清代温病医案488例的舌象分析

在51部清代医案中,梳理出记录有温病舌诊医案的著作29部,进一步将全部温病舌诊医案488例摘录出来,以高等中医院校中医诊断学教材的舌诊分类为主,对温病舌诊医案进行了统计分析。结果表明：488例温病医案中,以舌苔的记录比率最高,为65．16％,其中黄苔的比重最高,其次为白胎和黑苔。清代1850-1911年期间苔色的变化特征为：白苔、黄苔的出现率上升,黑苔的出现率下降,复合苔色的描述增加。舌色的纪录为23．16％,以红舌和绛舌的比例最高。苔质的记录为37．70％,清代1850～1911年,对腻苔的记录上升到苔质纪录的第一位。舌诊的运用范围涉及温热类温病、湿热类温病和瘟疫。

Analysis on tongue manifestations of 488 cases of Warm disease in Qing Dynasty

488 cases of warm disease with tongue diagnosis picked up from 29 monographs providing materials of tongue diagnosis are sorted out of 51 monographs of medical records in the Qing Dynasty. Statistics and analysis were made on these 488 cases of tongue diagnoses, according to the classification of tongue manifestations in the Textbook of Diagnostics of Chinese Medicine for TCM schools of higher education. Results showed that, among all the cases, the recording rate of tongue fur was 65. 16% and was the highest one of the recording materials. The frequencies of different fur recorded from high to low were yellow, white and black. From 1850 to 1911 in the Qing Dynasty, occurrence rate of tongue coating had changed. Those of white, yellow and compound fur were increased. On the contrary, that of black fur was decreased. The recording rate of the color of tongue proper was 23. 16%, among which the proportions of red and crimson tongue were the highest. The recording rate of fur quality of fur was 37. 7%. From 1850 to 1911 in the Qing Dynasty, the recording rate of greasy fur reached the first place in fur quality. Tongue diagnosis was applied in warm-heat and damp-heat types of Warm Disease and pestilence.