刘景源论伤寒与温热病初期辨治之别

LIU Jingyuan's discussion on differentiation and treatment of exogenous cold diseases and warm diseases in the early stage

在临床中,辨外感寒邪导致的伤寒病与外感温热邪气导致的温病的区别,关键在于其初期恶寒与发热的轻重。外感寒邪,因寒主收引,闭塞腠理,故恶寒重、发热轻;外感温热邪气,腠理并不闭塞,但表邪欲入里而导致表郁,故发热重、恶寒轻。二者以此为鉴别要点。辛温解表法,是针对外感寒邪初期的治法,它通过发汗散寒以解表;辛凉轻解法,是针对外感温热邪气初期的治法,它通过疏风清热以解表。在“八法”中二者一属汗法,一属清法,作用截然不同,临床不可混淆。

In clinical practice,the key to distinguishing exogenous cold diseases caused by exogenous cold pathogens from warm diseases caused by exogenous warm-heat pathogens lies in the severity of cold and fever in their initial stage.Caused by exogenous cold pathogens,diseases are manifested as the syndrome of severe cold and mild fever as cold pathogens have the property of contraction and tend to block striae.While caused by exogenous warmheat pathogens,diseases are manifested as the syndrome of severe fever yet mild cold,for exterior pathogens tend to enter the interior,leading to stagnant superficies yet no blocking in striae.These are the key points for identifying the two different types of diseases.The method of relieving superficies syndromes with pungent and warm natured drugs can be employed for the treatment of exogenous cold pathogens in their early stage,which can relieve superficies syndromes by sweating and dispelling cold.While the method of resolving superficies syndromes with pungent and cool natured drugs can be manipulated for the treatment of exogenous warm-heat pathogens in their early stage,which can relieve superficies syndromes by dispersing wind and clearing heat.In the"eight methods"of traditional Chinese medicine,the two belong to the sweating method and the clearing method respectively,which perform completely different actions and cannot be confused in clinic.