【摘要】補(bu)(bu)中(zhong)(zhong)益氣湯是中(zhong)(zhong)醫學(xue)史一首著名的(de)補(bu)(bu)土方劑(ji)，乃“升(sheng)陽益氣”的(de)代表方。但對于(yu)該(gai)方是否(fou)適用于(yu)“陰火(huo)易(yi)于(yu)升(sheng)”的(de)南(nan)(nan)方地域(yu)，歷史上曾經有過爭論。筆者由嶺南(nan)(nan)“炎(yan)方土薄”的(de)地域(yu)特點(dian)出發，結(jie)合多位名醫的(de)觀(guan)點(dian)論述，對補(bu)(bu)中(zhong)(zhong)益氣湯是否(fou)適用于(yu)嶺南(nan)(nan)進行(xing)剖析，并提出該(gai)方應用于(yu)嶺南(nan)(nan)時的(de)化裁(cai)思路。

【關鍵詞】補(bu)中益氣湯；嶺南；補(bu)土流派

“三(san)因(yin)(yin)制(zhi)宜(yi)”乃指因(yin)(yin)時、因(yin)(yin)地(di)(di)(di)(di)、因(yin)(yin)人(ren)(ren)制(zhi)宜(yi)，中(zhong)醫(yi)(yi)在(zai)(zai)使(shi)用(yong)(yong)方(fang)(fang)(fang)藥時需考慮氣(qi)(qi)(qi)(qi)(qi)候(hou)(hou)、地(di)(di)(di)(di)域特點及(ji)(ji)病(bing)人(ren)(ren)自(zi)身三(san)方(fang)(fang)(fang)面因(yin)(yin)素的(de)(de)影(ying)響(xiang)，其中(zhong)地(di)(di)(di)(di)域因(yin)(yin)素是許多特色方(fang)(fang)(fang)藥形(xing)成的(de)(de)前提(ti)(ti)[1]。補(bu)(bu)中(zhong)益氣(qi)(qi)(qi)(qi)(qi)湯是補(bu)(bu)土(tu)流派最(zui)為(wei)著名的(de)(de)方(fang)(fang)(fang)劑之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)一(yi)，首(shou)載(zai)于(yu)(yu)(yu)《內(nei)外傷(shang)(shang)(shang)(shang)辨(bian)惑論(lun)(lun)·飲食(shi)勞倦(juan)論(lun)(lun)》：“勞者溫之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)，損者溫之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)。蓋溫能(neng)除大(da)熱(re)，大(da)忌(ji)苦(ku)寒之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)藥瀉胃(wei)土(tu)耳(er)。今立(li)補(bu)(bu)中(zhong)益氣(qi)(qi)(qi)(qi)(qi)湯”。后(hou)世對于(yu)(yu)(yu)該方(fang)(fang)(fang)的(de)(de)應(ying)用(yong)(yong)頗(po)為(wei)廣泛(fan)，相關(guan)文獻著作頗(po)豐。然自(zi)朱丹(dan)溪“相火易動”及(ji)(ji)“滋(zi)陰降(jiang)(jiang)(jiang)火”的(de)(de)理(li)論(lun)(lun)提(ti)(ti)出(chu)后(hou)，部分醫(yi)(yi)家受此(ci)(ci)(ci)影(ying)響(xiang)，認為(wei)補(bu)(bu)中(zhong)益氣(qi)(qi)(qi)(qi)(qi)湯不(bu)(bu)(bu)宜(yi)用(yong)(yong)于(yu)(yu)(yu)氣(qi)(qi)(qi)(qi)(qi)候(hou)(hou)炎熱(re)的(de)(de)南(nan)(nan)方(fang)(fang)(fang)，如《丹(dan)溪心(xin)法·丹(dan)溪翁傳(chuan)(chuan)》中(zhong)云(yun)：“謂李之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)論(lun)(lun)飲食(shi)勞倦(juan)，內(nei)傷(shang)(shang)(shang)(shang)脾胃(wei)，則胃(wei)脘之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)陽不(bu)(bu)(bu)能(neng)以(yi)升(sheng)舉，并及(ji)(ji)心(xin)肺之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)氣(qi)(qi)(qi)(qi)(qi)，陷(xian)入(ru)中(zhong)焦，而(er)用(yong)(yong)補(bu)(bu)中(zhong)益氣(qi)(qi)(qi)(qi)(qi)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)劑治之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)，此(ci)(ci)(ci)亦前人(ren)(ren)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)所無也。然天不(bu)(bu)(bu)足于(yu)(yu)(yu)西北(bei)(bei)，地(di)(di)(di)(di)不(bu)(bu)(bu)滿于(yu)(yu)(yu)東(dong)南(nan)(nan)。天，陽也；地(di)(di)(di)(di)，陰也。西北(bei)(bei)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)人(ren)(ren)，陽氣(qi)(qi)(qi)(qi)(qi)易于(yu)(yu)(yu)降(jiang)(jiang)(jiang)；東(dong)南(nan)(nan)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)人(ren)(ren)，陰火易于(yu)(yu)(yu)升(sheng)。茍不(bu)(bu)(bu)知此(ci)(ci)(ci)，而(er)徒(tu)守其法，則氣(qi)(qi)(qi)(qi)(qi)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)降(jiang)(jiang)(jiang)者固可(ke)愈(yu)，而(er)于(yu)(yu)(yu)其升(sheng)者亦從而(er)用(yong)(yong)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)，吾恐反(fan)(fan)增其病(bing)矣”[2]。清(qing)代朱時進在(zai)(zai)《一(yi)見能(neng)醫(yi)(yi)·醫(yi)(yi)藥辨(bian)》中(zhong)亦提(ti)(ti)到(dao)，今人(ren)(ren)有“東(dong)垣(yuan)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)法，可(ke)用(yong)(yong)于(yu)(yu)(yu)北(bei)(bei)；丹(dan)溪之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)法，可(ke)行于(yu)(yu)(yu)南(nan)(nan)”的(de)(de)看法[3]。南(nan)(nan)方(fang)(fang)(fang)一(yi)般指秦嶺(ling)(ling)-淮河以(yi)南(nan)(nan)的(de)(de)地(di)(di)(di)(di)域，按《傷(shang)(shang)(shang)(shang)寒兼證(zheng)析義·方(fang)(fang)(fang)宜(yi)》中(zhong)所說(shuo)(shuo)，正南(nan)(nan)方(fang)(fang)(fang)的(de)(de)代表性區域正是“廣粵(yue)一(yi)帶”，即“四季放花(hua)，冬無霜雪”的(de)(de)嶺(ling)(ling)南(nan)(nan)。嶺(ling)(ling)南(nan)(nan)素來被稱為(wei)“炎方(fang)(fang)(fang)”，氣(qi)(qi)(qi)(qi)(qi)易升(sheng)而(er)難降(jiang)(jiang)(jiang)，正合于(yu)(yu)(yu)《丹(dan)溪翁傳(chuan)(chuan)》中(zhong)所說(shuo)(shuo)的(de)(de)“陰火易于(yu)(yu)(yu)升(sheng)”之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)地(di)(di)(di)(di)，即寓“相火不(bu)(bu)(bu)降(jiang)(jiang)(jiang)”之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)意，故后(hou)世出(chu)現了“治南(nan)(nan)當用(yong)(yong)丹(dan)溪不(bu)(bu)(bu)用(yong)(yong)東(dong)垣(yuan)”之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)說(shuo)(shuo)。而(er)虞摶(tuan)在(zai)(zai)《醫(yi)(yi)學(xue)正傳(chuan)(chuan)·醫(yi)(yi)學(xue)或問》中(zhong)對此(ci)(ci)(ci)則持相反(fan)(fan)觀點：“或曰：東(dong)垣(yuan)生于(yu)(yu)(yu)北(bei)(bei)方(fang)(fang)(fang)，天傾西北(bei)(bei)，陽氣(qi)(qi)(qi)(qi)(qi)下(xia)陷(xian)，此(ci)(ci)(ci)法固宜(yi)，恐東(dong)南(nan)(nan)方(fang)(fang)(fang)土(tu)不(bu)(bu)(bu)宜(yi)也。曰：地(di)(di)(di)(di)不(bu)(bu)(bu)滿東(dong)南(nan)(nan)，土(tu)氣(qi)(qi)(qi)(qi)(qi)下(xia)陷(xian)，故脾胃(wei)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)氣(qi)(qi)(qi)(qi)(qi)不(bu)(bu)(bu)升(sheng)。脾胃(wei)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)氣(qi)(qi)(qi)(qi)(qi)不(bu)(bu)(bu)升(sheng)，則上脘不(bu)(bu)(bu)通，谷氣(qi)(qi)(qi)(qi)(qi)不(bu)(bu)(bu)行，而(er)內(nei)傷(shang)(shang)(shang)(shang)之(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)病(bing)作矣。是以(yi)此(ci)(ci)(ci)法，尤(you)利于(yu)(yu)(yu)東(dong)南(nan)(nan)方(fang)(fang)(fang)也，學(xue)者不(bu)(bu)(bu)可(ke)不(bu)(bu)(bu)知此(ci)(ci)(ci)意”[4]。兩(liang)者說(shuo)(shuo)法都看似有理(li)有據，然而(er)醫(yi)(yi)理(li)不(bu)(bu)(bu)辯不(bu)(bu)(bu)明，故筆者試由嶺(ling)(ling)南(nan)(nan)地(di)(di)(di)(di)域特點入(ru)手，分析補(bu)(bu)中(zhong)益氣(qi)(qi)(qi)(qi)(qi)湯用(yong)(yong)于(yu)(yu)(yu)南(nan)(nan)方(fang)(fang)(fang)尤(you)其是嶺(ling)(ling)南(nan)(nan)地(di)(di)(di)(di)區的(de)(de)宜(yi)忌(ji)。

1 地理環境

《嶺南(nan)(nan)衛生方(fang)·大梁李待詔瘴瘧論》中(zhong)云：“嶺南(nan)(nan)既號炎方(fang)，而(er)(er)又(you)(you)瀕(bin)海，地卑而(er)(er)土(tu)薄(bo)。炎方(fang)土(tu)薄(bo)，故(gu)陽(yang)(yang)燠之(zhi)氣(qi)(qi)(qi)常(chang)泄(xie)；瀕(bin)海地卑，故(gu)陰濕之(zhi)氣(qi)(qi)(qi)常(chang)盛”。嶺南(nan)(nan)地區四季炎熱而(er)(er)瘴氣(qi)(qi)(qi)充斥，常(chang)處于一種陽(yang)(yang)氣(qi)(qi)(qi)上壅(yong)而(er)(er)外(wai)泄(xie)、陰濕之(zhi)氣(qi)(qi)(qi)彌漫(man)不散的環(huan)境中(zhong)。居(ju)民長期生活于此，則(ze)“人(ren)居(ju)其(qi)間(jian)，氣(qi)(qi)(qi)多(duo)上壅(yong)，膚多(duo)汗出(chu)，腠理(li)不密，蓋(gai)陽(yang)(yang)不返本而(er)(er)然……人(ren)居(ju)其(qi)間(jian)，類(lei)多(duo)中(zhong)濕，肢(zhi)體重倦，又(you)(you)多(duo)腳氣(qi)(qi)(qi)之(zhi)疾，蓋(gai)陰常(chang)偏(pian)(pian)勝而(er)(er)然”，故(gu)嶺南(nan)(nan)人(ren)常(chang)因陽(yang)(yang)氣(qi)(qi)(qi)外(wai)泄(xie)而(er)(er)里陽(yang)(yang)不足，濕氣(qi)(qi)(qi)傷人(ren)而(er)(er)陰邪偏(pian)(pian)盛[5]。針對南(nan)(nan)方(fang)地域(yu)和體質特點，《素問·五(wu)常(chang)政大論》中(zhong)提出(chu)了：“東南(nan)(nan)之(zhi)氣(qi)(qi)(qi)，收而(er)(er)溫(wen)(wen)(wen)之(zhi)”的治法(fa)原(yuan)則(ze)。《類(lei)經·運氣(qi)(qi)(qi)類(lei)》中(zhong)解析道：“東南(nan)(nan)氣(qi)(qi)(qi)溫(wen)(wen)(wen)氣(qi)(qi)(qi)熱，人(ren)多(duo)食(shi)涼而(er)(er)內寒生，故(gu)宜(yi)治以溫(wen)(wen)(wen)熱，又(you)(you)必強其(qi)內守，欲令陽(yang)(yang)氣(qi)(qi)(qi)不泄(xie)，而(er)(er)固其(qi)中(zhong)也”[6]。所謂(wei)“溫(wen)(wen)(wen)而(er)(er)收之(zhi)”，即(ji)指溫(wen)(wen)(wen)補里陽(yang)(yang)并堅固本氣(qi)(qi)(qi)，嶺南(nan)(nan)作為(wei)典型的南(nan)(nan)方(fang)地域(yu)，正適(shi)用于這一治法(fa)。

同時，南方(fang)地域水(shui)土(tu)(tu)卑(bei)下又(you)陽(yang)(yang)盛外(wai)(wai)(wai)泄，居民稟賦不(bu)如西北(bei)(bei)之(zhi)(zhi)(zhi)(zhi)(zhi)人強健，故西北(bei)(bei)每多(duo)傷(shang)(shang)(shang)(shang)(shang)寒之(zhi)(zhi)(zhi)(zhi)(zhi)患，而(er)東(dong)南尤其是(shi)嶺(ling)(ling)(ling)(ling)南每多(duo)內傷(shang)(shang)(shang)(shang)(shang)之(zhi)(zhi)(zhi)(zhi)(zhi)病(bing)(bing)。《脾胃(wei)(wei)論·脾胃(wei)(wei)虛實(shi)傳變論》中提出(chu)“陽(yang)(yang)精所(suo)降(jiang)其人夭”是(shi)脾胃(wei)(wei)內傷(shang)(shang)(shang)(shang)(shang)病(bing)(bing)產(chan)生(sheng)的(de)重要原因之(zhi)(zhi)(zhi)(zhi)(zhi)一，而(er)《類經·運氣(qi)類》中解(jie)釋“陽(yang)(yang)精所(suo)降(jiang)其人夭”的(de)意思為“陽(yang)(yang)精所(suo)降(jiang)之(zhi)(zhi)(zhi)(zhi)(zhi)地，陽(yang)(yang)氣(qi)易泄，故人多(duo)夭，謂污下之(zhi)(zhi)(zhi)(zhi)(zhi)處(chu)(chu)也”，此正(zheng)與(yu)嶺(ling)(ling)(ling)(ling)南“地處(chu)(chu)卑(bei)下”的(de)特點吻合，故嶺(ling)(ling)(ling)(ling)南素來(lai)就具有產(chan)生(sheng)內傷(shang)(shang)(shang)(shang)(shang)病(bing)(bing)的(de)地域基礎。《翼醫通考·四方(fang)風(feng)土(tu)(tu)不(bu)同服藥(yao)亦異》中也指出(chu)：“治(zhi)北(bei)(bei)人之(zhi)(zhi)(zhi)(zhi)(zhi)病(bing)(bing)，宜以攻伐外(wai)(wai)(wai)邪為多(duo)；治(zhi)南方(fang)之(zhi)(zhi)(zhi)(zhi)(zhi)疾，宜以保養內氣(qi)為本(ben)”[7]。《醫宗(zong)金鑒·刪(shan)補(bu)名醫方(fang)論》則進一步解(jie)析(xi)了南方(fang)多(duo)見“內傷(shang)(shang)(shang)(shang)(shang)”的(de)原因為“趙羽(yu)皇(huang)曰：東(dong)南地土(tu)(tu)卑(bei)濕，凡患感(gan)冒(mao)，輒以傷(shang)(shang)(shang)(shang)(shang)寒二字混稱。不(bu)知傷(shang)(shang)(shang)(shang)(shang)者，正(zheng)氣(qi)傷(shang)(shang)(shang)(shang)(shang)于中，寒者，寒氣(qi)客于外(wai)(wai)(wai)，未有外(wai)(wai)(wai)感(gan)而(er)內不(bu)傷(shang)(shang)(shang)(shang)(shang)者也”[8]。認為東(dong)南地帶氣(qi)候(hou)溫暖，外(wai)(wai)(wai)傷(shang)(shang)(shang)(shang)(shang)寒邪者較為少見，然(ran)而(er)居民本(ben)氣(qi)不(bu)足(zu)，故日常疾病(bing)(bing)中反以內傷(shang)(shang)(shang)(shang)(shang)病(bing)(bing)為突出(chu)。由此可見，嶺(ling)(ling)(ling)(ling)南既然(ran)崇尚(shang)“溫而(er)收之(zhi)(zhi)(zhi)(zhi)(zhi)”的(de)治(zhi)法(fa)，又(you)為內傷(shang)(shang)(shang)(shang)(shang)病(bing)(bing)多(duo)見之(zhi)(zhi)(zhi)(zhi)(zhi)地，補(bu)中益(yi)氣(qi)湯在嶺(ling)(ling)(ling)(ling)南應大(da)有用武之(zhi)(zhi)(zhi)(zhi)(zhi)地。

2 追本溯源

那么提出(chu)“相火易亢”的(de)朱丹(dan)溪果真反對在南(nan)(nan)方使用補中(zhong)(zhong)益氣(qi)(qi)(qi)(qi)湯(tang)嗎？《丹(dan)溪心(xin)法(fa)·中(zhong)(zhong)寒》中(zhong)(zhong)云(yun)：“有卒中(zhong)(zhong)天地之(zhi)寒氣(qi)(qi)(qi)(qi)者，有口得(de)寒物(wu)者，從(cong)補中(zhong)(zhong)益氣(qi)(qi)(qi)(qi)湯(tang)中(zhong)(zhong)加發散藥，屬內傷(shang)者十(shi)居(ju)八九(jiu)……倉(cang)卒感(gan)受(shou)大寒之(zhi)氣(qi)(qi)(qi)(qi)，其(qi)(qi)病(bing)(bing)即發，非若傷(shang)寒之(zhi)邪，循經以漸而深(shen)也。以上治(zhi)法(fa)，宜(yi)用于南(nan)(nan)，不(bu)宜(yi)北”[9]。文后解釋(shi)，此(ci)處的(de)“中(zhong)(zhong)寒”非指尋常(chang)“傷(shang)寒”，而是(shi)“謂身受(shou)肅殺(sha)之(zhi)氣(qi)(qi)(qi)(qi)，口傷(shang)生冷物(wu)之(zhi)類。因(yin)胃(wei)氣(qi)(qi)(qi)(qi)大虛，膚腠(cou)疏豁”，即病(bing)(bing)人素有脾胃(wei)不(bu)足，遇秋(qiu)冬(dong)肅殺(sha)之(zhi)氣(qi)(qi)(qi)(qi)，則陽氣(qi)(qi)(qi)(qi)更難升發，故(gu)(gu)(gu)發為內傷(shang)病(bing)(bing)；癥狀頗(po)似(si)于傷(shang)寒，但非寒邪入里，故(gu)(gu)(gu)需以補中(zhong)(zhong)益氣(qi)(qi)(qi)(qi)湯(tang)治(zhi)之(zhi)。朱丹(dan)溪特別強調這種(zhong)(zhong)情(qing)況常(chang)見于南(nan)(nan)方：“東(dong)(dong)南(nan)(nan)二方，溫和之(zhi)地，外傷(shang)極少(shao)，雜病(bing)(bing)亦有六經所見之(zhi)證，故(gu)(gu)(gu)世(shi)(shi)俗混而難別”，由(you)此(ci)提出(chu)了補中(zhong)(zhong)益氣(qi)(qi)(qi)(qi)湯(tang)治(zhi)療“中(zhong)(zhong)寒”之(zhi)法(fa)“宜(yi)用于南(nan)(nan)，不(bu)宜(yi)北”。這是(shi)和《丹(dan)溪翁傳》完全相反的(de)觀點(dian)，由(you)于傳記為后人所作，故(gu)(gu)(gu)所謂的(de)“東(dong)(dong)垣(yuan)(yuan)(yuan)之(zhi)法(fa)宜(yi)用于北而不(bu)宜(yi)于南(nan)(nan)”可(ke)能(neng)是(shi)后人的(de)一種(zhong)(zhong)誤讀，而非丹(dan)溪本(ben)意。觀丹(dan)溪行醫于江南(nan)(nan)，然亦頗(po)推(tui)崇東(dong)(dong)垣(yuan)(yuan)(yuan)的(de)學(xue)術思想(xiang)，曾謂“自長沙以下(xia)，諸家推(tui)明甚(shen)至，千世(shi)(shi)之(zhi)下(xia)，能(neng)得(de)其(qi)(qi)粹者，東(dong)(dong)垣(yuan)(yuan)(yuan)也”，可(ke)見其(qi)(qi)于南(nan)(nan)方地域中(zhong)(zhong)應用東(dong)(dong)垣(yuan)(yuan)(yuan)學(xue)說必頗(po)有收效。

3 化裁思路

然而(er)(er)(er)(er)(er)(er)為(wei)(wei)(wei)何(he)后(hou)(hou)(hou)世會(hui)產(chan)生(sheng)(sheng)“補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)不(bu)(bu)宜(yi)(yi)用(yong)(yong)(yong)于(yu)(yu)南(nan)(nan)(nan)(nan)(nan)”的(de)(de)(de)看(kan)法(fa)(fa)(fa)(fa)？觀嶺南(nan)(nan)(nan)(nan)(nan)確(que)為(wei)(wei)(wei)地卑土(tu)薄之(zhi)(zhi)(zhi)(zhi)(zhi)地，陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)不(bu)(bu)藏而(er)(er)(er)(er)(er)(er)易(yi)上(shang)(shang)(shang)沖，故《脈義簡摩(mo)·察(cha)脈施治(zhi)(zhi)有(you)貧富貴賤》中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)云(yun)：“滇粵之(zhi)(zhi)(zhi)(zhi)(zhi)人，恒受瘴熱(re)，慣食檳(bin)榔，表(biao)里疏豁……縱有(you)風寒(han)，止宜(yi)(yi)清(qing)解，不(bu)(bu)宜(yi)(yi)輕(qing)用(yong)(yong)(yong)發散(san)(san)(san)(san)(san)”。因(yin)嶺南(nan)(nan)(nan)(nan)(nan)人腠理疏松，陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)外(wai)泄(xie)(xie)，故辛(xin)散(san)(san)(san)(san)(san)重開(kai)之(zhi)(zhi)(zhi)(zhi)(zhi)法(fa)(fa)(fa)(fa)不(bu)(bu)適(shi)用(yong)(yong)(yong)于(yu)(yu)嶺南(nan)(nan)(nan)(nan)(nan)，恐發表(biao)則(ze)(ze)(ze)陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)耗(hao)傷(shang)(shang)(shang)(shang)更甚。而(er)(er)(er)(er)(er)(er)《內經》中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)提(ti)出(chu)的(de)(de)(de)“溫而(er)(er)(er)(er)(er)(er)收(shou)之(zhi)(zhi)(zhi)(zhi)(zhi)”也(ye)強調(diao)了要以(yi)(yi)收(shou)斂(lian)(lian)內守為(wei)(wei)(wei)主，故過分的(de)(de)(de)升(sheng)(sheng)散(san)(san)(san)(san)(san)并不(bu)(bu)相宜(yi)(yi)。補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)乃益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)與(yu)升(sheng)(sheng)散(san)(san)(san)(san)(san)并舉，用(yong)(yong)(yong)于(yu)(yu)嶺南(nan)(nan)(nan)(nan)(nan)或有(you)陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)耗(hao)散(san)(san)(san)(san)(san)、氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)機難降(jiang)之(zhi)(zhi)(zhi)(zhi)(zhi)慮(lv)。然筆者(zhe)認為(wei)(wei)(wei)可(ke)(ke)(ke)(ke)(ke)從兩方(fang)(fang)面避免此(ci)類問題：一(yi)是(shi)補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)(de)使(shi)用(yong)(yong)(yong)必以(yi)(yi)“辨(bian)證(zheng)論治(zhi)(zhi)”為(wei)(wei)(wei)前提(ti)，并非(fei)一(yi)見(jian)東(dong)(dong)南(nan)(nan)(nan)(nan)(nan)虛(xu)(xu)(xu)損(sun)體(ti)質(zhi)者(zhe)即可(ke)(ke)(ke)(ke)(ke)通用(yong)(yong)(yong)。嶺南(nan)(nan)(nan)(nan)(nan)元氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)不(bu)(bu)足，脾(pi)胃(wei)(wei)內傷(shang)(shang)(shang)(shang)者(zhe)雖多見(jian)，然內傷(shang)(shang)(shang)(shang)亦(yi)有(you)程(cheng)度(du)及具體(ti)病(bing)(bing)(bing)機的(de)(de)(de)不(bu)(bu)同(tong)(tong)。如(ru)(ru)(ru)僅為(wei)(wei)(wei)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)虛(xu)(xu)(xu)而(er)(er)(er)(er)(er)(er)不(bu)(bu)至(zhi)于(yu)(yu)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)下陷(xian)的(de)(de)(de)程(cheng)度(du)，只需用(yong)(yong)(yong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)之(zhi)(zhi)(zhi)(zhi)(zhi)方(fang)(fang)如(ru)(ru)(ru)四君子類即可(ke)(ke)(ke)(ke)(ke)，升(sheng)(sheng)提(ti)的(de)(de)(de)補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)確(que)實(shi)不(bu)(bu)對(dui)(dui)(dui)證(zheng)，反有(you)升(sheng)(sheng)散(san)(san)(san)(san)(san)之(zhi)(zhi)(zhi)(zhi)(zhi)嫌。然而(er)(er)(er)(er)(er)(er)對(dui)(dui)(dui)于(yu)(yu)確(que)有(you)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)下陷(xian)者(zhe)，則(ze)(ze)(ze)必益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)與(yu)升(sheng)(sheng)提(ti)并舉，此(ci)為(wei)(wei)(wei)陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)已無力升(sheng)(sheng)發，故不(bu)(bu)必慮(lv)其助長外(wai)散(san)(san)(san)(san)(san)，放手(shou)用(yong)(yong)(yong)之(zhi)(zhi)(zhi)(zhi)(zhi)；二(er)(er)是(shi)可(ke)(ke)(ke)(ke)(ke)發揮“因(yin)地制(zhi)宜(yi)(yi)”的(de)(de)(de)特(te)(te)色，對(dui)(dui)(dui)補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)進行化(hua)裁(cai)(cai)(cai)。嶺南(nan)(nan)(nan)(nan)(nan)的(de)(de)(de)一(yi)大特(te)(te)點(dian)是(shi)陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)易(yi)升(sheng)(sheng)而(er)(er)(er)(er)(er)(er)外(wai)散(san)(san)(san)(san)(san)，故初起(qi)可(ke)(ke)(ke)(ke)(ke)見(jian)陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)難降(jiang)，相火(huo)(huo)易(yi)亢(kang)，而(er)(er)(er)(er)(er)(er)日(ri)久陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)外(wai)泄(xie)(xie)而(er)(er)(er)(er)(er)(er)不(bu)(bu)足，氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)虛(xu)(xu)(xu)日(ri)甚，則(ze)(ze)(ze)又可(ke)(ke)(ke)(ke)(ke)見(jian)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)陷(xian)生(sheng)(sheng)熱(re)之(zhi)(zhi)(zhi)(zhi)(zhi)病(bing)(bing)(bing)。此(ci)乃陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)耗(hao)散(san)(san)(san)(san)(san)的(de)(de)(de)不(bu)(bu)同(tong)(tong)階(jie)段，故初起(qi)可(ke)(ke)(ke)(ke)(ke)以(yi)(yi)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)兼(jian)斂(lian)(lian)降(jiang)為(wei)(wei)(wei)主，發展至(zhi)后(hou)(hou)(hou)期者(zhe)則(ze)(ze)(ze)必益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)合(he)升(sheng)(sheng)提(ti)，兼(jian)顧收(shou)斂(lian)(lian)。然從整體(ti)上(shang)(shang)(shang)看(kan)，補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)可(ke)(ke)(ke)(ke)(ke)補(bu)益(yi)(yi)(yi)(yi)(yi)(yi)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)土(tu)而(er)(er)(er)(er)(er)(er)充實(shi)肺氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)，以(yi)(yi)減(jian)少(shao)(shao)陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)的(de)(de)(de)外(wai)泄(xie)(xie)，故經化(hua)裁(cai)(cai)(cai)后(hou)(hou)(hou)在各階(jie)段均可(ke)(ke)(ke)(ke)(ke)使(shi)用(yong)(yong)(yong)。如(ru)(ru)(ru)《石室秘(mi)錄·東(dong)(dong)南(nan)(nan)(nan)(nan)(nan)治(zhi)(zhi)法(fa)(fa)(fa)(fa)》云(yun)：“東(dong)(dong)南(nan)(nan)(nan)(nan)(nan)治(zhi)(zhi)法(fa)(fa)(fa)(fa)，以(yi)(yi)補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)加(jia)(jia)(jia)減(jian)，俱得(de)其妙(miao)，不(bu)(bu)必再言”。至(zhi)于(yu)(yu)如(ru)(ru)(ru)何(he)加(jia)(jia)(jia)減(jian)，東(dong)(dong)垣載于(yu)(yu)補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)后(hou)(hou)(hou)的(de)(de)(de)“立方(fang)(fang)本旨”已為(wei)(wei)(wei)后(hou)(hou)(hou)人示(shi)例(li)，補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)可(ke)(ke)(ke)(ke)(ke)“少(shao)(shao)加(jia)(jia)(jia)黃(huang)柏以(yi)(yi)救腎水(shui)，能瀉陰(yin)(yin)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)之(zhi)(zhi)(zhi)(zhi)(zhi)伏火(huo)(huo)。如(ru)(ru)(ru)煩猶(you)不(bu)(bu)止，少(shao)(shao)加(jia)(jia)(jia)生(sheng)(sheng)地黃(huang)補(bu)腎水(shui)，水(shui)旺而(er)(er)(er)(er)(er)(er)心(xin)(xin)火(huo)(huo)自降(jiang)。如(ru)(ru)(ru)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)浮心(xin)(xin)亂，以(yi)(yi)朱砂安(an)神(shen)丸鎮固之(zhi)(zhi)(zhi)(zhi)(zhi)則(ze)(ze)(ze)愈(yu)”。東(dong)(dong)垣創立補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)時(shi)也(ye)考(kao)慮(lv)到(dao)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)虛(xu)(xu)(xu)不(bu)(bu)升(sheng)(sheng)同(tong)(tong)時(shi)兼(jian)有(you)“陰(yin)(yin)火(huo)(huo)”的(de)(de)(de)情(qing)況，若(ruo)(ruo)本底(di)尚堅實(shi)可(ke)(ke)(ke)(ke)(ke)少(shao)(shao)用(yong)(yong)(yong)苦寒(han)泄(xie)(xie)火(huo)(huo)，若(ruo)(ruo)兼(jian)見(jian)腎水(shui)虧，可(ke)(ke)(ke)(ke)(ke)加(jia)(jia)(jia)用(yong)(yong)(yong)甘寒(han)滋陰(yin)(yin)之(zhi)(zhi)(zhi)(zhi)(zhi)品以(yi)(yi)制(zhi)火(huo)(huo)。如(ru)(ru)(ru)更甚者(zhe)有(you)心(xin)(xin)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)浮，心(xin)(xin)火(huo)(huo)盛的(de)(de)(de)，可(ke)(ke)(ke)(ke)(ke)合(he)用(yong)(yong)(yong)朱砂安(an)神(shen)丸。此(ci)乃內傷(shang)(shang)(shang)(shang)病(bing)(bing)(bing)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)“制(zhi)火(huo)(huo)”之(zhi)(zhi)(zhi)(zhi)(zhi)法(fa)(fa)(fa)(fa)，在“相火(huo)(huo)易(yi)亢(kang)”的(de)(de)(de)嶺南(nan)(nan)(nan)(nan)(nan)使(shi)用(yong)(yong)(yong)本方(fang)(fang)時(shi)亦(yi)可(ke)(ke)(ke)(ke)(ke)以(yi)(yi)此(ci)為(wei)(wei)(wei)參(can)考(kao)進行化(hua)裁(cai)(cai)(cai)。嶺南(nan)(nan)(nan)(nan)(nan)的(de)(de)(de)另一(yi)特(te)(te)點(dian)是(shi)濕(shi)(shi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)彌(mi)漫(man)，當(dang)地內傷(shang)(shang)(shang)(shang)兼(jian)患濕(shi)(shi)邪者(zhe)不(bu)(bu)少(shao)(shao)，故補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)又需化(hua)裁(cai)(cai)(cai)用(yong)(yong)(yong)之(zhi)(zhi)(zhi)(zhi)(zhi)。著名(ming)的(de)(de)(de)嶺南(nan)(nan)(nan)(nan)(nan)醫家何(he)夢瑤(yao)便是(shi)化(hua)用(yong)(yong)(yong)東(dong)(dong)垣方(fang)(fang)藥(yao)的(de)(de)(de)好手(shou)，如(ru)(ru)(ru)其針(zhen)對(dui)(dui)(dui)嶺南(nan)(nan)(nan)(nan)(nan)陽氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)外(wai)耗(hao)的(de)(de)(de)特(te)(te)點(dian)提(ti)出(chu)“內傷(shang)(shang)(shang)(shang)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)虛(xu)(xu)(xu)多汗，調(diao)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)，即補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)加(jia)(jia)(jia)白(bai)芍、五味也(ye)，以(yi)(yi)收(shou)耗(hao)散(san)(san)(san)(san)(san)之(zhi)(zhi)(zhi)(zhi)(zhi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)”，便是(shi)依嶺南(nan)(nan)(nan)(nan)(nan)“溫而(er)(er)(er)(er)(er)(er)收(shou)之(zhi)(zhi)(zhi)(zhi)(zhi)”之(zhi)(zhi)(zhi)(zhi)(zhi)法(fa)(fa)(fa)(fa)對(dui)(dui)(dui)補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)進行的(de)(de)(de)化(hua)裁(cai)(cai)(cai)。針(zhen)對(dui)(dui)(dui)嶺南(nan)(nan)(nan)(nan)(nan)的(de)(de)(de)“濕(shi)(shi)熱(re)”，何(he)夢瑤(yao)在《醫砭·勞倦傷(shang)(shang)(shang)(shang)》一(yi)篇(pian)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)云(yun)：“又補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)除當(dang)歸(gui)、白(bai)術(shu)，加(jia)(jia)(jia)木(mu)香、蒼(cang)術(shu)，亦(yi)名(ming)調(diao)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)，有(you)濕(shi)(shi)而(er)(er)(er)(er)(er)(er)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)滯者(zhe)宜(yi)(yi)之(zhi)(zhi)(zhi)(zhi)(zhi)。若(ruo)(ruo)濕(shi)(shi)多熱(re)少(shao)(shao)，清(qing)陽為(wei)(wei)(wei)濕(shi)(shi)所郁不(bu)(bu)得(de)上(shang)(shang)(shang)升(sheng)(sheng)，其證(zheng)身(shen)重而(er)(er)(er)(er)(er)(er)痛，二(er)(er)便不(bu)(bu)調(diao)，灑(sa)(sa)灑(sa)(sa)惡(e)寒(han)，（陽不(bu)(bu)外(wai)達(da)。）慘慘不(bu)(bu)樂(le)，（陽不(bu)(bu)外(wai)伸。）升(sheng)(sheng)陽益(yi)(yi)(yi)(yi)(yi)(yi)胃(wei)(wei)湯(tang)(tang)(tang)(tang)(tang)(tang)（見(jian)惡(e)寒(han)。）……若(ruo)(ruo)熱(re)多濕(shi)(shi)少(shao)(shao)，陰(yin)(yin)火(huo)(huo)困脾(pi)，陽不(bu)(bu)上(shang)(shang)(shang)升(sheng)(sheng)，補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)去白(bai)術(shu)、當(dang)歸(gui)、陳皮，加(jia)(jia)(jia)石膏、黃(huang)芩、黃(huang)連、蒼(cang)術(shu)、羌(qiang)活。若(ruo)(ruo)腎火(huo)(huo)上(shang)(shang)(shang)蒸，時(shi)顯燥(zao)熱(re)，加(jia)(jia)(jia)生(sheng)(sheng)地、黃(huang)柏”[10]。篇(pian)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)乃取東(dong)(dong)垣原創方(fang)(fang)藥(yao)治(zhi)(zhi)法(fa)(fa)(fa)(fa)，示(shi)后(hou)(hou)(hou)人如(ru)(ru)(ru)何(he)根據嶺南(nan)(nan)(nan)(nan)(nan)內傷(shang)(shang)(shang)(shang)兼(jian)有(you)濕(shi)(shi)熱(re)的(de)(de)(de)情(qing)況以(yi)(yi)化(hua)裁(cai)(cai)(cai)使(shi)用(yong)(yong)(yong)。故對(dui)(dui)(dui)于(yu)(yu)內傷(shang)(shang)(shang)(shang)病(bing)(bing)(bing)的(de)(de)(de)不(bu)(bu)同(tong)(tong)階(jie)段和病(bing)(bing)(bing)機，可(ke)(ke)(ke)(ke)(ke)參(can)照(zhao)東(dong)(dong)垣的(de)(de)(de)其他組方(fang)(fang)，亦(yi)為(wei)(wei)(wei)活用(yong)(yong)(yong)補(bu)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)益(yi)(yi)(yi)(yi)(yi)(yi)氣(qi)(qi)(qi)(qi)(qi)(qi)(qi)(qi)湯(tang)(tang)(tang)(tang)(tang)(tang)的(de)(de)(de)一(yi)種(zhong)方(fang)(fang)法(fa)(fa)(fa)(fa)。

4 小結

由(you)補(bu)(bu)(bu)中(zhong)益(yi)氣(qi)(qi)(qi)湯(tang)(tang)的(de)(de)(de)化裁演變可(ke)(ke)以看(kan)出地(di)(di)域因(yin)(yin)素對于方(fang)(fang)藥調整的(de)(de)(de)影響(xiang)，亦體(ti)現(xian)出中(zhong)醫“三因(yin)(yin)制宜”理(li)念的(de)(de)(de)重要性(xing)。東垣創立(li)“補(bu)(bu)(bu)土派”是建立(li)在(zai)(zai)壬辰年“土疫”流(liu)行的(de)(de)(de)氣(qi)(qi)(qi)候背景下(xia)（公(gong)元1232年），故(gu)后世亦有醫家認為(wei)(wei)該(gai)方(fang)(fang)是一張(zhang)運氣(qi)(qi)(qi)方(fang)(fang)，適用于以寒濕(shi)為(wei)(wei)主的(de)(de)(de)年份[11]。而(er)從患(huan)者群(qun)體(ti)的(de)(de)(de)角(jiao)度看(kan)，該(gai)方(fang)(fang)本為(wei)(wei)治(zhi)療“內傷(shang)脾(pi)胃(wei)病”而(er)創立(li)，當用于以內傷(shang)突(tu)出的(de)(de)(de)病人，故(gu)補(bu)(bu)(bu)中(zhong)益(yi)氣(qi)(qi)(qi)湯(tang)(tang)多(duo)(duo)用于治(zhi)療慢(man)性(xing)病。黃(huang)煌教授亦提出該(gai)方(fang)(fang)所適用的(de)(de)(de)患(huan)者多(duo)(duo)為(wei)(wei)體(ti)型瘦長或(huo)昔肥今瘦、面(mian)色萎黃(huang)呈貧血貌(mao)，且常伴有“虛性(xing)發熱”者[12]。而(er)在(zai)(zai)地(di)(di)域方(fang)(fang)面(mian)，筆者則(ze)認為(wei)(wei)補(bu)(bu)(bu)中(zhong)益(yi)氣(qi)(qi)(qi)湯(tang)(tang)適用于嶺南這(zhe)種氣(qi)(qi)(qi)虛外泄，虛損突(tu)出之(zhi)地(di)(di)。將“三因(yin)(yin)制宜”學(xue)說與補(bu)(bu)(bu)中(zhong)益(yi)氣(qi)(qi)(qi)湯(tang)(tang)的(de)(de)(de)臨(lin)床使用相結合，補(bu)(bu)(bu)土學(xue)說可(ke)(ke)以有更(geng)為(wei)(wei)深遠的(de)(de)(de)應(ying)用價值和意(yi)義，亦有利于推動嶺南醫學(xue)的(de)(de)(de)發展。

參考文獻

[1]鄭洪，李華(hua)明(ming). 中(zhong)醫(yi)地域醫(yi)學(xue)研究芻議[J]. 江(jiang)西中(zhong)醫(yi)學(xue)院學(xue)報，2011（02）：5-8.

[2]朱震(zhen)亨撰.丹溪(xi)先生心法 附錄一至(zhi)四冊[M].北京：中華書局，1985：432.

[3]朱時進撰.一見能醫(yi)[M].陳熠，鄭雪君點校；王詠(yong)匯(hui)集；查煒，陳守鵬(peng)點校.上海：上海科學技(ji)術出版(ban)社，2004：78.

[5]李璆，張(zhang)致遠原(yuan)輯.100種(zhong)珍(zhen)本(ben)古醫籍校注集成·嶺南衛生方[M].釋繼洪纂修；張(zhang)效霞校注.北京：中醫古籍出版社，2012：1.

[6]張介賓(bin)編著.類經(jing)[M].郭洪(hong)耀，吳少禎校注.北京：中國中醫藥出版社，1997：405.

[7]徐春甫原集.古今醫統大(da)全(quan)精(jing)華本(ben)[M].余瀛鰲等編選.北京：科(ke)學出版社，1998：46.

[8]吳謙等編.醫宗金鑒 第2分冊(ce) 刪補名醫方論[M].北京：人民衛生出(chu)版(ban)社(she)，1963：771.

[9]朱丹溪撰.丹溪心(xin)法(fa)[M].田(tian)思勝校(xiao)注.北京：中國(guo)中醫藥出版社，2008：24.

[10]何夢瑤撰.醫碥[M].鄧鐵濤，劉紀(ji)莎(sha)點校.北京(jing)：人(ren)民(min)衛生出版社，1994：187.

[11]老膺(ying)榮(rong).顧植山談“補土(tu)派”[J]. 中(zhong)醫文獻雜志，2015（01）：52-57.

[12]黃煌.中醫十大類方[M]. 南京：江蘇科學技術出版社， 2010：8.

文(wen)章來源：?中國民族(zu)民間醫藥·上(shang)半月

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