대통령을 묻어버린 '거짓의 산' 108편 | 손석희의 JTBC는 대한민국 국민을 바보로 취급했다!


https://youtu.be/brNx8j7NWyU
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이인규 前 중수부장 vs. 원세훈 前 국정원장

노무현 전 대통령 시계수수 범죄사실 수사 관련 입장문

조갑제닷컴

무학산     2018-06-28 오후 2:13

이게 다 이명박 정권이 노무현 뇌물 사건을 야무딱지게 처리하지 않았기 때문에 있게 된 일이다. 이명박은 노무현 자살 앞에서 벌벌 떨었다. 그래서 우겨서 국장으로 했고 이는 국민들이 자살자에 대한 동정심을 유발시킨 가장 큰 원인이 되었으며 나아가 '폐족'들이 집권한 계기가 되었다. 세상 천지에 뇌물 피의자를 호텔에서 조사하는 나라가 어디에 있나? 그때 야무딱지게 처리했더라면 오늘 감방에 가 있지도 않을 것이며 박근혜 또한 여기서 자유로울 수 없다 지금 문재인 정권이 거칠 것 없이 나대는 것도 만약 다음에 정권 교체가 있더라도 우익은 자기들에게 보복하지 못할 거라고 믿기 때문에 일개 정권이 나라를 제 맘대로 휘젓는 것이다. (발췌)

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약의 가격을 내릴 수 있는 방법
---->한의학의 약과 침구를 도입하면, 약값을 크게 낮출 수 있고, 치료 효과도 눂일 수 있다. 한의학의 약은 새롭게 개발하는 게아니라, 기존의 약초를 응용해 새로운 치료 방법을 찾는 것이므로, 개발비가 거의 들지 않는다.  
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----------------------------------------------------------------------------------------- 주류 경제학의 수요 공급 이론의 헛점   Problems with Mainstream Theories of Supply and Demand     •Frank Shostak     One of the few things economists agree on is that prices are determined by supply and demand. This is summarized by means of supply and demand curves, which describe the relationship between the prices and the quantity of goods supplied and demanded.   Within the framework of supply-demand curves, an increase in the price of a good is associated with a fall in the quantity demanded and an increase in the quantity supplied. Conversely, a decline in the price of a good is associated with an increase in the quantity demanded and in a decline in the quantity supplied.   The law of supply is depicted by an upward-sloping curve while the law of demand is presented by a downward-sloping curve.   The equilibrium price is established at the point where the two curves intersect. At this point, the quantity supplied and the quantity demanded is equal — at the equilibrium price the market is said to "clear."   Graphs vs. Reality   In the conventional supply-demand framework, consumers and producers confront a given price; that is, at a given price, consumers demand and producers supply a certain quantity of a good. Demand is not a particular quantity, such as 10 potatoes, but rather a full description of the quantity of potatoes the buyer would purchase at each and every price that might be charged. Likewise, supply is not a particular quantity but a complete description of the quantity that sellers would like to sell at each and every possible price. At a given price, people demand a certain quantity of a good while producers supply a certain quantity.   Within this framework, neither consumers nor producers have anything to say as far as the origin of a good’s price is concerned. The price is just given. Both consumers and producers react to a given price. However, who has given the price? Where has the price come from?   The law of supply and demand originates from imaginary construction of economists   The law of supply and demand as presented by mainstream economics does not originate from the facts of reality but rather from the imaginary construction of economists. None of the figures that underpin the supply and demand curves originate from the real world; they are purely imaginary.   The framework of supply-demand curves rests on the assumptions of unchanged consumer preferences and income and the unchanged prices of other goods. In reality, however, consumer preferences are not frozen, and other things do not remain constant. Obviously, then, no one could have possibly observed these curves. According to Mises,   "It is important to realize that we do not have any knowledge or experience concerning the shape of such curves."1   Yet, economists heatedly debate the various properties of these unseen curves and their implications regarding government policies.   The whole idea that the price of a good is simply given produces the impression that the price is an attribute of a good--i.e., that it is part of the good itself. There is, however, no such thing as a price of a good in general. The prices of goods are established in a particular transaction at a particular place and at a given time. According to Ludwig von Mises,   A market price is a real historical phenomenon, the quantitative ratio at which at a definite place and at a definite date two individuals exchanged definite quantities of two definite goods. It refers to the special conditions of the concrete act of exchange. It is ultimately determined by the value judgments of the individuals involved. It is not derived from the general price structure or from the structure of the prices of a special class of commodities or services. What is called the price structure is an abstract notion derived from a multiplicity of individual concrete prices. The market does not generate prices of land or motorcars in general nor wage rates in general, but prices for a certain piece of land and for a certain car and wage rates for a performance of a certain kind.2   The value that an individual assigns to goods is the product of his mind judging the facts of reality. Individuals assess the usefulness of a good as a means to support their life and wellbeing. On this Carl Menger wrote,     Value is thus nothing inherent in goods, no property of them, nor an independent thing existing by itself. It is a judgment economizing men make about the importance of the goods at their disposal for the maintenance of their lives and wellbeing. Hence, value does not exist outside the consciousness of men. It is therefore, also quite erroneous to call a good that has value to economizing individuals a "value," or for economists to speak of "values" as of independent real things, and to objectify value in this way.3   Similarly, Mises wrote,     It would be absurd to look upon a definite price as if it were an isolated object in itself. A price is expressive of the position which acting men attach to a thing under the present state of their efforts to remove uneasiness.4   How Prices Are Determined   Contrary to the mainstream view, prices are not just given — somebody sets them. This somebody is a producer. Whenever a producer sets a price for his product, it is in his interest to secure a price where the quantity that is produced can be sold at a profit.   In setting this price, the producer/entrepreneur will have to consider how much money consumers are likely to spend on the product, the prices of various competitive products, and the cost of production.   Producers set the price. However, consumers, by buying or abstaining from buying, are the final decision-makers as to whether the price set will lead to a profit.   Producers in this regard are at the total mercy of consumers. If, at a set price, a producer cannot make a positive return on his investment because not enough people are willing to buy his product, the producer will be forced to lower the price to boost turnover. Obviously, by adjusting the price of the good, the entrepreneur must also adjust his costs in order to make a profit.   A producer will secure a profit when, at the set price of a good, consumer buying will generate revenue that will exceed the cost plus interest. Profit is an indication that both producers and consumers have improved their wellbeing.   By investing a given amount of money, producers have secured a greater amount of money. This, in turn, enables them to secure a greater amount of goods and services, which in turn promotes their lives and wellbeing. Likewise, consumers, by exchanging their money for goods that are on their highest-priority lists, have raised their living standards.   In fact, price setting is never mechanistic and automatic. It is up to the producer/entrepreneur to assess whether it is a good or a bad idea to raise prices; after all, what matters for him is making a profit.   When a good makes a profit at a particular price, then it is a signal to entrepreneurs that consumers are willing to support the product at the set price. Prices, therefore, are an important factor in establishing how producers employ their resources.   Observe, then, that what determines the amount of goods supplied is not some hypothetical demand schedule, but a producer's appraisal as to whether, at a given place and a given time, consumers will approve of the goods supplied. He has to be as accurate as possible in setting the right price that will enable him to sell his supply at a profit.   Further Issues with the Supply-Demand Framework   In the supply-demand framework, production cost is an important input in determining the prices of goods. In the supply-demand framework, an increase in the cost of production will shift the supply curve to the left. For a given demand curve, this will raise the price of a good.   We have already seen, however, that it is consumer buying or abstention from buying that is the sole determining factor for the prices of goods. No individual buyer is preoccupied with the cost of producing a particular good. The price that he will agree to pay for a good is in accordance with his particular priorities at a given point in time. The cost of production is of no relevance to him.   Moreover, the cost-of-production theory runs into trouble when attempting to explain the prices of goods and services that have no cost because they are not produced — goods that are simply there, like undeveloped land. Likewise, the theory cannot explain the reason for the high prices of famous paintings. On this Murray Rothbard wrote,     Similarly, immaterial consumer services such as the prices of entertainment, concerts, physicians, domestic servants, etc., can scarcely be accounted for by costs embodied in a product.5   Using the supply-demand framework for a particular good, mainstream economists proceed further and introduce supply and demand curves for the whole economy. They hold, for example, that if the economy is under performing then what is needed is a bolstering of demand by means of fiscal or monetary policies.   For a given supply curve, they contend, this will push the demand curve to the right, thereby lifting overall output. Observe that the supply-demand framework provides the rationale for government and central bank interference with businesses.   This framework, however, says nothing how the increase in demand generates more output. Furthermore, it is silent regarding the funding required in order to raise output. Also, we have seen that, in reality, it is producers that initiate the introduction of new products. They set in motion increases in goods and services, and not consumers as such.   Producers present new products, so to speak, to consumers who, in turn, by buying or abstaining from buying, determine the fate of products. Hence, there is no such thing, as an autonomous demand that somehow triggers supply.   Supply-demand graphics also provide the justification for various imaginary monopolistic theories, which in turn provide the rationale for the government destruction of successful businesses. For instance, it is held that a company that forces the price above the competitive price level is engaged in monopolistic activities and therefore must be taken to task.   Even if we were to accept, this way of thinking as valid there is no way to establish whether the price of a good is above the so-called competitive price level (monopoly price). By what criteria can one decide what a competitive price is?   On this Rothbard wrote,   There is no way to define 'monopoly price' because there is also no way of defining the competitive price' to which the former must refer.6   In the supply-demand framework for the economy, economists employ the quantity of output produced and its average price. However, neither the average price nor the total output can be established.   It is not possible to establish an average price for $10 /shirt and $50/liter of wine. Likewise, it is not possible to add ten shirts and one liter of wine to establish the total output. Hence, the entire graphical framework of the supply and demand for the economy rests on misleading premises.   What’s more, the whole issue of so-called equilibrium is misleading in the way the supply-demand framework presents it. Equilibrium, in the context of conscious and purposeful behavior, has nothing to do with the intersection of supply and demand curves.   Equilibrium is established when an individual’s ends are met. When a supplier is successful in selling his supply at a price that yields profit, he is said to have reached equilibrium. Similarly, consumers who bought the supply have done so in order to meet their goals.   Therefore, government and central bank policies aimed at shifting imaginary curves toward so-called equilibrium in fact prevent both consumers and producers from attaining their goals and hence prevent the achievement of the true equilibrium.   Conclusion     Despite its great appeal because of its simplicity, the supply-demand graphic as employed by mainstream economics is a tool that is detached from the facts of reality.   The real-world economy is far too complex to be faithfully rendered by simple graphs that take no account of uncertainty, entrepreneurial speculation, and the ceaseless change of the market economy.   By no means is this framework harmless, because government and central bank decision-makers make use of this tool in forming various policies. This is why they are continually surprised when the real economy performs in a manner different from what their graphical analysis would seem to predict.   ----------------------------------------------------------------------    장중경의  본래 의도로 돌아가라   回归仲景原意 在临床中诠释经典 ——《黄仕沛经方亦步亦趋录》评介 熊兴江　中国中医科学院广安门医院心内科 （本文发表于中国中医药报） 　　近读中国中医药出版社出版的经方新著《黄仕沛经方亦步亦趋录——方证相对医案与经方问对》，获益匪浅，感慨良多。黄仕沛先生出生于中医世家，幼承庭训，正步杏林，从医多年，体验非凡。上世纪90年代起转攻仲景之学，于经方致力尤勤，尤其服膺仲景方证之学，大有“觉今是而昨非”之感。书中不仅通过大量经方治疗危急重症病案展示出一位当代中医临床名家疗效卓著、屡起沉疴的大师风范，更展示出先生对中医学的真挚感情，对中医学子的提携厚爱。黄师谆谆告诫后学学习中医学的关键与捷径——方证相对，笔者对此感同身受。 　　忠实仲景原文，亦步亦趋 　　黄师常谓“仲景步亦步，仲景趋亦趋，是学习经方最基本要求，也是最高境界”，黄师指出对医圣亦步亦趋，以仲景书为法，探索经方的辨治体系和用药规律是学习捷径所在。而学习、掌握、运用经方的基础与关键则在于忠实仲景经典原文。临证时，只有熟练掌握方证条文，才可以辨别方证进而据证用方。书中记载的大量经方验案与经典原文高度相似，可以说是经典条文的高频再现，是经方医案的原味翻版。如“胸中一股寒气上冲咽喉，时而数日一发，时而一日数发，发作时觉胸中窒息感”即“胸痹心中痞，留气结在胸，胸满，胁下逆抢心”之枳实薤白桂枝汤证；“上腹部跳动感半年”的十二指肠球部溃疡即“心中悸而烦者”的小建中汤证；应激性肠炎患者的“大便失禁，清稀如水状，量多”即“自利不渴者，属太阴，以其脏有寒故也”的理中汤证等。 　　拓展运用经方，深入挖掘 　　由于经典原文叙症极其简略，这给我们学习继承带来了极大的困难，因此如何做到古方新用、古方今用，还原、丰富、充实方证主治就成了学习经方的重要任务。黄师以其深厚的理论功底和扎实的临床实践经验，深入挖掘经典高效古方方证，拓展经方证治，还原经方剂量，读来启发甚多。以小续命汤为例，该方原文主治中风痱，黄老将本方拓展运用于治疗多发性硬化、脊髓膜瘤术后脊髓萎缩、急性胸颈段神经根炎、帕金森综合征、胸腺瘤术后放疗后脊神经受损等出现四肢肌力下降，肌张力降低，下肢活动不利、乏力，感觉障碍，麻痹不仁，言语不清，吞咽功能障碍，神经性疼痛等。黄师对方证的临证发挥还有很多，如不仅将木防己汤用于治疗关节疼痛，指（趾）端如鼓槌状，还用于慢性肺源性心脏病肺动脉高压出现指端发黑、杵状指的治疗，认为这是条文“面色黧黑”的延伸；甘草泻心汤治疗银屑病、慢性结膜炎、手足口病；防己地黄汤、风引汤治疗老年女性的嘴巴不自主抖动，脑梗后肢体不自主舞蹈等。 　　不尚玄理空谈，力倡客观 　　“仲景之学，至唐而一变”，自宋以降，中医学思辨盛行，徐灵胎针对当时医界诡辩盛行深有感慨，“今则以古圣之法为卑鄙不足道，又不能指出病名，惟以阳虚、阴虚、肝气、肾弱等套语概之”。黄师敏锐意识到该问题的严重性，临床不尚玄理，不尚空谈，不尚浮夸，反对以虚无飘忽的理论解释仲景学说。通过文献考证发现，《伤寒论》与《内经》并非同一传承体系，若以《内经》理论解释仲景学说则大失圣人之意，所以黄师反复告诫学生，“须知仲景用药，皆以证为依据”。如麻黄汤中桂枝为桂枝证而设，不仅能主治恶寒发热头痛，更能定悸，减轻麻黄发汗太过而出现“心下悸欲得按”之弊；芍药甘草汤并非“酸甘化阴”所能解；血府逐瘀汤中桔梗、牛膝一升一降只是基于良好主观愿望的一厢情愿，桔梗去之也无妨等。 黄师力倡回归仲景原意，主张在临床中诠释经典，反对以虚玄的理论敷衍解释伤寒，甚至在其《陋质铭》中说“可以丢素问、去难经，无生克之乱耳，无六气之无形”，看似偏激，但其言论切中时弊、掷地有声、振聋发聩。况且黄师也不完全反对《内经》，只是强调要把有限的精力放在重点上，而这里的重点则指“方证”。柯韵伯曾说，“夫仲景之道，至平至易，仲景之门，人人可入，而使之茅塞如此，令学人如夜行歧路，莫之指归，不深可悯耶？”中医学大道至简，而方证则是中医学的核心所在，是执简驭繁的关键。总的来说，笔者认为该书瑕不掩瑜，不失为学习经方之一大助，为嘉惠杏林的一部应时佳作。     ---------------------------------------------------------------------  黄仕沛의 지황 사용법 《神农本草经》谓干地黄“治折跌绝筋，伤中逐血脉，填骨髓，长肌肉，……除寒热、积聚，除痹。”     《伤寒杂病论》中使用地黄的方剂有10首，分别是：胶艾汤、当归建中汤、黄土汤、炙甘草汤、薯蓣丸、三物黄芩汤、百合地黄汤、防己地黄汤、肾气丸、大黄庶虫丸。 10首方中地黄用量最大的是防己地黄汤，用生地黄二斤，其次是炙甘草汤用生地黄一斤。百合地黄汤则用生地黄汁一升。大黄庶虫丸用干地黄十两，肾气丸用干地黄八两，当归建中汤的加减法中，若去血过多，崩伤内衄不止，加地黄六两，胶艾汤、三物黄芩汤用干地黄四两，黄土汤用地黄三两，薯蓣丸用干地黄十分，用量皆相当大。     地黄在配伍上有广泛的亲和力，如与养血、活血、益气、温阳、清热、养阴、利水均可配伍。     从地黄的使用指征来看，地黄用于皮肤干燥枯槁，大便干结，口干舌干，唇干裂，舌瘦苔少，或唇红舌红，脉细数、结代。后世温病验齿，叶天士“看舌之后，亦须验齿”，所以地黄的药证当是唇舌干燥，牙齿枯槁。但无论用于何证，配伍何药，地黄都必须重用，非重用不足以为功。黄师用地黄常用30-90克，最大用至180克。 黄仕沛老师临床上善用地黄，他认为，综合来看，地黄之用在于滋阴养血，具体效能主要包括：1.润燥，2.制燥，3.定躁，4.安神、5.定悸。除此之外，地黄还可以止血、清热，本文不一一尽述。     一、地黄剂的主要功效     1 润燥     1.1用于治疗皮肤科疾病     《伤寒论》196条：“阳明病，法多汗，反无汗，其身如虫行皮中状者，此以久虚故也。”此乃阳明久虚，津液不足，汗源不充，故法多汗反无汗，而皮肤干燥瘙痒。如荨麻疹、带状疱疹、神经性皮炎等，特别是老年性皮肤干燥症，考虑为阳明久虚，津液不足，潮红，脱屑比较明显者，黄师常用大剂量生地，最大用至90g。 黄师曾治一过敏性皮炎患者，全身片状皮疹，干红，瘙痒明显，以甘草泻心汤加麻黄、生地、石膏治疗，处方：     麻黄十二克（先）川连六克黄芩十五克 法夏二十四克     干姜六克   大枣十五克  甘草三十克  党参三十克     石膏九十克  生地三十克     十剂后症状明显好转。     黄师曾述，当年黄继祖师公，曾治一妇人，身痒久不愈，几欲自尽，嘱予生地煲瘦肉，服之越旬而愈。 我亦曾治一糖尿病周围神经病变患者，全身皮肤干燥、潮红，瘙痒难忍，满布搔抓的痕迹，抓痕处有渗血、谌液。发病已接近1年，时好时坏，本次加重接近1月，反复使用过多种抗过敏药物，甚至使用过激素，效果不佳。予百合地黄汤合麦门冬汤加减，处方：     百合三十克  生地三十克  麦冬六十克  法夏二十四克     大枣十五克  甘草十克  党参三十克     并与生地三十克、甘草三十克煎水外洗，治疗十余天后皮肤干燥、瘙痒症状较前明显缓解。     1.2用于治疗阴枯液竭的患者     黄仕沛老师认为欲养真阴非重用生地、麦冬不足以为功。     仲景的炙甘草汤、薯蓣丸，甚至大黄庶虫丸中使用生地，都是因为它能滋阴养血，改善阴液枯竭的症状。 炙甘草汤又名复脉汤，《金匮要略﹒肺痿肺痈咳嗽上气脉证并治》附《外台秘要》“肺痿涎唾多，心中温温液液者”。现代很多医生都用炙甘草汤改善肿瘤患者的恶液质状态。黄师曾以炙甘草汤治疗肺癌术后及冠心病支架植入术后阴液枯竭的患者，疗效显著。     薯蓣丸和大黄庶虫丸都出自《金匮要略﹒血痹虚劳脉证并治》。“虚劳诸不足，风气百疾，薯蓣丸主之。”此方自然是补虚之剂。“五劳虚极羸瘦，腹满不能饮食，食伤，忧伤，饮伤，房室伤，饥伤，劳伤，经络营卫气伤，内有干血，肌肤甲错，两目黯黑。缓中补虚，大黄庶虫丸主之。”大黄庶虫丸是《金匮要略》治疗干血痨的方剂，治疗瘀血内结日久，伴有明显的阴液枯竭。与治疗妇人产后腹痛的下瘀血汤比较，本方重用地黄，并加用其他一些活血破瘀药物，这便足见仲景组方的用意。《千金要方》有治月水不通，脐下坚，大如盘。发热往来，下利羸瘦，方用生地黄三十斤，取汁，内干漆，为末一斤，微火煎，令为丸，每服酒下如梧丸大三丸。此方也是化在瘀的同时，重用大量生地治疗阴枯液竭。八十年代初，黄师就以大黄庶虫丸治愈一例疑为席汉氏综合征的消瘦、肌肤甲错、腹胀、闭经患者，取得了很好的效果。     黄师曾治一鼻咽癌放化疗术后中年男性，2011年6月初确诊，6月中旬接受化疗，约两周前化疗完成。8月22日开始接受放射治疗，现仍进行中。9月初逐渐出现口腔溃疡，咽喉干痛，饮食难进，胃脘胀满，呕吐。曾用西药治疗，效果不显。9月27日经友人介绍请黄仕沛老师诊治。刻诊患者咽痛、咽干、口干，口腔双侧颊侧溃疡，舌面溃疡，吞咽障碍，饮食难进，胃脘胀满，时有呕吐，唇舌红色如染，舌干瘦，无苔。不寐而烦。     黄师拟黄连阿胶鸡子黄汤合麦门冬汤加生地。     处方：黄莲6克、黄芩15克、白芍15克、大枣5克、党参30克、法夏60克、麦冬30克、生地90克、甘草30克、阿胶15克（烊化，兑）、鸡蛋黄一枚（药成放之搅拌）。七剂。     10月4日再诊，诸证悉除；唇舌红已退，如常色，口腔及舌痛溃疡己愈，唯余咽仍有少痛，能进食粥、面条。除10月3日一点醒来，个多小时后才再入睡，几天来睡得很好。     2 制燥     地黄在经方的配伍中还有制燥的作用。如炙甘草汤三分阳药，七分阴药，此方中地黄还有制桂枝温燥的作用。如防己地黄汤，生地二斤配伍防己、防风、桂枝等辛温的药物也是此意。《千金》、《外台》亦有多方是使用地黄制燥的。后世方如大秦艽汤用地黄也是此理。     黄师用温燥药物时也常用生地制燥，如曾治一例脑梗塞恢复期患者，左侧肢体乏力，言语欠清，但舌红少苔，大便干结，便予续命汤加生地90克，治疗后舌红、便秘症状好转，肢体活动功能也较前改善。     3定躁     躁者，躁动不安，定躁即定躁熄风，风指的就是后世的所谓“内风”，所以这里所谓定躁就如同后世医家的育阴熄风。此时生地更应用大量，一般90-120克。     防己地黄汤出自《金匮要略﹒中风历节病脉证并治》“治病如狂状，妄行，独语不休，无寒热，其脉浮。”黄仕沛老师认为，仲景的防己地黄汤重用生地二斤，滋阴养血，治疗以阴虚阳亢为主的中风，开后世育阴熄风的先河。     叶天士喜用生地育阴，《临证指南医案﹒肝风门》的三十二个医案中，用地黄的有二十多案，可见地黄的重要。吴鞠通的复脉汤、一甲、二甲、三甲复脉汤、大定风珠及张锡纯的建瓴汤皆用地黄。 黄师曾以防己地黄汤治疗两例脑梗塞后出现不自主运动的患者，一例双手舞动不止，型似兰花，一例嘴巴不自主抖动，皆用生地九十克，治疗后症状缓解，未见再次发作。     杨森荣师兄的伯父因慢性阻塞性肺病住院，除气促、咳痰以外，还出现双上肢不自主颤动，师兄以防己地黄汤，生地120克治疗，数剂后双上肢颤动停止。     叶天士有：“凡肝阳有余，必须介类以潜之，柔静以摄之，味取酸收，或佐咸降，务清其营络之热，则升者伏矣”。黄师还认为后世提出的平肝熄风，育阴潜阳之法，实蕴含于风引、侯氏黑散、防己地黄汤三方之中。候氏黑散的菊花清肝热，皂矾除痰；风引汤介类潜阳，大黄通腑；防己地黄汤以地黄养阴血。临床上三方应互联使用。黄师曾治一脑梗塞急性期的老年男性，左侧上下肢不自主舞动不休，以防己地黄汤育阴合金石介类潜阳，生地最大用至一百二十克，十余剂后不自主运动得以控制，现行动如常。     4 安神     仲景用地黄的方剂十首，其中用生地黄的方剂包括炙甘草汤、防己地黄汤、百合地黄汤共有三首，这三个方证皆有“神”的症状，如防己地黄汤“如狂状，妄行，独语不休”，百合地黄汤所治百合病“意欲食复不能食，常默默，欲卧不能卧，欲行不能行，饮食或有美时，或有不闻食臭时”的“神识之疾”。此时生地也应用90-120克。     黄师近期治疗一老年女性患者，近期常有幻听，似觉常常听见隔壁的敲击声，问其子女均未听见，故心烦意乱，心中怵惕不安，夜间常不能入睡。黄师先以柴胡加龙骨牡蛎汤治疗，一周后患者心悸症状明显缓解。但仍有明显幻觉，难以入睡，遂改予防己地黄汤加减，处方：     防己二十四克  生地九十克  桂枝二十克  防风十五克     甘草十克  生龙牡各三十克     两周后幻听减少，地黄逐渐加量至一百五十克，继续服用治疗。     5定悸     《伤寒论》第178条：“伤寒，脉结代，心动悸，炙甘草汤主之”，炙甘草汤重用生地一斤，是治疗心悸的千古名方。     曹颖甫用本方深有体会，他说：“脉结代，心动悸，炙甘草汤主之。此仲景先师之法，不可更变也。”可谓一语中的。仲景治悸有多方，但脉结代而又心动悸者，此无可替代之方也。《经方实验录》中共载有三案，如唐君案：“素有心脏病，每年买舟到香港，就诊于名医陈伯坛先生，先生用经方，药量特重，如桂枝、生姜之属动以两计。大锅煎熬，药味奇辣，而唐君服之，疾辄良已。今冬心悸，脉结代又发，师与炙甘草汤，服至三五剂，心悸愈，结代渐稀……。”深感粤沪两位经方大家，解读《伤寒论》虽各有见地，然审证用药则一也。 当然对于治疗心悸，桂枝是最关键的，但后世解释炙甘草汤多认为生地黄有此功效。黄师以炙甘草汤治疗心律失常包括频发室性、预激综合征等多例，每次皆能起效。     二、地黄剂的煎煮法     仲景凡地黄剂均与酒同用，几成定例。     历代注家多从酒之性去诠释；如“酒可通经”，柯韵伯则曰：“清酒引之上行。”但细观仲师之地黄方，如胶艾汤亦与酒同煎，然胶艾汤乃止血方，无须通经，也无须引药上行。防己地黄汤是以酒渍防己等四味一宿，绞取汁，再与地黄汁和合。尤在泾释：“酒浸取汁，用是轻清，归之于阳，以散其邪。”可见注家常落臆解俗套，恐非仲景原意也。试想药与酒同煎，汤成则酒味俱挥发殆尽，何以通经、上行？近人解释地黄剂用酒同煎是起“溶媒”作用，有利于地黄等有效成份析出，应为仲师本意也。     黄师于大剂量生地的地黄剂，如炙甘草汤、防己地黄汤等也常与酒同煎。汉代未有蒸馏酒，故不应是高粱酒之类，应是黄酒，如花雕酒之类。但如果如炙甘草汤以“清酒七升，水八升”同煎则酒费不菲也。我们往往是以水七、八碗煎至三碗左右，放花雕酒半支或一支。再煎成一碗。感觉放酒效果较好。     三、生地固可凉血，但并非虚人不能用     世人一般认为，熟地补血，生地败血，所以一般滋养补虚用熟地，凉血则用生地。其实并非如此。     首先，汉时并无熟地，但仲景用地黄总体是用来治虚的。     其次，熟地补血，生地败血，此说可能来自叶天士的“入血就恐耗血动血，直须凉血散血，如生地……”。但叶天士又有“舌淡红无色者，或干而色不荣者，当是胃津伤而气无化液也，当用炙甘草汤，不可用寒凉药” 之说。由此可见，叶氏认为重用一斤生地的炙甘草汤并不是寒凉药，而是改善胃津损伤的补虚药，那么叶氏同样也将生地用作补虚。     再次，吴鞠通用生地皆是“非重用，不为功”。细看《温病条辨》中的各方，“阳明温病，无上焦症，数日不大便，当下之；若其人阴素虚，不可行承气者，增液汤主之。”又如“阳明温病，下后汗出，当复其阴，益胃汤主之”；“下后无汗，脉不浮数，清燥汤主之”；“下后数日，热不退，或退不尽，口燥咽干，舌苔干黑，或金黄色，脉沉而有力者，护胃承气汤微和之”；此外还有新加黄龙汤、增液承气汤。上述各方中用生地都是为了滋阴养血。     由此可见，生地固可凉血，但并不是说虚人就不能用。 -------------------------------------------------------------------------------------- 어제인가 그제 kbs에서 현훈에 대한 프로그램을 했는데, 보지는 않았지만 물론 엉터리 서구의학 이론을 읊었을 것이다.  아래는 장중경의 책 중에서 현훈에 대한 약을 몇가지 추려낸 것이다. 论张仲景治眩晕之法 李玉玲 湖北中医学院05级教改实验班 　　在《伤寒论》和《金匮要略》中，眩晕又称“癫眩”、“冒眩”、“眩"或“冒”，共有9处条文涉及此症，整理成篇，以飨同道，以希临床勿忘仲景之法。所列标明条数者，皆出自《伤寒论》，其他则出自《金匮要略》。 　　阳虚饮停 　　1.脾阳虚，水气上冲——苓桂术甘汤  　　“伤寒若吐若下后，心下逆满，气上冲胸，起则头眩，脉沉紧……苓桂术甘汤主之。”（67）脾胃阳虚，运化失司，水气上逆则心下逆满；脾虚不能制水，水气上冲则气上冲胸。水气上蒙清窍则头晕，起则清阳之气更难达头部，则头晕目眩加重。脉沉主水，脉紧为寒，水寒为病，故脉沉紧。治当温阳健脾，利水降冲，方用苓桂术甘汤。茯苓为主药，淡渗利水；桂枝温阳降冲，配合茯苓温阳化气，淡渗利水。白术与茯苓相配，健脾利水，与甘草相配，健脾益气。本方温能行气，甘能补脾，燥能祛湿，淡能利水，合奏温阳健脾，利水化饮之效。在《金匮要略》中“心下有痰饮，胸胁支满，目眩，苓桂术甘汤主之”与（67）条基本病机一致，故治法相同。 　　2．肾阳虚，水泛于上——真武汤  　　“……其人仍发热，心下悸，头眩，身瞤动，振振欲擗地者，真武汤主之。”（82）肾阳虚不能化气行水，则水气不行，水气上凌于心上逆，蒙蔽清阳则头晕目眩。“阳气者，精则养神，柔则养筋。”筋肉为水气浸渍，加之阳虚失于温养则时跳动，身体振颤，站立不稳，而欲倒仆于地。发热乃虚阳浮越于外所致。治以温阳利水，方用真武汤。附子辛热，温肾壮阳，补命门之火使水有所主；白术苦温，燥湿健脾，使水有所制。白术附子同用，温煦经脉而除寒湿；生姜辛温，宣散水气，亦可行水；茯苓淡渗利水，与白术相合，健运中土；芍药敛阴和营，并制生姜，附子刚燥之性，保证二物既能温经散寒，又不伤阴耗液，五物合用，共奏温阳利水之功。 　　3．饮停下焦——五苓散  　　“假令瘦人，脐下有悸，吐涎沫而癫眩，此水也，五苓散主之”证属下焦饮逆，饮停下焦，水气凌心，水饮上逆犯胃，胃失和降故吐涎沫；上蒙清阳，清阳不升故眩晕，治疗以五苓散化气行水，导饮下行外出；方中茯苓，猪苓，泽泻利水驱邪，白术健脾制水，桂枝辛温温阳化气兼具有发汗之功，故能使水饮之邪内外分消。 　　饮邪偏盛 　　1．饮停心下——泽泻汤 　　“心下有支饮，其人若冒眩，泽泻汤主之”。心下泛指胸隔胃脘，饮停心下，邪盛上返，蒙蔽清窍故眩晕，法当健脾利水，用泽泻汤。张仲景用泽泻，利水祛邪，导浊阴下行，白术健脾燥湿，崇土制水。泽泻汤常用与水饮上泛引起的眩晕病种涉及梅尼埃病，前庭神经炎，高血压病，脑椎——基地动脉供血不足等，临证应随症加减，如呕吐甚者，可加小半夏汤；兼脾阳不足者，可加苓桂术甘汤，兼肝阳上亢者，可见菊花，钩藤，天麻；兼肝阴不足者，可加白芍，枸杞子；兼气血两虚者，可加党参，黄芪，当归；情志不畅诱发者，可加柴胡，郁金，合欢皮；兼耳鸣者，可加龙骨，牡蛎；兼耳聋者，可见石菖蒲。 　　2.饮停隔间——小半夏加茯苓汤 　　“卒呕吐，心下痞，隔间有水，眩悸者，小半夏加茯苓汤主之。"水饮停聚隔间，若犯及、胃，胃气上逆则呕，水饮阻滞气机则心下痞；，邪盛上犯清阳不升，故目眩，水气凌心乃心悸，法当蠲饮降逆，宣阳制水，用小半夏汤加茯苓汤。方中半夏，生姜既能蠲饮散结，开宣上中两焦阳气，又能降逆止呕，安胃和气，茯苓利水祛饮，宁心安神。 　　3．妊娠水气——葵子茯苓散 　　“妊娠有水气，身重，小便不利，洒淅恶寒，起则头眩，葵子茯苓散主之”。“妊娠有水气”即后世所称的“子肿”，此证多因胎气影响，膀胱气化被阻，水湿停聚所致。水盛身肿故身重，水停而卫气不行，故洒淅恶寒；水阻清阳，清阳不升则头眩。治以葵子茯苓散利水通阳，葵子滑利通窍，茯苓淡渗利水，使小便通利而水湿去，水有去路而气化阳通，则诸症自除，此为叶天士“通阳不在温，而在利小便”之谓也。 　　浊邪上逆 　　1．谷疸，湿热上熏——茵陈蒿汤  　　“谷疸之为病，寒热不食，食则头眩，心胸不安，久久发黄为谷疸，茵陈蒿汤主之。”此证为湿热黄疸，饮食不节，湿热蕴结脾胃，营卫生化不利而致形寒发热，不能饮食，若勉强进食则脾胃湿热更甚，上熏则头眩，心胸不安，久久湿热波及血分则发为谷疸。当治以清利湿热，活血退黄，方用茵陈蒿汤。茵陈清利湿热退黄，栀子清三焦之热兼凉血，大黄凉血活血，解毒。三药合用，湿热祛除，脾胃得健，头眩则自除。 　　2．阳明燥屎内结——大承气汤 　　“病人小便不利，大便乍难乍易，时有微热，喘冒不能卧者，有燥屎也，宜大承气汤。”（242）证属阳明里实，燥热与糟粕相结形成燥屎，腑气不通，燥屎阻结，热邪深伏于里，难达于外，故时有微热。腑气不通，燥热上迫于肺则喘，热邪上逆，扰乱清窍则头眩。治以泄热通腑，方用大承气汤。 　　结语 　　关于眩晕，后世多从虚实论治，病变脏腑与肝脾肾三脏有关，虚者为髓海不足或气血亏虚，清窍失养；实则为风，火，痰，淤，扰乱清空。虚者滋养肝肾，补益气血，填精益髓；实证则平肝潜阳，清肝泻火，化痰行瘀。常用处方有天麻钩藤饮、归脾汤、左归丸、半夏白术天麻汤、通窍活血汤之类。然仲景认为“无痰不作眩”，水湿痰饮等浊邪上泛，蒙蔽清窍则为眩。肾阳虚者治以真武汤；脾阳虚者治以苓桂术甘汤、五苓散；饮邪偏盛者治以泽泻汤、小半夏加茯苓汤；妊娠水气者治以龙葵茯苓散；浊邪上犯者，治以大承气汤、茵陈蒿汤。其中苓桂术甘汤，五苓散，小半夏加茯苓汤，均可用于治疗狭义痰饮出现头晕目眩症，但各有侧重。苓桂术甘汤证为饮停心下胃脘，波及胸胁，部位偏于中上，伴胸胁支满短气等，其重在温阳健脾蠲饮；五苓散证是饮停下焦，病位偏于中下，伴脐下悸、吐涎沫，重在化气行水；小半夏加茯苓汤汤是治疗悬饮停于心下胃脘及隔间，其部位偏于中上，伴有呕吐、心下痞、悸等，重在蠲饮，和胃降逆。 -----------------------------------------------------------------------------