从“木得桂而枯”论防己地黄汤在神志病中的应用

Interpretation of Fangji-Dihuang Decoction in mental illness from the perspective of “the wood withered after the laurel”

关键词:  木得桂而枯  防己地黄汤  神志病  桂枝  柔肝

Key words:  The wood withered after the laurel  Fangji-Dihuang Decoction  mental illness  cassia twig  nourishing liver

摘要:

“木得桂而枯”出自金陵版《本草纲目》，本意是指树木一旦植于桂木之旁即会枯死。而桂枝本身的含义并未明确体现可治疗神志病，所以自张仲景《金匮要略》创立防己地黄汤开始，方中桂枝之配伍一直被历代医家所争议，本方为血虚夹风所致癫狂证，症见“如狂状，妄行，独语不休”，而此类神志病用桂枝的独特配伍为“木得桂而枯”开辟了一个新的思路。文章从“木得桂而枯”的原始含义、防己地黄汤配伍桂枝的意义以及历代医家对“木得桂而枯”的论述来探讨“木得桂而枯”所蕴含的医理以及防己地黄汤为何配伍桂枝来治疗神志病。

Abstract:

“Wood becomes cinnamon and withered” from the Jinling edition of the Compendium of Materia Medica，the original meaning is that trees will die once planted next to the laurel tree. Since the establishment of Fangji Dihuang Decoction in Zhang Zhongjing’s Synopsis of Golden Chamber，the combination of cassia twig has been disputed by doctors of all ages. This prescription is the syndrome of madness caused by blood deficiency and wind，and the symptoms are “like madness，unreasonable behavior，and endless talk”. And this kind of mental illness with the unique compatibility of cassia twig for “wood and laurel and withered” opened up a new way of thinking. In this paper，the original meaning of “wood and laurel and withered”，the significance of Fangji Dihuang Decoction with cassia twig and withered and the discussion of doctors of the past dynasties，the medical theory of “wood and laurel and withered”and why Fangji Dihuang Decoction with cassia twig to treat mental illness.