朱子文“湿不单见,脾不独虚”论治泄泻特色

ZHU Ziwen's Specific Clinical Experience in Treating Diarrhea from"Not Noly Dampness Existing or Spleen Deficiency"

总结朱子文治疗泄泻的经验特色。认为泄泻"湿不单见,脾不独虚",其证候寒热交织,正虚邪恋,治疗上注重判别泄泻之邪正虚实,或涩或利,活法应用。认为急性泄泻不可骤用补涩,当祛湿分利,调畅中州,慎思明辨防危证,如暑湿泄泻出现热陷心包,宜急需解毒开窍;慢性泄泻不应漫投分利,当肝肾脾同调,匡扶正气,如脾阳虚之泄泻,宜理中汤灵活加减。所附医案颇具特色且效验确切。

We summarize ZHU Ziwen's specific clinical experience in treating diarrhea.In ZHU Ziwen's view,the pathogenesis of diarrhea are"not only dampness existing with spleen deficiency",the syndromes of diarrhea are"cold interweaving with heat and healthy Qi is deficient with evil Qi lingering".In the treatment,ZHU Ziwen focused on judging the excess and deficiency of the healthy Qi and the evil Qi,flexibly applying the treatment of astringing and promoting urination.Acute diarrhea should be treated by removing dampness,promoting urination and perspiration,regulating spleen and stomach instead of reinforcing or astringing immediately.He advocated doctors should deliberate and carefully distinguish to prevent the appearance of danger syndromes.For example,detoxification and resuscitation should be urgently adopted when syndrome of heat invading pericardium appears in diarrhea with syndromes of summer dampness.Chronic diarrhea should be treated by regulating liver,kidney and spleen,reinforcing the healthy Qi instead of promoting urination and perspiration carelessly.For example,the diarrhea of spleen yang deficiency should be flexibly treated with Lizhong decoction by adjustment.And the case reports of ZHU Ziwen's attached are observably characteristic with specific effects.