张子和攻法浅析

An Analysis of Zhang Zi-he′s Eliminating Method

张子和认为:"病之一物,非人身素有之也。或自外而入,或由内而生,皆邪气也。"邪气入侵人体,导致疾病发生,并且影响病程与病情。"轻则传久而自尽,颇甚则传久而难已,更甚则暴死。"人与天地相统一,是一个有机的整体,天之六气,地之六气,人之六味应相互协调,不和谐就会产生邪气。"天邪发病,多在乎上,地邪发病,多在乎下,人邪发病,多在乎中,此为发病之三也,处之者三,出之者亦三。"汗、吐、下三法可尽治其病。凡是解表的方法都是汗法,发汗应先"辨阴阳,别表里,定虚实",张子和提出辛凉发汗之法,补充了《伤寒论》汗法的不足。凡是上行的方法均为吐法,上焦病变可用,"宜先小服,不涌,积渐加之",涌吐次数根据病情或患者体质而定;除了汗、吐二法之外的一切攻邪方法均为下法。张子和将攻邪三法归纳为汗法开玄府而逐邪气,吐法令其条达,下法推陈致新,临床运用时既遵守原则,又根据病情灵活选择,随证运用。

Zhang Zi-he thinks that "Disease is not inherent in a person.It comes either from outside or from inside,and all is due to pathogens." When pathogens invade the human body,disease will occur,and they will also affect the length and severity of the disease."If pathogen is light and spreads for a long time,it will disappear by itself.If it is slightly serious and spreads for a long time,it will be difficult to cure.If it is more serious,the patient will die suddenly." The unity of man and heaven and earth is an organic whole.The six qi of heaven,the six qi of earth and the six flavors of man should be coordinated with each other.Disharmony will produce pathogenic qi.Diseases caused by abnormal qi circulation in the heaven are mostly in the upper part of the human body.Diseases caused by abnormal qi circulation of the earth are mostly in the lower part of the human body.Diseases caused by people′s eating disorders are mostly in the middle of the human body.These are the three cases of disease.There are three ways for disease pathogens to invade,and there are also three ways to expel pathogens.Sweating method,vomiting method,and purgative method can be used properly.Any method for releasing the exterior is the sweating method.Sweating should first "differentiate yin and yang,the exterior and the interior,the deficiency and the excess".He puts forward the method of sweating with pungent-cool medicinals,which supplements the shortcoming of the sweating method in Treatise on Cold Damage Diseases.The method of ascending is vomiting method,and the lesions of upper energizer can be used."It is advisable to take small dose first,and if there is no vomiting,proper dose can be added step by step.The frequency of vomiting depends on the disease condition or physical strength.Any method of removing pathogens can be called eliminating method.Zhang Zi-he summarizes the functions of the three methods of eliminating pathogens as follows:The sweating method can open sweat pores and expel pathogenic qi;vomiting method can make the patient act freely;and purgative method can bring forth the new through the old.Therefore,in clinical practice,he not only abides by the principles,but also can flexibly choose proper treating method according to the patient′s condition and exact syndrome.