也谈《伤寒论》的六经辨证

Discussing Six-Meridian Syndrome Differentiation in“Treatise on Febrile Diseases”

《伤寒论》的六经辨证是辨病、辨证、辨症论治相结合的有机体系,辨病论治体现治疗的全局性,辨证论治体现治疗的阶段性,辨症论治体现治疗的即时性。太阳病的本质为邪袭太阳,经气不利,营卫失和,正气奋起抗邪,正邪交争于袁；阳明病病位在中焦的胃肠,性质属实,其有寒、热两大类；少阳病属于热证、实证的范畴,反映了邪犯少阳,枢机不利,胆火上炎,灼伤津液的本质,相对于太阳病而言,其病住在里,热邪初化,但未至阳明病燥热程度；太阴病的性质,尽管其多属脾阳不足证,但亦有脾阴不足证；少阴病的提纲,是寒化、热化的共同提纲,其脉象应为“脉微、细”,从中断句,脉微而见但欲寐,则是寒化证的初期表现,脉细而见但欲寐,则是热化证；厥阴病为两阴交尽,具有阴尽阳生、极而复远的特点。

Six-meridian syndrome differentiation is an organic system, which integrates disease differentiation, syndrome differentiation and symptom differentiation in ＂Treatise on Febrile Diseases＂. Disease differentiation demonstrates the whole situation of treatment while syndrome differentiation demonstrates the time-phased treatment, and symptom differentiation demonstrates timely treatment. The essence of Taiyang syndrome is the conflict between the vital-qi and the pathogens in exterior due to the pathogens attacks Taiyang meridian that results in meridian qi performing abnormal and ying-wei disharmony. The disease location of Yangming syndrome is interior where stomach and intestine located in middle-jiao. Both excess heat and excess cold syndrome are the characteristics of Yangming syndrome. Contrast to Taiyang syndrome, the disease location of Shaoyang syndrome is interior, but the heat degree is not so much as yangrning syndrome because Shaoyang syndrome is the first period when heat occurs. It belongs to the category of heat syndrome and excess syndrome and reflects the essence of losing body fluid resulted from burning of rising guts fire due to evil-qi attacking and disorder of meridian qi. Although the character of Taiyin syndrome is the syndrome of spleen yang deficiency, sometimes the syndrome of spleen yin deficiency occurs. The outline of Shaoyin syndrome integrates cold transforming and heat transforming, and the pulse tracings demonstrates weak or slim. It is at the initial stage of cold transforming when it shows weak pulse and feeling sleepy, while it is heat syndrome when it shows slim pulse and feeling sleepy. Jueyin syndrome is the period of exhausting two kind of yin, and it shows the character of yang rising aider yin exhausting.