陈修园乌梅丸心传

Professor CHEN Xiu-yuan’s Clinical Treatment Experiences in Using The Wumei Piu

陈修园是清代著名医家,对《伤寒杂病论》研究颇有成就,尤其是对其中厥阴病篇乌梅丸理解深刻独到。本文以陈修园著述合集为蓝本,分别从厥阴病提纲证、乌梅丸方证、厥阴病欲解时等理论出发,联系古今医家,采众家之长,深入剖析其使用乌梅丸的心识体会。陈修园认为厥阴代表了两阴之尽、一阳之生,其病机寒热错杂,包括风气上扰、少阳相火内发、肝肾阴寒之证。乌梅丸主治脏寒,为统领厥阴各证之总方且擅治久利,其组方以柔养肝木、敛戢风气、苦寒下逆、温补肝肾、调补中焦为主旨,并针对肝体阴用阳等生理特点补气和血,与张仲景提出的治肝之大法完全契合。此外,各疑难杂症于下半夜出现症状或症状加重者都可以考虑选用乌梅丸。

CHEN Xiu-yuan is a famous physician of the Qing dynasty,who is either rigorous and expert.He has a profound understanding of the Treatise on Cold Pathogenic and Miscellaneous Diseases,especially the Wumei Piu of the Jueyin Syndrome.This article explains the theory of the Jueyin Syndrome,the prescription-syndrome of the Wumei Piu,and the recovery time of the Jueyin Meridian diseases,quoting from the publications of a great many physicians.Meanwhile,it dives deep into CHEN Xiu-yuan’s experience in using the Wumei Piu.CHEN considered that Jueyin is ending of the Yin and beginning of the Yang,the pathogenesis is complex,including cold-heat jumble,hyperaction of liver Yang,Shaoyang fire,deficiency of kidney and liver Yang.The indications of Wumei Piu consisted cold syndrome in infant,nearly all the Jueyin diseases and long treatment dysentery.The Wumei Piu nourishing liver,dispel wind,calm the adverse-rising energy,reinforce liver kidney spleen and stomach,benefit Qi and nourishing blood,which conform with ZHANG Zhong-jing's theory of Liver belonging to Yin in physique and Yang in function theory.Besides,treating all the difficult miscellaneous diseases that worse in the dawn may take Wumei Piu into account.