《黃帝內經》的膀胱與胞涵意初探

Preliminary Study on the Meaning of Bladder and Bao in Huangdi Neijing

中醫泌尿生殖科一直是少為討論的主題，為了建立中醫泌尿生殖科的基礎架構，我們試圖依《黃帝內經》文本來理解古人對於泌尿系統的原始認知。我們選用明嘉靖二十九年顧從德影宋刻二十四卷本的《素問》，以及明趙府居敬堂本的《靈樞》為底本。將兩書中有關「膀胱」與「胞」的所有內文逐一摘出，針對二字詞在《內經》文本中的意義著手，以結構、生理、病理與診斷的角度，逐條來釐清《內經》對於「膀胱」及「胞」的認識。我們發現文本中不同於西醫儲尿功能的膀胱，中醫膀胱的功能主要為氣化作用，是將津液輸送並轉化為要排出體外的物質。而「胞」則有一字多義的意涵，分別為解剖膀胱（與儲尿有關）、生殖之胞、與心包絡。

Traditional Chinese Genitourinary medicine has always been a less discussed subject. In order to establish the Foundation of Traditional Chinese Genitourinary medicine, we tried to analyze ancient concepts about the genitourinary system based on the Yellow Emperor's Inner Cannon, which is a medical text from around 300 B.C. composed of ＂Plain Questions＂ and ＂the Magic Pivot＂. The Plain Questions version from the Song Dynasty written by Cong-De Gu and the version of the Magic Pivot from the Ming Dynasty written by Hou-Yu Zhu were chosen as our study materials. We examined all the paragraphs related to ＂bladder＂ and ＂Bao＂ in those two books, and explored its meaning in each paragraph from the perspective of body structure, physiology, pathophysiology and diagnosis. Our findings show that the meaning of ＂bladder＂ in the Yellow Emperor's Inner Cannon is different from the meaning and function in Western medicine. The function of ＂bladder＂ in the Yellow Emperor's Inner Cannon is mainly qi transformation, which means to transport and convert body fluids into substances to be excreted. The word ＂Bao＂ in the Inner Cannon has multiple meanings, such as bladder (which in Western medicine is related to urine storage), or an organ related to reproduction or has the meaning of pericardium.