基于出土秦汉简帛医药文献认识《金匮要略》阴狐疝气  

Understanding Yin Fox Hernia in Synopsis of the Golden Chamber Based on Excavated Qin and Han Medical Manuscripts

作　　者：周登威 胡天祥 高燕翔[1] ZHOU Dengwei;HU Tianxiang;GAO Yanxiang(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou,Guangdong,China,510120)

机构地区：[1]广州中医药大学第二附属医院,广东省中医院,广东广州510120

出　　处：《河南中医》2024年第10期1471-1474,共4页Henan Traditional Chinese Medicine

基　　金：广州市科技局基础与应用基础专题项目(2024A04J2927)。

摘　　要：在西汉初期,狐病与疝病是两类不同的疾病,狐病以症状时隐时现、伴见少腹痛为特点;疝病以心腹痛为特点,狐病与疝病共有腹痛证候。两汉之际或东汉初期,《黄帝内经》成书时,狐病与疝病已呈现融合之象,如出土《脉书》中的偏疝,在《黄帝内经》中被记载为狐疝,即可为证。在此过程中,疝气的范畴发生了变化,仓公时期,女子亦患疝气,魏晋之后疝气则限于男子病。《金匮要略》中有阴狐疝气病名,阴狐病位在肚脐下,病证时隐时现,伴见少腹痛,而疝则表现为腹痛,阴狐与疝气共有腹痛症状,故仲景将二病合称为阴狐疝气。此外,《金匮要略》中的狐惑病名,也因其病证时隐时现、变幻无常,故命名为狐惑。可知《金匮要略》阴狐疝气较《黄帝内经》狐疝更具有秦汉早期医学的特征,进而可以推测,《金匮要略》中可能保存有更多早期医学的知识。In the early Western Han Dynasty,fox disease and hernia disease were two distinct conditions.Fox disease was characterized by symptoms that appeared and disappeared intermittently,often accompanied by lower abdominal pain,while hernia disease was marked by pain in the heart and abdomen.Although both conditions shared abdominal pain symptoms,fox disease gradually merged into the category of hernia.By the late Western Han Dynasty or early Eastern Han Dynasty,during the compilation of Huangdi′s Internal Classic,fox disease and hernia were already showing signs of merging.The unilateral hernia mentioned in the excavated Pulse Classic was referred to as fox hernia in Huangdi′s Internal Classic,providing evidence of this fusion.During this period,the concept of hernia expanded.In Cang Gong′s era,women also suffered from hernia,but later,it became limited to men.In Synopsis of the Golden Chamber,there is the term yin fox hernia,where yin fox refers to a condition located below the navel,with symptoms that appear and disappear occasionally,often accompanied by lower abdominal pain,while hernia presents with abdominal pain.Thus,Zhang Zhongjing combined the two conditions into yin fox hernia.However,it still retains elements of the earlier fox disease,indicating that fox disease and hernia had not yet fully merged.Additionally,in Synopsis of the Golden Chamber,the term fox delusion names for its symptoms that appear and disappear unpredictably.This suggests that the concept of yin fox hernia in Synopsis of the Golden Chamber reflects more characteristics of early Qin and Han medical practices compared to Huangdi′s Internal Classic,and it can be inferred that its content may preserve more early medical knowledge.

关 键 词：阴狐疝气 狐病 疝病 《金匮要略》 张仲景 

分 类 号：R222.3[医药卫生—中医基础理论]