黄元御《四圣悬枢》疫病思想探析

Study on the thought on epidemic disease of HUANG Yuanyu's Sisheng Xuanshu

《四圣悬枢》五卷汇集了清代医家黄元御对疫病病源及病因病机的认识及诊治经验,集中体现了黄元御的疫病思想:岁气不正是疫病产生之根,客邪传经、气血俱伤是疫病传变之源。由风、寒二气失序引起的营卫失调,是疫病病机的关键:温疫始于风伤卫气、但病在血分,顺逆在脾,阴衰营陷多凶险;寒疫始于寒伤营血、但病在气分,顺逆在胃,阳衰卫陷多凶险。同时,明确将痘病、疹病同归疫病。在疫病治疗上,以解表透邪、外发营卫为大法,用药强调析别表里寒温,先后缓急,尤擅以浮萍为主药治疗温疫,以紫苏叶为主药治疗寒疫。梳理总结《四圣悬枢》疫病思想,以期为黄元御学术思想研究提供资料,为当下疫病诊治提供启发。

The five volumes of Sisheng Xuanshu records the plague ideas of causae,etiology and pathogenesis,transmutation among six meridians,diagnosis and treatment from HUANG Yuanyu in Qing dynasty.The deviation of climates is the root of epidemic disease,and the injury of qi and blood by exogenous pathogen transmitting meridian is the source of epidemic disease transformation.The imbalance of Ying qi and Wei qi caused by the disorder of wind and cold is the key to the pathogenesis.Warm pestilence originates in the wind evil injuring Wei qi,but blood aspect is sick.The spleen is the key to the disease,and yin failure is dangerous.Cold pestilence originates in the cold evil injuring Ying blood,but qi aspect is sick.The stomach is the key to the disease,and yang failure is dangerous.At the same time,it concludes that pox and rash disease are classified as epidemic diseases.In the treatment of epidemic diseases,the main therapy is relieving the exterior and dispelling evil.In the usage of medication,it is quite important to distinguish the cold and warm,interior and exterior,before and after,chronic and urgent.Duckweed and perlla leaf are used as the principal drugs to treat warm and cold pestilence respectively.It will provide materials for the study of HUANG Yuanyu's academic thoughts,while providing inspiration for the treatment of current epidemic diseases.