白长川论麻黄升麻汤证治

Bai Changchuan′s Discussion on Mahuang Shengma Decoction in Clinical Syndrome Differentiation and Treatment

麻黄升麻汤自古以来争议颇大,历代医家见解不一。柯韵伯、舒驰远、汪机、陆渊雷等医家认为,麻黄升麻汤非仲景原方;吴谦、徐灵胎、刘渡舟等医家认为,麻黄升麻汤为集仲景学说大成之方。白长川认为,关于麻黄升麻汤的由来,没有必要争论是否仲景之方,只要有效就当用之不疑,否则便是舍本逐末;麻黄升麻汤证的病机为寒邪束表、阳气闭郁、上热下寒、热盛伤阴,方中虽药味繁多,看似驳杂无序,实则宣清合用、补泻兼施、寒热并治,体现了“合方治疑难”的证治思路。

Mahuang Shengma Decoction has been controversial since ancient times,and doctors of the past dynasties have different opinions.Physicians such as Ke Yunbo,Shu Chiyuan,Wang Ji,and Lu Yuanlei believed that Mahuang Shengma Decoction is not the original formula created by Zhongjing;Wu Qian,Xu Lingti,Liu Duzhou and other medical practitioners believe that Mahuang Shengma Decoction is the ultimate formula coming from Zhongjing′s theory.Bai Changchuan believes that regarding to the origin of Mahuang Shengma Decoction,there is no need to argue whether it is the original prescription of Zhongjing,as long as it is effective,it should be used without doubt,otherwise it should be abandoned.The pathogenesis of Mahuang Shengma Decoction syndrome is that the pathogenic cold constricting the surface,the Yang Qi being blocked,the upper Heat surpassing the lower Cold,and the excess Heat hurts the Yin.There are many medicinal flavors in the prescription,which seems to be mixed and disordered.Actually,dispersing Qi and clearing Heat,tonifying and discharging as well as cooling and heating should be applied in combination in treatment,reflecting the treatment idea of"combination of prescriptions to treat complex diseases".