“脚气”与风痿厥痹辨析

An Analysis of"Beriberi"and Wind Disease and Syncope and Flaccidity Syndrome and Rheumatism

“脚气”理论在晋唐时期已较为成熟,在宋金元时期出现了较大转变,病机认识从以风为主导到以湿为主导,并且由于其病名、症状较多,出现与多种疾病混淆的情况。“脚气”非痿证、非厥证,属“风病”“痹证”范畴,病因为脾肾内伤,外感风湿、瘴气等邪气,主要病机为外邪侵袭先中于足,脾肾内伤,湿气下注于足,发为脚弱、脚痛、足胫肿胀、呕吐心悸气喘(即脚气冲心)等症状,此类症状可独立出现,并伴有发热、身痛等,亦可同时出现,风、湿为其辨证要点。

The theory of"beriberi"was mature in the Jin and Tang dynasties,and changed greatly in the Song,Jin and Yuan dynasties.The pathogenesis was changed from"wind"to"dampness".Due to its many names and symptoms,it was confused with many diseases.Beriberi is not a syndrome of flaccidity or a syndrome of syncope,but belongs to the category of"wind disease"and"rheumatism".The etiology is internal injury of the spleen and kidney,rheumatism,miasma and other pathogens.The main pathogenesis is that external pathogen invades the foot first,leading to internal injury of the spleen and kidney,then dampness falls on the foot,leading to such symp-toms as weak feet,foot pain,swelling of the feet and tibia,vomiting,palpitation and asthma(i.e.beriberi attacking the heart).Such symptoms can occur independently,accompanied by fever and body pain,or at the same time.The key points of syndrome differentiation are wind and dampness.