《医学心悟》辨证方法初探——兼论脏腑辨证特点

Primary Study of the Syndrome Differentiation in Thoughts After Study of Medicine——Discuss on the Characteristics of Syndromes Differentiation in Accordance with the Visceral Theory

关键词:  辨证方法  《医学心悟》  脏腑辨证

Key words:  syndrome differentiation  Thought After Study of Medicine  CHENG Zhong-ling  differentiation of synˉdromes in accordance with the visceral theory

摘要:

《医学心悟》系清代名医程国彭所著,“其书似平淡无奇,而千变万化总不出其范围”,乃程氏30年业医心得之总结。清代中医辨证日臻完善,辨证方法丰富多样。通过对《医学心悟》中辨证方法运用的分析、探讨,得出以下结论 :1)病种不同,侧重有别,依据病证特点选择辨证方法 ;2)脏腑辨证作为辨治疾病的核心 ;3)充分发挥每种辨证方法的优势,综合使用。以脏腑辨证为核心的辨证方法,决定了《医学心悟》中疾病的证型或病机概括必定以脏腑病理变化为主,并且有其自身特点。1)病机、证型的阐明以脏为主,尤其重视先天之本(肾)和后天之本 (脾)。2)辨证求因,执简驭繁,务求简明。

Abstract:

Thoughts After Study of Medicine was written by CHENG Guo-peng,a famous doctor in Qing Dynasty after he had practiced medicine for30years."It seemed common but changed always on it’s ground".In Qing Dynasty,the the-ories of syndrome differentiation increasingly became perfected and their differentiation methods plentiful.By analyzing the use of syndrome differentiation,the next conclusions was obtained:1)choose different syndrome differentiation according to different diseases.For different diseases there was different therapeutic emphasis;2)differentiation of syndromes in ac-cordance with the visceral theory was regarded as the core of syndrome differentiation and treatment;3)take advantage of each syndrome differentiation and make full use of them.This syndrome differentiation had decided that the pathological changes of internal organs must be the core of the syndrome-classification and pathogenesis in this book and had its own characteristics.Illustrating the syndrome and pathogenic factors would be put emphasis on the internal organs and espe-cially on the kidney,the origin of the congenital constitutions,and the spleen,the root of acquired constitution.Seek for simplicity must be taken in the course of inferring the cause and juding the pathogenesis.