東垣《脾胃論》陽氣興衰與陰火生成之五運六氣亢害原理

Yang-Qi imbalance and Yin-Fire production viewing from Five-Circuit and Six-Qi rebound phenomenon in Dong-Yuan’s Splenic-Gastric Doctrine

金元醫家李東垣，師承張元素共創易水學派，《脾胃論》以中央土立論，脾胃為後天之本，水穀精微運化之所。中央土比擬四時運轉、「藏氣法時升降浮沉補瀉」為易水學派核心，論脾土氣機升降，法春生夏長以維護陽氣，對陰陽有獨特見解：「天以陽生陰長」、「天地互為體用」、「甘溫退熱」等，本文將以《易經》及中央土概要探討之。以五行亢害原理論病機，則陰盛於下便有陽亢逆上之可能，東垣以少陽相火及龍雷之火言之。當脾胃虛損則陽氣隨之不及，胃為水穀氣血之海，脾病則穀氣不行，進而水濕下流乘腎，陰氣重疊名曰「重陰」。重陰使五行生克亢害啟動，造成火亢，東垣提出陰火是由水濕閉塞下焦所產生的，此論後來丹溪翁以龍雷火述釋。陽根於陰，少陽相火及少陰君火根起於下焦，內經以此二火乃六氣中之常氣，若水濕下流為重陰，易引起病理性之相火上亢，此乃《脾胃論》陰火生成之常與變。明白了五運六氣之亢害承制原理，對了解金元醫家的學術思想，相對重要。

 

"Medical Doctor Li Dong-Yuan from the Jin-Yuan Dynasties was the follower of Zhang Yuan-Su who used to be the co-founders of Yi-Shuei medical groups. Doctrine of Splenic-Gastric doctrine was written by Dong-Yuan. Central-earth theory represented the Splenic-Gastric system. This medical group refers historically to their idea of splenicgastric supplement. Central-earth simulates the movement of the four-seasons and Arise-Fallen-Float-Sink of Qi as a core medical concept. This concept was yielded from the nature, Yang Qi maintained this lifecycle which initiated in Spring and grown in Summer. Basing on Yin-Yang : 1. Spring-Summer Yang grows and Yin grows as well, 2.body structure and Qi is interchangeable during the four-seasons changes and 3. Sweety-Warmth treatment can expel internal heat. This paper illustrates Yin-Yang from Yi-Jing and central-earth philosophy. There are generate-prevail relationships in the Five-Circuit and redundancy-harmful from five-circuit-six-qi. These concepts explained that Yin redundancy in lower-burner may give internal fire rebound to the upper-burner. This lower-burner fire used to be generated physiologically sometimes refers it to young-yang fire or dragon-thunder fire. While splenic-gastric Qi was weakened by Yang deficiency, gastrium used to refer as the sea of digestions. Illness of the spleen may stop transmit nutrient for the stomach then water-dampness may invade the lower burner of the kidney territory which causes Yin-accumulation or double-Yin. The generate-prevail system mentions that redundancy-harmful mechanism is initiated then the double-Yin may rise to Yin-fire offensively. This paper focuses on yin roots on yang, the two internal fires (young-yin and young-yang) both are rooted from the lower burner which refers to physiological fire in Nei-Jing. While double-yin formed which may give pathological fire to fight back. Understanding this Five-Circuit and redundancy-harmful theory, we grasp more easily and essentially to the medical treatment concepts of the Jin-Yuan scholars."