基於《金匱要略》中「同病異治、異病同治」的二難推理與多難推理（II）

Dilemma and Multilemma Based on “Same Disease, Different Treatments; Different Diseases, Same Treatment” in “Medical Synopsis of the Golden Chamber”(Ⅱ)

「同病異治、異病同治」是《金匱要略》對方證運用的一大特色。在《金匱要略》中「同病異治、異病同治」的方證條文，所佔的比例大約是全書的三分之一。《金匱要略》的研究需要多學科的介入，特別是有「工具」之稱的《邏輯學》的參與。然而，成書於東漢的《金匱要略》文簡意奧，注疏者近千，其見解殊異。當我們對《金匱要略》的語言進行仔細的考察，就會發現《金匱要略》中的句子許多是一種被稱之為「觀察句」、「記錄句」或「問答句」的語句，後世研究《金匱要略》者，多是採用一種「語文學」的方法對這些條文進行注釋，以期人們能更好的理解原文，其間縱有理論的形成，嚴格地說來也只是一種詮釋理論。筆者以為要研究中醫就要清楚中醫學的語言，要清楚中醫學的語言我們就要分析它，知道它說的是什麼？只有明白它說的是什麼，我們才能研究它。「同病異治」是指同一種疾病，在不同的發展階段，反映出的病機、病性之不同，治法與方藥就不同；「異病同治」是指多種不同的疾病，在某一病變階段，如果反映出的病因、病位、病機和病性相同，就可以用同樣的治法與方藥。「二難推理」則為人們在論辯過程中經常運用的一種推理，論辯者的一方說出具有兩種可能的大前提，對方不論肯定或是否定其中的哪一種可能前提，結果都會陷入進退維谷、左右為難的境地，故稱之。

“Same disease, different treatments; different diseases, same treatment” plays a significant role in the monograph. In the “Golden Chamber”, “Same disease, different treatments; different diseases, same treatment” by such provisions, the proportion is about one-third of the book. “Golden Chamber” and the involvement of multi-disciplinary research needs, especially the “tools” of the “logic” participation. However, a book in the Eastern Han Dynasty’s “Golden Chamber” Austrian concise text, commentaries are nearly a thousand, their opinions Distinct. When the “Golden Chamber” careful examination of the language, you will find “Golden Chamber” in the sentence is called a number of “observation sentences”, “record sentence” or “question and answer period”, the statement, later research “Golden Chamber”, the more is the use of a “philological” approach to these provisions notes, with a view to better understanding of the original people, during the formation of longitudinal theoretical, strictly speaking, to have only a theoretical interpretation. I think we should know to study medicine in medical language, the language of medicine to make it clear we will analyze it and know what it says? Only understand what it says is that we can study it. “Same disease, different treatments; different diseases, same treatment” plays a significant role in the monograph. It is one of the best features for the usage of “prescriptions based upon syndromes” in the book. “Same disease, different treatments” means that the treatments are different for the same disease because the pathogenesis and syndromes presented are different at different stages. “Different diseases, same treatment” means that the treatment is the same for different diseases if the etiology, disease-bit, pathogenesis and syndrome presented are the same at a certain stage. Dilemma is in the process of application of the argument often a reasoning, the argument of a party say has two possible major premise, the other party no matter affirmation or denial of which of the premise, the results would be in may be awkward dilemma situation, so call it as a Dilemma.