消亡。如果不是秦桂丸的温热作用，怎么能使子宫温暖而成胎呢？我说：《诗经》说妇人平和，就能乐于有子。和气则气血不乖逆，平气则阴阳不争竞。现在服用了这种药，经血转为紫黑色，逐渐衰少，或提前或错后，开始时饮食突然增加，久了则口苦口干，阴阳不平，血气不和，疾病蜂拥而起，怎么能成胎呢？即使成胎，生下的孩子也多病且不长寿。这是秦桂丸耗损了天真之阴的缘故，务必戒慎啊！
郑廉使的儿子，十六岁，求医时说：我出生七个月时患淋病，每五日或七日必发作一次。发作时剧痛难忍，叩地呼天，小便通畅后才停止，排出的状物像漆混合着粟米，大约一盏的量，然后才安定下来。诊察他的脉搏，轻取涩滞，重按弦硬。观察他的形体瘦削且稍长，面色青苍。推测他的父亲必定因为多服用下部通利药物，将余热遗留在胎中，留存于儿子的命门而导致此病。于是用紫雪和黄柏细末，制成梧桐子大小的药丸，晒干至十分干燥，每次给予二百丸作为一服，通常用热开水送下，并用食物压住药力。又过了半天，疼痛大作，牵连腰腹，小便才得以通行，排出像漆混合着粟米的物质一大碗左右，病情减轻了十分之八。后来张子忠用陈皮一两，桔梗、木通各半两，组成一帖药给他服用，又排出漆粟样物质一合左右，于是痊愈。父亲得了燥热之邪尚且能致病于儿子，何况母亲得之的呢？我写下此文以印证李东垣红丝瘤之事。
Severe cases of Shan Qi (hernia) manifest as urgent pain in the testicles connected to the lower abdomen. Some pain is located in the testicles, while some is near the Wushu (GB25) acupoint; all belong to the Foot Jueyin Liver Meridian. There may be visible forms or invisible ones; there may be sounds or no sounds. Visible forms resemble melons, and audible sounds resemble frogs croaking. Since the *Suwen* (Plain Questions), famous physicians of successive dynasties have all attributed this condition to Cold. This is because Cold governs contraction and pulling; when meridians are affected by Cold, qi and blood flow are obstructed, thus causing pain. Theoretically, this is indeed the case. However, there are instances where one contracts Cold but does not develop Shan Qi; therefore, an explanation must be provided to clarify this mechanism. I have personally walked on snow at gateways, waded through water reaching my knees, and crossed ice barefoot multiple times without suffering from this disease, because my interior naturally lacks Heat. Reflecting on this, I believe this syndrome originates from Damp-Heat accumulating in the meridians, stagnating for a long time, and then being externally constrained by Cold pathogenic factors. Because the Damp-Heat cannot dissipate, pain ensues. If one only discusses it in terms of Cold, the theory is likely incomplete. Someone asked: The Jueyin meridian is distant and its position is low; how does Damp-Heat accumulate there? I replied: Excessive labor causes Fire to arise in the sinews; drunkenness and overeating cause Fire to arise in the Stomach; sexual exhaustion causes Fire to arise in the Kidneys; extreme anger causes Fire to arise in the Liver. When Fire accumulates in this meridian for a long time, the Mother organ (Liver) becomes deficient and fails to generate the Child, leading to an abundance of Dampness. Jueyin belongs to Wood, is affiliated with the Liver, which is called the "General," possessing a rapid nature. Fire is also violent. Constrained by Cold, it is natural that the pain would be sudden and severe. My view is that using equal parts of Aconite Root (Fuzi) and Gardenia Fruit (Zhizi) as a decoction yields rapid effects. Later, I modified this formula according to specific syndromes and physical constitutions, achieving success in every case. However, treating Damp-Heat requires distinguishing the proportion of Dampness versus Heat. If Dampness predominates, swelling is prominent, which characterizes the pathology. In cases complicated by Deficiency, Ginseng Radix (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu) should be used as primary agents, assisted by draining and guiding herbs; this corresponds to a pulse that is deep, tight, yet large and empty/powerless. The pain is also mild, characterized mainly by a sensation of heaviness, dragging, and traction!
The cause of infertility often lies with women. Physicians, failing to investigate the root cause, peruse ancient prescriptions and find that Qin Gui Wan (Qin Gui Pill) has precise indications and focused intent, utilizing warm-hot herbs that align with human desires. Thus, they accept it gladly and take it decisively, willingly suffering the disaster of burning scorching, yet remaining ignorant and unrepentant. Why? When Yang essence is emitted, Yin Blood must retain it; essence forms the fetus, and blood forms the uterine sac, allowing conception to occur. Now, women who are infertile generally suffer from insufficient Blood to retain essence. The deficiency of Blood arises from various causes. However, those desiring pregnancy must tonify Yin Blood until there is no deficit. To push excess resources into forming a fetus, why use hot formulas lightly, which fry the zang-fu organs and cause qi and blood to boil, bringing disaster swiftly? Someone asked: In spring, the temperature is mild, and all things grow; in winter, the air is cold, and all things perish. Without the warmth of Qin Gui Wan, how can the uterus become warm enough to conceive? I said: The *Book of Songs* states that if a woman is harmonious and peaceful, she will joyfully bear children. Harmony means qi and blood do not conflict; peace means yin and yang do not contend. With this medicine, menstrual blood turns purple-black, gradually becoming scanty, irregular in timing. Initially, appetite increases sharply, but later, bitter taste and dry mouth appear. Yin and yang become imbalanced, qi and blood disharmonious, and diseases arise like bees swarming. How can conception occur? Even if conception happens, the child will likely be sickly and short-lived. Qin Gui Wan depletes the innate Yin essence; beware and be cautious!
The son of Commissioner Zheng Lian, aged sixteen, sought medical treatment saying: "I suffered from Lin Syndrome (strangury) starting at seven months old, recurring every five or seven days. During attacks, I experienced excruciating pain, beating the ground and crying to heaven. Only after urination did the pain subside. The discharge resembled lac mixed with millet grains, about one cup in volume, before settling." His pulse was choppy on light palpation and wiry on heavy pressure. His physique was thin and slightly elongated, with a bluish-green complexion. I surmised that his father must have taken excessive drugs for lower-jiao ailments, leaving residual heat in the fetal stage, which remained in the son's Mingmen (Gate of Life). I prepared pills made from Zi Xue (Purple Snow) and fine powder of Phellodendron Bark (Huangbai), sized like wu-tzu seeds, dried thoroughly. Each dose consisted of two hundred pills, taken with hot water, followed by food to suppress the drug's action. Half a day later, the pain intensified, radiating to the waist and abdomen, and urination finally occurred, discharging about a large bowl of substance resembling lac mixed with millet. The illness decreased by eighty percent. Later, Zhang Zizhong prescribed a single dose containing one liang of Tangerine Peel (Chenpi), half a liang each of Platycodon Root (Jiegeng) and Akebia Stem (Mutong). After another discharge of about one he of lac-millet-like substance, the patient recovered. If a father's dry-heat pathogen can affect his son, how much more so if the mother is affected? I record this to corroborate Li Dongyuan's case of red thread tumors.