中医药研究论丛

263.4 《金匮要略》「女劳疸」之重新阐释与厘订
TJ TCM.26(3) : : 51-66, 2023
DOI : 10.6516/TJTCM.202309_26(3).0004
 
《金匮要略》「女劳疸」之重新阐释与厘订
Redefinition and Proofreading of “Female
Overloading Jaundice” in the Synopsis of the Golden Chamber
吕平安 1 李伊婷 2 陈季襄 3 张家诚 4 林淑銮 5 张永明 6,7,8,*
彰化基督教医院中医部,彰化,台湾
秀传纪念医院中医部,彰化,台湾
中国医药大学中医学系,台中,台湾
义守大学医学院物理治疗学系,高雄,台湾
一品堂鹿港中医诊所,彰化,台湾
一品堂丰原中医诊所,台中,台湾
义守大学医学院学士後中医学系,高雄,台湾
义守大学医学院中医部,高雄,台湾
【摘要】
背景:女劳疸之阐述历代医家说法不一,或有大劳大热而成,或有因房劳之说,因其诠释纷乱,进而影响後世取方理法之临床实用性。
目的与方法:藉由经文之间对校以及各典籍校勘,厘订经文的缺漏和错简,并对照现代医学概念使条文能贴近临床。
结果与结论:厘定後经文,经文1:「……。额上黑,微汗出,手足中热,薄暮即发,膀胱急,小便不利,名曰女劳疸。腹如水状,不治。……」。经文2 :「黄家,身尽黄,日晡所发热,而反恶寒。膀胱急,少腹满,额上黑,足下热,此女劳之病,腹胀如水状难治。大便必黑,时溏,因作黑疸。硝石矾石散主之。」经厘订後,作者认为:1.《金匮要略》「女劳疸」经文不属黄疸篇,理当回归妇人杂病篇。2.融合现代医学重新诠释女劳疸,可意指女子因为过度劳损,导致卵巢提早功能不全或衰竭,诱发头面部色素过度沉积,身体出现潮热、出汗,并且伴随泌尿生殖系统等一系列症状,以澄清「女劳疸」应非指女子房事过度或沉溺色欲而造成黄疸。
【关键词】女劳疸、黑疸、卵巢早期功能不足或衰竭、围绝经期综合徵、更年期症候群
Ping-An Lu1 Chi-Hsiang Chen2 I-Ting Lee3 Chia-Cheng Chang4 Shu-Luan Lin5 Yung-Ming Chang6,7,8,*
1 Department of Chinese Medicine, Changhua Christian Hospital (CCH) , Changhua, Taiwan
2 The School of Chinese Medicine, China Medical University, Taichung, Taiwan
3 Department of Chinese Medicine, SHOW-CHWAN Memorial Hospital, Changhua, Taiwan
4 Department of Physical Therapy, I-SHOU University, Kaohsiung, Taiwan
5 1PT Lukang Chinese Medicine Clinics, Changhua , Taiwan
6 1PT Fengyuan Chinese Medicine Clinics, Taichung, Taiwan
7 The School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung , Taiwan
8 Chinese Medicine Department, E-Da Hospital, Kaohsiung, Taiwan
Summary
There are many doubts about “Female Overloading Jaundice” in the Synopsis of the Golden Chamber. Some physicians explained “Female overloading jaundice” There are many doubts about “Female Overloading Jaundice” in the Synopsis of the Golden Chamber. Some physicians explained “Female overloading jaundice” literally as female having excessive sexual activities. Others considered the word “female” as pleonasm so “Female overloading jaundice” should be revised to “overloading jaundice”. The confusion of interpretations by physicians has affected clinical practicability. This article revises the clauses by using symmetry between clauses, scripture grammar, and collation of related classics. Also, comparing the clauses with the concept of modern medicine to make the clauses closer to clinical use. After the revision, the author considers: 1. The scripture of “Female Overloading Jaundice” is not belong to Chapter XVJaundice, it should return to Chapter XXIIMiscellaneous Gynecological Diseases. 2. Redefinition of “Female Overloading Jaundice” means that female overloading leads to premature ovarian insufficiency or failure, which induces pigmentation in the cheekbones of the face and forehead. 3.Therefore, “Female Overloading Jaundice” does not mean that women have jaundice caused by excessive intercourse or indulging in lust.
KeywordsFemale Overloading JaundiceBlack JaundicePremature ovarian insufficiency or failure Perimenopausal syndrome Menopausal syndrome