『傷寒論』의 四方⋅四神湯中朱鳥湯의 不在에 관한 고찰

A Study on the Absence of the Zhuniao decoction among the Four Directions Sishen decoction in 『Shanghan Lun』

동아시아의 고대 사상 중에는 東南西北의 四方을 호령하는 四神에 관한 신화가 존재하고, 이는 醫學 분야에도 투영되어 『傷寒論』에는 青龍湯⋅白虎湯⋅玄武湯에 관한 내용이 존재하지만 오직 朱鳥湯에 관한 내용만 不在한다. 이는 陰陽的 사고를 기반으로 病證을 인식하고 治方을 모색하는 『傷寒論』의 일관된 관점을 고려할 때 異例的이다. 이에 본 논문에서는 四神湯의 개념 자체가 『傷寒論』의 저자들이 病證의 인식과 대응에 있어 八綱辨證 체계를 새롭게 정립하면서 출현한 개념임을 밝혔다. 이를 토대로 그들이 表寒實證⋅裏熱虛證⋅裏寒虛證에 대해서는 적절한 證方으로서 青龍湯⋅白虎湯⋅玄武湯을 제시할 수 있었지만, 表熱實證에 대해서는 적절한 證方을 제시할 수 없었기에 朱鳥湯이라는 方名을 의도적으로 사용하지 않았을 가능성에 대해 고찰했다.

Among the ancient ideas of East Asia, there is a myth about symbol of the Four Gods who commands all directions in the east, south, west, and north, and this is also reflected in the medical field. However, although there are contents about Qinglong Decoction(青龍湯), Baihu Decoction(白虎湯) and Xuanwu Decoction(玄武湯) in 『Shanghan Lun(傷寒論)』, there is no content only about Zhuniao decoction(朱鳥湯). Considering the consistent perspective of 『Shanghan Lun』, which recognizes the disease-syndrome and seeks prescriptions based on yin and yang thinking, this is very unusual. Therefore, in this study, it was revealed that the concept of ‘Sishen Decoction(四神湯)’ itself was a concept that emerged when the authors of 『Shanghan Lun』 newly established the ‘eight-principles syndrome differentiation(八綱辨證)’ system in their recognition and response to diseases-syndromes. Based on this, I considered the following possibilities. In other words, they were able to present Qinglong decoction, Baihu Decoction and Xuanwu decoction, as appropriate prescriptions for ‘exterior cold excess syndrome(表寒實證)’, ‘interior heat deficiency syndrome(裏熱虛證)’, and ‘interior cold deficiency syndrome(裏熱實證)’. However, it is possible that the name of the prescription ‘Zhuniao decoction’ was not intentionally used, because it was not possible to provide an appropriate prescription for ‘exterior cold excess syndrome(表熱實證)’.