李东垣阴火论及甘温除热法

Li Dongyuan′s Theory of Yin Fire and Method of Removing Heat with Sweet-Warm Medicinals

李东垣所论之阴火,为脾胃内伤引起体内阴阳失衡,脏腑功能失常而产生的一种内火。病机有脾胃内伤,君火不守;脾胃内伤,相火浮越;脾胃内伤,气郁化火;脾胃内伤,阳气内伏化火;脾胃内伤,湿火相合;脾胃内伤,内燥化火。各个病机相互联系,相互影响。甘温除热法为阴火之治疗大法,临证根据阴火的形成机制及病情发展不同,应用不同治法,或益气升阳,补泻共用;或益气升阳,滋水伏火;或益气升阳,疏理气机;或益气升阳,疏散邪火;或益气升阳,燥湿泻火;或益气升阳,养阴泻火。用药不仅仅拘泥于甘温之品,在采用甘温之品的基础上,明确阴火的病机,随证治之。凡是扶助正气,祛邪退热之法,均可视为甘温除热法。

According to Li Dong-yuan,yin fire a kind of internal fire caused by the imbalance of yin and yang,dysfunction of viscera induced by internal injury of the spleen and stomach.The pathogenesis of the disease includes internal injury of spleen and stomach leading to disorder of sovereign fire,or floating minister fire,or qi stagnation transforming into fire,or latent yang qi trans-forming into fire,intermingled dampness and fire,or internal dryness transforming into fire.Each pathogenesis is related to and affects each other.The method of removing heat with sweet-warm medicinals is regarded as the treatment principle.According to the formation mechanism of yin fire and the development of disease,different methods are applied to treat it.They include invigorating qi and elevating yang by using supplementation and drainage together,or by nourishing the kidney and removing fire,or by regulating qi movement,or by dispersing pathogenic fire,or by drying dampness and purging fire,or by nourishing yin and purging fire.Drug use should not only be limited to sweet and warm medicinals,but also clarify the pathogenesis of yin fire and treat disease according to exact syndrome on the basis of it.Any method of supporting healthy qi and removing pathogenic factors and heat can be regarded as the method of removing heat with sweet-warm medicinals.