湯方辨證依據陰陽病勢而無關五行學說

Differentiation of Decoction Depending Ying-Yang and Disease Tendency not Five-Element Theory

從敦煌《輔行訣臟腑用藥法要》推知伊尹《湯液經法》誤宗以五行學說之臟腑生剋補瀉。《金匱要略》五臟風寒積聚病篇：肺中寒、心中風…等亦誤宗以“臟腑辨證”。以上湯方論述與著於針灸之《黃帝內經》代表不同之流派。針灸感傳得知十二經之流轉有如天體五星之運轉不滅，五象各有臟腑歸屬，各象臟腑互為陰陽又合為統一，五象之間相生相剋而整體向前運轉，此稱五行學說。但數百種藥物間並無生剋關係，藥效不能強制歸入某臟腑，不能以經脈走向來框限藥效。針灸感傳可直達臟腑，湯方療法除胃腸病以外，並無此標靶作用。仲景在《湯液經法》之基礎上變制組成，捨去“臟腑辨證”，不用五行學說，以病位與病性分類而創《傷寒論》。病勢朝陽發展者有陽明病與溫病，病勢朝陰發展者有太陽病、少陽病與三陰病。病勢朝陰者以扶陽為先，病勢朝陽者以救陰為急。扶陽而屬一般體質者，為太陽病與少陽病；扶陽而體質偏寒者，則為三陰病。救陰而體質偏溫者，則為溫病；救陰而體質偏熱者，則為陽明病。宋朝張元素“藥物歸經”純屬推測，異於「穴位歸經」之感傳實證。小柴胡湯非為三焦與肝膽病而設，日本小柴胡湯死亡事件即“柴胡入肝經”與“臟腑辨證”誤導所致。針灸依陰陽學說與五行學說；湯方僅依陰陽「病勢」。高血壓病勢朝陰者須開四物湯、甚至是乾薑附子等溫補。低血壓而病勢朝陽者，須開苦寒瀉藥。朱木通前輩治癒亞急性盲腸炎用當歸四逆湯（病勢朝陰）與大黃牡丹皮湯（病勢朝陽）。經方能治外感又能治雜病。發燒要不要用冰枕非發燒度數所決定，而是由其病勢決定；38度用冰枕、38.5度用普拿疼、39度用瀉鹽之所謂標準程序者，則病人自己也會開藥，或交給電腦即可。中醫健保不應以西醫病名分類，美其名與現代醫學接軌，實乃戕害中醫之辨證思惟。試問白虎湯證、吳茱萸湯證等相當西醫何病名？又中醫師之角色即在判斷陰陽病勢。

Yiyin's Decoction Classic was under the principle of reinforcing and reducing for Zang-Fu organs from the five-element theory. Synopsis of Golden Chamber was under the principle of Zang-Fu organs differentiations. They were different from the theory of Huang Di Nei Jing. The therapy of acupuncture with sensation transmission along meridians is based on five-element theory which believes in mutual generation and restriction between the five elements and the relation between Zang-Fu organs. But, there is no mutual generation and restriction between hundreds of herbs. The effect of medicinal herbs can not be forced on certain organs or be limited by distribution of meridians. Acupuncture with sensation transmission along meridians can directly target the organs, but decoction therapy can't. On the basis of 'Yiyin's Decoction Classic', Chang Chung-ching removed the five-element theory (differentiations of Zang-Fu organs) and developed 'Shang Han Lun' based on disease location and characteristics. The diseases with yang tendency include yangming diseases and warm pathogen diseases. Taiyang diseases, Shaoyang diseases and Sanyin diseases are classified into yin-tendency. The key point of treating the yin-tendency diseases is strengthening yang-qi. The first treatment step of the yang-tendency diseases is bring back yin.