浅议少阳病不可汗、吐、下之理

A brief discussion on the principle of prohibiting the use of sweating method,vomiting method or catharsis method in treating Shaoyang diseases

少阳经居于太阳经之里与阳明经之表,古今医家多认为其处于半表半里之间。少阳经包括足少阳胆经与手少阳三焦经。三焦经为物质运行之通路,将饮食水谷所化生之气、血输布全身,为人体生命活动提供物质基础。胆应春升之气,与肝互为表里,可主决断而辅心神,化饮食而佐中土,理气机而顺诸脏。三焦经与胆经相合,则为人体精微运化与气机流转之要塞,故称少阳为转圜之枢纽。少阳为病,其病机以“郁而不疏,郁久化火”为主,见口苦、咽干、目眩等症,又因其位于半表半里之间,除少阳经所及之处外,还可见似表证之往来寒热,以及似里证之呕恶、纳差等症状。少阳病之论治,现多以“和解”立法,内清泻少阳之郁火,外宣畅郁滞之气机,兼以顾护脾胃之克化,使其表里通畅,开阖有度,共复少阳枢转之功。少阳病多辨误,为防误治而生变,后世又多以汗法、吐法、下法为其治禁。然何为少阳治禁之理?何为少阳可汗、可下之机?研究即对少阳病相关条文进行整理与分析,旁征医家注释,以求发微,阐析少阳病治禁之理与其可汗、可下之机,以便指导临床。

Shaoyang meridians(少阳经)are located between Taiyang meridians(太阳经)and Yangming meridians(阳明经).Ancient and modern doctors mostly believe that it is between half-superficies and half-interior.Shaoyang meridians include foot Shaoyang(少阳)gallbladder meridian and hand Shaoyang triple energizer meridian.Hand Shaoyang triple energizer meridian is the passage of material movement,which transports Qi(气)and blood produced by food and water to the whole body to provide the material basis for human life activities.The gallbladder manages the rising Qi of spring,and gallbladder and liver are mutually external and internal,which can make the main decision and supplement the mind,digestive diet and assist spleen soil,and regulate Qi movement to restore the normal function of the viscera.The combination of hand Shaoyang triple energizer meridian and foot Shaoyang gallbladder meridian is the fortress of the refinement essences of the human body and the circulation of Qi movement,so Shaoyang meridians are called the pivot of the turnaround.The pathogenesis of diseases at Shaoyang meridians is mainly characterized by depression,and fire due to stagnation for a long time,which can be seen symptoms such as bitter mouth,dry throat and dizziness.Because Shaoyang meridians are located between half-superficies and half-interior,in addition to the area around Shaoyang meridians,it can also be seen the symptoms such as cold and heat like the surface syndrome,and nausea like the inside syndrome.If the doctor is not clear about the disease,the syndrome differentiation is not precise,and the treatment is improper,it is easy to mistreat and cause other diseases.In terms of the treatment of Shaoyang disease,the method of reconciliation is mainly adopted,which is to clear depression-fire of Shaoyang meridians inside,to dredge Qi stagnation outside,and to care for the digestion function of spleen and stomach,so that they are smooth inside and outside,with moderate opening and closing functions,so as to restore Shaoyang pivots.Shaoyang diseases are often misdiagnosed.In order to prevent the deteriorated case caused by erroneous treatment,the imprudent use of sweating method,inducing vomiting method or purgation method was forbidden in later generations in the treatment of the disease.What is the principle of Shaoyang disease treatment prohibition?When can we treat Shaoyang diseases by sweating method or purgation method?The author sorts out and analyzes the relevant provisions of Shaoyang diseases,and quoted the notes of doctors as examples to explain the treatment contraindications of Shaoyang diseases as well as the timing of the use of sweating method and purgation method,so as to guide the clinical practice.