基于《王仲奇医案》探析湿温辨治特色

Analysis of Differentiation and Treatment Characteristics of “Damp-warm Syndrome” Based on WANG Zhongqi’s Medical Cases

基于《王仲奇医案》从暑湿交蒸、湿漫三焦、邪伏膜原、午后发热四个方面分析新安医家王仲奇辨治“湿温”的特色。王仲奇认为暑湿交蒸宜清暑化湿,常用佩兰、青蒿、通草、薏苡仁、金银花、连翘、夏枯草、桑叶之类;湿邪弥漫三焦应以畅通三焦气机为要,责之白豆蔻、枳壳、大腹皮、橘叶、杏仁、佩兰、法半夏、青蒿、茯苓之属;邪伏膜原则以疏利膜原为急,多以吴又可之达原饮加减;午后发热经久不愈多以寒凉清解、淡渗利湿为法,偏喜连翘、金银花、栀子、薏苡仁、青蒿、滑石、郁金之辈。

Based on WANG Zhongqi’s Medical Cases,this paper analyzes Xin’an famous doctor WANG Zhongqi’s differentiation and treatment characteristics of“damp-warm syndrome”from four aspects:summerheat-dampness steaming,dampness spreading the triple energizer,latent pathogen in membrane source,and afternoon fever.WANG Zhongqi believes that the summerheat-dampness steaming should be treated by clearing summerheat and dissipating dampness,commonly using Peilan(Eupatorii Herba),Qinghao(Artemisiae Annuae Herba),Tongcao(Tetrapanacis Medulla),Yiyiren(Coicis Semen),Jinyinhua(Lonicerae Japonicae Flos),Lianqiao(Forsythiae Fructus),Xiakucao(Prunellae Spica),Sangye(Mori Folium),etc.Dampness spreading the triple energizer should be treated by promoting qi movement of the triple energizer,commonly using Baidoukou(Amomi Fructus Rotundus),Zhiqiao(Aurantii Fructus),Dafupi(Arecae Pericarpium),Juye(Folium Citri Reticulatae),Xingren(Armeniacae Semen Amarum),Peilan(Eupatorii Herba),Fabanxia(Pinelliae Rhizoma Praeparatum),Qinghao(Artemisiae Annuae Herba),Fuling(Poria),etc.Latent pathogen in membrane source should be treated by promoting the function of the pleurodiaphragmatic interspace,mainly using addition and subtraction of Dayuan Yin(达原饮)by WU Youke.Afternoon fever sustaining for a long period should be treated by clearing and releasing with herbs cold and cool in nature as well as elim-inating dampness with bland medicinal,preferring to use Lianqiao(Forsythiae Fructus),Jinyinhua(Lonicerae Japonicae Flos),Zhizi(Gardeniaae Fructus),Yiyiren(Coicis Semen),Qinghao(Artemisiae Annuae herba),Huashi(Talcum),and Yujin(Curcumae Radix),etc.