Why does the character "疝" look like this (疒 + 山)? What does it have to do with a mountain?

[王白水]

First, let’s review what a hernia is: An organ or tissue in the human body leaves its normal anatomical position
Look up Shuowen Jiezi, the character for hernia looks like this

Try to understand “疝” through its pictographic components

On the left is 疒 (which looks like a bed), and on the right is 山 (mountain)

疒 can be said to be very vivid—when you are sick, you must lie in bed, so bed is related to illness. But what does mountain have to do with it?
Looking up the dictionary, the character “山” besides meaning a geographic mountain, also has the meaning of “to disperse” (宣)

[Shuowen] 山 means to disperse. Dispersing qi gives rise to all things; it is a stone that is high.

Now look at the explanation of “疝”

Next, look up “疝” in the dictionary

[Shuowen Jiezi] Abdomen pain. From the radical 疒 and the sound 山. Pronounced suo wan qie
[Shuowen Jiezi commentary] (疝) means abdominal pain. Explanation: Heart pain is called 疝. 疝 also called 詵. Qi is intensely moving upward causing pain. “Yin” swelling is called 隤. Qi moving downward causes 隤. Also said, 疝 also means 詵. 詵 means drawing in the lower abdomen, causing acute pain. From 疒 and the sound 山. Pronounced suo wan qie. Section 14.

It mentions that 疝 is also 詵, and there is a character we haven’t seen before, “詵”. Let’s check the dictionary

[Shuowen Jiezi] Means to speak earnestly. From 言 and 先, where 先 is also the sound. From the poem: “螽斯羽詵詵兮。” Pronounced suo zhen qie

It seems unrelated to hernia, but the two characters sound very similar—疝 (shàn), 詵 (shēn)
My personal understanding is they are homophones used interchangeably

Back to “疝”

[Shuowen Jiezi commentary] (疝) abdominal pain. Explanation: Heart pain is called 疝. 疝 is 詵. Qi intensely moving upward causes pain. Yin swelling is called 隤. Qi moves downward causing 隤. Also said 疝 means 詵 too. 詵 means drawing in the lower abdomen causing acute pain. From radical 疒 and sound 山. Pronounced suo wan qie. Section 14.

It says heart pain is called 疝, yin swelling is called 隤 (tuí)
Yin swelling called 隤 is easy to understand—it should be the scrotal swelling caused by inguinal hernia

隤 means to fall or drop, exactly matching the pathophysiology of inguinal hernia. Since 山 has the meaning of disperse, and 隤 means downward falling inguinal hernia, I boldly guess 疝 refers to the diaphragm hernia which protrudes upward.

Am I correct?

[Shi Ming·Explanation of diseases] Explaining diseases: Yin swelling is called 隤, qi moves downward causing 隤. Also called 疝. Also means 詵, causing acute pain pulling in the lower abdomen.

Haha, turns out 隤, 疝, 詵 all mean the same thing and should all refer to inguinal hernia

Summary and question

[Shi Ming·Explanation of diseases] Explaining diseases: Yin swelling is called 隤, qi moves downward causing 隤. Also called 疝. Also means 詵, causing acute pain pulling in the lower abdomen.

• 隤 means downward fall, yin swelling is called 隤, qi moves downward causing 隤. It makes sense to name the inguinal hernia as “隤”.
• The left side of 疝 is 疒, right side is 山, and 山 means to disperse; it can be understood as normal structures dispersing to other locations, which is logical. Later, not only inguinal hernias but all hernias used this character to name.
• 詵 and 疝 are homophones used interchangeably.

Question: Why was the character “疝” chosen over “隤” to name it finally? My guess is 疝 is easier to write

References

https://www.zdic.net/hans/疝
https://www.zdic.net/hans/山
https://www.zdic.net/hans/疒
https://www.zdic.net/hans/詵
https://ctext.org/shi-ming/shi-ji-bing/zh

[星期天的萨莉亚]

@王白水

疒 can be said to be very descriptive; when you are ill, you need to lie in bed, so the bed is related to illness, but what does it have to do with a mountain?
Looking it up in the dictionary, the character “山” (mountain) besides referring to a geographical mountain also has the meaning of “to declare” or “to announce”.

The formation method of the character “疝” is actually a phono-semantic compound character, not that complicated, composed of 疒 and the sound of 山.
Of course, a character can be both a phono-semantic compound and an ideogrammic compound; saying it carries the meaning of declaring from the inside out is also acceptable.

[星期天的萨莉亚]

@Wang Baishui

It doesn’t seem related to hernia, but their pronunciations are very similar — hernia (shàn), shēn (shēn)
My personal understanding is that these are homophones used interchangeably; there are many similar cases

Although hernia and shēn share the same initial consonant, their finals have been quite different from ancient times to the present. Hernia is a mountain rhyme with second-grade sound category, while shēn belongs to the zhen rhyme with third-grade sound category. Is there an example of interchange between mountain and zhen in Old Chinese?

[星期天的萨莉亚]

@Wang Baishui

The character 隤 implies a sense of falling, which perfectly aligns with the pathogenesis of inguinal hernia. The character 山 implies spreading. Since 隤 represents a downward falling inguinal hernia, I boldly speculate that hernia should refer to an upward protruding diaphragmatic hernia.

Reading the chapter on cold hernia abdominal pain in Jin Gui, I think the ancient term “疝” may not completely correspond to the modern concept of hernias. The phrase “气诜诜然上” likely describes the situation of qi ascending against its normal flow in the human body, and not necessarily the actual organs protruding through the esophageal hiatus into the diaphragm as in a diaphragmatic hernia.