基于《冯氏锦囊秘录》探讨冯兆张诊治麻疹学术特色

Study on the Academic Characteristics of FENG Zhaozhang’s Diagnosis and Treatment of Measles in FENG’s Secret Book of Medicine

[目的]研究冯兆张《冯氏锦囊秘录》诊治麻疹的学术特色,从而为临床诊治麻疹提供思路。[方法]以《冯氏锦囊秘录·痘疹全集·麻疹门》为主要研究对象,结合《黄帝内经》《医贯》等著作中的相关内容,对冯氏诊治麻疹的特色进行系统研究。[结果]冯兆张是我国医学史上最早系统论述麻疹的医学家之一。诊断方面,他从皮疹的颜色、形态、部位、患者一般状况等方面判断病情之轻重,并将麻疹与广义伤寒、天花等病相鉴别。治疗方面,他赞同前人以清凉、疏散之法治疗麻疹,善用火郁发之、表里分消之法,但鲜明地提出麻疹的病机不仅有肺胃蕴热,还有脾胃内伤、命门亏虚,治疗虚证应始终以固本培元为先,对纠正古往今来滥用寒凉、疏散治疗麻疹的风气有补偏救弊之功。此外,冯氏对麻疹的调护和妊娠合并麻疹的治疗,亦多有精辟的论述。[结论]冯兆张诊治麻疹经验丰富,理法方药完备,为临床诊治麻疹提供了思路和方法,具有重要的学术价值。

[Objective]To study the academic characteristics of the diagnosis and treatment of measles in FENG’s Secret Book of Medicine,so as to provide schemes for the diagnosis and treatment of measles.[Methods]Taking the section of measles in FENG’s Secret Book of Medicine as the main object of the study,the article systematically studied the characteristics of FENG’s diagnosis and treatment of measles by combining the relevant contents in Inner Canon of Huangdi,Yi Guan and some other writings.[Results]FENG Zhaozhang was one of the physicians who systematically studied measles earliest in the history of Chinese medicine.In terms of diagnosis,he judged the severity of the disease by color,shape,location of the erythra and general condition of the patient,and differentiated measles from febrile diseases,smallpox and other diseases.In terms of treatment,he agreed with the predecessors on treating measles by cooling and diffusing,and he specialized in dissipating excessive stagnation of fire and eliminating fire by diaphoresis and purgation respectively.However,he clearly pointed out that the pathogenesis of measles was not only fire in lung and stomach,but also deficiency in spleen,stomach and Mingmen,and treating deficiency syndromes should always be based on strengthening the vitality,which had corrected the abuse of cooling and diffusing medicine in the treatment of measles through the ages.In addition,FENG’s experience of nursing and treating pregnancy combined with measles was also of significance.[Conclusion]FENG Zhaozhang was well-experienced in the diagnosis and treatment of measles,and established complete theories,methods and prescriptions,which provided theories and methods for the diagnosis and treatment of measles,and was of significant value.