《伤寒论》太阳病篇若干问题评述(续2)

On Several Questions Concerning Taiyang Syndrome in Treatise on Febrile Diseases (continued 2)

续上篇继续对太阳病的有关问题进行讨论。认为仲景设类证辨似 ,目的在于强化辨证 ,并认为桂枝去桂加茯苓白术汤证等也当属于类似证 ,而非变证 ;热入血室证原属太阳病之变证 ,是辨热入血分的体现 ;蓄水证、蓄血证都是太阳病过程中可能出现的兼证或变证 ,属于里证范畴 ,所谓“太阳里证”的提法是不妥的 ,临床重在辨表里而不必拘于经府 ;纵、横是仲景运用五行相克论述脏腑之间的病理联系 ,实寓有脏腑辨证的精神 ;太阳病篇还有一些“具有全局性指导意义的条文” ,这些条文虽列于太阳病篇 ,但不专属太阳病 ,而应着眼于其普遍的指导意义。

The author holds that ZHANG Zhong-jing's purpose in establishing the differentiation of similar syndromes is to emphasize syndrome differentiation. He also believes that the syndromes indicated by Guizhi Qugui Plus Bazhu Decoction belong to similar syndromes, not complications; the syndrome of heat in the blood belongs to the complication of Taiyang disease, indicating the invasion of heat into the blood system; and the syndromes of retention of water or blood are possible accompanying syndromes or complications of Taiyang disease, belonging to interior syndromes. It is not appropriate to talk of “Taiyang interior syndrome', and in clinical practice emphasis should be laid on the differentiation between exterior and interior syndromes. The vertical-transverse theory refers to the fact that ZHANG Zhong-jing used the theory of the five elements to describe the pathological relationship among the zang-fu organs, which embodies the essence of the differentiation of syndromes according to the zang-fu organs. There are some descriptions about the Taiyang disease that are “of globally guiding significance'. Although these are listed in the volume of Taiyang disease, they do not belong to the Taiyang disease, and attention should be paid to their universal guiding significance.