《伤寒论》体质观探析

An Analysis of the Constitution View in Treatise on Cold Damage Diseases

《伤寒论》系统论述了初病即可兼见或纯见他经证候的不同发病方式,并将其归结于体质因素所致。体质不仅影响着发病方式,也影响了六经病的寒热虚实属性,即邪气或病情随体质而发生变化。《伤寒论》既重视外感邪气引起疾病发展变化的共性规律,又强调体质因素造成疾病传变的个性化特点;根据患者体质的不同,误治后出现的病情变化也不尽相同;体质壮实者虽经误治,阴阳受损而未衰,仍可阴阳自和而愈;不同的体质对药物的耐受性不同,仲景用药十分注意遵循"能毒者,以厚药;不胜毒者,以薄药"的原则;体质较强的病人自和能力强,预后较好,若患者体质较差,则自和能力弱,预后较差。

Treatise on Cold Damage Diseases systematically discusses the different ways of onset in which the initial illness can be seen concurrently or purely by other syndromes,and attributes them to constitutional factors. Constitution not only affects the way of onset,but also affects the attributes of deficiency and excess andcold and heat in the six meridians diseases,that is,pathogenic factors or conditions change with constitution. Treatise on Cold Damage Diseases not only emphasizes the common law of disease development and change caused by exogenous pathogenic factors,but also emphasizes the individualized characteristics of disease transmission caused by physical factors. According to the different constitutions of patients,the changes of illness after mistreatment are also different. The strong constitution can be healed by the harmony between yin and yang even though it is damaged by mistreatment. Different constitutions have different tolerance to drugs. Zhang Zhong-jing pays great attention to following the principle:" For those who can endure toxic materials,let him take thick medicine;For those who cannot endure toxic materials,let him take thin medicine". Patients with strong constitution have strong self-ability and good prognosis,and patients with poor constitution have weak self-ability and poor prognosis.