金匱要略疏義 巻之4
type: CreativeWork
main entity of page: https://archivebase.ldas.jp/utokyo/kano/resource/kyushu-4492046
text: 金匱要略疏義四 キー4 5965発 金匱玉国要略方論疏義卷第四 江都喜多村直寛士栗学 一辨黃疸病脈證并治第十五 疸音 旦 一案疸字本作痺痺熱也故内經有消痺瘧一 等之稱而熱鬱發黃謂之黃疸疸乃非黃病 之謂然說文疸黄病也凡亦旦聲漢書嚴助一 傳南方暑湿近夏痺熱顔師古注又曰瘴黄一 病也世遂以疸爲黃病之義而篇中更有省 黃字單稱疸者則亦可互通也 寸口脈浮面緩。浮則為風、緩則爲痺、痺非中風、四肢 痰音於○案緩則為痺之 苦煩脾色必黄痰熱以行一 痺字、當從劉説爲痺譌、始 一通、且緩煩瘴三字、以 黃行二字并係押韻、 此一篇總綱、辨明黄疸脈証、言脈浮緩者、必発黄、 浮則為風緩則爲熱浮緩相搏則爲風熱在脾胃 之診罪主四肢是以苦煩、脾主轉輸、故以其所疼 之色流布運行而肢體面目盡黃矣故曰瘡熱以 行 劉廉夫曰案痺非中風文義不屬恐有脫誤 劉龍庭曰、案平人気象諭曰、緩而滑、曰熱中、邪気、 藏府病形篇曰、緩者多熱、平脈法曰緩者胃気実、 實則穀消而水化也、又傷寒論曰、傷寒脈浮而緩 手足自温者。是爲繋在太陰太陰者身當發黄昏 此諸義觀之、則知是緩爲胃熱而浮緩爲發黃之 診又知浮則爲風之風卽熱氣外熏之謂 写寒論 有此例 一非邪氣中表之義、又知緩則爲痺之痺字葢是痺 字之議始與文義相叶顧以其論作痺後人不辨 遂補痺非中風一、句也再痺非中風一句推他文 例當是風痺相搏四字 跌陽脈緊而數、數則為熱、熱則消殺、緊則為寒食即 爲滿、尺脈浮爲傷腎。鉄陽脈緊爲傷脾風寒相搏食 一金匱要略以来 學訓堂襲現 穀即眩穀気不消胃中苦濁、濁気下流小便不通陰 数音朔の書 被其寒熱流膀胱身體盡蓋。身體黄。名曰穀疽」。 本連接下二 章為一條、今依脈経各一 為別條案通脱叶韻、 此條申明穀疸澄、当為三截看、趺陽脈緊至食即一 為滿、此就其脈證別寒熱也、脈浮為傷腎二句、舉一 為滿、此就其脈證別寒熱也、脈浮為傷腎二句、擧 穀痕及女勞疸脈象風寒相搏以下、辨穀疽證也 設。疽及女勞痘脈象、風寒相搏以下、游證也。 疸本脾胃主病、故當就跌陽以診之脈緊而數數 則為胃熱熱、熱故消殺、此為陽痺、緊則、為胃寒、寒即 則為胃熱、熱故消穀、此為陽瘴、緊則為胃寒、寒即 為涌、穀気不化、湿濁停蓄故也、此為陰瘴気候 為満、穀気不化、湿濁停蓄故也、此為陰痺、尺脈候一 医、若不況而浮、則為傷腎、此女労疽也、平脈法曰、 尺中時一小見脈再擧頭者。腎氣也。跌陽候胃若 不緩而緊、則為傷脾此穀疸也若夫風寒相搏邪 不消穀胃中苦濁食穀則眩、淸氣組於上行故也。 一濁気下流、陰破其寒言喞胃停湿也、小便不利陽一 受其熱、言脛氣不轉也、是以轉粗流被而身體盡一 黃因作穀疸也。 金鑑曰、若胃脈数、是熱勝於濕、則從胃陽熱化熱 則消穀故能食而謂之陽黃若胃脈緊是湿勝於 熱、則從脾陰寒化、寒則不食故食卽滿面謂之陰 黄也陽黄則爲熱疸酒疸。陰黄則爲女勞疸穀疸。 也、若尺脈不況而浮、則為傷腎、腎傷病疸、亦為女、 勞疸也、胃脈不緩而緊則爲傷脾、脾傷病疽、亦爲、 穀痘也 劉廉夫曰、巣源云、黄疸之病、此由酒食過度、府蔵 未和、水穀相并、積於脾胃二、復為風湿所搏、痰結不一 散、熱気鬱蒸、故食巳如飢、令身體面目、及爪甲、小 便盡黃而欲安臥黃疸也。穀疸之狀食畢頭食畢頭歇心 松佛鬱不安而發黃由失飢大食冐氣衝熏所致 劉絡翁曰、尺脈浮、為傷腎、跌陽脈緊、為傷脾二句 也 挿入以對示女勞疸穀疸二證之脈此不承食卽 爲滿句亦不接風寒相搏句、注家與上下相連爲 解殆覚路謬 額上黒微汗出手足中熱薄暮即發膀胱急小便自一 額五 利名曰女勞疸腹如水狀不治ヵ 陥翻 此釈女労疽証証、額上為腎之部位、故額上黒而微一 汗出五心熱薄暮發者病在裏在陰也下虚不約、 故膀胱乃急而小便自利也此得之房勞過度精 液乏竭故也、女勞疸猶是鬱黯所致也若此證小 便之自利者更不利、而腹如水狀則脾腎兩敗眞一 元閉絶故云不治 趙氏曰、女勞疸、惟言額上黒、不言身黄、省文也、後一 人雖曰交接水中所致特其一端耳 九氏曰、腎勞而熱、黑色上出猶脾病而黃外見也。 額於部為庭霊枢云庭者顔也。又云腎病者。歓与 顔黒 劉廉夫曰巣源云女勞疸之狀身曰皆黄發熱悪 寒少腹滿急小便難由大勞大熱而交接交接竟 入水所致也 劉旧庭曰、按女労死、注家以為腎熱、其説誠是蓋 人斷喪太過精液虧之、則腎中之陽必元極営血 爲之鬱黯遂爲發黃也 ・奥於刀翻 心中懊懐而熱不能食時欲吐名曰酒疸 同一冊一一 此掲酒疸證言飮酒過多濕熱醒醸則心中懊濃一 不寧、而熱内蓄、則不能食、熱上衝、則時欲吐、此得、 之麹蘖之毒所成故名酒疸一 陽明病脈遅者食難用飽飽則發煩頭眩小便必難 且欲行衆道雖下之、腹満如故、所以然者脈遅故也 此條出傷寒論陽明篇疏義既辨證之茲不復衍 也 魏氏曰仲景又為引傷寒論中之言疸者以申之 此條在傷寒論中、余既註之矣今金匱與傷寒論 兼言之、而寒熱表裏之故、大明且無不由于胃虚 之故亦大明也矣 次病濟黃疸必小便不利其候心…
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