王燕昌《王氏医存》疫病学术思想探析

Study on the plague academic thought of WANG Yan-chang's Wangshi Yicun

根据清代医家王燕昌《王氏医存》探讨其对瘟疫的认识与诊疗防护经验。王燕昌认为瘟疫是外感内伤之兼证,其病因是“秽污之气”及其染易者、“伏热”,尤其是前者在瘟疫诊断中有决定性作用。瘟疫总病机为“水弱火强”,具有“三焦传变”与“伏热内发传变”的传变规律,及多有夹病夹证的特点。辨治方面,强调辨清瘟疫病情轻重、病位传变范围、夹病夹证,勿犯瘟疫治忌,把握用药尺度,以养阴生水贯穿治疗始终,初病兼以解表;其邪所传变相及之处,遂经所欲,随证并治;夹病、夹证可兼治、缓治;病危急用预备妙验方药速治。防护方面,强调管理传染源,静养生阴配阳,注重饮食、闭汗调适,愈后扶正御邪。

To discuss the Qing dynasty TCM doctor WANG Yan-chang’s plague academic thought about plague understanding,treatment and protection based on his Wangshi Yicun.WANG Yan-chang believed that plague was a concurrent pattern of external contraction and internal damage,and its etiology was"pestilential",pestilential-infected and"deep-lying heat",especially the former played a decisive role in the diagnosis of plague.The main pathogenesis of the plague is'weak water and strong fire’,and it has the.rules of‘triple burner shifts’and‘deep-lying heat internal shift’,and has the characteristics with more accompanying diseases and syndromes.In the aspect of differentiation and treatment,he was emphasized to distinguish the severity of the disease,the ranges of the shift of the plague,and the accompanying diseases and the syndromes,not to outrage the treatment contraindication,to grasp the criteria of medication,to nourish yin and engender water throughout the treatment,assisting with exterior-resolving method at the initial disease;when the pestilential spreads and shifts,its treatment may be accorded by the infected-channel’s requirement and syndrome;accompanying diseases and syndromes should be cured at the same time or later;critical illness should be treatment immediately with the prepared effective prescription.In terms of protection,emphasis is placed on the management of infection sources,growth-yin by rest cure to reconcile with yang,nurse of diet and ischidrosis,supports healthy energy to defend evils after the plague has been cured.