《黄帝内经》及涉医简帛“异梦、疟、麻风”病因观念比较及其临床意义分析

该文以出土涉医简帛（下称”简帛”）及《黄帝内经》为中心，辅以传世文献，比较病因思想。并重点从异梦、疟、麻风类三病比较病因建构的方法。结果发现“简帛”中有大量鬼神致病说內容，甚至对致病鬼神有干支、五方的分类思维；《黄帝内经》则以气论六淫作主要病因。再考察异梦在《黄帝内经》述为不正之邪内藏人体，简帛述为鬼魅引发；疟在《黄帝内经》述为外风及伏邪，简帛述为鬼魅；麻风类疾患在《黄帝内经》述为“大风”，简帛则以“虫”及“风”作主要病因。可见《黄帝内经》透过实际病因学改变，以“气论”及“伏邪”取代“鬼神”及未能观测的“虫”致病之记述。使疾病思考系统进入“可言传”“可感知”“可评价”“可修正”的自然哲学及理性思维模式去认识疾病。

This article is based on Inner Canon of Huangdi (called as “Neijing” later) and the medical realted bamboosilk literature (called as “bamboosilk” later), with the aid of other literature, to compare the etiology. We focus on the etiology of nightmare and other special dream, Yue and leprosy-like disease, to deduce the methodolody behind the etiology. In result, we found that “bamboosilk” support ghost illness, even with the categorization of the illness-casuing-ghost into heavenly stemand earthly branches. While Neijing use model of Qi and six naturalism pathogens as its etiology. For the 3 inspected disease: nightmare and other special dream's causation is YinYang imbalance in Neijing, and about ghost in bamboo-silk. Nue's causation is wind and the cold-heat pathology in Neijing, about ghost in bamboo-silk. Leoprosy like disease's causation is about serious-wind-pathogen in Neijing, bugs in bamboosilk. In the view of methodology, Inner Canon of Huangdi reject ghost illness completely by means of inventing the naturalism model, building up etiology model by the concept of Qi, and use the concept of “Qi of illness” to replace “ghost illness” and the unseenable “bugs” to explain those special disease. Defining the etiology of Chinese medicine into a naturalistic and rational paradigm, which is “explainable by words” “perceptible” “amenable”.