以“肠辟”为例辨识“辟”“澼”“僻”“癖”之病证

Take“intestinal PI”as an Example to Identify“Pi”,“Pi”,“Pi”and“Pi”Disease Evidence

“肠澼”作为一种病证,历代医家对其内涵及“澼”字含义争论颇多,与之相关的还有“辟”“僻”“癖”的病证含义。笔者在查阅《内经》和相关历史文献后认为,“澼”“癖”“僻”三字初皆作“辟”,是由于历史的发展、文字的演进而出现的后起形声字,用于表达“辟”在具体语境中的特定含义;并且,通过上述文献的相互佐证,指出各字具体含义和病名演变规律;最后,结合临床实际,指出“肠澼”具体内涵乃是血气枯竭、肠腑皱缩、气血坠积于肛门的虚实夹杂证,并非单纯的症状表达,尤其包含了古人对肛肠细致查体而发现的肠壁皱褶壅塞于肛门的特殊表现。

As a kind of disease syndrome,the connotation of“Intestine-Pi”and meaning of the word“Pi”have been controversial among physicians in various dynasties,and related to it are the meanings of“Pi”,“Pi”,and“Pi”disease syndrome.After consulting the Neijing and relevant historical literature,the author believes that the three characters“Pi”,“Pi”,and“Pi”were originally referred to as“Pi”,which are the latecomered pictophonetic character that emerged due to the development of history and the evolution of characters,and are used to express the specific meaning of“Pi”in specific contexts;Moreover,through mutual evidence from the above literature,points out the specific meaning of each word and the evolution rule of the disease name;Finally,based on clinical practice,points out that the specific connotation of“Intestinal-Pi”is a combination of deficiency and excess syndrome characterized by exhaustion of blood and qi,contraction of the intestines,and accumulation of qi and blood in the anus.It is not a simple symptom expression,especially the special manifestation of intestinal wall folds clogging the anus,which was found by careful physical examination of the anus and intestines by ancient people.