《金匱要略》婦人「熱入血室」重新釐訂與闡釋

Proofreading and Interpretation of the Heat Invading Women's Blood Chamber in''The Synopsis of the Golden Chamber''

背景：綜觀《金匱要略》與《傷寒論》共有四條熱入血室經文，其中疑點諸多，使後世詮釋紛亂。目的：釐訂經文錯簡。方法：經文之對稱語法，與典籍校勘。結果：校正如下，經文1：「婦人傷寒，發熱，惡寒，經水適來，晝日明了，暮則譫語，如見鬼狀，此為熱入血室，治之無犯胃氣及上下焦，必自愈」，經文2：「婦人中風，發熱，惡寒，經水適來，晝日熱除，身涼和，暮則譫語，此為熱入血室，治之無犯胃氣及上下焦，必自愈」，經文3：「婦人中風七八日，往來寒熱，發作有時，胸脇滿，屬少陽，經水適斷，譫語者，其血必結，此為熱入血室，小柴胡湯主之」，經文4：「婦人，濈然汗出者，轉屬陽明，經水下血，譫語者，此為熱入血室」。結論：從四條經文分析，共探討三大重點：〔1〕熱入血室的路徑，〔2〕月經失調狀態，〔3〕月經失調後伴隨臨床症狀表現，其中月經失調後伴隨臨床症狀表現皆描述譫語為主。

Background: There are four clauses in ''The Synopsis of the Golden Chamber'' and ''Shanghanlun'', with many arguments, which affects the clinical practicability. Purpose: Identify missing and errors. Methods: Symmetry between clauses, scripture grammar, and collation of related classics. Result: Clause 1 ''Women with Taiyang disease caused by Cold resulting in menstruation coming early, the patient has fever, chill and self-mumbling with unstable emotion at night, but returns to normal during the day. These are symptoms of Heat invading the Blood Chamber. Be careful not to disturb Stomach qi and the Upper and lower Portion of Body Cavity, a self-healing will follow.'' Clause 2 ''Women with Taiyang disease caused by Wind resulting in menstruation coming early, the patient has fever and chill. Her perceives fever subsided and Comfortable during the day, but self-mumbling with unstable emotion at night. These are symptoms of Heat invading the Blood Chamber. Be careful not to disturb Stomach qi and the Upper and lower Portion of Body Cavity, a self-healing will follow.'' Clause 3 ''Women suffer from tidal fever and chill with fixed time, feeling fullness of chest and flank during the seventh or eighth day leading to menstrual pause. It belongs to Shaoyang disease. These are symptoms of Heat invading the Blood Chamber. She causes self-mumbling with unstable emotion and unclean menstrual discharge. Xiao Chaihu decoction can adopted to cure the disease.'' Clause 4 ''Women with sweating profusely belong to Yangming disease. These are symptoms of Heat invading the Blood Chamber. She causes self-mumbling with unstable emotion and abnormal menstrual bleeding. Needle therapy at acupoint Qimen (LR 14) will release the pathogenic heat.'' Conclusion: Three main emphases were drawn from the four clauses: 1. The route for heat invading the blood chamber, 2. Menstrual cycle disorder, and 3. Clinical symptom followed by menstrual cycle disorder, i.e., self-mumbling.