基于王旭高“治肝三十法”浅析杂病治肝思想

An analysis of the thought of treating miscellaneous diseases from the liver based on WANG Xugao’s thirty methods for treating diseases from liver

王旭高,晚清著名医学家,善于治疗外科、内科杂病,著有《西溪书屋夜话录》等。本书对中医影响深远,将肝病分为肝气、肝风、肝火等不同类型,并提出了30种相应的治法。这些分类法不仅与前人的分类方法迥然不同,而且在治疗上也颇具特色。临床杂病多具有内外合邪、表里同病,易致虚实夹杂、气血逆乱的病理特点。而肝藏血,主疏泄、调畅气机,体阴而用阳,肝经连头足、络脏腑而贯周身。因此杂病与肝关系密切,在杂病治疗上往往需要“责之于肝、论之于肝、治之于肝”。研究基于王旭高治肝理论,进一步分析其治肝思想精髓,浅述临床“杂病之治在于肝”,以期拓展临床诊疗思路。

WANG Xugao,a famous medical expert in the late Qing Dynasty,was good at treating surgical and internal diseases,and was the author of Xixi Shuwu Yehua Lu(《西溪书屋夜话录》).Xixi Shuwu Yehua Lu has a far-reaching impact on traditional Chinese medicine.It divides liver diseases into liver Qi(气),liver wind,liver fire and other different types,and puts forward 30 corresponding treatments.This classification is not only completely different from previous classification methods,but also has characteristics in treatment.Most clinical miscellaneous diseases have the pathological characteristics of combining internal and external pathogens,causing the same disease both externally and internally,which can easily lead to mixed deficiency and excess,and reversal of Qi and blood.The liver stores blood,and is mainly used to dredge and regulate Qi.Its entity belongs to Yin(阴),but its function belongs to Yang(阳).The liver meridian connects the head,feet and viscera all over the body.Therefore,miscellaneous diseases are closely related to the liver.In the treatment of miscellaneous diseases,it is often necessary to search for pathogens from the liver,diagnose symptoms from the liver,and treat symptoms from the liver.Based on WANG Xugao’s 30 methods of treating liver,this paper further analyzes the essence of WANG’s clinical thought,and briefly states that the treatment of clinical miscellaneous diseases lies in the liver,in order to expand ideas for clinical diagnosis and treatment.