竹皮大丸经义释疑与校诠

Interpretation and Correction of Zhupi Da Pill Syndrome

竹皮大丸始见于《金匮要略·妇人产后病脉证治》,原文为“妇人乳中虚,烦乱呕逆,安中益气,竹皮大丸主之”。近现代医家多从方证研究角度出发,根据原文“烦乱呕逆”之症,认为该方主治产后虚烦、产后呕逆,又以“阴虚内热,中气不足”之证,认为该方具有清热降逆、安中益气之功。虽可自圆其说,亦存诸多不通之处。笔者认为,原文应断句为“妇人乳,中虚烦乱呕逆,安中益气,竹皮大丸主之”,则竹皮大丸之因(妇人乳)、之机(中虚)、之症(烦乱呕逆)、之治(安中益气)全矣。

Zhupi Da Pill was first discussed in Jin Kui Yao Lue·Fu Ren Chan Hou Bing Mai Zheng Zhi.In the original text it is said that"in treating the middle deficiency of women′s breast,disturbing and vomiting,Zhupi Da Pills is the primary choice to calm the middle and replenish Qi".According to the symptoms of"upsetting and vomiting"in the original text,modern physicians believe that this prescription is mainly used to treat postpartum dysphoria and postpartum vomiting.According to the symptoms of"Yin deficiency,internal Heat,and middle Qi deficiency"in the original text,it is believed that this prescription has the functions of clearing Heat and reducing adverse reactions,calming the middle and replenishing Qi.Although this cognition can be justified,there are still many inconsistencies.The author thinks that the sentence in the original text is read as"in treating disturbing and vomiting caused by middle deficiency of women′s breast,Zhupi Da Pills is the primary choice to calm the middle and replenish Qi",then the cause(women′s breastfeeding),the mechanism(middle deficiency),and the symptoms(disturbing and vomiting),and the treatment(calming the middle and replenishing Qi)is complete.