《伤寒论》第38条再议

Re-discussion on Article 38 of Treatise on Typhoid Fever

《伤寒论》第38条为"太阳中风,脉浮紧",与《伤寒论》第2条所定义的太阳中风证的脉证描述不一致,在中医史上引起广泛的关注和争议。中风之状,本当如《伤寒论》第2条所言:"发热,汗出,恶风,脉缓",此处脉浮紧,发热恶寒,身疼痛,不汗出症状如同伤寒。但是,感邪虽同,若其人禀赋阴阳不同,可出现不同病证。《伤寒论》第38条所描述的正是卫阳强盛之人中风的情况。外邪中于卫阳,卫阳在表,其脉定见浮象,风邪导致的腠理疏泄太过,更刺激卫阳之收敛,营卫平衡关系被打破,卫气功能反而病理性增强,收敛太过,遏闭营血,则营郁热甚,而见燥烦症状;卫气过强,人身呈现收敛之象,故脉紧身痛,发热恶寒。

"Taiyang apoplexy leading to floating tight pulse"in Article 38 of Treatise on Febrile Diseases is not consistent with the description of Taiyang apoplexy syndrome defined in Article 2 of the same book,which has received extensive attention and controversy in the history of Chinese medicine.Apoplexy should have been said in Article 2 of Treatise on Febrile Diseases:"fever,perspiration,aversion to wind and bradycardia".Here,symptoms of floating tight pulse,fever,chills,body pain,no sweating and irritability are like that of the typhoid fever.However,although the pathogenic factors are the same,if the endowment of Yin and Yang is different,different diseases and syndromes may appear.Article 38 describes the special situation of the strong and powerful people in Wei Yang.When the external evil invades the Wei Yang and the Wei Yang is on the surface.The circulation of Wind evil can stimulate the convergence of Wei Yang.In the body where the Wei Yang is prosperous,the Wind is not as good as the convergence of the Wei Qi.The balance between the Ying and Wei is broken,and the function of the Wei Qi is strengthened.If the convergence is too much,the Ying is depressed and the symptoms of dryness are observed.If the Wei Qi is too strong,the body presents the image of convergence,so the pulse is tight and painful,and the fever is averse to cold.