论《伤寒论》第29条、第30条  

Discussion About No.29 Article and No.30 Article in Treatise on Cold Damage Diseases

作　　者：王明炯 余钰[2] WANG Ming-jiong;YU Yu(Shanchuntang Medcal Center,Changsha,Hunan,China,410200;Xiangya School of Public Health of Naional Medical Central South University,Changsha,Hunan,China,410008)

机构地区：[1]善春堂国医馆,湖南长沙410200 [2]中南大学湘雅公共卫生学院,湖南长沙410008

出　　处：《河南中医》2019年第2期163-165,共3页Henan Traditional Chinese Medicine

摘　　要：《伤寒论》第29条言:"……少与调胃承气汤",《伤寒论》第213条言:"阳明病,其人多汗,以津液外出,胃中燥,大便必硬,硬则谵语,小承气汤主之。若一服谵语止,更莫复服。"所以第30条中"阳明内结,谵语,烦乱"无论是从仲景原文看还是临床上看都应是承气汤。根据第30条的变化,29条中的"咽中干,烦躁"症状和"胃气不和,谵语"之证是不能分开的,所以《伤寒论》第29条应该为"伤寒脉浮,自汗出,小便数,心烦,微恶寒,脚挛急,反与桂枝汤,欲攻其表,此误也,得之便厥。若胃气不和,咽中干,烦躁,谵语者,少与调胃承气汤。吐逆者,作甘草干姜汤与之,以复其阳。若厥愈足温者,更作芍药甘草汤与之,其脚即伸。若重发汗,复加烧针者,四逆汤主之。"In Treatise on Cold Damage Diseases,No.29 article reads,"--a small dose of Stomach-Regulating and Purgative Decoction can be used".No.213 article reads,"Yangming disease is characterized by perspiration,body fluid going out of body,dry stomach,hard stool,delirium.Minor Bupleurum Decoction should be used.If delirium stops,the patient should not take it again."Therefore,in No.30 Article,"Yangming disease marked by delirium,and irritability"should use Purgative Decoction based on both in the original text of Zhang Zhong-jing and in clinical practice.According to changes in No.30 article,in No.29 article,the symptoms of dry throat and irritation and"discordant stomach and delirium"in No.29 article can not be separated.So No.29 Article in Treatise on Cold Damage Diseases should be stated as follows:Cold damage leads to floating pulse,self-sweating,frequent urination,irritability,slightly aversive cold,foot contracture.If Cinnamon Twig Decoction is used to relieve exterior symptoms,it will be a mistake.If the patient takes it,he will lose consciousness.For vomiting,Licorice and Rhizoma Zingiber Decoction should be used to nourish yang qi.If convulsion is healed and foot temperature is warmed,Peony and Licorice Decoction should be used,then the patient’s feet can stretch out.If the patient has serious sweating and high fever,Frigid Extremities Decoction can be used.

关 键 词：《伤寒论》 第29条 第30条 甘草干姜汤 调胃承气汤 张仲景 

分 类 号：R222.2[医药卫生—中医基础理论]