基于“通透”祛邪法对吴又可开达膜原治疫思想探骊

Discussion on WU You-ke's thought of treating epidemic disease with relieving moyuan based on'unclogging and exuding' dispelling evil method

“通透”,即通里透表,以汗法和下法为代表治法,是中医界治疗疾病常用的祛邪法则。文章发现,明代温病学家吴又可在治疫过程中对人体形成了“表-膜原-里”的朴素整体结构观。而疫病初起,疫气从口鼻直入半表半里的膜原,邪气传变有走表、入里两个途径,都为吴又可利用“通透”祛邪法因势利导,为开达膜原提供了先决条件。同时文章对达原饮、达原饮三阳加法以及三消饮分析发现,三方病机为邪气即离膜原而未离,有不同程度的走表入里,所以三方均为吴又可应用“通透”祛邪法开达膜原治疗疫病的具体体现。

‘Unclogging and exuding’ means making evil to go out from the gastrointestinal tract and from the muscle surface, with sweating and defecation as representative treatment. It is a common rule to remove evil in the treatment of diseases in TCM. It is found that WU You-ke, a warm epidemiologist in Ming dynasty, formed a simple overall structure view of the human body: ‘surface, moyuan and interior’ in the process of curing epidemic disease. At the beginning of epidemic disease, the evils of epidemic disease goes straight from mouth and nose into the moyuan of half a surface and half a inside. There are two ways for the evils of going out and going in, which provides the prerequisite for WU You-ke to use the ‘unclogging and exuding’ method to take advantage of the situation for relieving moyuan. At the same time, the analysis of Dayuan Decoction, Dayuan Decoction Sanyang Jiafa and Sanxiao Decoction shows that the pathogenesis of the three prescriptions is evil, that is, leaving the membrane original but not leaving, with different degrees of inward and outw ard, so the three prescriptions are the specific embodiment of WU You-ke application of ‘unclogging and exuding’ dispelling evil method to relieving moyuan original to treat epidemic disease.