吴又可《温疫论》理法方药新探

New Discussion on Principles,Methods,Formulas,and Medicinals in Wen Yi Lun by WU Youke

探讨分析《温疫论》中的理法方药。分析认为,现存最早论治温疫的专著《温疫论》蕴含着吴又可辨治温疫的一整套理法方药体系,其中颇多创见。吴又可提出新的病因学说--杂气说及疠气说,力主温疫不同于伤寒。建立表里辨证模型,创立表里九传辨证体系。提出和阐发阳郁化热理论,揭示温疫的基本病机是邪阻气机,阳郁化热或化火,耗气搏血,伤津耗液。治疗强调逐邪为第一要义,视邪之所在、邪之所趋,因势利导使用汗、吐、下三法,导邪外出,宣通气机。丰富了攻下法和治疗温疫的方药。阳郁化热理论是吴又可学术思想的核心,温疫的辨证、治法、方药及治疗禁忌均是在这一原理指导下的具体运用。

This paper discussed and analyzed the principles,methods,formulas,and medicinals in Wen Yi Lun(Treatise on Pestilence).The analysis found that Wen Yi Lun,the earliest monograph on treating pestilence,contains a complete set of principles,methods,formulas,and medicines that WU Youke used in the syndrome differentiation and treatment of pestilence,with many innovative ideas.Also,WU Youke proposed two new etiological theories,namely pathogenic qi theory and pestilent qi theory,which insisted that pestilence is different from cold damage.WU Youke also established a model of exterior-interior syndrome differentiation and created a system of syndrome differentiation based on nine kinds of exterior-interior disease locations and their corresponding manifestations.The theory of depressed yang transforming into heat was put forward and elucidated,which reveals that the basic pathogenesis of pestilence is the pathogen obstructing qi movement,depressed yang transforming into heat or fire,qi consumption of qi and blood,and damage to liquid and fluid.The treatment emphasizes that dispelling pathogen is the first,which is,to locate the pathogen and find out the development trend of pathogen,and then to make good use of the methods of sweat promotion,emetic promotion,and purgation promotion for expelling pathogen and restoring the normal qi movement.Besides,he enriched the formulas and medication of offensive purgative method and the treatment of pestilence.The theory of depressed yang transforming into heat is the core of academic ideas of WU Youke and the guidance of specific applications of syndrome differentiation,treatment methods,formulas and medication,and contraindications to the treatment of pestilence.