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相火理论的本义溯源及理论探讨
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摘要
中医有关火热致病的研究内容丰富,尤其是金元时期的医家十分重视火热病的研究和治疗。《黄帝内经素问》中也有六气皆从火化之义。这其中相火的理论是最有特点的,它来源于五运六气学说,逐渐演化成用来阐释人体生理病理变化的理论,并用来指导临床实践。然而在理论发展的过程中各家的观点出现了许多分歧,概念含义模糊不清,使用的标准也不够明确。因此,很有必要将相火的理论进行细致的梳理,从而把相火理论的发展脉络呈现出来。
     “相火”一词最早出现于《黄帝内经素问·天元纪大论》中“君火以明,相火以位”,是用来阐述运气学说的。在宋金元时期,刘完素首先把相火运用于人体,言“心为君火,肾为相火”。在此基础上,朱丹溪继承并极大发挥了相火理论,认为肝肾内寄相火,正常相火可以助生化之功,而相火妄动则为元气之贼。他的理论被后世广泛认可,进而也开创了对相火病理状态即相火妄动所致疾病的研究。凡后世用论治相火大多引用丹溪的理论来辨证治疗。
     文献综述部分对近20年有关相火理论的文献做了归纳总结。按内容把所有的文献分成了理论研究文献和临床应用文献,并且做出了2篇文献综述分别对二者进行总结。综述一为相火理论文献的研究进展,按时间顺序,把历代医家与现代学者对相火的阐述进行了梳理总结。综述二为相火理论现代应用的研究进展,把近20年对相火理论应用于现代临床研究的进展做了总结,以期对相关疾病的临床治疗提供一种有益的参考。
     论文正文分三个部分。
     第一部分是本义溯源。以《黄帝内经素问》和《灵枢经》中的理论作为依据,对历代医家相火理论的阐述进行评议。为了把相火理论的涵义全面、清楚的展现在读者面前,这一部分内容分别从相火与君火、龙雷火、阴火、民火的联系与区别,相火的性质特点、相火的部位、相火致病的证治以及三焦心包络的考证等方面进行分析。最后得出《黄帝内经素问》中“相火以位”的个人理解。
     第二部分是理论探讨。这一部分把与相火理论相关的问题做进一步的探讨,以期找到相火理论的本质内容。内容分为足少阳胆经与相火属性的辨析;相火与肾、命门的关系、相火与阳气的关系、君火与神明的关系、从古代君相关系来看君火与相火的关系、相火阳气说与龙雷相火说的关系等六个部分。最后得出笔者归纳的相火理论的内容:相火的本质是人体阳气,寄位于少阳三焦、心包之处。其气根源于肾、命门,而通行全身,对人体起着温煦脏腑经络、四肢百骸,促进脏腑气化,保持人体生机的功能。相火与君火在实质上是同一的,均是阳气,而君火是阳气之精华,是神明。二者共同对人体的机能活动起着非常重要的作用。
     第三部分是结语和讨论。本文从近20年研究相火理论的文献入手,对历代医家有关相火理论的阐述进行总结,并归纳了相火理论现代临床应用的进展。而后从古代文献入手,对相火理论内容中的各个部分做逐一分析,得出“相火以位”的含义。最后对相关问题做进一步的探讨,得出了笔者对相火理论的理解。
The theory of traditional Chinese medicine research about disease caused by fire has rich contents. Especially physicians lived in jinyuan period pay more attention to research and treatment caused by fire. The Yellow Emperor's Internal Classic also have the meaning of six QI are transformed into fire. Ministerial fire theory is the most characteristic, it derive from Wu Yun Liu Qi theory, gradually change into theory to express human physiology and illness. However, in the process of theory development, it appeared a lot of different views. The concept is unclear and standard of how to use is also confused. So we should trace to the original meaning of this theory.
     "Ministerial Fire" is a word first appeared in the sentence of "sovereign fire yi ming, ministerial fire yi wei" from the chapter Su Wen Tian Yuan Ji Da Lun. The word is used to express the theory of Yun Qi. In the period of song jin yuan, Liu Wansu first use this word into human body. He argued that "sovereign fire is at heart while ministerial fire is at kidney". On the basis of this, Zhu Danxi develop this theory, he point out that ministerial fire exist in liver and kidney, the normal ministerial fire play a good part in body metabolism, on the contrary, The abnormal ministerial fire do harmful to Yuan Qi. His argument is widely Accepted by the followed physicians. Research on illness caused by abnormal ministerial fire mostly quote his argument to cure illness.
     Literature reviews summarized literature related with the theory of ministerial fire for the recently 20 years. This is divided into two parts theory research literature and clinical treatment literature. Literature reviews part one analysis and summarize are made for view of ministerial fire argued by ancient and modern physicians. Part two is all about modern clinical use based on the theory of ministerial fire in the recently 20 years. This can provide a reference of clinical treatment.
     The dissertation is composed of four parts.
     The first part is tracing the source of the theory. According to the theory of The Yellow Emperor's Internal Classic, I give evaluations to each view made by physicians in every period. In order to come up with a clear meaning of ministerial fire, I compared it with sovereign fire, longlei fire, yin fire and min fire. And discussed the characteristic of ministerial fire, and it's position, treatment, and the essence of sanjiao, envelop of heart. Finally, come a conclude of my understanding of ministerial fire's location.
     The second part is theory discussion. In this part, I made a further discussion about issues related to ministerial fire in order to find the essence of it's meaning. Including these six parts:the difference between attribute of ministerial fire and Gall Bladder Channel of Foot-Shaoyang, the relation between ministerial fire and kidney, vitaport, the relation of ministerial fire and yangqi, the connection of sovereign fire and deities, the relation of sovereign fire and ministerial fire, the difference between two theories, yangqi ministerial fire theory and longlei ministerial fire theory. Then finally come to a conclusion of my understanding:the essence of ministerial fire is yangqi. It locates in sanjiao and envelop of heart. It stems from kidney, vitaport and circulate all parts of body. It's function is accumulate metabolism. The essence of sovereign fire and ministerial fire is the same yangqi. But sovereign fire is deities, quintessence of yangqi. The two fire play a vey important part in our body metabolism.
     The third part is the conclusion and discussion. This dissertation summarized each view made by physicians in every period and sum up the modern clinical treatment of ministerial fire with the method of researching the lately 20 years modern literature. In addition, I studied ancient literature, analysed each parts of ministerial fire content and came up with the meaning of ministerial fire's location. Then I made further discusstion, finally draw a conclusion of my understanding of ministerial fire theory.
引文
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