《温热经纬》辨治痢疾刍议

总结《温热经纬》对痢疾辨证论治的特点.从发病时节、病因、病位、病机、临床表现、辨证论治方面进行阐述,强调痢疾大多由湿热引起.在辨证中重视四诊及整体情况,辨寒热、气血、虚实,寒者辛温疏利,热者宣通祛热;在血分者重用行血,在气分者偏于导气;实者可疏利清热、导气行血,虚者不可一味攻积清夺.在对不同治法的运用上,淡渗注重寒温并...

Discussion on Syndrome Differentiation and Treatment of Dysentery in Compendium on Warm Febrile Disease

This paper summarizes the characteristics of syndrome differentiation and treatment of dysentery in Compendium on Warm Febrile Disease. From the aspects of onset season,etiology,location,pathogenesis,clinical manifestations,syndrome differentiation and treatment,it is emphasized that most dysentery is caused by dampness-heat. In syndrome differentiation,attention should be paid to the four diagnostic methods and the overall situation,distinguishing cold and heat,qi and blood,deficiency and excess. Those suffering from cold are relieved with pungent-warm and those suffering from heat are dispersed to dispel heat. If the disease is in blood aspect,we should promote blood circulation. If it is in qi aspect,moving qi should be considered. Dredging and clearing heat,and moving qi and promoting blood circulation can be used for excess syndrome,while purgation should not be used for deficiency syndrome. In the application of different treatment methods,eliminating dampness with bland medicinal emphasizes the combination of cold and warm. Only those with qi deficiency and sinking,elevating qi can be promoted. Abuse of tonifying deficiency should be opposed strongly. Relaxing and facilitating bowel movement should be advocated.In the treatment of different syndrome types of dysentery,it is emphasized that those in pestilent dysentery with unobstructed urine can be treated. To anorectic dysentery,clearing heat and replenishing qi should be used. Clearing heat,drying dampness and moving qi should be used to treat dampness-heat dysentery. It is considered that deficiency-cold dysentery is rare,so supplementing and astringing should be used with caution.It is emphasized that those who have long defecation time and still want to defecate but fail are of yin deficiency dysentery,and those who still do not feel comfortable after defecation were of interior excess syndrome. The prognosis of patients with appetite recovery is better. It is proposed that diarrhea is mostly cold syndrome while dysentery is mainly heat syndrome,so the treatment of diarrhea is usually warming and drying,while dysentery is usually treated with clearing heat and draining dampness.