“遏病”与“补虚”:宋代黄耆药用重心的变化

“Remedy” and “Tonic”:Changes of Medical Center of Astragalus in Song Dynasty

宋代以前,黄耆主治痈疮、兼顾补虚,重在"遏病",不被视为典型的补益药物。随着唐宋之际人们对植物类药物的深入利用,北宋中期至南宋末年,黄耆被不断赋予"补气"良药的理论地位。由于处于南北政权对峙,黄耆在供需紧张之中而被人为地抬高了身价。黄耆的药用重心,出现了从重于"遏病"向重于"补虚"的变化。这变化既来源于汉唐以来杰出医药学家的拓展实践,也有赖于宋代官修药方和官办药局的认可普及。南宋时,黄耆补脾(补气)的地位的确立,对后世(特别是明清)过分注重气血补益有一定消极影响。

Before Song Dynasty,astragalus with its secondary effect to complement deficiency mainly cured carbuncle sore,and was mainly used for＂remedy＂.It was not considered to be a typical tonic medicine.With people making broaden use of botanical drugs in Tang and Song Dynasties,astragalus was endowed with the theoretical position of＂Tonifying Qi＂medicine,from the middle of Northern Song to the end of Southern Song.Because of confrontation between Northern Song Dynasty and Southern Song Dynasty,the supply and demand of astragalus was increasingly unbalanced and artificially inflated.The medicinal focus of astragalus shifted from ＂remedy＂to＂tonic＂.The changes not only originated from the development of the knowledge of astragalus,but also depended on the recognized popularization of the official prescription and the official medicine bureau in Song Dynasty.After Southern Song Dynasty,the status of astragalus about Tonifying spleen（Tonifying Qi）was established,which had negative effect on the excessive emphasis on supplement Qi and blood in the later world（especially Ming and Qing Dynasty）.