伤寒学说的发展:内伤与温病学说合论

Developments of exogenous cold disease theory: Internal injury and epidemic febrile disease theories

伤寒学说自建立以来在中医辨证领域长期居于主导地位,后世李东垣创内伤学说,吴又可、叶天士等人创瘟疫、温病学说,有捍动伤寒学术地位之势。阴火是气虚湿陷、郁火上冲、心火下乘所致,温病则是邪犯肺、胃,或邪伏于肾所致,二者病机虽异,但同为火自内生,从下上逆,从内外达。寒邪具有闭敛之性,热邪具有开泄之性,二者发展、传变趋势不同,因此辨证方法不同,内伤、温病学派是根据邪气性质的不同,补充、发展伤寒学说。病有时异,故辨证论治体系也当因时而完善。

The theory of exogenous cold disease had occupied the leading role in the aspect of traditional Chinese medicine since established. After that, LI Dong-yuan put forward the theory of internal injury, while WU You-ke and YE Tianshi put forward that of plague and epidemic febrile disease, which had taken the place of exogenous cold disease theory to some degree. Yin fire was the result of qi deficiency, pathogenic dampness, stagnated fire and cardiac fire. The epidemic febrile disease was caused by pathogen invasions of lung, stomach or kidney. Internal injury and epidemic febrile disease were not the same. However, they were both caused by the fire burning inside bodies. Cold-evil had the characteristic of hiding while the hot-evil dispersing, so their changing progresses were different, which required different ways to syndrome differentiation. The theory of internal injury and epidemic febrile disease were developments, rather than denial, of the exogenous cold disease theory according to the different evils. Evils at different times had their own characteristics. Therefore, the system of syndrome differentiation and treatment should be perfected constantly.