论《伤寒论》之“坏病”

On "Deteriorated Disease" in "Treatise on Febrile Disease"

《伤寒论》之"坏病",现均理解为"变证",不属六经范畴,可按照《伤寒论》第16条,其原意应指病仍在太阳,并非变证。细考之,"坏病"的原意,是指太阳病经过误治、或病人具有某种特殊体质、病证不按常规演变、因而需要观察证候变化以作相应治疗的一类病证。"观其脉证,知犯何逆,随证治之"的思想,本义并非能够指导各种疾病的辨证论治,因为未经过误治的病证能预测疾病的传变,而坏病不能预测才需要随证治之。以此思想理解《伤寒论》太阳病篇17至30条,可发现原文顺序的有机联系,是坏病证治的具体示范。

The ＂deteriorated disease＂ in Treatise on Febrile Disease＂（called ＂Treatise＂hereafter） can be understood as ＂changed symptom＂,not belonging to 6 channels;it can refer to No 16 in the Treatise;it points out it lies in Taiyang,not changed symptom.Studying it carefully,its primary meaning is that the Tanyang disease is mis-treated,or the patient has some special constitution,the disease doesn＇t evolve normally,so it needs observing sign changes for therapy.＂Observe pulse sign,know disease,treat under according to sign＂ originally doesn＇t mean to guide all disease treatment,for those not mistreated diseases can prospect its progress,while the deteriorated disease can＇t be prospected,but needs observing the sign before treatment.Thus we can find the organic relation of text order from NO 17-30 in the Treatise,it is the detailed demonstration of deteriorated disease treatment.