《说文》疝，腹中痛也。《释名》疝，犹诜也，气诜诜上也。然则腹气逆上作痛者疝也
，许
略而刘详耳！《金匮》寒疝正指此，故次于腹满下，不与狐疝同篇，其各条经文，不涉及前
阴一字。隋巢元方知此义，故《病源》载诸疝候，亦无涉及前阴，惟疝非前阴茎卵之病，故
女子亦得有之。如《素问》厥疝，《外台》血疝、石疝之属是也。疝以寒疝为正，若狐疝、
疝诸关前阴者，特以其兼腹痛，故以疝之名名之，其不兼腹痛，则直云阴缩、阴 而已，
诸经中自有条理可寻也。近世以狐疝为正疝，遂不识《金匮》寒疝为何病，而乌头等方乃废
。至张石顽《医通》、徐灵胎《轨范》，皆合狐疝、寒疝为一门矣，而浅者又目为肝气矣。
《素问》有隔，《伤寒论》有格，《病源》、《千金》、《外台》有鬲，音义皆相近，
而要非
今之所谓膈也。何以言之？隔为不便（经曰隔阳不便，王注亦屡曰隔，隔塞而不便写也，）即
仲景书之关元方书之内关外格也。格为吐逆（见《伤寒平脉法》，王注《素问》亦用之），义
取格拒。鬲为鬲气，其别有五，其症不一，不过寒食气结所为，皆与膈轻重悬殊。治隔可利
其二便，治格可平其胃气（据仲景干姜黄芩黄连人参汤症言），治鬲可运其阳气。若今之所谓
膈，乃吴江徐氏所谓胃口枯槁，不能受食者，实噎与反胃之极境，属六极，故多死，无药可
治。不得以鬲、膈字同，隔、格、膈音同而牵合之。
《说文解字》解释“疝”为腹中疼痛。《释名》解释“疝”，音义同“诜”，指气机向上冲逆。既然这样，那么腹部气机逆上导致疼痛的病症就是“疝”，只是许慎的解释简略而刘熙的解释详细罢了！《金匮要略》中的“寒疝”正是指这种病，所以它排在“腹满”篇之后，不与“狐疝”合为一篇，其各条经文没有一字涉及前阴部。隋代巢元方懂得这个道理，所以《诸病源候论》记载的各种“疝”候，也没有涉及前阴部。正因为“疝”不是前阴或睾丸的疾病，所以女子也会得此病。例如《素问》中的“厥疝”，以及《外台秘要》中的“血疝”、“石疝”等都属于此类。“疝”以“寒疝”为正统，至于像“狐疝”等那些主要关联前阴部的病症，只是因为它们兼有腹痛的症状，所以才用“疝”的名称来命名；如果它们不兼有腹痛，就直接称为“阴缩”、“阴冷”而已，在各类医经中自有条理可以寻究。近代人把“狐疝”当作正统的“疝”，于是就不认识《金匮要略》中的“寒疝”是什么病了，导致乌头等方剂被废弃。到了张璐（字石顽）的《张氏医通》、徐灵胎的《医学源流论》（此处原文作《轨范》，实指其著作），都将“狐疝”和“寒疝”合并为一个门类，而见识浅薄的人又将其视为“肝气”病。
《素问》中有“隔”，《伤寒论》中有“格”，《诸病源候论》、《千金要方》、《外台秘要》中有“鬲”，它们的读音和意义都相近，但实质上并不是现在所说的“膈”病。为什么这样说呢？“隔”是指二便不通（经典中说“隔阳不便”，王冰注也多次提到“隔”，意为阻隔闭塞而导致排泄不畅），这也就是仲景书中提到的关元穴处的气机阻滞，以及方书中所说的内关外格。“格”是指呕吐逆反（见于《伤寒平脉法》，王冰注释《素问》时也使用这个概念），其含义取的是格拒之意。“鬲”是指鬲气，它细分为五种，症状各不相同，不过都是由寒邪、食积、气结所致，这些都与现在的“膈”病在轻重程度上相差悬殊。治疗“隔”病可以通利二便，治疗“格”病可以平复胃气（依据仲景干姜黄芩黄连人参汤证而言），治疗“鬲”病可以运化阳气。至于现在所说的“膈”病，乃是吴江徐氏所说的胃口枯槁，不能受纳饮食的情况，实际上是“噎”和“反胃”病的极重境界，属于“六极”之一，所以大多死亡，无药可治。不能因为“鬲”和“膈”字形相同，“隔”、“格”、“膈”读音相同就牵强地混为一谈。
The *Shuowen Jiezi* defines "Shan" (Hernia/Abdominal Pain) as pain in the abdomen. The *Shiming* explains that "Shan" is homophonous with "Shen," referring to Qi rushing upward. Therefore, abdominal pain caused by rebellious Qi ascending is what is meant by "Shan"; Xu Shen's explanation was brief, while Liu Xi's was detailed! The "Han Shan" (Cold Hernia) in the *Jin Gui Yao Lue* precisely refers to this condition; hence, it is placed after the chapter on abdominal fullness and is not grouped with "Hu Shan" (Fox Hernia). None of its individual textual entries mention the anterior genitalia even once. Chao Yuanfang of the Sui Dynasty understood this principle; thus, the various hernia syndromes recorded in the *Bing Yuan* (*Zhu Bing Yuan Hou Lun*) also do not involve the anterior genitalia. Precisely because "Shan" is not a disease of the anterior genitalia or testicles, women can also suffer from it. Examples include "Jue Shan" (Rebellious Hernia) in the *Su Wen*, and categories such as "Xue Shan" (Blood Hernia) and "Shi Shan" (Stone Hernia) in the *Wai Tai Mi Yao*. "Shan" takes "Han Shan" (Cold Hernia) as the orthodox type. As for conditions like "Hu Shan" (Fox Hernia) that are primarily associated with the anterior genitalia, they are named "Shan" only because they are accompanied by abdominal pain; if they do not accompany abdominal pain, they are directly referred to as "Yin Suo" (Yin Retraction) or "Yin Leng" (Yin Cold). There is a clear logic to be found within the classical texts. In recent times, people have taken "Hu Shan" (Fox Hernia) as the orthodox "Shan," thereby failing to recognize what disease the "Han Shan" (Cold Hernia) in the *Jin Gui Yao Lue* represents, leading to the abandonment of formulas containing herbs such as Wutou (Aconiti Lateralis Radix Preparata). By the time of Zhang Shiwen's *Zhang Shi Yi Tong* and Xu Lingtai's *Gui Fan* (likely referring to his works on medical principles), "Hu Shan" and "Han Shan" were merged into a single category, and those with superficial understanding further categorized them as "Gan Qi" (Liver Qi) disorders.
The *Su Wen* contains the term "Ge" (Obstruction), the *Shang Han Lun* contains "Ge" (Repulsion), and the *Bing Yuan*, *Qian Jin Fang*, and *Wai Tai Mi Yao* contain "Ge" (Diaphragm/Qi Stagnation). Their pronunciations and meanings are similar, but essentially they are not what is currently referred to as "Ge" (Dysphagia/Regurgitation syndrome). Why is this so? "Ge" refers to difficulty in excretion (Classics state "Yang obstruction leads to difficulty in excretion"; Wang Bing's commentary frequently uses "Ge," meaning blocked and obstructed, leading to inability to discharge). This corresponds to the stagnation at the Guanyuan point mentioned in Zhongjing's writings, and the internal closure and external repulsion described in formula books. "Ge" refers to vomiting and regurgitation (seen in *Shang Han Ping Mai Fa*; Wang Bing's commentary on the *Su Wen* also uses this term), taking its meaning from the concept of repulsion/barrier. "Ge" (as in Diaphragm Qi) refers to Qi stagnation in the diaphragm region. It has five subtypes and varied symptoms, but all are caused by cold, food retention, and Qi knotting. These differ significantly in severity from the current "Ge" (Dysphagia). Treating "Ge" (Obstruction) can benefit the two bowels; treating "Ge" (Repulsion) can calm the Stomach Qi (based on Zhongjing's Gan Jiang Huang Qin Huang Lian Ren Shen Tang syndrome); treating "Ge" (Diaphragm Qi) can circulate Yang Qi. However, the "Ge" (Dysphagia) discussed today refers to what Xu of Wujiang described as a withered stomach opening unable to receive food. This is actually the extreme stage of "Ye" (Choking/Dysphagia) and "Fan Wei" (Regurgitation), belonging to the "Six Extremes" (Liu Ji), and thus often results in death with no medicinal cure available. One must not conflate them simply because the characters "Ge" (Diaphragm) and "Ge" (Dysphagia) are identical, or because "Ge" (Obstruction), "Ge" (Repulsion), and "Ge" (Dysphagia) share similar pronunciations.