2019년 4월 18일 목요일

나경원 자유한국당 원내대표,  김경수 지사의 보석과 관련

이번 결정을 보면서 차베스 정권의 베네수엘라 사법부를 생각했다. 베네수엘라가 이러한 좌파독재의 길을 가는 데의 정점은 결국 사법부를 끊임없이 압박해서 차베스 정권의 하수인으로 만든 것이다.
박근혜 전 대통령에 대한 형집행정지 신청이 된 것으로 알고 있다. 이 형집행정지는 요건 충족 여부를 공정하게 면밀하게 따져봐야 될 것이다. 또한 요건 충족뿐만 아니라 국가발전과 국민통합의 시각에서 이번 신청의 건을 합리적으로 심의해줄 것을 요청한다.
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2019. 4. 18(수) 10:30, 대북제재위반조사특별위원회 회의 주요내용(출처: 자유한국당)
<나경원 원내대표>
오늘 당에서 대북제재위반조사특위를 저희 원내에서 발족한다. 대북제재조사특위를 발족하는 이유는 다른 것이 아니다. 실질적으로 지금 미국은 ‘대북제재를 계속 유지하겠다’는 입장인데, 사실상 대한민국 정부가 대북제재 부분에 있어서 ‘같이 이 입장을 제대로 갖고 있느냐’에 대한 상당한 의문이 들고 있다.
 우리가 이 특위에서는 지금 저희가 현재 대북제재위반 선적이라든지 이러한 부분에 대한 것을 살펴보는 것은 물론이고, 여기에 따른 그동안의 정부의 대처가 과연 적극적이고 제대로 되어 있었는지를 보겠다. 실질적으로 적극적인 대처를 했다기보다는 사실상 묵인한 것은 없는지 하는 그런 의심도 들고, 실질적으로 그러한 대처자체가 절차에 따라 제대로 되지 않았다는 생각도 많이 있다. 그래서 저희 당으로서는 이런 대북제재 위반에 대해서 여러 가지 조사를 통해서 앞으로 대북제재의 대상이 대한민국 정부자체가 되지 않도록 미연에 방지하겠다는 취지에서도 특별위원회를 구성했다. 특별위원회 위원장을 유기준 의원님으로 하시고, 북한 석탄수입 의혹 관련된 이건은 단순히 외통위 소관뿐만 아니라 외통위, 기재위가 모두 포함되기 때문에 관련된 상임위 위원님들을 같이 포함시켜서 이 위원회를 구성한다. 
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김진태
 결국 김경수가 보석으로 풀려났다. MB 풀어줄 때 웬일인가 했더니 결국 이러려고 그랬던 모양이다. 
  
  김경수를 구속한 성창호 판사는 박통에게도 중형을 내린 판사다. 오죽했으면 김경수를 구속했겠나. 성 판사는 결국 검찰에 의해 기소됐다. 그러니 이번 판사가 정권의 뜻에 어긋나는 결정을 할 수 있겠나.
  
  박통은 구속기간을 넘겨가며 2년이 지나도 안 풀어주고 김경수는 77일 만에 풀어주는 게 공정한 나라인가. 드루킹도 아직 구속돼 있다. 지시한 주범을 풀어주고 실행한 하수인만 잡아놓는 경우는 없다. 
  
  그러니 김경수에게 지시한 사람은 오늘 안도의 한숨을 쉬었을 것이다. 김경수는 쾌재를 부르며 증거인멸에 착수할 것이고, 이 사건은 김경수 선에서 마무리 될 조짐이다.
  
  이 땅에 아직 정의가 살아있다면 문재인-김정숙 특검밖엔 답이 없다. 우리 당은 여기에 모든 화력을 집중해야 한다.
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 ---평양의 경제 상황은 어떤가?
  "대불황이다. 하여간 장사 부진이 심하다. 시장에서 물건이 안 팔리고 매대의 사용비(시장세)를 내면 적자가 된다고 장사를 그만두는 사람이 많다. 중구역, 모란봉구역 등 시 중심부의 시장에서조차 빈자리가 눈에 띈다. 시내에서 교외로 나가는 버스편이 절반 이하가 됐다. 이것은 돈주(신흥 부유층)들이 투자해 만든 회사가 운영해 돈을 벌어왔는데, 승객도 짐을 나르는 장사꾼도 줄어들어 경영이 악화됐다"   이시마루 지로(아시아프레스)  
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중국과의 무역 협정으로 중국을 구해줘서는 안 된다.

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영국의 파시스트가 러셀에게 토론을 제안하자, 러셀은 다음과 같이 대답했다.


Dear Sir Oswald,

Thank you for your letter and for your enclosures. I have given some thought to our recent correspondence. It is always difficult to decide on how to respond to people whose ethos is so alien and, in fact, repellent to one’s own. It is not that I take exception to the general points made by you but that every ounce of my energy has been devoted to an active opposition to cruel bigotry, compulsive violence, and the sadistic persecution which has characterised the philosophy and practice of fascism.
I feel obliged to say that the emotional universes we inhabit are so distinct, and in deepest ways opposed, that nothing fruitful or sincere could ever emerge from association between us.
I should like you to understand the intensity of this conviction on my part. It is not out of any attempt to be rude that I say this but because of all that I value in human experience and human achievement.
Yours sincerely,
Bertrand Russell
당신과 나는 너무나 다른 정서적 세계에 살고 있어서, 생산적인 대화는 불가능하므로, 정중하게 거절합니다. 
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1986년에 자기 집의 지붕에 상어를 박아놓은 빌 헤인이 사망했다고 한다. 생전에 그는 상어를 철거하라는 정부와 싸워서 승리했다.
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미국 브로드웨이 벽화에 있는, 중국의 공화국 시대(1920 ~ 30년대)의 중국 국기.
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[황태순TV] 목숨 걸고 북한에 정제유 보내온 세력의 정체!!


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장윤정 불나비


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새로운 반자본주의 운동은 노골적인 반(反)인류 운동이다.

It is not a call to ditch capitalism in favour of a new system that could provide abundance for all. On the contrary, the environmental critique of capitalism is that we have too much stuff, too much wealth, and we should now return to a pre-industrial feudalistic state.
For instance, in that viral clip, two of the things Monbiot told us to give up are meat and air travel.
현대의 반자본주의자들은 그들의 목적이 인간의 불행을 조장하는 것이라고 밝히고 있다. 
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기후 변화 때문에 사용되었다는 3500만 달러는 사실은 지난 10년 동안의 비용이었다.
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오바마가 노트르담 성당의 손실을 애도했다고 하는데, 그는 이전에 알카에다를 무장시켜 시리아의 수많은 교회와 수도원을 파괴한 장본인이다.
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과거로부터 수집한 정보는 도움이 되지 않는다. 우리의 현재와 과거를 하나로 통합하는 난로컬non-local한 숨은 변수가 있기 때문이다.
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사실은 자본주의 마인드를 갖고 있던 버니 샌더스!
10년 동안의 세금이 공개됨으로써 그동안 자본주의자들을 비난했던 버니 샌더스가 사실은 부자, 그것도 수퍼리치라는 사실이 밝혀졌다.
자신의 부를 정당화 하기 위해, 결국 샌더스는 자본주의자들이 쓰는 관용구로 자신의 부를 정당하게 이루었다고 밝혔다.
 
Bernie Tells America: Pull Yourself up by Your Bootstraps!
 
Ryan McMaken
 
On Monday, Bernie Sanders released ten years of tax returns, and it turns out he's a millionaire. Thanks especially to revenues from book royalties, Sanders is now, as CNN put it, "in the category of the super-rich." Or, as some might say, he's part of "the 1%."
 
After years of denouncing "millionaires and billionaires" and a supposed source of America's economic problems, this information is a little awkward for Sanders.
 
Some critics of Sanders have claimed this makes him a hypocrite. Here's a man who trashes millionaires, and yet is one himself.
 
"Hypocrite," however, isn't really the right term here. So long as Sanders pays the taxes he says millionaires should pay, his income alone doesn't make him a hypocrite. Moreover, Sanders can (plausibly) claim that when he denounced millionaires, he didn't mean all of them. He just meant 90 percent of them. And he can then include himself in the "good" ten percent.
 
Nevertheless, Sanders appears not entirely comfortable with his status as a rich man.
 
When confronted as being among those he has long villainized, Sanders became defensive:
 
“I wrote a best-selling book,” he declared. “If you write a best-selling book, you can be a millionaire, too.”
 
Translation: "I made my money fair and square, so quit hassling me about it."
 
It is at this point that we start to see Bernie Sanders undermine his own claims about millionaires, wealth, and capitalism.
 
Bernie Sanders, Capitalist
For a normal person, Sanders's defense of his riches would be no big deal. There's little doubt that a great many wealthy people, when asked how they earned their money, would respond with "I worked for it. I earned it."
 
But, when Bernie Sanders says this, it's quite remarkable.
 
After all, one of the central myths of the Bernie Sanders wing of the American left is that people who become rich do so on the backs of the poor. As is the case with orthodox Marxists, there is a persistent and widespread belief on the left that wealth is gained by exploiting workers. Moreover, it is believed that market-based economies systematically favor the wealthy while closing off economic success to those who are not already well off. In this narrative, those who haven't exploited workers directly have likely inherited their money from others who have exploited others.
 
To hear Bernie Sanders on the matter, however, it sure sounds like he does believe that wealth can be had through a little hard work: "I wrote a best-selling book. If you write a best-selling book, you can be a millionaire, too."
 
Translation: "You can make a lot of money if you work at it. It's just that easy!"
 
This sounds suspiciously like the "bootstraps" argument which the left so often and so vehemently rejects. And it's pretty odd to hear it from Bernie Sanders.
 
It shouldn't surprise us, though, that when called upon to justify his riches, Sanders ended up resorting to a capitalist cliché.
 
He did this, of course, because the argument makes sense to a lot of people. Sanders needed to make the case that his wealth was obtained morally. So he pointed out the most common-sense argument in favor of letting people keep their wealth: he earned it.
 
Assuming we're only talking about income received from book sales, Sanders is right. No one forced anyone to buy his books, and he made money when people voluntarily handed over money in exchange for the books. By this measure, Sanders did indeed "earn" the money.
 
But Sanders's observations about the origins of his wealth don't stop there. By noting that this was a "best-selling book" Sanders is also admitting that delivering a product or service to a large number of people is a key factor in getting rich.
 
In other words, had Sanders merely written a book, he would not have made millions. But since he wrote a best-selling book, that brought in a lot of money. But if the key to getting rich is to sell something a lot of people want, doesn't that show that "millionaires and billionaires" are providing a benefit to society? Sanders is recognizing that the extent of one's riches are tied to how many consumers an entrepreneur serves in the marketplace. Sanders apparently thinks at least one millionaire himself got rich by giving people what they want. And if this is the case, is it fair to assume that rich people aren't paying their "fair share?"
 
We might go on to extrapolate even more from this.
 
As to the matter of inequality, Sanders hints at its origins. What if not everyone writes a best-selling book? Wouldn't that mean some people have millions of dollars and other people have much smaller amounts of money? Wouldn't that create inequality?
 
The answer, of course, is "yes." And we can see from Sanders's own success in selling books that inequality is not necessarily a result of the wealthy exploiting the poor. It can simply be a result of some people selling more books than others.
 
We can also conclude that Sanders apparently believes it is possible to produce a good or service without exploiting the workers. After all, his books did not appear by magic out of thin air. Human beings worked to print the books, assemble them, and distribute them. Sanders made money from their labors. In fact, he made a lot more money than any truck driver who delivered his books to stores. He made a lot more than any factory worker who assembled the books. Does Sanders believe he took advantage of these workers? Apparently not. Sanders justifies his wealth as a matter of writing books. He doesn't mention anything about the workers at all.
 
So, in this one short interview, we've learned a few things from Sanders:
 
1. He believes that providing an in-demand product or service justifies high incomes for those who produced it.
 
2. There is a connection between income earned and the total number of customers served.
 
3. If you do the same, you can be a millionaire, too.
 
That's quite a little capitalist manifesto from Sanders.
 
Unfortunately, he's unlikely to take any of these newfound revelations and translate them into decent public policy going forward. Instead, he's likely to keep telling his supporters what they want to hear. Why stop now? It's made him a rich man.
 
Ryan McMaken (@ryanmcmaken) is a senior editor at the Mises Institute

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제갈량의 사당에서 읇은 두보의 시
《古柏行》
孔明庙前有老柏,柯如青铜根如石。
霜皮溜雨四十围,黛色参天二千尺。
君臣已与时际会,树木犹为人爱惜。
云来气接巫峡长,月出寒通雪山白。
忆昨路绕锦亭东,先主武侯同閟宫。
崔嵬枝干郊原古,窈窕丹青户牖空。
落落盘踞虽得地,冥冥孤高多烈风。
扶持自是神明力,正直原因造化功。
大厦如倾要梁栋,万牛回首丘山重。
不露文章世已惊,未辞剪伐谁能送。
苦心岂免容蝼蚁,香叶终经宿鸾凤。
志士幽人莫怨嗟,古来材大难为用。

孔明廟前有老柏,柯如青銅根如石。
霜皮溜雨四十圍,黛色參天二千尺。
君臣已與時際會,樹木猶爲人愛惜。
雲來氣接巫峽長,月出寒通雪山白。
憶昨路繞錦亭東,先主武侯同閟宮。
崔嵬枝幹郊原古,窈窕丹青戶牖空。
落落盤踞雖得地,冥冥孤高多烈風。
扶持自是神明力,正直原因造化工。
大廈如傾要樑棟,萬牛回首丘山重。
不露文章世已驚,未辭翦伐誰能送?
苦心豈免容螻蟻,香葉終經宿鸞鳳。
志士幽人莫怨嗟:古來材大難爲用。

 孔明庙前有一株古老的柏树,
  枝干色如青铜根柢固如盘石。
  树皮洁白润滑树干有四十围,
  青黑色朝天耸立足有二千尺。
  刘备孔明君臣遇合与时既往,
  至今树木犹在仍被人们爱惜。
  柏树高耸云雾飘来气接巫峡,
  月出寒光高照寒气直通岷山。
  想昔日小路环绕我的草堂东,
  先生庙与武侯祠在一个宫。
  柏树枝干崔嵬郊原增生古致,
  庙宇深邃漆绘连绵门窗宽空。
  古柏独立高耸虽然盘踞得地,
  但是位高孤傲必定多招烈风。
  它得到扶持自然是神明伟力,
  它正直伟岸原于造物者之功。
  大厦如若倾倒要有梁栋支撑,
  古柏重如丘山万年也难拉动。
  它不露花纹彩理使世人震惊,
  它不辞砍伐又有谁能够采送?
  它虽有苦心也难免蝼蚁侵蚀,
  树叶芳香曾经招来往宿鸾凤。
  天下志士幽人请你不要怨叹,
  自古以来大材一贯难得重用。
Ballad of an Old Cypress
In front of the shrine of Zhu-ge Liang
there was an aging cypress,
its boughs were like green bronze,
its roots were like the stone.
Its frosted bark was streaked by rains
forty armspans round,
dark arch of mascara touching sky
two thousand feet above.
Already the minister and his lord
have met their moment,
yet still is this tree
cherished by men.
When clouds come, its vapors touch
the full length of Wu Gorges;
as the moon appears, its chill reaches
the white of the Mountains of Snow.
I think back now where the road wound
east of Brocade Pavilion,
where the Ruler of Shu and his Warrior Count
share a common shrine.
Trunk and branches loomed high there,
ancient upon the meadows,
with paintings dark and hidden away
through the empty doors and windows.
Spreading wide, roots coiled and clasped –
but though it found firm place,
high and alone in the black of sky
there are many violent storms.
Surely that which holds it up
is the might of some bright god;
its upright straightness is finally due
to the deed of the Fashioner.
If some great mansion should collapse
and they needed rafters and beams,
ten thousand oxen would turn their heads
at its weight, which is a mountain’s.
Even before it shows its grain,
all the world is amazed;
it would not object to being cut,
but who would be able to send it?
Its bitter core cannot keep out
intrusions of termites,
yet its fragrant leaves have ever given
night’s lodging to the phoenix.
Let neither sigh — not the man of grand aims
nor the man who lives hidden away —
it has always been true that the greatest timber
is hardest to put to use.
—Translation by Stephen Owen
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육경변증으로 불임증을 치료한다.  
作者:张奎增中医

摘要:《伤寒论》是疾病总论,其主要精神,是在研究患病机体一般的反应规律。并在其基础上,讲求疾病的通治方法。每一种疾病除了它自己特有的规律外,同时还存在着所有疾病都具有的共同的一般的规律。不孕症也不例外。笔者以7个典型病案为例,介绍了通过六经方药辨证,并配合针灸等方法来治疗不孕症的经过和体会。笔者认为,方证、药证是仲景诊疗系统的逻辑起点,六经辨证是其分析方法,而《易经》太极阴阳论是其哲学背景。

一、 太阳病(月经先期伴不孕症)
张某,26岁,初诊于1985年10月7日。婚后3年未孕,月经初潮16岁,一直先期,量多期长,色淡质稀,基础体温双相,卵泡期短,黄体不健。检查:形体消瘦,神疲乏力。肤色苍白,多年来时觉恶风自汗,微微发热,但体温正常,脉浮濡而略数,舌淡红苔薄白腻,腹诊无特殊。治疗:按太阳病中风证论治,投以桂枝汤3剂解肌祛风,调和营卫,温摄经血。桂枝、生白芍、炙甘草各10g,大枣5枚,生姜5片;针刺风池2,风门2。针药后恶风稍减,自汗略敛,发热转微,脉浮濡不数。上方加当归10g,川芎6g,继服7剂。当月经适期来潮,量中,色暗红,偶有恶风自汗。桂枝汤加味,桂、芍量减半守方半月,诸症悉除,停药观察,来月经停有妊,后足月产1女婴。
按:所有疾病除了它各己特殊规律外,同时还存在着疾病的共同的普遍规律。不孕症也不例外。《伤寒论》援从诊治外感热病入手,研求患病机体的普遍反应规律,并在其基础上,讲求疾病的通治方法。即“诸病不离六经”,“伤寒之理万病皆通”。仲景自信《伤寒杂病论》中所揭示的诊治疾病的普遍规律,“虽未能尽愈诸病,庶可以见病知源”,医家“若能寻余所集,思过半矣”。金元以后,经千百年临床实践的掏洗,医家逐渐认

识到“《伤寒论》是疾病总论”。什么是疾病总论呢?,疾病总论就是诊治疾病的普遍规律的学说。值得指出的是,以“天人合一”、“整体和谐”为特点的中医学更加重视研究疾病的普遍规律。《内经》所谓的“通合道理”,其实质就是要求医生把医道(诊治疾病的普遍规律)与医理(诊治疾病特殊的规律)融会贯通。而医道和医理相比,“唯道是大”(老子),“道尽万物之理”(韩非),即医道处于主导地位是不容置疑的。正因为《伤寒论》是以《易经》太极阴阳论为哲学背景的医道,所以历代医家奉仲景为医圣,视《伤寒杂病论》为“玉函”、“金匮”。
此案患者,用伤寒六经辨证来分析,属持续多年的太阳中风证,她虽有“恶风自汗,微微发热”等自觉症状,但由于体温正常,就没有引起医家应有的重视。此案治疗时由于严格掌握太阳中风的基本脉证,并且重视患者的体质药证。(形体消瘦,肤色苍白,恶风自汗等属于“桂枝体质”)。然后综合各方面的情况,选择了桂枝汤。由于方证契合,针药并用,多年月经先期之病,短期之内一举纠正,随后就出现李梃所论述的“妇人月水循环,纤疴不作而有子”的可喜疗效。

二、 少阳病(经期下利兼不孕症)
李某,32岁,初诊于1985年5月7日。继发性不孕5年,1980年9月流产后,月经后发,量中色淡质稀,1周净。基础体温测定双相,呈阶梯性上升,月经周期60天,卵泡期长达44-45天,黄体期仅8-9天。每次行经期,漉漉肠鸣,水样腹泻,经净后逐渐复常,平时胃胀痞满,嘈杂嗳气,便溏不成形,眠欠安而心烦,时发口疮,脉弦,舌淡红,苔薄黄腻。腹诊:心下痞满而硬,背部至阳穴处强压痛,按之而舒。证属胃寒肠热,虚实夹杂的少阳痞证。遂投甘草泻心汤:炙甘草、半夏各10g,黄芩、干姜各5g,黄连3g,大枣5枚,党参10g,15剂。并嘱其自我按压至阳穴,每日12次,每次半分钟。二诊时,心下痞硬减轻,经期腹泻次数大为减少,至阳穴压痛稍稍见减,便偏软,酌减分量,守原法治疗。末次月经在1985年7月2日来潮,经期仍投原方,月经净后停药观察。9月底,妇检已妊,来年5月,生1女孩,全家欢喜不尽。

按:六经辨证是以阴阳论为指导的“治人为本”的医学体系。阴阳,它所揭示的是机体在疾病的发展过程中的整体状态的变化,而不是疾病的病因、病位;是疾病的动因,而不是疾病的本原。
如此例患者,前医者的不足之处,就是在仅仅注重于一脏一腑的局部异常 只在冲、任、肝、肾上寻原因,而忘记了在六经上求根本。
此案是少阳病变证。腹证“心下痞硬”是泻心汤类汤证的主要指标。但临床要确定为甘草泻心汤证时,必须考虑到伴随症状---“眠欠安而心烦”。可见“腹诊”与“四诊合参”并不矛盾。

三、 太阳、阳明合病(原发性痛经并不孕症)
王某,30岁,初诊于1982年7月21日。患者15岁初潮,每于经期左胁下至少腹针刺样疼痛,疼痛向左腰腿部放射,经期尚准,经量稍少,色黯紫有块,行经不畅。延至婚后,诸证有加,婚后7年未孕。西医诊为原发性痛经并不孕症,中医曾投少腹逐瘀汤等祛瘀未效。诊见型体虽丰腴,但面色黯而少华,便秘,脉弦涩,舌淡紫有齿痕,苔白厚水滑。腹诊:腹部充实,两侧腹直肌挛急;左少腹急结,按之疼痛;左胁苦满。证属寒凝血瘀实证。方投桃仁承气汤合大黄附子汤:桃仁10g,桂枝15g,大黄、甘草各6g,元明粉10g(冲),附片10g,细辛5g(后入)。7剂,并嘱其用清艾条自灸左少腹急结压痛处,每日两次,每次15分钟。灸、药后,大便通畅,每日一行,左少腹急结消失,重按之仍有感痛,两侧腹肌也稍有挛急现象,乃转方桂枝茯苓丸料,连服35剂,每日按时坚持自灸,诸症悉除,经来痛消。停药观察,到1982年10月,停经,诊为早孕。此后胎孕正常,足月顺产。
按:患者瘀血阻滞征候明显,但泛投一般祛瘀剂却未果。虽然其中原因颇多,然而忽视腹证的特殊性可能是一个关键的因素。患者经期中出现自左胁下至少腹疼痛向腰腿放射的现象,是《金匮》所谓“胁下偏痛”而牵引他处疼痛的大黄附子汤的特殊腹证,“少腹急结,按之痛甚”是《伤寒论》中的桃仁承气汤证。据日本汉方家桑木崇秀经验,凡“下腹部(主要为左侧)有压痛与触及肿块时”是桂枝茯苓丸的腹证。日本汉方家大塚敬节、矢数道明、桑大崇秀、寺师睦崇对此均有论述。笔者据腹证活用经方并结合艾炙而终能生效。可见日本汉方证吉益东洞所教诲的:“腹证不详,不可处方。”的确为得道之言。

四、阳明病(经前紧张症伴不孕症)
刘某,27岁,初诊于1983年9月15日。患者消瘦,婚后四年未孕,月经量中,色暗红,无血块,每于经前10天左右出现烦躁、头疼、头晕、乳房胀痛、腹泻、下肢浮肿等症,每值月经来潮后自行减弱。来诊时,适值经前诸症蜂起,且伴有口干、微咳、尿黄不利等象,脉弦细数,舌红苔薄黄。腹诊:全少腹胀满、脐下动悸。证属水热阻胞,阴津不足。投以猪苓汤:猪苓、茯苓、泽泻各15g,阿胶(烊)10g、滑石粉(包)12g。7剂。并嘱其用清艾条自炙气海、关元穴,每日两次,每次10分钟。经此炙、药兼施后,诸症递减。嗣后,嘱其每月经前10天,服猪苓汤7剂并自炙关元、中极二穴。经此治疗3月,诸证基本消失,逐停治观察。到1984年5月娠妊试验为阳性,翌年1月分娩,产1男婴。
按:经前紧张症,其病因虽多,而其病理基础却有相同之处,即经前数天雌激素浓度达到高峰,出现水钠排出迟滞而发生电解质平衡失调,细胞外液增加而出现水肿。因此刺激乳腺增生而胀痛。这种水肿不仅表现于体表,也存在于内脏,包括脑组织,因而出现头痛烦躁,。
用六经辨证的角度来看,此案是阳明病水热相结的猪苓汤证。阳明为燥金,《易经》曰:“火就燥”,而《说卦》则云:“燥万物者,莫熯乎火”。日常生活经验告诉我们,离火近的地方干燥,那必然离火远的地方就会形成水湿。由此可见,阳明的燥热是造成津液不足与水湿蕴积的主要原因。少腹胀满、脐下动悸是水饮停聚之腹证。水气不行,故小便不利;水饮偏渗大肠则下利;水气犯胃则呕;射肺则咳;清阳不升则头痛而眩;饮邪久郁、气机不利则络脉痹阻,故经前乳房肿痛;阴亏火旺、灼津为痰,故形体消瘦、失眠、烦躁、舌红脉数。参合腹、脉、舌症及诸临床主要表现而选投猪苓汤滋阴利水而取效。

五、 少阳太阴同病(月经后期兼不孕)
娄某,27岁,初诊于1984年5月10日。婚后4年未孕,自诉月经衍期,40—50日1行,量少不畅,经前1周乳房胀痛,西医妇科诊为卵巢囊肿并不孕症。现症见:神色忧郁、心悸而烦,口干苦而不欲饮,喜叹息,肩背拘急凝重、纳呆,大便溏薄、小便短黄,脉弦长,舌淡红苔白腻而厚。腹诊:胸胁苦满,脐上动悸,脐周及左少腹广泛性压痛。经络压诊:腰俞穴处有显著压痛。证属肝郁饮停、瘀阻冲任。先投柴胡桂枝干姜汤合当归芍药散合方:柴胡、黄芩、当归、赤芍、川芎、白术、泽泻各10g,桂枝12g,干姜5g,生牡蛎30g,天花粉12g,茯苓15g。同时在其腰俞压痛点上给予刺血后拔罐,并以言语疏导,使其消除心理负担,加强治疗信心。经如此连续服药30多天和刺血拔罐3次后,诸诊渐减,经前乳胀亦缓。原方再服2月,终于1984年9月受孕,来年得1男婴。
按:此案根据患者口苦、咽干、目眩、胸胁苦满、脉弦等诊断为少阳病柴胡证,又根据纳呆、便溏、小便频短而涩、右下肢略有浮肿、舌淡白有齿痕、苔白而腻、脉弦紧而滑等脉症诊为太阴寒湿为胜,予以柴胡桂枝干姜汤疏解少阳并温散太阴。由于月经衍期而量少的原因常常是因为血虚,患者也存在着当归芍药散的腹症故投与当归芍药散养血活血利水,因为血虚会导致水湿相对地盛,所以投与当归芍药散和柴胡桂枝干姜汤的合方。这样不仅疏经活血,急则治标,同时养血行水,既为治本。当归芍药散的腹证,《金匮》中仅提到“腹中绞痛”,语焉不详。日本汉方家稻叶克、和久田寅经长期研究得知其具体的腹证是“脐旁、脐上脐下、四周拘挛,按之痛而彻背。”(《腹证奇览》)刺血通络亦是治疗中重要的一环。本案就是综合利用内外合治而取效。

六、少阴病(带下病兼不孕症)
孙某,27岁,初诊于1985年3月7日。婚后5年未孕,白带清稀量多,西医诊为宫颈炎、子宫发育不良、卵巢功能低下所致之不孕症。其基础体温单相。现症:神疲,下睑暗黑,全身肌肉不时跳动。心悸气短,大便溏软不成形,下肢沉重,经前略有凹陷性水肿,月经经期稍延后,月经量少色淡而稀,脉濡细,舌淡形大有齿痕,苔白厚。腹诊:全腹膨满,按之软弱缺乏弹力,脐上腹部主动脉的悸动应手。证属少阴阳虚水泛。投大剂真武汤:附片30g(先煎半小时),白芍12g,茯苓30 g,白术15 g,生姜5片。10剂,并嘱其每日用清艾条自灸脐上动悸处(水分穴)15分钟。灸、药后,白带减少,其他诸症亦减轻。再以原方投服50剂,至6月初,测基础体温,出现排卵体温,7月底,已知妊娠。因左少腹有轻微压痛,时有下肢浮肿,又给予当归芍药散,间断性服药两个月。1986年3月果然临盆,产1男婴。
按:患者一派少阴真火虚衰、肾阳不振、水气四泛之证,故白带清稀而多,肢冷肌悸、心悸便溏。据“月经周期前半月为阴,后半月为阳”(赵松泉语)的理论,可把基础体温低水平单向诊为阳气不振的潜症。据脉症投真武汤,重用附、术,并加自灸水分穴,得致天明日丽阴霾尽化而大奏功。笔者认为腹证不仅是选方的依据,其所在部位亦是针灸治疗的重要位置。
日本汉方家矢数道名在《汉方处方解证》中说:“汉方医学的特点就是‘随证治疗’因而可称之为‘证候学’或‘方证相对医学’甚至可称之为‘处方学’,证候的诊断直接与处方相联系,‘诊断即治疗’,故‘证’即是‘方’。”在治疗此案的过程中深深地体会到患者的主要脉症与《伤寒论》中的少阴病的“心下悸,头眩,身目瞬动”,及“腹痛,小便不利,四肢沉重疼痛,自下利者,此为有水气……真武汤主之”环环相扣,条文基本反映出一方证辨证的证候学、病态学、药物学与治疗学的关系。故依证投方,而获功效。

七、厥阴病(闭经、不孕症)
章某,32岁,1984年2月10日初诊。已婚5年未孕,初潮18岁,月经一直衍期,3-4月一行,近8个月一直闭经,基温单向,西医诊为继发性闭经(原因待查)。面色淡青不华,少腹冷痛,形寒肢冷,唇周干燥,手足心皲裂而寒冷、大便溏细,白带量多而清稀,脉沉紧,舌质淡暗苔白厚而腻。腹诊:下腹部胀满,按之松软如棉,无肿块。经络按诊:腰俞穴处有压痛。证属厥阴病,肝经气血凝阻,阳气失宣。予以温经汤:当归、半夏、麦冬各10g,党参15g,阿胶10g(烊),丹皮、川芎、桂枝各6g,甘草2g,吴萸1.5g,干姜3g。并每隔1周,在腰俞穴压痛处刺血拔罐1次。经如此治疗50天后,基温双相,出现排卵征象,后再续服原方加定期刺血,终于1984年6月妊娠,后顺产1男婴。
按:厥阴病的病机特点是阴阳顺逆、阴阳消长、阴阳错杂,其中还涉及肝气的疏泄以及相应的血证。厥阴病中的常用方剂当归四逆汤和当归四逆汤加吴茱萸生姜汤皆以当归命名汤方,则厥阴多病血证的特点卓然可见。温经汤由当归四逆汤加吴茱萸生姜汤的加减化裁而成。载《金匮•妇人杂病门》,主治“小腹里急、腹满、手掌烦热、唇干口燥”,“亦主妇人少腹寒、久不受胎……或月水……至期不来”,是仲景用以“养血温经”的良方。腹诊以少腹冷痛,胀满,按之无力及无肿块为目标。此案方证相符,故经汛自调而有孕。闭经一病,查腰骶部常有敏感压痛点,特别是腰俞、腰阳关、十七椎下(日人称之为上仙穴)等处穴位更是明显多见,如能在这些穴点加予刺血拔罐,则获效宏。
月经与“肝藏血”与“肝主疏泄”的生理功能关系密切、一藏一疏,一出一入均由厥阴主事。如虚寒内生,冰伏血海,常见宫寒不孕,带清稀冷,所以金代医家刘完素倡导“天癸既行,皆从厥阴论之

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손에 땀이 차는 증세는 위장에 병이 있다.
手汗症是一种对身体健康没有大妨碍的病症,症状就是手汗多,特别在夏天,手汗多得甚至会滴下水来,给患者的日常工作生活造成了一定的困扰。手汗症不分男女,在东方人比较常见,发病率约为1%,在亚热带发病率可以达到3%左右,其中约2%有家族史。在临床上,手汗症分原发性和继发性两种,大多数人为原发性手汗过多。它的治疗可以分为内科治疗和外科治疗。可以内服西药,在抑制手汗的同时,也抑制全身的汗腺分泌,这样相对来说副作用比较大;也可以用药水浸泡治疗,虽然见效但效果短暂;可以外科电视胸腔镜下胸交感神经切断手术治疗,这样不但花费较高,而且手术并发症较多。选用中医辨证治疗,不但花费低,而且安全、可靠,疗效持久。
病案
张某,男,18岁,患者手出冷汗10年余,于2007年6月10日来我处就诊。症见手掌汗出如洗,擦干数分钟即现,汗出冰冷,精神可,纳食一般,大便两日一次,略干,小便量少,身无汗,舌淡白苔白厚滑,舌中心色略黄,脉弦。经多方医治,效果不佳,西医建议作神经阻断治疗。患者担心手术有一定危险性,故求治于余。根据患者病情,辨证为寒湿中阻,蕴久化热。治以温阳化湿,泻下清热。处以厚朴、草果、陈皮、干姜、槟榔、茯苓、白术各 15g,大黄5g,黄芩10g,木香5g,车前子10g,甘草 5g。6剂,水煎服。
6月17日二诊,服上方后,舌苔渐退,水湿渐化,但手掌汗出较前加重,且手背也汗出如洗,患者仍周身无汗。故续服前方以温化寒湿,清热泻下,加用防风通圣散疏风解表,通达腠理。
6月24日三诊,患者手掌汗出明显减少,惟指端仍汗出较多,续服前方巩固疗效。
7月1日四诊,患者手掌干燥,苔净脉和,以益气健脾,养阴和胃善后,处以太子参10g,白术10g,茯苓10g,麦冬30g,玉竹15g,石斛15g,沙参15g甘草6g。3剂,水煎服。
按:《望诊遵经?诊汗望法提纲》曰:“手足汗出者,病在于胃。”故手足汗出的病位在脾胃,多因阳明热盛或寒聚胃脘所致。本患者由于寒聚胃脘,久而生湿,寒湿内盛,发越于外,则手汗如洗,汗出冰冷;郁久化热,故舌中心苔黄。治疗以温化寒湿,泻下清热。二诊患者水湿渐化,但汗出加重,虽至盛暑,患者仍周身无汗,考虑到患者寒湿内阻,长期汗液代谢失常,腠理闭郁,故加用防风通圣散疏风解表,通达腠理,使患者汗液代谢正常,循腠理出表。患者痊愈后考虑到寒湿久聚脾胃,脾胃虚弱,有用温燥辛散之品,耗气伤阴,故以益气健脾、养阴和胃善后,而收全功。
2、治疗手汗的确效方(民间中医网  先学医圣的帖子)
​我的女儿现在已经16岁了,但是她手汗如流水一般的已经有13个年头了,看了许多医生,吃够很苦的药,都没有效果。 《医宗金鉴》曰:手足濈濈然汗出,便硬尿利本当攻,寒中汗冷尿不利,攻之固瘕泻澄清。    
汗出一般有这样二种情况:
1、热聚于胃,胃中津液必干,便硬,小便自利。
2、脾寒不约,汗出冷,小便不利。    
根据这样的一个治疗原则,诊断我女儿的手汗是因为胃热,大便不硬是因为热并不过盛,尿利,不冷,更确信为胃热。立方如下:  麦冬12g  知母10g  生石膏25g  白术7g  黄芩7g  甘草5g    
麦冬为胃提供津液,知母和生石膏为“白虎”能凉胃去火,黄芩去因胃热导致的肝胆热,白术和甘草防止药物寒凉伤害脾胃。一次买了三副,服药一次,手汗减少,三副没有吃完就完全好了。后又追加一副,变方如下,是担心黄芩过冷,孩子肺上还有些热: 麦冬12g  知母10g  生石膏25g  白术7g  桑白皮15g 天花粉10g  甘草5g    
第二种情况:附子理中丸、四神丸可以解决问题。这样的中成药虽然不是完全对症,效果也是很不错的。它的主要的缺点是没有解决消化也就是降胃的功效,对于寒不是很重的人有变热的可能。    
白术12  山药15  干姜7  生鸡内金7  甘草5  如果寒盛,加附子3  肉桂3(后入:待药快煎好放入,煮3分钟左右即可)
方中加了生鸡内金使整个方剂变得更加顺畅,鸡内金有消化降胃和活血化瘀的功效,凡是食积都能花开,生山药滋阴(脾阴、肾阴)养胃。
山石神韵注:​手足濈濈然汗出,便硬尿利本当攻,寒中汗冷尿不利,攻之固瘕泻澄清。
【注】胃主四肢为津液之主,今热聚于胃,蒸其津液,傍达于四肢,故手足濈濈然汗出,且小便自利,胃中津液必干,大便必硬,本当攻也。若中寒胃阳土虚,脾不约束,津液横溢,四肢犹如阴盛淫雨滂沱,故汗出而冷也。阳虚失运,中寒不化,故小便不利也。今虽便硬而手足汗出,非为热越者比,慎不可攻,攻之必变生,固瘕泄泻澄清不止也。
3、验方:葛根+明矾  各20g 煮水洗手
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什么叫以西医理论指导用中药?试举例言之。最近会诊一颜面神经麻痹、左侧面瘫之中年患者。主诊医生用了牵正散,但又加入大量鱼腥草等凉药。推论其意,须“消炎”之故,治之近10日不效。殊不知寒则凝滞,经络更不畅通,岂能收效?邀诊,我仍用牵正散加减,其中以防风易白附子,重用黄芪等益气药,服药1周歪者得正。此例足以证明,知其方而忽视中医之理,未能灵活变通,故收效亦难,虽有效亦不理想也。

谈到中医理论,对于治疗发热性、流行性、感染性疾病,伤寒与温病学说,往往是我们的指路明灯。叶天士说:“或透风于热外,或渗湿于热下,不与热相搏,势必孤矣。”这是至理明言,是西医细菌学说所缺乏的。叶天士所说的“热”是致病的主因(可以看成是细菌之类的致病物质),叶氏不仅重视清热,还重视“透风”。所谓透风就是解表类药,风与寒这种致病因素往往为西医所忽视,重在杀菌以消炎,不知解表使邪有出路的重要性。同样,“渗湿”也就是使由细菌引起的毒素,从小便而去。上则透风,下则渗湿使病邪孤立,使细菌没有生存的环境,而病人的正气又更易于恢复。为什么用抗生素退热后,即使无明显副作用,病人仍精神不振,倦怠乏力,胃纳欠佳。而用中药随着身热递减,精神则复,就是这个道理。

中医师学了西医的“发炎”理论,往往忘记了治发热性病,还有伤寒论学说。一遇发热病,首先考虑的是抗生素,岂知“桂枝汤证”、“麻黄汤证”决非抗生素所能除。

为什么外国那么害怕流感?因为他们只有抗生素及未有成熟的抗病毒药之故。尤其是“小柴胡汤证”,用西医方法治之甚难,而用小柴胡汤3剂便可收功。我曾会诊此等证,常使西医同道觉得惊讶。月前一位老朋友因肺部感染住院,症见发热喘咳,用最新最贵抗生素治疗多日,发热退而咳喘甚。友人多病,常找我诊治,这次便给我来电话,通过问诊,口授方药:用桂枝汤合三子养亲汤。友人素体虚寒,用各种抗生素,已抑制正气,表邪不能外解,故用桂枝汤;喘甚亦由于寒痰,故用三子养亲汤。药服8剂而愈。

中医院应为发扬中医的基地,千万不能丢掉中医,不要以为有了抗生素,便照用可也。由于细菌的抗药性,抗生素越出越新,价钱越来越贵,一天用药千元以上,非我国一般人经济所能负担,何况还有明显的副反应。此时正是发挥中医药优势之时,拿起《伤寒论》与《温病学》等武器,大胆细心地去实践,用中药取代抗生素,既能减少病人的负担,又能减少药后的副作用。这是一种挑战,更是中医的发展机遇。最近有双黄连注射液,据说效果不错。只要努力于临床研究与剂型改革,使治疗细菌感染性疾病,重新领先于世界医林,相信是可以做得到的。

항생제에 대한 老中醫의 생각. 서구 의학은 항생제의 덫에 걸렸다. 환원주의라는 서구 의학의 기본 철학부터가 잘못되었다. 
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2015-11-15 刘新生 康美治疗中心

最近天津医科大学肿瘤医院教授吴雄志老师来多伦多讲学。其寒温、中西汇通,着重先辨中医之病,再定中医之主药,再由主药选主方,令人耳目一新。同时,提到抓独法、截断法等比较新的临床思路,很不错。比如截断法,过去姜春华教授主要是讲到温病治法上不必因循卫气营血传变的时序,要主动出击,将阻断疾病的纵深发展。而吴老师将之发展成为了伤寒、杂病一体的常规治法,并大大扩展了应用范围。

导赤散吴教授将其归于口腔用药法,治疗口腔溃疡、口疮一类疾病。因为吴教授工作在肿瘤医院,因各类毒性颇大的放化疗,导致口腔溃疡的患者很多。吴教授用导赤散,其加减法提到加用细辛,甚者附子,是一种少阴寒化表现,这与肿瘤患者多因放、化疗伤了正气同时有毒热稽留有关系。而导赤散本身治证传统说法是心火下移小肠。心主血脉,主行血,可以将血带到全身。血液系统更像是正邪共存的河流,不少毒物都在血中,就可以伤害组织,包括粘膜。小肠主液,心血热就可以将血带到小肠系统,影响小肠主液功能,引起小便不利,小便黄赤。其要点在于口舌生疮,小便短赤,渴喜冷饮。实际上,小便不利一条并非必见证。除了导赤散外,吴教授采用比象方法,将一些清灵药物组合来治疗粘膜损伤,效果也是不错。

我们知道,伤寒论中158条讲的是伤寒误治引起寒热错杂证,用甘草泻心汤来治疗。原文“伤寒中风,医反下之,其人下利,日数十行,谷不化,腹中雷鸣,心下痞硬而满,干呕心烦不得安。医见心下痞,谓病不尽,复下之,其痞益甚。此非结热,但以胃中虚,客气上逆,故使硬也。甘草泻心汤主之。” 汉朝不少医生也像胡万林同志一样,不管什么病先一下了之,的确不少病用了下法,症状会缓解,但很多情况下会误治,引起变证蜂起。现代研究发现胃肠道有几类运动,比如蠕动、节段性运动、大幅度运动等,其运动完全是为了配合消化的需要。而不对证的大下之法等于破坏了这种自节律,导致运动紊乱,下行运动过快和逆运动同时出现,这就是后世讲的气机升降失常之一。结热,类似虚性亢奋,而胃中虚,客气上逆是其病机。胃气虚是由于大下之后,导致胃动力不足的表现,而客气上逆就是运动紊乱的一种表现。但甘草泻心汤的玄机却不止于调节寒热和升降紊乱。

我们看《金匮》中的论述:“狐惑之为病,状如伤寒,默默欲眠,目不得闭,卧起不安,蚀于喉为惑,蚀于阴为狐,不欲饮食,恶闻食臭,其面目乍赤、乍黑、乍白。蚀于上部则声喝,[一作嗄。]甘草泻心汤主之” 根据此条,甘草泻心汤用于白塞氏病(其实,应该叫狐惑病,因为仲景比西方发现得早多了)和口腔溃疡,特别是反复发作的。这个方子可以说是专病专方的。甘草泻心汤的组成很有意思,完全超过了这两种适应证,也给后世合方、寒热并用提供了很好的范例。有人说,甘草泻心汤是治疗粘膜、结缔组织损伤的方子。从胚胎发生学上看,肌肉、结缔组织和骨是同一个胚层起源,然后再分化。而筋膜呢,是填充在三大胚层之间的。消化道本身就有四层结构,包括肌肉和粘膜。因此,本方既可以治疗消化道平滑肌运动失常,也可以修复粘膜。中医来看,就是调节了中焦的枢机,也调节了半表半里的枢机。

总结一下导赤散、甘草泻心汤、三黄泻心汤治疗口疮、口腔i溃疡的要点(抓独):

1.导赤散:口舌生疮,渴饮冷饮,舌红脉数。可热化也可寒化,热化就合黄连和黄芩法;寒化就是细辛附子法。

2.甘草泻心汤:口腔溃疡反复发作。完全是枢机的作派,半表半里。甘草泻心汤加生地,就有点合导赤散的意味了。

3.三黄泻心汤:口舌生疮,脉有力,大便干。
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