论《伤寒论》之渴(下)

Discussion About Thirst in Treatise on Cold Damage Diseases (Ⅱ)

厥阴病之渴乃胃热所致,此热乃虚热,"消渴"和"吐蛔"实非厥阴提纲的"必然证",而是"或然证"。小青龙汤证水气停留在"胸膈之间",致"寒水射肺"或"支乘于心",寒水射肺则"欲饮水",支乘于心则"恶水不欲饮",故小青龙汤证有"渴"与"不渴"。文蛤散证实乃水饮所致,此水在胸隔之间时,"渴"与"不渴"均可出现。五苓散证之渴的原因比较独特,是由"肺中、心下有水"和"脾虚客热"共同作用而致,仲景称之消渴。《伤寒论》中的口渴多为"阳明有热"和"水气内停"所致,亦有复杂情况,涉及此两个因素中的一个时患者反无口渴,与人体阳气的功能状态和涉及脏腑不同相关。

The thirst of jueyin disease is caused by stomach heat,which is deficient heat.Diabetes and vomiting ascaris are not necessarily syndromes of jueyin disease,but probable syndromes.In syndrome of Minor Green Dragon Decoction,edema stays between chest and diaphragm to cause"cold and edema attacking the lung"which causes thirst or"attacking the heart which causes no thirst,so syndrome of Minor Green Dragon Decoction has thirst and no thirst.Wenge Powder(WGP)is caused by water retention,when water retention is between chest and diaphragm,both thirst and no thirst may appear.The reason for thirst of syndrome of Five Substances Powder with Poria is unique,which is caused by the joint action of"water retention in the lung"and"spleen deficiency with heat".Zhongjing calls it diabetes.The thirst in Treatise on Cold Damage Diseases is mostly caused by"heat in yangming"and"water retention".There are also complex situations.When one of these two factors is involved,the patient has no thirst,which is related to the functional state of yang qi in human body and different viscera involved.