肝脏在五脏中的地位演变

Change of the liver's value in five visceral theory

在藏象学说中,据《内经》的记载,心与胃处于较重要的地位。自元代朱丹溪强调郁证之后,肝脏在五脏中的地位逐渐提高。主要表现为:①肝病的辨证颇为精细,如王旭高提出治肝三十法,这种细致分类为其它脏所未有。②若干常见病、多发病与肝有关。③其它一些脏腑病变与肝有关。到了明清,一些医家已将肝脏列为五脏的首要地位。文献复习表明,早在《内经》时期,人们已了解到肝脏具有脾、肾等脏的部分功能。这种一脏具有多脏功能的情况可能导致脏象研究未能取得突破性的进展。建议结合当代科学发展和临床实践,对藏象学说进行认真评价。

Heart and stomach were in very important position based on the recording of Internal classic in viscera-manifestation doctrine. Having stagnation syndrome been emphasized by Zhu Dan-xi, who was a famous physician of the Yuan Dynasty > the position of liver had been gradually raised in five organs, mainly were; 1. Differentiation of symptoms and signs of liver diseases got more and more detail than others exemplified as 30kinds of therapies to treat liver diseases advanced by Wang Xu-gao. 2. Many commonly and frequently encountered diseases were closely related to the liver. 3. Other visceral diseases and syndromes had something to do with the liver. To the Ming Dynasty some physicians had put the liver to the first position. The scholars as early as period in Internal Medicine had known that the liver possessed partly functions of spleen and kidney being reviewed the literatures. That one organ possesses the functions of others may be the causes of research on viscera having not been achieved breakthrouth progress. The authors suggested that we should be carefully assessment to the viscera-manifestation doctrine by combination with the modern science and clinical practice.