《伤寒论》对后世“温病”的启迪(上)  

Enlightenment of Treatise on Cold Damage Diseases on Later Seasonal Febrile Diseases(1)

作　　者：王明炯[1] 王文华[1] 

机构地区：[1]长沙医学院中医学院,湖南长沙410219

出　　处：《河南中医》2016年第10期1680-1682,共3页Henan Traditional Chinese Medicine

摘　　要：《伤寒论》太阳病的本证,包括了伤寒、中风与温病三大类,一般认为伤寒的代表方是麻黄汤,中风则是桂枝汤,可是太阳温病却没有,以致后世一直忽视《伤寒论》中的温病内容。要想弄清楚《伤寒论》中涉及温病之证,首先必须从大青龙汤入手。笔者通过对大青龙汤与少阴证进行详细的鉴别后认为,大青龙汤证是四组症状体征相矛盾的集合体:1可能会出现脉浮紧也可能出现脉浮缓;2可能出现身疼痛也可能出现身重(不疼);3可能出现烦躁也有可能出现不烦躁(但欲寐);4可能汗出也可能无汗。仲景当年写大青龙汤证时只有也只能错笺、省文:一则警醒后世,二则开三纲鼎立之局。不然,中风表虚证的桂枝汤证和伤寒表实的麻黄汤证都将被推翻。大青龙汤证如此行文实乃仲景开辨证思维一大法门。In Treatise on Cold Damage Diseases, the original syndromes of taiyang diseases include cold damage diseases, stroke and seasonal febrile diseases. Generally speaking,the representative formula of cold damage diseases is Ephedra Deeoctinn, while that of stroke is Cinilanlon Twig Deeuetinn, but there is not any for taiyang seasonal febrile diseases, so that the people of later generations have ignored Ihe eunlent of seasonal febrile diseases in Treatise on Cold Damage Diseases. In order to understand the involved syndrome, Ma.inr Green Dragon Decoction shouht he first considered. After having caret＇oily identified Major Green Dragon Decoction with shauyiu syndrome,the authors think syndrome of Major Green Dragon Decoetiou is a contradictotry aggregate of four groups＇ symptoms and signs：（1）The patient may have floating and tense pulse or floating and slow pulse;（2）The patient may have body pain or heavy body without pain：（3）The patient may have irritability or no irritability but with desire for sleep;,（4）The patient may have sweat or unhidrosis. At that time Zhongjing was writing Major Green Dragon Decoction syndrome in simple words probably in order to save words. One reason is to alert future generations,the other reason is to open up the situation hi The Three Kingdoms. Otherwise,Cinnamon Twig Decoction for treating stroke of superficial deficiency and Ephedra Decoction syndrome for trearing cohl damage aud superficial excess will be overthrown. Major Gteen Dragon Decoction written in this way is Zhongjing＇s secret to open the dialectical thinking.

关 键 词：大青龙汤 伤寒论 温病 少阴证 太阳中风 伤寒 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]