浅谈《伤寒论》“不可余药”  

Discussion About "Bu Ke Yu Medicine" in Treatise on Cold-Damaged Diseases

作　　者：白鸽[1] 赵鸣芳[1] 

机构地区：[1]南京中医药大学,江苏南京210046

出　　处：《河南中医》2015年第6期1202-1203,共2页Henan Traditional Chinese Medicine

基　　金：江苏省教育"十一五"规划课题(编号:D/2009/01/115)

摘　　要：《伤寒论》第126条云:"伤寒有热,少腹满,应小便不利,今反利者,为有血也。当下之,不可余药,宜抵当丸。"历代医家对此条文中的"不可余药"说法不一,对此句的解释,关键在于"余"的含义,共有四种:一,作"其他"讲,即不可使用其他药物。二,作"剩余"讲,即不可剩余药渣,药汤及渣一起服下。三,作"过度"讲,即不可过度投用峻下瘀血之药。四,作"以后"讲,即不可待蓄血的典型证候悉备后而药之。依据"余"的含义,仲景的行文习惯,语法结构,条文病证来看,本条"不可余药"中"余"作"过度"讲最为合适,即"不可过度投用峻下瘀血之药"。According to 126 th section of Treatise on Cold-Damaged Diseases,Cold-Damage leads to fever,abdominal fullness and distention,unsmooth urine; If smooth urine appears,blood stasis accompanies. The best method to get rid of blood stasis is not excessively using drastic purgative,but Didang Pill（ DDP）. In terms of ＂ Yu＂ of ＂ Bu Ke Yu Medicine＂ in this section,doctors of different generations in history have various opinions,mainly including the following four understandings： First, ＂ Yu＂ means the other,that is to say,the other medicines should not be used. Second, ＂ Yu＂ means the left,that is to say,the residues should not be left; the decoction and the residues should be taken together. Third, ＂ Yu＂ means excessively,that is to say,drastic purgative to get rid of blood stasis should not be used excessively. Fourth, ＂ Yu＂ means later,that is to say,medicines should not be used until the typical syndrome of blood retention appears. According to ＂ Yu＂ meanings,Zhang Zhongjing＇ s writing habits,grammatical structure,and disease symptoms of the provision, ＂ Yu＂ of ＂ Bu Ke Yu Medicine＂ here should mean excessively,that is to say,drastic purgative to get rid of blood stasis should not be used excessively.

关 键 词：不可余药 抵当丸 《伤寒论》 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]