摘要
脉诊出自医经家,源于经络检查,为中医特色诊法之一。脉诊的发展是在医经派与经方派的融合中,在辨证论治即对于疾病的“平脉辨证”存在需求时,脉法亦由古代遍诊法的以定位为主逐步转化为独取寸口法的以定性为主,其间经历了几个世纪的漫长岁月。在此过程中完善了方法,统一了脉名、脉形,由最初的色脉两诊不分而逐步成为与色诊分开的单诊脉动的技术方法,并以极其鲜明的特色成为两千多年来中医理论与临床工作不可缺少的手段。
清代著名医学家吴鞠通,深入钻研《黄帝内经》、《伤寒论》、《金匮要略》等经典医籍,博采众长,勤于实践,勇于创新。所著《温病条辨》、《医医病书》和《吴鞠通医案》等,对温病学术多有贡献,被后世誉为清代温病四大家之一。
吴鞠通,和汉代张仲景比肩而立,并为我国中医学史上的两大柱石。张仲景,以他的光辉著作《伤寒论》、《金匮要略》开创了中医药物疗法的基本格局,是为中医学的泰斗;而吴鞠通则总结前人的医学成就,著述了“实可羽翼伤寒”的《温病条辨》,最终完成了开拓中医学又一个重要领域的伟大工程。其在《温病条辨》中对脉学论述颇多,精辟可堪。
《温病条辨》为明清医学中温热学派的名著之一。全书共六卷,卷首引证《内经》经文,冠以原病篇。前三卷把温病分上、中、下焦篇,详细论述了温病的病源和证治,另有原病篇和杂论、解产难、解儿难等篇。全书以三焦学说为经,卫气营血学说为纬,既严绳墨,又富心裁,经方活用,殊寓新义,着重阐述了温病自上而下、由浅入深的演变过程,总结了温病的治疗经验。
本课题试对《温病条辨》脉学理论,进行系统而详尽的研究,补充现今研究之不足。其中重点讨论和归类了与临床密切相关的脉象主病的内容,最终旨在弘扬《温病条辨》脉学理论,并为临床诊断与治疗提供有价值的参考资料。
通过以下几个方面的探讨,希望能对《温病条辨》有关脉学的资料作一个初步整理,并由此找到吴鞠通运用脉诊的一些规律和特点。这对于系统地继承和掌握吴鞠通的学术思想,指导临床应用,进一步深化对吴鞠通脉学理论的认识,都有着十分重要的意义。
本研究分4个部分对《温病条辨》的脉诊内容进行了较为系统的研究和探讨:
1以《温病条辨》的正文为研究对象,上溯《内经》、《难经》,下涉诸家,探讨吴鞠通脉学思想的源流。
2将《温病条辨》正文中有关脉象的条文全部摘录,书中所述脉象多数是两种以上的相兼脉,为了描述方便起见,以浮、沉、数、迟、虚、实等六纲脉类之,以纲脉来统兼脉。
3通过对《温病条辨》脉诊内容的整理,对吴氏在临床中如何运用脉象来诊治疾病有了初步的认识,总结其在温病诊治运用脉诊的特点。
4脉诊是四诊之切诊的重要内容,是诊断疾病的重要手段,吴氏继承《内经》、《难经》的脉诊理论,并在临床实践中有所发挥,依据脉象辨别病名、病因、病机、病位、病性、病势,这种藉脉阐述病因病机,确定治疗原则,指导治疗用药,推测疾病预后的方法,对指导临床具有十分重要的意义。
通过对《温病条辨》脉诊内容的整理,可以看出《温病条辨》一书中,广泛地应用脉法来解释病机、鉴别病证、确定之法、判断预后等,脉诊与理法方药的每一方面都存在有机的联系,这是吴鞠通学术体系中极为重要的组成部分,在此书中,集中体现了吴鞠通的脉学思想。
本课题从《温病条辨》的脉诊理论出发,对吴鞠通脉学思想作了系统地研究,探讨其脉学思想的源流,整理其脉诊内容,总结其脉诊特点,归纳其脉诊临床意义如下:
1《黄帝内经》、《伤寒论》等书的脉学理论是吴鞠通脉诊思想形成的基础。
2吴鞠通脉诊特点:以脉为纲,以纲脉统兼脉;在温病诊治过程中,运用相兼脉多于单一脉;以三焦为纲,把脉象与三焦辨证结合起来,使其成为辨证施治的有机组成部分。
3吴鞠通在继承前人脉诊理论的基础上,并在临床实践中有所发挥,依据脉象辨别病名、病因、病机、病位、病性、病势,对指导临床具有十分重要的意义。
Pulse from a medical clinic by the family, from Meridian to check for patient characteristics, method of Chinese medicine. The development of Pulse Diagnosis by the Yes camp and at the medical camp by the side of integration, in the treatment for the disease that is the "green veins Differentiation," there is demand, the pulse method from ancient times to attending law gradually into the main position was given the qualitative law-based, which has experienced some of the long years of the century.
Qing Wu Jutong famous medical scientists, in-depth study, "Huang Di Nei Jing", "Treatise on Febrile Diseases," "Essence" and other classic medical works, absorbing and diligent practice, make innovations. Book, "Wen disease Differentiation", "book doctor for medical treatment" and "Wu Jutong medical case" and so on, contribute to many of the Doctrine of Epidemic Febrile Disease patients, as the Qing Dynasty by later generations temperature four patients, one of U.S..
Wu Jutong, and Han Zhang stand shoulder to shoulder, and the history of our country in the two pillars of medicine. Zhang, in his brilliant book "Treatise on Febrile Diseases," "Essence" in traditional Chinese medicine to create the basic pattern of drug therapy is greatest in medical science;and Wu Jutong, then summing up the medical achievements of our predecessors, writing the "real typhoid fever can wing "and" Article disease identified temperature, "finally completed the development of Chinese medicine and an important area of the great project. In the "Article disease identified temperature" of the pulse on a lot of study, always insightful.
"Article disease identified temperature" for the Ming and Qing Dynasties in the medical school's famous hot one. A total of six volumes of the book, citing"Neijing" scripture, known as the original disease articles. Wen put before the three-volume disease at upper, middle and lower coke articles detail the temperature of the source of the disease and permits patients governance, otherwise the original papers and miscellaneous disease theory, solution of the middle class hard, difficult children, such as solution articles. Theory for the whole book as a triple, Wei Qi, Ying and Xue Wei theory for bothstrict and rich conception, through to use, is put a new justice, focused on top-down temperature disease, the evolution of easy-to-digest, summed up the temperature treatment of disease.
Examination of this issue, "Wen disease be identified," study the pulse theory, a systematic and detailed study, added less than the present study. One of the focus of discussion and with the clinical classification of the pulse is closely related to the contents of the main disease, and ultimately seeks to promote the "Article disease identified temperature" pulse theory and for clinical diagnosis and treatment provide a valuable reference.
Through the following aspects of the hope that it can "be identified temperature Disease" Study on the clock for a preliminary information collation, and thus find the use of Wu Jutong Pulse Diagnosis and characteristics of some of the laws. This is a systematic succession and master Wu Jutong idea of academic, clinical applications, further deepen the study of Wu Ju Tongmai recognize the theory, are of great significance.
This four part study on "Febrile Disease Differentiation" Pulse of the contents of a more systematic study and discussion:
1 To "be patient temperature identified" the body of this study could be traced, "Canon", "hard by the" home of all involved to explore Tongmai Ju Wu study the origins of thought.
2 To "be patient temperature identified" the body of the provisions of the pulse of all extracts, the majority of the book are described in two or more pulse phase and pulse, in order to describe the sake of convenience, in order to float, Shenyang, the number of late, false, false, etc. The six categories of gang connections to network connections and network to reunification.
3 By "disease be identified temperature" pulse diagnosis organize the content of Wu in the clinical use of pulse diagnosis and treatment of disease have come to recognize the preliminary summing up of its diagnosis and treatment of disease in the temperature characteristics of the use of pulse diagnosis.
4 Pulse is the cut of four attending an important aspect of consultation is an important means of diagnosis of the disease, Wu inherited "Canon", "hard by the" Theory of pulse diagnosis and has been in clinical practice exert, according to pulse to identify disease , etiology, pathogenesis, disease, and disease, the patient's condition, which borrow on the Etiology and Pathogenesis of the pulse to determine the treatment of principles to guide the treatment of medication, that the method of disease prognosis, and clinical guidance of great significance.
By "disease be identified temperature" pulse diagnosis organize content, you can see the "Article disease identified temperature" one book, the wider application of the pulse method to explain pathogenesis, identification of diseases, to determine the law, to determine prognosis, such as pulseprescription consultation with every aspect of the existence of organic contact, Wu Jutong This is extremely important in the academic system, an integral part of, in this book embodies the Wu Jutong idea of pulse study.
The subject from the "disease be identified temperature" of the pulse diagnosis theory, study of the idea Tongmai Ju Wu made a systematic study to examine the idea of its study of the origins of the pulse, pulse diagnosis organize its contents, summarizes the characteristics of pulse diagnosis, summed up its Clinical significance of pulse diagnosis:
1 "Huang Di Nei Jing", "Treatise on Febrile Diseases" such as book study of the pulse Tongmai Ju Wu theory is thought to form the basis of consultation.
2 Wu Jutong pulse characteristics: as the key link to the pulse to pulse integration and network connections; in disease diagnosis and treatment temperature, the use of more than a single pulse and pulse; to triple as the key link, the pulse with the triple combination of differentiation, so that Differential Treatment of becoming an integral part.
3 Wu Jutong inherited at the Pulse on basic theory and clinical practice has been at play, according to pulse to identify disease, etiology, pathogenesis, disease, and disease, the patient's condition, is very important in guiding the clinical significance .
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