《金匮要略》大黄甘遂汤条文新解

New explanation of Dahuang Gansui Decoction article in Synopsis of Golden Chamber

对《金匮要略》大黄甘遂汤条文争议问题作出新的解释。通过校勘、训诂,考证本条“如敦状”原作“如敦敦状”,意为下坠感,“敦”读作平声“堆”而非“对”。“生后者”非新产后妇人,本义为有生育史的女性,其现代蕴含义当扩大为性活跃期女性。“水与血并结”所结之血为瘀积之经血而非恶露瘀浊,本条此处或隐含平素月经不利之意。综合小腹坠胀、小便微难等症状及好发人群特征,从盆腔炎症疾病、泌尿系感染等女性常见疾病角度可更好地理解本条文。

A new explanation was given to the controversial issues of Dahuang Gansui Decoction article in Synopsis of Golden Chamber.Through the method of collation and exegesis,the research result showed that the original appearance of“like dun style”was“like dun-dun style”.It was more accurate to extend“like dun-dun style”to the feeling of heavy and falling.The pronunciation of“Dui”should be the first tone instead of the fourth.The term“multipara”was not a new postpartum woman,but originally referred to a woman with childbearing history.Its modern connotation should be expanded to the women in the sexually active period.The blood formed by“the combination of water and blood”was the menstrual blood stasis rather than the postpartum lochia.This article might imply that the patient's menstruation was abnormal.Based on symptoms such as the feeling of lower abdomen falling down,slight difficulty in urination and the characteristics of susceptible persons,this article could be understood from pelvic inflammatory disease,urinary tract infection and other common female diseases.