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[小说文学]短篇小说集：坐窗观风景[第242页] |
| 作者:San若梦 |
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@San若梦 2017-09-03 06:45:46 Another preparation of even higher potency is Squibb's Delestrec, which at this writing is not yet on the market in the United States, but is well known in Germany and other European countries under the name of Progynon Depot (Schering). It is chemically Estradiol Undecylate in oil, likewise slowly absorbing, and containing 100 mg. to 1 cc. Injections of 1 cc. once or twice a month can be sufficient. Occasionally, however, larger doses are required to influence the patient's emotional distress. ----------------------------- 另一种更高效的制剂是Squibb's Delestrec，此书写作时在美国还未上市，但以Progynon Depot (Schering)的名称在德国及别的欧洲国家广为人知。它的化学名叫雌二醇十一烷酸，溶于油中，同样的吸收缓慢，含量为每毫升100毫克。每月注射一至两次，每次一毫升就足够。但偶尔，需要更大的剂量来影响病人精神上的困扰。 |
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These estrogenic preparations are solutions in oil. There are also suspensions of tiny estrogenic crystals in water (aqueous) available for intramuscular injections. They are of much lesser potency and would have to be given more frequently (twice weekly or more) over many months to produce sufficiently feminizing results. |
| In general, injections, as compared to oral medications, are justified for more easily measurable dosage, and usually prompter effects, but also for the fact that some psychological guidance or even brief psychotherapy can take place during the patient's visits, not to speak of the important physical checkups. Self-medication by patients is definitely to be discouraged. |
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@San若梦 2017-09-03 09:52:11 In general, injections, as compared to oral medications, are justified for more easily measurable dosage, and usually prompter effects, but also for the fact that some psychological guidance or even brief psychotherapy can take place during the patient's visits, not to speak of the important physical checkups. Self-medication by patients is definitely to be discouraged. ----------------------------- 一般来说，相较于口服药，针剂注射更合适，因为用量更容易测量，见效更快，而且病人为打针造访医生时还能获得心理指导，或者甚至短暂的心理分析，更不用说重要的体检。由病人自己用药绝对不应该鼓励。 |
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Oral use Of the oral preparations, there is a considerable choice. They can be employed together with injections or in their stead. |
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@San若梦 2017-09-03 10:36:19 Oral use Of the oral preparations, there is a considerable choice. They can be employed together with injections or in their stead. ----------------------------- 口服药 口服制剂也有相当多的选择，可以与针剂配合使用，也可代替针剂。 |
| Diethyl Stilbestrol is the cheapest, but has the most frequent side effects in the form of nausea and gastrointestinal upsets. Better borne and rarely causing nausea is ethinyl estradiol in the form of Schering's Estinyl. The largest dose of 0.5 mg. daily or three times a week is usually necessary to accomplish positive results. Occasionally a patient may not tolerate Estinyl and then Premarin (Ayerst) or Amnestrogen (Squibb) in doses of at least 5 mg. daily could be employed. These are excellent preparations of so-called natural female hormones, of somewhat lesser potency but often useful and sufficient, especially in patients operated upon and castrated, to prevent castration symptoms, and to further their feminization. |
| Potency and dosage of the estrogen preparation is not always the deciding factor in this type of hormone therapy. Many patients have the unfortunate tendency to believe that the more estrogen they take the more they will accomplish. They may actually do the opposite. Doses that are too large for a particular patient may not only constitute certain hazards for the liver but, by suppressing the pituitary gland function with its growth hormone, may actually accomplish less, for instance, in breast development. Smaller doses may do more; the regularity and length of treatment has appeared to me more important than the dose. The optimal dose will have to be determined for each patient individually. |
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@San若梦 2017-09-03 12:52:09 Potency and dosage of the estrogen preparation is not always the deciding factor in this type of hormone therapy. Many patients have the unfortunate tendency to believe that the more estrogen they take the more they will accomplish. They may actually do the opposite. Doses that are too large for a particular patient may not only constitute certain hazards for the liver but, by suppressing the pituitary gland function with its growth hormone, may actually accomplish less, for instance, in breast development. Smaller doses may do more; the regularity and length of treatment has appeared to me more important than the dose. The optimal dose will have to be determined for each patient individually. ----------------------------- 雌性激素的效力及用量在这类激素治疗中并不总是决定性因素。许多病人有种很不幸的倾向，相信服用的雌性激素越多，他们取得的效果越大。但实际可能正好相反。对某个特定病人而言，太大的剂量不仅可能对肝脏造成一定的危害，而且因激素剂量加大抑制了垂体功能，实际可能取得更小的效果，比如在乳房发育上。小剂量可能取得的效果更大；规律性及治疗时间长度在我看来比剂量更重要。最佳剂量将基于每个病人个体的情况决定。 |
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The latest female hormone preparation that has been used in cases of transsexualism is Enovid (Searle), the well-known birth control pill, containing both estrogen and progesterone. Promising results have been observed, but more extensive observations by a number of different clinicians is advisable. Enovid in doses of 10 to 20 mg. daily has served me well in the endocrine management, particularly of those transsexual males who were underweight. An increase in appetite and weight was almost regularly observed. The repressing influence on libido and sex functions seemed to me less pronounced than that of estrogen alone. Therefore combinations of Enovid with Estinyl or Premarin occasionally gave the best results. |
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@San若梦 2017-09-03 13:16:05 The latest female hormone preparation that has been used in cases of transsexualism is Enovid (Searle), the well-known birth control pill, containing both estrogen and progesterone. Promising results have been observed, but more extensive observations by a number of different clinicians is advisable. Enovid in doses of 10 to 20 mg. daily has served me well in the endocrine management, particularly of those transsexual males who were underweight. An increase in appetite and weight was almost regularly observed. The repressing influence on libido and sex functions seemed to me less pronounced than that of estrogen alone. Therefore combinations of Enovid with Estinyl or Premarin occasionally gave the best results. ----------------------------- 最新的一种用于变性欲的雌性激素制剂是Enovid (Searle)，一种广为人知的避孕药，含雌激素和黄体酮。这种药很有前景的结果已被观察到，但由多名不同的临床医生进行更为全面的观察是有必要的。我为病人的内分泌控制开出的每天10至20毫克的剂量效果很好，尤其对那些体重过轻的变性欲男性而言，他们的食欲和体重上升几乎能有规律地观察到。对性欲及性功能的抑制作用在我看来不如雌激素，所以Enovid 与 Estinyl 或 Premarin 的组合偶尔能达到最好的效果。 |
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Female hormone —— 雌性荷尔蒙，雌性激素，包含很多种不同激素的总称。 Estrogen —— 雌激素，人体雌性激素里含量最高的一种，因此经常与雌性激素混用。 前面的译文里我几乎全部给翻成了【雌性激素】，以后修订时会改过来。现在起一律翻成【雌激素】。 |
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Finally, in addition to the parenteral and oral routes of administering estrogen, the topical (local) use must be mentioned. A cream that can be easily absorbed and that contains a sufficient dose of estrogen and progesterone can aid the development of breast tissue. Goldzieher [6] and others proved conclusively that estrogen is absorbable through the skin and can aid the mammary development of hypogonadal young girls. The same is true in transsexual men although only as contributing treatment. |
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@San若梦 2017-09-04 01:34:42 Finally, in addition to the parenteral and oral routes of administering estrogen, the topical (local) use must be mentioned. A cream that can be easily absorbed and that contains a sufficient dose of estrogen and progesterone can aid the development of breast tissue. Goldzieher [6] and others proved conclusively that estrogen is absorbable through the skin and can aid the mammary development of hypogonadal young girls. The same is true in transsexual men although only as contributing treatment. ----------------------------- 最后，在肠胃外注射及口服这两种雌激素的服用方式之外，还有一种局部的（区域性的）的用法必须提及。有一种很容易被吸收、含足量雌激素及黄体酮的药膏，对乳房发育很有帮助。Goldzieher 及别的一些人已经结论性地证明了，雌激素能通过皮肤被吸收，因此对性腺机能减退的年轻女孩的乳腺发育有帮助。它对变性欲男性也同样有效，虽然仅只是辅助性治疗。 |
| A twenty-six-year-old male transsexual had used rather liberally a commercially available hormone cream on his breasts without any other treatment. There was only a modest response (if any) of the breast tissue, but when this patient came under my observation and a hormone assay was made of a twenty-four-hour urine specimen, the 17-ketosteroids were found to be normal but the estrogen contents very high (110), when the normal is considered to be from 0 to 30. |
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@San若梦 2017-09-04 02:00:06 A twenty-six-year-old male transsexual had used rather liberally a commercially available hormone cream on his breasts without any other treatment. There was only a modest response (if any) of the breast tissue, but when this patient came under my observation and a hormone assay was made of a twenty-four-hour urine specimen, the 17-ketosteroids were found to be normal but the estrogen contents very high (110), when the normal is considered to be from 0 to 30. ----------------------------- 一位二十六岁的男性变性欲，相当随意地用了一种市面上就能找到的激素药膏，没有接受任何别的治疗，他只是把药膏涂在乳房上。当这位病人来接受我的诊治时，他的乳房组织只有很微弱（假如真有的话）的反应，但对他的二十四小时尿液样品做激素测验发现，17-酮类固醇很正常，但雌激素含量超高（110），正常值在0至30。 |
| Some years ago, workers in a chemical factory that produced estrogenic preparations complained of developing gynecomastia, impotence, and other feminization symptoms. They had constantly, over a considerable period of time, handled this estrogenic material without protection for their hands. The steady hormone absorption, through the skin, although in minimal doses, was found to be the cause. Such factory or laboratory work is now continued with glove protection of the exposed parts of the hands. |
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@San若梦 2017-09-04 05:03:58 Some years ago, workers in a chemical factory that produced estrogenic preparations complained of developing gynecomastia, impotence, and other feminization symptoms. They had constantly, over a considerable period of time, handled this estrogenic material without protection for their hands. The steady hormone absorption, through the skin, although in minimal doses, was found to be the cause. Such factory or laboratory work is now continued with glove protection of the exposed parts of the hands. ----------------------------- 几年前有个生产雌激素制剂的化工厂的工人们，抱怨说有男性乳房发育症、性无能、以及另外一些女性化症状。他们在一个相当长的时间段里，经常地用未加任何保护的手去处理这种雌激素物质，这种持续的透过皮肤对激素的吸收——虽然是最小量的——被发现是祸因。这类工厂或实验室的工作现在仍在继续，只需戴手套保护好裸露部位。 |
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In presenting the above experiences, it is my wish merely to give the doctor some general lines of a possible therapeutic approach to this largely untrodden field of medicine. A better system of treatment may well be evolved, larger or smaller doses of estrogen may be found advisable, and more suitable combinations. It is my own conviction that "much does not help much" and that the general tendency should be to use the smallest possible doses that give sufficiently satisfactory results for a particular patient. |
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@San若梦 2017-09-04 05:18:46 In presenting the above experiences, it is my wish merely to give the doctor some general lines of a possible therapeutic approach to this largely untrodden field of medicine. A better system of treatment may well be evolved, larger or smaller doses of estrogen may be found advisable, and more suitable combinations. It is my own conviction that "much does not help much" and that the general tendency should be to use the smallest possible doses that give sufficiently satisfactory results for a particular patient. ----------------------------- 通过展示上述的经验，我的愿望只是在这个医学界尚未开发的领域里，给医生们提供一个一般性的、可能的治疗方向的标线。一个更好的治疗体系很可能会发展出来，雌激素的用量该更大还是更小，还有更加合适的组合等等，都能有更加合理的方式。我本人的信条是“多并不一定就好”，普适的倾向应该是针对某个特定的病人，尽可能用最小的量来达到令人足够满意的结果。 |
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Finally, and to conclude the discussion of the nonsurgical therapy for transsexuals, it may be most interesting in future years to watch these patients who have received estrogen over a long period of time. Will they be less prone to develop coronary heart disease and other circulatory ailments that go with the process of aging? A well- known cardiologist, noted for his research in cholesterol metabolism, who had occasion to see a number of transsexuals under estrogen therapy, remarked jokingly, "These people will probably live forever." |
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@San若梦 2017-09-04 06:29:15 Finally, and to conclude the discussion of the nonsurgical therapy for transsexuals, it may be most interesting in future years to watch these patients who have received estrogen over a long period of time. Will they be less prone to develop coronary heart disease and other circulatory ailments that go with the process of aging? A well- known cardiologist, noted for his research in cholesterol metabolism, who had occasion to see a number of transsexuals under estrogen therapy, remarked jokingly, "These people will probably live forever." ----------------------------- 最后，也是对变性欲的非手术治疗的讨论做个小结，将来的若干年中更引人关注的事，可能是观察这些长期接受雌激素的病人。他们在变老的过程中，会更不容易得冠心病及别的循环性疾病吗？一位因在胆固醇新成代谢方面的研究而闻名的心脏病专家，偶尔也看过几位接受雌激素治疗的变性欲病人，开玩笑地说道，“这些人可能会长命百岁。” |
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Another question may be asked and possibly receive an answer in years to come. Will "chemical castration" with estrogen act similarly to surgical castration? Will estrogen-treated or operated transsexuals become bald as rarely as eunuchs do and less often than the average man? The sexologist as well as the endocrinologist of the future will undoubtedly find fascinating new avenues of study in the management of transsexualism. |
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@San若梦 2017-09-04 01:32:53 Female hormone —— 雌性荷尔蒙，雌性激素，包含很多种不同激素的总称。 Estrogen —— 雌激素，人体雌性激素里含量最高的一种，因此经常与雌性激素混用。 前面的译文里我几乎全部给翻成了【雌性激素】，以后修订时会改过来。现在起一律翻成【雌激素】。 ----------------------------- @周一沉 2017-09-04 07:01:36 嗯涨姿势了，谢楼主 ----------------------------- 一沉劳动节愉快！ 我也是一边译一边学，知识见识都大涨～～：） |
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@San若梦 2017-09-04 07:13:56 Another question may be asked and possibly receive an answer in years to come. Will "chemical castration" with estrogen act similarly to surgical castration? Will estrogen-treated or operated transsexuals become bald as rarely as eunuchs do and less often than the average man? The sexologist as well as the endocrinologist of the future will undoubtedly find fascinating new avenues of study in the management of transsexualism. ----------------------------- 另外一个可能也有人会问的问题，在未来几年也许就能有答案。雌激素的“化学阉割”将来能够达到与手术阉割相似的效果吗？（…………?）将来的性学家以及内分泌学家毫无疑问在变性欲管理方面会找到新的、引人入胜的研究方向。 |
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第六章完 |
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Convertion Operation ? Part I. Technique of the operation ? Part II. Nature of the operation ? Contraindications ? Four Motives for the Conversion Operation ? Procuring the Operation |
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@San若梦 2017-09-04 07:32:45 Convertion Operation ? Part I. Technique of the operation ? Part II. Nature of the operation ? Contraindications ? Four Motives for the Conversion Operation ? Procuring the Operation ----------------------------- 变性手术 ·第一部份. 手术的技术问题 ·第二部份. 手术的本质问题 ·禁忌问题 ·变性手术的四种动机 ·手术的完成 |
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Part I. Technique of the operation In the majority of cases the operation consists of three principal steps: (1) Castration; (2) penis amputation; (3) plastic surgery to create an artificial vagina and external genitalia, which should resemble those of a female. |
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1. Castration. The technique is well known to every urologist. The question faced by some surgeons is, however, whether to remove the testicles or preserve them, yet make them invisible. A surgeon who prefers the preservation described his technique as follows: |
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@San若梦 2017-09-04 07:49:58 1. Castration. The technique is well known to every urologist. The question faced by some surgeons is, however, whether to remove the testicles or preserve them, yet make them invisible. A surgeon who prefers the preservation described his technique as follows: ----------------------------- 1. 阉割术。这个技术为每位泌尿科医生所知。但有些外科医生所面临的一个问题是，睾丸是该去除呢，还是保留下来但让它看不见。一位倾向于保留的医生这样描述他的技术： |
| The patient has first one and then the other inguinal ring opened. The testicle is isolated from the scrotal sac and is pressed upward through the inguinal ring into the abdomen. The inguinal canal is then closed as in a hernia operation. The testicle now lies like an undescended one outside the perineum, but inside the abdominal cavity. It is hidden from sight and touch. It loses its procreative, but retains its glandular function. |
| The reason why some surgeons may wish to retain the testes is chiefly endocrine, based on the theory that the testes in transsexual men may produce more estrogen than they do normally. The findings reported in Chapter 5 strengthen this view, although they have as yet found no confirmation.[1] In any event, this reasoning supports the patient's intended feminization. |
| Another reason for a surgeon's wish to preserve the testes is because of a legal technicality. He cannot be accused of a (possibly illegal) castration operation. |
| In most conversion operations, I believe, the testes are discarded, that is to say, the patient is castrated. The consensus would probably be in favor of this procedure. |
| While most transsexuals themselves prefer to be castrated in order to remove more of their masculinity, an occasional patient wants to see the testicles retained with the strange, completely unfounded idea that they are necessary for a future climax during sex relations. It is astonishing how often the wrong information, superstition, and gossip circulate among transsexuals when they are those who should want correct information more than anyone else. |
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2. The removal of the penis is called penectomy or penotomy. The principal technical difficulty is the preservation of a functionally normal though greatly shortened urethra. I have seen poor results in this respect, the urethra requiring constantly repeated dilatations, or even corrective surgery. Unskilled surgeons have also left a penile stump, which resulted in later complications. |
| 3. The plastic surgery is a challenge to the urologist, the gynecologist, and the plastic surgeon. It can be divided into two parts: the creation of female-looking external genitalia and of a functionally useful vagina. |
| Scrotal tissue is used to fashion the labia majora and, in the hands of a skillful surgeon, the appearance ultimately can indeed be deceiving. I know of a case when even a gynecologist was fooled. He had made a vaginal examination (undoubtedly superficial ) and exclaimed: "I cannot find any uterus in this girl." |
| Occasionally the skin of the penis is utilized to form labia minora-like folds. All these tissues contain sensory nerve ends which later may help to convey sexual satisfaction, possibly climaxing in orgasm. |
| The creation of the artificial vagina is for many transsexual males (those with a primary sex motive for the conversion [2]) the crucial part of the operation. Its success or failure may spell the success or failure of the entire sex change undertaking. |
| In years past the creation of the artificial vagina was performed as a separate stage of the conversion, that is, months or even years after the first stage, which was castration and penectomy. With greater perfection of the surgical technique, all this is now done in one operation. |
| For the vaginal plastic, a pouch, eight or more inches deep, is dissected in the perineum, close to but well above the rectum, so that a firm floor of the vagina may later exist, eliminating or minimizing the danger of a vaginal- rectal fistula. This pouch or channel passes behind the posterior aspect of the prostate. The incision extends upward from the apex of the perineal wound to the posterior surface of the seminal vesicles. The question then arises how to line this channel so that it can remain open and serve as a permanent vagina. |
| Three types of material have been and are still being used for that purpose. The oldest method is to use the skin from the thigh, buttocks, or back. Such skin is soft and contains relatively few hairs but has no natural lubrication. It is cut in thin transplants with the help of a special instrument, the dermatome. The transplants are placed around a rubber form, about two inches in diameter. The skin sections are then inserted into the pouch and are stitched to the skin of the perineum to prevent slipping. If all goes well, the skin segments will heal in and, with the help of artificial lubrication, the patient will then have a functioning vagina. The most striking studies in the physiology of the vaginal function and vaginal lubrication were made by W. H. Masters and V. E. Johnson. Those particularly interested in this special field would do well to peruse the pertinent articles by these two scientists.[ 3] |
| Dilatation, however, first with one or two fingers, then with an instrument, a test tube or a plastic mold, is essential. Some patients have to wear a mold for several months. If they do not or if they do not dilate regularly, the vagina is likely to contract more and more and eventually close up entirely. A new operation would then be required. Only if the wall between vagina and rectum is thin, the wearing of a mold would be inadvisable as the constant pressure could produce a fistula. |
| In recent years a rather ingenious and, from what I have seen, so far the most successful method, has been perfected and is exclusively used by Dr. George Burou, a French surgeon in Morocco. Instead of using skin from the body to line the vaginal canal, the skin is stripped from the amputated penis and is inverted like the finger of a glove. This tube like organ is then inserted into the previously prepared canal and utilized to form the inside of the tunnel that is destined to be a vagina. Penile skin offers advantages over skin from other areas because it has no hair at all and has nerve endings which cause it to bear the closest resemblance to that of a sexual organ. The two wound surfaces usually heal together without difficulty but dilatation is required the same as previously described. An uncircumcised penis is better because more skin is available, thus permitting the vagina to be made deeper. In any event, the outside skin of the penis, later on, represents the inner wall of the vagina. |
| Complications in the form of contractions through scar formations, occasional granulations (keloids), and insufficient depth of the vagina can occur after either method. They may necessitate additional minor surgery. Major surgery would be required only if the vagina has become obliterated and useless for normal sex relations. |
| As a third technique a more complicated procedure has been devised that is rarely, employed for the first attempt to form a vagina. It is probably more often the logical method when others have failed. |
| This third method utilizes a part of the gut, a loop of ileum, to serve as a vagina. The operation is a more formidable one as it requires not only the opening of the abdominal cavity but also a more intricate technique to insure the proper blood supply for the implant. The advantage is that a mucous membrane (with natural lubrication) and not skin forms the vaginal wall and that this wall may be less likely to contract. |
| 嗯？更新两帖都被吞了？ |
| 嗯？ |
| 哦，还好只是更新太慢 |
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@San若梦 2017-09-05 12:07:25 This third method utilizes a part of the gut, a loop of ileum, to serve as a vagina. The operation is a more formidable one as it requires not only the opening of the abdominal cavity but also a more intricate technique to insure the proper blood supply for the implant. The advantage is that a mucous membrane (with natural lubrication) and not skin forms the vaginal wall and that this wall may be less likely to contract. ----------------------------- 这个第三种方法是用肠道的一部分，回肠（胃部下方，小肠末端和最窄的一段，负责从食物中吸收营养物质）的一段来作阴.道。这个手术更为艰巨，因为它不仅需要打开腹腔，还需要用到一个更为复杂的技术来保证移植时妥当的血液供应。好处是黏膜（有天然的润滑剂）代替皮肤形成阴.道壁，而这种阴.道壁可能比较不会收缩。 |
| In one patient undergoing a fourth attempt of vaginal plastic after others had proved unsuccessful, the method seems to have worked well. I have only the patient's written report; there was no personal inspection, nor an examination by a gynecologist. |
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@San若梦 2017-09-05 13:08:37 In one patient undergoing a fourth attempt of vaginal plastic after others had proved unsuccessful, the method seems to have worked well. I have only the patient's written report; there was no personal inspection, nor an examination by a gynecologist. ----------------------------- 有一位病人前面三次都不成功，第四次再试阴.道整容术，这种方法看起来成功了。不过我只有这位病人的书面报告，没有对本人做过检查，也没有妇科医生检查过。 |
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@San若梦 2017-09-05 12:37:51 哦，还好只是更新太慢 ----------------------------- @镜水中天 2017-09-05 17:53:00 不仅仅如此吧！我不过说周末两天出去了，而楼主更新很快，我需要补课了。居然也被删了？？？ ----------------------------- 嘿嘿，大概是@花魁 今天值班，有删帖子的权限。你那帖我看见了，还评论了一帖。 |
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@镜水中天 2017-09-05 17:55:57 楼主你翻译的内容好多已经看不见了吧？ 我只看见一连串的原文段落。 ----------------------------- 嗯，基本上是我今天全部的功课，一些可能的敏感词我都处理过的，比如阴.道。 先给客服发个信息看看。我都有存档，待会再发一遍。 |
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@为顶帖而来 死活放不下是吧？我要翻一本科普著作，你说你搞这些有的没有的小把戏，难道还能阻止我不成？想什么呢？ |
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