从万全医案探析小儿五脏观

万全是明代著名医家,《万密斋医学全书》中附有349则医案。从万全医籍所附医案探讨其小儿五脏观,得出以下四点结论。①以五脏有余不足释小儿生理,提出“三有余、四不足”之说,即肝常有余、心常有余、阳常有余,脾常不足、肺常不足、肾常不足、阴常不足。②以调理脾胃作为治疗重点,主张脾与胃异同论,提倡节饮食,适寒温,遵“中和”之道。③小儿疾病以五脏为纲,从肝、心、脾、肺、肾五个生理系统,进行分证论治。④小儿亦有五脏情志病,怒、喜、思、悲、恐等情志活动与五脏密不可分,需顺欲治疗。

Analysis on Theory of Children's Five Zang-organs from WAN Quan's Medical Cases

WAN Quan was a famous doctor in the Ming Dynasty. There are total 349 medical cases in Wanmi Zhai Medical Encyclopedia,based on which this paper discussed his theory on children's five zang-organs and drew the following conclusions. First,excess and deficiency of five zang-organs were used to explain children's physiology,based on which he put forward the theory of "three excesses and four deficiencies",i.e. liver is often more,heart often more,Yang often more,spleen often insufficient,lung often insufficient,kidney often insufficient,Yin often insufficient. Second,he attached importance to regulating spleen and stomach,arguing for the similarities and differences between spleen and stomach,advocating diet,adapting to environment and following "neutralization". Third,children's diseases were differentiated and treated based on five zang-organs from the five physiological systems of liver,heart,spleen,lung and kidney. Fourth,children also had emotional diseases,anger,joy,thinking,sadness,fear and other emotional activities related to the five zang-organs closely,which should be treated by obeying to their disposition.