2018년 4월 25일 수요일


친북(親北) 냄새 풀풀 나는 만찬 메뉴 짜느라 잔머리깨나 굴렸겠구나
문무대왕(조갑제닷컴 회원)


  우리 민족의 평화와 통일을 위해 애쓴 사람들을 기리며 메뉴를 정했다는 청와대 대변인의 설명은 초미의 관심사인 북핵 문제와 한반도의 평화정착을 다루는 정상회담이 아니라 음식 전시회를 준비하는 듯하다. 죽은 사람 이름을 들먹이는 것이 잔치상이 아니라 제사상 차리는 것같아 보인다. --->그렇게 되기를 진심으로 바란다.
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북한의 핵 포기는 그리 기뻐할 일이 아니다.
북한이 핵을 포기한다는 것은, 핵 없이도 한국을 접수할 수 있는 자신이 있다는 뜻이다. 한국 사회는 이미 주사파들에 의해 주도되고 있고, 온갖 매체는 모두 철저한 통제 아래 놓여 있다. 박 대통령의 불법 탄핵이라는 원죄를 지은 소위 말하는 우파 정당들은, 마지 못해 국민의 지지를 받고 있을 뿐이다. 언론과 이들 정당은 자신들의 원죄로 인해, 태블릿 조작이라는 호재가 있음에도, 적극적으로 문죄인 정부를 공격하지도 못하고 있다. 그리하여 한국은 지금 문죄인과 개정은이 연출하는 평화공세, 나아가 연방제 음모에 속수무책이다--자유의남신
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썩어빠진 군인들. 연방제하면 김정은한테 충성할 인간들.
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세줄요약


1. 4일전인 4.22일 중국인 관광객 32명과 북한인 4명이
   교통사고로 사망했다는 기사가 북한발로 나옴


2. 김정은이 직접 병문안 가고, 시체 실은 전용열차도 직접 가서 환송함.  교통사고 치고는 과하다 싶음


3. 이번에 죽은 중국인 32면 전원이 북한핵을 지지하는 중국 핵과학자, 학자, 좌빨 사이트 편집인등임

[출처] (묻재업)중국인 핵관련 인사 32명 집단사망(4.22,황해도)
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전원책 변호사
인류 역사에서 평화조약이 약 8000건이 체결됐으나 그 효력이 지속되기는 평균 2년 정도에 불과했다.
저는 이 말이 맞다고 본다. 평화협정은 찢어버리면 그만이다. 종잇조각에 불과하다
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이런 미친 짓이 처벌 받지 않고 넘어간다면 한국은 정말 희망이 없다.
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지금 재활용 정책은 실행될 수 없는 과제를 시민들에게 떠맡기고 그것이 이루어지기를 바라는 한심한 정책이다. 쓰던 비닐을 깨끗이 닦아서 버리는 사람이 얼마나 될까? 그보다는 재활용 될 수 없는 모든 것들은 매몰하거나 소각하는 게 낫다. 지금 재활용 한다고 걷어가는 것들은 대부분은 거의 재활용 가치가 없는 것들이다. 따라서 그것들은 일반 쓰레기와 함께 매몰되어야 한다. 하지만 환경보호라는 눈속임 구호로, 엉터리 정책을 계속 고집하고 있다. /사진 출처: 일베
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인터넷을 보니까 굽타라는 의사는 이미 오래 전부터 대마의 의약품 사용을 주장해 왔다.  그가 예로 든 간질이나 다발성 동맥 경화, 통증 등을 대마로만 고칠 수 있다는 데는 동의하지 않지만, 어쨌든 대마가 의약품이 될 수 있다는 데는 동의한다. 대마 외에도 양귀비는 기침에 아주 특효를 발휘하기도 한다. 하지만 지금은 마약이 될 수 있다는 이유로, 양귀비를 약으로 쓸 수 없다. 안타깝다.
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태양광과 풍력 에너지가 그렇게 싸다면, 전기세는 왜 그렇게 비싼가? 시간이 갈수록 전력의 가치가 떨어지고, 고가의 백업 전력을 더욱 더 많이 필요로 하기 때문이다.
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[변희재의 시사폭격] 트럼프의 중국 쪼개기 원대한 꿈 앞에서, 김정은 & 문재인의 위험한 도박


https://youtu.be/vzSLNNp0a5s


변희재는 정치적 야심이 많아서 좌충우돌하고, 또 한때 좌파였던 경력을 숨기고 우파의 투사를 자처하는 등 문제가 많은 인물이다. 하지만 요즘 변 씨처럼 매일 시사 논평을 하는 정치인은 없다. 이 사람의 예측은 너무 낙관적이고, 그래서 대부분 틀린 것으로 드러났지만, 그래도 정치판에서 오래 있던 사람이라, 들어두면 유익한 말도 적지 않다.
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오스트리아 학파의 이론에 기여한 예거 교수 잠들다
Leland Yeager, R.I.P.
 
David Gordon
 
 
I am sorry to report that Leland Yeager passed away on April 23, at the venerable age of 93. Although he described himself as a “fellow traveler” rather than a full member of the Austrian School, he greatly admired Ludwig von Mises and Murray Rothbard and made important contributions to Austrian theory.
 
In his essay, “Tautologies in Economics and the Natural Sciences,” he defended the deductive method of praxeology:
 
Tautologies are analytic or logically necessary propositions.Analytic propositions can give us new knowledge (or aid us in its pursuit).Logic and mathematics, although apodictically certain, can sometimes yield surprising results”. Mises would not have put it any differently.
 
Yeager ranged widely in his contributions to economic theory. He early established a reputation in international trade theory and was a strong critic of protectionist and restrictionist schemes of all sorts. He was a master of the difficult field of capital theory, and here the mistaken approach of Frank Knight could excite him to fury. In monetary theory, he wrote in the tradition of Clark Warburton. He translated Mises’s Nation. State, and Economy.
 
He was a great scholar, and in all of his work it is evident that for each topic he considered, he had read all the relevant literature in several languages. (He was a gifted linguist able to read a vast number of languages, who had worked during World War II as a Japanese cryptanalyst translator, and was one of the foremost proponents of Interlingua, an artificial language.) He analyzed each article he read in minute detail, and if authors failed to meet his exacting standards, he could be a mordant critic.
 
Yeager’s mastery of the sources extended to philosophy. His most important work in this area, Ethics As Social Science, is an outstanding defense of a modified form of utilitarian ethics, in the tradition of Mises and Henry Hazlitt, whose Foundations of Morality he rated highly.
 
Yeager was a Professor at the University of Virginia for thirty years, where he was a mentor to a number of Austrian economists including Roger Garrison. After his retirement there, he taught for another ten years at Auburn University as Ludwig von Mises Distinguished Professor of Economics, retiring again in 1995. The Mises institute played a key role in bringing Yeager to Auburn, where he was a renowned and rigorous teacher. His students at Auburn included Mark Thornton and many of the early Mises Fellows.
 
He regularly attended conferences and programs at the Mises Institute. In a seminar I attended several years ago when he was in his late 80s, he delivered a perfectly organized lecture, standing for nearly one hour.
 
He was a shy person, rather formal in manner; but once one got to know him, it was evident he liked people and wanted to go over arguments with them. His high scholarly standards are an inspiration to us, though few can hope fully to meet them.
 
David Gordon is Senior Fellow at the Mises Institute, and editor of The Mises Review.
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경제 전쟁이라는 잘못된 표현
경제 관계를 전쟁에 비유하는 학자들이 있지만 그것은 오해에서 비롯된 것이다. 경제학은 상호 이익을 얻는 게임이기 때문이다.
기업 사냥꾼은 언론의 매를 맞지만, 사실은 경쟁력이 없는 기업을 인수해, 그것에 다시 경쟁력을 불어 넣어주는 사람이다.
고객 홍길동이 a 가게에서 물건을 살 때, b 가게의 주인은 비록 이 거래를 좋지 않게 생각해도, 이 거래의 당사자가 아니다. 즉 제 3자이므로 그의 적대감은 잘못된 것이다.
 
Economic Warfare
 
Walter Block
 
Pundits are accustomed to utilizing the language of war and strife to depict economic relationships. This is confusing, irrational and misleading. For the dismal science addresses mutual benefit, or positive-sum games. All participants gain whenever a trade, a purchase, sale, rental agreement, job, etc., gets consummated; necessarily so in the ex ante sense, and in the overwhelming majority of cases ex post.
 
For example, if I purchase a newspaper for $1, it is an apodictic undeniable truth that at that moment, I ranked the periodical more highly than the money I had to pay for it. Why else, for goodness sakes, would I have been willing to engage in this commercial transaction was this not so? I anticipated that I would benefit from this trade. Even in the ex post sense, from the vantage points of afterward, in virtually all such cases I and everyone else in this position gains. Rare is the case where I, or anyone else for that matter, regrets the purchase of a paper on the ground that there was no good news in it after all, and that was what the buyer was seeking and expecting.
 
Consider in this regard, then, concepts such as "price war," or "hostile takeover." Here, it would appear, there is not mutual benefit occurring in the market, but rather an antagonistic relationship. Nothing could be further from the truth.
 
Take the latter first. This charge is fueled by the spectre of corporate raiders who swoop down on a helpless firm, engage in a "hostile takeover," sell off its assets, and fire all the employees. There are numerous fallacies here. First of all, unemployment is created by artificially boosting wages above workers' productivity. If the minimum wage law, or a union, insists that an employee be paid $10 per hour, but he is only worth $7 in terms of productivity, he will be unemployed, period. This has nothing to do with so-called hostile takeovers. Yes, people are fired, but unemployment is no higher in industries that witness such activities than in any other.
 
But do not corporate raiders sometimes dismember firms for their assets? Indeed, they do. However, they only earn a profit when these selfsame assets are actually worth more in other areas of endeavor than where they were first deployed. This means that if jobs are lost in one corporation, they will be created in others, to the places where the assets are now more productively employed, thus raising wages.
 
Another socially beneficial effect of the corporate raider concerns salaries of chief executive officers. Many commentators complain that CEO salaries have hit the stratosphere, and constitute an unconscionable exploitation of the workingman. Suppose that the capital value of a firm would have been $100 million if the CEO salary was "moderate," but, because of a stupendous compensation package, it is now worth only $10 million. Such a firm would be ripe for the pickings of a corporate raider. He would purchase this business for, say, $11 million, fire the parasitical CEO, watch the firm's value rise to its "proper" $100 million, and pocket a hefty $89 million in profit. The corporate raider is to outrageous CEO salaries what the canary is to coal mine safety; only he does the bird one better: not only does he warn of a problem, he solves it in one fell swoop. Yet, government, in jailing people like Michael Milken, has obliterated this beneficial market mechanism. And now they have the audacity to complain of out-of-control CEO pay.
 
As for "hostility" there is no such thing between the buyer and seller of stock. The only "hostile" person is the CEO who was ripping off the firm. But when we say that in the market there is only peaceful cooperation, we mean on the part of those who engage in any specific transaction; e.g., the newspaper buyer and seller. Third parties, of course, can always be hostile. A Marxist, for example, might have his nose put out of joint by all commerce. He is "hostile" to all of them. So what?
 
What of price war? This, too, is a linguistic contortion. When grocers, or filling stations, for example, lower their prices in an attempt to attract customers, they are very far from having a "war" with those who buy from them. Very much the opposite is the case. As far as the relation of these vendors with each other, the supposed participants in this "war," they are in the same position as the too-high-salaried CEO and the corporate "raider." They are third parties to all these transactions, and, as such, have no standing in any of them. They cannot reveal or demonstrate (Rothbard 1997) their hostility. That is, when customer A purchases groceries or gasoline from seller a, seller b might not like it, but he is not part of this transaction.
 
Excerpted from Building Blocks for Liberty, chapter 23, "Language, Once Again: Civil War, Inclusive Language, Economic Warfare, National Wealth" (2006; 2010).
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마크 페리는 남녀 임금 불평등에 대해, 노동 시간, 결혼 여부, 아이의 수, 교육, 직업, 직업 경험, 작업 조건, 작업 안전, 작업장 유연성, 작업장의 친화성, 직업 안정성, 통근 시간 등이 모두 남자가 임금을 더 많이 받는 변수들인데, 이런 것들이 고려되지 않았다고 말하고 있다.
남녀 동등 임금 주장에 따르면 여성을 고용하는 것이 아주 아주 많이 수지가 맞는다는 것이다. 하지만 기업가는 늘 탐욕스럽다는 저들의 논리와 결합되었을 때, 그렇게 탐욕스러운 기업가들이 수지가 맞는 여성 고용을 회피한다는 말이 된다. 스스로 모순되는 말이고, 그들의 엉터리 주장이 아닐 수 없다.
 
The Myths Behind "Equal Pay Day"
 
Gary Galles
 
 
April 10 marked 2018’s “Equal Pay Day,” decrying the almost 20 percent difference between median yearly incomes for men and women working full time (35 hours or more per week) for the most recent reporting year (2016). As has become traditional, “celebrants” reiterated assertions that the data establishes unjustifiable discrimination against women “doing the same work as men.”
However, as Mark J. Perry points out, that data fails to adjust for differences in “hours worked, marital status, number of children, education, occupation, number of years of continuous uninterrupted job experience, working conditions, work safety, workplace flexibility, family friendliness of the workplace, job security, and time spent commuting,” each of which would lead one to expect men to be paid more.
 
How do “Equal Pay Day” activists explain omitting that dozen (or even more) clearly relevant variables from being taken into account? Mainly, they ignore such issues, using constant repetition and the threat of tarring critics as sexists to establish their core claim as an unchallengeable premise for public conversation.
 
However, there is reason to think that even activists doubt their mantra. First, it serves their political purposes whether it is valid or not, and the worse they can make it look, the better it serves those purposes. Second, such discrimination has been illegal for years, and, if proven, would be a litigation goldmine for lawyers, yet we don’t see a flood of easy money victories. But I find it even more important to ask whether a woman who worked two more hours a week than a man (roughly the average excess men work than women in the “full time” data) would insist that it justifies greater compensation. I have never met one who said she thinks it would make no difference, when she would gain from it. And the same is true for every other difference supporters want people to ignore to reach “Equal Pay Day” conclusions.
 
Another logical anomaly is similarly telling. I cannot count how many times employers in general, and “big business” in particular, have been accused of being too selfish or too greedy to pay for accusers’ pet “do-gooding” causes. They are too greedy to care enough about pollution/global warming/climate change. They are too greedy to do enough to eliminate poverty. They are too greedy to care about their labor force or the community, when opposing tax hikes or regulatory burdens, mandates for legal increases in wage and/or non-wage compensation, closing unprofitable production facilities, eliminating jobs when capital equipment is cheaper, ad infinitum. However, despite such universal allegations of excessive greed, employers are somehow not greedy enough when it comes to female employment.
 
“Equal Pay Day” logic implies that it would be outrageously profitable to just hire women, because the labor costs of production would be one-fifth lower as a result. That is, employers supposedly won’t do enough “good” anywhere it costs them money, yet they are determined to discriminate against women at a phenomenal cost. And the discriminators would include women-owned businesses and firms with female CEOs and HR heads. Is everyone, including women, willing to pay so much to discriminate against women?
“Equal Pay Day” activities feature statistics that no one who ever stayed awake in a course in the subject would accept, combined with self-contradictory logic. What they ignore when it advantages their claims of discrimination they reject as applying to themselves. Further, they routinely accuse their “targets” of being too greedy in multiple areas, yet not greedy enough when it comes to employing women. Such Swiss-cheese holes reveal “Equal Pay Day” as an attempt to establish an unsupportable premise, which tortured logic can then twist into even more unsupportable conclusions.
 
Gary M. Galles is a professor of economics at Pepperdine University. He is the author of The Apostle of Peace: The Radical Mind of Leonard Read.
 

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孔大夫治疗小儿口疮验方处方


小儿口腔溃疡一般为心胃火旺,心开窍于舌,心火旺盛则舌上溃疡,胃火旺则满口都有可能溃疡,心与小肠相表里,故心火旺盛可用【导赤散】清心利小便,引心火下移小肠。胃火旺盛者可加用【白虎汤】


【基本方】生石膏15g(先煎)、川黄连3g、青连翘6g、生知柏各6g、灯芯2g、鲜茅苇根各15g、生甘草2g、滑石块10g、蒲公英10g、淡竹叶8g
    【加减】脾经湿热者合用泻黄散,三焦火旺加焦栀子6g,肝火旺盛加用羚羊粉0.6g,大便秘结者加元明粉3g,有时小儿内热较盛,往往是心肝肺胃诸经皆受影响,可以以上诸法结合运用。
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수족구병의 험방


现代医学认为“手足口病”为病毒传染性疾病,常发生于婴儿和儿童。以发热、口腔溃疡和疱疹为特征。


初始症状为低热、食欲减退、不适并常伴咽痛。发热1-2天后出现口腔溃疡,开始为红色小疱疹,然后常变为溃疡。口腔疱疹常见于舌、牙龈和口腔颊粘膜。1-2天后可见皮肤斑丘疹,有些为疱疹,皮疹不痒,常见于手掌和足底,也可见于臀部。有的病人仅有皮疹或口腔溃疡。发病季节常为夏季和早秋季节,即为暑湿季节。
    【诊断】孔老认为此病多为小儿湿热内蕴,适感暑湿,湿热或发于口,或流于手足而为病,治疗上量其热重还是湿重,以清热解毒和渗化湿热两法结合治疗,效如桴鼓。


    【基本方】生石膏20g(先煎)、薄荷4g(后下)、金银花8g、生知柏各6g、青连翘7g、鲜茅苇根各20g、霜桑叶8g、杭菊花7g、淡竹叶7g、白通草4g、生甘草3g、滑石块10g、黄连2g、灯芯2g


    【方解】方中以桑菊、银翘、白虎加减治之,表里双清,兼用通草、滑石清利湿热,黄连、竹叶、灯芯取导赤散之意清心经之火,诸药合用,湿热火毒一并清除。


     【加减法】热毒壅盛者加蒲公英10g、野菊花6g、大青叶8g之属。


舌苔厚腻,恶心,纳呆者减生石膏,加藿香6g、佩兰6g、白蔻4g。
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피부 소양증
 【歌诀】祛风止痒用牡蛎,珠母益母归生地,防风荆芥夜交藤,甘草蝉衣粉丹皮
    【组成】牡蛎,珍珠母各30克,生地24克,当归24克,益母草24克,夜交藤24克,丹皮15克,防风12克,荆芥9克,蝉衣7克,甘草9克。

    【用法】先将上药用水浸泡30分钟,牡蛎,珍珠母另煎1小时,再合余药,共煎煮30分钟,每剂煎2次,将2次煎出的药液混合。每日1剂,早、中、晚各温服1次。
    【功效】平肝熄风,凉血止痒。
    【方解】瘙痒是皮肤病中最常见的症状。究其病因不外乎风胜、湿胜、热胜、虫淫、血虚等几个方面,临床最常见的是肝肾阴虚、血虚生风,也有血热或夹湿者。该证皮肤剧痒,但多无原发皮损,经反复搔抓后,则可引起抓痕、血痂、
湿疹化、苔癣样变等继发皮损。本方系自拟方,经数十年临床验证,疗效良好。方中牡蛎、珍珠母平肝熄风;生地、当归滋补肝肾,畅通血脉;丹皮、益母草凉血化瘀;夜交藤宁心安神;防风、荆芥、蝉衣祛风止痒;甘草缓和,解毒矫味。全方合成,适用于肝肾阴虚、血瘀、血虚生风之“风瘙痒”。其审证要点为:多为老年,病程较久,瘙痒与情绪有关,苔薄舌红,脉细数或弦数。
    【主治】风瘙痒。
    【加减】若热重者,加黄柏;夹湿者,加泽泻。
    【附记】尚需注意,服药期间勿饮酒,忌食辛辣食物,避免各种刺激,以免影响疗效。

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남녀 성교 전후의 질병 치료


阴阳易与夹色伤寒


 


阴阳易即是男方或女方原有旧病或新瘥,因犯房事(性交)而发病。阴阳易的“易”字,中国古代医学文献有两种解说:“男病传女”、“女病传男”。认为:“男子病新瘥未平复,而与妇人交接得病,名曰阳易;妇人新瘥未平复,男子与之交得病,名曰阴易。”
夹色伤寒是指男女性交前或后,感受风寒而发的病。
根据临床所见,夹色伤寒多寒热虚实夹杂,因其起病多与外感有关。外感初起,多有实邪;因其病多与性交有关。因性交后肾阴或肾阳必受损,故其病必有虚象。
此病的主要症状有三个方面:1、头部:头重抬不起来,多伴眩晕;2、少腹及生殖器:少腹拘急,牵引生殖器拘挛;3、全身:全身酸楚或疼痛,困倦嗜卧。
此病治法不固定,须看证型、地区、时令、体质等因素。《伤寒论》方中用得较多的是:桂枝加附子汤、桂枝加龙骨牡蛎汤、麻黄附子细辛汤、真武汤、四逆汤、白通汤等。
以后会从文献中摘录治疗此病的医案,以飧博友。



夹色伤寒病案一:吴茱芋汤治性交后眩晕、呕吐


某男,42岁,干部。患者忙碌一天,夜晚与家人饱食一餐,就寝后与其妻性交,后见头重不欲举,眩晕不止,如在舟中转动。诊见:面色苍白,唇淡,语音低沉而慢,干呕,只能吐出少许涎沫,不渴,恶寒-体温37度,要盖被而不喜揭开,少腹急结,引及阴部,血压正常,二便常,脉迟弱,舌尖红,苔薄白。用吴茱芋汤:吴芋、生姜各30,党参15,红枣12枚-切开,黄连9。立即煎服,药后少倾患者即入睡,服二煎后已无其他不适,惟见疲乏。
注:《伤寒论》:“干呕,吐涎沫,头痛者,吴茱芋汤主之。”因其舌尖红,属上有热而加黄连。此病发于性交之后,因此,可看作是夹色伤寒。



夹色伤寒病案二:桂枝附子汤治性交后受寒之格阳症


某女,26岁,同房后感寒,见寒热头痛,服辛凉解表药六、七日不解,口唇焦破,面赤,鼻衄,口燥渴,喜热饮,热欲得衣,少腹有时绵痛,大便微溏,小便短赤不利,但欲寐,苔白燥而不糙,脉浮无力。属太少两感格阳之症,宜表里同治,引阳和阴,用桂枝加附子汤:桂枝、白芍、附子、茯苓、白术、玄参、知母、黄柏各9,姜炭、小茴、灸甘草各3,童便二盏,一剂寒热、烦渴渐减,小便渐利,面赤鼻衄已除。去知母、黄柏、童便,再一剂寒热再减而口唇焦皮渐脱落,惟第二剂头煎服后3小时少腹突然绞痛不已,此属少阴寒凝少腹不化。第三剂照第二剂药方,但用肉桂0.9克烽盐少许匀冲先服。患者述服肉桂后1时许腹痛即止,当晚得微汗后诸症皆愈,用六君汤加肉桂、附子善后。


夹色伤寒病案三:白通汤治性交后受寒之真寒假热格阳症


某男,40岁,性交后一日,恶寒发热,头疼身痛,无汗,西医治疗病反剧,汗出肢冷,转中医治疗,用大量辛温发表药及桂枝附子汤后汗更多,四肢厥冷过肘膝,伴鼻衄、咳血、烦躁不安,舌淡白滑,脉细无力。此属治疗不当,太阳未解而表先虚,少阴既虚而阳又亢,遂呈格阳危候。急宜敛阴通阳略佐驱邪外出之品,否则非大汗亡阳即下厥上竭,用白通汤加味:桂枝、灸甘草各3,白芍、附片、白术、茯神、白薇9,干姜4.5,灸黄芪15,葱白五寸,龙骨18,牡蛎24,胆汁一匙,童便二盏。药后当晚汗止,烦厥除,但竖晨复恶寒,汗出肢厥,去白薇,加党参15,再服后大汗止,厥逆回,诸症均愈,惟时觉头微痛,晚间盗汗,迭进二剂而愈。


夹色伤寒病案四:桂枝加龙骨牡蛎汤治炎夏性交后受寒


某男,42岁,炎夏长途步行,当夜当风行房事,事后小腹发冷,阴茎内缩,龟头冰冷,阴囊湿如牛鼻上汗汗出淋漓,骨内蒸蒸而热,头昏重不欲举,眼内冒火干涩,眼屎多,走路头重脚轻有飘浮感,尿短似浓茶,舌干苔白,脉浮大中虚、右尺无根。服烧浑散无效。此为夹色伤寒症,急投桂枝、白芍、甘草、肉桂、小茴各10,龙骨、牡蛎各15,热敷脐下,外灸关元。四剂后小腹回温,龟头不冷,阴茎不缩,汗止,劳热退,头昏减,继服四剂愈。
注:此案与前面病案有相似之处,病机类似,亦有虚耻外越之象,此加龙骨、牡蛎敛浮阳,而前案用附子纳浮阳,皆法同而选药不同。若误投井下石寒凉清泄之品,则病必严重。



夹色伤寒病案五:麻黄附子细辛汤治汗出后手淫犯病


某男,16岁,劳动后出汗,又犯手淫,初觉龟头有内抽感,当夜少腹急痛,恶寒发热,唇紫,苔白,脉弦。此汗出当风,属太、少两感,兼手淫精泄不畅、败精瘀腐内阻。用麻黄附子细辛汤加木通。二剂愈。加木通能开泄下郁,又能反佐而防其年少不任辛附大热。
注:此案说明,同是太阳、少阴两感,治法有桂枝伍附子及麻黄伍附子之异。手淫亦房劳,因两者同有排精。《上海中医杂志》1981年11期亦载一10余岁农民性交后受寒发病,症与此案类似,用麻黄附子细辛汤加乌药、灸甘草二剂愈。另:1980年第4期《江西中医药》载,某男,48岁,犯夹阴伤寒,寒热往来似虐,一夜数作,头昏重,肢冷,用麻黄附子细辛汤加味二剂愈。



夹色伤寒病案六:当归四逆加吴芋生姜汤治妇人性交后缩阴


某妇,四旬余,体素虚弱,某日农作过劳,傍晚归途遇雨,衣履尽湿,归公更衣,不甚介意。晚间又经房事,风雨之夜,寒气彻骨,夜半去厕后不久,睡感寒甚,数被不温,少腹拘急绞痛,次第加剧,至天明时见阴户紧缩,自觉向腹中牵引,冷汗尽出,手足厥冷,头晕神困,不能起立,服药乏效,诊见脉微细,舌润不渴,属阴寒证,其夫说:“阴户收缩,成一杯大空洞形时流清液……”。予当归四逆加吴茱芋生姜汤,嘱一日服完二大剂,并艾灸气海、关元十余炷,用壶盛开水时熨脐下,次日已愈,惟身略倦而已。


夹色伤寒病案七:碧玉合鸡苏散加味治伤暑、性交复伤风


某青年农妇,夏月劳作,赤日熏蒸感受暑气,汗多体瘦,夜间房事后去小便又感风邪。竖晨颇觉不适,傍午猝觉阴户左右抽搐,时作时止,至夜增剧。住院治旬日少效。诊见:脉洪大而虚,唇降舌干,口渴心烦,身热尿黄饮食知味。先伤暑,后房劳,复伤风,宜清暑祛风为主,予碧玉散合鸡苏散清暑热,加羌活、香薷、虫退、钩藤祛外邪,兼冲服牵正散搜经络之风,另蒸参汤作茶饮以扶正气。日进二剂,当晚搐止热清。再以清暑益气汤加减调理数日乃愈。
碧玉合鸡苏散에서 계소鸡苏란 용뇌, 박하를 가리킴
벽옥산: 滑石180克 甘草30克 青黛適量
夹色伤寒病案讨论


案二用桂枝加附子汤加味治性交受寒而病,案三先用桂枝加附子汤乏效而后用白通汤加味挽救得愈,案四用桂枝加龙牡汤敛浮阳,说明同属浮阳外越,同用桂枝汤加味,而所配之药随证而异。
案一至五,多有太阳、少阴两感证候,治法当辩其正气已衰未衰,在表里兼顾、或急先救里两治法间作出选择。方有桂枝加附子汤、桂枝加龙骨牡蛎汤、麻黄附子细辛汤、白通汤加味等变化。
受风寒属太阳病。性交后肾气受损,属少阴病。故凡在性交前后受风寒而发的病,有脉浮、苔薄白、头痛、恶风寒等表证,复兼少阴病脉证者,多可用太阳、少阴两顾之方治疗。若证候复杂,寒中夹热者,可加阴药反佐,案一加黄连,案二加童便、知母、黄柏,案三加胆汁、童便,皆一法之变化而加减选药略异。
案六素体血虚,淋雨受寒,复犯房事而发病,用当归四逆汤加吴茱芋、生姜和卫温肝、养血而病愈。案七夏日先伤暑,后性交,复受风邪而病,属暑证,用清暑祛风法而愈。
合而观之,上述病案,同中有异。同者皆为性交前后外感而发病,异者外邪有风、寒、暑、湿之别,治法也有别。因皆与性交有关,所见的证候皆牵涉到生殖器与少腹部。男则少腹急结引及生殖器,或少腹时绵痛,或龟头有内抽感。女则或少腹拘急绞痛,阴户紧缩内抽,或阴户左右抽搐。因皆兼外感,故多有太阳病外证。呈太阳、少阴两感者,治宜解外温里两顾,方如桂枝加附子汤、麻黄附子细辛汤。呈太阳、厥阴两感者可用当归四逆加吴茱芋生姜汤法。夹色伤寒用当归四逆加吴茱芋生姜汤的原因:1、足厥阴肝经绕阴器至少腹,厥阴肝病者常在阴器与少腹部有病变反应;2、当归四逆加吴茱芋生姜汤属厥阴病方,有血虚寒滞病机者适用此方。
综上所述,夹色伤寒多由性交前后外感而发病,呈现的证候不一,治法不一,须辩证论治,非一味单方可统治。可按《伤寒论》条文,辩证用其方药。
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승양익위탕 해설


升阳益胃汤升清降浊祛湿热
□ 高建忠山西中医学院附属医院


    脾胃虚则怠惰嗜卧,四肢不收,时值秋燥令行,湿热少退,体重节痛,口干舌干,饮食无味,大便不调,小便频数,不欲食,食不消;兼见肺病,洒淅恶寒,惨惨不乐,面色恶而不和,乃阳气不伸故也。当升阳益气,名之曰升阳益胃汤。
    文中怠惰嗜卧、四肢不收、体重节痛、食不消等症状的描述似参考《难经》。
    《难经·十六难》:“……假令得脾脉,其外证:面黄,善噫,善思,善味;其内证:当脐有动气,按之牢若痛;其病:腹胀满,食不消,体重节痛,怠惰嗜卧,四肢不收……假令得肺脉,其外证:面白,善嚏,悲愁不乐,欲哭;其内证:脐右有动气,按之牢若痛;其病:喘咳,洒淅寒热……”
    临床辨证的要诀之一在于“合参”。四诊合参,脉症合参,病症合参,以及天人合参等等。没有“合参”,也就没有“辨”。
    怠惰嗜卧,四肢不收,虚在脾胃,实在湿困。倘值夏暑,可能是清暑益气汤证。如值秋令,湿热退而燥气行,则不可能是清暑益气汤证。
    中医临床是不可能离开“四时”的,没有与四时合参的中医标准化是不符合中医临床的。
    脾胃主受纳、运化、化生气血、升清降浊。辨析脾胃状态,多从饮食、大小便、精神气色三大方面考察。
    肺主皮毛。辨析肺的状态,气机在皮毛的布化与出入是否正常是很重要的一个方面。
    脾胃虚弱,受纳、运化不足,则“饮食无味”、“不欲食”、“食不消”。运化、升清降浊失司,则“大便不调”、“小便频数”。气血生化不足,则“怠惰嗜卧,四肢不收”、“兼见肺病”。
    肺气不足,不能布化于皮毛,温煦皮毛不足,则“洒淅恶寒,惨惨不乐,面色恶而不和”。肺气不足的原因是脾胃之气不足,阳气不能上升外达,因此说“乃阳气不升故也”。
    升阳,包括使阳气“伸”,也包括恢复中焦气机升降。益气,既包括补益肺气、胃气,也包括运脾和胃。
    升阳益胃汤组成:黄芪二两,半夏(洗,此一味脉涩者用)、人参(去芦)、甘草(炙)各一两,独活、防风(以秋旺,故以辛温泻之)、白芍药(何故秋旺用人参、白术、芍药之类反补肺,为脾胃虚则肺最受邪,故因时而补,易为力也)、羌活各五钱,橘皮四钱,茯苓(小便利不渴者勿用)、柴胡、泽泻(不淋勿用)、白术各三钱,黄连一钱。上咀,每服称三钱,水三盏,生姜五片,枣二枚,煎至一盏,去渣,温服,早饭后。或加至五钱。
    秋主降,“秋旺”指秋降太过。治疗以春升药治其秋降太过,因此说独活、防风“辛温泻之”,泻其太过。
    病本内伤脾胃,肺金本虚,为什说“秋旺”?
    肺金虚是指脏气不足,秋旺是指正值秋令。天人相应,外界之秋降助体内之秋降。不足宜补,故用黄芪、人参、白术、芍药之类;太过宜泻,故用独活、防风、羌活、柴胡之类。
    因时而补,是基于内伤不足而言,如春季补肝、秋季补肺等等。
    从药物组成分析,升阳益胃汤由补中益气汤去升麻、当归加半夏、茯苓、独活、防风、羌活、白芍药、泽泻、黄连组成。
    所加药物实际上分为两组:一组是升清药,独活、防风、羌活;一组是降浊药,半夏、茯苓、白芍药、泽泻、黄连。
    两组药合用,在升清降浊的同时有治疗湿热之功,实针对上文所说的“湿热少退”。“少退”不是“全退”。
    本方主要针对肺脾气虚,湿热内滞,中焦升降失司而设。
    本方也可以看作由六君子汤加黄芪、独活、防风、羌活、柴胡、白芍药、泽泻、黄连而成。
    本方与六君子汤的不同之处在于,增加了恢复气机升降的药物。
    费伯雄在《医方论》中论到升阳益胃汤时说过如下一段话:“东垣论饥饱劳役,阳陷入阴,面黄气弱,发热者,当升举阳气,以甘温治之。此真卓识确论,为治阳虚发热者开一大法门。唯方中辄用升、柴,恐上实下虚者更加喘满。在东垣必能明辨,当病而投。后人若执定此法,一概施之,则误人不浅矣。”
    此段话从临床中来,学东垣而误人者并不鲜见。但读这段话总感觉有不太合适之处。一是,东垣用升、柴并不是治疗发热。如升阳益胃汤用独活、防风、柴胡、羌活相伍,都不是为治发热而设;二是,中医临床从来没有任何一法可“执定”,可一概施之。学东垣如此,学他人也如此。

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