某 先天不足，肾气虚寒，膀胱失化，肾囊胀大，疝气上攻，呕吐不止。防其发厥。
肉桂 金铃子 乌药 巴戟肉 胡芦巴 半夏 吴茱萸 泽泻 小茴香 荔枝核
又末药方∶
棉子肉（四两，炒） 小茴香（二两，盐水炒） 糯米（半升，炒黄）
共研末，砂糖调服。
渊按∶水盛凌土之象，须崇土御水为主。
曾 嗜酒之人多湿，湿注下焦而成 疝，肿胀久而不已，虑其变酿囊痈、湿漏等疾，是属淹缠。
萆 橘核 桃仁 茯苓 焦白术 海藻（洗清） 昆布（洗清） 泽
泻延胡索 川黄柏 川楝子（炒打） 通草
附丸方∶
金铃子（一两，炒打） 萆 （一两，炒） 茯苓（一两，烘） 泽泻（一两，炒
）防己（一两） 焦山栀（一两） 白术（八钱，炒） 黑白丑（各二钱，炒） 黄柏（五钱，
炒） 川连（三钱，吴萸二钱煎汁，炒） 苡仁（一两，炒） 茅术（八钱，米泔水浸）
昆布（一两，洗淡，炒） 橘核（一两，炒，打） 海藻（五钱，洗淡，炒）
上药共研细末，用老丝瓜筋三两，砂仁三钱，通草三钱，煎汤泛丸。每朝三钱，开水送下。
秦 湿热素盛，下注小肠厥阴之络，囊肿，胯筋胀痛，小有寒热已经匝月。拟泄肝络，兼通小肠。
金铃子散加柴胡、青皮、穿山甲、全蝎、龙胆草、枳壳、山楂肉、黑山栀、沉香、吴茱萸、橘核。
又 疝本属寒，久则化热。其热为标，其寒为本。当标本兼治。
金铃子散加木香、乌药、吴茱萸、橘核、小茴香、车前子、川黄柏、枸杞子、胡芦巴。
吴 子和论七疝，都隶于肝。近因远行劳倦，奔走伤筋，元气下陷，其疝益大。盖筋者，肝之合也。睾
丸者，筋之所聚也。大凡治疝不越辛温苦泄，然劳碌气陷者，苦泄则气益陷。今先举
其陷下之气，稍佐辛温，是亦标本兼治之法。
补中益气汤加茯苓、茴香、延胡、全蝎、木香。
又丸方∶
党参 白术 茯苓 吴茱萸 乌药 木香 小茴香 当归 枸杞子 川楝子 淡苁蓉
上药研末，用荔枝半斤，去壳煮烂，取肉捣烂，另将核炙脆，研末，连前药末共捣成丸。朝暮用盐花汤
送下三钱。
周 中气不足，湿热下注厥阴之络，胯凹肾囊之间，每逢劳碌必发疝气攻痛，兼有寒热。前用搜络方法，
未获效验。今用补中益气汤加搜络清里之药。
补中益气汤去黄 、炙草，加黄柏、茴香、全蝎、吴茱萸、黑山栀、川楝子、橘核、丝瓜络。
又药酒方∶
枸杞子 沙苑子 茴香 仙茅 川楝子 熟地 菟丝子 吴茱萸 杜仲 巴戟肉 党参
烧酒十斤浸，夏五冬十日饮，勿醉。
王 肝经久有湿热，伏于下焦经络之中。疝气交春而发，夏甚秋衰，至冬而平。发时每有寒热，是属湿
火无疑，断非寒疝可比。去冬迄今患疟，兼以咳嗽，舌底红裂而苔黄 ，此疟邪湿热
伤阴之象。法以养阴化痰、和胃泄肝为治。
制首乌 鳖甲 陈皮 杏仁 桃仁 川楝子 青皮 延胡
川贝 沙参 红枣 生姜
仁渊曰∶古人谓七疝都隶于肝，以少腹前阴皆厥阴经脉部位故也。湿热寒邪袭郁厥少而成疝，此言诚是。
然余谓病标在肝，病本在脾肾。盖厥阴风木，寄体在土，滋灌赖水。苟日暄雨
润燥湿得宜，欣欣向荣，何疝之有？惟水寒土湿，木失其荣，藏舍空而经络虚，始寒湿、热湿之邪乘虚袭入；
邪郁不化，木不条达，愈郁愈横，于是将军之性猝发难遏，其气不得升达，横塞本
位经脉之间而作疝也。所以不涉他部者，他脏尚不虚耳。冲心则死，亦以心阳大虚，寒邪得以直犯君主耳。
气体实而标邪盛者，其治尚易；惟积年累月，邪虽不重，而脏真大虚，一切苦寒辛通
之药，未可径施，施亦未必效验，最为难疗。若治疝都用辛通温散入方者，不独散其寒，亦所以通其气耳。
通则不痛，痛则不通，是之谓乎！
某患者先天禀赋不足，肾气虚寒，膀胱气化功能失常，导致阴囊肿大，疝气向上攻冲，呕吐不止。需防止其发生厥证（四肢逆冷、昏厥）。
肉桂 金铃子 乌药 巴戟天肉 胡芦巴 半夏 吴茱萸 泽泻 小茴香 荔枝核
又末药方：
棉子肉（四两，炒制） 小茴香（二两，盐水炒制） 糯米（半升，炒至微黄）
共研为细末，用砂糖调服。
渊按语：这是水湿过盛凌犯脾土的征象，必须以培补脾土、抵御水湿为主要治疗原则。
曾姓患者嗜酒之人多体内有湿，湿气下注于下焦而形成疝病，肿胀日久不愈，担心变酿成囊痈、湿漏等疾患，这属于缠绵难愈的病症。
萆薢 橘核 桃仁 茯苓 焦白术 海藻（清洗洁净） 昆布（清洗洁净） 泽泻 延胡索 川黄柏 川楝子（炒后捣碎） 通草
附丸方：
金铃子（一两，炒后捣碎） 萆薢（一两，炒制） 茯苓（一两，烘干） 泽泻（一两，炒制） 防己（一两） 焦山栀（一两） 白术（八钱，炒制） 黑白丑（各二钱，炒制） 黄柏（五钱，炒制） 川连（三钱，用吴茱萸二钱煎汁炒制） 苡仁（一两，炒制） 茅术（八钱，米泔水浸泡） 昆布（一两，洗去咸味，炒制） 橘核（一两，炒制，捣碎） 海藻（五钱，洗去咸味，炒制）
上述药物共研为细末，用老丝瓜筋三两，砂仁三钱，通草三钱，煎汤作为粘合剂泛制成丸。每晨服用三钱，开水送下。
秦姓患者湿热素来旺盛，下注于小肠及足厥阴肝经之络脉，导致阴囊肿大，大腿根部筋脉胀痛，伴有轻微寒热症状已近一个月。拟采用疏泄肝络，兼通小肠的方法治疗。
金铃子散加柴胡、青皮、穿山甲、全蝎、龙胆草、枳壳、山楂肉、黑山栀、沉香、吴茱萸、橘核。
又案：疝气本属寒证，日久则化热。其热为标象，其寒为本源。应当标本兼治。
金铃子散加木香、乌药、吴茱萸、橘核、小茴香、车前子、川黄柏、枸杞子、胡芦巴。
吴姓患者子和论述七疝，都归属于肝经。近期因远行劳倦，奔走损伤筋脉，元气下陷，导致疝气更加肿大。盖因筋是肝所合，睾丸是筋汇聚之处。大凡治疗疝气不离辛温与苦泄之法，然而对于劳碌导致气机下陷者，若用苦泄法则会使气机更加下陷。如今先提升其下陷之气，稍佐辛温药物，这也是标本兼治的方法。
补中益气汤加茯苓、茴香、延胡索、全蝎、木香。
又丸方：
党参 白术 茯苓 吴茱萸 乌药 木香 小茴香 当归 枸杞子 川楝子 淡苁蓉
上述药物研为细末，用荔枝半斤，去壳煮烂，取果肉捣烂，另外将荔枝核炙脆，研为细末，与前药末共同捣匀制成丸剂。早晚用盐花汤送服三钱。
周姓患者中气不足，湿热下注于足厥阴肝经之络脉，在胯部凹陷与肾囊之间，每逢劳碌必发作疝气攻痛，兼有寒热。此前使用搜风通络的方法，未获效验。如今使用补中益气汤加入搜风通络、清里热的药物。
补中益气汤去掉黄芪、炙甘草，加入黄柏、茴香、全蝎、吴茱萸、黑山栀、川楝子、橘核、丝瓜络。
又药酒方：
枸杞子 沙苑子 茴香 仙茅 川楝子 熟地黄 菟丝子 吴茱萸 杜仲 巴戟天肉 党参
用十斤烧酒浸泡，夏季浸五日，冬季浸十日饮用，切勿醉酒。
王姓患者肝脏经久以来就有湿热，潜伏在下焦经络之中。疝气在春季发作，夏季加重，秋季衰退，到了冬季则平息。每次发作时常伴有寒热，这确属湿火无疑，绝非寒疝可比。去年冬天至今患疟疾，兼有咳嗽，舌底红裂而苔黄，这是疟邪湿热伤及阴液的征象。治法以养阴化痰、和胃泄肝为主。
制首乌 鳖甲 陈皮 杏仁 桃仁 川楝子 青皮 延胡索
川贝母 沙参 红枣 生姜
渊曰：古人说七疝都归属于肝，因为少腹和前阴都是足厥阴经脉循行的部位。湿热寒邪侵袭郁结于厥阴、少阳而成疝，这种说法确实正确。
然而我认为病标在肝，病本在脾肾。盖因厥阴风木，寄居体用于脾土，滋润灌溉依赖肾水。如果日照温暖雨水滋润，燥湿得宜，生机欣欣向荣，哪里有疝病呢？只有当水寒土湿，肝木失去荣华，脏腑空虚无藏，经络虚弱，此时寒湿、热湿之邪才乘虚侵入；邪气郁结不能化解，肝木不得条达舒畅，越郁结越横逆，于是肝将军之性猝然爆发难以遏制，其气不能升发通达，横塞在本位经脉之间而发为疝病。所以不涉及其他部位，是因为其他脏腑尚且不虚。如果寒气上冲于心则致死，也是因为心阳大虚，寒邪得以直接侵犯君主之官。
体质充实而标邪盛者，治疗尚容易；唯有积年累月，邪气虽不重，但脏腑真气大虚，一切苦寒辛通的药物，不可直接使用，即使使用也未必有效，最为难治。如果治疗疝气都用辛通温散的药物入方，不仅是为了散寒，也是为了通行气机。通则不痛，痛则不通，说的就是这个道理！
Patient Mou: Congenital deficiency, Kidney Qi deficiency and cold, failure of the Bladder to transform (Qi transformation), leading to enlargement of the scrotum, hernia Qi attacking upward, incessant vomiting. Prevent the occurrence of Jue syndrome (cold limbs or syncope).
Rou Gui (Cinnamon Bark), Jin Ling Zi (Melianthus Fruit), Wu Yao (Lindera Root), Ba Ji Rou (Morinda Officinalis Cortex), Hu Lu Ba (Trigonella Foenum-graecum Seed), Ban Xia (Pinellia Tuber), Wu Zhu Yu (Evodia Fruit), Ze Xie (Alisma Rhizome), Xiao Hui Xiang (Fennel Fruit), Li Zhi He (Litchi Seed).
Another powder prescription:
Mian Zi Rou (Gossypii Herba, 4 liang, stir-fried), Xiao Hui Xiang (Fennel Fruit, 2 liang, stir-fried with salt water), Nu Mi (Glutinous Rice, half sheng, stir-fried until yellow).
Grind into powder together, take mixed with rock sugar.
Note by Yuan: This is a manifestation of Water overwhelming Earth (Spleen). The primary treatment must be to strengthen Earth to control Water.
Patient Zeng: People who indulge in alcohol often have Dampness. Dampness sinking to the Lower Jiao forms Hernia. Swelling persists for a long time without resolution; there is concern it may develop into Scrotal Carbuncle (Nang Yong) or Damp Fistula (Shi Lou). This belongs to lingering and difficult-to-cure conditions.
Bi Xie (Dioscorea Hypoglauca Rhizome), Ju He (Tangerine Seed), Tao Ren (Peach Seed), Fu Ling (Poria), Jiao Bai Zhu (Charred Atractylodes Macrocephala Rhizome), Hai Zao (Sargassum Thallus, washed clean), Kun Bu (Ecklonia Stipe, washed clean), Ze Xie (Alisma Rhizome), Yan Hu Suo (Corydalis Rhizome), Chuan Huang Bo (Phellodendron Bark), Chuan Lian Zi (Toosendan Fruit, stir-fried and crushed), Tong Cao (Tetrapanax Medulla).
Attached Pill Prescription:
Jin Ling Zi (Melianthus Fruit, 1 liang, stir-fried and crushed), Bi Xie (Dioscorea Hypoglauca Rhizome, 1 liang, stir-fried), Fu Ling (Poria, 1 liang, dried), Ze Xie (Alisma Rhizome, 1 liang, stir-fried), Fang Ji (Stephania Tetrandra Root, 1 liang), Jiao Shan Zhi (Charred Gardenia Fruit, 1 liang), Bai Zhu (Atractylodes Macrocephala Rhizome, 8 qian, stir-fried), Hei Bai Chou (Black and White Morning Glory Seeds, 2 qian each, stir-fried), Huang Bo (Phellodendron Bark, 5 qian, stir-fried), Chuan Lian (Coptis Rhizome, 3 qian, stir-fried with decoction of Wu Zhu Yu 2 qian), Yi Ren (Coix Seed, 1 liang, stir-fried), Mao Zhu (Atractylodes Lancea Rhizome, 8 qian, soaked in rice wash water), Kun Bu (Ecklonia Stipe, 1 liang, washed to remove saltiness, stir-fried), Ju He (Tangerine Seed, 1 liang, stir-fried and crushed), Hai Zao (Sargassum Thallus, 5 qian, washed to remove saltiness, stir-fried).
Grind all medicines into fine powder. Use Lao Si Gua Jin (Old Loofah Vine Fiber, 3 liang), Sha Ren (Amomum Fruit, 3 qian), Tong Cao (Tetrapanax Medulla, 3 qian) decocted in water as the binder to form pills. Take 3 qian every morning, delivered with warm water.
Patient Qin: Damp-Heat has been abundant since youth, sinking downward to the collaterals of the Small Intestine and Foot-Jueyin Liver Meridian. The scrotum is swollen, tendons between the thigh and groin are distended and painful, accompanied by slight chills and fever for nearly a month. Plan to drain the Liver collaterals and simultaneously unblock the Small Intestine.
Jin Ling Zi San (Melianthus Powder) plus Chai Hu (Bupleurum Root), Qing Pi (Citrus Unripe Peel), Chuan Shan Jia (Pangolin Scale), Quan Xie (Scorpion), Long Dan Cao (Gentiana Root), Zhi Ke (Aurantii Fructus), Shan Zha Rou (Hawthorn Flesh), Hei Shan Zhi (Charred Gardenia Fruit), Chen Xiang (Aquilaria Wood), Wu Zhu Yu (Evodia Fruit), Ju He (Tangerine Seed).
Another case: Hernia originally belongs to Cold, but after a long time transforms into Heat. The Heat is the branch (manifestation), the Cold is the root (origin). Treat both root and branch simultaneously.
Jin Ling Zi San (Melianthus Powder) plus Mu Xiang (Aucklandia Root), Wu Yao (Lindera Root), Wu Zhu Yu (Evodia Fruit), Ju He (Tangerine Seed), Xiao Hui Xiang (Fennel Fruit), Che Qian Zi (Plantago Seed), Chuan Huang Bo (Phellodendron Bark), Gou Qi Zi (Goji Berry), Hu Lu Ba (Trigonella Foenum-graecum Seed).
Patient Wu: Hezi discussed the Seven Hernias, all belonging to the Liver. Recently due to long-distance travel and fatigue, running damaged the sinews, causing Yuan Qi (Original Qi) to sink, making the hernia even larger. Sinews are what the Liver combines with. Testicles are where sinews gather. Generally, treating hernia does not exceed Xin Wen (Acrid-Warm) and Ku Xie (Bitter-Draining). However, for those whose Qi sinks due to labor, using Ku Xie will cause Qi to sink further. Now, first lift the sunken Qi, slightly assist with Xin Wen herbs. This is also a method of treating root and branch simultaneously.
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fu Ling (Poria), Hui Xiang (Fennel Fruit), Yan Hu (Corydalis Rhizome), Quan Xie (Scorpion), Mu Xiang (Aucklandia Root).
Another pill prescription:
Dang Shen (Codonopsis Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Fu Ling (Poria), Wu Zhu Yu (Evodia Fruit), Wu Yao (Lindera Root), Mu Xiang (Aucklandia Root), Xiao Hui Xiang (Fennel Fruit), Dang Gui (Angelica Sinensis Root), Gou Qi Zi (Goji Berry), Chuan Lian Zi (Toosendan Fruit), Dan Cong Rong (Cistanche Stem).
Grind medicines into powder. Use half a jin of Litchi, remove shell, boil until soft, take flesh and mash. Roast the seeds until crisp, grind into powder. Mix with previous medicine powder and mash into pills. Take 3 qian morning and evening, delivered with Salt Flower Soup.
Patient Zhou: Middle Qi is insufficient, Damp-Heat sinks downward to the collaterals of Foot-Jueyin Liver Meridian. Between the groin depression and scrotum, whenever labor occurs, Hernia Qi attacks with pain, accompanied by chills and fever. Previously used Luo-sweeping methods without effect. Now use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Luo-sweeping and interior-clearing herbs.
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) remove Huang Qi (Astragalus Root) and Zhi Cao (Prepared Licorice Root), add Huang Bo (Phellodendron Bark), Hui Xiang (Fennel Fruit), Quan Xie (Scorpion), Wu Zhu Yu (Evodia Fruit), Hei Shan Zhi (Charred Gardenia Fruit), Chuan Lian Zi (Toosendan Fruit), Ju He (Tangerine Seed), Si Gua Luo (Loofah Sponge).
Another medicinal wine prescription:
Gou Qi Zi (Goji Berry), Sha Yuan Zi (Astragalus Complanatus Seed), Hui Xiang (Fennel Fruit), Xian Mao (Curculigo Rhizome), Chuan Lian Zi (Toosendan Fruit), Shu Di (Rehmannia Root), Tu Si Zi (Cuscuta Seed), Wu Zhu Yu (Evodia Fruit), Du Zhong (Eucommia Bark), Ba Ji Rou (Morinda Officinalis Cortex), Dang Shen (Codonopsis Root).
Soak in ten jin of distilled spirits. Soak for five days in summer, ten days in winter. Drink, do not get drunk.
Patient Wang: Liver has had Damp-Heat for a long time, hiding within the meridians of the Lower Jiao. Hernia flares up in Spring, worsens in Summer, declines in Autumn, and calms in Winter. Each flare-up is accompanied by chills and fever. This is undoubtedly Damp-Fire, certainly not comparable to Cold Hernia. From last winter until now, suffered from Malaria, accompanied by cough. The underside of the tongue is red and cracked with yellow coating. This is a sign of Malaria pathogen and Damp-Heat injuring Yin. Treatment method: Nourish Yin and resolve phlegm, harmonize Stomach and drain Liver.
Zhi Shou Wu (Prepared Fleeceflower Root), Bie Jia (Turtle Shell), Chen Pi (Tangerine Peel), Xing Ren (Apricot Seed), Tao Ren (Peach Seed), Chuan Lian Zi (Toosendan Fruit), Qing Pi (Citrus Unripe Peel), Yan Hu Suo (Corydalis Rhizome).
Chuan Bei (Fritillaria Bulb), Sha Shen (Glehnia Root), Hong Zao (Jujube Fruit), Sheng Jiang (Fresh Ginger).
Yuan said: Ancients stated that the Seven Hernias all belong to the Liver, because the lower abdomen and anterior yin are the areas traversed by the Jueyin Meridian. It is true that Damp-Heat and Cold pathogens invading and stagnating in Jueyin and Shaoyang form hernia.
However, I believe the branch of the disease is in the Liver, while the root is in the Spleen and Kidney. Jueyin Wind-Wood resides in Earth (Spleen) and relies on Water (Kidney) for nourishment. If warmth and rain are appropriate, keeping dryness and dampness balanced, vitality flourishes, how could there be hernia? Only when Water is cold and Earth is damp, Wood loses its prosperity, organs become empty and collaterals deficient, allowing Cold-Damp and Damp-Heat pathogens to invade via deficiency. Pathogens stagnate and fail to transform, Wood fails to be smooth and reaching, becoming more stagnant and rampant. Thus, the nature of the General (Liver) erupts suddenly and cannot be restrained. Its Qi cannot rise and reach, blocking horizontally between the meridians at its original site, forming hernia. It does not involve other parts because other Zang organs are not yet deficient. If Cold Qi rushes to the Heart, death ensues, also because Heart Yang is greatly deficient, allowing Cold pathogens to directly attack the Sovereign (Heart).
For those with solid constitution and excess branch pathogens, treatment is relatively easy. Only for those with years of accumulation, where pathogens are not heavy but Zhen Qi (True Qi) of organs is greatly deficient, can one not directly apply bitter-cold and acrid-unblocking drugs. Even if applied, they may not be effective; this is the most difficult to treat. If treating hernia always uses acrid-unblocking and warm-dispersing drugs in prescriptions, it is not only to disperse Cold, but also to unblock Qi. When unblocked, there is no pain; when painful, there is blockage. This is what is meant!