叶天士辨治中风思路探讨

Discussion of YE Tianshi Treating Wind Stroke

叶天士认为中风的病机乃身中阳气之变动,肝为风脏,因精血衰耗,水不涵木,木少滋荣,故肝阳偏亢,内风时起。治疗上强调肝病治疗三法,无非治用治体。治肝不应,当取阳明。三法者,不外辛以理用,酸以治体,甘以缓急。同时兼顾肝胃同治之法,辩证看待左血右气理论。认为人身气机升降合乎天地自然,肺气从右而降、肝气由左而升的理论认识在辨治中风时有重要指导意义。

According to YE Tianshi,the mechanism of wind stroke was the change of Yang Qi. The liver is a wind organ and liver Yang tends to be over-abundant manifesting as internal wind when essence and blood are deficient which could lead to water failing to nourish wood. YE Tianshi emphasized three methods for treating liver disease,all aiming at treating the function and entity. When the liver does not respond during the treatment,Yang ming should be treated. The three methods are the pungent to recovery the physiological function of liver,the sour to nourish the liver,and the sweet to relieve the tension. At the same time,liver and stomach should be treated together. The left blood and right Qi theory should be applied critically. The ascending and descending movement of human body resembles the nature law of the university. Lung Qi descends from the right and liver Qi ascends from the left,which is the basis for treating wind stroke.