摘要
明代儿科诸医学著作中,对于疾病论述较为详尽系统者《保婴撮要》为其一。作者对于准确辨证的重要性和参考吸收前人经验尤为重视,认为"小儿之热,有心肝脾肺肾五脏之不同;虚实温壮,四者之不一;及表里血气、阴阳浮陷,与夫风湿痰食,各当详之"。该书广泛系统地收集整理了明代以前中医儿科小儿发热的证治理论,从辨热之所在脏腑(心肝脾肺肾)、热之病因病机(风湿痰食)、热之病位(表、里及表里之间)、热之性质(虚热与实热)、发热在气在血及热之类型(壮热与温热)5方面对小儿发热进行辨治,构成了小儿发热的诊治框架。值得强调的是,发热作为儿科临床中的常见症状可由多种原因引起,且常作为其他疾病的兼症,而非单一出现。又因小儿易感易受、易于传变的生理、病理特点,治则治法方面难免呈现碎片化的形式,不易形成体系。故临床上应提纲挈领,追本溯源,方能得其根本。
Among the pediatric works in Ming Dynasty, BaoYingCuoYao was the one written and finished in a more systematically and detailed way by widely collected the medical books before. The writer thought highly of the accurate diagnosis technique and worked hard in learning other famous doctor's experience. He thought that the types of pediatric fever are not constant due to different perspectives on it: considering it in five organs system way the types are five; in deficiency and excess, exterior and interior way the types are four, in the causes of symptom way the types are four(the author thought pediatric fever can be caused by pathogenic wind, pathogenic dampness, phlegm stasis and improper diet) and so on. The author had summarized the treating methods toward pediatric fever and putted them into 5 aspects: 1. in which the fever on different organs (heart spleen and lung and kidney). 2. etiology and reasons of the fever (rheumatic, phlegm and food). 3. the "location" of the fever (exterior or interior or between them). 4. the nature of the fever(deficiency or excess). 5. the type of fever (Wen-heat or Zhuang-heat), which forms the outline of diagnosis and treatments on pediatric fever. What should be emphasized is that fever as an accompanying symptom can be caused by many reasons, the immature and fragile immane system of child makes them susceptible to diseases, which performs as "fragments" rather than system theory. So doctors should grab the main point and find the parts which are useful to clinical work.
出处
《吉林中医药》
2017年第3期220-222,共3页
Jilin Journal of Chinese Medicine
基金
国家科技部"973"项目(2013CB532004-2)
关键词
《保婴撮要》
小儿发热
诊治框架
急泻其阳
峻补其阴
Bao YingCuo Yao
fever in children
outline of treatment theory
draining yang
invigorating yin