湘医周诒观《秘珍济阴》论治带下病特色探骊

Exploration of the characteristics of treating morbid vaginal discharge in Mizhen Jiyin by Hunan Province’s doctor Zhou Yiguan

《秘珍济阴》是清代医家周诒观所著的一本妇科专著,周诒观师从周于纶、陈树蕙,以妇科见长,为湘中妇产名医。书中有关带下病的论治部分特色鲜明,与明清时期多数医家对带下病的发病机制认识不同,周诒观并未从“湿”论治带下,而是秉承带下病多为“因虚致病”的观点,指出其病位在下元,治疗上以补益下元为法则,创制了以调理冲任、补肾涩精为主要作用的益智天冬四物汤。除此之外,书中还对带下病与白浊、白淫的鉴别,崩带的四种危重症候有详细的论述。后附带下病用药歌部分采用诗歌体裁,用药去繁化简,便于初学者诵记,也反映出作者本人汰繁存要的学术特点。本文通过研阅本书中有关带下病的内容,对周诒观治疗带下病的治疗思想、辨证及用药特色进行探讨,以期为临床治疗带下病提供新的思路。

Mizhen Jiyin is a monograph on gynecology written by Zhou Yiguan,a physician in the Qing Dynasty,who studied medicine from Zhou Yulun and Chen Shuhui.He specializes in gynecology and is a famous doctor of obstetrics and gynecology in Hunan.The part of the book on the treatment of morbid vaginal discharge has distinctive features.Unlike most physicians in the Ming and Qing Dynasties,Zhou Yiguan had a different understanding of the pathogenesis of morbid vaginal discharge,Zhou Yiguan did not treat morbid vaginal discharge from“dampness”.Instead,he held the view that morbid vaginal discharge was mainly“caused by deficiency”.He pointed out that the location of the disease was in Xiayuan,and the treatment was based on the principle of nourishing Xiayuan,and he created Yizhi Tiandong Siwu Decoction with the main functions of coordinating chong and conception vessels and invigorating kidney and astringent essence.In addition,the book also discusses in detail the identification of morbid vaginal discharge from white turbidity and Baiyin,and the four kinds of critical symptoms of collapsing leucorrhea.Part of the accompanying medicinal song for morbid vaginal discharge adopts the poetic style,and the medicines are simplified the complex,which is easy for beginners to memorize and also reflects the academic characteristics of the author himself who abandons the complicated and reserved the essential.This article discusses the treatment thought,syndrome differentiation,and medication characteristics of Zhou Yiguan’s treatment of morbid vaginal discharge by studying the contents of the book about morbid vaginal discharge,in order to provide new ideas for clinical treatment of morbid vaginal discharge.