about 太陽病 1-3

idim77

There is a similar 條文 in <傷寒雜病論>
275. 問曰 風濕相搏 一身盡疼 法當汗出而解 値天陰雨不止  醫云此可發汗 汗之病不愈者何也?  師曰 發其汗 汗大出者 但風氣去 濕氣在 是故不愈也.  若治風濕者 發其汗 但微微似欲出汗者 風濕俱去也.


Why 師曰 發其汗 汗大出者 但風氣去 濕氣在 是故不愈也 ??
If we 用發散藥, it will 散 all the 風寒濕 邪氣 於外.
Then, why 師 said such a remark?
發散劑之目標 not only lie in 散風寒濕邪, there is another important 目標.
表層循環系 正常化.!!
     




血管外之血 爲死血,瘀血,邪血, 血管外之水 爲邪水, 淋巴管外之水 亦爲邪水.
if that 邪水入於血管淋巴管 it turns into 生理的水.
If we 用發汗劑 而治表證, we 散表層剩餘之邪水與熱 and also we return the 氣血津液 to the body.
If 表層循環系 get 正常化. That 表證 never 再發生.
We want this!!.
If 表層循環系 正常, it will 吸收邪水,邪濕 and turn it 生理的水.
     
This is 桂枝湯 方後注文
右五味 㕮咀. 以水七升 微火煮取三升 去滓 適寒溫 服一升. 服已須臾 啜熱稀粥一升餘 以助藥力
溫覆令一時許 遍身漐漐 微似有汗者益佳 不可令如水流漓 病必不除.


There said, 微似有汗者益佳 不可令如水流漓 病必不除.
Don't 過多發散. that 汗,熱氣 are my resources(資源), Don't waste it.
If you waste that, 表層循環(表層回收路) cannot get 正常化.
表層回收路 should get 津液 to get the enough volume to flow ordinary.

     
大靑龍湯 is the 最强發汗劑 in 傷寒論
but 大靑龍湯 方後注文 also said like this,
溫服一升 取微似汗. 汗多者 溫粉粉之.
     
Why they all said, Don't sweat too much??
1. 過多發汗 損傷正氣, 津液 (This is all we have known)
2. 表層循環 正常化: This is 榮衛調和.
I think, many people here didn't like the 用語 '表層循環' '回收路' 等等 and that kind of 槪念.
Yeah, but it is "榮衛循環"
(All the doctors said "榮衛調和" when they used 桂枝湯.  But what is 榮衛調和??  why did they say, 桂枝湯 made 榮衛調和?
what's the proof of 榮衛調和??  How did they know 榮衛調和 has done??)
     
What is 榮衛調和??
     
營氣循環 is 血液循環, 衛氣循環 is 淋巴循環.
     
And Why we should make 榮衛調和 at 表證時期??
     
To return the 氣血 to the body. and to prevent from getting that 表層停滯 again.
     
If we don't return the 氣血 to the body at 表證, 胃腸管乾燥 進行.
That's why 太陽病 傳 陽明病.
(Have you heard about it? why 太陽病 傳 陽明病 ?
<傷寒論> already said it, but no one noticed it.
後代醫家 just said, 熱 made 陽明病. 陽明爲多氣多血 so 易生熱.... 熱生乾燥)

But if we use 發汗劑 過多而汗出多, it also occur 胃腸管乾燥 急速進行


489. 本太陽病 初得病時發其汗 汗先出不徹 因轉屬陽明也.
348. 二陽幷病 太陽初得病時 發其汗 汗先出不徹 因轉屬陽明 續自微汗出 不惡寒. 若太陽病證不罷者 不可下 下之爲逆 如此可小發其汗. 設面色緣緣正赤者 陽氣怫鬱在表也 當解之 熏之; 若發汗不徹 徹不足言 陽氣怫鬱不得越 當汗之不汗 則其人煩躁 不知痛處 乍在腹中 乍在四肢 按之不可得 更發汗則愈; 若其人短氣 但坐者 以汗出不徹故也 何以知汗出不徹? 以脈濇故知之也.

濇脈 is 血虛脈 血管內少有津液 so 血運行濇滯.
Though you did 發汗法, you fail to return the 表位氣血 to the body, so 脈管 have little blood, 脈濇.
發汗法 is not the 治法 just to kill and push out the 風寒邪.

     
結局, 表證治療法 亦是 return 氣血 to the body.
You should know this.
     
Next, we will see 桂枝湯類方. 小建中湯 桂枝加龍骨牡蠣湯
Do you know how they can treat 虛勞症?  Why 桂枝湯劑 can treat 虛勞症??
You already have 解答. right ??

焦俊杰

Thank you for your story ! your sketch is vivid .《内经》曰：营行脉中，卫行脉外。But 桂枝汤 act on 卫气 or 营气？

idim77

焦俊杰:
Thank you for your story ! your sketch is vivid .《内经》曰：营行脉中，卫行脉外。But 桂枝汤 act on 卫气 or 营气？

Thanks for questioning [s:188]

营行脉中，卫行脉外

脈 means 血管. especially 動脈(artery) because 脈 has 波瀾(搏動) so they call 動脈 as 脈.
脈外 means 血管外經路. but it doesn't mean 衛氣行自由奔放.
衛氣 has its own 通路. It is 淋巴管. It runs 脈管外.


Many traditional doctors think on that 節 “營行脈中 衛行脈外”, 衛氣行于 血管表面.
They think 衛氣 is like a air, or 電氣, or 防禦膜氣.
Most of 氣 in our body 運行 through controlled route, 通路, 管.
So 衛氣 can make 陰陽氣之變化 very regularly[規則的]. 日中 衛氣行於陽分25度 而盛陽氣 we 覺醒而行事
入夜 衛氣行於陰分25度 而陰氣盛 we 入寐.
if 衛氣 行 freely like air, That 現象 can't happen.






衛氣 有 '其道' and 衛氣 can get 凝(結)
衛氣  is not like 無形 air, 無用量 無質之電氣energy.




衛氣 can 充空間, and make 滿






精微(very small thing) can go into the blood 竅.
悍大(more large thing. like 脂肪質) cannot go into the blood 竅, it can go into 淋巴管(it has large 竅)
if we take food, 精微入血分, more 巨大分子(脂肪,蛋白質) 入淋巴管
脂肪質 is 滑, 輕浮.










even though they have different 管, 通路
they meet at neck, 淋巴液 入鎖骨下靜脈 and go into heart.(入心)












表層循環系之 榮衛循環(血管 淋巴管)正常化 is 榮衛調和. So 當然 桂枝湯 act on both 營 and 衛.

焦俊杰

Terrific, many thanks!