【摘要】 《史载之方》首载“疫毒痢”病名，该病具有人群易感性及地方流行性，常因“气运失和，毒气流行”引发，以脾气亏虚为基本病机，病变脏腑可累及心、肝、肾，证候多端，病者表现为发寒热、便次多、痢下质如脓涕、色赤甚有浓血、心烦躁、腹刺痛等复杂症状。史堪基于运气学说辨析疫毒痢证型，从司天之气、运气相合与客主加临三个层次，将其分为寒湿犯火、湿热郁蒸、风湿相争三大基本证型，且强调知常达变，不拘数推，是将运气理论应用于临床的早期范例，并详诊脉候辨析病势缓急，以“先夺其寒”为治疗总则，以方测证，随效更方。自拟通神散、还真散与舶上硫黄丸等方剂，随病程变化，多方联用共同调治。更多还原

【Abstract】 Formulas of SHI Zaizhi first recorded the name of “epidemic toxic dysentery”. This disease is characterized by population susceptibility and local epidemicity,often triggered by “disharmony of qi movement and the prevalence of toxic qi ”. Its basic pathogenesis is deficiency of spleen qi,and the affected viscera may involve heart,liver,and kidneys. The syndromes are diverse,and patients may present with complex symptoms such as fever and chills,frequent bowel movements,dysentery with stools like purulent nasal discharge,red stools or even stools with pus and blood,restlessness,and stabbing abdominal pain. SHI Kan differentiated the syndromes of epidemic toxic dysentery based on the theory of circuit and qi. From three aspects including the qi of the governing year,the combination of circuit and qi,and guest qi adding to host qi,he divided it into three basic syndromes:cold-damp invading fire,damp-heat stagnation and steaming,and wind-damp conflict. He also emphasized the importance of understanding the general rules and being flexible,not being restricted by numerical deductions. This is an early example of applying the theory of circuit and qi to clinical practice. He carefully examined the pulse conditions to distinguish the urgency of the disease. Taking “expelling cold first” as the general treatment principle,he inferred the syndromes from the formulas and changed the formulas according to the curative effects. He self-formulated formulas such as Tongshen Powder（通神散）,Huizhen Powder（还真散）,and Boshang Liuhuang Pills（舶上硫黄丸）,and used multiple formulas in combination to regulate and treat the disease according to the changes in the course of the disease.更多还原