“带下”本义与狭义化过程中的“误读”现象

带下,一般认为有广义与狭义之分。广义"带下"泛指妇产科疾病;狭义"带下"特指"沃与血相兼,带而下"为主证的妇科疾病。隋朝巢元方之前,"带下"常指广义的妇科疾病。战国初期扁鹊"带下医"之"带下"所指应非带脉之下,而是衣带之下。《金匮要略》以"带下"统称妇科病,如瘕聚、经水不利、带下无子等皆属带下。至巢元方更改仲景原文,将"属带下"改为"必带下",为狭义带下作出了定义,带下也从妇科疾病变为带下之证。宋代妇产科理论逐渐成熟,医家认识到经带疾病的重要性,医书的次序逐步调整为经、带、胎、产。

Original Meaning of"Daixia"and Semantic Misunderstanding in Narrowing Process of Its Meaning

Daixia is generally understood in broad and narrow senses.The broad sense of it refers to obstetrics and gynecology diseases and the narrow sense refers specifically to the gynecological diseases whose main symptom is"fatty water and blood leaked together".Before Chao Yuanfang of the Sui Dynasty,"Daixia"often refers to generalized gynecological diseases.In the early Warring States Period,"Daixia"used by Bian Que′s in"Daixia Medicine"refers to part under the belt of the skirt but not beneath the Daimai(GB26).In Ji Gui Yao Lue,gynecological diseases are collectively called"Daixia",such as lumps,poor menstrual flow,and childlessness.Chao Yuanfang changed the original text written by Zhang Zhongjing,and"being related to Daixia"was changed to"must be Daixia",which defines Daixia in the narrow sense,and also transform its meaning into leucorrhoea diseases from gynecological diseases.In the Song Dynasty,the theory of obstetrics and gynecology gradually matured.Doctors realized the importance of menstruation and leucorrhea diseases,and the content order of medical books was gradually adjusted to menstruation,leucorhea,fetus,and birth.