文/庞素银
“温者,火之气也,自口鼻而入,内通于肺。”春季阳气生发,又到了温病容易流行的季节。风热邪气取道口鼻侵袭人体引起温病,起病急骤、传染性强。
"Warmth, theqiof fire, enters from the mouth and nose and into the lung." In spring, with the rise of yangqi, warm pathogen is easy to spread. The invasion of wind-heat pathogen from mouth and nose tends to cause warm disease, which is acute and infectious.
清代吴鞠通是举世公认的治疗温病的名医圣手。相传他1 9 岁时,父亲患病卧床不起,四处求医而无果,直至去世都不知所患何病。“父病不知医,尚复何颜立天地间”,深受刺痛的吴鞠通,自此立下了弃儒学医的志向。
Wu Jutong in the Qing Dynasty was a renowned doctor in the treatment of warm disease. Legend has it that when he was 19 years old, his father became ill and bedridden. He sought medical advice everywhere but failed. He did not know what his father was suffering from until his father died. Wu Jutong, who was deeply hurt by his father's illness and his failure to cure it. As a result, he decided to abandon Confucian and devote himself to medicine.
吴鞠通针对肆虐一时的温病,潜心研究,博采众长,在吸收吴又可《瘟疫论》、叶天士《温热论》等前人论著精华基础上,形成了理法方药完备的温病辨治体系,撰成对后世影响极大的《温病条辨》。广为人知的银翘散就出自其中,以疗效显著而名扬天下。
Wu Jutong became immersed in learning and collecting wisdom from others in order to seek the therapy for warm disease. On the basis of absorbing the essence of previous works such as Wu Youke's"On Plague"and Ye Tianshi's"On Warm and Heat Pathogen", he formed a complete dialectical therapy system for warm diseases, and wrote"Treatise on Differentiation and Treatment of Seasonal Febrile Diseases", which had a great influence on later generations. Yinqiao san powder, well-known prescription for warm diseases, came from it and was famous for its remarkable curative effect.
银翘散由10味药组成,因用药辛凉平和,吴鞠通称之为“辛凉平剂”。
Yinqiao san powder consists of 10 traditional Chinese medicines and features pungent-cool but mild attribution, Wu Jutong called it "moderate pungentcool prescription".
全方以金银花、连翘为君药,辛凉透表且芳香辟秽,主清热解毒;以薄荷、牛蒡子、荆芥穗、淡豆豉为臣药,前两味疏散风热,后两味解表散邪;以竹叶、芦根、桔梗为佐,生津润燥、开宣肺气;甘草兼具佐使,既利咽止咳,又调和药性。In the whole prescription, honeysuckle and forsythia are used as the monarch medicine,which have pungent-cool exterior-releasing effect and repel foulness with aromatics to clear heat and resolve toxin. Peppermint, burdock seed, schizonepeta spike and tempeh are used as the minister medicine. Peppermint and burdock seed dispel wind and heat from the body while schizonepeta spike and tempeh have the effect of exterior-releasing and dispelling pathogen.Bamboo leaves and reed root are used as the assistant medicine which have the effect of promoting salivation; moistening dryness and ventilating lungqi. Licorice is used as the guide medicine which has the effect of relieving pharynx and cough and reconciling medicines mentioned above.
银翘散能够显著改善温病初期的头痛、咳嗽、咽痛口渴等病症,该方严格遵循《温病条辨》首创的“三焦辨证”学说“治上焦如羽,非轻不举”原则,用药清轻宣散。比如,煎药时间短,煮沸后5 min~10 min即可,取清轻之药肃上焦之邪;服用少而频,“宁可再服、不可重剂”,以剂量控制药力恰达病位;可随证加减,衍生出多个变方。
Yinqiao san powder can significantly relieve symptoms in the early stage of warm disease including headache, cough, pharyngeal pain and thirst. The prescription strictly follows the theory of "Three Jiao syndrome differentiation"which was created by"Treatise on Differentiation and Treatment of Seasonal Febrile Diseases".The prescription follows the principle that the prescription for diseases in upper-jiao should be of small dose. For example, the decocting time is to be short within five to ten minutes after boiling. Small dose dispels pathogen in upper-jiao.Take less and frequently and "would rather take again, than heavy agent". The dose of medicine is controlled precisely just up to the curative effect.The dose can be added and subtracted along with the symptom and derive a number of variations.
时至今日,在流感、扁桃体炎、咽喉炎、肺炎、腮腺炎等疾病的初期治疗中,银翘散仍然被广泛使用。
Nowadays, Yinqiao san powder is still widely used in the initial treatment of influenza, tonsillitis,pharyngitis, pneumonia, mumps and other diseases.
“无开门揖盗之弊,有轻以去实之能”。银翘散被誉为外感温病第一方,其标准密码在于“辛凉解表”四个字,选药、煎煮、服用之法皆利在上焦,充分彰显了三焦辨证、紧扣病机的治病原则。
Yinqiao san powder prevents invasion of pathogen and can treat warm diseases in small dose. The prescription is known as the first choice of therapy for warm diseases.The standard password of the prescription is"Pungent-cool and exterior-releasing". The methods of drug selection, decocting and serving are all beneficial to upper-jiao, which fully demonstrates the principle of "Three Jiao syndrome differentiation" according to the pathogenesis.