经曰∶任脉为病,男子内结七疝,女子带下瘕聚。夫疝者,少腹控引睾丸,胀急而肿痛也。
由郁热内积,抑遏至久,寒湿外侵,收引拘缩,相搏而痛。冲上则面黑口噤;坠下则仆地昏沉,
甚至绝者,亦为顽证,有七种之别。水疝,肿胀明亮,瘙痒水出,得之醉酒饮冷,汗泄当风,宜
逐水。寒疝,囊冷结硬,阴茎不睾,得之坐卧湿处,子嗣艰难,宜温经。 疝,大如升斗,不痒
不痛,得之地卑土薄,江淮多感,宜渗湿。血疝,小腹之旁,横骨中肿(俗名便毒),得之气血凝滞
,留结为痈,宜攻散。气疝,状连肾区,下及阴囊,得之号哭忿怒,气郁而成,宜散滞。狐疝,
卧入昼出,往来有声(今铁圈托),得之郁怒愤气,抑遏不舒,宜逐气。筋疝,阴肿溃痛,挺纵
溲浊,得之房欲之伤,邪术所感,宜制火。经曰∶肝脉急大沉为疝,牢急者顺,弱急者逆。治宜
除内热,祛外邪,兼疏利行气,后补逐并施。治宜龙胆泻肝汤兼主方。
主方 乌药 陈皮 苍术 茴香(酒炒) 香附(各一钱) 当归 玄胡索 木香 川乌
(各五分) 甘草(三分) 加姜煎服。
囊热加栀子,去川乌;冷湿加吴萸。诸疝定痛,山楂、枳实、
橘核、荔核、青皮、胆草、川楝子、三棱、蓬术、槟榔、抚芎、柴胡、山甲、砂仁、益智等酌用
。痛甚,调乳香、没药;有痰,加海石、半夏;小便涩,配五苓散。
茱萸内消丸 肾经虚弱,膀胱为邪气所搏结,成寒疝偏大。
吴茱萸 山茱萸肉 肉桂 马蔺花 陈皮 木香 山药 川楝子 青皮 茴香(盐炒,研,
等分)
上为末,酒糊丸桐子大。每服五十丸,空心温酒送下。
保命丹 远年近日,小肠疝气,偏坠脐下,搐痛,以致闷乱。阴间痒疮。
吴茱萸(拣净,一斤,分四分煮。酒、米醋、盐水、童便,各浸一宿,晒焙干) 泽泻(二
两)
上为末,酒煮,薄面糊丸桐子大。每五十丸空心盐汤下。
硫黄丸 疝气,甚至手足厥冷,上冲心腹欲死者,数服愈。
硫黄(溶化即投水中,去毒,研细末) 陈皮 荔枝核(打碎炒黄,各等分,研细末)
上饭丸桐子大,每服五丸,酒下。勿多用。
苍附汤 治诸疝痛。或加破故纸、葫芦巴。
苍术 香附(俱盐水炒) 黄柏(酒炒。各一钱) 青皮 玄胡索 益智 桃仁(研。各七
分) 茴香(炒) 附子(盐水炒) 甘草(三分)
水煎服,或为末,汤下。
楂橘丸 治诸疝痛。
山楂(四两) 橘核(炒) 山栀(炒,二两) 柴胡 牡丹皮 桃仁(炒) 大小茴香(
俱盐炒。各一两) 吴茱萸(炮,半两) 为末,酒糊丸桐子大,十丸,盐汤下。
简便方 寒疝。玄胡索、胡椒、小茴香(等分)为末,每二钱,酒调下。或桂心末(一钱)
或灵脂、蒲黄末(二钱);或苦楝子末(二钱)或丹参末(一钱)并酒下。
诸疝∶小茴、穿山甲、全蝎(洗,炒),木香(等分)为末,每服二钱,空心酒下。
又 茴香、猪苓、木通、甘草(等分)灯心、淡竹叶煎,调乳香服。
又 枇杷叶、野苏叶、椒叶、苍耳叶、葡萄叶煎洗。或炒盐包熨。
又 柏香五钱,好酒煎,去渣服。再饮酒至醉,三服安。
血疝∶四物汤加大黄、枳实、浓朴,水煎,入芒硝服。
偏坠∶牡蛎粉、良姜末(等分),津调敷。或槐子炒研,入盐少许,酒下。或五倍子研末,
酒下至醉。
小肠气∶小茴香(盐炒)、枳壳末(各一两)、没药末(五钱)匀,每一钱酒下。或荔核末
酒下。或乌药(酒浸一宿)、良姜、茴香,青皮(等分)为末,每二钱酒下。或干丝瓜烧灰,研
末酒下。
法∶两手合搓热掌,揉数百回痛止,久可消。小儿偏坠用双蒂茄悬房门上,出入令儿视之,
茄干愈。或钉钉,日视多次。
医经中说:任脉发生病变,男子会出现体内结聚的七种疝气,女子则表现为带下病和瘕聚(腹内结块)。所谓疝气,是指少腹部牵引睾丸,出现胀急且肿痛的症状。
这是由于郁热在体内积聚,被压抑遏阻时间长久,加上寒湿从外部侵袭,导致筋脉收缩拘挛,内外邪气相互搏结而引发疼痛。如果气逆向上冲,会导致面色发黑、牙关紧闭;如果气坠向下,则会使人跌倒昏迷,甚至出现假死状态,这也属于顽固难治的证候,共有七种类型。
水疝,表现为肿胀光亮,瘙痒并有水液流出,多因醉酒饮冷、出汗时当风受凉所致,治疗宜采用逐水法。
寒疝,表现为阴囊冰冷结硬,阴茎萎缩不举,多因坐卧湿地所致,影响生育,治疗宜温通经脉。
<疝>(注:原文此处缺字,据上下文及《诸病源候论》等古籍,通常指“气疝”或特指某种疝,此处依原文直译),表现为肿物大如升斗,不痒也不痛,多因地势低洼、土壤贫瘠,江淮地区人多感染,治疗宜渗利湿气。
血疝,发生在小腹旁边横骨部位肿胀(俗称便毒),多因气血凝滞,留结而成痈肿,治疗宜攻散瘀血。
气疝,形状连接肾区,下延至阴囊,多因大声哭叫或愤怒导致气机郁结而成,治疗宜疏散滞气。
狐疝,白天站立时突出,夜间平卧时缩回,往来移动有声(今人用铁圈托住),多因郁怒愤懑之气,抑遏不得舒展所致,治疗宜驱逐气滞。
筋疝,表现为阴部肿胀溃烂疼痛,阴茎挺纵且小便浑浊,多因房事过度损伤,或感受邪术所致,治疗宜制约火邪。
医经说:肝脉急大沉涩主疝气,脉象牢急为顺证,弱急为逆证。治疗应当清除内热,祛除外邪,同时疏利行气,后续补益与逐邪并用。主治方剂宜选用龙胆泻肝汤作为主方。
主方:乌药、陈皮、苍术、茴香(酒炒)、香附(各一钱),当归、玄胡索、木香、川乌(各五分),甘草(三分)。加生姜煎服。
若阴囊发热,加栀子,去掉川乌;若寒冷湿重,加吴茱萸。各种疝气定痛,可选用山楂、枳实、橘核、荔枝核、青皮、胆草、川楝子、三棱、蓬术、槟榔、抚芎、柴胡、山甲、砂仁、益智等药物酌情使用。疼痛剧烈者,调服乳香、没药;有痰湿者,加海浮石、半夏;小便涩滞,配伍五苓散。
茱萸内消丸:适用于肾经虚弱,膀胱被邪气搏结,形成寒疝且偏大者。
组成:吴茱萸、山茱萸肉、肉桂、马蔺花、陈皮、木香、山药、川楝子、青皮、茴香(盐炒,研末,等分)。
制法:以上药物研为细末,用酒糊制成梧桐子大小的丸药。每次服用五十丸,空腹时用温酒送下。
保命丹:适用于多年陈旧的近日小肠疝气,睾丸偏坠脐下,抽搐疼痛,以致烦闷扰乱。以及阴间瘙痒疮疡。
组成:吴茱萸(拣净,一斤,分四份煮。分别用酒、米醋、盐水、童便浸泡一夜,晒焙干),泽泻(二两)。
制法:以上药物研为细末,用酒煮,薄面糊制成梧桐子大小的丸药。每次五十丸,空腹用盐汤送下。
硫黄丸:适用于疝气严重,甚至手足厥冷,气上冲心腹欲死者,数次服用可愈。
组成:硫黄(溶化后投入水中以去毒,研成细末),陈皮,荔枝核(打碎炒黄,各等分,研成细末)。
制法:以上药物用饭粒制成梧桐子大小的丸药,每次服用五丸,酒送下。不可多用。
苍附汤:治疗各种疝痛。也可加入破故纸、葫芦巴。
组成:苍术、香附(俱用盐水炒),黄柏(酒炒,各一钱),青皮、玄胡索、益智、桃仁(研,各七分),茴香(炒),附子(盐水炒),甘草(三分)。
用法:水煎服,或研为细末,用汤药送服。
楂橘丸:治疗各种疝痛。
组成:山楂(四两),橘核(炒),山栀(炒,二两),柴胡,牡丹皮,桃仁(炒),大小茴香(俱用盐炒,各一两),吴茱萸(炮制,半两)。
制法:研为细末,用酒糊制成梧桐子大小的丸药,每次十丸,盐汤送下。
简便方:
寒疝:玄胡索、胡椒、小茴香(等分)研为细末,每次二钱,酒调服。或者桂心末(一钱),或者灵脂、蒲黄末(二钱);或者苦楝子末(二钱)或者丹参末(一钱),均用酒送服。
各种疝气:小茴香、穿山甲、全蝎(洗,炒),木香(等分)研为细末,每次服用二钱,空腹用酒送下。
又方:茴香、猪苓、木通、甘草(等分),用灯心草、淡竹叶煎汤,调服乳香。
又方:枇杷叶、野苏叶、椒叶、苍耳叶、葡萄叶煎汤外洗。或者炒盐包熨烫患处。
又方:柏香五钱,用好酒煎煮,去渣服用。再饮酒至醉,服用三次即可安宁。
偏坠:牡蛎粉、良姜末(等分),用唾液调和敷贴。或者槐子炒研,加入少许盐,酒送服。或者五倍子研末,酒送服至醉。
小肠气:小茴香(盐炒)、枳壳末(各一两)、没药末(五钱)混合均匀,每次一钱酒送服。或者荔枝核末酒送服。或者乌药(酒浸一夜)、良姜、茴香,青皮(等分)研为细末,每次二钱酒送服。或者干丝瓜烧灰,研末酒送服。
方法:两手合搓使手掌发热,揉按数百次疼痛停止,久用可消除。小儿偏坠可用双蒂茄悬挂在房门上,让儿童出入时观看它,茄子干枯即痊愈。或者钉钉子,每天多次观看。
As stated in the medical classics: When the Ren Mai (Conception Vessel) is diseased, men suffer from seven types of internal hernia (Shan Qi), while women experience leukorrhea and Jia Ju (abdominal masses). Hernia (Shan Qi) refers to pain, swelling, and distension in the lower abdomen radiating to the testicles.
This condition arises from accumulated internal heat stagnation suppressed for a long time, combined with external invasion of cold-dampness causing contraction and spasm. The conflict between these pathogens leads to pain. If the pathogenic qi rushes upward, it causes blackening of the face and lockjaw; if it sinks downward, it may cause fainting or even apparent death. These are considered stubborn syndromes, categorized into seven types.
1. Water Hernia (Shui Shan): Characterized by bright swelling, itching, and discharge of fluid. It results from drunkenness, drinking cold beverages, or exposure to wind during sweating. Treatment requires draining water.
2. Cold Hernia (Han Shan): Characterized by cold, hard scrotum and flaccid penis. It results from sitting or lying on damp ground and can impair fertility. Treatment requires warming the meridians.
3. [Missing Character] Hernia: Swelling as large as a sheng or dou vessel, without itching or pain. Common in low-lying, poor-soil areas like the Jianghuai region. Treatment requires leaching out dampness.
4. Blood Hernia (Xue Shan): Swelling beside the lower abdomen at the pubic bone (commonly known as Biandu). It results from blood and qi stagnation forming an abscess. Treatment requires attacking and dispersing stasis.
5. Qi Hernia (Qi Shan): Shape extends from the kidney area down to the scrotum. It results from crying or anger causing qi stagnation. Treatment requires dispersing stagnant qi.
6. Fox Hernia (Hu Shan): Protrudes when standing during the day and retracts when lying down at night, moving with sound (now supported by iron rings). It results from suppressed anger and frustration. Treatment requires driving out stagnant qi.
7. Sinew Hernia (Jin Shan): Swollen, ulcerated, and painful genitals with persistent erection and turbid urine. It results from sexual excess or evil spell influence. Treatment requires controlling fire.
The classics state: A liver pulse that is rapid, large, deep, and choppy indicates hernia. A firm and rapid pulse is favorable; a weak and rapid pulse is unfavorable. Treatment should clear internal heat, expel external pathogens, regulate qi movement, and later combine tonification with expulsion. The primary formula is Longdan Xiegan Tang (Gentian Liver-Draining Decoction).
Primary Formula: Wuyao (Linderae Radix), Chenpi (Citri Reticulatae Pericarpium), Cangzhu (Atractylodis Rhizoma), Huixiang (Foeniculi Fructus, wine-fried), Xiangfu (Cyperi Rhizoma) (each 1 qian); Danggui (Angelicae Sinensis Radix), Yuanhuxsuo (Corydalis Rhizoma), Muxiang (Aucklandiae Radix), Chuanwu (Aconiti Radix Preparata) (each 0.5 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (0.3 qian). Add fresh ginger and decoct.
If the scrotum is hot, add Zhizi (Gardeniae Fructus) and remove Chuanwu; if cold and damp, add Wuzhuyu (Evodiae Fructus). For pain relief in various hernias, selectively use Shanzha (Crataegi Fructus), Zhishi (Aurantii Fructus), Juzhe (Citri Reticulatae Semen), Lizhihe (Litchi Semen), Qingpi (Citri Reticulatae Pericarpium Viride), Dancao (Gentianae Radix), Chuanlianzi (Toosendan Fructus), Sanleng (Sparganii Rhizoma), Pengze (Curcumae Rhizoma), Binglang (Arecae Semen), Fuxiong (Ligustici Chuanxiong Rhizoma), Chaihu (Bupleuri Radix), Shanjiya (Manis Squama), Sharen (Amomi Fructus), Yizhi (Alpiniae Oxyphyllae Fructus). For severe pain, mix with Rushiag (Olibanum) and Moyao (Myrrha); for phlegm, add Haishi (Calcitrum) and Banxia (Pinelliae Rhizoma); for difficult urination, combine with Wuling San (Five-Ingredient Powder with Poria).
Zhuyu Neixiao Wan (Evodia Internal-Dissolving Pill): For kidney deficiency where bladder is bound by evil qi, forming a large cold hernia.
Ingredients: Wuzhuyu (Evodiae Fructus), Shanzhuyu (Corni Fructus), Rougui (Cinnamomi Cortex), Malinhua (Iridis Flos), Chenpi, Muxiang, Shanyao (Dioscoreae Rhizoma), Chuanlianzi, Qingpi, Huixiang (salt-fried, powdered, equal parts).
Preparation: Powder all ingredients, mix with wine paste to make pills the size of tung tree seeds. Take 50 pills per dose with warm wine on an empty stomach.
Baoming Dan (Life-Preserving Pill): For chronic small intestine hernia, unilateral scrotal swelling below the navel, spasmodic pain causing confusion, and genital itching/sores.
Ingredients: Wuzhuyu (1 jin, cleaned, divided into four parts boiled separately in wine, rice vinegar, salt water, and child's urine overnight, then dried and roasted), Zexie (Alismatis Rhizoma) (2 liang).
Preparation: Powder ingredients, boil in wine, mix with thin flour paste to make tung-seed-sized pills. Take 50 pills per dose with salt water on an empty stomach.
Liuhuang Wan (Sulfur Pill): For severe hernia with cold extremities and qi rushing to heart/abdomen causing near-death sensation. Effective after several doses.
Ingredients: Liuhuang (Sulfur, melted and dropped into water to detoxify, then powdered), Chenpi, Lizhihe (Litchi Semen, crushed and fried yellow) (equal parts, powdered).
Preparation: Make pills with rice paste, tung-seed-sized. Take 5 pills per dose with wine. Do not overdose.
Cangfu Tang (Atractylodes and Cyperi Decoction): Treats various hernia pains. Can add Gubuzhi (Psoraleae Fructus) and Huluba (Trigonellae Semen).
Ingredients: Cangzhu, Xiangfu (both salt-water fried), Huangbai (Phellodendri Cortex, wine-fried) (each 1 qian); Qingpi, Yuanhuxsuo, Yizhi, Taoren (Peach Seed, pounded) (each 0.7 qian); Huixiang (fried), Fuzi (Aconiti Lateralis Radix Preparata, salt-water fried), Gancao (0.3 qian).
Usage: Decoct in water or powder and take with liquid.
Zha Ju Wan (Hawthorn and Tangerine Peel Pill): Treats various hernia pains.
Ingredients: Shanzha (4 liang), Juzhe (fried), Shanzhi (Gardeniae Fructus, fried, 2 liang), Chaihu, Mudanpi (Moutan Cortex), Taoren (fried), Da Xiao Huixiang (Greater and Lesser Fennel Seeds, both salt-fried, each 1 liang), Wuzhuyu (processed, 0.5 liang).
Preparation: Powder, mix with wine paste, make tung-seed-sized pills. Take 10 pills with salt water.
Simple Prescriptions:
Cold Hernia: Yuanhuxsuo, Hujiao (Black Pepper), Xiao Huixiang (Small Fennel Seed) (equal parts) powdered. Take 2 qian mixed with wine. Or Gui Xin (Cinnamon Heart) powder (1 qian); or Lingzhi (Styracis Resina) and Puhuang (Tiliae Pollen) powder (2 qian); or Kulianzi (Meliae Toosendan Fructus) powder (2 qian); or Danshen (Salviae Miltiorrhizae Radix) powder (1 qian). All taken with wine.
Various Hernias: Xiao Huixiang, Shanjianya (Manis Squama), Quanxie (Scorpio), Muxiang (equal parts) powdered. Take 2 qian with wine on an empty stomach.
Another Prescription: Huixiang, Zhuling (Polyporus), Mutong (Akebiae Caulis), Gancao (equal parts). Decoct with Dengxincao (Junci Medullia) and Danzhuye (Lophatheri Folium), mix with Rushiag.
Another Prescription: Decoct Pipaye (Eriobotryae Folium), Yesuye (Perillae Folium), Jiaoye (Zanthoxyli Folium), Cang'er Ye (Xanthii Folium), Putaoye (Vitis Folium) for washing. Or apply hot salt packs.
Another Prescription: Bo Bai Xiang (Boswellia) 5 qian in good wine, strain and drink. Then get drunk. Three doses bring relief.
Blood Hernia: Siwu Tang (Four Substances Decoction) plus Dahuang (Rhei Radix et Rhizoma), Zhishi, Nongpo (Magnoliae Officinalis Cortex). Decoct in water, add Mangxiao (Natrii Sulfas).
Unilateral Scrotal Swelling: Musli Fen (Ostreae Concha Pulvis) and Liangjiang (Alpiniae Katsumadai Rhizoma) (equal parts). Mix with saliva and apply externally. Or fry and powder Huai Zi (Sophorae Tonkinensis Semen), add little salt, take with wine. Or powder Wu Beizi (Galla Chinensis), take with wine until drunk.
Small Intestine Qi: Xiao Huixiang (salt-fried), Zhike (Aurantii Fructus) powder (each 1 liang), Moyao (5 qian). Mix evenly, take 1 qian with wine. Or Lizhihe powder with wine. Or Wuyao (wine-soaked overnight), Liangjiang, Huixiang, Qingpi (equal parts) powdered. Take 2 qian with wine. Or burn dried Loogourd (Luffae Fructus) to ash, powder, take with wine.
Method: Rub hands together to generate heat, rub the affected area hundreds of times until pain stops; long-term use can eliminate it. For children with unilateral scrotal swelling, hang a double-stemmed eggplant on the door frame for the child to see daily; when the eggplant dries, the condition cures. Alternatively, nail something and have the child look at it frequently.