费伯雄与秦伯未诸痛证治比较

Analysis and Comparison of Syndrome and Treatment of Various Pain Between FEI Boxiong and QIN Bowei

费伯雄为孟河名家,秦伯未为孟河医派传人,二者代表作《医醇賸义》《谦斋医学讲稿》均设专篇论述诸痛证治,且秦氏之作多处引用费氏自制方论。论治头痛,二者均分外感内伤,外感者,费氏善融秦氏所言多法于一炉;内伤者,费氏血虚、肝阳二方可与秦氏血虚之论互参。论治胸痛,二者皆宗仲景,秦氏偏重胸痹、肝着理法,费氏则仿泻心、四逆之意。论治胁痛,二者均重视肝胃、气血,费氏尚言外感,内伤又重肝肺、肝心、肝肾关系。论治胃痛,二者皆分虚实,强调温通气血、疏肝健脾和胃,实者费氏则尚虑结胸、虫邪。论治腹痛,二者皆强调脾、肾、肠之病变,秦氏重治内伤,尚论及肝与冲任气血,费氏则在治疗外感方面更具心得。论治腰痛,二者皆重肾虚,费氏燥、胀、劳可与秦氏阴阳之虚互补,秦氏尚论祛寒湿、理气血,费氏则又有通利二便之法。论治四肢痛,秦氏祛邪扶正兼顾而分部论治,费氏则重在扶正,和缓祛邪。此外,费氏所论伏饮背痛,亦与秦氏治肺法异曲同工。希冀对诸痛证治的梳理可予临床以帮助,并进一步完善孟河医派学验传承及发展。

FEI Boxiong was a famous scholar in Menghe,and QIN Bowei was a descendant of the Menghe School of Medicine.Their representative works Yichunshengyi and Qianzhai Medical Lecture both had dedicated chapters on various pain syndromes and treatments,and QIN's works quoted FEI's self-made prescriptions in many places.In terms of treating headaches,they were both equally divided into external and internal injuries.For those with external effects,FEI was good at integrating multiple methods mentioned by QIN into one.For internal injuries,FEI's prescriptions of blood deficiency and liver-Yang could interact with QIN's theory of blood deficiency.On the treatment of chest pain,both inherited Zhongjing's theory while QIN focused on the treatment of chest arthralgia and liver stagnation,and FEI imitated the principles of drain the heart and counterflow cold of the limbs.In terms of treating hypochondriac pain,both attached great importance to the liver and stomach,Qi and blood.FEI paid more attention to external sensations,and relationship between liver,lung,heart and kidney in internal injuries.On the treatment of stomach pain,both were divided into deficiency and excess,emphasizing warming Qi and blood,soothing the liver,strengthening the spleen and stomach.In the case of excess,FEI considered the accumulation of pathogens in chest and insect pathogens.On the treatment of abdominal pain,both emphasized the lesions of spleen,kidney and intestine.QIN was emphasized on internal injury,and also discussed the liver,Chong-Ren and Qi-blood,while Fei had more experience in treating external sensations.On the treatment of low back pain,both emphasized kidney deficiency.FEI's dryness,swelling and fatigue complement QIN's deficiency of Yin and Yang.QIN's theories also included dispelling cold and dampness and conditioning Qi and blood,while FEI's method also included evacuating the bowels and bladder.On the treatment of limb pain,QIN's treatment focused on both eliminating pathogenic factors and strengthening the body,while Fei's treatment focused on strengthening healthy and relieving pathogenic factors to soothing the body.In addition,FEI's theory of Fuyin backache was also similar to QIN's lung treatment method.It is hoped that the documentation of syndrome and treatment of various pain can be helpful to clinical treatment,and improve the inheritance and development of Menghe medical school.