从《伤寒论》阴性症状运用谈张仲景辨证思维特点

Dialectical Characteristic of Thought of ZHANG Zhong-jing from Utilization of Negative Symptom in Treatise on Febrile Diseases

东汉名医张仲景因其创造性的提出六经辨证和脏腑经络辨证的辨证方法,被后世尊称为医圣。在其著作《伤寒论》中多次出现阴性症状的描述和运用,通过对其中阴性症状的总结分析,可以看出张仲景辨证思想具有如下特点:1)将把握疾病动态变化规律作为临床辨证前提。2)建立了以分析主症或关键症状为核心的辨证思维模式。3)适应疾病表现和变化的多样性,将辨证思维由静态转向动态,由分析走向综合。4)将病症的临床表现以变通和组合分解的方式进行描述,提示了疾病发展的多种可能性,反映出张仲景辨证思维的发散性、相关性、蕴含性和可扩性。

ZHANG Zhong-jing, the famous doctor in Eastern Han Dynasty, is respectively called the sage of doctor by the future generation owing to his creative proposing the differentiation method of six meridians and differentiation of ZANG FU-organs and meridian. The description and utilization of negative symptom could be found for many times in Treatise on Febrile Diseases. Through the summary and analysis of negative symptom in it the characteristic of his dialectical thought might be as follows： 1）He took grasping the rule of disease dynamic change as premise of clinical differentiation of symptoms and signs. 2）Established the dialectical thought pattern, in which analyzing the main symptom or the key symptom was taken as the core. 3）Adapted to the diversification of the appearance or change of disease the dialectical thought would be changed from stationary state to dynamic and from analyzed to comprehensive. 4）The clinical manifestation was described by the way of accommodation or aggregation and isolation, indicating the multi-possibility of the disease development and reflecting the divergency, the correlation and the expanding characteristic of Zhong-jing＇s dialectical thought.