파면 팔수록 악취가 진동하는 인간 김기식

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손병호

[김기식 검찰수사 결정]

드디어 김기식을 검찰에서 정식으로 수사하게 됐습니다.

보수성향의 시민단체인 “정의로운 시민연대“가 김기식을 특정범죄 가중처벌법상 뇌물,직권남용,등으로 고발했고,
자유한국당도 뇌물수수혐의로 각각 중앙지검에 고발했는데, 대검은 남부지검에 수사를 배정했습니다.
수사는 남부지검 형사6부 김종오 부장검사가 담당하는군요.

상급기관이 수사를 배정하는 것은 수사명령입니다.
드디어 김기식은 정식으로 특정범죄 가중처벌법상 뇌물죄와 직권남용죄로 수사를 받아야합니다.

공직자가 이지경이 되면 금융감독원장직에서 사임해야하는데, 임명권자도 게기고
수사 피의자도 게기는군요,사실 저러는게 좌빨의 민낯입니다.

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배진영

김기식 금융감독원장이 과거 더미래연구소 운영위원장 시절 기업들로부터 고액의 수강료를 받으며 운영했다는 논란이 제기된 ‘미래리더아카데미’ 강사진에 청와대 장하성 정책실장, 조국 민정수석 등이 포함된 것으로 드러났다.
박근혜 전 대통령에게 징역 24년을 선고한 논리대로라면, 김기식은 뇌물죄로 다스려야 하고, 정하성과 조국은 김기식과 ‘경제공동체’, 즉 공범이 되어야 하는 것 아닌가?

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자본가들의 도덕적 실천이 사람들에게 준 것은 무엇이냐고 물으면, 우리는 그것은 바로 사람들의 생명이라고 대답할 수 있다. 사회주의자들은 이전에 스스로 자급자족하던 프롤레타리아를 자본가들이 착취했다고 주장하지만, 그건 완전한 허구이다. 프롤레타리아 대부분은 자본가들이 나타나 그들에게 생존의 수단을 제공해 주지 않았다면, 살아날 수 없었다.
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우리는 인구의 증가가 절대적으로 선하다고 주장하는 게 아니다. 단지 특정한 규범을 추종하는 특정한 집단의 인구 증가가 이들 집단의 자연선택에 이르게 되었고, 이들의 우위가 또 다시 더 많은 인구 증가의 원인이 되었다는 사실을 말하는 것이다.
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시장 경제가 그 기본 규범을 채용한 집단을 다른 집단보다 더 번성하게 함으로써 여타의 질서를 압도했다면, 시장 가치에서의 계산은 결국 생명의 계산이 된다. 다시 말해, 그것이 그들의 의도는 아니었지만, 이런 계산에 인도된 사람들은 그들의 인구를 증가시키는 일을 한 셈이다.
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페이스북을 규제하지 말라. 그건 바로 저커버그가 원하는 바이다.

 

더 많은 경쟁이 우리가 원하는 것이라면, 우리는 시장의 문턱을 낮춰야 하고, 정부의 규제는 폐지하거나 최소화 해야 한다. 또 소비자들은 그들이 원하는 기업의 서비스를 자유롭게 선택할 수 있어야 한다.

규제는 새 직업을 얻는 정부 관료와 인기를 얻는 정치가, 그리고 현재 시장의 주도적인 기업이 이익을 얻는다.

정부의 규제는 경쟁과 소비자의 기호에 맞추려는 동기를 모두 낮춤으로써, 소비자 주권을 감소시킨다.

저커버그가 새로운 규제를 환영한다고 한 말은 진심이었다. 새로운 규제는 경쟁자들을 물리칠 수 있는 가장 쉬운 방법 중의 하나이다.

 

Don't Regulate Facebook — That's What Zuckerberg Wants

 

 

•Ryan McMaken

 

 

If Facebook disappeared forever this afternoon, I wouldn't exactly be upset about it. I'm astounded when I see people post loads of personal information on the site, including posts about all their travel plans, their shopping habits, their daily routines, and their family members. Long is the list of people who have been harassed by law enforcement agencies or "child welfare" agencies in response to something they said or did on Facebook. And, given what we know about Big Tech's willingness to collaborate with government agencies, people who are fond of posting their every move in Facebook might as well hand over their daily itineraries to the FBI.

 

Similar problems exist with other tech platforms as well, from Twitter to Google.

 

However, there is a fairly easy way to minimize the amount of information Facebook and other platforms collect on the user. The user can stop using the platform, or at least stop using it so often. Unlike the state, which is free to mandate that people use their "services," consumers are still free to not use Facebook.

 

Also, it is still the case that producers are free to create new firms that will compete with Facebook. And many have done so. Recent data suggests that Facebook users are spending less time on Facebook, and younger users are preferring to spend their time elsewhere. Facebook is expected to actually lose users in the under-25 category this year. Some will keep using Facebook-owned Instagram, but many will go to services not owned by Facebook, such as Snapchat.

 

For whatever reason, whether it's increased competition or a decline in social media use overall, Facebook is not bulletproof, and it is facing competition from others. True, none of Facebook's competitors are just like Facebook. But that's how competition works. Other firms offer a choice for consumers, and offer different products.

 

After all, we've already seen firms like Facebook be beat by competition in the past. Remember MySpace? It was once bigger than Facebook. And now it's not.

 

If consumers want to use social media platforms that aren't Facebook, and which offer different choices, the answer lies in greater competition. But, if greater competition is what we want, barriers to entry must be kept low, government regulations must be abolished or minimized, and consumers must be free to use or not use firms as they please. So long as this is the case, Facebook will never have a true monopoly. Consumer preferences can always change. And sometimes they change drastically.

 

Get Ready for More Regulation

 

Unfortunately, this week's Congressional hearings with Facebook founder Mark Zuckerberg suggest that things are going in a direction that will only end with increasing whatever monopoly power Facebook currently has. Washington politicians are interested in regulating the social media world, and ultimately, this will only strengthen the big firms that dominate the industry now — while making things harder for smaller start-ups and future competitors.

 

Oh sure, politicians are making a big show of how concerned they are about everyone's privacy, although it is embarassingly obvious that the elderly and out-of-touch-with-reality members of the Senate have no idea how social media works. What most they could do was read questions written for them by staff and try to understand Zuckerberg's answers.

 

(These people, by the way, will be the ones voting on any future legislation that regulates social media.)

 

But even if members of Congress had a wonderful grasp of the internet and social media, would anyone benefit from any new regulations on the industry?

 

Well, yes, of course some people would benefit. Those who would benefit include the government agents who will get jobs as regulators, the politicians who can score political points for passing new legislation, and the large incumbent firms that now dominate the social-media market.

 

Dominant Firms Want Regulation

 

It should not surprise us, then, that even before he testified to Congress, Mark Zuckerberg was calling for his own industry to be regulated:

 

Facebook chief executive Mark Zuckerberg said on Wednesday that he’s open to having his company be regulated.

 

“Actually, I’m not sure we shouldn’t be regulated,” Zuckerberg said in an interview...I actually think the question is more ‘What is the right regulation?’ rather than ‘Yes or no, should it be regulated?’” Zuckerberg told CNN.

 

But why so open to regulation? Zuckerberg cleared this up himself in one of his answers to questions from members of Congress:

 

I think a lot of times regulation puts in place rules that a large company like ours can easily comply with but that small start-ups can't," Zuckerberg said as he testified for the second consecutive day on Capitol Hill.

 

Indeed.

 

Government regulations such as minimum wages and financial mandates are especially burdensome on small firms because small firms have less access to capital and enjoy fewer benefits of economies of scale.

 

It's far easier for a firm like Walmart, for instance, to pay higher wages than for a small start-up. And, should the economy fall on hard times, higher costs can be weathered better by large firms that can borrow large amounts to get through a crisis. Small firms have far less borrowing power.

 

One example of this can be seen in the decline of small banks in the wake of the new banking regulations found in the Dodd-Frank legislation. Compliance costs created by the new legislation have led to fewer small firms, fewer start-ups, and fewer community banks. Huge financial institutions have benefited greatly from additional legislation. Market share for small firms, meanwhile, is being destroyed.

 

These barriers to both entry and survival for small firms, end up destroying competition. Per Bylund notes:

 

Regulated markets are different from open, free markets in that they have artificial barriers to entry: they redistribute costs of business to protect some incumbent firms by forcing the cost on (some) entrants. In other words, there are fewer new businesses and thus less competition.

 

Moreover, this decline in competition then means that the surviving large firms can afford to be less responsive to the desires of consumers. Efforts to reduce prices also fall by the wayside and competition wanes. Bylund continues:

 

Under interventionism, businesses do not always need to discover accurate consumer prices because the threat from new entrepreneurs entering the market is smaller than it otherwise would have been.

 

In other words, government regulations diminish consumer sovereignty by reducing both competition and thus the incentive to stay in tuned with what consumers want.

 

Dominant Firms Control the Regulators

 

The other great danger in regulation exists in the fact that regulatory bodies have a tendency to be taken over by the large dominant firms themselves.

 

This is a common occurrence in regulatory schemes and is known as “regulatory capture.” When new regulatory bodies are created to regulate firms like Facebook and other dominant firms, the institutions with the most at stake in a regulatory agency’s decisions end up controlling the agencies themselves. We see this all the time in the revolving door between legislators, regulators, and lobbyists. And you can also be sure that once this happens, the industry will close itself off to new innovative firms seeking to enter the marketplace. The regulatory agencies will ensure the health of the status quo providers at the cost of new entrepreneurs and new competitors.

 

Moreover, as economist Douglass North noted, regulatory regimes do not improve efficiency, but serve the interests of those with political power: "Institutions are not necessarily or even usually created to be socially efficient; rather they, or at least the formal rules, are created to serve the interests of those with the bargaining power to create new rules."

 

After all, how much incentive does the average person have in monitoring new regulations, staying in touch with regulators, and attempting to affect the regulatory process? The incentive is almost zero. The incentive for regulated firms, on the other hand, is quite large.

 

So, once Congress begins its process of regulating social media firms, you can be sure that Facebook and the other major firms involved will be at the table, and will be key in writing the legislation, and in guiding it through the legislative process. And why wouldn't they be allowed to be closely involved? As The Verge has already shown, Facebook freely writes checks to members of Congress as "political donations." And once the new regulatory bodies have been created, Facebook will be involved every step of the way, from selecting regulators, to writing new regulatory rules.

 

Needless to say, it won't exactly be a priority for Facebook to make sure that start-ups and other small firms get a fair shake at slicing off a piece of Facebook's market share.

 

Mark Zuckerberg isn't pandering when he says that he welcomes new regulations from Congress. He doesn't want Facebook to end up like MySpace, and new regulations are among the easiest ways to crush the competition.

 

 

Ryan McMaken (@ryanmcmaken) is the editor of Mises Wire and The Austrian.

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한겨레/
[단독] “북, 비핵화 대가 5개안 미국에 제시했다” 
 
2018-04-13 05:05
 
[한겨레] 정상회담 실무접촉에서 요구 

 ① 미국 핵 전략자산 한국 철수

② 한·미 전략자산 훈련 중지

③ 재래식·  핵무기 공격 포기

④ 평화협정 체결 ⑤ 북·미 수교

[출처] 기사/ 미국 평화협정 체결, 북미 수교 긍정 검토중/

어쩌면 우리는 최악의 상황을 예상해야 할지도 모른다.
[변희재의 시사폭격] 문재인과 김정은, 주한미군 무력화 통해 스스로 철수하도록 유도


https://youtu.be/Af5pWPXa3oA

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권력 집중화를 찬성하는 유일한 사람들은 로비스트, 관료들 그리고 수도 워싱턴의 기생충들이다.
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과학은 증명이 아닌 '반증'(falsification) 위에 기초해 있다. 이런 사실을 잊으면 과학주의의 오만에 빠지게 된다.
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로컬리즘의 실천으로 정치적 좌우를 넘어서다.
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암의 통증을 어떻게 치료하나?
대황부자탕으로 암의 통증을 치료했다는 경험담


我们都认为，西医是治疗急症的医学。那么，对于疼痛急症，用西医西药一定都有不错的效果了吧。事实上，你相信吗？这次我们以肿瘤疼痛为例，来看看西医是如何治疗急症的。同时我也提供中医（包括针灸）治疗肿瘤疼痛的方法，两个对比一下，临床再试用一下，读者可以自己体会。肿瘤疼痛是临床一大难题。病人本来因患肿瘤而心理压力极大，兼之又伴有剧烈的疼痛，心身皆极是痛苦。对于此，西医也苦于无法可施，不得已只好求助于吗啡、杜冷丁等强力镇静麻醉剂。虽然此类药物有不错的临时止痛效果，但药效一过，疼痛又会复发，且此类药物伴随有巨大的毒副作用，如此也让临床医生颇伤脑筋。我的朋友告诉我，她的家人胃癌疼痛不止，西医给一天打了三次止痛针，一直到病人休克。我相信，所有的肿瘤病人都不想反复应用吗啡，都希望能找到一种自然疗法，不损伤健康而能取得止痛效果，而且如果能保证持续的疗效，将是最为理想的结果。那么，中医有办法吗？当然有。
对于肿瘤疼痛，不要一味地相信吗啡了，求诸中医吧。通过多年的临床经验，我可以保证中医不会让这样的病人失望的，即使是肿瘤晚期引起的剧烈疼痛，中医一样可以帮助止痛。传统中医对于治疗周身的各种疼痛有着丰富的经验和神奇的疗效，不但是治疗一般性的头痛、胃痛、关节痛、腰痛等疗效不错，即使于对于肿瘤疼痛亦显出极强的疗效，比西药具有更强的优势。现在肿瘤病人分布在各地，都来寻医也不现实，那么，能不能不通过辨证，就有合适的止痛处方呢？当然有，我这里就提供一个可以帮助肿瘤患者止痛的方子。
东汉有一位伟大的中医学家，叫张仲景，他写了本书《伤寒杂病论》，被认为是中医临床的经验。其中提供了一个方子——大黄附子汤，这个方子即有不错的镇痛效果。请听我为大家慢慢地分解此方。大黄附子汤以大黄、附子、细辛组成，是一首温下之剂，原书主治寒实内结之肋下偏痛。功能温经散寒，通便止痛。虽然仲景用本方治疗的病证仅此一条，但我们如果能透过条文，认真地分析一下本书，可以发现此方有极大的其他功效。本方中大黄苦寒，能攻实荡热，但与辛温大热的附子相配合后即改寒下的作用为温下的作用，因此能攻内结之实寒，再加细辛之温经散寒，更增强了去除寒邪的作用。因此，本方为驱冷除实寒的温下之剂。
肿瘤为什么会引起疼痛呢？我们要先分析一下肿瘤的成因。
我们知道，肿瘤是寒凝痰结瘀滞而形成的，但肿瘤的形成不是随意的，它需要一个三阴体质。也就是需要一个导致肿瘤的环境，这个环境要偏于虚寒，要气血瘀滞一些，还要阴寒内盛一些，还要有情志因素引起的肝气郁结。如此环境下，久之才可能形成肿瘤。其中七情不畅是一个极为重要的原因。所以，肿瘤一般都会气血运行不畅，“不通则痛”。按六经理论来看，肿瘤其本是三阴证，而其标为阳明证，要攻下始可止痛。
通过以上分析，大黄附子汤温下寒结，不正是攻逐肿瘤，活血通络止痛的一首方便处方嘛。按仲景所说，此方是治疗“肋下偏痛，发热脉弦紧，此寒也。”但除此以外，本方在临床上的运用极为范围，不仅治疗右肋下疼痛，如现代医学的胆囊炎以及胆道的一部分功能性疾患，而且还可以治疗一切因为阴寒内盛所导致的疼痛疾患。因为大黄附子汤寒热并用，既有驱逐寒邪的作用，又有清热荡实的作用。肿瘤虽然多属于三阴体质，但表现为颇多的热象，是属于寒热实结之邪为患，此方正好治之。所以临床疗效相当不错。
据日本《皇汉医学》载：“此方实能治偏痛，然不特偏痛已也。亦能治寒疝，胸腹绞痛延及心胸腰脚。阴囊焮肿，腹中时时有水声，而恶寒甚者。若拘挛剧者，合芍药甘草汤。如上所云，不仅治偏痛，亦能治两侧肋下及腰腹痛。故不可拘泥于偏痛二字也。”我用此方治疗周身各种疼痛，特别是剧烈疼痛，如牙痛、胃肠绞痛、肾痛等，都收到药到痛除之效。诚如古人所言，其效之来，如风来吹云，明乎若见苍天。其方：制附片30克，细辛30克，生大黄30克。一付，水煎服，日一剂。可以久煎两小时。我治肿瘤疼痛的经验是：不论是年轻还是老高，也不管是新病久病，不论其疼痛性质是刺痛、钝痛、钻痛或者隐痛，都以此方治之，绝大部分患者都可以马上获效。如果病人热象较为明显，可以加生石膏30-60克，以监制附子之热性，使其寒热平调，而收良效。服此方后，如果大便略稀，可不必在意，继续服此方数剂，至疼痛消失即可停药。若疼痛再发作，即再服，勿虑。若大便泻下而日超过五次，可加山药30克，以健运脾气。或者暂停服药亦可。或病人因体虚而不耐其泻，亦可略为变方。如下：生石膏30克，细辛30克。一付，水煎服。或者上药研成极细末，每次三克，温水冲服，日两次。此方亦走少阴阳明。药简而力不减，用于肿瘤疼痛，确有不错的效果。用中医的方法我治疗了不少晚期肿瘤患者，大抵都取得了相当不错的疗效。病人的疼痛很快地得到控制，而且诸症渐渐好转。虽然有些病患最终归于不治，但在存活的期间没有剧烈的疼痛。
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상한론의 설사를 치료하는 10가지 방법

以下十条为转载，来自网络。《伤寒论》涉及下利的条文90余条，现将主要治法总结出10种，列举如下。

一、表里双解法
32条,“太阳阳明合病，必自下利，葛根汤主之”，以疏解二阳经表之邪，表解里和，下利证自愈。
34条，“太阳病，桂枝证，医反下之，利遂不止，脉促者……葛根黄芩黄连汤主之”。
163条，“太阳病，外证未除而数下之，遂协热而利，利下不止，心下痞硬、表里不解者，桂枝人参汤主之”。

二、健脾除痞法
158条，“伤寒中风、医反下之，其人下利日数十行，谷不化腹中雷鸣，心下痞硬满，干呕心烦不得安……甘草泻心汤主之”。
157条，“伤寒汗出解之后，胃中不和，心下痞硬，干噎食臭，胁下有水气，腹中雷鸣下利者，生姜泻心汤主之”。

三、泻热通滞法
256条，“阳明少阳合病，必下利……脉滑而数者，有宿食也，当下之，宜大承气汤”。
321条，“少阴病自利清水、色纯青，心下必痛、口干燥者可下之，宜大承气汤”。
374条，“厥阴下利沾语者，有燥屎也，宜大承气汤”。

四、刺灸壮阳法
308条，“少阴并，下利便脓血者，可刺。拟选关元、天枢、脾俞”。
292条，“少阴病，吐利……脉不至者，灸少阴七壮”。
325条，“少阴病，下利脉微涩、呕而汗出，必数更衣……反小者，当温其上，灸之”。
362条，“下利，手足厥冷，无脉者，灸之”。

五、清热解毒法
172条，“太阳与少阳合病，自下利者，与黄芩汤”。
371条，“热利下重者”。
373条，“下利欲饮水者，以有热故也”。
258条，“脉数不解，必协热便脓血”。可用白头翁汤主治。

六、温健固涩法
159条，“伤寒服汤药，下利不止，心下痞硬，服泻心汤已，复以他药下之利不止，医以理中与之，利益甚。理中者，理中焦，必利在下焦，赤石脂禹粮汤主之；复利不止者，当利其小便”。

七、涤水逐饮法
316条，“少阴病，二三日不已，至四五日，腹痛，小便不利，四肢沉重疼痛，自下利者，……真武汤主之，咳而呕渴心烦不得眠，猪苓汤主之”。

八、温里回阳法
354条，“大汗，若大下利而厥冷者，四逆汤主之”。
91条，“伤寒，医下之，续得下利清谷不止，身疼痛，急当救里，宜四逆汤”。
370条，“下利清谷、里寒外热、汗出而厥，通脉四逆汤主之”。
314条，“少阴病、下利、白通汤主之”。

九、疏达阳郁法
318条，“少阴病、四逆，其人或咳，或悸，或小便不利，或腹中疼，或泄利下重者，四逆散主之”。

十、温清并施法
338条，“消渴气上撞心，心中痛热，饥而不欲食，食则吐蛔，下之利不止，久利，乌梅丸主之”。
357条，“伤寒、六七日，大下后，寸脉沉而迟，手足厥逆，下部脉不至，喉咽不利，唯脓血，泄利不止者，为治，麻黄升麻汤主之”。

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상한론의 기색(氣色)  모음


1.  风温病，若被火者，微发黄色。  2。  太阳病，桂麻各半汤证之面色反有热色者，未欲解也，以其不得小汗出，身必痒。    3. 设面色缘缘正赤者，阳气怫郁在表，当解之熏之。    4.太阳病中风，以火劫发汗。邪风被火热，血气流溢，失其常度。两阳相熏灼，其身发黄。   5.太阳病，身黄，脉沉结，少腹硬，小便不利者，为无血也。小便自利，其人如狂者，血证谛也，抵当汤主之。6.  伤寒七八日，身黄如橘子色，小便不利，腹微满者，茵陈蒿汤主之。7.伤寒身黄，发热，栀子柏皮汤主之。 8.伤寒淤热在里，身必发黄。（身黄如橘子色）伤寒发汗已，身目为黄，所以然者，以寒湿在里不解故也。以为不可下也，于寒湿中求之。   9.阳明中风，脉弦浮大而短气，腹都满，胁下及心痛，久按之气不通，鼻干，不得汗，嗜卧一身及目释黄，小便难，有潮热，试试哕，耳前后肿，刺之少差。为不解，病过十余日，脉续浮者，与小柴胡汤。    10.通脉四逆汤证之身反不恶寒，其人面色赤。     11。鼻头色青，腹中痛，苦冷者死；（注：大乌头煎或可服。）鼻头色微黑者，有水气；色黄者，胸上有寒；色白者，亡血也。设微赤非时者，死。其目正圆者痉，不治。又色青者为痛，色黑为劳，色赤为风，色黄者便难，色鲜明者有留饮。    12.唇口青，身冷为入藏，即死。    13.病者身热足寒，颈项强急，恶寒，时头热，面赤目赤，独头动摇，卒口噤，背反张者，痉病也。    ·14.湿家病身疼发热，面黄而喘----      15.狐惑病之，其面目一会赤一会黑一会白。    16.男子面色薄者，（注：青白或青灰）。主渴及亡血。卒喘悸，脉浮者，里虚也。   17.男子脉虚沉弦，无寒热，短气里急，小便不利，面色白，时目瞑，兼鼻血，少腹满，此为劳使之然。20。大黄庶虫丸之肌肤甲错，两目黯黑。21.病者面色痿黄，躁而不渴，胸中寒实而利不止者死。22.心伤者，其人劳倦，即头面赤而下重，心中痛而自烦，发热，绕齐跳，其脉弦，此为心脏伤所致也。23.膈间支饮，其人喘满，心下痞坚，面色黧黑，目防巳汤主之。24.---若面热如醉状，此为胃热冲其面，加大黄以利之。21.里水者，一身面目黄肿，其脉沉，越婢加术汤主之。25.唇痿舌青之淤血证。26.女劳疸之额上黑。27.酒疸下之，久久为黑疸，目青面黑，虽黑微黄。28.产后中风，发热，面正赤，喘而头痛，竹叶汤主之。 
상한론에서 환자의 얼굴 상태를 묘사한 부분만 모아 놓았다. 저런 글을 잘 외워두면, 환자를 진찰할 때 큰 도움이 된다.
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눈, 입, 생식기 종합증(여성)


일반적으로 감초사심탕으로 치료한다. 여기에서는 감초사심탕과 당귀패모고삼탕을 가감해서 치료하고 있다.
【案例追踪】陈某，女，24岁，2月10日初诊。自述患外阴溃疡反复发作已一年，近一周复发，伴脘痞，恶心纳差，眼红干涩，肠鸣，大便时干时稀；舌红苔白，脉细。











 【处方1】：法半夏10克，黄连6克，黄芩10克，干姜6克，炙甘草12克，党参15克，炒白术12克，土茯苓30克，陈皮10克，苦参30克，当归12克，浙贝10克，地榆30克，大枣10克。7剂，水煎服。
处方2：苦参30克，黄柏30克，甘草10克。7剂，水煎坐浴。
　　二诊时患者上述症状略有减轻，但时有盗汗，舌脉同上，守上方加黄芪30克，穿山龙30克。三诊时患者自述外阴溃疡已不复发，其余症状明显改善，守上方以巩固疗效。
　　综观患者之脉证，成肇仁老师诊断为“狐惑病”。“狐惑”一病，首见于《金匮要略》，以目赤干涩疼痛，口腔、咽喉以及前阴、后阴腐蚀溃烂为主要特征。湿热蕴毒生虫、蚀于上下，“蚀于喉为惑，蚀于阴为狐”。

     西医谓之“眼-口-生殖器综合征”或“白塞综合征”。除“狐惑病”外，患者尚见脘痞，恶心纳差，肠鸣，大便时干时稀，此为脾胃虚而不运之象，故成肇仁老师治从脾胃，复其升降之识，则一身之水火既济、阴阳调和，取张仲景之甘草泻心汤和当归贝母苦参汤加减。

    【方解】方中用黄芩、黄连苦寒，清热解毒；干姜、半夏辛燥化湿；佐参、芪、枣、术、陈、甘草以和胃扶正；苦参、当归、贝母养血润燥，清热燥湿，加用土茯苓既健脾胃又解毒化湿，搜剔湿热之蕴毒；妙在加用地榆、穿山龙，取其解毒敛疮，助溃疡之愈合之功。全方清热化湿，安中解毒，加用外洗药，内外同治，药症相应，

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반하후박탕 경험 소결 小結

半夏厚朴汤出自《金匮要略•妇人杂病脉证并治》：“妇人咽中如有炙脔，半夏厚朴汤主之。”
半夏一升 厚朴三两 茯苓四两 生姜五两 干苏叶二两
上五味，以水七升，煮取四升，分温四服，日三夜一服。

       我们从原文看会产生以下两个疑问：
                1， 半夏厚朴汤治疗“咽中如有炙脔”，那么“咽中如有炙脔”是什么症状？
                2， 半夏厚朴汤为何出现在妇人杂病篇？

      所谓“咽中如有炙脔”，即《千金要方》中所说的：“胸满，心下坚，咽中帖帖如有炙脔，吐之不出，吞之不下”。《医宗金鉴》称之为梅核气。此证主要是咽喉的异物感，咽痒、咽痛，咳嗽等不适，甚至由此引起胸闷、失眠等。
“咽中如有炙脔”的症状可以是器质性的，如喉源性咳嗽，喉炎，咽中就会有这种不适的感觉。并伴有干咳频频，痰少，色白，稍有刺激便引起咳嗽，讲话吸气时，吸入冷空气或者粉尘时，睡眠醒来时，皆会引发咳嗽。
    当然“咽中如有炙脔”也可以是精神因素引起的。患者老是觉得咽中如有物阻，肢冷，并伴有不同程度的焦虑、抑郁、失眠的症状，而这样的症状多见于妇人，所以半夏厚朴汤出现在妇人杂病篇就不足为奇了。
    《局方》称半夏厚朴汤为“四七汤”或叫“七气汤”，谓可治七气（寒、热、喜、怒、忧、愁、愤）。可见，此方是治疗精神症状的效方。

二

     半夏厚朴汤之所以可以治疗上述症状，其关键在于半夏。此方用半夏一升，在仲景使用半夏的诸方中算是次大量的方（最大量是大半夏汤，用半夏二升）。

    下面请看半夏的药证：

               1， 利咽

     试看仲景的以下两方，第312条：“少阴病，咽中伤，生疮，不能语言，声不出者，苦酒汤主之。”第313条：“少阴病，咽中痛，半夏散及汤主之。”

     这两方都是仲景治疗咽痛，咽中溃烂的。

     仲景用半夏皆为生半夏，看这两个方的煎煮法；只是将半夏＂洗＂去粘潺后，煮三沸，只煮三沸，半夏尚未全熟，所以仲景所用的半夏并不是今天所用的，制得性味全无的法夏。半夏治疗咽痛，咽中溃烂，可能主要就是靠半夏对咽喉局部粘膜的刺激，以达去腐生新的作用，由何得知？试看两方的服法，苦酒汤是“少少含咽之”，半夏散及汤是“少少咽之”，这样做就是要延长药物在咽喉的停留时间。当然这两个方证的＂咽中伤，生疮＂并非一般之咽喉红肿，要求半夏的作用也与其他方用半夏不同，因此煎法不同。

     除了上述几个方，麦门冬汤“大逆上气，咽喉不利”，此方中的半夏也有利咽的意思。

     由此可见，半夏厚朴汤也是治疗咳嗽、咽痛的效方。此方也是服四次，日三夜一服，估计也是要增加药物对咽喉局部的作用时间。所以，黄仕沛老师用半夏厚朴汤治疗喉源性咳嗽时，也常嘱患者含咽之。

                 2， 止呕

      半夏多配姜以止呕，如小半夏汤、大半夏汤、生姜半夏汤、半夏干姜散等。

                  3， 治疗痰饮

       小青龙汤、射干麻黄汤、厚朴麻黄汤、越婢加半夏汤。

                4，安眠

       《内经》半夏秫米汤。《灵枢•邪客》篇治“目不瞑”：“饮以半夏汤一剂，阴阳已通，其卧立至……其汤方以流水千里以外者八升，扬之万遍，取其清五升，煮之，炊以苇薪火，沸至秫米一升，治半夏五合，徐炊，令竭为一升半，去其滓，饮汁一小杯，日三稍益，以知为度，故其病新发者，复杯则卧，汗出则已矣，久者，三饮而已也。”

       《吴鞠通医案》亦载有多例不寐，用此方取效。

       再看仲景以下两个含咽半夏的方，都是治疗失眠和其他一些精神症状的。甘草泻心汤，“狐惑之为病，状如伤寒，默默欲眠，目不得闭，卧起不安”；柴胡加龙骨牡蛎汤“胸满烦惊，小便不利，谵语，一身尽重，不可转侧”，柴胡加龙骨牡蛎汤证主要是焦虑抑郁的表现，这样的患者也必定有失眠。

      由此进一步证实，半夏厚朴汤中的“咽中如有炙脔”，除了器质性的情况外，也可能是一种有精神心理因素引起的症状。

       黄仕沛老师用半夏治疗失眠，半夏多用至45g-60g。

三

     半夏厚朴汤用于治热象不显的喉源性咳嗽，黄仕沛老师多配合桔梗汤和诃黎勒散治疗。《伤寒论》第311条：“少阴病二三日，咽痛者，可与甘草汤；不差者，与桔梗汤”。仲师的诃黎勒散是治疗下利的“气利，诃黎勒散主之。”黄仕沛老师以诃黎勒散治疗咳嗽，主要源于刘河间《宣明论方》的诃子散，此方便是甘桔汤加诃子，治咽痛声瘖，失音不能言语。《丹溪心法》中又有诃子散（诃子、甘草、桔梗、木通），治咳嗽，声不出。

     黄仕沛老师常规以半夏泻心汤加诃子、甘草、桔梗。治咽源性咳嗽。咽源性咳嗽者，热象不显，干咳频频，痰少，说话，迎风，或在空调机前其咳便作。很多久咳不愈，误为支气管炎者，往往用上方服一两剂便应手而愈。

     半夏厚朴的咳嗽，也可以看作是温病之凉燥，温病凉燥用杏苏散，《内经》曰：“燥淫所胜，治以苦温，佐以甘辛。”杏苏散可能就是从半夏厚朴汤演变过来的。

     黄仕沛老师曾治一老干部，干咳月余，一日过访友人家时，咳嗽发作，顿时气绝昏厥，一两分钟才苏醒。次日在家，咳嗽又作，再度昏厥。后黄师以上方三剂而愈。

     又曾治一法国回来的侨领，某中央领导后天要接见她，但她恰值干咳十多天不愈，假若领导面前频频咳嗽，岂不尴尬？求之于黄师，两剂果愈，如期顺利会晤首长。

四

      半夏厚朴汤除了可以治疗喉源性咳嗽以及抑郁焦虑症状外，还可以治疗胃食管反流引起的泛酸，咽喉不适，胃脘胀满，呕吐等症状，此外还可以治疗吞咽困难。

      黄仕沛老师又曾以半夏厚朴汤合泽泻汤治疗一个“小儿增殖腺肥大”的9岁小孩。该患儿体胖，3个月前曾因发热鼻塞，流涕后，便常鼻塞张口呼吸，间有睡眠呼吸暂停，影响睡眠。经五官科诊断为“增殖腺肥大”，并建议手术治疗。后延治于黄师，七剂而愈。

      泽泻汤是治疗支饮的，“咳逆倚息，短气不得卧，其形如肿，谓之支饮”，黄师认为该患儿肥胖，就是＂如肿＂。 睡眠呼吸暂停，每睡鼻息必鼾，时有呼吸困难，就是“短气不得卧”之证，所以联用泽泻汤。

반하후박탕은 매핵기라고 부녀자들이 목에 무엇이 걸린 듯한 느낌이 들 때, 복용하면 곧장 효과가 나타나는 방제이다. 그외에 후원성 해수를 비롯 여러가지 병에도 응용된다.
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과민성 질병의 치료 경험

浅谈过敏性疾病治疗的一些体会

 

在本博文《漆过敏治疗妙招》里，朋友周大夫提出关于脾虚型的过敏性疾病治疗。本文浅谈过敏性疾病治疗的一些体会，并与此与周大夫进行交流。

过敏性疾病有多种，常见的有过敏性皮肤病、哮喘、鼻炎、紫癜等，西医治疗离不了抗过敏药、钙剂。中医治疗则方法多样，但总离不开辨证施治四个字。

中医治疗过敏性疾病有没有一个统治方呢？名医祝谌予总结了一个方剂叫脱敏煎，组成基本药物有：银柴胡、防风、乌梅、五味子四味。对于不同病种的过敏性疾病，祝老经验是在此四味基础上根据不同的病种进行辨证加减。本人也使用过此方，但对于某些过敏性疾病（主要是阳虚型），此方效果也并不理想。下面谈谈个人经验体会。

一、急性过敏性皮肤病。

此类病发病急，病因往往是血热。症见皮肤起鲜红色疹子，甚或成块成片，瘙痒不堪，便结，小便黄，舌红苔黄或腻，脉浮数。我治疗此种皮肤病，使用紫草快斑汤加，收效甚捷，当然对于虚热者也可用脱敏煎加减。对于实热者我一般使用如下几味药：紫草、蝉蜕、防风、生地、赤芍、茜草、蒺藜、功劳木、凌霄花、甘草等。最妙的是曾治一例旅游后皮肤过敏患者，初诊考虑到凌霄花难找价稍贵不用，结果二剂后收效甚微，复诊原方加入此药，二剂即愈。凌霄花有活血化瘀、凉血解毒功用，大凡遇温即瘙痒加重的疾病，不妨加用此药，其效甚妙。

二、过敏性哮喘、鼻炎

此类病常为慢性表现。总的原因不外是气虚或阳虚。气虚者主要特征是少气乏力，登高尤甚，上楼梯上气不接下气。阳虚者主要特征是四肢不温，遇冷病情加重，如气喘难舒、憋闷，喷嚏频频。

对于过敏性哮喘，祝老用脱敏煎合三子养亲汤（紫苏子、白芥子、莱菔子）加减，本人对于气虚者则喜用六君子汤合玉屏风散、地龙、莱菔子、薤白，肾阳虚者加紫河车和/或蛤蚧培元固本，标本兼治，怕冷者酌加附子、肉桂。

最有体会的还是过敏性鼻炎治疗。我总结了一条经验，即凡遇喷嚏频频者，只要怕冷、涕是清水样、脉虚，不管涕色黄还是青、白，是否脉数（不必迷惑于表象），即与补气温阳法治疗，方用黄芪建中汤合玉屏风散（饴糖、桂枝、芍药、生姜、大枣、黄芪、白术、炙甘草、防风、附子），血虚者再加当归，虚热者加地骨皮、桂枝以肉桂代，如虚火较甚可加黄芩，鼻塞声重不通者加细辛、苍耳子。用此方常一剂即可通气，病人服药后常有血液运行加快，全身变暖的感觉。过敏性鼻炎治疗不可过用辛散药，尤其不可过用寒凉，应以温补固本为主，否则越治鼻越塞难通。使用温补药后即使病人虚不受补上火了待其鼻塞症状解除后再吃点解热药，也比一开始就使用过多的寒凉药容易解决问题

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