论湿

Discussion on Dampness

湿为浊邪,外湿易困阻清阳,蒙蔽清窍;阻于皮肤,逆于腠理;流注肌肉关节,阻痹经络。内湿源于脾胃,待其既成,多以脾胃为中心,以三焦为通路,蒙上、滞中、闭下,使气、水运行通路受阻。内湿与外湿在病因上虽截然不同,但二者相召相引,常相兼为病。湿邪外袭常易内归脾胃,脾失健运又易滋生内湿;脾运不健、内湿素盛之体,又每每容易招致外湿而发病。最后,湿浊常随环境气候和体质的不同而呈现不同的兼化。湿之为病首当辨其病位所在,其在上、在肌表者宜宣发为主;在中上焦,清阳阻滞者宜芳香化湿为主;在中焦者宜苦燥为主;在下焦者宜渗利为主,同时辅以行气、健脾诸法。湿无定体,病因复杂,证候变化多端,临证审因辨证的同时尤须注重辨舌苔脉象。湿邪致病,舌苔多腻,观其厚薄、部位、颜色可辨湿之多少、部位、寒热;其脉象多濡,或见滑缓、滑数。在治疗上,要着眼三焦,重视湿邪之所在,灵活运用表散、宣上、畅中、渗下、健运、行气诸法,因势利导,标本兼顾。

Dampness belongs to turbid pathogen. External dampness lends to obstruct clear yang and block the brain. It blocks the skin and enters the muscles and joints and obstructs the meridians anti collaterals. Secondly,internal dampness originates from the spleen and stomach. After the dampness forms, it centers on the spleen and stomach and lakes the triple energizer as the pathway, disturbing the upper,stagnating the middle and blocking the lower and making the flow of qi and water unsmooth. Thirdly, despite of the difference in etiology , the internal dampness anti external dampness interact as both cause and effect or concurrent. External attack of dampness is likely to enter the spleen and stomach. Failure of transportation of the spleen is easy to cause internal damphess. Body with tailed transportation and excessive internal dampness is susceptible to the external dampness. Last,damp turbidity usually complieales differently based on the environment,climate and individual eonstilulion. For disease with dampness,the location of the disease should be differentiated. For the upper or exterior one, method of dispersing should be applied;for the dampness in upper and middle energizer, method of removing dampness with aromatics should be used to clear yang and slagnalion;for lhe dampness in the middle energizer,drying wilh bitter drugs should be applied ;for the dampness in the lower energizer, the method of promoting diuresis to remove dampness and simultaneously moving qi and shengthening the spleen. Dampness is not fixed,the etiology is complex and syndromes are changeful. During lhe etiology identification and syndrome differentiation, the tongue and pulse should be attached great importance to. For the disease caused by damp palhogen,it usually manifests as greasy tongue coaling. The inspection of the thickness, location and color of the tongue coating helps to differentiate the seriousness of dampness, location,cold or heat ;the pulse is commonly soft or slippery and slow or slippery and rapid. For the treatment ,attentions should be paid to the triple energizer and the location of the damp palhogen. The methods of dispersing the upper, unblocking the middle, promoting diuresis,strengtilening the transportation and moving qi should be flexibly applied,and the tool cause and superficial manifestations should be both taken inter consideration.