郁证发微(三十四)——郁证遗精论

Series of discussion on depression syndrome(34): Spermatorrhea due to depression syndrome

通过全面复习古代有关文献,认为:遗精多属于郁证的范畴。引起遗精的主要是恣情纵欲、劳心过度、妄想不遂、肝气郁结、君相火旺、思虑过度等情志因素;遗精在本质上属于心病,肝气郁结、思虑伤脾为其常见病机。肾虚与肾虚不藏是两个不同的概念,肾虚因于久病大病,未必有失封藏而遗精;肾虚不藏必因于情志因素,并通过心肾不交或心肝肾联动机制而发生遗精。遗精常见的伴随症状多具有郁证表现的特征。古代对于郁证遗精多从心论治,甚至认为通过净心舒情可不药而愈。演变至今日,遗精从肝论治者日益增多;诊治遗精当知郁证性遗精,切不可只知一味补肾。

Through the comprehensive review on ancient literatures,it finds that spermatorrhea mainly belongs to the category of depression syndrome. The main emotional causes lead to spermatorrhea include indulging oneself in carnal pleasure without restraint,excessive worry,psycholagny,depression of liver qi,hyperactivity of sovereign fire,overthinking and so on. In essence,spermatorrhea is a kind of heart disease,and the stagnation of liver qi and worry impairing spleen are the common pathogenesis. Kidney deficiency and kidney dysfunction in essence storage are two different concepts. Kidney deficiency results from chronic and serious illness,and may not appear spermatorrhea caused by dysfunction of essence storage; while kidney dysfunction in essence storage must be due to emotional factors,and lead to spermatorrhea through disharmony between heart and kidney and linkage mechanism of heart-liver-kidney. The common concomitant symptoms of spermatorrhea are mostly characterized by depression syndrome. In ancient times,the therapy for spermatorrhea due to depression syndrome was treated from the heart,and even emphasized clearing mind which could recover the illness without medicine. Until nowadays,more and more doctors have treated spermatorrhea from the liver. In the diagnosis and treatment of spermatorrhea,doctors should not only tonify kidney,but also be conscious of spermatorrhea due to depression syndrome.