呕吐病位探析
Study on Disease Location of Nausea and Vomiting
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摘要: 呕吐为临床常见症状,一般以有物有声谓之呕、有物无声谓之吐,在中医诊断学上属于胃失和降而胃气上逆的病位特征表现。根据《灵枢·经脉》中呕吐见于足太阴脾经而非足阳明胃经的论述,对“呕吐在脾不在胃”的观点加以探讨;根据《黄帝内经》与《伤寒论》的有关论述,提出“五脏皆令呕,必当令胃呕”的理论,列述五脏致呕的病机与治法方药,总结出“呕吐不在胃,亦不离于胃”的辨治规律,揭示了中医学辨证而非辨症的核心思路。Abstract: Being common symptoms in clinic, both nausea and vomiting are the characteristic reflection of failure of descending of stomach-qi from Diagnostics of Chinese Medicine. This paper probes into the view of "vomiting location being spleen rather than stomach", based on the record in Miraculous Pivot that such symptoms as nausea and vomiting only belong to diseases of spleen meridian of foot-taiyin. Furthermore, a theory that "vomiting due to dysfunction of five viscera will lead to discomfort of stomach" is put forward, according to the relevant discussion in Huangdi's Canon of Internal Medicine and Treatise on Febrile Diseases. By analyzing the pathogenesis, treatment and prescription of vomiting due to dysfunction of five viscera, treatment rules that "stomach regulation can't be neglected though vomiting location isn't in stomach" is summarized, revealing that Chinese medicine emphasizes more of syndrome differentiation than symptom differentiation.
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