冯昌汉应用升降散临证经验

摘要

[Objective]To discuss the experience of FENG Changhan, a famous and highly-experienced TCM practitioner, in using Shengjiang Powder in clinical cases. [Method] Based on Distinguish About Typhoid and Epidemic and related discussions on Shengjiang Powder and heat accumulation syndromes by physicians of all through the ages, we analyse chief physician FENG's understandings on the cardinal syndromes and pathogenesis which Shengjiang Powder is applicable to, sum up his experience in flexible applications of Shengjiang Powder for heat diseases and miscellaneous internal damage diseases, and then interprets a typical case. [Result] FENG believes that Shengjiang Powder is extensively used in the clinic. However, in clinical practice, physicians should pay attention to coatings on patients' tongues and their pulse condition, the cardinal syndromes and pathogenesis are diseases caused by heat accumulation and disorder of Qi activity. He claims the treatment of exogenpus heat diseases must focus on dispersing outward the accumulated heat while the treatment of internal damage diseases should aim at regulating the Qi flowing in the channels. Shengjiang Powder can be flexibly applied to symptoms including wind-phlegm, damp-heat and heat-toxin accumulation, all of which interact as both cause and effect with disorder of Qi activity. To achieve a coordinated Qi movement and the balance of Yin and Yang, the prescription should be modified according to symptoms. The theory was well proved by LIU 's case. [Conclusion] The insightful view and clinical experience of Mr. FENG in applications of Shengjiang Powder is worth learning and spreading.%[目的]探讨名老中医冯昌汉应用升降散的临床经验.[方法]基于《伤寒瘟疫条辨》及历代医家对升降散和郁热证的相关论述,探讨冯昌汉主任医师对升降散证机要点的认识,总结其对外感热病和内伤杂病灵活运用升降散的经验,并解读典型案例.[结果]冯昌汉主任医师认为升降散临床应用广泛,但临证要注重舌脉,其证机要点主要是郁热为患,气机失调.主张治外感热病,重在宣发郁热;治内伤杂病,着眼调畅气机.可灵活应用于风痰、湿(痰)热、热毒郁滞与气机失调互为因果的病证,随证加减,以达到气机升降协调、阴阳平衡的目的.所举案例获得良效.[结论]冯老应用升降散的独到见解和临床经验值得学习和推广.