This subscription account is hosted by the Hu Xishu Research Studio of the 3+3 Project for the Inheritance of Traditional Chinese Medicine in Beijing. Mr. Hu Xishu is a renowned modern TCM practitioner and educator known for his clinical expertise in classical formulas. He is praised as a “notable researcher of the unique theoretical system of the ‘Shang Han Lun’ (Treatise on Cold Damage) and a master of classical formulas” in China. Spend 2 minutes each day learning classical formulas, accumulating knowledge like building a tower from grains of sand. Reply ‘search’ on the subscription account dialogue page to find more content.
Click to view Article 89: If the patient has cold, sweats again, and has cold in the stomach, they will surely vomit.
Article 90:To induce sweating and then purge is contrary; if sweating is done first, it is not contrary.To purge first and then induce sweating is contrary; if purging is done first, it is not contrary.
This is a condition that should have been treated with sweating first; if sweating is not done and purging is performed instead, this is contrary treatment. What if sweating is done first? Then it is not contrary treatment. This is one interpretation, and there is another meaning: if it should have been treated with sweating first, but purging is done instead, this is contrary treatment. If sweating is done first, and then there are symptoms that warrant purging, then it is not contrary treatment. This explanation also makes sense.
However, the following statement is not acceptable: “To purge first and then induce sweating is contrary,” meaning that if a condition should be treated with purging, but sweating is induced instead, this is contrary treatment. If purging is done first, then it is not contrary treatment; this cannot be interpreted in that way. According to the previous statement, it should have been purged first, but sweating is induced instead, which is contrary treatment. If after purging there is an opportunity to induce sweating, then it is not contrary treatment; theoretically, this makes sense, but in practice, there is no case where a condition can be treated with purging first. For example, in Yangming disease, after purging, sweating cannot be performed; that does not happen. Therefore, based on this statement, we know that the previous statement cannot be interpreted that way.
To warm first and then induce sweating is contrary; if warming is done first, it is not contrary. Warming first and then resolving the exterior is acceptable, and this is supported by many cases. However, there are no examples of purging first. In clinical practice, we do not see such reactions in actual diseases. Therefore, this section discusses: there are conditions that require sweating and those that require purging. The ancients said, “When Yang is excessive and Yin is deficient, sweating leads to death; when Yang is deficient and Yin is excessive, purging leads to loss.”
Thus, inducing sweating when purging is required, or purging when sweating is required, is both contrary treatment. Do not think that what was just said is a later interpretation; it is actually from the ‘Nei Jing’ (Inner Canon). In this context, Yang refers to heat, and Yin refers to body fluids. When Yang is excessive and Yin is deficient, it means body fluids are depleted, and we cannot harm the body fluids. The concept of Yin and Yang here differs from that in the ‘Nei Jing’; Yang often refers to body fluids. We have many references to this in previous texts, so we should review them. When heat is excessive and body fluids are deficient, sweating cannot be induced. If heat is not excessive and body fluids are abundant, sweating can be induced.
Gui Zhi (Cinnamon Twig) is contraindicated when Yang is excessive, as it leads to death, alluding to excessive heat. In fact, all the conditions treated by Gui Zhi Tang (Cinnamon Twig Decoction) have some degree of heat. This heat is exterior heat; it does not mean that heat cannot be used with Gui Zhi. Exterior heat still necessitates its use. Therefore, using the ‘Nei Jing’ to interpret the ‘Shang Han Lun’ can sometimes lead to confusion.
Recommendation: Discussing the myriad changes, it all comes down to the interplay of Yin and Yang, exterior and interior.
Recommendation: Clinical guidelines: When both exterior and interior conditions are present, should we resolve the exterior first or support the interior first?
Many friends have inquired about clinic information. First, this subscription account primarily focuses on academic inheritance, promotion, and exchange, and does not provide medical consultations. You can check the corresponding clinic information in the bottom menu of this subscription account, and it is advisable to seek medical care in appropriate medical settings.Please understand.