문재인 대통령은 오늘 현충일 추념사에서 자신의 정체성을 드디어 커밍아웃하였습니다. 사실상 본인이 자유 대한민국의 체제에 반대하고 북한편에 서 있음을 말입니다. 비록 김원봉이 일제강점기에 조선의열단과 조선의용대 등 독립운동을 했다고는 하나, 독립 이후 좌파 혁명운동을 하며 1948년 월북하여 6·25 전쟁의 공으로 북한 김일성으로부터 훈장까지 받고 북한에서 상당기간 주요한 자리를 거친 자가 아닙니까? 그런데 오늘처럼 6·25 전쟁 등에서 대한민국을 지키기 위해 목숨을 바친 순국선열들을 추모하는 자리에서 감히 가해자인 김원봉을 떠받들다니…
문재인 대통령은 현충원에 묻힌 국가유공자들, 그 자리에 있던 국가유공자나 이를 들은 국가유공자들과 그 가족들의 가슴에 대못을 박고 피눈물을 흘리게 한 셈입니다. 어떻게 문 대통령은 그런 생각을 갖고 현충일 추념식을 간 겁니까? 김원봉이 마지막에 김일성의 배신으로 숙청당했다고 해서 그의 자유 대한민국에 대한 반역적 행적, 6·25 당시 100만이 넘는 우리 국민들의 피눈물 어린 희생이 정당화되는 겁니까? (발췌)
문재인 대통령은 현충원에 묻힌 국가유공자들, 그 자리에 있던 국가유공자나 이를 들은 국가유공자들과 그 가족들의 가슴에 대못을 박고 피눈물을 흘리게 한 셈입니다. 어떻게 문 대통령은 그런 생각을 갖고 현충일 추념식을 간 겁니까? 김원봉이 마지막에 김일성의 배신으로 숙청당했다고 해서 그의 자유 대한민국에 대한 반역적 행적, 6·25 당시 100만이 넘는 우리 국민들의 피눈물 어린 희생이 정당화되는 겁니까? (발췌)
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"태블릿은 촛불 난동의 알파요 오메가이다"
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미중 냉전이 돌아올 수 없는 다리를 건너고 있다. 이 냉전이 길어지면 중국은 경제적으로 상당한 타격을 받을 수 밖에 없다.
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공산당이 미국을 적으로 규정했으므로, 재미 중국인들은 미국과 중국 중에 하나를 선택해야 한다.
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출처: 일베
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영아들이 조사(早死)할 위험이 높으면, 부모들은 많은 자식을 낳아 이에 대처한다. 하지만 의술의 발달로 영아 사망율이 낮아지면 부모들은 아이들을 조금 낳는다. 따라서 인구 과잉의 해결책은 의료의 개선이다.
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2020년이면 모든 빙하가 사라진다고 사기치다가, 앞으로 2년 밖에 시간이 남지 않은데다, 빙하도 건재하므로, 슬그머니 표지판를 치워버린 빙하 국립공원.
https://wattsupwiththat.com/2019/06/06/glacier-national-park-quietly-removes-its-gone-by-2020-signs/?fbclid=IwAR0RbZf6shMgXLnn_yW3BN3fPUKJQAEJBkhT8W7lzfg9C2pvij0cHB5LE_g
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부자가 되는 방법
특정한 지식이란 훈련을 통해 얻을 수 있는 게 아니다. 만일 당신을 훈련시켜 특정한 지식을 전달할 수 있다면, 사회는 누군가를 훈련시켜서 당신을 대체할 것이다. / 발췌
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인간에게 주어진 최대의 기쁨을 심각하게 받아들일 도덕적 의무가 있다.
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펜앤직격인터뷰] 차명진 “황교안 ‘좌클릭’ 요구하는 공무원 출신, 복당파 때문에 망한다”
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중국붕괴의 시작 … 은행 연쇄파산 & 위안화 붕괴 임박! ... 트럼프,
이것을 다 예측하고 있었다! ...이슈진단#.24 ... [박훈탁TV]
발전에서 석탄을 쓰지 않는다고 하지만, 영국은 네덜란드의 석탄 발전소에서 전기를 수입하고 있다.
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영아들이 조사(早死)할 위험이 높으면, 부모들은 많은 자식을 낳아 이에 대처한다. 하지만 의술의 발달로 영아 사망율이 낮아지면 부모들은 아이들을 조금 낳는다. 따라서 인구 과잉의 해결책은 의료의 개선이다.
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https://wattsupwiththat.com/2019/06/06/glacier-national-park-quietly-removes-its-gone-by-2020-signs/?fbclid=IwAR0RbZf6shMgXLnn_yW3BN3fPUKJQAEJBkhT8W7lzfg9C2pvij0cHB5LE_g
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부자가 되는 방법
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The New Evolution Deniers by Colin Wright
Greg Ellis reads The New Evolution Deniers, Colin Wright’s essay about how the denial of evolutionary biology has migrated from the Christian Right to the secular Left. It was published in Quillette on 30th November 2018.
https://quillette.com/2019/06/06/the-new-evolution-deniers-by-colin-wright/
Evolutionary biology has always been controversial. Not controversial among biologists, but controversial among the general public. This is largely because Darwin’s theory directly contradicted the supernatural accounts of human origins rooted in religious tradition and replaced them with fully natural ones. The philosopher Daniel Dennett has described evolution as a sort of “universal acid” that “eats through just about every traditional concept, and leaves in its wake a revolutionized world-view, with most of the old landmarks still recognizable, but transformed in fundamental ways.” Fearing this corrosive idea, opposition in the US to evolution mainly came from Right-wing evangelical Christians who believed God created life in its present form, as described in Genesis.
In the 1990s and 2000s there were repeated attempts by evangelicals to ban evolution in public schools or teach the so-called “controversy” by including Intelligent Design—the belief that life is too complex to have evolved without the aid of some “Intelligent Designer” (i.e. God)—in the biology curriculum alongside evolution. But these attempts failed when scientists demonstrated in court that Intelligent Design was nothing more than Biblical Creationism gussied up in scientific-sounding prose. Since then, however, Creationism and Intelligent Design have lost a tremendous amount of momentum and influence. But while these right-wing anti-evolution movements withered to irrelevancy, a much more cryptic form of left-wing evolution denialism has been slowly growing.
At first, left-wing pushback to evolution appeared largely in response to the field of human evolutionary psychology. Since Darwin, scientists have successfully applied evolutionary principles to understand the behavior of animals, often with regard to sex differences. However, when scientists began applying their knowledge of the evolutionary underpinnings of animal behavior to humans, the advancing universal acid began to threaten beliefs held sacrosanct by the Left. The group that most fervently opposed, and still opposes, evolutionary explanations for behavioral sex differences in humans were/are social justice activists. Evolutionary explanations for human behavior challenge their a priori commitment to “Blank Slate” psychology—the belief that male and female brains in humans start out identical and that all behavior, sex-linked or otherwise, is entirely the result of differences in socialization.
This stance is maintained by the belief that evolutionary explanations for sex-linked behavioral differences are biologically essentialist, which is the fatalistic notion that biology alone directly determines our behavior. Blank Slate psychology, however, is universally rejected by experts, as the evidence for innate sex-linked personality differences in humans is overwhelmingly strong. But experts also universally reject that this view demands we embrace biological essentialism, because the environment does play a role, and observed sex differences are simply averages and overlap tremendously between the sexes. Sex no more determines one’s personality than it determines one’s height. Sex certainly influences these traits, but it does not determine them. For instance, most of us know females who are taller than most males, and males who are shorter than most females, though we are all aware that males are, on average, taller than females. In humans, the same is true for behavioral traits.
I am an evolutionary behavioral ecologist, and most of my work is concerned with how individual differences in behavior (i.e. personality) influence individual fitness, and the collective behavior and success of animal societies. Most are probably not aware, but animal personality research is a vibrant field within behavioral ecology due to the ubiquity of personality as a phenomenon in nature, and its ability to explain interactions both within and between species. In nearly every species tested to date for the presence of personality, we’ve found it, and sex-linked personality differences are frequently the most striking. Sex-linked personality differences are very well documented in our closest primate relatives, too, and the presence of sexual dimorphism (i.e. size differences between males and females) in primates, and mammals generally, dramatically intensifies these differences, especially in traits like aggression, female choosiness, territoriality, grooming behavior, and parental care.
Given that humans are sexually dimorphic and exhibit many of the typical sex-linked behavioral traits that any objective observer would predict, based on the mammalian trends, the claim that our behavioral differences have arisen purely via socialization is dubious at best. For that to be true, we would have to posit that the selective forces for these traits inexplicably and uniquely vanished in just our lineage, leading to the elimination of these traits without any vestiges of their past, only to have these traits fully recapitulated in the present due to socialization. Of course, the more evidenced and straightforward explanation is that we exhibit these classic sex-linked behavioral traits because we inherited them from our closest primate ancestors.
Counterintuitively, the social justice stance on human evolution closely resembles that of the Catholic Church. The Catholic view of evolution generally accepts biological evolution for all organisms, yet holds that the human soul (however defined) had been specially created and thus has no evolutionary precursor. Similarly, the social justice view has no problem with evolutionary explanations for shaping the bodies and minds of all organisms both between and within a species regarding sex, yet insists that humans are special in that evolution has played no role in shaping observed sex-linked behavioral differences. Why the biological forces that shape all of life should be uniquely suspended for humans is unclear. What is clear is that both the Catholic Church and well-intentioned social justice activists are guilty of gerrymandering evolutionary biology to make humans special, and keep the universal acid at bay.
Despite there being zero evidence in favor of Blank Slate psychology, and a mountain of evidence to the contrary, this belief has entrenched itself within the walls of many university humanities departments where it is often taught as fact. Now, armed with what they perceive to be an indisputable truth questioned only by sexist bigots, they respond with well-practiced outrage to alternative views. This has resulted in a chilling effect that causes scientists to self-censor, lest these activists accuse them of bigotry and petition their departments for their dismissal. I’ve been privately contacted by close, like-minded colleagues warning me that my public feuds with social justice activists on social media could be occupational suicide, and that I should disengage and delete my comments immediately. My experience is anything but unique, and the problem is intensifying. Having successfully cultivated power over administrations and silenced faculty by inflicting reputational terrorism on their critics and weaponizing their own fragility and outrage, social justice activists now justifiably think there is no belief or claim too dubious that administrations won’t cater to it. Recently, this fear has been realized as social justice activists attempt to jump the epistemological shark by claiming that the very notion of biological sex, too, is a social construct.
As a biologist, it is hard to understand how anyone could believe something so outlandish. It’s a belief on a par with the belief in a flat Earth. I first saw this claim being made this year by anthropology graduate students on Facebook. At first I thought they mistyped and were simply referring to gender. But as I began to pay closer attention, it was clear that they were indeed talking about biological sex. Over the next several months it became apparent that this view was not isolated to this small friend circle, as it began cropping up all over the Internet. In support of this view, recent editorials from Scientific American—an ostensibly trustworthy, scientific, and apolitical online magazine—are often referenced. The titles read, “Sex Redefined: The Idea of 2 Sexes Is Overly Simplistic,” and “Visualizing Sex as a Spectrum.”
Even more recently, the most prestigious scientific journal in the world, Nature, published an editorial claiming that classifying people’s sex “on the basis of anatomy or genetics should be abandoned” and “has no basis in science” and that “the research and medical community now sees sex as more complex than male and female.” In the Nature article, the motive is stated clearly enough: acknowledging the reality of biological sex will “undermine efforts to reduce discrimination against transgender people and those who do not fall into the binary categories of male or female.” But while there is evidence for the fluidity of sex in many organisms, this is simply not the case in humans. We can acknowledge the existence of very rare cases in humans where sex is ambiguous, but this does not negate the reality that sex in humans is functionally binary. These editorials are nothing more than a form of politically motivated, scientific sophistry.
The formula for each of these articles is straightforward. First, they list a multitude of intersex conditions. Second, they detail the genes, hormones, and complex developmental processes leading to these conditions. And, third and finally, they throw their hands up and insist this complexity means scientists have no clue what sex really is. This is all highly misleading and deceiving (self-deceiving?), since the developmental processes involved in creating any organ are enormously complex, yet almost always produce fully functional end products. Making a hand is complicated too, but the vast majority of us end up with the functional, five-fingered variety.
What these articles leave out is the fact that the final result of sex development in humans are unambiguously male or female over 99.98 percent of the time. Thus, the claim that “2 sexes is overly simplistic” is misleading, because intersex conditions correspond to less than 0.02 percent of all births, and intersex people are not a third sex. Intersex is simply a catch-all category for sex ambiguity and/or a mismatch between sex genotype and phenotype, regardless of its etiology. Furthermore, the claim that “sex is a spectrum” is also misleading, as a spectrum implies a continuous distribution, and maybe even an amodal one (one in which no specific outcome is more likely than others). Biological sex in humans, however, is clear-cut over 99.98 percent of the time. Lastly, the claim that classifying people’s sex based on anatomy and genetics “has no basis in science” has itself no basis in reality, as any method exhibiting a predictive accuracy of over 99.98 percent would place it among the most precise methods in all the life sciences. We revise medical care practices and change world economic plans on far lower confidence than that.
Despite the unquestionable reality of biological sex in humans, social justice and trans activists continue to push this belief, and respond with outrage when challenged. Pointing out any of the above facts is now considered synonymous with transphobia. The massive social media website Twitter—the central hub for cultural discourse and debate—is now actively banning users for stating true facts about basic human biology. And biologists like myself often sit quietly, afraid to defend our own field out of fear that our decade of education followed by continued research, job searches, and the quest for tenure might be made obsolete overnight if the mob decides to target one of us for speaking up. Because of this, our objections take place almost entirely between one another in private whisper networks, despite the fact that a majority of biologists are extremely troubled by these attacks to our field by social justice activists. This is an untenable situation.
It is undoubtedly true that trans people lead very difficult lives, which are only made more difficult by the bigotry of others. But social justice activists appear completely unwilling or unable to distinguish between people who criticize their ideology and people who criticize their humanity. Their social immune system appears so sensitive that it consumes itself. We need to acknowledge that trans issues and ideology are complex, and concern one of the most marginalized communities in the world. Because of this, we must give these issues the respect they deserve by approaching them with nuance and compassion instead of crudeness and cruelty. But we must not jettison truth in this process. If social justice activists require scientists to reject evolution and the reality of biological sex to be considered good allies, then we can never be good allies.
Back when evolution was under attack from proponents of Biblical Creation and Intelligent Design, academic scientists were under no pressure to hold back criticism. This is because these anti-evolution movements were almost exclusively a product of right-wing evangelicals who held no power in academia. Now we have a much bigger problem, because evolution denialism is back, but this time it’s coming from left-wing activists who do hold power in academia. This makes the issue both harder to ignore and harder to remove. Social justice and hyper-militant trans activism now seems to act as a kind of anti-universal acid, and not merely a strong buffer solution. While the universal acid of evolution eats through old cherished beliefs and replaces them with deeper understanding and a clearer picture of reality, the anti-universal acid of social justice ideology is a recklessly destructive force, aiming to abolish scientific truth and replace it with relativistic postmodern nonsense.
I did not train to be a scientist for over a decade just to sit quietly while science in general, and my field in particular, comes under attack from activists who subvert truth to ideology and narrative. When I reflect on my initial reasons over a decade ago for choosing a career as an academic scientist, it was largely due to the inspiration I felt from outspoken public intellectuals like Richard Dawkins, Sam Harris, Stephen Fry, and the late Christopher Hitchens, who led by example and followed reason wherever it took them. At the time, it seemed to me that a career as an academic scientist would be the most intellectually satisfying profession imaginable. It would allow me to dive deep into questions at the frontier of human knowledge, teach and train students to think critically, and pass on the virtues of boldly engaging with unreason in the search for truth to a new generation.
But it seems clear to me that academia now is not as it was advertised a decade ago when I started down this path. It is no longer a refuge for outspoken, free-thinking intellectuals. Instead, it seems one must now choose between living a zipper-lipped life as an academic scientist, or living a life as a fulfilled intellectual. Currently, one cannot do both.
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난경难经의 복진腹诊
中医腹诊理论起源于《内经》《难经》，后世医家如张仲景将其应用于临床。刘保和认为《难经》关于腹诊的腹部五脏分区和诊动气有关记载，对临床指导意义尤为突出，并经临床反复实践，总结出《难经》腹诊理论在经方中的应用。► 识别上方二维码，开始阅读《难经》
1.《难经》腹诊理论
《难经·十六难》曰：“假令得肝脉……其内证脐左有动气，按之牢若痛……有是者肝也，无是者非也”；“假令得心脉……其内证脐上有动气，按之牢若痛……有是者心也，无是者非也”；“假令得脾脉……其内证当脐有动气，按之牢若痛……有是者脾也，无是者非也”；“假令得肺脉……其内证脐右有动气，按之牢若痛……有是者肺也，无是者非也”；“假令得肾脉……其内证脐下有动气，按之牢若痛……有是者肾也，无是者非也”，说明脐中属脾，脐左、上、右、下分别属肝、心、肺、肾。腹诊时脐左、上、中、右、下有动气，按之有坚硬或疼痛感，是判断病位分别在肝、心、脾、肺、肾的重要依据。此理论，对临床诊疗疾病具有重要的指导意义。
2.腹诊方法及定位
让患者仰卧，两腿屈曲，两臂沿身体两侧平伸，露出腹部。以中指同身寸为度量标准，分别按压其脐上、下、左、右、中处。“脐上”应在脐上1 寸处，即任脉的水分穴；“脐下”应在脐下1.5寸处，即任脉的气海穴； “脐左”与“脐右”分别在脐左与脐右的0.5寸处，即足少阴肾经的左肓俞穴与右肓俞穴。
3.腹诊理论的经方辨证应用
3.1 脐上压痛
主心病，心主血脉，多与全身性瘀血证候有关，主方以《金匮要略》旋覆花汤加减（经验方，由旋覆花、当归、郁金、桃仁、茜草、泽兰、柏子仁各10 g 组成）治疗。► 识别上方二维码，开始阅读《金匮要略》
案1：李某，女，43岁，2009年3月9日初诊：主诉胃脘痛阵发1年，近1周发作频繁，疼痛加重。发作时胃脘绞痛，手足逆冷，自觉有气从脐上攻冲至胃脘，随即呕吐。舌红、苔中根腻，脉沉细涩、偏数。按其脐上压痛甚，并觉指下腹主动脉搏动有力。给予上述旋覆花汤加减，7剂水煎服，每日1剂。3月16日二诊：服药后胃痛渐止，已2d未发作。停药观察后随访无复发。
3.2 脐左压痛
主肝病，肝主疏泄，凡肝病疏泄失常均可出现此症，主方以四逆散治疗。
案2：申某，男，22岁，2007年9月6日初诊：主诉入睡难1月余，常躺下2~3h亦不入睡，但睡后即不再早醒。白天巅顶及太阳穴处发胀，下午及晚上严重，自觉有“血下不去”感觉，并伴手足冷、大便干。平时两腿烦扰不宁，喜捶打，已2年余。舌质正常、苔白腻、脉沉弦细，按腹部脐左压痛明显。给予四逆散合二陈汤，7剂水煎服，每日1剂。9月13日二诊：诸症大减，口干心烦，上方加丹皮、栀子、知母继服7剂。后随访诸症除，无复发。
3.3 脐右压痛
主肺病，肺主宣发、肃降，尤以从右而降为主，肺气不降可以引起肝气上逆、肝血瘀滞，《金匮要略》奔豚汤证即属此类证候。主方以奔豚汤（桑白皮、黄芩、白芍、当归、川芎、半夏、葛根各10g，生姜、炙甘草各6g）治疗，奔豚汤原方中甘李根皮药房常不备，故以桑白皮代之，效果亦佳。
案3：王某，男，13岁，2005年1月9日初诊：主诉阵发性呕吐5年，近1个月加重。患者自2000年2月开始突发呕吐，甚则将胆汁呕出，伴右侧头痛，西医诊断“十二指肠球炎”，之后每月发作1 次，近1个月发作频繁。平素多食胃胀，大便溏，每日2~3次。唇舌红，苔白腻，脉弦数。脐右压痛。给予奔豚汤合二陈汤，7剂水煎服，每日1剂。2月16日二诊：胃胀除，未发呕吐，续服上方7剂。半年后随访，呕吐未发作。
3.4 脐下压痛
属肾病，此处乃肾原之气的发生地，凡肾阴、肾阳、肾气、肾精亏损均可出现压痛，主方以《金匮要略》肾气丸化裁治疗。《金匮要略》肾气丸原为肾阳不足，下元虚冷诸症而设，若下焦无虚寒者，可去附子、桂枝( 即六味地黄丸加减) 。► 识别上方二维码，查看肾气丸具体组成
案4：杨某，女，62岁，2011年6月3日初诊：主诉全腹胀、嗳气，有时泛酸，左胸上隐痛。时发胸闷咽憋，食冷则胃痛尤甚。左膝关节及腰背痛，下肢浮肿，午后加重。夜尿3~4次。脉寸浮、尺弱、舌胖红、苔黄腻，脐中、脐下压痛。予六味地黄丸合当归芍药散、香苏饮。7剂水煎服，每日1剂。6月10日二诊：药后诸症均减，续服14剂。6月24日三诊：腹胀、吐酸、嗳气均除，稍肿，夜尿2次，续服7剂。后随访，除劳累后偶发下肢肿外，诸症未发。
3.5 脐中压痛
属脾病，脾位于人体中央，主运四旁，为四运之枢轴，而胃气的存亡关乎人体的生死，故前人多谓此处压痛应给予理中、四逆辈治疗。据临床所见，杂病中并不常见如此危重证候，但亦多有脐中压痛者，主方以《金匮要略》当归芍药散（当归、白芍、川芎、白术、茯苓、泽泻各10g）治疗最佳。
案5：梁某，女，26岁，1998年1月17日初诊：主诉婚后2年未避孕而未孕。患者17岁初潮后即因生气停经2年，复潮之后3～6个月经行1次。23岁结婚，婚后2年余未避孕且一直未孕。现月经已50d未来潮，无明显不适。舌胖大有齿痕，脉细尺无力，脐中、脐下压痛明显。给予当归芍药散加平补肝肾诸药：当归、川芎、白芍、白术、茯苓、泽泻、杜仲、川断、桑寄生、枸杞子、菟丝子、沙苑子各10g。7剂水煎服，每日1剂。1月24日二诊：23日月经来潮，量不多，腹稍痛。续服上方7剂，后以当归芍药散加味调理。1998年4月28日早孕试验( ) ，1年后随访顺产一健康女婴。
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천금방의 온비환温脾丸
十年前从刘力红先生在《思考中医》中提畅学习中医要回归经典以来、中医学者对《伤寒论》·《内经》·《神农本经》等经典的研究日益，而作品汗牛充栋。对《千金》的研究则很少、而更多的是文献价值的研究。《千金方》千金方、是一坐金矿！怎样把木乃依式的文献价值转化为高效的临床价值、真正服务于患者、是摆在当代中医学者面前共同的课题！如果把《伤寒论》比喻为皇冠上的明珠，那么《千金方》无疑是古中医学的皇冠！仲师《伤寒论》是法度法轨。孙真人《千金方》则是法度法轨边际地症候群的对应方剂。《千金方》是古中医学之集大成者、是中医学的大百科全书。
清初医家张璐在《千金方衍义》中指出：长沙为医门之圣、其立法诚为百世之师。继长沙而起者、唯孙真人《千金方》可与仲圣诸书颉颃上下也！伏读三十巻中、法良意美、圣谟洋洋
、其辨治之条分缕析、制方之反激逆从、非神而明之、熟能与于斯乎。
特别指出的是、由于每个医者的体系、视野的不同对《千金方》繁多的方剂中的认知和取象当然也不同。一千个医者的眼中会有一千个孙真人、可见《千金方》在学术上是包容的、兼收并蓄的。孙真人是中医史上最后一位圣人、《千金方》驻世了一千五百年、仍将惠民于千古！
一、温脾丸
张大昌先生云：脾胃是用主在消化、消者，以除糟秽也。化者，蒸其清精上升以为营卫也。
中焦乃阴阳交混之处治中部方极难撰定、唯《千金》温脾丸堪备职耳。《千金》、《外台》之方曰温脾丸者多矣、为何大昌先生只眼独荐此方呢？谓奇？奇在哪呢？愚以为首先当从此方的药物结构来分析。
温脾丸：治久病虚羸气弱、食不消喜噫方。
附子、干姜、细辛、桂心、吴茱萸、
黄连、黄柏、当归、
大黄、神曲、麦芽、
共为细末、炼蜜为丸、空心酒服。
此方结构曾相似否？由此就拽出了另一个凡医中人、无人不知无人不晓的千古名方乌梅丸！乌梅丸：
附子、干姜、细辛、桂心、川椒
黄连、黄柏、当归、
乌梅、人参、
二者结构上的异同一目了然。
1、五味温阳药吴茱蓃易川椒。二者都是辛温暖肝之药、也都有下气之功、但不同的是川椒止咳、温肾利关节并有杀虫的功能、而吴茱萸化痰冷、重在温脾而下气更速。吴茱萸辛苦温、苦味分清浊、清苦者燥湿而升清、浊苦者祛湿而下糟秽也。《本草述钩元》云吴茱萸、利五脏、通关节、及大肠壅气、治冲逆。吴茱萸能暖膀胱、水道既淸大肠自固、他药虽热不能分解清浊也。《千金方》孙真人论述吴茱萸：咳逆寒热、除湿血痹、逐风邪开腠理、去痰冷、诸冷食不消！诸冷食不消尤为贴切。
2、根本不同在于补与敛（人参、乌梅）、消与通（神曲、麦芽、大黄）。
乌梅丸与温脾丸一虚一实堪称厥阴寒热错杂临证之姐妹篇。
张璐先生［衍义］：
温脾反用三黄、专为真火式微不能消磨宿食、蕴积于中而热积于上，非用三黄之苦寒拔上盛，则蓃、桂、姜附入胃先助上热何能直达下焦，又恐寒热相梧更须细辛、当归调和经府气血。然后曲麦藉辛温之力得以消导。恬不顾虚羸竞行辛烈峻攻者正恐病势纠缠、他时愈难攻击也！
马新童老师的研究成果：乌梅丸关死门、温脾丸开生门、厥阴之治治从中。
临症心得：
1、结肠炎：乌梅丸乃仲师为吐蛔而设、愚不敏临症从未遇过此症不敢妄议。但又主久痢、用之常得心应手。临症凡见久痢不愈而现上热下寒、或夜热早凉等寒热错杂之疾用之效佳。然而在运用乌梅丸治疗结肠炎时、虽有寒热错杂症、但有积滞未消而现实证者则力有不逮。温脾丸原有加减方法或加桔梗、枳实等临床不可食古不化。医案一则：老太八十有二、结肠炎而求诊。刻下失眠、怕冷、便秘、排脓性白便。思之、失眠乃上热而火不归原、排白便乃相火不足胆经不降、便秘乃釜底无火食不能化、脓性便乃气机不畅。书方五贴：附子10、细辛10、干姜15、肉桂15、吴茱萸15、黃连15、黄柏10、当归15、大黄20、神曲15、炒麦芽15、桔梗15、枳实15、一贴三次分服一曰二次。服后转天、排宿便半脸盆、药讫便色转深、脓性便少。早补中益气丸、晚人参健脾丸善后。
2、盗汗：余老母八十、爱吃生菜沾酱、旅劝不逮日久。一日晨起云晚间颈及前胸盗汗三天、不假思索温脾丸改汤一剂、下而愈。中寒积滞龙虎不能回环、阳热不能归巢则向上向外、睡则卫气失司则津随热泄！
3、更年期综合症：某女50岁。刻下潮热汗出、失眠、胃胀、大便头秘而后溏、脉两寸上鱼际、浮取浊、右关沉紧、左尺沉紧。书方：温脾丸合升降散桂枝茯苓丸加减而愈。
4、由于有大队的温三阴之药及大黄、吴茱蓃之浊苦、连、柏之清苦，这样一个结构特点、温脾丸几乎可用于所有代谢性疾病的适应症中。见仁见智、有缘者得之！
附1《千金》下痢丸：治数十年痢、下气消谷令人能食、夏月长将服之不霍乱方。
原方：大麦蘖、法曲各一升，乌梅二升半，附子、干姜、桂心、黃连、黄柏各二两，川椒半两，吴茱蓃四两。蜜丸
附2《千金》麦蘖丸：治数十年下痢不止，消谷下气、䃼虚羸方。
原方：大麦蘖、好曲各一升，乌梅肉四两，附子二两，干姜四两，桂心二两，黄连四两，川椒一两，吴茱萸四两，当归二两。蜜丸
附3《千金》乌梅丸：治久痢诸药不瘥数十年者、消谷下气补虚方。
原方：乌梅肉四两、干姜四两、桂心二两、黄连四两、川椒一两半、吴茱萸四两、当归三两。
蜜丸
附4《伤寒》乌梅丸：略
张璐先生对附1、附2、附3、附4方总评之［衍义］：
下痢积年不瘥必然正气虚寒。然能消谷必有热伏于内、且浊气下泄虽能进食不能如期克运、必有留滞于中，所以首推曲蘖推陈致新，连柏破除积热，则椒姜蓃附之属得以建温脾之功，乌梅专收耗散之津液。麦蘖丸（附2）即于下痢丸（附1）中除去黄柏增益黄连，复加当归以和脾家之血。乌梅丸（附3）中又于麦蘖丸中除去曲、蘖、附子峻温专克之味、惟以平和、温补为务。又方（附4指伤寒乌梅丸）以细辛代茱萸温散肝脾之寒、参合下痢丸中附子、黄柏分解冷热之交结，独进人参以助中土温消之力，较下痢丸、麦蘖丸大义不殊而细微迥别，非以心印心，几失先哲之心印。
附5《千金》大曲蘖丸：主消谷断下温和又寒冷者、常服不患霍乱方。
原方：大曲糵各一升、附子、干姜、当归、人参各三两、赤石脂一两、桔梗、女萎各二两、
吴茱萸、皂荚各五两、川椒二两半、乌梅五十枚。蜜丸、下甚者加龙骨、阿胶、艾各三两。
张璐先生［衍义］：大曲蘖丸用人参、姜、附、椒、萸一派辛温、佐曲蘖以温中消导、专取皂荚以通关窍、破坚积逐风、其性过烈、且有姜附等助长其势、不得不以参归桔挭女萎和之。女萎专主风寒洒洒霍乱泄利、惊痫寒热、石脂乌梅收涩药力。
爱新觉罗恒伟
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삼황탕, 소건중탕의 임상 경험
[转载]童耀辉泻心汤、小建中汤经验
[转载]童耀辉泻心汤、小建中汤经验
经方败案群20150707童耀辉泻心汤、小建中汤经验交流语音整理版
发言人：马来西亚童耀辉
整理人：浙江杭州刘道邈
发言人：马来西亚童耀辉
整理人：浙江杭州刘道邈
1.三黄汤，又叫“火齐汤”，相传是商朝宰相伊尹所创，用于治疗“涌疝”，二便不通，《张氏医通》有载。故此方不但用于清热泻下，还可用于小便不通的治疗。
2.《千金方》三黄圆，用治五劳七伤，消渴，不生肌肉。
3.三黄散，用于黄疸。治新生儿黄疸可涂于婴儿口腔内。此方记载于《本事方》。
4.三黄，药味简单，多不单用。我常与葛根汤、桂枝汤、桂枝防风汤（《幼幼集成》，桂枝汤加防风）、麻黄汤等解表剂合用。用于白喉、扁桃体脓肿、带状疱疹。
5.用于治疗白喉，最早是多年前给我母亲使用。当时她除了咽痛，咽部一层白膜，就是发热、恶风、自汗、身痛等桂枝汤证。当时我开了桂枝汤合三黄汤。三剂病愈。此后常用此方法治疗白喉。或合桂枝汤，或合麻黄汤，或合葛根汤，或合桂枝防风汤。桂枝防风汤，用于脉浮缓，而无汗。
6.扁桃体脓肿，也是用这一方法。一般3~5天痊愈、破溃。有一同道祖传中医所谓秘方，就是使用三黄泻心汤治疗带状疱疹。用得比较多的，是用于带状疱疹，合上解表方剂，包括自己身上使用，还有学生使用，3~5天常结痂痊愈，效果理想。
7.三黄也常和小建中汤合用，补虚同时去积滞，可以推陈致新，用于小孩癌症化疗后，烦躁，哭闹，发热，双足无力，用小建中汤合三黄后效果满意。此间小孩多体虚无力。小建中汤和三黄比例是2:1，热象轻而体虚重则3:1。
8.三黄和二陈汤的合方：2003年，接诊一21岁年轻患者车祸后股骨骨折，术后骨髓栓塞曾经出现休克。体温39℃，血压220/140mmHg，角弓反张。肺部反复感染，痰鸣音重，极为危重，用三黄合二陈汤，再加白茅根、羚羊角（刨丝）。二陈汤、白茅根、羚羊角一起煎煮后浸泡三黄。陈皮、半夏各用50克，余药常量。第二天随访，其母反馈当天服药15分钟后角弓反张消失，血压降至150/90 mmHg，体温下降，当晚泻下黑便不少。随后感染控制，痰少，抽痰次数减少。但是神志仍差，三年后死于褥疮。
9. 三黄和二陈汤的合方：常用于肺部感染、痰多。一周可解决感染与痰多问题。记得一摔伤头部着地、七孔流血病人，颅脑手术后反复感染，前医用箭猪枣（箭猪体内结石），一天服用10分，经三个月而无显效。我接手此病患后也是用此方而立功。
10.三黄汤合加味半夏厚朴汤：加味半夏厚朴汤即半夏厚朴汤加陈皮、杏仁、桔梗。对于烟霾所致支气管肺炎，运用三黄汤合加味半夏厚朴汤效果很好，但要注意服药前三天会出现咳嗽加重、大量粘痰。
11.大黄之用：大黄不但通腑，利小便的作用也非常好。猪苓汤加少量大黄（3~5克），大黄起催化作用，利尿作用则更好。大黄又称将军，取将军之威，小剂量则可，通腑泄热才需要大剂量。
12.猪苓汤加大黄不但治疗尿道感染，也常与小柴胡汤合用治疗荨麻疹等过敏性疾病，效果很好。
13.苓桂术甘汤加大黄：用于治疗鼻炎、鼻窦炎，在使用开始会排出大量或浓或清的鼻涕。我使用此方治愈了不少此类疾病。
14.肺积水的喘证，使用葶苈大枣泻肺汤加大黄。以前使用葶苈大枣泻肺汤效果不满意，加入大黄后泄水作用明显增强，效果满意。曾治我一学生喘证，咳喘牵引及两胁疼痛，最初想使用麻杏石甘汤，后腹证两胁以及心下都疼痛拒按，使用了大柴胡汤合葶苈大枣泻肺汤，其中就包含了葶苈大枣泻肺汤加大黄。服药后泻下大量粪水，也不脱水，这就是《金匮要略》中的“悬饮”。所处地域没有芫花、甘遂、大戟等药，我都使用大柴胡汤合葶苈大枣泻肺汤，其泄水之功不亚于十枣汤。
15.半夏泻心汤：半夏泻心汤加大黄，其实就是合上三黄。不因半夏泻心汤证多有便溏而弃用。很多急性胃肠炎、食物中毒病人，误服止吐止泻药物后出现心下痞、胸闷欲呕不得，肠鸣而大便不通。此时使用半夏泻心汤加少量生大黄，汤剂5克左右，服后会出现呕吐、泻下臭秽物，之后则舒适。
16.小结大黄之用：多用小剂量，取其性，合他方、他药。或合消食导滞药治疗食积，或合利水药以利水，效果很好。
17.“以医悟道”群友补充：三黄片合附子理中片用于消食效果很好。三黄片用于中上焦的郁火效果满意。
18.小建中汤的运用：《金匮要略》条文：“虚劳里急，悸，衄，腹中痛，梦失精，四肢酸疼，手足烦热，咽干口燥，小建中汤主之。”甲亢最吻合以上诸症。甲亢常有心悸、自汗、四肢酸痛、五心烦热等症。临床常加入龙骨、牡蛎，烦热加石膏、知母。临床使用此方治疗甲亢效果满意，降T3、T4快，睡眠也明显改善。
19.饴糖：因为所处地域无饴糖，我常用山药、麦芽代替。
20.小建中汤治疗各种痹症：各种关节肌肉劳损、疲劳而导致的各种疼痛。用方抓手：遇劳则损。虚劳疼痛病人常有睡眠不佳、烦躁、烘热等特点。常加石膏，不论有无烦热，效果均比不加好。
21. 小建中汤改善体质，儿科运用小建中汤较多。常加黄芩，治疗癌痛、慢性咽炎、慢性扁桃体肿大。虚劳病人常有劳热表现，非实热也，常加黄芩、石膏、知母等除烦热。
22.小建中汤合当归补血汤，也就是黄芪建中汤加当归，黄芪大剂量使用。用于血虚而导致失眠、身体疼痛、经痛，效果很好。曾治子宫切除术后出现血虚性失眠病人，服用此方后睡眠非常好。
23.黄芪建中汤、四味健步汤治疗虚劳所致关节劳损。服用后可改善疼痛，并且可长期服用。
24.使用小建中汤经验小结：用于痹症疼痛时，赤白芍同用；劳热重者，可根据病情斟酌加上黄芩、栀子、石膏、知母等。盗汗者，加白薇。
25.小建中汤合焦三仙、大黄。用于食伤而导致的各种虚弱性症状，补虚而推陈致新。不但用于小儿，大人也多见。使用后会胃口大开、体力增长。
26群友“纽约陶”补充：三黄打粉加冰片（生大黄30克、黄连15克、黄芩15克、植物冰片15克）治疗小儿烫伤一例效果很好、疤痕也不明显。
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2.《千金方》三黄圆，用治五劳七伤，消渴，不生肌肉。
3.三黄散，用于黄疸。治新生儿黄疸可涂于婴儿口腔内。此方记载于《本事方》。
4.三黄，药味简单，多不单用。我常与葛根汤、桂枝汤、桂枝防风汤（《幼幼集成》，桂枝汤加防风）、麻黄汤等解表剂合用。用于白喉、扁桃体脓肿、带状疱疹。
5.用于治疗白喉，最早是多年前给我母亲使用。当时她除了咽痛，咽部一层白膜，就是发热、恶风、自汗、身痛等桂枝汤证。当时我开了桂枝汤合三黄汤。三剂病愈。此后常用此方法治疗白喉。或合桂枝汤，或合麻黄汤，或合葛根汤，或合桂枝防风汤。桂枝防风汤，用于脉浮缓，而无汗。
6.扁桃体脓肿，也是用这一方法。一般3~5天痊愈、破溃。有一同道祖传中医所谓秘方，就是使用三黄泻心汤治疗带状疱疹。用得比较多的，是用于带状疱疹，合上解表方剂，包括自己身上使用，还有学生使用，3~5天常结痂痊愈，效果理想。
7.三黄也常和小建中汤合用，补虚同时去积滞，可以推陈致新，用于小孩癌症化疗后，烦躁，哭闹，发热，双足无力，用小建中汤合三黄后效果满意。此间小孩多体虚无力。小建中汤和三黄比例是2:1，热象轻而体虚重则3:1。
8.三黄和二陈汤的合方：2003年，接诊一21岁年轻患者车祸后股骨骨折，术后骨髓栓塞曾经出现休克。体温39℃，血压220/140mmHg，角弓反张。肺部反复感染，痰鸣音重，极为危重，用三黄合二陈汤，再加白茅根、羚羊角（刨丝）。二陈汤、白茅根、羚羊角一起煎煮后浸泡三黄。陈皮、半夏各用50克，余药常量。第二天随访，其母反馈当天服药15分钟后角弓反张消失，血压降至150/90 mmHg，体温下降，当晚泻下黑便不少。随后感染控制，痰少，抽痰次数减少。但是神志仍差，三年后死于褥疮。
9. 三黄和二陈汤的合方：常用于肺部感染、痰多。一周可解决感染与痰多问题。记得一摔伤头部着地、七孔流血病人，颅脑手术后反复感染，前医用箭猪枣（箭猪体内结石），一天服用10分，经三个月而无显效。我接手此病患后也是用此方而立功。
10.三黄汤合加味半夏厚朴汤：加味半夏厚朴汤即半夏厚朴汤加陈皮、杏仁、桔梗。对于烟霾所致支气管肺炎，运用三黄汤合加味半夏厚朴汤效果很好，但要注意服药前三天会出现咳嗽加重、大量粘痰。
11.大黄之用：大黄不但通腑，利小便的作用也非常好。猪苓汤加少量大黄（3~5克），大黄起催化作用，利尿作用则更好。大黄又称将军，取将军之威，小剂量则可，通腑泄热才需要大剂量。
12.猪苓汤加大黄不但治疗尿道感染，也常与小柴胡汤合用治疗荨麻疹等过敏性疾病，效果很好。
13.苓桂术甘汤加大黄：用于治疗鼻炎、鼻窦炎，在使用开始会排出大量或浓或清的鼻涕。我使用此方治愈了不少此类疾病。
14.肺积水的喘证，使用葶苈大枣泻肺汤加大黄。以前使用葶苈大枣泻肺汤效果不满意，加入大黄后泄水作用明显增强，效果满意。曾治我一学生喘证，咳喘牵引及两胁疼痛，最初想使用麻杏石甘汤，后腹证两胁以及心下都疼痛拒按，使用了大柴胡汤合葶苈大枣泻肺汤，其中就包含了葶苈大枣泻肺汤加大黄。服药后泻下大量粪水，也不脱水，这就是《金匮要略》中的“悬饮”。所处地域没有芫花、甘遂、大戟等药，我都使用大柴胡汤合葶苈大枣泻肺汤，其泄水之功不亚于十枣汤。
15.半夏泻心汤：半夏泻心汤加大黄，其实就是合上三黄。不因半夏泻心汤证多有便溏而弃用。很多急性胃肠炎、食物中毒病人，误服止吐止泻药物后出现心下痞、胸闷欲呕不得，肠鸣而大便不通。此时使用半夏泻心汤加少量生大黄，汤剂5克左右，服后会出现呕吐、泻下臭秽物，之后则舒适。
16.小结大黄之用：多用小剂量，取其性，合他方、他药。或合消食导滞药治疗食积，或合利水药以利水，效果很好。
17.“以医悟道”群友补充：三黄片合附子理中片用于消食效果很好。三黄片用于中上焦的郁火效果满意。
18.小建中汤的运用：《金匮要略》条文：“虚劳里急，悸，衄，腹中痛，梦失精，四肢酸疼，手足烦热，咽干口燥，小建中汤主之。”甲亢最吻合以上诸症。甲亢常有心悸、自汗、四肢酸痛、五心烦热等症。临床常加入龙骨、牡蛎，烦热加石膏、知母。临床使用此方治疗甲亢效果满意，降T3、T4快，睡眠也明显改善。
19.饴糖：因为所处地域无饴糖，我常用山药、麦芽代替。
20.小建中汤治疗各种痹症：各种关节肌肉劳损、疲劳而导致的各种疼痛。用方抓手：遇劳则损。虚劳疼痛病人常有睡眠不佳、烦躁、烘热等特点。常加石膏，不论有无烦热，效果均比不加好。
21. 小建中汤改善体质，儿科运用小建中汤较多。常加黄芩，治疗癌痛、慢性咽炎、慢性扁桃体肿大。虚劳病人常有劳热表现，非实热也，常加黄芩、石膏、知母等除烦热。
22.小建中汤合当归补血汤，也就是黄芪建中汤加当归，黄芪大剂量使用。用于血虚而导致失眠、身体疼痛、经痛，效果很好。曾治子宫切除术后出现血虚性失眠病人，服用此方后睡眠非常好。
23.黄芪建中汤、四味健步汤治疗虚劳所致关节劳损。服用后可改善疼痛，并且可长期服用。
24.使用小建中汤经验小结：用于痹症疼痛时，赤白芍同用；劳热重者，可根据病情斟酌加上黄芩、栀子、石膏、知母等。盗汗者，加白薇。
25.小建中汤合焦三仙、大黄。用于食伤而导致的各种虚弱性症状，补虚而推陈致新。不但用于小儿，大人也多见。使用后会胃口大开、体力增长。
26群友“纽约陶”补充：三黄打粉加冰片（生大黄30克、黄连15克、黄芩15克、植物冰片15克）治疗小儿烫伤一例效果很好、疤痕也不明显。
本文经“经方败案微友群临床学术委员会”审订。
经方败案微友群
2015、7、30
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