“逆传心包”刍议

Rustic Opinion on "Reverse Spread to the Pericardium"

  • 摘要: “温邪上受,首先犯肺,逆传心包”是温病致病的一般规律,历代医家对“逆传心包”一句看法不一,尤以其中“逆”字最为关键。仝小林教授提出,心主神明,心包与心其气相通,心受邪由心包代受,叶天士所提“逆传心包”,实为温邪顺传于脑。将流脑作为本底疾病,可与卫气营血传变的典型阶段一一对应。结合顶焦理论,认为“心主神明”的功能更侧重于现代解剖意义上的脑。将中医传统温病辨治思路与现代医学有机结合,揭示疾病本质,把握病机核心,从新角度解析“逆”字,探讨其真正含义,对明确其内涵并探索温病发展规律、指导温病辨证治疗具有重要意义。

     

    Abstract: "When warm evil is received, it first attacks the lungs and then spread to the pericardium reversely" is the general rule of warm diseases. Doctors of different dynasties have different views on the phrase "reverse spread to the pericardium", especially the word "reverse". Professor Tong Xiaolin proposed that the heart governs the mind, the pericardium and the heart are connected in qi, and when the heart is affected by evil, the pericardium instead suffers from the evil. The "reverse spread to the pericardium" proposed by Ye Tianshi is actually the spread of warm evil to the brain. Taking meningococcal meningitis as the basic disease, it can be matched one by one with the typical stages of the transmission of Wei-Qi-Ying-Xue. Combined with the theory of Dingjiao, it is believed that the function of "the heart governing the mind" focuses more on the brain in the modern anatomical sense. Combining traditional Chinese medicine's ideas on diagnosis and treatment of warm diseases with modern medicine, revealing the essence of the disease, grasping the core of the pathogenesis, analyzing the word "reverse" from a new perspective, and exploring its true meaning, is of great significance for clarifying its connotation, exploring the development laws of warm diseases, and guiding the diagnosis and treatment of warm diseases.

     

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