秦之桢“食滞为病”学术特色探析

Study on Academic Characteristics of QIN Zhizhen’s“Disease Caused by Food Stagnation”

以清代名医秦之桢所撰《伤寒大白》为底本,系统归纳秦之桢辨治食滞的临床经验,并与《伤寒论》论治食滞相比较。秦之桢指出食滞容易化热,常以望唇之润、燥、枯推断里热的程度。胃有食滞可出现经气不利、表邪不解、阳气失布、神志失常、气机不通5种衍生病理变化。在治疗方面,秦氏善用朱丹溪之保和丸,常改丸剂为散、汤剂速去食滞,若食滞日久化热者用保和散冲服竹沥、萝卜汁润燥消食,并根据谷食、肉食、面食等不同病因加减。在治疗禁忌方面,指出消食法不可用于因虚致实证,防止体虚不耐攻伐。因食物赖于胃阳腐熟消化,故不宜用寒凉下法损伤胃阳,较《伤寒论》补充了“胃宜温消,肠宜寒下”的胃肠分治原则。认为夹食伤寒应消食与发表并举。并提出病中、病后顾护胃气对疾病痊愈有积极意义。

Based on Plain Explanation of Treatise on Febrile Disease written by QIN Zhizhen,a famous doctor in Qing Dynasty,this paper systematically summarizes the clinical experience of QIN Zhizhen in differentiating and treating food stagnation,and compares it with treatment in Treatise on Febrile Disease.QIN Zhizhen points out that food stagnation will easily cause heat,the degree of which often can be inferred by inspecting the moist,dryness and withering of the lips.There are five kinds of pathological changes in stomach with food stagnation,such as unfavorable channel qi,irresolving of superficial evil,loss of distribution of yang qi,mental disorder and impassability of qi.In terms of treatment,QIN makes good use of Baohe Pills(保和丸)of ZHU Danxi,and often changes pills to powder and decoction to quickly remove food stagnation.For those who suffer from prolonged food staganation and heat,Baohe Powder(保和散)is used to be combined with bamboo shavings and radish juice to moisten dryness and relieve food,and it is modified according to the different causes,such as grain,meat and pasta.In terms of treatment contraindications,it is pointed out that food stagnation relieving method can not be used for the excess syndrome caused by deficiency,to avoid attacking the weak body.Because the food depends on the stomach yang to decompose and digest,therefore,it is not appropriate to use cold and cooling method to damage stomach yang,it adds the separation and treatment principle of staomach and intestine of“stomach should be warmly relieved and intestine should be relieved with cooling method”compared with Treatise on Febrile Disease.It is suggested that typhoid fever should be relieved simultaneously by eliminating food stagnation and the relief of exterior.It is suggested that taking care of stomach qi during and after illness has positive significance for the recovery of disease.