《金匮要略》“短气”辨

Discussion About "Short of Breath" in Essentials from the Golden Cabinet

由于张仲景所著《伤寒论》基本不涉及脏腑,且对于"短气"一症的解释较少,所以笔者从《脉经》对于"短气"的论述入手,对于《金匮要略》中"短气"一症做出了全面的考证,认为"短气"一症和五脏相关,且分虚实,原因分别有1心气不足,外邪侵袭。2肺气痿弱,水饮内停。3脾脏"虚寒"。4脾脏有"实",有"热"。5肝肾之气不足,阴寒乘袭。且王叔和对于短气症状本身的特点做出了重要的补充,王叔和认为:呼出障碍和吸入障碍都属于"短气"症状。总之,全面学习仲景对"短气"的病因病机的理解对于临床有着深刻的指导意义,值得研究。

The syndrome of ＂ short of breath＂ seems not serious,but in fact it has something to do with the five zang-organs,and is divided into asthenia and sthenia. Obstacles of exhalation and inhalation are both considered symptoms of ＂ short of breath＂. The syndrome of ＂ short of breath＂ is related to the heart,the lung,the spleen,the liver and the kidney,but only ＂ sthenia＂ short of breath due to the middle energizer can be cured by purging method. Short of breath due to ＂ asthenia cold syndrome＂ of the middle energizer is not cured（ or hard to cure）,while ＂ short of breath＂ due to the heart,the lung,the liver and the kidney is hard to cure,which is directly pointed out by Zhang Zhong-jing. Zhang Zhong-jing’s understanding of ＂ short of breath＂ has good guidance to the clinical practice,which is worth deeply exploring.