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【本篇是:彭博士讲《黄帝内经》系列-精华篇-之五百零三。(更多精彩内容持续更新中……)】
“青,脈之至也。長而左右彈。有積氣在心下,肢胠。名曰肝痹。得之寒濕,與疝同法。腰痛足清頭痛。”——《黃帝內經·五藏生成篇》
听众朋友们大家好,我是中医彭鑫博士,今天我们继续讲解《黄帝内经·素问·五脏生成篇第十》,我们先来看原文∶“青,脉之至也。长而左右弹。有积气在心下,肢胠。名曰肝痹。得之寒湿,与疝同法。腰痛足清头痛。”这段话从字面上的意思来理解并不是很难。
我们先看“青,脉之至也”,也就是外面气色见到青色。“脉之至”就是脉来的时候长而左右弹,就是脉来颇长,而且左右弹指,把上脉之后,左边、右边,两侧都会弹指。这种情况就是病情积聚在心下。(今日头条@中医彭鑫博士)“胠”指的就是腋下到腰这个位置,就是我们老百姓所说的两肋这个地方。这个地方特别胀满,叫做肢胠。这种病名叫做肝痹。怎么得的呢?叫做“得之寒湿,与疝同法”,致病因素主要是受了寒湿,病理跟疝气相通。有什么症状呢?有腰痛、足冷、头痛这三个症状。清指的就是清冷,就是脚凉的意思。这些病组在一起,病名就叫做肝痹,就是肝气闭塞不通,肝气不能宣达这样一个病名和病机。
在这里我再带着大家的从头到尾把一些关键的地方带大家捋一遍,尤其是古代医家的注解。第一个叫做“长而左右弹”,弹指的是脉应指搏击,如弹人手。弹的意思就是脉摸上去之后,脉给你的反作用力就好像脉搏在弹你的手一样。《类经》里边注解∶“言两手俱长而弦强也”,张景岳认为脉象的表现就是两个手的脉都特别弦长,而且按上去像琴弦,非常强硬这种脉象。皇甫谧写的《针灸甲乙经》可以参考,皇甫谧有很多内容是从《素问》《灵枢经》当中直接抄录下来的。在这个地方《甲乙经》底下有一个字就是弦,也就是说长而左右弹弦,有一个弦字,也可以参考,指的脉不仅长,而且有特别弦。
“胠”,一个月字边,一个来去的去,本意指腋下的意思,《说文解字》里边注解∶“胠,腋下也”。《广雅·示亲》里边解释说:“胠,胁也”。胁指的也是腋下到腰这个位置。我们之前也学过《素问·咳论》里边讲的叫做“甚则不可以转,转则两胠下满”,如果是严重不可以转侧,转侧胁肋就会胀满,这就是“胠”字的含义。
大家可以这么理解,“胠”指的就是腋下胁下这个位置,其实就是肝经所过的位置。所以张介宾在《类经》里边注解∶“肝邪有余,故气积心下,及于肢胠,因成肝痹”。邪气要是有余就会积累在心下的位置,因此就成了肝痹。“得之寒湿”,与寒湿这种外邪有关系。“与疝同法”什么意思?疝就疝气的疝。张介宾在《类经》里边讲∶“得之寒湿而积于心下肢胠者,则为肝痹。积于小腹前阴者,则为疝气。总属厥阴之寒邪,故云与疝同法”。张介宾是博闻强记,他把《伤寒论》里边一些内容也记住了,要是积于小腹前阴就是疝气,用什么药治呢?用当归四逆加吴茱萸生姜汤就治这种病,或直接用当归四逆汤也治。
如果“得之寒食,而气积心下肢胠者,则为肝痹”,也就是单纯在人体上半部,也就是在腰以上部位积聚,就是肝痹,那疏肝解郁就行了。我们在临床可能会用到四逆散,也可能用到四逆散合当归四逆汤。总而言之,把足厥阴肝经的寒湿郁给解了就好了。如果积于小腹前阴,这个位置也是中医所说的足厥阴肝经所经过的部位,这个地方如果是积聚就会出现疝气,这个时候就用当归四逆加吴茱萸生姜汤或者当归四逆汤或者是吴茱萸生姜汤,都能根据临床症状都可以得到很好的解决。因此张介宾说∶“总属厥阴之寒邪,故云与疝同法”。他认为其实《黄帝内经》这段话虽然讲的是肝痹,但是这个病跟疝气也特别像,而且是同样一个经络所得的病,因此用同样的方法来治就可以。(未完待续)
本篇是:彭博士讲《黄帝内经》系列-精华篇-之五百零三。(更多精彩内容持续更新中……)
免责声明:本文为健康知识分享。文中所涉及的药物、药方、针灸以及其他各种治疗和养生方法,请在专业医师指导下应用,切勿自行应用。如因不当使用所产生的问题,概不负责。
版权声明:本文作者彭鑫,本文为原创文章,未经许可,不得转载或引用。
(版权归原作者所有,并保留相关法律权利)
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八卦家族,乾坤六子。 八经卦看作是一个家庭,就是父母求子女,分别是父母和六个子女,所以也叫八卦家族。八卦家族相对应的两个卦是互为旁通的关系,也就是说它们两个之间的关系是最近的。 乾…
2022年9月14日 -
广字头的有什么字?广字头的有什么字儿!
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广东广西的“广”字看似字形有缺陷,字体不够饱满,在全国其他各省没有这样的字,其实在包容、团结方面比其他各省做得好,而“广”字的宽广、广阔、广袤、做东无疑成广东经济发展动力,成绩迥然…
2022年11月20日 -
峄字怎么念?昔字五行属什么属性!
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(接上文:本该属于枣庄的兰陵,是如何一步步成为了临沂的?兰陵归属考证3) (原本属于枣庄的千古地名兰陵,却给了临沂苍山,兰陵归属考证2 ) (真正的兰陵到底属于枣庄还是属于临沂苍山…
2022年10月28日 -
当代人起名哲学
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给孩子起名,对全世界的父母来说,都是一件重大却令人头疼的事。 2021 年 5月12 日,北京。在公园“溜娃”的年轻母亲。 /图·视觉中国 美国专栏作家德里克·汤普森在《引爆流行》…
2022年9月13日 -
这应该是正确拼音表读法吧,认字先认音
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现在很多语文老师教的拼音,有些按照英语的发音来发音,汉语拼音o应该读wo,而不是ou,正确拼音表应该是: 单韵母:啊窝额一屋玉 复韵母:唉诶巍奥欧呦耶约儿 前鼻韵母:安嗯稳音揾 后…
2022年9月13日 -
罡的含义是什么意思?罡怎么读_拼音!
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庙门上的钉 ● 孙洪鹏 慢慢地,温彬来到了童万身边,在村中心大街,和那群老人拉开着一段距离。两个人坐在一起,像两个前朝遗老,也像两只孤独病老的狮子。 童万听到温彬住院的消息,一脸的…
2023年4月12日 -
美妆巨头露华浓,负债200多亿,多次走在破产边缘
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破产营销? 美妆巨头露华浓正式申请破产了。 6月16日,露华浓申请破产的新闻一经公布就登上了微博热搜。据媒体报道,当地时间6月15日,露华浓在美国纽约南区法院递交了破产保护申请。法…
2022年9月14日