傷寒論答問 巻之3-4
type: CreativeWork
main entity of page: https://archivebase.ldas.jp/utokyo/kano/resource/kyushu-1446090
text: 傷寒論答問三 61 ・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・ 521 あ 10 傷寒論荅問巻三 東都鱸川北村直英広達答 郷人北川泰温俊達 後藤有隣前庵等問 林田医宦山村紀綱明善訂 太陽下篇 小問曰病有 首条 結胸云云 問云汪氏云按結胸症其人本胃中挟食下之太早則食 不能去外邪反入結歌胸中以故按之則痛不能嘆食 此以結胸為因食者其義如何 一順天薬室 文 〇0 700mm 答曰本篇篇九条云為水結在胸脇也且方中有甘遂有 一苧塵其非宿食固無論己汪氏所謂大謬極矣 蔵結無陽 第二条 証云云 問云蔵結亦内寒結実而云無陽症然則与貴結胸無 熱症者亦為大易混笑 本篇第十二条云此本有寒分 答云惟彼則不大便 巴反下之若利止必為結胸此貝 前條 時〻下利 言之 此為其別也彼寒結之中自有陽之猶 持下攻与此寒極陰盛不可攻之不同矣 同同二年八病発於陽而 第三条一 反下之云云 問云山田図南云言熱入而不言寒入者以結胸得諸外 00 一 来之邪痞得諸心気之結也成無已諸人不会此義妄 謂痞亦表邪入裏所結殊不知仲景氏以熱入二字冠 之結胸而不冠痞者自有深意存焉果痞之從外邪而 来乎所謂傷寒汗出解之後心下痞鞭省其謂之何乎 又云言所以成結胸而不言所以成痞者以結胸多得 諸下畢而痞則不必然也此説大発此條之徴旨始開 千古之疑城 答云其説概原銭氏類似得緒端然以予観之猶未必為 然也盖此条以言結為為主其言痞者客也故於結物 其言詳之於痞其言略之略言之詳畧因其義之主客 文一 00 而分焉猶言病発於陽而反下之熱入因作結胸病発一 於陰而反下之熱入巴作痞所以成結胸成痞者以下 之太旱故也矣而指痞謂之不因外来因早下者亦謬 也下篇 二条 第三十 云傷寒中風医反下之其人下利日数 十行穀不化腹中雷鳴心下痞報而満云云此痞亦因 熱入因早下之明徴也其条下云此非熱結但以胃中 虚客気上逆故便鞭也者此熱入直帰寒化故也乃此 條所謂病発於陰之処也不知有此義妾以為説呼ノ予 焉從之乎若猶欲言痞之不因下不因熱入則先当知 本篇 結胸之有不因下者 八條 本篇第 不因熱者不因熱者共 十五條 唯痞興結 00 胸因熱入因早下者此事之常也故於此条姑例其常 耳学者不知常変未足与論此書矣 第四條 結物者項 赤強云云 問云結胸之症水気実結在胸中即其方以大陥胸湯主 之矣而瓜帝散条云胸中痞鞭下 下為四 十条 又云邪結在胸 中 殿陰為 三十件 少陰扁四十四条此胸中ニ 又云胸中実ホ 実不可下也当吐之云云 無亦 太相似乎 答曰似則似矣然彼則無痛此則必痛此其別也 結胸證其脉 第五条 浮大者云 問云此條不言治法法之如何 三二順天薬室 答云張兼善云柴胡加桂枝乾羊湯以和解之常器之云 可与増損理中丸如水効用黄連巴豆搗和泥封膜上 俱非此條之治法蓋表邪未解当先解表表解已而後 攻之 結胸證悉 第六条 具云云 問云大陥胸湯所主之症中有短気躁煩而此条言死者 何也 答云雖大陥胸湯本条謂躁煩症而彼未至其症悉具也 若上結於心胸下至少腹鞭満而痛不可逃則是結胸 症已悉具者固其勢為深劇也加以煩躁則愈益暴急 可能救乎故曰亦死也 太陽病脈浮 第七条十一 而動数云云 問云案証治準縄載朱震亨説云胃中空虚短気煩躁虚 乏甚矣豈可迅攻之乎以梔子致湯吐胸中之邪而可 也此説如何 答曰桂山先生云銭氏則言朱氏不善読書者因歴挙 七条以弁其誤可誤可謂至当矣文繁不録 第八条 問云前云所以成結胸者以下之太畢故也此不言了後 而云傷寒六七日結胸熱実此蓋不因下早也而致之 四順天薬室 } 者何也 答云表撚盛実転入胃府則為陽明証表熱盛実不転入 胃府而陥入膈則為結胸症故不必誤下始成候係張 兼善云下早結胸事之常熱実結胸事之変所入之因 不同其證治則一理而已是也 問云注家成無己諸人皆謂此是為一種水結胸矣治人 乃定之方云水結胸小半夏加茯苓湯小柴胡加牡蠣 湯亦主之此等言亦為得乎 答云銭氏嘗有詳弁云尚論言後人誤謂結胸之外復有 水結胸一症又謂下文支結乃支飲結聚亦別是一症 十月廿一日 00 殊為可笑愚謂若水飲必不与熱邪並結則大陥胸方 中何必有逐水利痰之甘遂乎可謂一言破惑 太陽病重発汗 第十条 而復下之云云 問云按自太陽病重発汗至日晡所小有潮熱全陽明白 虎承気之症也但従心下至少腹鞭満而痛不可近者 此結胸矣蓋病有三異而但取一用陥胸者何也 答云三者之中結胸尤急故攻之以陥胸則余症従而解 矣辟諸漢王一討楚王而海外諸蛮皆望風憐服不亦 愉快哉 此山田 図南説 小結胸 第十一条 病云云 五順天薬室 〇〇 本 34 問云此症与大陥胸湯症及心下痞鞭症相比則軽重如シ 何 答云蓋結胸者不按而自痛痞鞭者雖按不痛今曰按之 則痛然則小結胸則在二者之間而為頗緩也雖然験 之行事凡病人心下鞭而満者少有按之不痛者或云 按之則痛不欲近手…
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