杨仁斋曰∶有胞系转戾不通,不可不辨。
胞转证候,脐下急痛,小便不通。凡强忍小便,或尿急疾走,或饱食忍尿,或忍尿入房,使水气上逆,气
逼于胞,故屈戾而不得舒张也,胞落即殂。
王海藏曰∶转胞小便,非小肠、膀胱、厥阴受病。盖因强忍房事,或过忍小便,以致此疾。非利药所能利,
法当治其气则愈,以沉香木香汤主之。
朱丹溪曰∶有妇妊孕九月,转胞小便不出,下急,脚肿,不堪活。诊脉右涩,左稍和,此饱食气伤,胎系
弱,不能自举而下坠,压着膀胱,偏在一边,气急为其所闭,故水窍不能出。转胞之病,大率如此。方用参、术、
陈皮、炙草、归、芍、半夏、生姜,补血养血,气血既旺,胎系自举,则不下坠,方有安之理。顿饮之,控喉
令吐药,如是四服,小便通,下皆黑水。再服腹皮、枳壳、砂仁、青葱二十剂,以防产而安。
朱丹溪曰∶转胞病,胎妇禀受弱者,忧闷多者,性躁急者,食浓味者,大率有之。古方皆用滑利疏导药,
鲜有效。因思胞为胎所压,展在一边,胞系了戾不通耳。胎若举起,悬在中央,胞系得疏,水道自行。然胎之
坠下,必有其由也。
徐春甫曰∶转胞病,由脬为热所迫,或忍小便,俱令水气迫于胞,屈辟不得充畅。外水应入不得入,内溲
应出不得出,内外壅滞,胀满不通,故为转脬。其状小腹急痛,不得小便,甚者致死。
Yang Renzhai stated: There are cases where the vesical ligament twists and becomes obstructed, which must not be overlooked.
The syndrome manifestations of *Zhuanbao* (bladder displacement/obstruction) include urgent pain below the umbilicus and inability to urinate. This occurs when one forcibly retains urine, or runs rapidly while the urge to urinate is strong, or retains urine after a full meal, or engages in sexual intercourse while retaining urine. These actions cause water qi to reverse upward, and the qi forces upon the bladder, causing it to twist and preventing it from expanding normally. If the bladder collapses, death ensues.
Wang Haizang stated: The urinary obstruction caused by *Zhuanbao* is not due to disease in the Small Intestine, Bladder, or Jueyin meridians. It is generally caused by forcibly enduring sexual activity or excessively retaining urine. This condition cannot be treated with simple diuretic drugs; the method should focus on regulating qi for recovery, primarily using Chenxiang Muxiang Tang (Agarwood and Costus Root Decoction).
Zhu Danxi stated: In a woman pregnant for nine months, *Zhuanbao* may occur with urinary retention, lower abdominal urgency, and leg swelling, making life unbearable. The pulse was rough on the right side and slightly harmonious on the left. This indicates that overeating damaged the qi, the fetal ligaments were weak, and unable to support the fetus, causing it to descend and press against the bladder. The bladder was pushed to one side, and the urgent qi was blocked by this pressure, so the urinary orifice could not release urine. This is generally how *Zhuanbao* presents. The prescription used Ginseng, Atractylodes Macrocephala, Tangerine Peel, Honey-fried Licorice, Angelica Sinensis, White Peony Root, Pinellia, and Fresh Ginger to nourish blood and qi. Once blood and qi are abundant, the fetal ligaments naturally lift the fetus, preventing descent, thus providing a rationale for stabilizing the pregnancy. The patient drank it all at once, even inducing vomiting to expel the medicine. After four doses, urination became unobstructed, and dark fluid was discharged. Subsequently, twenty doses containing Big Fruit Skin (Ampelopsis Radix), Bitter Orange, Amomum, and Green Onion were administered to prevent premature labor and stabilize the pregnancy.
Zhu Danxi stated: *Zhuanbao* is common among pregnant women with weak constitutions, those who are prone to worry and depression, those with irritable temperaments, and those who consume rich and heavy flavors. Ancient formulas relied on slippery and draining herbs, but rarely achieved efficacy. I reasoned that the bladder is compressed by the fetus, shifting to one side, causing the vesical ligament to twist and become obstructed. If the fetus is lifted and suspended centrally, the vesical ligament will relax, and the water pathway will function naturally. However, the descent of the fetus must have a specific cause.
Xu Chunfu stated: *Zhuanbao* arises because the bladder is forced by heat, or due to retained urine, both of which cause water qi to press upon the bladder, making it twist and deviate, preventing it from filling and flowing smoothly. External fluids cannot enter as they should, and internal urine cannot exit as it should. Internal and external stagnation leads to distension and obstruction, hence the term *Zhuanpao* (transposed bladder). The symptoms include urgent pain in the lower abdomen and inability to urinate; severe cases can lead to death.