伤寒论评话 第35章喜忘有关血与气蓄血瘀血证不同——阳明病血热证、湿热证的辨证治疗

Discussion of Shanghan Lun:Chapter 35 Or Forget About Blood and Blood Gas Accumulation of Blood Stasis Syndrome is Different——Yangming Disease of Blood Heat,Damp Heat Syndrome Sifferentiation Treatment

1将阳明的"喜忘"作为"喜妄",首先从文字的角度,"喜"用作动词,"妄"为副词,动词修饰副词,于理不通。其次阳明蓄血与太阳蓄血不同,一个在小肠与手少阴心相表里,直接影响到心神,故有狂妄;一个在大肠与手太阴肺相表里,间接影响及气血,故有健忘。2阳明蓄血"喜忘",一则气血并于下,心肺气血虚,不能上奉于脑,脑失所养;二则阳明蓄血在下,肠道传导失司,糟粕停滞,酿生浊毒,浊毒上扰清窍,气血逆乱,脑神受扰,使记忆失常;三则阳明邪热与素有瘀血互结,瘀血不去,新血不生,心神失养,皆可导致神明不清,最终导致"善忘"。3所谓阳明蓄血,是肠道本有瘀血,与阳明邪热相合,而形成"喜忘"的蓄血证;而阳明瘀血是在阳明病的过程中,热盛伤血,血分津液被耗,而形成瘀血。蓄血与瘀血既有区别,又有联系,瘀血不一定能成为蓄血,但蓄血则一定是由血行瘀滞所导致。一般而言瘀血在经。蓄血在腑。蓄血有形可证,诸如下血、黑便等;瘀血惟像可辨,诸如舌暗,脉涩等。

①From the perspective of the text,＆quot;Xi＆quot; used as a verb,＆quot;wang＆quot; as an adverb,adverbs modify verbs not in principle. Second yangming hematic retention is different from Taiyang blood-retention. One in small intestine related to Shaoyin heart,directly affect the mind. The other in the large intestine related to hand-Taiyin,indirectly affect Qi and blood.②Yang-ming blood storage,Qi and blood, cardiopulmonary gas hemopenia,can＆#39; t serve in the brain. Yang-ming blood storage,intestinal conduction loss,brain disturbance and memory disorder. Yangming evil heat and blood stasis knot,blood stasis,no new blood and heart dystrophy can lead to forget.③Yang-ming blood storage is the intestinal blood stasis,with Yang-ming evil heat. Yang ming blood stasis is formed in the process of Yangming disease. There are differences between blood accumulation and blood stasis,also having contact. Blood stasis can＆#39;t become the blood ac-cumulation. But blood storage must be caused by blood stasis. In general blood stasis in the meridians. Blood accumulation is in the in-ner parts. Blood storage is tangible verifiable,such as black stools,etc. Blood stasis is distinguished as surface,such as tongue dark and pulse acerbity.