刘鸿恩应用大黄的经验

Liu Hongen's Experience in the Application of Rhubarb

晚清医家刘鸿恩在其《医门八法》一书中，对大黄的应用独具匠心。对一切实证，不论伤寒、温病，刘氏均主张及早用大黄攻邪，否则就会护疾养毒，致生他变；刘氏把舌苔的有无、苔色的黄白作为是否应用大黄攻下的依据；对于实热之证，刘氏不主张用清热法直折热势，却力主用大黄攻逐实邪，如此则实既去，热无所生，势必消退；对当下难下者，则巧妙配伍，但“必以祛邪为首务”。再如实热隆闭、外感表实，通便攻下。

Abstract To any excess sydrome,regardless of exogenous febrile disease and epidemic febrile disease,he maintained that rhubarb should promptly be applied to eliminate the pathogenic factor,otherwise,it may produce other pathologic change. He maintained that whether to use rhubrb or not for purgation should be based on the tongue fur's existence and color.He maintained that heat-clearing method should not be used to set back the heat momentum,but that rhubarb should be used to eliminate pathogenic factor of excess type,hence,the excess syndrome is eliminated,the heat has no chance to breed,and the momentum dispears.For those which should have been eliminated but difficult to be done,the prescription should be made up ingeniously, but the key purpose is to eliminate the pathogenic factor.For instance,to the heat of excess type and difficulty in urination,and the exterior syndrome of excess due to exopathy,the method of relaxing the bowels and purgation has the rapeutic effect.