先秦至隋唐时期“痈”和“疽”的演变

Evolution of“Yong(痈)”and“Ju(疽)”from the Pre-Qin Period to Sui and Tang Dynasties

"痈"和"疽"是中医外科学中两个重要的概念,《灵枢·痈疽》所载二者的区别被历代医家奉为圭皋,但后世医家在实际运用中却常混淆不清。通过对先秦至隋唐时期相关医学文献进行整理与分析,梳理"痈""疽"二者概念演变的大致脉络,发现此二者的区别除《灵枢·痈疽》所述内容外,还在于二者词性和字义不同,即"疽"仅用于疾病的名称使用上,均为名词;而"痈"字通过假借的方式使其字义逐渐丰富,除表示病名外,还用于特指某具体病灶、表肿胀、表壅滞和浮肿之意,既可为名词,亦可为形容词。二者在古籍中有着看似混乱,实则规律的运用。

"Yong(痈)"and"Ju(疽)"are two important concepts in TCM surgery.The differences between them recorded in Ling Shu"Yong Ju"(《灵枢·痈疽》Miraculous Pivot"Obstruction-and Impediment-Illnesses")have been regarded as standard statement by doctors of the past dynasties.But they are often confused in the practice of later generations.This article summarized the general development of the concepts of"Yong(痈)"and"Ju(疽)"by organizing and analyzing relevant medical literatures from the Pre-Qin Period to the Sui and Tang Dynasties.It is found that apart from the differences recorded in Miraculous Pivot"Obstruction-and Impediment-Illnesses",they also have different characteristics and meanings."Ju(疽)"is a noun and is only used to express the name of disease;while the word"Yong(痈)"is both a noun and an adjective,whose meaning was gradually enriched with the way of phoneticloan.Besides the name of disease,"Yong(痈)"is also used to refer to specific lesions,swelling,stagnation and edema.The applications of them recorded in ancient books seem confusing,but actually regular.