对“因发知受”发病学原理的探讨

On pathogenic theory of “speculating nosopoietic factors according to symptoms and signs”

清初医家钱潢用"外邪之感,受本难知,发则可辨,因发知受",高度概括了机体因感受外邪而发病,医家们再依据发病的症状体征推测病因,从而求得病机、进行论治的思维过程。因发知受的本质,实际上包括了审证求因、由因求机和审机论治3个过程,由"因机"预测"发",由"发"知"因机",再审机论治。在临床中,结合现代科技手段及现代辨证体系,对还未显现出临床症状的疾病进行预测和干预治疗,即"未发"亦"知因机",实现"司内揣外",与传统中医"司外揣内"相互补充。因发还能知传知变,对疾病的预后与转归有一定指导作用。

Qian Huang highly summarized pathogenic laws of disease,disease invasion due to external pathogen,in traditional Chinese medicine（ TCM） with sixteen Chinese words,including ＂speculating nosopoietic factors according to symptoms and signs＂,and later doctors have summed up the thinking process of speculating nosopoietic factors,acquiring pathogenesis and giving treatment according to symptoms and signs. The essence of ＂speculating nosopoietic factors according to symptoms and signs＂ actually has 3 procedures： speculating disease causes according to patterns,speculating pathogenesis according to disease causes,and giving treatment after investigating pathogenesis. Disease invasion is predicted according to disease causes and pathogenesis,disease causes and pathogenesis are understood from disease invasion,and treatment is given after investigating pathogenesis. In clinical practice,modern science and technology and modern differentiation pattern system are combined to predict and give interventional treatment to the diseases without showing clinical symptoms. ＂Speculating nosopoietic factors according to symptoms and signs＂can be also applied to understand disease transmission and transmutation,and guide to know disease prognosis and outcome.