伤寒论评话 第40章 少阴虚寒多死证,经证寒热各不同——少阴死证及经证的辨证论治  

Discussion of Shanghan Lun: Deficiency-cold in Shaoyin is More Dead Syndrome,Differention of Cold and Hot in Channels—Syndrome Differentiation and Treatment of Dead Syndrome of Shaoyin and Channels Syndrome

作　　者：梁华龙[1] 

机构地区：[1]河南中医学院,河南郑州450046

出　　处：《中医学报》2015年第4期495-498,共4页Acta Chinese Medicine

基　　金：国家中医药管理局专项课题(2009-0001);河南省科技厅基金项目(496060303)

摘　　要：1第294条的"厥"是寒邪侵袭,寒凝于足,使用火法迫汗不当,就成了火逆证,火邪入血,迫血妄行,血从口或鼻而出,寒邪凝于足而致的厥不仅没有解除,阴血又从上窍流失,所以称作"下厥上竭"。本条的"厥",既不是阳虚失温的寒厥,也不是热邪深伏的热厥,而是外感寒邪,寒凝于足的"厥",因为是"凝于足者为厥",所以称作"下厥"。2客热咽痛和客寒咽痛虽然都是少阴经咽痛证,所谓客热客寒,即外来的风寒邪气和温热邪气。两种咽痛证是介于少阴经表证和少阴寒化证、热化证之间的病证,是邪气在由经传入脏的经传过程中产生的病证,虽然客寒或者客热仍旧稽留在少阴经,但其病变反映在少阴经循行的所过部位,而不是反映在经表,也不是反映在少阴经所连属的心肾,所以他既不是经表证,不能以辛温或者辛凉解表的方法进行治疗。也不是真正的寒化证或者热化证,所以也不能用苦寒清热泻下或者辛热温经扶阳来治疗。（1） article 294 ＂Jue＂ is cold invasion, cold in the foot, improper use fire forced to sweat, inverse became deterioration with Hot against, fire-evil into the blood, heat into the blood, then injury of superficial venules exert bleeding, blood is flowing from mouth or nose,cold evil coagulation in the foot isn＇t remove, Yin-blood runoff from upper orifices, so this is＂ lower is Jue and upper is exhaus- tion＂. ＂Jue＂ in this article, neither Yang deficiency cold lead to cold limbs, nor heat deep into the body lead to limbs cold ,but external cold, cold coagulation on foot, coagulation on foot lead to cold feet, so this call coldness in the lower limbs. （2） Pseudoheat lead to the pain in the throat and the eold in the epiglottis lead to the pain in the throat both are ShaoYin channel anginosis, the pseudoheat and pathogenic cold are the anemofrigid pathogen and warm-heat pathogen come from outside. Two kinds of pharyngalgia among syndrome of Shaoyin biao and Shaoyin cold, Shaoyin hot, this is evil from channels to viscera. Although cold and hot still at Shaoyin, pathological changes reflect following parts of Shaoyin channels, not at biao, heart and kidney which connecting. So it＇s not only symptom of channel biao,which can not use relieving the exterior syndrome with drugs pungent in flavor and cool（warm） in property and xinliang, but also syndrome cold or hot transformation, which can not use clearing heat by bitter cold, pungent drugs and warming channels for strengthe- ning yang-qi.

关 键 词：“下厥上竭” 少阴经咽痛证 少阴死证 少阴经证 张仲景 《伤寒论》 

分 类 号：R222.2[医药卫生—中医基础理论]