小柴胡汤在《伤寒杂病论》中的应用

The Application of Minor Bupleurum Decoction in Treatise on Cold Damage and Miscellaneous Diseases

《伤寒杂病论》原文中关于小柴胡汤的记载共15条条文,专门提到少阳病用小柴胡汤的仅有第266条,而在太阳病篇出现失治误治的时候应用小柴胡汤是十分广泛的,并且在阳明病出现柴胡证而未成腑实热结可用小柴胡汤条畅气机;厥阴病末疾病传至半表半里,出现"呕而发热"者,亦可用小柴胡汤和解透热,降逆止呕;还可用于妇人中风热入血室证以及黄疸腹痛呕吐等证。故而小柴胡汤非但专为少阳病专设,即使证在少阳,当有"胁下硬满,干呕不能食"等"柴胡证"时亦可用小柴胡汤。胸胁气机不利,三焦气化失司,邪在半表半里而见阳证者皆可依证而用之,当合仲景之本义。

There are 15 articles about Minor Bupleurum Decoction in the original article of Treatise on Cold Damage and Miscellaneous Diseases,only No. 266 article refers specifically to Minor Bupleurum Decoction for Shaoyang Disease,while Minor Bupleurum Decoction is widely used in the mistreatment of Taiyang disease. For Yangming disease with Bupleurum syndrome which has no excess of fu-organ and heat accumulation,Minor Bupleurum Decoction can be used to dredge qi activity. For advanced stage of Jueyin disease which has had half exterior and half interior syndrome manifested as vomiting and fever,Minor Bupleurum Decoction can be used to reconcile and remove fever,lower the adverse flow of qi and stop vomiting. For women stroke with syndrome of heat entering uterus,jaundice,abdominal pain and vomiting,it can also be used. Therefore,Minor Bupleurum Decoction is not created only for Shaoyang disease,even the syndrome lies in Shaoyang Meridian,the patient should also have Bupleurum syndrome manifested as fullness and rigidity of hypochendrium,retching without desire for food,etc. In this case,Minor Bupleurum Decoction can be adopted. For excess leading to dysfunction of chest and hypochendrium,disturbance in qi activity of sanjiao,pathogens stay in half exterior and half interior manifested as yang syndrome,Minor Bupleurum Decoction can be used based on syndrome differentiation,which is in line with the original meaning of Zhang Zhong-jing.