“八法”在《伤寒杂病论》中的运用研究
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摘要
“八法”为清人程国彭在《医学心悟》中所提出。前而推之,“八法”理论实发端于《内经》,集大成于张仲景的《伤寒杂病论》；后而推之,后世医家对此多有发挥,或专论某法,或“八法”并述,使得这一理论得到了进一步的充实。
现代文献关于“八法”理论的论著较多,但多停留于对具体方证层面的探讨。本文试图通过对“八法”在《伤寒杂病论》中的具体运用研究,探求“八法”所赖以存在的医理之本,揭示其系统性的深层次机理,从而更有效地运用于临床实践。
通过对古代及现代有关“八法”文献的研究,特别是对于中医经典包括《内经》、《伤寒杂病论》、《难经》的研究,并结合临床实践,对“八法”中各个治法在《伤寒杂病论》中的具体运用进行梳理,归纳。分而论各法的精要,合而论各法的融合。这种研究基本是按照下面的思路进行：基于哲学层面——理论到实践,实践再到理论,理论得以提升；基于“八法”理论层面——有关“八法”的现代文献回归中医经典,中医经典参验于临床,临床再到“八法”理论,“八法”理论得以提升。
通过对汗法理论及运用的研究,特别是基于太阳病与少阴病的相互递传的临床实践支持,并结合《内经》形气相感,同气相求理论,强调正虚为外邪致病的重要因素,试图对传统理论中所谓的外感病与内伤病,亦即《伤寒论》与《金匮要略》病因学上的统一做了理论上的尝试。
通过对“八法”理论在《伤寒杂病论》中具体运用及临床实践的研究,最终得出以下结论：“八法”之间不是孤立的,既有横向的联合,又有纵向的递进,而终不出元精理论体系指导下的发散收敛学说的统领。
从发散收敛理论层面研究各治法中的方药配伍,如麻黄汤中既有麻黄之发散,又有杏仁之收敛；桂枝汤中既有桂枝之发散,又有芍药之收敛。可知是阳主阴从,阴阳互根理论在方药配伍方面的延伸。
以上研究结果进一步说明：“八法”之意旨在和阴阳。分而论之即：桂枝汤证为以汗法而和之；痞证为以消法而和之；柴胡类方证以和法而消支结、微结；承气汤证为以下法而和之。并在此基础上提出了“阴阳和为一动态平衡区间”的结论。
Eight therapies are put forward in Medical Insights by Cheng Guo-peng in Qing Dynasty. Prior to eight therapies, the theory was originated from Huangdi's Internal Classic and made great achievements in Treatise on Cold Damage and Miscellaneous Diseases of Zhang Zhong-jing; Afterwards, the practitioners made the full scope of the theory, specialized in a certain therapy, and discussed eight therapies together, which make the therapy more accomplished than before.
Though there are enormous works in terms of eight therapies in modern documents, they mostly discuss in specific syndromes and formulae. This thesis endeavors to study the application of eight therapies in Treatise on Cold Damage and Miscellaneous Diseases to seek for its fundamental theory of medicine and reveals the systematic and in-depth mechanism so as to be more effectively applied in clinical practice.
We researched on the literatures in modern and ancient times, especially traditional Chinese classics, including Huangdi's Internal Classic, Classic of Difficult Issues, Treatise on Cold Damage and Miscellaneous Diseases. Meanwhile, the clinical practice was applied in the study as well to summarize application of every eight therapies in Treatise on Cold Damage and Miscellaneous Diseases. The study is based on the following mentality: In philosophy-we practice according to the theory and form new theory through practice, as a result, the theory is enhanced; in the theory of eight therapy-modern literatures related to eight therapies return to TCM classics and make it apply to clinics, and then return to the theory of eight therapies. In this way, the theory o eight therapies is improved.
Through the research on diaphoretic theory and application, especially clinical practice support for the mutual transmission of Taiyang and Shaoyin diseases, combined with inter-affecting between the physique and qi and origin-analogue theory in Huangdi's Internal Classic, Stressed that weakened body resistance is an important factor for external influences. And the researcher tried to theoretically unify traditionally-called exogenous diseases and internal diseases, namely the etiological unification on Treatise on Cold Damage Diseases and Synopsis of Prescriptions of the Golden Chamber.
Based on the research on the concrete application and clinical practice of eight therapies in Treatise on Cold Damage and Miscellaneous Diseases, the following conclusions were eventually obtained:the relationship between eight therapies was not isolated. The eight therapies were both transversal union and lengthways progression, whereas they were finally under the control of the diverging and astringing theory guided by original essence theory system.
The compatibility of medicine among different therapeutic methods from the diverging and astringing theory was studied. For example, there were Herba Ephedrae with diverging function and Semen Armeniacea Amarum with astringing function in Mahuang decoction, Ramulus Cinnamomi with diverging function and Paeonia lactiflora with astringing function in Guizhi decoction. It can be thus evident that these are the extension of yang-dominating and yin-subordinating theory and the interdependent theory between yin and yang in the compatibility of medicine.
The study above further illustrated that the significance of eight therapies is mainly to harmonize yin and yang. Discussing separately is like this:yin and yang is harmonized by the diaphoresis with Guizhi decoction; epigastric fullness syndrome is harmonized by the purgation; Chaihu-like syndrome is applied the resolution to eliminate brachial masses and small masses; Chengqi Fang syndrome is adopted the purgation to harmonize. Based on these opinions, the conclusion that the harmonization of yin and yang is a dynamic balance range is mentioned.
现代文献关于“八法”理论的论著较多,但多停留于对具体方证层面的探讨。本文试图通过对“八法”在《伤寒杂病论》中的具体运用研究,探求“八法”所赖以存在的医理之本,揭示其系统性的深层次机理,从而更有效地运用于临床实践。
通过对古代及现代有关“八法”文献的研究,特别是对于中医经典包括《内经》、《伤寒杂病论》、《难经》的研究,并结合临床实践,对“八法”中各个治法在《伤寒杂病论》中的具体运用进行梳理,归纳。分而论各法的精要,合而论各法的融合。这种研究基本是按照下面的思路进行：基于哲学层面——理论到实践,实践再到理论,理论得以提升；基于“八法”理论层面——有关“八法”的现代文献回归中医经典,中医经典参验于临床,临床再到“八法”理论,“八法”理论得以提升。
通过对汗法理论及运用的研究,特别是基于太阳病与少阴病的相互递传的临床实践支持,并结合《内经》形气相感,同气相求理论,强调正虚为外邪致病的重要因素,试图对传统理论中所谓的外感病与内伤病,亦即《伤寒论》与《金匮要略》病因学上的统一做了理论上的尝试。
通过对“八法”理论在《伤寒杂病论》中具体运用及临床实践的研究,最终得出以下结论：“八法”之间不是孤立的,既有横向的联合,又有纵向的递进,而终不出元精理论体系指导下的发散收敛学说的统领。
从发散收敛理论层面研究各治法中的方药配伍,如麻黄汤中既有麻黄之发散,又有杏仁之收敛；桂枝汤中既有桂枝之发散,又有芍药之收敛。可知是阳主阴从,阴阳互根理论在方药配伍方面的延伸。
以上研究结果进一步说明：“八法”之意旨在和阴阳。分而论之即：桂枝汤证为以汗法而和之；痞证为以消法而和之；柴胡类方证以和法而消支结、微结；承气汤证为以下法而和之。并在此基础上提出了“阴阳和为一动态平衡区间”的结论。
Eight therapies are put forward in Medical Insights by Cheng Guo-peng in Qing Dynasty. Prior to eight therapies, the theory was originated from Huangdi's Internal Classic and made great achievements in Treatise on Cold Damage and Miscellaneous Diseases of Zhang Zhong-jing; Afterwards, the practitioners made the full scope of the theory, specialized in a certain therapy, and discussed eight therapies together, which make the therapy more accomplished than before.
Though there are enormous works in terms of eight therapies in modern documents, they mostly discuss in specific syndromes and formulae. This thesis endeavors to study the application of eight therapies in Treatise on Cold Damage and Miscellaneous Diseases to seek for its fundamental theory of medicine and reveals the systematic and in-depth mechanism so as to be more effectively applied in clinical practice.
We researched on the literatures in modern and ancient times, especially traditional Chinese classics, including Huangdi's Internal Classic, Classic of Difficult Issues, Treatise on Cold Damage and Miscellaneous Diseases. Meanwhile, the clinical practice was applied in the study as well to summarize application of every eight therapies in Treatise on Cold Damage and Miscellaneous Diseases. The study is based on the following mentality: In philosophy-we practice according to the theory and form new theory through practice, as a result, the theory is enhanced; in the theory of eight therapy-modern literatures related to eight therapies return to TCM classics and make it apply to clinics, and then return to the theory of eight therapies. In this way, the theory o eight therapies is improved.
Through the research on diaphoretic theory and application, especially clinical practice support for the mutual transmission of Taiyang and Shaoyin diseases, combined with inter-affecting between the physique and qi and origin-analogue theory in Huangdi's Internal Classic, Stressed that weakened body resistance is an important factor for external influences. And the researcher tried to theoretically unify traditionally-called exogenous diseases and internal diseases, namely the etiological unification on Treatise on Cold Damage Diseases and Synopsis of Prescriptions of the Golden Chamber.
Based on the research on the concrete application and clinical practice of eight therapies in Treatise on Cold Damage and Miscellaneous Diseases, the following conclusions were eventually obtained:the relationship between eight therapies was not isolated. The eight therapies were both transversal union and lengthways progression, whereas they were finally under the control of the diverging and astringing theory guided by original essence theory system.
The compatibility of medicine among different therapeutic methods from the diverging and astringing theory was studied. For example, there were Herba Ephedrae with diverging function and Semen Armeniacea Amarum with astringing function in Mahuang decoction, Ramulus Cinnamomi with diverging function and Paeonia lactiflora with astringing function in Guizhi decoction. It can be thus evident that these are the extension of yang-dominating and yin-subordinating theory and the interdependent theory between yin and yang in the compatibility of medicine.
The study above further illustrated that the significance of eight therapies is mainly to harmonize yin and yang. Discussing separately is like this:yin and yang is harmonized by the diaphoresis with Guizhi decoction; epigastric fullness syndrome is harmonized by the purgation; Chaihu-like syndrome is applied the resolution to eliminate brachial masses and small masses; Chengqi Fang syndrome is adopted the purgation to harmonize. Based on these opinions, the conclusion that the harmonization of yin and yang is a dynamic balance range is mentioned.
引文
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