《伤寒论》汗法浅析

An Analysis of Sweating Method in Treatise on Cold Damage Diseases

《伤寒论》中,汗法不仅适用于表证,亦适用于经误治后表不解兼有他证和表里同病须解表者。若汗出不彻尚未转属阳明,病仍在太阳者,亦可用汗法。《伤寒论》中还用汗法治疗水气病、风湿外侵、溢饮、消渴等内伤杂病。汗为人体津液所化,误用汗法,易耗气、伤津、伤血,故《伤寒论》非常重视汗法使用禁忌。汗法的禁忌证有:邪非在表、阴虚、阳虚、阴阳两虚、气血亏虚、太阳温病、少阳病、里热、里虚寒、三阴病等。若表里同病,里证不急或病证在表,先治其表;若里证重且急,或者里证为主证时,先治其里;若表里同病,病势均不急,可表里同治。得汗的尺度以周身微汗为佳,防止汗出不彻或汗出太过,故需要合理服药,并在服药后配合适当护理,以达到最佳得汗效果。服药后一要啜热稀粥或饮暖水;二要温覆;三是服药期间要有饮食禁忌。汗后饮水要适量,饮食不可过饱,需避风寒外邪,不可接触冷水,不可汗出过多,若不慎汗出过多,则以“温粉扑之”。

In Treatise on Cold Damage Diseases,sweating method is not only applicable to exterior syndrome,but also to those who are mistreated and have other syndromes and disease involving both exterior and interior which need releasing.If sweating is not complete and the syndrome has not entered yangming meridian,and the disease is still in taiyang meridian,sweating can also be used.Sweating method can also be used to treat internal injuries and miscellaneous diseases such as fluid retention,rheumatism,external invasion,subcutaneous fluid retention and diabetes.Sweat is transformed from body fluid.Misuse of sweating method is easy to consume qi,injure body fluid and blood.Therefore,Treatise on Cold Damage Diseases attaches great importance to the use of contraindications of sweating.The contraindications of the method of sweating include:pathogenic factors not existing on the surface,yin deficiency,yang deficiency,yin and yang deficiency,qi and blood deficiency,taiyang warm disease,shaoyang disease,internal heat,internal deficiency and cold,three-yin diseases,etc.For disease involving both exterior and interior,mild interior syndrome,or pathogenesis on the surface,the exterior syndrome should be released first.If interior syndrome is serious and urgent,or the interior syndrome is in the dominant position of the disease pathological contradiction,the interior syndrome should be treated first.If disease involves both exterior and interior,and disease tendency is not urgent,exterior and interior syndromes can be treated together.The best degree of sweating is mild sweating around the body to prevent incomplete or too much sweating.Therefore,it is necessary to take medicine reasonably and cooperate with proper nursing after taking medicine to achieve the best effect of sweating.First of all,after having taken medicine,one should drink hot porridge or warm water.Second,cover oneself warm.Third,there should be diet contraindications during taking medicine.After sweating,drinking water should be appropriate,food should not be eaten too full,wind and cold should be avoided,cold water should not be contacted,and excessive sweating should not be allowed.If excessive sweating occurs accidentally,the person should be puffed with warm powder.