《伤寒论》阳明病之二便辨析

Differentiation of Urine and Stool of Yangming Disease in Treatise on Febrile Diseases

《伤寒论》阳明病篇提纲即言“阳明之为病,胃家实也”,《灵枢·本输》云“大肠小肠皆属于胃”。阳明本燥,邪气并入大肠,传化糟粕功能失常而影响大便;小肠不得升清降浊致膀胱气化不利,亦可影响小便,及二便失司是阳明病常见征象。阳明病小便异常可提示津液有无,胃气虚实,湿热内结与浊气有无出路等;阳明病大便燥硬可反应“热”“实”“燥”互结于胃内;且大、小便之间互为关联。本文旨在梳理阳明病二便相关论述,探讨二便症状表现特点,辨析此篇内小便、大便病机,揭示其内在区别与联系,凸显二便在阳明病篇相关理论内涵。

The outline of Yangming disease in Treatise on Febrile Diseases is“Yangming disease is excessive heat in stomach and intestine”,and“The large intestine and small intestine belong to the stomach”in Lingshu Benshu.Yangming originally is dry,disease pathogens into the large intestine,transfer dross function disorders and affect the stool,and erdefecation disorders are common signs of Yangming disease.Small intestine can not rise clear fall turbid bladder gasification adverse,also can affect urination.Abnormal urination in Yangming disease can indicate whether there is body fluid,empty and solid stomach Qi,whether there is an outlet for damp and heat internal knot and turbidness Qi,etc.Yangming disease dry hard stool can react“hot”,“real”,“dry”mutual knot in the stomach.And defecation and urination are interrelated.The purpose of this paper is to sort out the relevant discussions of erdefecation in Yangming disease,explore the characteristics of erdefecation symptoms,analyze the pathogenesis of internal urination and defecation,reveal the internal differences and connections,and highlight the theoretical connotation of erdefecation in Yangming disease.