伤寒论评话 第36章 阳明不仅可蓄水 尚有柴胡气郁证——阳明病蓄水、气郁等证的辨证治疗

Discussion of Shanghan Lun: The 36th Chapter Yangming not just Stagnated Fluid,Still Chaihu Qi Depression Syndrome——Syndrome Differentiation and Treatment of Yangming Disease and Qi Depression Syndrome

1阳明经表风寒邪气,过经入腑结于阳明胃,使津液之腑不能正常游溢精气,寒水互结于胃,形成阳明蓄水证。寒气与饮邪互结与胃,与膀胱无碍,故小便数及因小便数而致的大便硬,口渴较轻者少少与饮水,重者以化气、行水、生津的五苓散进行治疗。太阳蓄水与阳明蓄水,均以口渴为主症,所蓄部位不同,就有小便数与小便不利的区别。2阳明胃肠虚实更替,以降为顺,以通为用,若邪入阳明,气机郁滞,更替失常,升降无节,不仅阳明胃肠本身的功能失常,也可连带其他经络脏腑的气机不能调畅。不大便是阳明腑实证的见症,但阳明气郁证也可出现不大便。小柴胡汤证可见于六经病的多个病群中,也可见于六经病以外的其他疾病中。3"得汤反剧者,属上焦",其病名称作"上焦吐",呕吐虽与胃气上逆密切相关,但有时并非胃家本身病变,是由其他原因导致的气机逆乱所致。

①Exterior wind-cold evils passed through into the fu accumulation in the Yangming stomach, viscera cannot swim normal o- verflow essence, cold-water in the stomach, then the formation of Yangming stagnated fluid syndrome. Cold and yin evils in the stomach, without obstruction the bladder, so frequent micturition and the stool hard due to it, less thirsty with a small amount of water, heavy thirsty with wuling power of transforming qi, activating water and promoting the production of body fluid. Taiyang and Yangming stagna- ted fluid syndrome both the main symptom of thirsty, due to different stagnated fluid places, there is a difference between frequent mictu- rition and difficult urination. ②Yangming stomach deficiency and excess turnover, to drop to shun, to pass through,if the evil in Yang- ming,qi stagnation,replacement of arrhythmia, lifting section dysfunction of Yangming stomach itself not only, also can be connected with other meridians and organs Qi not regulating. Don＇t shit is Yangming Fushi syndrome see disease, but Yang Qi stagnation syndrome also can appear not shit. Xiao Chaihu Decoction syndrome seen in diseases of six meridians of multiple disease group, is also seen in other diseases of six meridians disease outside the. ②Yangming stomach and intestine deficiency and excess turnover, descending of fuqi and purging fu-organs. If the evils in Yangming,qi stagnation, disturbance in ascending and descending, leading to dysfunction of Yangming stomach itself not only, also can be connected with other meridians and organs with qi depression. Don＇t shit is the symptom of Yangming Fushi syndrome, but Yangining qi stagnation syndrome also can appear no bowel. Xiao Chaihu Decoction syndrome can be seen in diseases of six meridians of multiple disease group, also in other diseases beyond six meridians disease. ③Drinking Soup and getting worse belonged to the upper jiao＂ ,the disease name as “the upper jiao vomiting” ,although vomiting is closely related to the ad- verse rising of stomach qi, but sometimes it is not the stomach itself lesions, but other reasons resulting in qi-movement disturbance.