《金匮要略》桔梗汤“亦治血痹”考辨

Discussion on Jiegeng Decoction "Also Being Used to Treat Blood Impediment" in Jin Gui Yao Lue

《金匮要略》原文中桔梗汤本用于肺痈脓成后的治疗,在其方后附有小字注文“亦治血痹”,然肺痈与血痹两病殊异,桔梗汤何以均能治疗?历代医家各陈己见,多以气血关系为出发点对此进行解读,但也未能令人信服。通过对《金匮要略》不同版本的校勘以及对唐及以前的医籍文献进行考察,认为该小字注文应为“亦治喉痹”。另外,该小字注文应为宋臣校正《金匮要略》时根据《备急千金要方》《外台秘要》等医籍文献中对桔梗汤功效的记载附注于此,而“亦治血痹”或为邓珍刊刻时所据底本有误,抑或是邓珍个人误写、修改所致。

In the original text of Jin Gui Yao Lue,Jiegeng Decoction is used for treatment of lung abscess after the formation of abscess.After the prescription,it is noted with small characters that"also being used to treat blood arthralgia".However,lung abscess and blood arthralgia are different.Why can Jiegeng Decoction be used to treat the two?Ancient physicians have their own views,mostly applying the relationship between Qi and blood as a starting point to interpret this issue.However,it is not enough to convince.Through the collation of different versions of Jin Gui Yao Lue and the investigation of medical literature in the Tang Dynasty and before,it is believed that the small-word annotation should be"also being used to treat throat paralysis".In addition,the small-word annotation should be attached there when Song Chen corrected Jin Gui Yao Lue according to the records of the efficacy of Jiegeng Decoction in medical literature such as Bei Ji Qian Jin Yao Fang and Wai Tai Mi Yao.Therefore,"also being used to treat blood arthralgia"was either based on Deng Zhen′s original version,in which there is an error,when it was printed or Deng Zhen′s personal miswriting and modification.