论《伤寒论》数脉主病

Analysis of the Indications of Rapid Pulse in Treatise on Exogenous Febrile Disease

对《伤寒论》条文中涉及的单纯数脉主病、数脉相兼脉主病和数脉相类脉主病等内容进行整理与分析。《伤寒论》中的数脉所反映出来的病机纷繁复杂,脉义具有多重性。单纯数脉主要反映虚证、提示病情变化;数脉相兼脉主要反映虚证、里实热证、秘结的大便与宿食等有形之邪、正邪斗争的疾病态势、痈疡病等;数脉相类脉主要反映里实热证、虚证、正邪斗争胶着的疾病态势。根据数脉主病可辨明病势是整体向愈还是整体恶化;脉证合参更有利于病机的判别。数脉涉及病机的核心在于“热”与“阳”,可以是阴虚所导致的虚热,或是正虚所导致的阳不秘(阳之失调),或是实邪导致的阳盛。探讨《伤寒论》中的脉法可为现代中医临床应用脉诊进行辨证提供参考。

The article sorted out and analyzed the indications of single rapid pulse,the indications of complex rapid pulse and the indications of similar rapid pulse that recorded in Treatise on Exogenous Febrile Disease.The rapid pulse in Treatise on Exogenous Febrile Disease reflects the complexity of the pathogenesis and presents the multiple meanings of the pulse.The single rapid pulse mainly reflects the deficiency syndrome and indicates the changes of illness state.The complex rapid pulse mainly reflects deficiency syndrome,interior excess and heat syndrome,tangible pathogens such as constipated stools complicated with indigestion,the condition of the struggle between healthy qi and pathogenic qi,carbuncles and ulcers,etc.The similar rapid pulse mainly reflects interior excess and heat syndrome,deficiency syndrome,and the condition of the struggle between healthy qi and pathogenic qi.The indications of rapid pulse predict the prognosis of overall healing or deterioration,and the comprehensive analysis of pulse and syndrome is more conducive to the identification of the pathogenesis.The core of the pathogenesis involved in the rapid pulse is due to heat and yang,which can be either deficiency heat due to yin deficiency,or disharmony of yang due to deficiency of healthy qi,or excessive yang due to pathogenic excess.The discussion of the pulse-feeling method in Treatise on Exogenous Febrile Disease can provide a reference for the clinical application of pulse examination in the syndrome differentiation in modern Chinese medicine practice.