摘要
“四饮”首见于《金匮要略》痰饮咳嗽病篇,该篇对“四饮”的因机证治进行了较为全面地阐发。古代医家以自然之水到人体之水的隐喻映射为基础认识水液代谢性疾病,从而形成“四饮”(痰饮、悬饮、溢饮、支饮)概念、临床表现、成因以及治法的系统论述。“四饮”概念与临床表现以自然之水为始源域,通过听觉模态隐喻、容器图式等表述和构建;饮病之成因源于对自然之水循环不同环节水液积蓄现象的观察;饮病之治疗基于自然水患状态与人体饮邪停滞状态间的映射,以治理自然水害经验为认知理据,形成因势利导、培土制水及温阳化饮等方法。从隐喻视角分析饮病概念及治法背后的思维方式,进一步加深对饮病的理解,更好地指导临床论治。
The concept of siyin(four types of fluid retention) was first seen in the chapter on Phlegm-Fluid Retention and Coughs in Jin Gui Yao Lve(Essentials from the Golden Cabinet),which comprehensively elucidated the etiology,pathomechanism,patterns and treatment of siyin.Ancient physicians used the metaphorical mapping of natural water to human bodily fluids as a basis to understand water metabolic diseases,thus forming a systematic discourse on the concept,clinical manifestations,causes,and treatment of the siyin,which consists of tanyin(phlegm-fluid retention),xuanyin,(pleural fluid retention),yiyin,(subcutaneous fluid retention),and zhiyin(thoracic fluid retention).The concept and clinical manifestations of siyin are expressed and constructed through auditory modal metaphors and container schemas,with natural water serving as the source domain.The cause of the siyin diseases is derived from the observation of water accumulation in different stages of natural water cycle.The treatment is based on the mapping between the state of natural floods and the stagnation of siyin evils in the human body.Drawing from the experience of natural flood control,methods such as making the best use of the situation,cultivating soil to regulate water and warming yang to dispel fluid retention are developed.By analyzing the concept of the siyin diseases and the treatment methods from a metaphorical perspective,a deeper understanding of the siyin diseases is achieved,thereby providing better guidance for clinical treatment.
作者
陈婷
李湛
赖敏
贾春华
CHEN Ting;LI Zhan;LAI Min;JIA Chunhua(School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029)
出处
《现代中医临床》
2024年第3期49-53,共5页
Modern Chinese Clinical Medicine
基金
国家自然科学基金项目(No.82074582)。
关键词
隐喻认知
金匮要略
四饮
因机证治
metaphorical cognition
Essentials from the Golden Cabinet
siyin
treatment based on pathogenesis
