【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
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文(wen)章來源:?中國民族(zu)民間醫藥·上(shang)半月
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