《伤寒论》之口渴浅探

Study on Thirst in Treatise on Cold Damage Diseases

《伤寒论》中,口渴病机有饮阻气化,水饮内停;热邪炽盛,津液损伤;风火内郁,阴虚火炽;少阴阳虚,气化失调;太阳蓄水,水精不布;少阳枢机不利,水饮内结;阴虚有热,水热互结;阳明腑实,水热互结;邪热炽盛,津气两伤。口渴与否,可揭示病位,辨别水饮内停位置、病属太阴或少阴。可鉴别汗后伤津证与太阳蓄水证、阳明病与肾阳虚证、少阳病与脾虚失运寒饮内停证等。口渴症状是否缓解,是辨别疾病是否传变的重要指征,可判断少阳是否转属阳明、太阳是否传变阳明。还可根据口渴判断预后,太阳病由口不渴转变为口渴,说明疾病向愈,厥阴病其他症状均已缓解渐愈,仅有口渴一症者,不需要药物治疗,只需少少饮水则愈。

In Treatise on Cold Damage Diseases,the degree of thirst is Fluid obstruction and qi transformation leading to fluid retention;Excessive heat pathogen hurting fluid;Internal stagnation of wind and fire leading to yin deficiency and excessive fire;Yang deficiency in the lesser yin meridian leading to disorder of qi transformation;Stagnated water in the greater yang meridian leading to failure to distribute fluid;Unfavorable pivot in the lesser yang meridian leading to fluid retention;Yin deficiency and heat leading to intermingled water and heat;Excess syndrome in the yang brightness meridian leading to intermingled water and heat;Excessive heat hurting both fluid and qi.Thirsty or not can also reveal the location of the disease,identify the position where water stops,and the disease belongs to greater yin disease or lesser yin disease.The symptoms of thirst can identify dryness in the stomach after sweating hurting fluid and greater yang water accumulation syndrome,yang brightness disease and kidney yang deficiency syndrome,lesser yang disease and spleen deficiency leading to cold fluid retention syndrome,etc.Whether the symptoms of thirst or not are relieved is an important indicator to distinguish whether the disease is transmitted or not.It can be used to judge whether lesser yang disease is transferred to yang brightness disease and whether the greater yang is transmitted to yang brightness disease.The prognosis can also be judged according to whether the patient is thirsty or not.The change from no thirsty to thirsty indicates that the disease is getting better;other symptoms of reverting meridian disease have been relieved and gradually healed.If the patient only has thirst,there is no need to take medicine,and just drinking a small amount of water is needed.