李士懋“溯本求源、平脉辨证”学术观点初探

Discussion on LI Shimao's Academic View of “Tracing the Origin and Differentiating the Pulse and Syndrome”

总结李士懋"溯本求源、平脉辨证"学术观点为6个方面。1)论诊断重脉诊:创立了脉诊辨证大纲说、虚实脉诊大纲说、气血脉理大纲说,提出了脉诊新说;2)论三法重汗法:将辛温发汗法既用于治疗实寒证,也用于治疗虚寒证;3)论伤寒重阳虚:认为内伤阳虚证是外感风寒侵袭的重要原因;4)论温病重火郁:首次明确指出温病的本质为郁热,善用以透为核心的清、透、滋三法治疗温病,创制新加升降散治疗郁热;5)论疑难重痰瘀:认为现代临床疑难杂病的特点与中医的痰证和瘀血证有相似性,喜用导痰汤、张仲景和王清任逐瘀诸方、桃红四物汤化裁治疗痰瘀证;6)论抢救重急症:认为中医善于治急症,中医急症学的研究要善于借助现代科学技术手段。

This article summarizes LI Shimao＇s academic view of ＂tracing the origin and differentiating the pulse and syndrome＂in six aspects. 1） Emphasizing pulse in diagnosis： he put forward the new theories of pulse diagnosis such as ＂differentiating syndrome by pulse diagnosis＂outline theory,＂deficiency and excess pulse diagnosis＂outline theory and ＂interpreting pulse mechanism with Qi and blood＂outline theory. 2） Emphasizing sweat promotion method in the ＂three methods＂（ including sweat promotion,emetic method and purgative method） ： he promoted sweat with acrid-warm drugs not only in the treatment of excess cold syndrome,but also in the treatment of deficiency cold syndrome. 3） Emphasizing Yang deficiency in cold damage syndrome： he regarded Yang deficiency as an important reason for the attack of externally-contracted wind-cold. 4） Emphasizing fire constraint in warm disease： he was the first to pinpointed that the nature of warm disease is stagnated heat,he was good at treating warm disease with clearing,venting and enriching methods of which venting is the core and he invented Xinjia Shengjiang San（ 新加升降散） to treat stagnated heat; 5） Emphasizing treating phlegm and stasis in the complicated diseases： he thought the difficult and complicated diseases in modern medicine were similar to the phlegm syndrome and stasis syndrome in Chinese medicine,so he liked modifying Daotan Tang（ 导痰汤）,ZHANG Zhongjing＇s formulae,WANG Qingren＇ s formulae for removing blood stasis and Taohong Siwu Tang（ 桃红四物汤） to treat phlegm and stasis syndromes; 6） Emphasizing emergencies in rescue period： he thought Chinese medicine did a great work in treating emergencies,and modern scientific and technological methods should be used in studying emergencies in Chinese medicine.