论曰内经谓胞痹者,少腹膀胱,按之内痛,若沃以汤,涩于小便,上为清涕,夫膀胱为
州都之官,津液藏焉,气化则能出矣,今风寒湿邪气,客于胞中,则气闭不能化出,故胞满
而水道不通。其证少腹膀胱,按之内痛,若沃以汤,涩于小便,以足太阳经不得下流,故热
而痛也,上为清涕,以足太阳经。其直行者,从巅入络脑,脑气下灌,出于鼻窍,则为清涕
矣。
治胞痹小便不利。肾着汤方
赤茯苓(去黑皮) 白术(各四两) 干姜(炮二两) 甘草(炙三两)
上四味 咀,每服五钱匕,水二盏,煎至一盏,去滓温服,空心食前各一。
治胞痹小便不利,腰脊疼痛,腹背拘急,绞痛。温肾汤方
赤茯苓(去黑皮) 白术 泽泻 干姜(炮各四两)
上四味, 咀,每服四钱匕,水二盏,煎至一盏,去滓温服,空心食前各一。
治胞痹少腹内痛。茯苓丸方
赤茯苓(去黑皮) 防风(去叉) 细辛(去苗叶) 白术 附子(炮裂去皮脐) 桂
(去粗皮
黄(焙各一分)
草(炙三分) 半夏(汤洗
上一十八味,捣罗为末,炼蜜和丸,如梧桐子大,每日空心温酒下十丸,日再,未瘥稍
加丸数。
治胞痹脐腹痛,小水不利。巴戟丸方
巴戟天(去心一两半) 桑螵蛸(切破以麸炒令麸黑色为度一两) 远志(去心三分) 肉
苁
子(炮裂
各三分) 生干地黄(焙别于木臼内捣一两) 五味子 山茱萸 桂(去粗皮各三分)
上一十六味,除别捣二味外,捣罗为末,然后入别捣者相和,再罗,炼蜜和丸,如梧桐
子大,每日空腹用温酒下三十丸,日再。
治胞痹少腹膀胱,按之内痛。黄 汤方
黄 (锉) 当归(切焙) 甘草(炙) 黄芩(去黑心) 远志(去心) 五味子 芍
药人参
风(去叉各一
上一十五味粗捣筛,每服五钱匕,水二盏,入羊肾一只细切,大枣二枚劈破,同煎至一
盏,去滓空心温服,日再。
治胞痹小便不利。人参汤方
人参 芍药 麦门冬(去心焙) 生干地黄(酒浸去土焙) 当归(切焙) 甘草(炙)
芎
粗皮三两)
上一十三味,粗捣筛,每服五钱匕,先用水二盏,煮羊肾一只,至一盏半,除肾下药末,
大枣三枚劈破,同煎至一盏,去滓空心温服,日三。
治胞痹少腹急痛,小便赤涩。肾沥汤方
桑螵蛸(一十枚切破炙令黄色) 犀角(屑) 麦门冬(去心焙) 五加皮(各一两半
锉) 杜仲(去粗皮涂酥炙锉) 木通(锉) 桔梗(锉炒各一两) 赤芍药(三分)
上八味,粗捣筛,每服五钱匕,水一盏半,入羊肾一只,去脂膜切,竹沥少许,同煎至
一盏,去滓空腹顿服,日再。
治胞痹秦艽酒方
秦艽(去苗土) 牛膝(酒浸切焙) 芎 防风(去叉) 桂(去粗皮) 独活(去
芦头) 丹
斛(去根) 干姜
两) 天麻子仁(一合炒)
上一十七味,细锉如麻豆,以生绢夹囊盛之,用酒一斗,浸七日,每日空腹温服半盏,
日再。
治胞痹,补益。百合饮方
生百合(三两) 赤茯苓(去黑皮二两) 麋角(屑三两) 麦门冬(去心焙) 肉苁
蓉(酒浸
上七味,细锉如麻豆,每服五钱匕,用水一盏半,煎至八分,去滓温服,空心日再。
论述说:《内经》提到胞痹,是指少腹膀胱部位,按压时内部疼痛,感觉像被热水浇灌一样,小便涩滞不畅,上部表现为清稀鼻涕。膀胱是州都之官,津液藏于其中,经过气化作用才能排出。如今风寒湿邪气侵入胞中,导致气机闭塞不能气化排出,所以胞部胀满而水道不通。其症状为少腹膀胱部位,按压时内部疼痛,感觉像被热水浇灌,小便涩滞,这是因为足太阳经之气不得下行,所以产生热痛;上部出现清涕,是因为足太阳经的直行分支,从头顶进入联络脑部,脑气向下灌注,出于鼻窍,就形成了清涕。
治疗胞痹引起的小便不利。肾着汤方
赤茯苓(去除黑皮) 白术(各四两) 干姜(炮制二两) 甘草(炙制三两)
以上四味药,切碎,每次服用五钱匕,加水二盏,煎煮至一盏,去渣温服,空腹及饭前各一次。
治疗胞痹引起的小便不利,腰脊疼痛,腹部和背部拘急挛缩,绞痛。温肾汤方
赤茯苓(去除黑皮) 白术 泽泻 干姜(炮制各四两)
以上四味药,切碎,每次服用四钱匕,加水二盏,煎煮至一盏,去渣温服,空腹及饭前各一次。
治疗胞痹引起的少腹内部疼痛。茯苓丸方
赤茯苓(去除黑皮) 防风(去除叉枝) 细辛(去除苗叶) 白术 附子(炮裂后去皮脐) 桂(去除粗皮) 黄(焙制各一分) 草(炙制三分) 半夏(汤洗... [原文此处有缺漏]
以上十八味药,捣碎过筛成粉末,用炼蜜调和做成丸药,如梧桐子大小,每天空腹用温酒送服十丸,每日两次,若未痊愈可稍增加丸数。
治疗胞痹引起的脐腹疼痛,小便不利。巴戟丸方
巴戟天(去除心一两半) 桑螵蛸(切开破开,用麸皮炒至麸皮呈黑色为一两) 远志(去除心三分) 肉苁蓉(炮裂... [原文此处有缺漏] 各三分) 生干地黄(焙干后在木臼内单独捣碎一两) 五味子 山茱萸 桂(去除粗皮各三分)
以上十六味药,除另外捣碎的两味药外,其余捣碎过筛成粉末,然后加入另外捣碎的药混合,再次过筛,用炼蜜调和做成丸药,如梧桐子大小,每天空腹用温酒送服三十丸,每日两次。
治疗胞痹引起的少腹膀胱部位,按压时内部疼痛。黄耆汤方 [注:原文“黄 汤”推测为黄芪汤或类似方剂,依字面译]
黄耆(锉碎) 当归(切后焙干) 甘草(炙制) 黄芩(去除黑心) 远志(去除心) 五味子 芍药 人参 防风(去除叉枝各一... [原文此处有缺漏]
以上十五味药粗捣筛,每次服用五钱匕,加水二盏,放入一只羊肾细切,大枣二枚劈破,同煎至一盏,去渣空腹温服,每日两次。
治疗胞痹引起的小便不利。人参汤方
人参 芍药 麦门冬(去除心焙干) 生干地黄(酒浸去土焙干) 当归(切后焙干) 甘草(炙制) 川芎(去除粗皮三两)
以上十三味药,粗捣筛,每次服用五钱匕,先用水二盏,煮一只羊肾,至一盏半,除去肾后下药末,大枣三枚劈破,同煎至一盏,去渣空腹温服,每日三次。
治疗胞痹引起的少腹急痛,小便赤色涩滞。肾沥汤方
桑螵蛸(十枚切开破开,炙烤至黄色) 犀角(屑状) 麦门冬(去除心焙干) 五加皮(各一两半锉碎) 杜仲(去除粗皮涂酥炙烤锉碎) 木通(锉碎) 桔梗(锉碎炒制各一两) 赤芍药(三分)
以上八味药,粗捣筛,每次服用五钱匕,加水一盏半,放入一只羊肾,去除脂膜切好,少许竹沥,同煎至一盏,去渣空腹顿服,每日两次。
治疗胞痹秦艽酒方
秦艽(去除苗土) 牛膝(酒浸切后焙干) 川芎 防风(去除叉枝) 桂(去除粗皮) 独活(去除芦头) 丹参 石斛(去除根) 干姜 ... [原文此处有缺漏] 两) 天麻子仁(一合炒制)
以上十七味药,细锉如麻豆大小,用生绢夹囊盛装,用酒一斗,浸泡七日,每天空腹温服半盏,每日两次。
治疗胞痹,具有补益作用。百合饮方
生百合(三两) 赤茯苓(去除黑皮二两) 麋角(屑状三两) 麦门冬(去除心焙干) 肉苁蓉(酒浸... [原文此处有缺漏]
以上七味药,细锉如麻豆大小,每次服用五钱匕,用水一盏半,煎煮至八分,去渣温服,空腹每日两次。
Discussion: The *Neijing* states that "Bao Bi" (Bladder Bi Syndrome) involves pain in the lower abdomen and bladder region upon palpation, a sensation as if scalded by hot water, difficulty and obstruction in urination, and clear nasal discharge above. The Bladder is the official of the "State Capital," where body fluids are stored; it can excrete them only through Qi transformation. Currently, pathogenic factors of Wind-Cold-Dampness invade the Bao (Bladder/Uterus), causing Qi blockage and failure of transformation and excretion, resulting in fullness of the Bao and obstruction of the water passages. The manifestations include pain in the lower abdomen and bladder upon palpation, a sensation as if scalded by hot water, and obstructed urination, because the Qi of the Foot-Taiyang Meridian cannot flow downward, generating heat and pain. The upper manifestation of clear nasal discharge occurs because the main branch of the Foot-Taiyang Meridian enters from the vertex to connect with the Brain; Brain Qi descends and pours out through the nasal orifices, forming clear nasal discharge.
Treatment for Bao Bi with difficult urination. Shen Zhuo Tang (Kidney-Attaching Decoction)
* Chi Fuling (Red Poria, removed black skin): 4 liang
* Baizhu (Atractylodis Macrocephalae Rhizoma): 4 liang
* Ganjiang (Dried Ginger, processed): 2 liang
* Gancao (Licorice Root, honey-fried): 3 liang
Crush the above four ingredients. Take 5 qianbi per dose, add 2 zhan of water, decoct until 1 zhan remains, remove dregs, and take warm. Administer on an empty stomach and before meals.
Treatment for Bao Bi with difficult urination, lumbar and spinal pain, abdominal and back stiffness/tension, and colic. Wen Shen Tang (Warming Kidney Decoction)
* Chi Fuling (Red Poria, removed black skin): 4 liang
* Baizhu (Atractylodis Macrocephalae Rhizoma): 4 liang
* Zexie (Alisma Rhizoma): 4 liang
* Ganjiang (Dried Ginger, processed): 4 liang
Crush the above four ingredients. Take 4 qianbi per dose, add 2 zhan of water, decoct until 1 zhan remains, remove dregs, and take warm. Administer on an empty stomach and before meals.
Treatment for Bao Bi with internal pain in the lower abdomen. Fuling Wan (Poria Pill)
* Chi Fuling (Red Poria, removed black skin)
* Fangfeng (Saposhnikoviae Radix, removed forked branches)
* Xixin (Asari Radix et Rhizoma, removed seedlings and leaves)
* Baizhu (Atractylodis Macrocephalae Rhizoma)
* Fuzi (Aconiti Lateralis Radix Praeparata, cracked, removed skin and umbilicus)
* Gui (Cinnamomi Ramulus, removed rough bark)
* Huangqi (Astragali Radix, baked): 1 fen
* Gancao (Licorice Root, honey-fried): 3 fen
* Banxia (Pinelliae Rhizoma, washed with boiling water)... [Text incomplete]
Grind the above eighteen ingredients into powder, mix with refined honey to form pills the size of Sophora seeds. Take 10 pills with warm wine on an empty stomach daily, twice a day. If not cured, slightly increase the number of pills.
Treatment for Bao Bi with umbilical and abdominal pain, and difficult urination. Bajie Wan (Morinda Pill)
* Bajitian (Morindae Officinalis Radix, removed heart): 1.5 liang
* Sangpiaoxiao (Mantis Ootheca, cut open, fried with bran until bran is black): 1 liang
* Yuanzhi (Polygalae Radix, removed heart): 3 fen
* Roushouyu (Cistanche Deserticola, processed)... [Text incomplete]: 3 fen
* Sheng Gan Dihuang (Fresh Rehmanniae Radix, dried, baked, pounded separately in a wooden mortar): 1 liang
* Wuweizi (Schisandrae Fructus)
* Shanzhuyu (Corni Fructus)
* Gui (Cinnamomi Ramulus, removed rough bark): 3 fen
Take the above sixteen ingredients. Except for two ingredients pounded separately, grind the rest into powder, then mix with the separately pounded ingredients, sieve again, and mix with refined honey to form pills the size of Sophora seeds. Take 30 pills with warm wine on an empty stomach daily, twice a day.
Treatment for Bao Bi with pain in the lower abdomen and bladder upon palpation. Huangqi Tang (Astragalus Decoction) [Note: Text implies Huangqi based on context, though character is missing]
* Huangqi (Astragali Radix, sliced)
* Danggui (Angelicae Sinensis Radix, sliced and baked)
* Gancao (Licorice Root, honey-fried)
* Huangqin (Scutellariae Radix, removed black center)
* Yuanzhi (Polygalae Radix, removed heart)
* Wuweizi (Schisandrae Fructus)
* Shaoyao (Paeoniae Radix Alba/Rubra)
* Renshen (Ginseng Radix)
* Fangfeng (Saposhnikoviae Radix, removed forked branches): 1 [unit missing]
Coarsely crush and sieve the above fifteen ingredients. Take 5 qianbi per dose, add 2 zhan of water, one sheep kidney finely cut, and two dates split open. Decoct together until 1 zhan remains, remove dregs, and take warm on an empty stomach, twice a day.
Treatment for Bao Bi with difficult urination. Renshen Tang (Ginseng Decoction)
* Renshen (Ginseng Radix)
* Shaoyao (Paeoniae Radix Alba/Rubra)
* Maimendong (Ophiopogonis Radix, removed heart and baked)
* Sheng Gan Dihuang (Fresh Rehmanniae Radix, dried, soaked in wine, removed soil, baked)
* Danggui (Angelicae Sinensis Radix, sliced and baked)
* Gancao (Licorice Root, honey-fried)
* Xiong (Chuanxiong Rhizoma, removed rough bark): 3 liang
Coarsely crush and sieve the above thirteen ingredients. Take 5 qianbi per dose. First, boil one sheep kidney in 2 zhan of water until 1.5 zhan remains. Remove the kidney, add the powdered herbs and three split dates. Decoct together until 1 zhan remains, remove dregs, and take warm on an empty stomach, three times a day.
Treatment for Bao Bi with acute pain in the lower abdomen and red, obstructed urination. Shen Li Tang (Kidney Drip Decoction)
* Sangpiaoxiao (Mantis Ootheca, ten pieces, cut open, roasted until yellow)
* Xijiao (Rhinocerotis Cornu, shaved): 1.5 liang
* Maimendong (Ophiopogonis Radix, removed heart and baked): 1.5 liang
* Wujia Pi (Acanthopanacis Cortex, sliced): 1.5 liang
* Duzhong (Eucommiae Cortex, removed rough bark, coated with butter, roasted, sliced)
* Mutong (Akebiae Caulis, sliced)
* Jiegeng (Platycodonis Radix, sliced and roasted): 1 liang
* Chishao Yao (Paeoniae Radix Rubra): 3 fen
Coarsely crush and sieve the above eight ingredients. Take 5 qianbi per dose, add 1.5 zhan of water, one sheep kidney (removed fat membrane and cut), and a little bamboo sap. Decoct together until 1 zhan remains, remove dregs, and take all at once on an empty stomach, twice a day.
Treatment for Bao Bi. Qinjiao Wine (Gentian Wine)
* Qinjiao (Gentianae Macrophyllae Radix, removed seedlings and soil)
* Niuxi (Achyranthis Bidentatae Radix, soaked in wine, sliced, and baked)
* Xiong (Chuanxiong Rhizoma)
* Fangfeng (Saposhnikoviae Radix, removed forked branches)
* Gui (Cinnamomi Ramulus, removed rough bark)
* Du Huo (Angelicae Pubescentis Radix, removed rhizome head)
* Danshen (Salviae Miltiorrhizae Radix et Rhizoma)
* Shihu (Dendrobii Caulis, removed roots)
* Ganjiang (Dried Ginger)... [Text incomplete]
* Tianma Zi Ren (Gastrodiae Rhizoma Kernel, roasted): 1 he
Finely slice the above seventeen ingredients like hemp seeds. Place in a raw silk bag, soak in 1 dou of wine for seven days. Take half zhan warm on an empty stomach daily, twice a day.
Treatment for Bao Bi, for tonification. Baihe Yin (Lily Drink)
* Sheng Baihe (Lilii Bulbus): 3 liang
* Chi Fuling (Red Poria, removed black skin): 2 liang
* Mi Jiao (Elaphoceri Cornu, shaved): 3 liang
* Maimendong (Ophiopogonis Radix, removed heart and baked)
* Roushouyu (Cistanche Deserticola, soaked in wine)... [Text incomplete]
Finely slice the above seven ingredients like hemp seeds. Take 5 qianbi per dose, add 1.5 zhan of water, decoct until 8/10 remains, remove dregs, and take warm on an empty stomach, twice a day.