《素问》“此至阴之类,通于土气”涵义之我见

Connotation of “extreme yin being related to earth qi” in Suwen

《素问·六节藏象论篇》是《内经》阐述藏象理论的重要篇章之一。对于该篇'脾、胃、大肠、小肠、三焦、膀胱……此至阴之类,通于土气'一段经文,历代医家的理解分歧较大。本文分析了对该句常见的几种理解中存在的问题,结合四分阴阳模型在该篇的应用及该篇写作模式,提出'至阴'可以视为作者试图解决四时五脏配属关系的折中说辞,'通于土气'可理解为'通于地之水谷之气';根据脾及诸腑生理功能相互配合、病理情况相互影响,提出将脾与诸腑统称'至阴之类'是对其转化水谷功能的概括,有临床意义。

Suwen:Liujie Zangxiang Lun(Plain Conversation:Discussion on Six-Plus-Six System and the Manifestations of Organs)is one of important chapters on the theory of visceral manifestations in Huangdi Neijing(Yellow Emperor’s Internal Classic).On the understandings of the passage of'spleen,stomach,large intestine,small intestine,triple energizers,bladder…are extreme yin and they are related to earth qi',the physicians in successive dynasties had great difference.The paper proposes,after analyzing the problems existing in several common viewpoints on the passage and combining the application of quartered yin-yang model and writing mode in the chapter,that the extreme yin can be regarded as a compromise saying by the author who tried to explain the relationship between four seasons and five zang-organs,and'extreme yin being related to earth qi'can be understand as extreme yin being related to qi of water and food.The paper also indicates that spleen and other zang-organs interact to each other in physical or pathological conditions.So it is a summarization on their functions of water-food conversion to name spleen and other zang-organs as extreme yin,which has clinical significance.