试论心包腑实和单纯腑实所致神昏的“辨证关键”

热入心包兼阳阴腑实和单纯阳明腑实均可引起神昏。二者的辨证关键 ,六版及有关《温病学》教材均认定是“舌蹇而言语不利。”但是 ,这种认定既不合逻辑 ,也不符合临床实际。理论上讲 ,二者的辨证关键是舌质绛 ,临证时必须四诊合参 ,全面诊察。

Key Points in Discriminating Coma Caused by Excess Syndrome of the Pericardium from That by Fu organs

Coma can appear as the result of attack of pericardium by heat and excess syndrome of the fu organs of yangming channel,or of one of the two.In the sixth edition of the college textbooks and the Treatise on Epidemic Febrile Disease,retraction of the tongue and difficulty in speaking are considered to be the key point in differentiating the two.However,it is illogical and not in conformity with the clinical practice.Theoretically,deep red tongue should be taken as the key,yet a comprehensive diagnosis should be made by collecting data through the four diagnostic methods.