杭垣万安桥天和烟店伙。年近七旬。平日体极健壮。身躯丰伟。戊子冬患小便不通。半载有余。久而愈闭。点滴难
出。气常下注。胀急欲死。不得已至西医处用吸水管吸出始安。凡一日数次。以为常也。延余延医。两寸关脉俱极
虚大。两尺细涩不调。余曰此症乃中虚清阳下陷。初则不过如癃闭。医者以熟地、桂、附、漫补。则清阳愈陷。下窍
填塞。遂致胞系了戾。膀胱之下口与溺管不相顺接。故溺难出。病名转胞。治之极易。何以半年之久。无有识此病者。
真属可笑。与补中益气汤。黄 重用至一两。加木通三钱。肉桂三分。两剂而便稍通。四剂其病如失。后以补中益
气全方。不加利水之药。更嘱其每日淡食猪脬数枚。取以胞补胞。同类相感而安。其从前之扰乱半月。后胃强体
健。渠以为神奇。其实亦是按症施治。何奇之有。噫。是症金匮诸书。凿凿具载。省垣甚大。何知医者之寥寥也。诚可
叹已。
杭垣水沟巷孙太太。两足自 至跗皆肿。热痛甚。皮色光亮。至晚发厥。延余诊之。脉沉而弦。余曰。此名香港脚入
腹。亦危症也。冲心即死。其足上有诸络现者。尽刺出血。并刺委中。遂与鸡鸣散。令五更鸡鸣时服。外以蚕矢汤熏洗。
次晚果不厥而热痛仍然。乃用槟榔、蚕沙、海桐皮、木瓜、片子姜黄、黄芩、滑石、薏仁等而愈。
【背景信息】
书名：一得集 章节：转胞症治验 / 孙太太香港脚入腹治验 类别：综合
【待处理原文翻译】
杭州城万安桥天和烟店的一名伙计，年龄接近七十岁。平时身体非常健壮，体格丰满魁梧。戊子年冬天患上小便不通（癃闭），持续半年多，病情逐渐加重导致完全闭塞，点滴难出。气机常向下注滞，腹部胀满急迫，痛苦欲死，不得已去西医处用吸水管吸出尿液才感到安宁。每天要反复进行数次，这已成为常态。后来请我诊治，两手寸部和关部的脉搏都极其虚大，两尺部脉象细涩且不协调。我说这个病症属于中气虚弱、清阳之气下陷。起初不过类似于癃闭，但医生使用熟地黄、肉桂、附子等药物盲目温补，导致清阳之气更加下陷，下窍被填塞，最终致使膀胱系带扭曲（了戾），膀胱下口与尿道连接不顺，所以排尿困难。这个病名叫转胞（妊娠或老年常见的小便不通，因胞系了戾所致）。治疗起来很容易，为什么半年之久，没有人识别出这个病呢？真让人觉得可笑。给予补中益气汤（补益中气，升阳举陷的代表方剂），重用黄芪至一两，加木通三钱，肉桂三分，服用两剂后小便稍微通畅，四剂后疾病消失。后来继续服用补中益气汤全方，不加利水药物，并嘱咐他每天吃几枚清淡煮制的猪膀胱，取“以胞补胞”之意，利用同类相感的原理使身体康复。他之前因为病情困扰而扰乱半月，之后胃口强健，身体康健，他认为这是神奇之事，其实这也是对症施治，有什么神奇的呢？唉，这个病症在《金匮要略》等书中记载得非常明确，省会城市这么大，为什么懂医的人这么少呢？真是令人叹息。
杭州城水沟巷的孙太太，双脚从脚踝到足背全部肿胀，热痛剧烈，皮肤颜色光亮，到了晚上出现四肢厥冷（手足逆冷）。请我诊察，脉象沉而弦。我说，这叫香港脚入腹（痛风或湿脚气邪毒内攻），也是危重病症。如果邪气冲心就会死亡。让她将足上显现的络脉全部刺破出血，并针刺委中穴（膀胱经合穴，位于膝后腘窝横纹中点），随即给予鸡鸣散（治疗湿脚气的代表方剂），令其在五更鸡鸣时分服用。外用蚕矢汤熏洗。第二天晚上果然不再出现厥冷，但热痛仍然存在，于是改用槟榔、蚕沙、海桐皮、木瓜、片子姜黄、黄芩、滑石、薏苡仁等药物治疗而痊愈。
[Background Information]
Book: Yi De Ji (Collection of Insights) Chapter: Clinical Experience in Treating Zhuanbao Syndrome / Mrs. Sun's Hong Kong Foot Entering the Abdomen Category: Comprehensive
[English Translation]
A shop assistant at Tianhe Tobacco Shop near Wan'an Bridge in Hangzhou, aged nearly seventy. He was usually very robust and physically large. In the winter of the Wuzi year, he suffered from urinary retention (Lungbi), which persisted for over half a year. The condition worsened until complete obstruction occurred, with only drops difficult to pass. Qi often sank downward, causing severe abdominal distension and urgency, making him feel as if he were dying. Reluctantly, he went to a Western medicine clinic where urine was suctioned out using a tube, bringing him relief. This had to be done several times a day and became a routine. Later, he sought my consultation. The pulse at both Cun (inch) and Guan (middle) positions on both wrists was extremely deficient and large, while the Chi (cubit) positions were fine, choppy, and irregular. I said this syndrome is due to deficiency of Middle Jiao Qi and sinking of Clear Yang. Initially, it was merely similar to Lungbi. However, physicians used Shu Di Huang (Prepared Rehmannia Root), Rou Gui (Cinnamon Bark), and Fu Zi (Aconite Root) for blind warming and tonification, causing Clear Yang to sink further and blocking the lower orifices. This ultimately led to twisting of the bladder ligaments (Liao Li), resulting in misalignment between the lower outlet of the bladder and the urethra, thus making urination difficult. This disease is named Zhuanbao (a condition characterized by urinary retention due to twisting of the bladder ligaments). It is easy to treat. Why has no one recognized this disease after half a year? It is truly laughable. I prescribed Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi), heavily using Huang Qi (Astragalus Root) up to one liang, adding Mu Tong (Akebia Caulis) three qian, and Rou Gui (Cinnamon Bark) three fen. After two doses, urination slightly improved; after four doses, the illness disappeared. Subsequently, he continued taking the full formula of Buzhong Yiqi Tang without adding diuretic herbs. I also instructed him to eat several pieces of lightly cooked pig bladder daily, employing the principle of "tonifying the organ with its own kind" and mutual resonance to restore health. Previously disturbed by his illness for half a month, his appetite strengthened and his body became healthy afterward. He considered this miraculous, but in fact, it was simply treating according to symptoms. What is so miraculous about that? Alas, this syndrome is clearly recorded in books such as Jin Gui Yao Lue (Essential Prescriptions from the Golden Cabinet). The provincial capital is so large, yet why are knowledgeable physicians so scarce? It is truly sigh-worthy.
Mrs. Sun in Shuigou Alley, Hangzhou, had swelling from her ankles to her dorsum feet bilaterally, accompanied by severe heat and pain. Her skin was shiny. In the evening, she experienced limb coldness (Jue). Upon my examination, her pulse was deep and wiry. I said this is named Hong Kong Foot Entering the Abdomen (Gout or Damp-Heat Podagra attacking inward), which is also a critical condition. If the pathogen attacks the Heart, death will ensue. She pricked all visible collateral vessels on her feet to bleed them and also punctured Weizhong (BL40, located at the midpoint of the popliteal crease). Immediately thereafter, I prescribed Jiming San (Chicken-Crowing Powder) for administration at dawn when chickens crow. Externally, she used Can Shi Tang (Mulberry Leaf and Silkworm Dropping Decoction) for fumigation and washing. The following evening, she indeed did not experience cold limbs, but the heat and pain remained. Therefore, I used Bing Lang (Areca Seed), Can Sha (Silkworm Droppings), Hai Tong Pi (Sarcandraglabra Bark), Mu Gua (Chaenomeles Fruit), Pianzi Jianghuang (Curcuma Longa Rhizome), Huang Qin (Scutellaria Root), Hua Shi (Talcum), and Yi Ren (Coix Seed) to cure her.