天回医简《脉书·下经》中的不言脉疾病及类病思维  

Diseases no evident in pulse diagnosis and disease classification thinking in Mai Shu-Xia Jing of Tianhui Medical Bamboo Book

作　　者：王晟兴 刘阳[1] WANG Shengxing;LIU Yang(China Institute for History of Medicine and Medical Literature,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院中国医史文献研究所,北京100700

出　　处：《长春中医药大学学报》2024年第10期1083-1086,共4页Journal of Changchun University of Chinese Medicine

基　　金：国家社科基金冷门“绝学”和国别史等研究专项:《黄帝内经》古音研究(19VJX163)。

摘　　要：天回医简《脉书·下经》的第一部分中有大量不言脉的疾病,它们按照风、痹、蹷等共通症状为主要分类手段。该部分独立于言脉疾病之外,但又以经脉为隐藏参照核心,和言脉疾病一样承担着诠释“病久则变化”的功能。言脉与不言脉疾病的分类系统具有“表里”的对应关系:言脉疾病是“表”病的疾病分类系统,与镵石针艾治疗手段相匹配;不言脉疾病是“里”病的疾病分类系统,与毒药(汤液)治疗手段相匹配。同时,二者在疾病的诊疗中又都依靠色脉诊的信息,同属于脉诊系统。所谓类病思维,即是分析古人以类划分疾病的方式来判断其思维模式。《脉书·下经》中的疾病分类方式及其匹配的治疗方法源于先秦秦汉时期医学以症为纲式的辨治方式,又在辨治方法的系统化需求下孕育了辨证治疗模式的萌芽。There are a large number of diseases no evident in pulse diagnosis in thefirst part of Mai Shu-Xia Jing in Tianhui Medical Bamboo Book,which is mainly classified according to common symptoms such as wind,paralysis and tumble.This part is independent of diseases treated through pulse diagnosis,but it also takes the meridians as the hidden reference core,and like diseases treated through pulse diagnosis,it undertakes the function of interpreting"changes with prolonged illness".The classification system of diseases treated through pulse diagnosis and diseases no evident in pulse diagnosis has the corresponding relationship of"exterior and interior",that is,diseases treated through pulse diagnosis are the disease classification system of"exterior"diseases,which matches the treatment methods of Chan needle acupuncture and moxibustion;Diseases no evident in pulse diagnosis are the disease classification system of"interior"diseases,which matches the treatment method of toxicant(decoction).At the same time,both of them rely on the information of color pulse diagnosis in the diagnosis and treatment of diseases,and both belong to the same pulse diagnosis system.The so-called disease classification thinking is the thinking mode that ancient people used to classify diseases according to their categories to judge diseases.The classification of diseases and its matching treatment methods in Mai Shu-Xia Jing originated from treatment based on syndrome differentiation based on taking symptoms as the key link in the pre-Qin,Qin and Han dynasties,and also gave birth to the embryonic stage of differential treatment model under the systematic demand of treatment based on syndrome differentiation methods.

关 键 词：天回医简 《脉书·下经》 不言脉 表里 类病思维 

分 类 号：R-09[医药卫生]