从《内经》气味学说探“咸”味之功用

Comment on the Salty Flavor Based on Qi and Flavor Theory of The Yellow Emperor’s Inner Classic

[目的]基于《黄帝内经》中对咸味的相关论述,结合气味学说,探析咸味功用及对临床用药的指导意义。[方法]依据《黄帝内经》中有关咸的条文,在查阅古籍的基础上对咸之内涵、功效、应用、配伍、禁忌等五方面进行阐述,并引用名家医案加以论证。[结果]咸味属水,位北色黑。从功效而言,咸味具有涌上泄下、软坚散结、软心补心、利胃关行脾气等作用,临床主要用于消积除滞、潜阳镇惊、平喘止呕及扶阳滋阴。当咸味药与其他气味药物配伍时,其临证应用更为广泛灵活,包括咸苦合用软坚泄下,咸辛合用散邪通络,咸甘合用降逆补虚,而咸苦甘寒更是温病热入营血证之用药大法。而过食咸味,则可引致泄津凝血、损肾凌心之害。[结论]现代临床应遵循《内经》气味学说,对咸味作用、配伍及禁忌等进行深入系统的研究认识,方可有效指导临床并拓宽其应用。

[Objective]To make a comprehensive comment on the therapeutic effect and clinical applications of the salty flavor from the perspective of the Qi and flavor theory based on the contents recorded in the book of The Yellow Emperor’s Inner Classic.[Methods]Make a full study on contents related with the salty flavor in The Yellow Emperor’s Inner Classic.Analyzing the connotation,functions,applications,compatibility and contraindications of saltiness through multiple study of classic books;Furthermore,cases records of ancient famous physicians are displayed to prove what the paper has concluded and summarized.[Results]The salty flavor pertains to water in the five-element theory and corresponds to the north and the black.From the perspective of function,medicinals with salty flavor can promote vomiting and induce purgation,soften the hardness and dissipate masses,relax the heart as well as supplement the heart,and promote the movement of spleen Qi and facilitate the stomach.In clinic,they can be used to remove stagnation,subdue Yang and suppress fright,relieve panting and arrest vomiting,and reinforce Yang and enrich Yin,etc.When combined with medicinals with different Qi and flavors,the application of salty medicinals can be broadened and more flexible.For instance,the combination of salty medicinals and bitter medicinals is to soften the hard masses and promote purgation,the combination of salty and acrid is to dispel pathogen and unblock the collaterals,the combination of salty and sweet is to direct counterflow downward and supplement the deficiency.Furthermore,the combination of salty,bitter,sweet and cold is regarded as the main principle for the treatment of invasion of pathogenic heat into the Yingblood level in warm febrile disease.On the other side,over intake of salty medicinals and food may cause multiple side effects such as consumption of body fluids and blood coagulation,and impairment to the kidney and heart.[Conclusion]In clinic,practitioners should follow the theory of Qi and flavor of The Yellow Emperor’s Inner Classic to achieve a deep and systematic understanding on the salty flavor,including its functions,compatibility and contraindications,etc.,so that salty medicinals can be applied in an effective and broadened way.