释《黄帝内经》中的“瘅”

本文考察了早期非医文献中"瘅"字具有"劳病""旱病""厚盛""难""恶""怒"等含义。"瘅"在《黄帝内经》中亦有"劳病"义,表示内脏因过用而劳伤的一类疾病,如脾瘅、胆瘅、消瘅等,病因通常与饮食、情志和五藏本身的柔脆相关;在脾瘅、消瘅等病中存在津液的亏耗,故"瘅"亦具有"旱病"义;杨上善、王冰注《黄帝内经》,"瘅"始有"热"义,表示疾病存在热象,它限定了"瘅"是一种带有"热"之特性的"劳病",不同于一般的热病或劳病;"瘅"尚有"厚盛"义,表示热势的亢盛。据此认为临床对瘅病的治疗既需关注火热的标象,又需注重其五脏虚弱、津液亏耗的病本。

Exegesis of"Dan"in the Inner Canor of Hnangdi

This paper investigates the meanings of the word"Dan"in the early non-medical literature,such as"fatigue disease""drought disease""abundance""difficulty""vice"and"anger"."Dan"also has the meaning of"fatigue disease"in the Inner Canon,which indicates the exhaustion of viscera,such as"Spleen Dan""Gallbladder Dan"and"Xiao Dan".The etiology is usually related to diet,mood and the crispness of the five viscera.There is a loss of body fluid in the diseases such as"Spleen Dan"and"Xiao Dan",so"Dan"also has the meaning of"drought disease".In the Sui and Tang Dynasties,YANG Shang-shan and WANG Bing noted Inner Cannon and"Dan"began to have the meaning of"heat",indicating that there was a heat symptom in the disease.It defined"Dan"as a"fatigue disease"with the characteristic of"heat",which is different from the general fever or eparsalgia."Dan"also means"abundance",indicating the degree of heat in pathological state.Therefore,the article believes that the clinical treatment of Dan disease should not only pay attention to the hot signs,but also pay attention to its five visceras weakness and body fluid depletion.