《类证治裁》木郁论治浅析

Analysis on the treatment based on stagnation of wood in Leizheng Zhicai

《类证治裁》为清代医家林佩琴所著,书中虽未对木郁证作专篇论述,但其对木郁之见解在"郁症论治""肝气肝火肝风论治"篇中有着充分体现。从运气学说出发,林佩琴认为按五行相因之理,木郁应为其它郁证之先导,可传变发展为五郁;从病机演变规律来看,木郁日久可生"化火、化风"之变,涉及临床多种病证;在遣方用药方面,林佩琴善用古方,灵活化裁,主张"用药不宜刚而宜柔,不宜伐而宜和"。文章整理分析该书中有关木郁证之论述,对理解林佩琴辨治思路特点及指导临床实践大有裨益。

Leizheng Zhicai was a famous book written by LIN Pei-qin, who was a famous doctor in the Qing dynasty. Although the syndrome of stagnation of wood was not made a special article in the book, his opinions about the stagnation of wood were fully reflected in the part of ‘treatment based on depression syndrome' and ‘treatment based on liver qi, liver fire and liver wind'. Starting from doctrine of five evolutive phases and six climatic factors, LIN Pei-qin believed that stagnation of wood should be the guide of other depression syndrome according to the mutual generation of five phases, and it could transmit and develop into five types of depression. In the view of the evolution of pathogenesis, stagnation of wood would have the change of transforming into fire and wind which involved a variety of clinical diseases. In the aspect of using drugs, LIN Pei-qin was good at using classical prescription flexibly. He held that ‘Medication should not be hardness but should be softness, and should not be assault but should be harmonization'. It would have a great advantage to understand LIN Pei-qin's thoughts and guide clinical practice by collating and analyzing the relevant discussions of stagnation of wood in the book.