〈蘭室秘藏‧小便淋閉論〉之臨床解析

The Clinical Interpretation for Difficult Urination Recorded in “Secret Book of Orchid Chamber”

〈蘭室秘藏．小便淋閉論〉是傳統中醫治療小便不利的重要文獻。文中以口渴與否的症狀對於小便不利進行鑑別診斷，分為在氣或在血的病機，並有相對應的治療策略與方藥。本文嘗試以臨床醫學的病機結構為視角，結合後代醫家們所提出之小便不利等證治相關的重要概念，以及現代醫學對於此病症的認識，嘗試對〈蘭室秘藏．小便淋閉論〉所論述之臨床操作準則進行解析，以期更深刻地理解東垣先生治療小便不利的臨床病機思維結構。

Among the traditional Chinese medicine literatures, “Difficult Urination” recorded in “Secret Book of Orchid Chamber” serves as one of the most valuable guidance to treat patients with difficult urination. For instance, the pathogenesis of difficult urination phenotype could be diagnosed as “Chi” or “Blood” base on the thirsty symptom of the patients. Then patients can receive proper medicine and medical strategy treatments. The purpose of this article is to better interpret the principles of the clinical operations recorded in the “Difficult Urination” recorded in “Secret Book of Orchid Chamber” by combing the concepts of treating difficult urination from other Chinese medicine literatures, and knowledge of the disease from modern medicine. The other goal is to gain a deeper understanding of Li Gao’s thoughts on clinical pathogenesis of the disease from today’s clinical medicine perspective.