《疡科心得集》中“辨”的思想

Thought of "Differentiation" in Experience Gained in Treating External Sores

《疡科心得集》一书非常注重辨疾病的阴阳,认为疾病的病因、辨证、治疗及预后均不离阴阳两端,提出"此阴阳,寒热,表里,虚实,气血,标本也,为疡科中之第一义,故首揭之"。《疡科心得集》根据每一个具体疾病分篇论述,而且根据发病部位、发病原因、治法等将两证或多证并而述之,将辨病和类症鉴别相结合,这种行文的优点不仅仅能使后人明晰是为何种疾病,同时在辨病、辨证的基础上再讲到具体的施治,论述清晰明了,有利于临床应用。该书在强调辨病与辨证相结合基础上,进一步进行治疗,这也宗仲景的思想。此外,高秉钧对于外科疾病的辨证不拘于一定之形,认为毒气之流行无定位,总结了毒入五脏的证候,并认为毒入六腑,也各有变象,兼证多端,也是高秉钧对外科疾病辨证的一大发展。

In Experience Gained in Treating External Sores, the author values much about the differentiation of yin and yang in a disease,holding that etiology, syndrome differentiation, treatment and prognosis are inseparable from the two aspects of yin and yang and proposing that ＂Yin and yang,cold and heat, exterior and interior,deficiency and excess, qi and blood, root cause and superficial symptoms are, the first essence in department of external sores＂. In this book, it doesn＇t describe each disease in one chapter, but describes two syndromes or multiple syndromes according to the location, cause of occurrence and therapies in a com- bined manner and combines the disease differentiation and similar symptoms. This style of writing not only makes the categories of disease, distinguishing of disease, symptoms of disease cleat＇, but also simultaneously details the concrete treatment based on dis- ease differentiation and syndrome differentiation, which also follows Zhang Zhongjing＇s idea. Besides, the author Gao Bingjun doesn＇t stick to the syndrome difirentiation of surgical diseases but believes that the toxic qi is not fixed ,and he summaries the symptoms of toxin invading the five zang-organs, holding that toxin attacking six fu-organs and manifesting differently with compli- cations,which is also a big development of his syndrome differentiation of surgical diseases.