探析叶天士斑疹辨治思想

Analysis of YE Tian-shi thinking on treating eruption

叶天士为我国清朝的温病大家,对温病学的发展作出了巨大贡献,其对斑疹的辨治提出"点大而在皮肤之上者为斑,或云头隐隐,或琐碎小粒者为疹"。斑疹的发生机理为"斑属血者恒多,疹属气者不少","若斑色紫,小点者,心包热也;点大而紫,胃中热也";临证过程中首先应辨明斑疹之阴阳属性,红紫色斑疹多属于阳热性质,淡红色斑疹多属于阴证性质;再根据其属性确定相应的治法,阳热性质的斑疹宜用清化之法,阴证斑疹宜温补之法且应以病体为本,避免损失正气;根据斑疹的形态、色泽等判断预后,斑疹色黑而光亮或四旁有赤色环绕、斑疹发出后神情清爽等属于预后较好的征兆,斑疹色黑而晦暗、斑疹发出后神志昏迷等属于预后不良的表现。

Ye Tianshi made a huge contribution to the development of the science of seasonal febrile diseases in Qing dynasty. He holds that the big spot is on the skin,while the small for the rash. The spot is due to the blood,while the rash is due to the Qi. The small and purple rash belong to the heart,while the big and purple spot belong to stomach. When we treat the eruption,we should know the red and purple spot caused by the heat,and the pink spot caused by the cold. To treat the eruption,we should reduce fire for the red and purple spot,warm for the pink spot. and protect the Qi. For the dark spot but bright or red around,and people with a clear thinking,it's good for the treatment. For the dark only spot,and people in a coma,it's so bad to be well.