Yang Qi is the key to the occurrence, development and outcome of edema. Yang deficiency leads to warm gasification, while overflow leads to swelling. "Cold is warm", the sun is full and the water is wet. Therefore, Zhongjing is good at treating edema by warming viscera and Yang Qi, which is also the main treatment principle of three diseases of yin and the key embodiment of Zhongjing's method of supporting yang.
Traditional Chinese medicine believes that yin and yang are the foundation of human beings, and the role of yang is particularly important. Su Wen's Anger for Heaven says: "If the sun is in the sky, and it loses its place, it will lose its life without showing it." "Yang solid, although there is a thief evil, Buddha can harm it. The spirit of the sun warms the body, just as the red sun warms the earth. When the sun's qi is strong, it is in the same shape as the gods. When the sun's qi is weak, it will lead to poverty. Therefore, on the basis of syndrome differentiation and treatment, we should pay attention to support in clinic and think that "Yang survives and Yang dies". ".
Zhang Zhongjing has a profound understanding of the pathological mechanism, development and outcome of yang deficiency. On the causes of yang deficiency or exogenous yin cold hurting yang: or internal yang deficiency and endogenous deficiency cold; Or improper treatment, loss of yang. In the treatment, Zhongjing usually helps Yang Qi in his work by activating her, or helps her use by warming her. This idea of supporting Yang's spirit runs through Zhongjing's theory.
Among the 398 articles in Treatise on Febrile Diseases, there are 123 articles that were mistreated due to sweating, vomiting and diarrhea, of which 75 articles obviously hurt yang, and 23 prescriptions (times) used aconite. The essence of the six meridians syndrome differentiation system established by him is a set of dialectical methods to determine the spread, development law and prognosis of the six meridians by the rise and fall of yang. Therefore, some scholars believe that the differentiation of six meridians can be regarded as a complete theory of yang protection. This paper discusses and analyzes Zhongjing's treatment of edema disease by supporting yang.
The Relationship between Yang Qi and Edema Disease
Zhongjing said that edema is water vapor, so he set up a chapter on water vapor disease in synopsis of golden chamber. "The husband drowned the patient, now lying in the silkworm, fresh face, pulse condition", "swelling of the head, face and limbs for a long time", etc., described the symptoms of edema. Moreover, water-vapor diseases can be divided into geomantic omen, skin water, yang water, Shi Shui and yellow sweat, and also into five internal organs. At the same time, according to the relationship between water and qi and blood, there are qi, water and blood.
Su Wen's theory of meridian differentiation says: "If you drink in the stomach, you will overflow essence;" If you drink in the spleen, you will lose your temper and disperse the essence; If you drink in the lungs, you will pass through the waterway and lose it in the bladder. Water essence weaves four times, and five meridians run in parallel. Zhongjing Fachong's Neijing holds that water does not move by itself, but depends on qi. Edema is the pathological manifestation of systemic gasification disorder and water-liquid metabolism disorder. The pathogenesis of edema disease is pulmonary dysfunction, spleen loss of health, kidney loss of opening and closing, triple energizer loss, bladder failure of gasification, and water and dampness overflowing the whole body.
As Jingyue Quanshu Swelling pointed out: "All syndromes such as edema are related to lung, spleen and kidney. Covering water is yin evil, so it is in the kidney, and water is soluble in gas, so it is marked in the lung, and water is only afraid of soil, so it is made in the spleen. Deficiency of lung will vaporize water but not be refined, deficiency of spleen will turn water into soil but not gram, and deficiency of kidney will make water act rashly without owner. 」
The key of water-liquid metabolic gasification lies in Yang Qi. Yonghe believes: "edema is a disease, and all this is due to the fear of deficiency of true yang." Yang-qi is weak, and gasification is weak, so that water and liquid can not be metabolized and operated normally, and stay outside the meridians, overflowing the skin and becoming edema. Water is yin evil and yang is metaplasia, so it is treated with "warm medicine".
Traditional Chinese medicine attaches great importance to the function of kidney yang, and has formed a systematic system of syndrome differentiation and treatment of edema characterized by supporting yang. The word "fu" is interpreted as "protecting, helping and governing" in the classics. Supporting yang should be understood as maintaining, maintaining, assisting and managing yang. Therefore, supporting yang should be understood as the function of maintaining, enhancing and regulating yang. It is the general name of a series of treatment methods aimed at correcting the deficiency of yang in quantity and quality (function); Under the guidance of syndrome differentiation and treatment, it is a method to restore Yang Qi's normal gasification function by using various treatment methods.
Help Yang Qi with its work.
This method is mainly aimed at treating Yang Qi's stagnation and functional limitation caused by exogenous pathogenic factors, stagnation of qi and blood, and qi stagnation. Su Wen Yi Xiang Yin and Yang: "Yin flavor comes from the lower orifices, while Yang Qi comes from the upper orifices", "Yang is outside, and Yin is also used". Yang Da Wei Biao, camp and Wei Biao are harmonious, Wei Biao is solid, and evil spirits can be prevented. Yang Qi reaches the muscle surface or converges to internal balance according to the change of qi. Only when the body is normal from top to bottom and the yang is transmitted to four o'clock, can it play a variety of functions such as warming, promoting, gasifying and strengthening the body. "Su Wen Liu Weizhi Darren" said: "If you go in and out, you will be destroyed. If you go up or down, you will be lonely and dangerous. Once qi and blood stagnate, ying and Wei are not coordinated, qi loses its pivot, epidemic qi is blocked, and yang is weak, diseases will occur. Under the guidance of this theory, Zhongjing's treatment methods are summarized as follows.
Method of activating yang, eliminating pathogenic factors and promoting diuresis
These are all due to the inhibition of Yang Qi by external pathogens, which can help Yang Qi sweat to eliminate pathogens and disperse water to reduce swelling. By promoting stagnation, Wei enlightened and effectively resisted evil spirits, thus correcting and eliminating evil spirits. "Synopsis of the Golden Chamber: Syndrome of Water-gas Disease and Pulse" says: "If there is water, it is swollen above the waist and sweating is the cure." "Water, sweat, heavy pulse, appropriate ephedra aconite decoction; What floats should be apricot soup. " Due to the disharmony between camp and health, exogenous pathogens attacking the exterior, lung imbalance and unfavorable treatment, water overflows the skin and the whole body is swollen. The evil of water and dampness lies between skin and flesh. The treatment should be supporting yang, dispersing lung and promoting diuresis.
"Bad wind, swollen body, floating pulse, no thirst, excessive sweating, no fever." Yang Qi was helped by Yuemai Decoction to induce diuresis and clear heat. If feng shui is accompanied by superficial deficiency, it can be seen that "the pulse is heavy, and the body is evil and sweaty", which is controlled by Ji Fang Huangqi Decoction. This is caused by the inconsistent appearance and unstable principle of Feng Shui. Therefore, Ji Fang Huangqi Decoction is used to replenish qi and consolidate exterior, and promote diuresis and dehumidification. If the skin water sees "limbs moving", it is a struggle between water and air, which is due to the deficiency of spleen and lung, the accumulation of water and dampness, and the suppression of yang, so that the self-made Fuling decoction can not ventilate yang and turn qi into qi, and it disappears from the outside to the inside.
Activating yang, removing blood stasis and activating blood circulation
Physiologically, both water and blood belong to yin, which are interdependent and mutually reinforcing. In pathological state, water disease will lead to blood stasis, and blood stasis will lead to edema. After a long period of time, water-wet edema stops gathering, and once a long illness enters the collaterals, it leads to unfavorable qi movement, poor blood flow and blood stasis; Second, the yang of zang-fu organs is damaged, and the blood loses its temperature and stays. On the other hand, blood stasis can aggravate edema. Blood stasis blocks the lungs, water cannot pass through the waterway, and water accumulates on the coke and overflows into swelling; Stagnation of blood stasis in kidney, loss of temperature, qi disorder, water stagnation and dampness.
When talking about the sequence of edema and blood stasis, Zhong Jing said that "blood fraction" is the combination of water and blood stasis, which is difficult to communicate, so it is difficult to treat; "gas separation" means that water and liquid block the airway, and the gas is shallow and easy to operate, so it is easy to treat. Its treatment is to raise yang to remove blood stasis, promote blood circulation and reduce swelling, and Danggui Shaoyao powder is widely used in clinic. If the blood stasis is hydrated in the bladder, it is made into Taohe Chengqi Decoction to promote yang and remove blood stasis.
The method of dredging yang, machine and water
Qi can promote the operation of water and liquid, and "Qi can also run water". The process by which water and liquid enter sweat, urine, etc. And the discharge from the body depends entirely on the rise and fall of qi. "Reading Doctor's Essay: On Ascension and Descent" says: "No ascent and descent, no discrepancy; If there is no discrepancy, there will be no rise and fall, and rise and fall are the hinge of each other. The coordination and balance of qi movement is an important link to ensure normal life.
Dispelling spleen qi, regulating the channels of lung qi, soothing the liver and relieving depression, transpiration and gasification of kidney essence, and dredging triple energizer can transport water and liquid to four places. When the ascending and descending movement of qi is normal, the transportation and excretion of body fluid can be smooth. On the contrary, the metabolic disorder of distribution will inevitably lead to the flooding of water and liquid. In article 96 of Treatise on Febrile Diseases, Zhong Jing said that it was caused by poor qi movement, abnormal triple energizer and stagnant water and drink. Therefore, Xiaochaihu decoction should be used to dredge yang, Scutellaria baicalensis Georgi should be removed to prevent it from condensing cold drinks, and Poria cocos should be added to dilute water.
Warm Yang Qi and help its use.
This method is mainly aimed at the treatment of deficiency of yang in zang-fu organs and deficiency of warming qi. Su Wen Yi Xiang of Yin and Yang: "Yang deficiency means yin is abundant" and "Yang deficiency means cold". Su Wen Zhi Zhen Da Lun said: "All diseases, body fluids and cold are cold. Yang Qi is the key to the occurrence, development and outcome of edema, while yang deficiency has no right to warm water and overflow is swollen. " Cold is warm ",yang is sufficient and water is wet. Therefore, Zhongjing is good at treating edema by warming viscera and Yang Qi, which is also the main treatment principle of three diseases of yin and the key embodiment of Zhongjing's method of supporting yang.
Warming lung and promoting diuresis
The lung is the source of water god, and it can dredge and regulate the distribution, operation and excretion of water and fluid in the body by declaring and descending the lung, thus maintaining the metabolic balance of water and fluid in the body. If the lung is cold, unable to spread, or unable to descend, the functions of the lung and water channels will be abnormal, resulting in obstacles in the transportation of water and liquid, which can not be eliminated in time, leading to the accumulation of water and dampness and skin edema. Zhongjing follows the principle of "the superior is the superior", and adopts the methods of warming lung to dispel cold, promoting diuresis and reducing swelling.
Article 40 of Treatise on Febrile Diseases: "For those who are confused by typhoid fever, there is moisture in their hearts ... or urine is unfavorable, their stomachs are poor, or they are short of breath. Xiaoqinglong Decoction is the main prescription." With warm-hearted ephedra, it warms the lungs, perspires and promotes diuresis; Guizhi warms yang and turns yin; Dried ginger warms water, lowers adverse qi and regulates stomach; Paeonia lactiflora and Cinnamomum cassia twig harmonize camp with health, Schisandra chinensis astringe lung to protect righteousness, and Glycyrrhiza uralensis Fisch harmonizes, * * * plays the role of warming lung qi, transforming drinking and promoting diuresis. If the exterior is cold and the interior is deficient, the ephedra aconite decoction is used to warm the yang and dispel the cold, spread the lung and promote diuresis.
Warming spleen and promoting diuresis
Su Wen Zhi Zhen Da Lun says: "All wet swelling belongs to the spleen", which shows the importance of the spleen in edema. Spleen is a state of water, which mainly transports water and dampness. Is too wet dirt, like dry and hate wet. If the sun is typhoid, the vomiting method is misused, the spleen yang is injured, or the heart yang is involved, and the fire does not produce soil, which leads to spleen yang deficiency, water-dampness insolubility, water-vapor upwelling, spleen deficiency and water stagnation, which is manifested by fullness of heart, flushing of chest, dizziness and tight pulse. "Medical Classic" said: "The husband's spleen is his own soil, and the body is often wet, so Yang is used. For example, wet soil can't be irradiated by the sun, and nothing can be born. " The main treatment is warming yang and strengthening spleen, promoting diuresis and eliminating pathogenic factors, and Gui Ling Shugan Decoction can be given. If "stop drinking under the heart, palpitation, sweating is not thirsty, and urination is not good", warming up Chinese drinks with Poria and Glycyrrhiza Decoction will promote yang and diuresis.
Warming kidney and promoting diuresis
Kidney is the dirty part of water, and it is an important organ for regulating hydrolysis metabolism. The operation of water and liquid depends on the promotion of yang, and kidney yang is the foundation of yang, so the operation of water and liquid is closely related to the rise and fall of kidney yang. Kidney qi opens yang, closes yin, water reaches yin, yin is abundant, yang declines, kidney yang declines, door closing is unfavorable, and water stops overflowing. The pathogenesis of edema focuses on spleen, lung and kidney, but the key is kidney.
Treatise on Febrile Diseases (3 16) points out that "shaoyin disease ..... urination is unfavorable, and the limbs are heavy and painful, which is self-beneficial". This is a disease of deficiency of yin and deficiency of kidney yang for a long time, which is very cold and insoluble in water and gas, and is in harmony with the qi of yin and cold and overflows the whole body. Therefore, Zhongjing summarized its pathogenesis with "this is water vapor", and used Zhenwu decoction to warm kidney yang and benefit water vapor. Processed aconite is pungent and hot, which can replenish the fire of life gate, warm kidney and help yang; Poria cocos and Atractylodes macrocephala have light permeability and diuresis, and cultivate soil and control water; Ginger is warm to drink, and Paeonia lactiflora is beneficial to diuresis and dehumidification. If the kidney qi is insufficient, Shenqi Pill can be given to warm the kidney and transform qi, so that the vaporized water can flow.
Warming bladder and promoting diuresis
"Su Wen Ling Lan Secret Book": "Bladder, the official of the state, body fluid is stored, and it can be gasified." The bladder meridian mainly vaporizes the kidney surface and helps the kidney to transpiration water vapor. If the sun is sick, the exterior evil is not solved, and it enters the fu-organs along the meridian, but the yang of the bladder meridian is blocked, which leads to water accumulation in the lower jiao, resulting in the syndrome of solar water storage. According to the relevant provisions of Treatise on Febrile Diseases, some scholars have summarized some main symptoms, including thirst, thirst, thirst for drinking water, poor or little urination, abdominal pain, sudden distension of the heart, thirst for drinking and vomiting, pulse floating or floating, slight fever and so on. , are external symptoms and water storage in the body. If there is something wrong with qi, the bladder can't be excreted smoothly, or even blocked. Therefore, Zhongjing's treatment is to stimulate the qi of bladder meridian to benefit water, and at the same time relieve exterior symptoms and eliminate evil spirits. Wuling powder is to raise yang and turn qi into water.
In short, edema can occur alone or in combination with other diseases. Zhongjing attaches great importance to and recognizes the heating in Yang Qi.