伤寒营卫之营与温病营血之营辨析

Differentiation and analysis of the Ying in cold-induced disease and in seasonal febrile disease

关键词:  伤寒  营卫  温病  营血

Key words:  cold-induced disease  Yingwei  seasonal febrile disease  Yingxue

摘要:

温病学家所讲的营分病特点是神志变化加上“斑点隐隐”,并且往往“营血”并称。而先秦两汉时期的医家往往“营卫”并称。在《伤寒论》中,无论外感还是内伤,出不出汗的问题是由营卫关系决定的。卫气不固,营阴外泄,表现出来的是汗症,这与《灵枢·营卫生会》篇中的观点一致,而与清代的温病学家认为营阴扰动后出现的“斑点隐隐”显然不同。实际上,温病讲的营分证就是血分证,只是比较轻,清营汤归根到底用的就是清热凉血解毒之法,温病学家借用了“营气”一词,把血分证的轻证称之为“营分证”.

Abstract:

The characteristics of Yingfen disease discussed by scholars of seasonal febrile disease are psychosis disorder and "indistinct macula". And they often combine Ying and Xue together, called "Yingxue". But doctors in Qin Dynasty and Han Dynasty often combined Ying and Wei together and called it "Yingwei". In Treatise on Exogenous Febrile Diseases, no matter whether the disease is induced by exogenous factors or by endogenous damages, the existence or inexistence of sweat are determined by the relationship of Ying and Wei. Sweating is the manifestation of Wei Qi's weakness and Ying Yin's discretion. This opinion is the same with that of Ying Wei Sheng Hui, but it's different with the opinion of scholars of seasonal febrile disease in Qing Dynasty, which suggested that the disturbed Ying Yin can lead to "indistinct macula". Actually, Yingfen syndrome discussed in seasonal febrile disease is Xuefen syndrome, which is just less serious. In one word, Qingying decoction essentially applied the method of clearing away heat, cooling the Ying and detoxification. Scholars of seasonal febrile disease borrowed the term of "Ying Qi" and called the less serious Xuefen syndrome as "Yingfen syndrome".