《医门棒喝》温病证治刍议  

Discussion on Syndrome and Treatment of Febrile Disease in“Yimen Banghe”

作　　者：马亚会[1] 连建伟[1] 郑洪[1] MA Yahui;LIAN Jianwei;ZHENG Hong(Zhejiang Chinese Medical University,Hangzhou(310053),China)

机构地区：[1]浙江中医药大学,杭州310053

出　　处：《浙江中医药大学学报》2021年第2期111-115,共5页Journal of Zhejiang Chinese Medical University

基　　金：连建伟名中医工作室建设项目(国中药人教函[2012]149号)。

摘　　要：[目的]探讨清代名医章楠所著《医门棒喝》中的温病学思想,分析其辨治温病的思维,以便更好地指导临床实践。[方法]采用文献学研究方法,研读《医门棒喝》及有关章氏温病证治思想的文章,从伤寒与温病的区分,温病、瘟疫的辨别,温病的分类以及章氏重视三才一贯思想等方面,分析总结章氏的温病思想及辨治特色。[结果]章氏对温病方论见解独特,认为伤寒与温病在邪入部位、病因病机、治法方药等方面各不相同。温病不能混为瘟疫,若误将一切风温、湿温、暑温等列作瘟疫,易成病轻药重之害。章氏将温病分为春温、风温、暑温、湿温、瘟疫五类,并详细论述。章氏认为天、地、人三者气脉相通,人与万物同禀阴阳五行之气生,三才一贯思想与温病证治思想关系密切。[结论]章氏阐张仲景之旨,辨温病、伤寒混同之误;纠吴鞠通之偏,析温病、瘟疫殽杂之愚;辨伏气病理,探温病源流,将温病分列五类;重视三才一贯思想。章氏对温病证治思想救正有道,其执着探索医理和勤于临证总结的精神堪为后世典范。[Objective] To explore the theory of febrile diseases in the famous Qing Dynasty doctor ZHANG Nan’s “Yimen Banghe”, and analyze ZHANG’s thinking on treating febrile diseases so as to better guide clinical practice.[Methods] Using literature research methods, studying “Yimen Banghe” and articles of treating febrile diseases of ZHANG Nan, this paper analyzed and summarized ZHANG Nan’s theory of febrile disease and its characteristics from the differences between typhoid fever and febrile disease, the discrimination of febrile disease and plague, the classification of febrile disease and ZHANG’s thoughts of attaching importance to three talents.[Results] ZHANG Nan had a unique view on the prescription of febrile disease, and thought that typhoid fever and febrile disease were different in the location of evil, etiology and pathogenesis, treatment and prescription. Febrile disease should not be mixed with plague, if all wind-warm syndrome, damp-warm syndrome, summerheat warmth syndrome and so on were listed as plague, it was easy to cause the harm of light disease and heavy medicine. ZHANG divided febrile disease into five categories: Spring warm syndrome, wind-warm syndrome, summerheat warmth syndrome, damp-warm syndrome and plague, and discussed in detail. ZHANG believed that the heaven, earth and human were connected, human and all things shared the Qi of Yin, Yang and five elements. The thoughts of three talents were closely related to the thoughts of syndrome and treatment of febrile diseases.[Conclusion] ZHANG expounded the intention of ZHANG Zhongjing, identified the mistakes of confusing febrile disease and typhoid fever;corrected WU Jutong’s bias, analyzed the mix of febrile disease and pestilence;distinguished the underlying Qi pathology, explored the source and flow of febrile diseases, and classified febrile diseases into five categories;and paid attention to the consistent thoughts of three talents. His persistent exploration of medical theory and diligence in clinical summary of the sp

关 键 词：医门棒喝 章楠 伤寒 温病 瘟疫 批判性思维 三才一贯思想 

分 类 号：R221[医药卫生—中医基础理论]