论《温病条辨》之五大死证

Discussion on the Five Fatal Symptoms of Detailed Analysis of Epidemic Febrile Diseases

温病是具有起病急、来势凶猛、传变快、变化多等特点的一类急性外感热病,临证时稍有不慎,便险证蜂起,难以救治。故清·吴鞠通在《温病条辨》一书中论述了温病死证之五大纲,即"在上焦有二:一曰肺之化源绝者死;二曰心神内闭,内闭外脱者死,在中焦亦有二:一日阳明太实,土克水者死;二曰脾郁发黄,黄极则诸窍为闭,秽浊塞窍者死,在下焦则无非热邪深入,消烁津液,涸尽而死也"。此五大死证,在现今临床上虽确属急危重证,但若能及时救治,则有可能转危为安,"死"仅喻病势凶险,并非无生还之希望。吴氏所主张之"救阴存液"的治疗原则对中医急症的治疗极具指导价值,谨就原著中有关章节内容,对吴氏所论之温病五大死证,作一初识。

s： Epidemic febrile diseases are acute exogenous febrile diseases with characteristics of acute onset, ferocious, change quickly and variously, which can easily lead to critical illness. Wu Jutong of Qing dynasty had briefly discussed the five outlines of fatal symptoms in Detailed Analysis of Epidemic Febrile Diseases. The author took relevant chapters of the original to get an acquaintance of Wu＇ s five fatal diseases of epidemic febrile disease.