摘要
台湾中医名家们的学术思想和临床经验是中医药宝库的一部分,对台湾的知名中医家们进行学术思想总结和临床经验整理研究,薪火相传,对不断推动中医学的发展,和促进两岸中医学术的交流具有重要意义。朱木通医师是台湾嘉义地区上个世纪40年代的知名中医师,以擅用经方和临床疗效好而著名,在当地享有较高的知名度。先生治学严谨,重视实践,临床经验丰富,实为后学楷模,当精心学习,细致领会,深入研究。本文对朱木通医师学术思想和方证辨证临床经验进行了较为深入的整理与研究。
本文通过收集整理朱木通医师的著作和文献资料,进行分类归纳总结,对朱木通医师的学术思想和方证辨证临床经验进行了深入的探讨。一个医家的学术思想是医家在学习和临床中不断积累和深化,逐渐形成的相对固定能有效指导临床的思想体系；临床经验是医家在实践中不断总结形成的实践经验,是学术思想的来源也是学术思想的具体化表现。
朱师临床积累了丰富的方证辨证经验,并且大多为经方,对众多方证有自己独到的认识,丰富了方证辨证和经方医学的内容；拓展当归四逆加吴茱萸生姜汤治疗阑尾炎、黄连汤治疗胃炎、甘草干姜汤治疗咳喘、桂枝人参汤治疗流感和莲子清心饮治疗前列腺炎等等,给后人留下了宝贵的经验。
论文首先系统回顾了朱木通医师的生平。朱木通又名朱芾亭,号虚秋,1904年生于台湾嘉义,出身金饰业家庭,自学成为集诗、书、画于一身的文人,他入选过四届台展。朱木通生平有四绝,除了诗、书、画,还有就是中医,朱木通研究学习伤寒论十年有余。至从投身中医事业以来,朱木通医师活跃于当时的中医界,加入了当时的日本汉方医学会,还在当时有名的医学杂志如《中国医药》、《中西医药新闻》、《革新中医》多次发表文章,其中发表在《中国医药》杂志第七卷第五期的《关于中医学现代化》一文被当时的台中私立求真函授学校收录入教材。朱木通医师著作有《高血压症自己治疗法》、《我的中医疗法心得》和《中医临床廿五年》等书。朱师一生勤于临床实践,正如朱师在《中医临床廿五年》自序中所说“与患者共朝夕,与药囊共甘苦,兢兢业业,临深履薄者转瞬廿五年矣。”他学验俱丰,是一位真正的临床中医大家。
论文对朱木通师医的学术思想进行了总结。朱师治学从《伤寒论》和《金匮要略》而始,对仲景学说,造诣彼深,推崇经典；旁采各家之长,对日本汉方医学精华和后世时方的经验兼收并蓄,自成一家；朱师认为中医临床诊治疾病必须依据四诊为基础,而在四诊之中首重问诊,问不厌其详；重视体质对疾病发生、生展和转归的影响,辨证论治以体质为先,临证首察体质；朱师强调辨证与论治必须统一才能提高临床疗效,坚持实践方证辨证,有是证用是方。
论文对朱木通医师实践方证辨证的临床经验进行了全面总结,就其常用的38个方的方证进详细的分析,分别论述了他辨治当归四逆加吴茱萸生姜汤证、小青龙汤证、真武汤证、大柴胡汤证、桃仁承气汤证、五苓散证、甘草泻心汤证、桂枝人参汤证、苓桂术甘汤证、大建中汤证、茯苓四逆汤证、葛根汤证、桂枝茯苓丸证、黄连汤证、宽中汤证、生姜泻心汤证、吴茱萸汤证、柴胡桂枝汤证、理中丸(人参汤)证、苓桂味甘汤证、泻心汤证、正气天香散证、半夏白术天麻汤证、半夏厚朴汤证、半夏泻心汤证、大黄附子汤证、甘草干姜汤证、葛根黄芩黄连汤证、黄连解毒汤证、小建中汤证、半夏汤证、桂枝加黄芪汤证、紫丸证、防风通圣散证、防己黄芪汤证、附子泻心汤证、莲子清心饮证、柴胡桂枝干姜汤证的经验。
作者认为,学习和研究朱木通医师学术思想和方证辨证临床经验,对于方证辨证方法的扩大运用,对于正确而深刻理解方证辨证的临床实践方法指导临床诊治疾病,对于一些与之相关的基础医学问题,对于学习前人临证经验,促进中医师的成长和临床水平的提高,对于正确认识中医发展方向,都有较大的意义。
Famous Taiwanese TCM experts'academic thoughts and clinical experiences are part of the treasure house of Traditional Chinese Medicine (TCM). Collation and study of these academic thoughts and clinical experiences is of great importance not only to the inheritance and development of TCM, but also to the academic exchanges in TCM between Taiwan and Chinese mainland. Zhu Mutong, a well-known Chinese medicine practitioners in Chiayi area, Taiwan in1940s who was in famous for classical prescription good clinical efficacy, enjoyed a high reputation in the local. Zhu Mutong, with his rigorous scholarship, emphasis on practice and rich clinical experience, deserve to be set as a role model and carefully studied. In this thesis, Zhu Mutong's academic thoughts and clinical experiences are meticulously organized and deeply studied.
In this thesis, not only writings and literature about Zhu Mutong are collected and summarized, but also the academic thoughts and experience in syndrome differentiation are thoroughly discussed. Academic thinking of a medical practitioner is constantly accumulated in the study and clinical practice, that's how a instructional knowledge hierarchy is gradually formed. Clinical experience, which is formed through constant practice, is the source and manifestation of academic thought.
Doc. Zhu accumulated a wealth of experience in syndrome differentiation based on prescription, most of which are classical prescriptions. It represents the unique understanding of Doc. Zhu and enriches the content of the the medical system of classical prescription. It also expand Dangguisinijiawuzhuyu decoction for appendicitis, Huanglian decoction for gastritis, Gancaoganjiang decoction for cough, Guizhirensheng decoction for influenza and Lianziqingxin decoction for prostatitis, leaving behind valuable experiences for the posterity.
Firstly, a systematic review of the life of Zhu Mutong is made. Zhu Mutong, also known as Zhu Futing or Xuqiu, was born in Chiayi, Taiwan, in1904, in a gold ornament industry family. He had been a literati being skilled in poetry, calligraphy and painting since young, and had been elected in four sessions of Taiwan painting and calligraphy exhibition. Except poetry, calligraphy and painting, Zhu Mutong was also good at TCM, and had been studying "Treatise on Fevers" for more than ten years. Since start TCM practice, Zhu was active in TCM area. He joined Chinese medical association of Japan, and publish a lot of essays in famous medical journals, such as "Chinese Medicine""Chinese and Western Medicine News","innovational TCM". One of those essays in "Chinese Medicine" was even selected in textbook by Taichung Qiuzhen private correspondence school. Zhu's works include "Self-therapy for Hypertension","My Experience of TCM Therapy" and "25Years of TCM Practition". Doc. Zhu'was diligent in clinical practice, as said by himself in "25Years of TCM Practition", and finally became a real expert in TCM.
Secondly, academic thoughts of Zhu is summarized here. Zhu learnt not only from the "Treatise on Fevers" and "Synopsis of Golden Chamber", but also from Japanese Kampo medicine, different schools of TCM and experience of current prescription. In Zhu's opinion, diagnosis and treatment of clinical medicine must be in accordance with the four diagnostic mathods, especially inquiry. He emphasize the significance of physique in the appearance, development, transformation, diagnosis and treatment of diseases. Zhu stressed the correspondence between diagnosis and treatment, and adhere to the practice of prescribing according to syndrome differentiation.
Thirdly, in-depth and comprehensive summary of Zhu's clinical experience based on syndrome differentiation is made, detailed analysis of38syndromes corresponding to38staple decoctions is conducted. The syndromes include those corresponding to Dangguisinijiawuzhuyu decoction, xiaoqinglong decoction, zhenwu decoction, dachaihu decoction, taorenchengqi decoction, wuling powder, gancaoxiexin decoction, huizhirensheng decoction, lingguizhugan decoction, dajianzhong decoction, fulingsini decoction, gegen decoction, guizhifuling pill, huanglian decoction, kuanzhong decoction, shengjiangxiexin decoction, wuzhuyu decoction, chaihuguizhi decoction, lizhong pill(rensheng decoction), lingguiweigan decoction, xiexin decoction, zhengqitianxiang powder, banxiabaizhutianma decoction, banxiahoupo decoction, banxiaxiexin decoction, dahuangfuzi decoction, gancaoganjiang decoction, gegenhuangqinghuanglian decoction, huanglianjiedu decoction, xiaojianzhong decoction, banxia decoction, guizhijiahuangqi decoction, zi pill, fangfengtongsheng powder, fuzixiexin decoction, lianziqingxin decoction, chaihuguizhiganjiang decoction.
The author believe that the study and research of Doc. Zhu's academic thoughts and clinical experience in syndrome differentiation have a great significance for diagnosis and treatment of diseases, for the expansion of use of the dialectical method, for the right and a deep understanding of the clinical practice of the prescription based on syndrome differentiation, for some associated preclinical medical problem, for the study of ancestors' clinical experience, for the growth of TCM practitioners, for the sound view of the direction of the development of TCM.
引文
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