炭藥(yao)(yao)(yao)止血，是(shi)中(zhong)醫藥(yao)(yao)(yao)治療血液病的特色(se)之一(yi)。夏老(lao)臨證時亦善用(yong)炭藥(yao)(yao)(yao)止血，體會如下(xia)。

1.止血用炭藥，存性須掌握

炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)藥(yao)有炒炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)與煅炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)之別(bie)。所謂(wei)炒炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)，是指(zhi)將藥(yao)物(wu)置炒制容器(qi)內(nei)，用武(wu)火或中火加(jia)熱，炒至外表焦黑色（又(you)稱炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)黑色），內(nei)部(bu)棕(zong)褐色或深褐色（又(you)稱老黃(huang)色）為度。這(zhe)樣就使藥(yao)物(wu)一半(ban)炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)化(hua)，不能灰化(hua)；另(ling)一半(ban)存性，而(er)且能嘗出藥(yao)物(wu)固有的(de)(de)(de)氣味。花、葉、草(cao)等炒炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)后仍(reng)可清晰辨別(bie)藥(yao)物(wu)原形，如生地炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、地榆炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、槐角炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、荊(jing)(jing)芥(jie)炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)等。所謂(wei)煅炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)，系指(zhi)將藥(yao)物(wu)直接放于(yu)無煙爐或適當的(de)(de)(de)耐火容器(qi)內(nei)燃燒，煅至炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)化(hua)，防止(zhi)(zhi)灰化(hua)，如血(xue)(xue)(xue)(xue)余炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、棕(zong)櫚炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、荷葉炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)等。臨床(chuang)常(chang)用于(yu)止(zhi)(zhi)血(xue)(xue)(xue)(xue)的(de)(de)(de)炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)藥(yao)有涼血(xue)(xue)(xue)(xue)止(zhi)(zhi)血(xue)(xue)(xue)(xue)的(de)(de)(de)地榆炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、槐角炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、茅根炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、大薊炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)；收斂血(xue)(xue)(xue)(xue)的(de)(de)(de)棕(zong)櫚炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、側柏炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、藕節炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)；化(hua)瘀止(zhi)(zhi)血(xue)(xue)(xue)(xue)的(de)(de)(de)蒲黃(huang)炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、茜(qian)根炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、血(xue)(xue)(xue)(xue)余炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)；溫經止(zhi)(zhi)血(xue)(xue)(xue)(xue)的(de)(de)(de)艾葉炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、炮姜(jiang)炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)；清熱涼血(xue)(xue)(xue)(xue)的(de)(de)(de)生地炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、丹皮炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、梔子(zi)(zi)炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、黃(huang)芩炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、金(jin)銀(yin)花炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)；祛風止(zhi)(zhi)血(xue)(xue)(xue)(xue)的(de)(de)(de)荊(jing)(jing)芥(jie)炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、防風炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)；理(li)氣止(zhi)(zhi)血(xue)(xue)(xue)(xue)的(de)(de)(de)枳殼炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、橘皮炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)；澀腸止(zhi)(zhi)血(xue)(xue)(xue)(xue)的(de)(de)(de)烏梅炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、訶(he)子(zi)(zi)炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)；補(bu)血(xue)(xue)(xue)(xue)止(zhi)(zhi)血(xue)(xue)(xue)(xue)的(de)(de)(de)熟地炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)、當歸(gui)炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)以(yi)及瀉火化(hua)瘀的(de)(de)(de)大黃(huang)炭(tan)(tan)(tan)(tan)(tan)(tan)(tan)(tan)等。

炭(tan)(tan)藥(yao)(yao)(yao)止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)，其(qi)(qi)(qi)(qi)理(li)(li)有二：一(yi)(yi)是水(shui)為(wei)(wei)黑之(zhi)(zhi)色(se)，血(xue)(xue)(xue)(xue)(xue)(xue)(xue)色(se)紅赤，逢黑必止(zhi)(zhi)(zhi)(zhi)(zhi)，取其(qi)(qi)(qi)(qi)水(shui)克火之(zhi)(zhi)義(yi)；二是燒(shao)(shao)炭(tan)(tan)存性(xing)，保持藥(yao)(yao)(yao)物原(yuan)有的(de)(de)(de)(de)作用(yong)(yong)(yong)。中(zhong)醫(yi)(yi)理(li)(li)論(lun)認(ren)為(wei)(wei)，藥(yao)(yao)(yao)物炒(chao)(chao)炭(tan)(tan)之(zhi)(zhi)后(hou)(hou)(hou)，雖然(ran)其(qi)(qi)(qi)(qi)四(si)氣(qi)、五味(wei)(wei)(wei)(wei)(wei)及升降浮沉等性(xing)能(neng)(neng)均發(fa)生(sheng)(sheng)(sheng)(sheng)(sheng)了一(yi)(yi)些變(bian)化(hua)，但其(qi)(qi)(qi)(qi)原(yuan)有主(zhu)要(yao)作用(yong)(yong)(yong)或(huo)某一(yi)(yi)方面的(de)(de)(de)(de)作用(yong)(yong)(yong)未發(fa)生(sheng)(sheng)(sheng)(sheng)(sheng)變(bian)化(hua)，此所謂“存性(xing)”。例(li)如(ru)黃芩，生(sheng)(sheng)(sheng)(sheng)(sheng)用(yong)(yong)(yong)味(wei)(wei)(wei)(wei)(wei)苦(ku)(ku)(ku)性(xing)寒(han)，清(qing)熱瀉(xie)火力專，多(duo)用(yong)(yong)(yong)于(yu)(yu)熱病邪入氣(qi)營等；炒(chao)(chao)炭(tan)(tan)后(hou)(hou)(hou)味(wei)(wei)(wei)(wei)(wei)苦(ku)(ku)(ku)性(xing)澀(se)(se)(se)，性(xing)微寒(han)，清(qing)熱止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)力勝(sheng)，多(duo)用(yong)(yong)(yong)于(yu)(yu)吐血(xue)(xue)(xue)(xue)(xue)(xue)(xue)、斑血(xue)(xue)(xue)(xue)(xue)(xue)(xue)等證，其(qi)(qi)(qi)(qi)清(qing)熱之(zhi)(zhi)功(gong)猶存。生(sheng)(sheng)(sheng)(sheng)(sheng)大(da)黃味(wei)(wei)(wei)(wei)(wei)苦(ku)(ku)(ku)瀉(xie)下，炒(chao)(chao)炭(tan)(tan)后(hou)(hou)(hou)味(wei)(wei)(wei)(wei)(wei)苦(ku)(ku)(ku)微澀(se)(se)(se)，長于(yu)(yu)止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)行瘀，其(qi)(qi)(qi)(qi)化(hua)癖(pi)之(zhi)(zhi)效仍在。烏梅生(sheng)(sheng)(sheng)(sheng)(sheng)用(yong)(yong)(yong)味(wei)(wei)(wei)(wei)(wei)酸(suan)(suan)生(sheng)(sheng)(sheng)(sheng)(sheng)津、斂(lian)(lian)(lian)肺；炒(chao)(chao)炭(tan)(tan)后(hou)(hou)(hou)味(wei)(wei)(wei)(wei)(wei)酸(suan)(suan)微苦(ku)(ku)(ku)澀(se)(se)(se)，長于(yu)(yu)澀(se)(se)(se)腸止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)，其(qi)(qi)(qi)(qi)收(shou)斂(lian)(lian)(lian)之(zhi)(zhi)性(xing)未減。生(sheng)(sheng)(sheng)(sheng)(sheng)荊(jing)芥(jie)主(zhu)升浮，能(neng)(neng)解表祛(qu)風；炒(chao)(chao)炭(tan)(tan)后(hou)(hou)(hou)偏(pian)主(zhu)沉降，能(neng)(neng)止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)寧絡(luo)(luo)，取其(qi)(qi)(qi)(qi)祛(qu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)分風邪之(zhi)(zhi)力。槐角生(sheng)(sheng)(sheng)(sheng)(sheng)用(yong)(yong)(yong)味(wei)(wei)(wei)(wei)(wei)苦(ku)(ku)(ku)性(xing)寒(han)，瀉(xie)熱涼血(xue)(xue)(xue)(xue)(xue)(xue)(xue)力勝(sheng)，多(duo)用(yong)(yong)(yong)于(yu)(yu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)熱妄行之(zhi)(zhi)吐、衄；炒(chao)(chao)炭(tan)(tan)后(hou)(hou)(hou)味(wei)(wei)(wei)(wei)(wei)苦(ku)(ku)(ku)微澀(se)(se)(se)，性(xing)偏(pian)平和(he)，止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)安絡(luo)(luo)力強(qiang)，多(duo)用(yong)(yong)(yong)于(yu)(yu)便血(xue)(xue)(xue)(xue)(xue)(xue)(xue)、痔血(xue)(xue)(xue)(xue)(xue)(xue)(xue)及崩漏等。炒(chao)(chao)炭(tan)(tan)的(de)(de)(de)(de)目的(de)(de)(de)(de)是使(shi)藥(yao)(yao)(yao)物增(zeng)強(qiang)或(huo)產生(sheng)(sheng)(sheng)(sheng)(sheng)止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)作用(yong)(yong)(yong)。現(xian)代藥(yao)(yao)(yao)理(li)(li)研究(jiu)表明，多(duo)數藥(yao)(yao)(yao)物炒(chao)(chao)炭(tan)(tan)后(hou)(hou)(hou)微量(liang)元素呈下降趨(qu)勢，鞣質含(han)(han)量(liang)多(duo)呈上(shang)(shang)升趨(qu)勢，而(er)(er)鞣質在醫(yi)(yi)療上(shang)(shang)常作為(wei)(wei)收(shou)斂(lian)(lian)(lian)劑，具(ju)有收(shou)斂(lian)(lian)(lian)止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)、止(zhi)(zhi)(zhi)(zhi)(zhi)瀉(xie)等作用(yong)(yong)(yong)。例(li)如(ru)荊(jing)芥(jie)主(zhu)含(han)(han)揮(hui)發(fa)油(you)(you)，炒(chao)(chao)炭(tan)(tan)后(hou)(hou)(hou)揮(hui)發(fa)油(you)(you)散失(shi)，生(sheng)(sheng)(sheng)(sheng)(sheng)成的(de)(de)(de)(de)炭(tan)(tan)可以止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)，內服(fu)能(neng)(neng)使(shi)實驗動物的(de)(de)(de)(de)出、凝血(xue)(xue)(xue)(xue)(xue)(xue)(xue)時間縮(suo)短(duan)；大(da)黃炒(chao)(chao)炭(tan)(tan)存性(xing)后(hou)(hou)(hou)結合(he)性(xing)大(da)黃酸(suan)(suan)絕大(da)部(bu)分均被(bei)破壞，而(er)(er)大(da)黃酚的(de)(de)(de)(de)含(han)(han)量(liang)增(zeng)高，故有止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)之(zhi)(zhi)功(gong)等。另據報道，藥(yao)(yao)(yao)物炒(chao)(chao)炭(tan)(tan)后(hou)(hou)(hou)其(qi)(qi)(qi)(qi)理(li)(li)化(hua)性(xing)質雖產生(sheng)(sheng)(sheng)(sheng)(sheng)了變(bian)化(hua)，但只要(yao)處理(li)(li)恰(qia)當(dang)，則無致癌危險；對于(yu)(yu)部(bu)分具(ju)有刺激性(xing)的(de)(de)(de)(de)藥(yao)(yao)(yao)物還(huan)可緩和(he)藥(yao)(yao)(yao)性(xing)。例(li)如(ru)艾葉炒(chao)(chao)炭(tan)(tan)后(hou)(hou)(hou)辛(xin)散之(zhi)(zhi)性(xing)大(da)減，緩和(he)對胃的(de)(de)(de)(de)刺激性(xing)，增(zeng)強(qiang)溫經止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)作用(yong)(yong)(yong)等。此外，對于(yu)(yu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)余炭(tan)(tan)、棕櫚炭(tan)(tan)而(er)(er)言，其(qi)(qi)(qi)(qi)生(sheng)(sheng)(sheng)(sheng)(sheng)品不(bu)能(neng)(neng)入藥(yao)(yao)(yao)，煅制的(de)(de)(de)(de)目的(de)(de)(de)(de)是為(wei)(wei)了改變(bian)藥(yao)(yao)(yao)性(xing)而(er)(er)止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)；從上(shang)(shang)可見，炭(tan)(tan)藥(yao)(yao)(yao)止(zhi)(zhi)(zhi)(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)并非(fei)以“血(xue)(xue)(xue)(xue)(xue)(xue)(xue)見黑即止(zhi)(zhi)(zhi)(zhi)(zhi)”一(yi)(yi)概而(er)(er)論(lun)，更重要(yao)的(de)(de)(de)(de)還(huan)在于(yu)(yu)“存性(xing)”。亦(yi)正如(ru)清(qing)代名醫(yi)(yi)陳修園所說(shuo)：“今藥(yao)(yao)(yao)肆(si)中(zhong)止(zhi)(zhi)(zhi)(zhi)(zhi)知燒(shao)(shao)灰則色(se)變(bian)黑，而(er)(er)不(bu)知存性(xing)二字……”見解深(shen)刻，不(bu)可不(bu)崇。

2.用藥不在多，方法宜靈活

盡管目前臨床常(chang)用(yong)(yong)(yong)于(yu)(yu)(yu)止(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)的(de)(de)(de)炭(tan)藥(yao)(yao)(yao)只有(you)20余(yu)種，但其用(yong)(yong)(yong)途確比(bi)較(jiao)(jiao)(jiao)廣泛(fan)，用(yong)(yong)(yong)法(fa)也(ye)非常(chang)靈活。既用(yong)(yong)(yong)于(yu)(yu)(yu)各種血(xue)(xue)(xue)(xue)(xue)(xue)(xue)液病(bing)(bing)(bing)引起的(de)(de)(de)出血(xue)(xue)(xue)(xue)(xue)(xue)(xue)，又(you)(you)用(yong)(yong)(yong)于(yu)(yu)(yu)其他疾(ji)病(bing)(bing)(bing)并發的(de)(de)(de)出血(xue)(xue)(xue)(xue)(xue)(xue)(xue)，既可(ke)入煎劑，又(you)(you)可(ke)入丸、散之(zhi)(zhi)劑；既能口服(fu)(fu)，又(you)(you)能外(wai)(wai)用(yong)(yong)(yong)。如(ru)近代(dai)名醫鄧(deng)鐵濤治(zhi)療(liao)崩漏的(de)(de)(de)“一(yi)味血(xue)(xue)(xue)(xue)(xue)(xue)(xue)余(yu)炭(tan)”等，又(you)(you)如(ru)柳學株治(zhi)療(liao)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)友(you)病(bing)(bing)(bing)的(de)(de)(de)“二(er)炭(tan)一(yi)粉”（生(sheng)地炭(tan)、茅根炭(tan)、 三七(qi)粉）等。筆(bi)者(zhe)體會，炭(tan)藥(yao)(yao)(yao)用(yong)(yong)(yong)于(yu)(yu)(yu)外(wai)(wai)治(zhi)時(shi)，一(yi)般以單用(yong)(yong)(yong)為(wei)(wei)主(zhu)，內服(fu)(fu)時(shi)既可(ke)單用(yong)(yong)(yong)，又(you)(you)可(ke)合用(yong)(yong)(yong)，然而應用(yong)(yong)(yong)最多(duo)(duo)的(de)(de)(de)是1~2味或數味炭(tan)藥(yao)(yao)(yao)與(yu)其他藥(yao)(yao)(yao)物配(pei)合，組(zu)為(wei)(wei)復方應用(yong)(yong)(yong)。例如(ru)涼(liang)(liang)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)止(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)藥(yao)(yao)(yao)，通(tong)常(chang)生(sheng)品涼(liang)(liang)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)力勝，炒炭(tan)后則止(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)作用(yong)(yong)(yong)強，具體運用(yong)(yong)(yong)時(shi)若(ruo)病(bing)(bing)(bing)人血(xue)(xue)(xue)(xue)(xue)(xue)(xue)熱較(jiao)(jiao)(jiao)盛，且方中(zhong)(zhong)已有(you)足夠的(de)(de)(de)涼(liang)(liang)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)止(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)藥(yao)(yao)(yao)時(shi)，選(xuan)加部分炭(tan)藥(yao)(yao)(yao)可(ke)增強止(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)同澀作用(yong)(yong)(yong)；反之(zhi)(zhi)，若(ruo)病(bing)(bing)(bing)人出血(xue)(xue)(xue)(xue)(xue)(xue)(xue)量較(jiao)(jiao)(jiao)多(duo)(duo)，血(xue)(xue)(xue)(xue)(xue)(xue)(xue)熱又(you)(you)不(bu)太盛，但方中(zhong)(zhong)已有(you)足夠的(de)(de)(de)止(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)炭(tan)藥(yao)(yao)(yao)時(shi)，選(xuan)加部分生(sheng)藥(yao)(yao)(yao)以增強清熱涼(liang)(liang)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)之(zhi)(zhi)功。可(ke)見，炭(tan)藥(yao)(yao)(yao)止(zhi)(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)，不(bu)在于(yu)(yu)(yu)多(duo)(duo)，而在于(yu)(yu)(yu)精；方法(fa)靈活，貴(gui)在變通(tong)。亦正如(ru)明代(dai)張介賓《景岳全書》所云：“治(zhi)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)之(zhi)(zhi)藥(yao)(yao)(yao)，凡為(wei)(wei)君為(wei)(wei)臣，或宜專用(yong)(yong)(yong)，或宜相兼(jian)，病(bing)(bing)(bing)有(you)深淺，方有(you)輕(qing)重，其間參合之(zhi)(zhi)妙固由乎人，而性(xing)用(yong)(yong)(yong)之(zhi)(zhi)殊知其矣。”可(ke)謂一(yi)言(yan)中(zhong)(zhong)的(de)(de)(de)。

3.急則治其標，辨證尤為要

臨(lin)(lin)(lin)床體會，止(zhi)(zhi)血(xue)(xue)(xue)雖為血(xue)(xue)(xue)證(zheng)常(chang)見治(zhi)(zhi)法(fa)之(zhi)(zhi)(zhi)(zhi)(zhi)一，但只有(you)(you)當(dang)出(chu)血(xue)(xue)(xue)量較多之(zhi)(zhi)(zhi)(zhi)(zhi)際，則(ze)無論任何(he)原(yuan)因(yin)引(yin)(yin)起(qi)，總以(yi)止(zhi)(zhi)血(xue)(xue)(xue)為首要，所(suo)謂(wei)急則(ze)治(zhi)(zhi)其標。炭(tan)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)性多收澀(se)寒涼(liang)，屬阻遏之(zhi)(zhi)(zhi)(zhi)(zhi)品，用(yong)(yong)(yong)(yong)于(yu)(yu)止(zhi)(zhi)血(xue)(xue)(xue)多為治(zhi)(zhi)標之(zhi)(zhi)(zhi)(zhi)(zhi)法(fa)。辨證(zheng)論治(zhi)(zhi)是中醫(yi)的一大特色，由(you)于(yu)(yu)證(zheng)有(you)(you)陰(yin)陽虛實之(zhi)(zhi)(zhi)(zhi)(zhi)別，藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)又有(you)(you)寒熱(re)溫涼(liang)之(zhi)(zhi)(zhi)(zhi)(zhi)分，故作為治(zhi)(zhi)療(liao)出(chu)血(xue)(xue)(xue)不(bu)(bu)止(zhi)(zhi)時(shi)應(ying)急之(zhi)(zhi)(zhi)(zhi)(zhi)炭(tan)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)，應(ying)用(yong)(yong)(yong)(yong)時(shi)必須根據血(xue)(xue)(xue)證(zheng)之(zhi)(zhi)(zhi)(zhi)(zhi)性質、緩急、輕重、上(shang)下而分治(zhi)(zhi)之(zhi)(zhi)(zhi)(zhi)(zhi)，并(bing)應(ying)充分考慮到(dao)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)物的性能(neng)，用(yong)(yong)(yong)(yong)之(zhi)(zhi)(zhi)(zhi)(zhi)得當(dang)，見效迅速(su)；用(yong)(yong)(yong)(yong)之(zhi)(zhi)(zhi)(zhi)(zhi)不(bu)(bu)當(dang)，變證(zheng)多端。亦(yi)正(zheng)如清(qing)代(dai)(dai)名醫(yi)張錫純所(suo)云：“吐(tu)衄之(zhi)(zhi)(zhi)(zhi)(zhi)證(zheng)，最忌重用(yong)(yong)(yong)(yong)涼(liang)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)及(ji)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)炭(tan)，強(qiang)止(zhi)(zhi)其血(xue)(xue)(xue)。因(yin)吐(tu)衄之(zhi)(zhi)(zhi)(zhi)(zhi)時(shi)，血(xue)(xue)(xue)不(bu)(bu)歸(gui)經，遂(sui)以(yi)涼(liang)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)及(ji)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)炭(tan)，則(ze)經絡瘀(yu)塞(sai)，血(xue)(xue)(xue)止(zhi)(zhi)之(zhi)(zhi)(zhi)(zhi)(zhi)后，轉成(cheng)血(xue)(xue)(xue)痹虛勞之(zhi)(zhi)(zhi)(zhi)(zhi)癥(zheng)。”夏老在臨(lin)(lin)(lin)床時(shi)，對于(yu)(yu)辨證(zheng)為實熱(re)出(chu)血(xue)(xue)(xue)者，善用(yong)(yong)(yong)(yong)炭(tan)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)止(zhi)(zhi)血(xue)(xue)(xue)；對于(yu)(yu)虛熱(re)及(ji)氣(qi)虛出(chu)血(xue)(xue)(xue)者，可(ke)(ke)暫用(yong)(yong)(yong)(yong)而不(bu)(bu)可(ke)(ke)久用(yong)(yong)(yong)(yong)，以(yi)免(mian)耗氣(qi)傷陰(yin)；至于(yu)(yu)瘀(yu)血(xue)(xue)(xue)出(chu)血(xue)(xue)(xue)者，則(ze)較少應(ying)用(yong)(yong)(yong)(yong)。此外(wai)(wai)，炭(tan)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)止(zhi)(zhi)血(xue)(xue)(xue)，并(bing)非一成(cheng)不(bu)(bu)變。如《金匱要略》柏(bo)葉(xie)湯(tang)，由(you)柏(bo)葉(xie)、艾葉(xie)、干(gan)姜、馬通汁組(zu)成(cheng)，原(yuan)系溫陽和血(xue)(xue)(xue)、引(yin)(yin)血(xue)(xue)(xue)歸(gui)經之(zhi)(zhi)(zhi)(zhi)(zhi)劑，用(yong)(yong)(yong)(yong)治(zhi)(zhi)吐(tu)血(xue)(xue)(xue)不(bu)(bu)止(zhi)(zhi)。近代(dai)(dai)名醫(yi)李壽山將(jiang)原(yuan)方三味生藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)炒(chao)(chao)炭(tan)，并(bing)以(yi)童便(bian)代(dai)(dai)之(zhi)(zhi)(zhi)(zhi)(zhi)馬通汁用(yong)(yong)(yong)(yong)治(zhi)(zhi)各種(zhong)咯血(xue)(xue)(xue)，均(jun)獲(huo)良效。岳(yue)美(mei)中教授也以(yi)其炒(chao)(chao)炭(tan)治(zhi)(zhi)療(liao)小兒鼻衄收效甚捷，夏老常(chang)崇之(zhi)(zhi)(zhi)(zhi)(zhi)。再如，清(qing)代(dai)(dai)唐容(rong)川(chuan)治(zhi)(zhi)療(liao)衄血(xue)(xue)(xue)“用(yong)(yong)(yong)(yong)十(shi)灰(hui)散塞(sai)鼻，并(bing)吞咽十(shi)灰(hui)散，為極穩妥”。夏老臨(lin)(lin)(lin)證(zheng)時(shi)對于(yu)(yu)因(yin)熱(re)邪較盛引(yin)(yin)起(qi)的出(chu)血(xue)(xue)(xue)，除(chu)按原(yuan)方用(yong)(yong)(yong)(yong)法(fa)應(ying)用(yong)(yong)(yong)(yong)之(zhi)(zhi)(zhi)(zhi)(zhi)外(wai)(wai)，也常(chang)將(jiang)方中諸藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)生用(yong)(yong)(yong)(yong)，水煎作湯(tang)劑服(fu)，取(qu)效亦(yi)良。總之(zhi)(zhi)(zhi)(zhi)(zhi)，炭(tan)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)止(zhi)(zhi)血(xue)(xue)(xue)雖為治(zhi)(zhi)標之(zhi)(zhi)(zhi)(zhi)(zhi)法(fa)，只有(you)(you)辨證(zheng)準(zhun)確，用(yong)(yong)(yong)(yong)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)及(ji)時(shi)恰當(dang)，標本(ben)兼(jian)顧(gu)，才能(neng)取(qu)得較好的療(liao)效。否則(ze)，亦(yi)正(zheng)如元代(dai)(dai)葛(ge)可(ke)(ke)久《十(shi)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)神書》所(suo)一言(yan)：'‘治(zhi)(zhi)吐(tu)血(xue)(xue)(xue)者……何(he)今(jin)日之(zhi)(zhi)(zhi)(zhi)(zhi)醫(yi)，動以(yi)引(yin)(yin)血(xue)(xue)(xue)歸(gui)經為談，不(bu)(bu)可(ke)(ke)概用(yong)(yong)(yong)(yong)止(zhi)(zhi)血(xue)(xue)(xue)之(zhi)(zhi)(zhi)(zhi)(zhi)味，甚至有(you)(you)吐(tu)出(chu)亦(yi)美(mei)，壅反(fan)為害，遂(sui)令(ling)遷移時(shi)日，陰(yin)虛陽旺，煎熬(ao)不(bu)(bu)止(zhi)(zhi)，至于(yu)(yu)不(bu)(bu)救，果誰之(zhi)(zhi)(zhi)(zhi)(zhi)咎。”此之(zhi)(zhi)(zhi)(zhi)(zhi)謂(wei)也。

本文地(di)址://n85e38t.cn/pianfang/86861.html.

聲明： 我們(men)(men)(men)致(zhi)力于(yu)保護作者(zhe)版權，注重(zhong)分享(xiang)，被刊用文章因(yin)無法核實(shi)真實(shi)出處，未能及時(shi)與(yu)作者(zhe)取得聯(lian)系，或有版權異議的(de)，請(qing)聯(lian)系管理員，我們(men)(men)(men)會立即處理，本站(zhan)部分文字與(yu)圖片資源(yuan)來自(zi)于(yu)網絡，轉載是出于(yu)傳遞更多信息之目(mu)的(de),若(ruo)有來源(yuan)標注錯(cuo)誤(wu)或侵犯了您的(de)合法權益(yi)，請(qing)立即通知我們(men)(men)(men)(管理員郵箱：)，情況屬(shu)實(shi)，我們(men)(men)(men)會第一(yi)時(shi)間予以刪除，并(bing)同時(shi)向您表示歉意,謝(xie)謝(xie)!

上一篇: 紫草濃煎液(ye)外擦防治(zhi)化療(liao)引起的血栓性淺···

下一(yi)篇: 桑(sang)寄(ji)(ji)生的功效與(yu)作用,桑(sang)寄(ji)(ji)生的副作用與(yu)···