《伤寒论》第282条之探析

Analyzing the No.282 from Treatise on Febrile Disease

[目的]分析《伤寒论》第282条,探讨其证之病因病机。[方法]基于《伤寒论》282条原文的论述,参考多家医家之注释,对照仲景其他条文的叙述,分析对该条文所述病因病机的认识,权衡急缓,附以适宜方药。[结果]原文冠首"少阴病",宜理解为"伤寒";"虚故引水自救"并非指向"阳虚",宜是阴虚;疾病本是错综复杂,原文虽存在阴虚证候,但总体仍是少阴寒化证;原条文虽未给出汤药,经过讨论,此处应及时处方以白通汤,以防病变加剧。[结论]《伤寒论》282条论述了一种少阴病寒化证的动态发展过程,结合其他与之并列条文,可见其完善了少阴寒化证的症状,原文虽未给出治法,然非无药可治,是仲圣已于其它处论述,这提示后人,有机地联系前后条文,是学习《伤寒论》方法之一。

[Objective]To analyse the No.282 from Treatise on Febrile Disease to make sure its principle.[Methods]Based on the discussion of No.282 from Treatise on Febrile Disease,analyzing the onset and process by means of reference to other great masters’ opinions,linking to other clauses,and give the treatment in conclusion.[Result]The writer believes it is not reasonable to treat the two"Shaoyin diseases"as the same,the first"Shaoyin diseases"should be regarded as"Shanhan". The reason leading to thirst is not the"deficiency of Yang",it should be regarded as"deficiency of Yin". Although there exists"Yinxu",on the whole,it is a"Shaoyin Hanhua Zheng".For treatment,Baitong Soup should be given as soon as possible to avoid deteriorated cases.[Conclusion] This section gives tips like the disease is progressing,we should control it as soon and best as possible.Inter-associating relevant clauses is a good way to learn scriptures.