《伤寒论》对后世温病的启迪(下)

Enlightenment of Treatise on Cold Damage Diseases to Later Generations in Treating Warm Disease (Part Ⅱ)

伤寒与温病有三个相同点:第一、伤寒温病致病原因相同,发病途径不同;第二、伤寒温病同以六经为传变途径;第三、伤寒和温病初期表现有相似之处。在此背景下,仲景写作的《伤寒论》必定会涉及温病。辨别《伤寒论》中涉及温病方证的方法:①脉证不符;②用药寒热同调;③里热或表里倶热;④阴液被伤。但是由于温病的复杂性,张仲景为了让后世找到治疗外感疾病的思路,不得不从最简单的伤寒入手,因为仲景创立的是一种规范,建立的是一个辨证之模型。如果能把仲景创立的辨证模型运用的得心应手,便能找到温病的门径,临床上就能如仲景所言"寻余所集,思过半矣"。后世薛雪、叶桂之温病名家的著作和观点无一不是从仲景之处得到启悟,开创温病治疗新局面。

There are three similarities between exogenous febrile disease and warm disease:First,the pathogenic causes of both kinds of diseases are the same and the paths of their occurrence are different.Second,both of them are transmitted by the six meridians.Third,both of them have similarities in their initial manifestations.In this knowledge background,Zhang Zhong-jing′s Treatise on Cold Damage Diseases is bound to involve warm disease.The methods of distinguishing the prescriptions and syndromes of warm disease in Treatise on Cold Damage Diseases are as follows:① Pulse and syndrome are inconsistent.② Medication is to regulate both cold and heat at the same time.③There are internal heat,or both internal and external heat.④ Yin fluid is hurt.However,due to the complexity of warm disease,Zhang Zhong-jing had to start with the simplest exogenous febrile disease in order to let future generations find a way to treat exogenous diseases,because Zhang Zhong-jing created a norm and established a model of syndrome differentiation.If the syndrome differentiation model established by Zhang Zhong-jing can be applied appropriately,we can find a way to treat warm disease.Clinical practice as Zhang Zhong-jing said can be successful.The works and opinions of famous warm disease doctors such as Xue Xue and Ye Gui-zhi of later generations were all inspired by Zhang Zhong-jing and created a new situation of warm disease treatment.