張從正繼劉完素論燥證從火治之五運六氣原理

劉河間提出天人相應之具體臨床醫學架構，《三消論》以五運六氣為本及臟腑六氣為標而立論。張子和私淑河間，亦提出燥證標本之治法，以燥為本，若退火則風與燥自行解除；以燥為標，則分為四種：外燥則皺揭、中燥則枯涸、上燥則焦乾、下燥則澀溺，而這思維乃基於河間對病機十九條之補闕：「諸澀、枯涸、乾勁、皴揭，皆屬於燥。」燥氣遊行於天地之中，影響及人，人體臟腑因而應之，若有所偏者太過或不及皆能受病於一身之上、下、中、外。子和治病善用汗、吐、下三法，治燥之法亦以退火為先，故立「休治風兮休治燥，治得火時風燥了。」之明確治燥方針，乃基於五運六氣亢害承制之概念。金元醫家除了醫理闡釋之外，最要是他們的臨床療效顯著，河間雖發明燥之病機，仍要醫家們實踐，才能使理法方藥得以完備，子和是河間之追隨者，運用了河間對燥之創新發明，在臨床上提出具體治燥之法，在《儒門事親》醫案裏亦合乎脈病證因治之臨床指引，留下臨床範式供後世參詳。

關鍵字

燥；五運六氣；亢害承制；標本；天人相應

並列摘要

Liu Wansu (Hejian) who proposed an Universe-Human union theory was applied to treatment clinically. Polydipsia, polyuria and polyphagia (diabetes like syndrome) which was a chapter written by Hejian, based on the theory of the ＂Five-Circuits and Six-Qi＂ with internal-organ correlations. Chang Ts'ung-cheng was one of the followers of Heijian who had been proposed the treatment of dryness syndrome. This concept of treatment was based on the ＂dryness evil＂ and suggested that put out of the fire then the wind-dryness evil could be alleviated. The dryness syndrome can be classified as the following four categories: External for winkle dryness, Internal for extreme dryness, Upper for charcoal dryness and Lower for voiding dripping. This clinical findings was based on the theory of Heijian who added the missing words for the doctrine of ＂Huang- Di-Neijing＂ which stated that ＂All kinds of astringent, extreme dryness, strong dryness and winkle dryness belong to Dryness Syndrome＂. Dryness was one of the Six-Qi which defined in TCM as six basic substances in the Universe. Human beings contacted with dryness-Qi while internal organs should adapt to it. Whichever too strong or too weak may give body sickness internally, externally, cephalically and caudally. Ts'ungcheng favored for treating diseases with sweating, vomiting, laxative while treating dryness illness by putting away fire evil. He proposed a motto about treating dryness as ＂Whenever dryness, do not treat its wind and dryness evil, treat its fire and the wind and dryness will be gone＂ and obviously this concept was based on the principal of ＂Five-Circuits and Six-Qi＂. Medical doctors during Jin and Yuan Dynasty (A.D.1100- 1300) proposed many useful concepts in treating diseases which really worked and had been progressive for a thousand years. Dryness was a newly emerged concept which was invented by Heijian and put forth clinically and practically by Ts'ung-cheng. Application of this concept to treatment was documented in the book ＂Confucianism scholars concerning health about their family＂ of Ts'ung-cheng. In his book, there were many good examples and medical principles for treating diseases and cases of dryness syndromes which were explicated deliberately.