从“少阳不可发汗”探析非汗法“汗出而解”的机制

Research on non-diaphoresis method for ‘recovery after diaphoresis' based on the theory of ‘contraindication for diaphoresis of shaoyang diseases'

病在表者,可汗而发之,病在里者,可引而下之,少阳非表非里,又因"血弱气尽,腠理开",正虚邪结,不可行汗下之法。少阳不可发汗,但服小柴胡汤后却能"汗出而解",其汗出机制在于三焦通利,津液布散复常。除此之外,表里调和,津液自和,泻热行血,清热行滞等均可导致"非汗法"而汗出。《黄帝内经》云:"阳加于阴谓之汗",以上汗出而解皆是人体达到阴阳动态平衡的标志,阴平阳秘,精神乃治,故而汗解。

It was known that diaphoresis and purgation could be used in the treatment of superficies syndrome and interior syndrome respectively. Shaoyang is a semi-exterior-interior syndrome, which is insufficiency of qi and blood and insecurity of the grain of skin and the texture of the subcutaneous flesh, body resistance weakened while pathogenic factors prevailing. Therefore the diaphoresis and purgation methods are forbidden in treating shaoyang disease. The mechanism that shaoyang disease could be recovered after taking Xiaochaihu Decoction by sweating is that sanjiao is cleared and the distribution of body fluid is back to normal. In addition, harmony between exterior and interior, normal distribution of blood fluid, purging heat and promoting blood, clearing heat and removing stagnantion are all reasons for sweating without diaphoresis method. As Huangdi Neijing said that yin-fluid steamed by yang qi being known as sweating. All of sweating above is the symbol of balance between yin and yang. Only when yin is at peace with yang could essence-spirit be normal, so the diseases can be recovered by sweating out.