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090417漢方松橋先生

●やさしい漢方医学

解剖学: 生理学的な諸現象の発言の場として認識
生理学: 気・血・津液、臓腑、経絡の働きを研究する学問

気血水: 生命活動を維持する基本精緻物質
臓腑:  基本精微物質の存在下にそれぞれの生理機能を発揮
経絡:  各臓腑・組織・器官を結びつけ、統一体として機能させている

気: 人参や黄耆に
血: 産婦にでる、爪のもろさ、しみ、髪の毛の弱さ、など
津液:滋養

・気の作用
温、推動、防御、固摂
気化: 血や津液を飲食物より化生
    津液を汗や尿に変化
  …サウナや風邪で気を失うと、補中益気湯とかで補う

・血の作用
 全身に栄養を送る
 精神活動の基本(なくなると物忘れ)

・津液
皮膚や肌を潤す (じゅくじゅくなら石膏、かさかさならばくもんどうとう・人参)
臓器を潤す
  …気で運ばれる →表の水を裁き新陳代謝あげ、やせれる防巳黄耆湯
             黄耆・ビャクジュツで気を補い水を動かす
           防巳黄耆湯は温めるのに、なぜさますか
            滞留した水→湿熱、をはらう

眼・鼻水・唾液などで潤す
関節内の津液は

津: すんでさらさらしたもの 各臓腑を潤す
液: 関節・筋膜・頭蓋内のねばねばした液。脳髄を潤す

…邪気に変わりうる。それは除く

気・津液は三焦(開放循環系)を流れる。ポンプは肺

臓 化生と貯蔵
腑 転化


心 オウレン、オウバク (含 ベルベリン 大腸の動きを止めて、下痢止め)
   〜シャシントウ類 →冷やす
    心臓の高ぶりを冷やすことで、下痢など治す
肺 マオウ (含む エフェドリン)


心臓→舌、肺→鼻、脾→口、肝→眼、腎→耳

心臓 思惟(考え抜く)

それぞれの生薬の使い分け
・あたためる、
  附子 … 腎に入る(下焦) 〜走りて守らず(体中に届く)
  カンキョウ … 脾に入る(中焦) 〜主に脾のみ温める
    → 同時に使うと温まる 気分を温める
  肉桂 … 気分を温める

ウンケイトウ
トウキシギャクカゴシュユショウキョウトウ
 女性の薬。血寒→血分を温める

附子・カンキョウ だけでは 血が乾いてしまうので使い分ける


●ほてり
 〜 内傷発熱
      (… 対するは、外感病…感染症 〜熱がでる)
実際には体温は変わっていない
「自覚的なほてり」

・大切なこと
 「冷まそうとばかり考えない」証をみる、証の進展をみる

1)虚証  …足りているべきものが足りない
a)血虚・陰虚
b)気虚・陽虚

2)実証  …なくていいものがある
a)気滞
b)血滞
c)痰湿(水滞)

a)血虚・陰虚のほてり : 血虚失養

気が相対的に多くて、ほてる
ほてりのときは、血とともに「気」を充分補うとうまくいく

肌がかさつくとかそんなんでなく、もっと足りない
→血のもとになる気も補わないといけない (気血同源)

気は作用
血は体

→どちらも充分補うのは、加味帰脾湯

(温清飲 は、シクンシトウ+冷ます、ので悪くはないがちょっと足りない)

●加味帰脾湯 : だるさ、発汗、動悸、不眠、イライラ感 (本治薬)
・人参 : 臓腑の気を補う 津液も補う
・黄耆 : 肌表の気を補う 血を補う
 …対薬  ↑同じ     ↑違う
・白朮 : 中焦の気を補う
・茯苓 :  (同上)
 → 脾胃の気を補う

・当帰 : 補血活血
  当帰と黄耆は対薬 …そのふたつだけで当帰補血湯 → 気を補って血を補う

・竜眼肉 : 黄耆で血を補う
      養血安神 (トランキライザー的)

当帰と竜眼肉は 補血の対薬

・酸棗仁 : 養心安神 大脳の高次機能を下げる
・遠志  : (同上) 大脳の高次機能を上げる(認知症とかに)

・柴胡  : 清熱 肝熱をシャす
・山梔子 : 清熱 心熱をシャす

・木香  : 理気 (補うだけでは滞るから)
・甘草

「こんな遠回りでは熱が冷めないんじゃないか」
→ 清熱作用を強めたかったら、白虎加人参湯 (標治)


『整体観念』 体全体を!

●白虎加人参湯
・石膏 : 辛(辛散 邪気を上のほうに飛ばす) 清熱養陰
・知母 : 苦(苦降 ) 清熱生津
  どちらも清熱作用、対薬で、バランスが取れる(足りないものを補い合う)
 ただ、清熱作用ある薬は胃を障害しやすい
・粳米 : 養胃
・甘草 : (同上)
・人参 : 気を補うことで陰を補う (気・津を補う)
  (ちなみに 黄耆は 気・血を補う)

→実熱にも虚熱にも使える
 外感にも内傷にも使える
 (ただし、無形の熱(全身にある)
   〜頑固な便秘・痰・黄疸などの有形の熱になっていない)

●気虚の発熱
(補中益気湯つくった、李東垣 リトウエンはあると言っている)
気虚 → 陰火亢盛
 熱をあるべきところに止めておけない → 分布させることができなくなる
 例:「上熱下寒」


比べると…
気虚: 昼夜問わず、上熱下寒、四逆
血虚: 夜、五心煩熱、

→ ●補中益気湯
「気虚」 疲れやすい、食欲がない、軟便、食べても太れない、自汗(自然と汗)、風邪を引きやすい
…なのに、ほてっているとき

・人参 : 補中益気
・白朮 : (同上)

・黄耆 : 補血
・当帰 : (同上)

・升麻 : 上底作用(胃下垂などを治す) → 血が足りていない上に血を流す
・柴胡 :
  …後天の気は、中焦からはいって、心肺までもちあげられ、体に運ばれる
   水穀の気を一度持ち上げる

・陳皮 : 胃がもたれないように
・甘草

●一般的血虚
血が乾く、ほてりがある、皮膚がかさつく
心の症状あるなら加味帰脾湯
心の症状ないとき…

補中益気湯と加味帰脾湯を足して二で割ったとき
「人参養栄湯」

●人参養栄湯
心には遠志だけはいっている、が、心血を養う薬はない

・肉桂(桂皮): 引火帰元(あるべきところに熱を帰す)

●腎陰虚 : 腰痛、関節痛、…老化
・陰虚
舌が力なくはっていて、
無苔
裂紋 → これすらなくなると、鏡面舌

→六味丸 (清熱作用は弱い 必要なら白虎加人参湯を)
 冷えがあるなら八味地黄丸を


●小柴胡湯
…潮熱 や、 ストレス から伸びやかに
 肝の気を流してあげる
  が、体を乾かすので長くは使えない

●カミショウヨウサン
気血両虚+気滞があるひとに使う
 〜更年期のはじめ
そうでないひとは…

・湿熱のほてり
●竜胆シャ汗湯
  水滞での熱

・気血両虚にオ血がともなうもの
●キュウキチョウケツイン
  (産後のひだち)

・オ血
桂枝茯苓丸


抗精神病薬の口渇は、白虎加人参湯はあり


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Hmm is anyone else encountering problems with the pictures on this blog loading? I'm trying to figure out if its a problem on my end or if it's the blog. Any feedback would be greatly appreciated.

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