彭子益治疗中风后遗症思路探讨

A discussion on TCM master PENG Ziyi’s thought of treating apoplexy sequelae

明末清初著名医学家彭子益著有《圆运动的古中医学》。彭子益以《易经》中的气机升降理论为原理,批判地继承和发展了黄玉璐的“医易同源”理论,从天人合一的角度重新认识了生命与宇宙的密切关联。彭子益详细叙述了中气和外维圆运动的关系。中气枢纽在内旋转,带动木、火、金、水在外轮运转,并以木升金降的形式进行四维运转。彭子益指出,外维荣卫根于中气,荣卫一疏一敛,形成圆运动。若中气受损,不能带动四维运转,荣卫由合而分,外邪乘虚而入,内外俱损,人体圆运动分裂,则产生疾病。治疗各种内伤杂病原理最终都可以归结于恢复圆运动。中风的病因是肾虚水冷,脾胃虚弱,运化不利,痰浊内生,肝虚生风;外邪侵入机体,引动内风。根据“轴轮并运”的理论,彭子益治疗中风后遗症的主要思路是温肾阳,健脾化痰,荣卫合则病愈;温肾水则生肝木,化营血而润木,平肝息风;胃气下行,兼敛肺金,可收浮热;肝木与肺金一升一降,阴阳平衡,最后达到“一气周流,轴轮并运”的治疗目的。彭子益的“本气自病、一气周流、轴轮并运”的理论在临床有广泛的运用空间,值得积极学习。

PENG Ziyi,a famous medical scientist in the late Ming and early Qing Dynasty,wrote Yuan Yundong de Guzhongyixue(《圆运动的古中医学》).PENG Ziyi critically inherited and developed TCM master HUANG Yulu’s theory of homology between medicine and Yi(易)-ology based on the theory of the rise and fall of Qi(气)movement in Yijing(《易经》),and recognized the close relationship between life and the universe from the perspective of the unity of heaven and man.PENG Ziyi described in detail the relationship between Zhongqi(中气)and the outer circular motion.Zhongqi hub rotates internally to drive wood,fire,metal and water to run in the outer ship and conduct four-dimensional operation in the form of wood rising and gold falling.PENG Ziyi pointed out that the external Rong(荣)and Wei(卫)is rooted in Zhongqi,and that the one is mainly responsible for evacuation and the other is mainly responsible for descending,forming a circular movement.If Zhongqi is damaged and cannot conduct four-dimensional operation,Rong and Wei will be separated from each other,and exogenous pathogenic factors will take advantage of the weakness to damage both inside and outside,and the circular movement of the human body will be split,which will lead to disease.The principle of treating various internal injuries and miscellaneous diseases can ultimately be attributed to the restoration of circular motion.The causes of apoplexy are kidney deficiency and cold water,spleen and stomach weakness,poor transport,phlegm turbidity,and wind in deficient liver.In addition,exogenous pathogenic factors invade the body,causing internal wind.According to the theory of simultaneous movement of axle and wheel,the main idea of treating apoplexy sequelae by PENG Ziyi is to warm Yang(阳)of kidney,strengthen spleen to remove phlegm,so as to achieve the purpose of reconciliation of Rong and Wei to cure the disease.Warming dampness of kidney was used by PENG Ziyi to nourish lieve,remove blood stasis to moisten wood,and calm liver to quench wind.The descending of Qi of stomach was also used by PENG Ziyi,it can not only improve lung function,but also reduce floating heat.Furthermore,the liver wood and lung gold rise and fall respectively,and then Yin(阴)and Yang are balanced,so as to finally achieve the therapeutic purpose of Qi circulates around,and axis and wheel move simultaneously.PENG Ziyi’s theory of pathogenesis due to out of round motion of human body,Qi circumfluence,and simultaneous movement of axle and wheel has wide application space in clinical practice,and is worth learning actively.