舌脉诊法考

舌脉诊法主要观察舌腹面血管系统的变化,为我国所特有。《内经》首载舌脉刺血治疟、狂、忧虑无言、心病等,以盛即粗张为施术指征。晋以后发展为诊法,葛洪用于虏黄,巢元方用于噤黄与五色黄病情深浅判断,《医门方》用于预测难产母子吉凶,陈自明编《产难生死诀》以广流传。本法继承了络脉诊法的理论,重视络脉形色观察,以盛与青黑为逆,从血瘀痰郁辨证。明清未见明显发展,但作为奇穴刺血治舌肿、喉闭、黄疸并未中断,周学海发挥刘守真“玄府论”,倡舌细络瘀血说,难能可贵的是与今微循环障碍理论符合。１９６４年张赞臣再倡,研究者日众,临床多而基础少,认为对瘀证及肿瘤、肝病、肺心病有较高诊断价值。

Textual research on diagnosis by lingual vessels

Being a unique Chinese diagnostic meausure,this method focussing its observation on the ventral vessels of the tongue,is first recorded in Neijing,saying that it is indicated when the vessels are varicose by puncturing for bloodletting in malaria,mad,and sadness.Ge Hong and Cao Yuanfan applied it for juandice,also for prognosis.Yimenfang predicts by this method the diagnosis for prognosis of the mother and foetus in difficult delivery,while Chen Zhiming popularized it in his Chan Nan Sheng Si Jue.Inherited from the theory of Collateral Vessel Diagnosis,this approach pays attention to the observation of the forms and colors of collateral vessel,claiming that dark green color and congestion have bad diagnosis.Though not well developed,it was applied as extra-acupoints for swelling tongue,sore throat and jaundice.While Zhou Xuehai elaborated Liu Shouzhen's idea and put forward a theory of minute-vessel-stasis which is wonderfully conincided with modern microciroulation theory.In 1964,Zhang Zanchen again advocated its diagnostic value in tumor,hepatopathy and cor pulmonale.