金匮乌头桂枝汤治寒疝腹中痛逆冷手足不仁若身疼痛灸刺诸药不能治者
乌头(蜜一斤煎减半去滓三个) 桂枝(汤煎解蜜半两)
上每服三合不知二合其知者如醉状得吐者为中病也若自汗出脉沉弦者止用乌头煎
按此用桂枝因身疼痛兼表有寒也太阳例药
二因大乌头桂枝汤治风寒疝气腹中刺痛手足不仁身体拘急不得转侧或致阴缩
大乌头(五个去皮尖蜜煎过洗切) 桂心 白芍(各三钱) 甘草(一钱)
上 咀每四钱入姜枣煎
补肾汤治寒疝入腹小腹疼痛时复泄泻胸膈痞塞
人参 茯苓 黄 附子(炮) 白术(各一两) 沉香(四钱) 木瓜(一两半) 羌活(半
两) 甘草(炙) 川芎(各二钱) 紫苏(三钱)
上 咀每三四钱入姜枣煎
局方夺命丹治远年日近小肠疝气偏坠搐疼脐下撮痛以致闷乱及外肾肿硬日渐滋长阴间湿
痒抓成疮
吴茱萸(净一斤四两用酒醋汤童便各浸过一宿焙干) 泽泻(二两)
上为细末酒煮面糊丸如梧子大每五十丸空心盐汤下
茱萸内消丸治肾经虚弱膀胱为邪气所搏结成寒疝阴 偏大
山茱萸(去核) 陈皮 吴茱萸 马蔺花 木香 肉桂 山药 川楝子 青皮 茴香
上为末酒糊丸如梧子大每五十丸空心温酒送下百一选方十补丸治小肠寒疝
附子(一两用防风一两锉盐四两黑豆一协议炒取附子去皮尖用) 葫芦巴 木香 巴戟肉
川楝肉 官桂 玄胡 荜澄茄 舶上茴香 破故纸(炒各一两)
上为末糯米粉酒打糊丸梧子大朱砂为衣每五十丸空心酒下
葫芦巴丸治小肠气蟠肠气奔豚疝气偏坠阴肿小腹有形如卵上下来去痛不可忍或绞结绕脐
攻刺呕吐者
葫芦巴(炒一斤) 大巴戟(炒六两) 川楝子(炒一斤二两) 吴茱萸(汤洗七次炒十两)
川乌(炮去皮六两) 茴香(二十两炒)
上末酒糊丸梧子大每十五至二十丸空心温酒下
按此与前方加减不同故两存之
宝鉴沉香桂附丸治中气虚弱其脾胃虚寒脏腑积冷心腹疼痛手足厥逆冷便利无度七疝引痛
不可忍喜热熨少缓者
沉香 附子(炮) 川乌(炮) 干姜(炮) 良姜 官桂 吴茱萸(汤炮去苦水)
茴香(炒各一两)
上为末好醋煮糊丸梧子大每五十丸至七八十丸空心米饮下
按以上诸方并太阳例药然初感寒邪所至或素虚寒之人宜此劫之皆可但久病者多有湿热寒
湿血虚等证之变而用者自宜详审
《金匮》乌头桂枝汤：治疗寒疝，症见腹中疼痛、四肢逆冷、手足麻木不仁；若伴有身体疼痛，且经过艾灸、针刺及多种药物治疗均无效者。
配方：乌头（用蜂蜜一斤，煎煮至减半，滤去药渣，制成“乌头煎”）；桂枝（用汤剂煎煮，加入半两蜜）。
用法：每次服用三合，若无效则改为二合。服药后若有知觉恢复，如醉酒状，或出现呕吐，即为药已中病。若患者自汗出、脉象沉弦，则仅使用乌头煎。
按语：此处使用桂枝，是因为患者兼有身痛，说明表证仍有寒邪，属于太阳经的常规用药法。
第二方：大乌头桂枝汤：治疗风寒疝气，症见腹中刺痛、手足麻木不仁、身体拘急不能转侧，甚至导致阴器收缩。
配方：大乌头（五个，去皮尖，用蜜煎煮后洗净切片）；桂心；白芍（各三钱）；甘草（一钱）。
用法：将药材切碎，每次取四钱，加入生姜、大枣煎服。
第三方：补肾汤：治疗寒疝入腹，症见小腹疼痛、时常腹泻、胸膈痞塞。
配方：人参；茯苓；黄芪；附子（炮制）；白术（各一两）；沉香（四钱）；木瓜（一两半）；羌活（半两）；甘草（炙）；川芎（各二钱）；紫苏（三钱）。
用法：将药材切碎，每次取三四钱，加入生姜、大枣煎服。
第四方：局方夺命丹：治疗多年或近期的小肠疝气，症见睾丸偏坠、抽搐疼痛、脐下拘挛疼痛以致烦闷扰乱，以及外生殖器肿胀坚硬、日渐增大、阴部潮湿瘙痒、抓破成疮。
配方：吴茱萸（净重一斤四两，用酒、醋、米汤、童便各浸泡一夜，焙干）；泽泻（二两）。
用法：研为细末，用酒煮面糊制成梧桐子大小的丸药。每次五十丸，空腹时以盐汤送服。
第五方：茱萸内消丸：治疗肾经虚弱，膀胱受邪气搏结，形成寒疝，症见阴囊一侧肿大。
配方：山茱萸（去核）；陈皮；吴茱萸；马蔺花；木香；肉桂；山药；川楝子；青皮；茴香。
用法：研为细末，用酒糊制成梧桐子大小的丸药。每次五十丸，空腹时以温酒送服。
第六方：百一选方十补丸：治疗小肠寒疝。
配方：附子（一两，与防风一两锉碎、盐四两、黑豆一协议同炒制，取出附子去皮尖使用）；葫芦巴；木香；巴戟肉；川楝肉；官桂；玄胡索；荜澄茄；舶上茴香；破故纸（炒，各一两）。
用法：研为细末，用糯米粉酒打成的糊制成梧桐子大小的丸药，朱砂为衣。每次五十丸，空腹时以酒送服。
第七方：葫芦巴丸：治疗小肠气、蟠肠气、奔豚气、疝气，症见睾丸偏坠、阴囊肿胀、小腹有形之物如卵状上下移动、疼痛难忍，或绞痛绕脐、攻刺作痛、呕吐者。
配方：葫芦巴（炒一斤）；大巴戟（炒六两）；川楝子（炒一斤二两）；吴茱萸（汤洗七次，炒十两）；川乌（炮制去皮六两）；茴香（二十两，炒）。
用法：研为细末，用酒糊制成梧桐子大小的丸药。每次十五至二十丸，空腹时以温酒送服。
按语：此方与前一方加减不同，故两者并存。
第八方：宝鉴沉香桂附丸：治疗中气虚弱，脾胃虚寒，脏腑积冷，症见心腹疼痛、手足厥冷、大便滑泄无度、七疝牵引疼痛不可忍受，喜热敷稍缓者。
配方：沉香；附子（炮制）；川乌（炮制）；干姜（炮制）；良姜；官桂；吴茱萸（汤泡去苦水）；茴香（炒，各一两）。
用法：研为细末，用好醋煮糊制成梧桐子大小的丸药。每次五十至七八十丸，空腹时以米饮送服。
按语：以上各方多属太阳经常规用药范畴。但对于初感寒邪所致，或素体虚寒之人，适宜采用此类峻猛之剂劫除寒邪。然而久病患者多有湿热、寒湿、血虚等证候变化，使用者应当详细审察。
Jinkui Wutou Guizhi Decoction: Treats cold hernia (Han Shan) characterized by abdominal pain, coldness and reversal of the limbs, and numbness of the hands and feet. It is indicated when body aches are present, and moxibustion, acupuncture, and various other treatments have failed.
Ingredients: Aconiti Lateralis Radix Preparata (Wutou, processed lateral root of Aconitum carmichaelii) — one jin of honey is used to decoct the herb until reduced by half, then filtered to make "Wutou Jian" (Aconite Decoction); Cinnamomi Ramulus (Guizhi) — decocted in water with half liang of honey added.
Usage: Take three he each time. If ineffective, reduce to two he. If sensation returns, resembling a state of drunkenness, or if vomiting occurs, it indicates the medicine has struck the disease. If spontaneous sweating and a deep, string-like pulse are present, use only Wutou Jian.
Note: The inclusion of Guizhi here is due to the accompanying body aches, indicating that exterior cold remains in the Taiyang channel, following the standard protocol for Taiyang disorders.
Second Formula: Da Wutou Guizhi Decoction: Treats wind-cold hernia, characterized by stabbing abdominal pain, numbness of the hands and feet, bodily stiffness and inability to turn, or even retraction of the genitals.
Ingredients: Aconiti Radix (Da Wutou, large root of Aconitum carmichaelii) — five pieces, peeled and tips removed, decocted with honey, washed, and sliced; Cinnamomi Cortex (Guixin); Paeoniae Radix Alba (Baishao, white root of Paeonia lactiflora) — each 3 qian; Glycyrrhizae Radix et Rhizoma (Gancao, licorice root) — 1 qian.
Usage: Coarsely crush the herbs. Take 4 qian per dose, decoct with fresh ginger and jujube.
Third Formula: Bushen Tang (Kidney-Nourishing Decoction): Treats cold hernia invading the abdomen, characterized by lower abdominal pain, frequent diarrhea, and chest/epigastric fullness and obstruction.
Ingredients: Ginseng Radix (Renshen); Poria (Fuling); Astragali Radix (Huangqi); Aconiti Lateralis Radix Preparata (Fuzi, processed lateral root of Aconitum carmichaelii); Atractylodis Macrocephalae Rhizoma (Baizhu); Aquilariae Lignum Resinatum (Chenxiang); Chaenomelis Fructus (Mugua); Notopterygii Rhizoma et Radix (Qianghuo); Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhigancao, honey-processed licorice); Chuanxiong Rhizoma (Chuanxiong) — each 2 qian; Perillae Folium (Zisu) — 3 qian.
Usage: Coarsely crush the herbs. Take 3–4 qian per dose, decoct with fresh ginger and jujube.
Fourth Formula: Jufang Duoming Dan (Bureau Formula Life-Seizing Pill): Treats long-standing or recent small intestine hernia, characterized by unilateral testicular descent, spasmodic pain, umbilical constriction causing restlessness, swelling and hardness of the external genitalia increasing daily, dampness and itching in the genital region, and sores from scratching.
Ingredients: Evodiae Fructus (Wuzhuyu, fruit of Evodia rutaecarpa) — net weight 1 jin 4 liang, soaked overnight separately in wine, vinegar, rice soup, and children's urine, then dried; Alismatis Rhizoma (Zexie, corm of Alisma orientale).
Usage: Grind into fine powder. Make pills using wine-boiled wheat paste, size of sophora seeds. Take 50 pills on an empty stomach with salt water.
Fifth Formula: Zhuyu Neixiao Wan (Cornus Internal-Dissolving Pill): Treats kidney meridian deficiency where bladder qi is constrained by pathogenic factors, forming cold hernia with unilateral scrotal enlargement.
Ingredients: Corni Fructus (Shanzhuyu, fruit of Cornus officinalis, pitted); Citri Reticulatae Pericarpium (Chenpi); Evodiae Fructus (Wuzhuyu); Iris Tectorii Flos (Malin Hua); Aucklandiae Radix (Muxiang); Cinnamomi Cortex (Rougui); Dioscoreae Rhizoma (Shanyao); Meliae Fructus (Chuanlianzi); Aurantii Fructus Viridis (Qingpi); Foetidae Fructus (Huixiang).
Usage: Grind into powder. Make pills using wine paste, size of sophora seeds. Take 50 pills on an empty stomach with warm wine.
Sixth Formula: Baiyi Xuanfang Shibu Wan (Hundred-One Selection Ten-Nourishing Pill): Treats small intestine cold hernia.
Ingredients: Aconiti Lateralis Radix Preparata (Fuzi) — 1 liang, stir-fried with 1 liang Saposhnikoviae Radix (Fangfeng), 4 liang salt, and black beans; extract the Fuzi, peel, and remove tips; Trichosanthis Radix (Huluoba? Note: Text says Hulu Ba, likely Trichosanthes seed or similar, but context suggests Trichosanthis Semen or similar warming herb, strictly translating as written: Trichosanthis Seed/Huluoba); Aucklandiae Radix (Muxiang); Morindae Officinalis Radix (Baji Rou); Meliae Fructus (Chuanlianzi); Cinnamomi Cortex (Guangui); Corydalis Rhizoma (Yanhusuo); Litseae Fructus (Bichengqie); Foetidae Fructus (Bo Shang Huixiang); Cnidii Fructus (Po Guzhi, fried) — each 1 liang.
Usage: Grind into powder. Make pills using glutinous rice flour and wine paste, size of sophora seeds, coated with Cinnabar (Zhusha). Take 50 pills on an empty stomach with wine.
Seventh Formula: Huluoba Wan (Trichosanthes Seed Pill): Treats small intestine qi, coiling intestinal qi, running piglet qi, and hernia, characterized by unilateral testicular descent, scrotal swelling, palpable mass in the lower abdomen moving up and down like an egg, unbearable pain, or cramping around the navel, stabbing pain, and vomiting.
Ingredients: Trichosanthis Semen (Huluoba, fried) — 1 jin; Morindae Officinalis Radix (Daba Ji, fried) — 6 liang; Meliae Fructus (Chuanlianzi, fried) — 1 jin 2 liang; Evodiae Fructus (Wuzhuyu, washed seven times in hot water, fried) — 10 liang; Aconiti Radix (Chuanwu, processed, peeled) — 6 liang; Foetidae Fructus (Huixiang) — 20 liang, fried.
Usage: Grind into powder. Make pills using wine paste, size of sophora seeds. Take 15–20 pills on an empty stomach with warm wine.
Note: This formula differs in modifications from the previous one, hence both are preserved.
Eighth Formula: Baojian Chenxiang Gui Fu Wan (Treasure Mirror Agarwood Cinnamon Aconite Pill): Treats middle qi deficiency, spleen-stomach deficiency-cold, accumulation of cold in the zang-fu organs, characterized by heart and abdominal pain, cold extremities, uncontrolled loose stools, severe pain from the seven types of hernias, relieved slightly by heat application.
Ingredients: Aquilariae Lignum Resinatum (Chenxiang); Aconiti Lateralis Radix Preparata (Fuzi, processed); Aconiti Radix (Chuanwu, processed); Zingiberis Rhizoma Exsiccatus (Ganjiang, processed); Alpiniae Officinarum Rhizoma (Liangjiang); Cinnamomi Cortex (Guangui); Evodiae Fructus (Wuzhuyu, soaked in water to remove bitter juice); Foetidae Fructus (Huixiang, fried) — each 1 liang.
Usage: Grind into powder. Make pills using good vinegar and paste, size of sophora seeds. Take 50–70 pills on an empty stomach with rice drink.
Note: The above formulas largely follow the Taiyang channel protocols. They are suitable for initial cold invasion or individuals with constitutional deficiency-cold, allowing for aggressive removal of cold pathogens. However, patients with chronic illness often present with variations such as damp-heat, cold-damp, or blood deficiency. Practitioners must examine these conditions carefully before use.