오길남, 김필재
<자유민주적 기본질서를 항상 옹호하고 이를 위해 헌신하고자 하는 자세를 담보할 수 있는 자만을 국가공무원으로 임용할 수 있다.>(독일) (발췌)
----->주체사상의 신봉자들이 한국의 정치가, 관료들이 되면서 한국이 망하기 시작했다.
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내놓고 친북해도 되는 세상이 되어 버렸습니다. 인공기와 김정은 사진 태운다고 수사하겠다고 덤비는 세상이 되었습니다. 북에서 내려온 어떤 여성을 왕비님처럼 모시고 KTX 전체를 전세내어 강릉으로 모시고 가는 세상이 되었습니다. 홍준표(자유한국당 대표) 페이스북
---> 빨갱이가 큰소리치고 애국자들이 핍박 받으며 감방 가는 세상이 되었다.
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일베가 사회적 터부가 되어버렸다. 사상, 언론의 자유를 잃어버리고 있다.
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문죄인의 사상적 스펙트럼을 알 수 있게 해주는 딸의 행동
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한국이 철저하게 부패한 조선시대를 빠르게 닮아가고 있다. 이번 대통령 탄핵 사태에도 부패한 관료들이 한 몫 했다.
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사립 법정(法廷)의 가능성
사적인 법률 시스템을 주장하는 이유는 정부가 강요하는 사법 독점의 폐해를 저지하기 위한 것이다.
The Possibility of Private Law
•Robert P. Murphy
In a recent article, I discussed the possibility of private, competing security agencies. I took for granted the background rule of law (or lack thereof), and merely made the relative argument that a monopoly institution of violence (i.e. the State) would not aid the achievement of a working consensus on legal norms, and that in fact (as history shows) government-controlled societies are certainly susceptible to civil war. In the present piece, I will elaborate on how law itself could be efficiently and equitably produced in a private setting.
PRIVATE JUDGES
Whether society is in anarchy or under the domination of a State apparatus, individuals will always have disputes. Although most arguments are settled between the parties themselves, some disagreements are too serious for such resolution. In such cases, the disputants (in anarchy) can turn to a judge, who is simply a person who agrees to render an opinion on their dispute. Although many anarchist theorists link private judges with enforcement agencies in their expositions, we should keep in mind that the two are conceptually distinct. In its essence, a private judicial ruling is just that—one person’s opinion as to who is right, and what he or she is owed, in a given dispute.
One major difference between private and State judges is that the former only entertain cases when both parties submit to the “jurisdiction” of the judge. (In contrast, one or both parties in a State court case may strongly object to the judge and/or jury who will decide the issue.) Cynics of private law may consider this proposal as ridiculous—the very idea that a rapist or bank robber would agree to plead his case before a third party, ha!
However, this glib dismissal overlooks the fact that most disputes in modern commercial society are not between an “obvious” innocent and an “obvious” malefactor. Rather, it is often the case that both parties to a dispute genuinely believe themselves to be in the right, and would be happy to make their cases in front of a disinterested third party.
Another consideration is that, without the government monopoly and selection of judges based on political pull and demagogic appeal, a crop of professional judges would arise who were, well, quite judicious. (Any unmarried female judges would quite truly be the fairest maidens in the land.) When reading their previous opinions on cases in which they had expertise, people would recognize their excellence, and say, “Wow, that was a great ruling! When I first heard the evidence, I thought the plaintiff was right, but after Judge Barnett explained it with his analogies, the defendant is obviously not guilty.”
In anarchy, people would demand judicial services for all the reasons that people desire law itself: They would want to satisfy their desire for abstract justice, but they would also want to foster predictable business relationships, as well as enjoy a good reputation among their neighbors.
Let’s consider a concrete example. Suppose Mark Johnson owns a store and he breaks the arm of Gary Owens, a customer. Owens proceeds to tell all his friends (and anyone else who will listen) that he was minding his own business when Johnson attacked him. Now in the standard view (and even to some extent that promoted by anarcho-capitalist writers), unless Owens belongs to a protection agency himself, he has no recourse.
But this is simply not true. It is bad for business if Owens runs around telling people he was brutally attacked, and if Johnson does nothing to rebut these charges. If people give any validity to Owens’ story, they will shop elsewhere. Even beyond the pecuniary aspects, if Johnson is at all a normal human being, he will feel uncomfortable at social events if people are whispering about the tale behind his back.
Consequently, Johnson will publicly invite Owens to bring his charges to any reputable judge who specializes in such cases. Now if Owens comes back and recommends that they take the case to his brother, Johnson will object that such a trial would be biased. But if Owens suggests several possible judges, all of whom are unrelated to the disputants and specialize in commercial theft and excessive force, and still Johnson refuses, then the community will give more credence to Owens’ claims of brutality. The point is that within a private legal system, there would be dozens of fair judges from which to choose; there would be no question on two honest disputants settling on one of them, and hence failure to do so would be interpreted as a sign of dishonesty.
EVIDENTIARY RULES, PRECEDENT, ETC.
Now once two parties (Johnson and Owens, in our example) agreed on a judge, he or she would presumably hear testimony, admit physical evidence, etc. according to rules and procedures that were designed to best promote the appearance of fairness and objectivity. After all, the one crucial asset a private judge would have is his or her reputation for unbiased rulings. In our fictitious case, Owens would probably be allowed to present medical records from the date of the alleged attack, while Johnson would submit the surveillance tapes if he had footage of Owens pocketing merchandise and then resisting when confronted.
When making his final decision, the judge would probably rely on precedent. He would probably say, “In other cases like this one, judges have found the store owner culpable of excessive force whenever…” and so on. We should realize that this reliance on precedent is not necessarily due to an abstract conception of ideal law, but also the result of the incentives faced by the judge. He wants future customers to bring cases before him, and they will be more likely to do so if his prior rulings are based on some type of judicial principles and are consistent with “reasonable” rulings made by other judges.
To see this point, imagine a ridiculous scenario. Suppose after hearing the evidence from both sides, the judge ponders for a moment and then announces, “I find in favor of the plaintiff, Mr. Gary Owens. Because of the unwarranted force used by the owner, I hereby declare that justice will be served only when Mr. Mark Johnson gives three hickeys to the plaintiff.” After such a ruling, this judge would likely go out of business.
APPEAL
Instead of the above ruling that would benefit neither party, suppose instead that the judge had ruled that Johnson owed Owens 50,000 ounces of gold. Johnson would surely object that this was ridiculous, and would refuse to comply. He would then appeal the ruling and demand that he and Owens bring the case before a different judge, who would “overturn” the prior ruling.
The incentives here would be similar to the situation that led to the first trial. Depending on how absurd the first ruling, the community would be more or less understanding of Johnson’s refusal to submit to the decision (even though he had agreed to do so beforehand). But once a judge had rendered a quite “reasonable” ruling, even if it had gone against Johnson, the store owner would eventually submit in order to put the issue behind him and get back to his business. As with someone who refused to go to trial at all, someone who continually appealed, especially after multiple rulings that were totally consistent with the prevailing legal norms, would be viewed with suspicion.
REFINEMENTS
The above examples serve to illustrate the fundamental basis of private law: individuals have disputes and want an expert, third party to render an opinion. Over time, of course, the free market would develop institutional refinements of this basic service.
Most obvious, people could arrange beforehand on the judge (or arbitrator) to be used in the event of a dispute. (For example, this could be specified in every contract, whether hiring an employee or renting an apartment.) The legal codes to be applied, the number of permissible appeals, etc. could all be specified beforehand, making it all the more suspicious if one of the parties violated these provisions after hearing the decision of the judge.
The other likely refinement would be the involvement of guarantors, or agencies that would vouch for individuals in the event that they were assessed large fines. Just as insurance companies presently pay catastrophic damages committed by their clients, so too would such agencies pay the fines if one of their clients were convicted, say, of bank robbery. In modern societies banks, large employers, real estate agents, etc. would all probably insist on dealing only with individuals who were represented by reputable agencies vouching for them.
OBJECTIONS
One major objection to such a system is that there wouldn’t be one uniform set of laws applicable to everyone. So what? If orthodox Jews want to have a rabbi apply the Mosaic Law to their disputes, while atheist libertarians want Stephan Kinsella to apply The Ethics of Liberty to their disputes, why shouldn’t they be allowed to do this? Yes, “bad laws” might be produced under anarchy, but people would not be subjected to them, or at least not nearly to the extent that they are forced to submit to bad government legislation. (In the same way, bad books will be produced under anarchy, but no one would be forced to read them.) In any event, under the government right now, there isn’t a uniform set of laws applied to everyone, so this objection is silly on its face.
Another common objection is that the rich could purchase rulings in a private court system. Again, this overlooks the rampant corruption in government courts. At least on the open market, future disputants could avoid judges accused of accepting bribes in the past. In contrast, under the State the only recourse against a corrupt judge is to hope that the voters remember (and care) and vote him or her out, or that the politicians appoint someone else.
Another typical concern is that my proposed system would work for “rational” people, but not for violent criminals. In an article such as this, I can only say that every action in a free society would be subject to the judicial process as I’ve described. I specifically constructed the example to include the use of force (rather than reneging on a debt contract, say) to illustrate the principles involved. Had Johnson hired a private security firm whose employees broke Owens’ arm, the situation would not be essentially altered. (Of course, Johnson would do well to patronize only reputable security firms that had a reputation for restraint when dealing with shoplifters.) This concern is related to the role (if any) of prisons in a free society, and here I do not have the space to deal with this fascinating subject (though I do so in my book ).
Finally, there is the allegation that I am somehow advocating legal positivism, i.e. that I am claiming any “law” that passes the profit-and-loss test is a good one. Nothing could be further from the truth; my ethical beliefs are informed by my Christian faith, and I am a firm believer in natural law. But in this article, I am describing not the content of the legal code(s) that would arise in a free market society, but rather the forces influencing their evolution. For those Randians who are tempted to email me and claim that there is one objective set of laws that any intelligent thinker can discover through ratiocination, I merely respond: Even if this were true, no government in history has yet achieved what you desire. Perhaps it is time to consider a different approach?
CONCLUSION
In closing, let me point out two real world examples of “private law” in action. First, there is the burgeoning arbitration industry. Just as millions of people opt for market-produced bottled water, despite the “free” government alternative, so too do millions of people resolve their disputes through private arbitration.
For another obvious example, consider the umpires and referees in professional sports. Despite the clichés, these “judges” have to be generally unbiased, because the owners of teams know that customers would stop watching games if they were rigged. Although die hard sports fans may still bitterly lament the horrible call back in 1978 (say) that cost their team victory, that’s just the point—you have to go back decades for most teams to remember such a travesty! And if anyone claimed that his football team had a losing record last season because of bad refs, everyone would know the guy was being absurd. Especially when it’s not their own team at stake, sports fans know and trust the integrity of their “judicial system.”
To argue for a private legal system is really just to argue against a government-imposed monopoly. In every other sector, the coercive approach fails, and there is nothing unique about law to change that conclusion.
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100년 정당을 자신하던 열린우리당이 생각난다
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아마 현재 각료 중에 유일하게 제 정신 갖고 있는 사람이다.
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출처: 일베
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법은 합법과 불법밖에 없어요. 부실이란 없어요.
그가 말한 부실이란 말은 불법이란 말을 곱게 표현한 것 뿐입니다.
그런데,말이란 때가 있는 법인데 그가 너무 늦게 그 말을 했어요.
만약 탄핵 당시 이 말을 했다면 반향은 엄청났을겁니다.
... 상황은 이미 끝났는데...하는 아쉬움이 남습니다만,
그래도 당시 당사자인 분이 용기있게 탄핵의 불법을 말했다는게 우리에게 힘을 줍니다.
사회 전반으로 이런 용기있는 분이 계속해서 나와야합니다.
조갑제티비
헌재 당시 공보관의 충격적 폭로-'박근혜 탄핵 심판은 졸속에 법치 훼손'
https://youtu.be/n4WwdOfu6E8
그가 말한 부실이란 말은 불법이란 말을 곱게 표현한 것 뿐입니다.
그런데,말이란 때가 있는 법인데 그가 너무 늦게 그 말을 했어요.
만약 탄핵 당시 이 말을 했다면 반향은 엄청났을겁니다.
... 상황은 이미 끝났는데...하는 아쉬움이 남습니다만,
그래도 당시 당사자인 분이 용기있게 탄핵의 불법을 말했다는게 우리에게 힘을 줍니다.
사회 전반으로 이런 용기있는 분이 계속해서 나와야합니다.
조갑제티비
헌재 당시 공보관의 충격적 폭로-'박근혜 탄핵 심판은 졸속에 법치 훼손'
https://youtu.be/n4WwdOfu6E8
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내각제 세력이 이제 꿈틀거리기 시작하는 것인가?
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배우들은 우리들에게 윤리학과 도덕에 대해 강의해서는 안된다.
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김순덕·이하경… 때 이른 배신인가 (정규재영상칼럼; 1월29일)
https://youtu.be/xoew_i-QD5A
---> 특히 동아에서 글을 쓴다는 김순덕이라는 여자는 정신적, 지적으로 좀 문제가 많아 보인다.
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张仲景寒热药共用组方探寻
引言:张仲景是中医方剂史上创制寒热药共用经典方剂的先师,笔者通过对其在《伤寒论》和《金匮要略》中以寒热药共用组成的方剂进行梳理、分析,发现有三种寒热药共用组方方法。
[转载]张仲景寒热药共用组方探寻寒热并治法
该法是针对疾病发生发展过程中表现为寒证和热证同时存在的寒热错杂证,需要寒热并治而采取的寒热药共用组方方法。其重要特点是:遣药组方时,药物的性味和功用全取。
寒热在表、里和半表半里
1.表寒里热证
例:《伤寒论》大青龙汤由麻黄、桂枝、炙甘草、杏仁、生姜、大枣、石膏组成。方中温热药麻黄、桂枝、生姜解表散寒,寒凉药石膏清热除烦。
2.表热里寒证
例:《金匮要略》竹叶汤由竹叶、葛根、防风、桔梗、人参、桂枝、附子组成。方中寒凉药竹叶、葛根发散风热,温热药桂枝、附子固护里阳。
3.半表半里兼表寒证
例:《伤寒论》柴胡桂枝汤由桂枝、黄芩、人参、甘草、半夏、芍药、大枣、生姜、柴胡组成。方中寒凉药柴胡、黄芩和解半表半里(少阳邪热),温热药桂枝发散风寒。
4.半表半里兼里寒证
例:《伤寒论》柴胡桂枝干姜汤由柴胡、桂枝、干姜、瓜蒌根、黄芩、牡蛎、甘草组成。方中寒凉药柴胡、黄芩和解半表半里(少阳邪热),温热药桂枝、干姜温里祛寒。
寒热在脏腑
1.脏寒腑热证
例:《金匮要略》苓甘五味加姜辛半杏大黄汤由茯苓、甘草、五味子、干姜、细辛、半夏、杏仁、大黄组成。方中温热药干姜、细辛、半夏温肺化饮,寒凉药大黄通利大便,泄胃热。
2.脏热腑寒证
例:《伤寒论》黄连汤由黄连、甘草、干姜、桂枝、人参、半夏、大枣组成。方中寒凉药黄连清心除烦,温热药干姜、桂枝温散胃寒。
寒热在同脏
例:《金匮要略》小青龙加石膏汤由麻黄、桂枝、芍药、细辛、甘草、干姜、五味子、半夏、石膏组成。方中温热药桂枝、细辛、干姜、半夏温肺化饮,寒凉药石膏清肺热(肺中寒饮郁热)。
寒热在同腑
例:《金匮要略》桔皮竹茹汤由桔皮、竹茹、大枣、生姜、甘草、人参组成。方中温热药生姜温胃阳,寒凉药竹茹清胃热(胃寒郁热)。
寒热在异脏
例:《伤寒论》栀子干姜汤由栀子、干姜两味药组成。方中寒凉药栀子清心除烦,温热药干姜温脾散寒。
寒热在异腑
例:《伤寒论》乌梅丸由乌梅、细辛、干姜、黄连、当归、附子、蜀椒、桂枝、人参、黄柏组成。方中寒凉药黄连、黄柏清胃火,温热药干姜、细辛、附子、桂枝、蜀椒温肠寒。
去性取用法
该法主要在治疗某些纯寒、纯热证时应用。即用大队温热药治疗寒证时,选用少量寒凉药于其中,则此药的寒性去,功用仍保留;用大队寒凉药治疗热证时,选用少量温热药于其中,则此药的热性去,功用仍保留的一种组方方法。其重要特点是:遣药组方时,对某些药物但取其功用,非取其性味。
例:1.《金匮要略》大黄附子汤由大黄、附子、细辛组成。方中温热药附子、细辛温阳散寒,寒凉药大黄为去性取用,即其寒性被附子、细辛之热性革除,保留其泻下通便之功用。
2.《金匮要略》瓜蒌薤白白酒汤由瓜蒌实、薤白、白酒组成。方中温热药薤白、白酒通阳豁痰,寒凉药瓜蒌实为去性取用,即其寒性被薤白、白酒之热性革除,保留其化痰散结之功用。
热药去性取用
例:1.《金匮要略》木防己汤由木防己、石膏、桂枝、人参组成。方中寒凉药石膏、木防己清热利湿,温热药桂枝为去性取用,即其热性被石膏、木防己之寒性革除,保留其通阳行水之功用。
2.《伤寒论》黄芩加半夏生姜汤由黄芩、芍药、甘草、大枣、半夏、生姜组成。方中寒凉药黄芩清热止利,温热药生姜、半夏为去性取用,即其热性被黄芩之寒性革除,保留其降逆止呕之功用。
张仲景是中医方剂史上创制寒热药共用经典方剂的先师,笔者通过对其在《伤寒论》和《金匮要略》中以寒热药共用组成的方剂进行梳理、分析,发现有三种寒热药共用组方方法。
反佐法
该法是指在治疗热证的寒剂中选加热性药,在治疗寒证的热剂中选加寒性药。这些加入的药物,主要是取其在方剂中发挥“性味”的作用,从反面协助诸药起相反相成之效的一种配伍方法。其重要特点是:遣药组方时,对某些药物但取其性味,非取其功用。
作引经之用
例:《伤寒论》通脉四逆加猪胆汁汤由甘草、干姜、附子、猪胆汁组成。方中热药附子、干姜逐寒回阳,猪胆汁苦寒作反佐,引阳药直达阴分。
作监制之用
例:《金匮要略》黄土汤由黄芩、附子、灶中黄土、干地黄、白术、阿胶、甘草组成。方中热药附子温中扶阳,黄芩苦寒作反佐,以监制附子刚燥之性。
行气之用
例:《金匮要略》薏苡附子败酱散由薏苡仁、附子、败酱草。方中寒性药薏苡仁、败酱草清热排脓消痈,微用附子作反佐,借其辛热而行郁滞之气。
作行血之用
例:《金匮要略》王不留行散由黄芩、蒴蓼叶、桑根白皮、王不留行、厚朴、芍药、甘草、干姜、川椒组成。方中黄芩、桑根白皮凉血止血,反佐干姜、川椒之温热而行血瘀。
作降下之用
例:《金匮要略》柏叶汤由柏叶、马通汁、干姜、艾叶组成。方中热药干姜、艾叶温中止血,反佐柏叶、马通汁之苦寒,使上溢之血抑之使降,引之使下,则妄行之血顺而能下,下而能守。
《破山寺后禪院》 常建
清晨入古寺,初日照高林。
曲徑通幽處,禪房花木深。
山光悅鳥性,潭影空人心。
萬籟此皆寂,惟聞鐘磬音。
【韻譯】:
清晨我信步來到破山寺,
朝陽映照著高高的樹林。
曲折山道通向幽靜處所,
禪房深藏之處花卉繽紛。
山光秀麗怡悅群鳥性情,
碧潭映影凈化人的心靈。
自然界的聲音全然消失,
只聽到院里的鐘磬聲音……
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冯世纶运用经方治疗慢性前列腺炎的经验作者:
冯师认为,慢性前列腺炎是指前列腺非特异性感染所致的慢性炎症,是20~40岁青壮年的常见病,具有起病缓慢、病情反复、缠绵难愈的特点。中医若能准确辨证论治,多有较好的疗效。
1、病因病机
中医认为本病病因病机为:或因纵欲不节或所愿不遂,气滞血瘀与相火灼伤精血,败精流注,而成精浊;或因体内湿热蕴积流注下焦或病后气弱阴虚,余邪引动下焦湿热,精室被扰;或因不洁性交,淫毒经生殖道逆行内侵,精室受犯,气机被遏,分清泌浊功能失调,精离其位,造成精浊等等。
冯师认为,本病病因病机复杂,从独特的经方理论来看,临床辨证不是从病因病机推理,而是分析临床症状得出辨证,从所辨之证中方中测得病机。前列腺炎的辨证亦是如此,即要详审其局部症状与全身症状,从客观的症状来进行六经八纲辨证,也就明确了具体的病因病机,继而细拟方药,则疗效多能满意。
2、辨证施治
2.1 猪苓汤方症
适应症特点:小便不利,尿时尿道灼热或涩痛,口干思饮,心烦失眠等,此证乍看是湿热下注,或肾阴虚相火旺,且黄柏、苦参、木通等苦寒清热利湿,又加以知母、地黄等滋阴补肾,则必致阳气、津伤而湿饮更盛。冯师认为此为病久津血阴液虚而水湿盛,治疗唯有用甘淡渗湿、养血生津之法,才能使邪去正复。药用:猪苓10g、茯苓15g、泽泻10g、阿胶10g,滑石12g。
2.2 桂枝龙骨牡蛎白薇附子汤合猪苓汤方症
适应症特点:小便不利,欲尿不尽,尿后或大便时尿道有蛋清样粘液溢出,时伴见必悸、盗汗、眠差、遗精、早泄等,用肾气丸治疗常无效,而用苦寒药治疗后常加重。冯师认为此为营卫不和,外寒内饮之证,病久精血虚而水饮盛,湿久郁而上扰致神明不安。治当调和营卫、益精养血兼以化饮敛神为法,药用:桂枝10g,白芍10g,生姜10g,大枣4枚,白薇12g,炙甘草6g,生龙骨15g,生牡蛎15g,川附子6g,猪苓10g,茯苓15g,阿胶10g,泽泻10g,滑石12g。
2.3 小建中汤方症
适应症特点:临床症状里轻时重,时多时少,常只见少腹拘紧或会阴隐痛,而不见小便不利等症。冯师认为此为里寒饮停,是小建中汤的适应症,着重温中化饮,药用:桂枝10g,白芍18g,炙甘草6g,大枣4枚,生姜10g,饴糖45g。
2.4 五苓散方症
适应症特点:小便不利,或尿频、尿急,或欲尿不尽,会阴不适,腰痛或身疼,口中和或口干不思饮,或饮水后胃脘不适,甚则呕吐等。在辨证过程中,若用肾气丸、六味地黄丸等补之,治疗应在解表的同时予以化饮,使表解饮去,局部症状和整体症状自然好转。药用:桂枝6g,茯苓10g,泽泻15g,白术10g,猪苓10g。
2.5 肾着汤方证
适应症特点:口中和或口干不欲饮,腰腹胀,滴白、小便不利及尿不尽,舌质淡、苔微白腻,脉沉细。冯师认为此为里虚寒之寒湿下注证。药用:茯苓15g,干姜15g,苍术15g,炙甘草10g。
2.6 其他方证
除以上方证外,临床还常遇寒湿痹阻、阳虚水气上犯的真武汤方证;邪郁半表半里、寒多微有热的柴胡桂枝干姜汤方证;血虚水盛的当归芍药散方证;上热下寒的甘草泻心汤方症;里虚外寒、气化不利的肾气丸方证;太少合病的柴胡桂枝汤方证;湿热下注的八正散方证,等等。有是证用是方,做到方药对证,慢性前列腺炎多能痊愈。
3、常用药物加减法
尿道溢液、滴白(前列腺液滴出)者,加生薏苡仁15g,川萆薢10g;乏力、腰痛明显者,加仙灵脾12g;盗汗明显者,加酸枣仁15g;尿痛者,加大黄(热痛明显)3g;小便涩痛者,加当归10g,赤小豆15g;会阴、睾丸坠胀者,加乌药6g,小茴香10g;尿频者,加桑螵硝10,并可适证加川楝子、五灵脂、吴茱萸等。
4、典型病例
张某,男,36岁,2007年7月21日初诊。患慢性前列炎多年,四处求医反复不愈。自诉小腹部疼痛连及睾丸,伴早泄,腰部及左膝困痛,下身畏凉,每日夜尿3次左右,大便溏薄。素有胃部冷痛,畏风,耳鸣,小便灼热,口干略苦。近日晨志喉中有黄痰,舌淡胖苔黄厚腻,脉弦细数。辨证属邪郁半表半里,寒饮内停,血虚水盛。治以和解半表半里、温化寒饮、活血利水为法。药用柴胡桂枝干姜汤合当归芍药散加味:柴胡12g,黄芩10g,花粉12g,生龙牡各15g,桂枝10g,干姜6g,白芍10g,当归10g,川芎6g,茯苓12g,泽泻12g,炙甘草6g,车前子(包)15g,小茴香10g。5剂,每日1剂,水煎服。5剂后,腰部困痛、小腹胀痛减轻,口干苦、小便灼热感基本消失,夜尿1~2次,喉中仍有痰。继服上方加减治疗1月余,诸症消失。
按:慢性前列腺炎临床症状复杂,治疗时必须辨证施治,方与证应方可取效。冯师主张辨证施方,而不囿于固定方,一味地补肾壮阳或益肾填精。本例患者的方证关键在于肢体冷痛,口干或苦,心下微结,表现为上热下寒,寒多热少之征,符合柴胡桂枝汤方证的邪郁半表半里偏寒的特点;另所表现的耳鸣、腹痛拘急、小便不利、大便溏薄、舌淡胖,脉细乃为血虚水盛之征,合当归芍药散证,故以补血活血利水法,方证对应,故收捷效。
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