《喻昌医学三书》学术思想研究
摘要
喻昌(1585-1664),字嘉言,晚号西昌老人,新建(今属江西南昌市)人,明末清初著名医学家。他治学严谨,深研经典,上溯《内经》、《难经》诸典,下及诸子百家,特别是仲景学说,钻研尤深,体会颇多。医疗上擅长内科杂病,强调识病议药,辨证论治;善用经方,灵活运用;诊治疑难杂证,多获奇效。是我国明末清初著名的医学家,与吴谦、张璐齐名,史称清初三大名医。著有《医门法律》、《尚论篇》、《寓意草》等10余种著作,为后世留下了珍贵的遗产,而《尚论篇》、《医门法律》、《寓意草》是其代表著作,后世合称为《喻昌医学三书》,为祖国医学的发展做出了重大贡献。
基于此,本文对喻昌的医学思想从《尚论篇》、《医门法律》、《寓意草》三部代表著作入手,从以下六个方面进行了整理、归纳、阐释,并评价其医学思想,以明确喻昌在中医学史上的地位和对中医学的贡献。
第一,考察喻昌编次《尚论篇》的内容。
喻昌否定王叔和编次、林亿校订《伤寒论》之功,推崇方有执三纲之说,将《伤寒论》按照三纲鼎立、以法统纲的原则进行重新编次。
喻昌认为《伤寒论》有纲有目,四时外感,尤其是冬伤于寒是《伤寒论》的大纲。三阴、三阳是分辨伤寒病的大纲。太阳篇里风伤卫、寒伤营、风寒两伤营卫,又是分析太阳病的大纲。即六经是分析伤寒病的大纲,风伤卫、寒伤营、风寒两伤营卫又是辨证的大纲,因此他确立伤寒病研究的“三纲鼎立”之说。另外将桂枝汤、麻黄汤、青龙汤作为鼎足三纲的三大治法。
喻昌将伤寒六经各自为篇,每一经之前,都叙述证治大意,再以法为目,法下分列条文,加以注释,并将合病、并病、坏病、痰病四类附于三阳经末,以过经不解、差后劳复阴阳易病等附于三阴经末,这样使得条理清晰,求理法方药于一统。喻昌对《伤寒论》错简重订思想颇受争议,后世对此褒贬不一。但它的提出对《伤寒论》重新编次、归类的方法,从伤寒学史来看,属创举之作,首开《伤寒论》学术争鸣之端,由此而引发的尊经派与错简派之争,促进了《伤寒论》研究的深入与发展,后世以方类证,以法类证等诸多归类法的问世,就方法论言,是受其影响。
同时喻昌将《伤寒论》中有关温症的条文提炼出来,按照三纲鼎立的方法,
将温症也分为三大类,即《内经》所提到的冬伤于寒,春必病温,此一大例;冬不藏精,春必病温,此一大例;既冬伤于寒,又冬不藏精,至春月同时病发,此一大例。他的注重护阴治法,对后世温病学家的思想影响颇大。
第二,探讨喻昌六气为病的思想。本章主要包括以下四个方面的内容
一是喻昌探讨中寒证治的内容,反对朱丹溪“阳常有余,阴常不足”之说,论述阴邪为患的病机、辨证及治法。将仲景《伤寒论》、《金匮要略》及前人有关阴邪为患的论述进行深入剖析与比类,将中寒证治的内容补充完整。
二是中风分外风和内风两种。外风是“阳虚邪害空窍为本,而风从外入者,必挟身中素有之邪,或火或气或痰而为标”;并首创“内风”之说,认为内风是“真中风之风,乃人身自有之风,平素蕴蓄,而一旦内出者也。”
三是纠正《内经》“秋伤于湿”为“秋伤于燥”,认为燥为秋之主气,燥胜而干,创著名清燥救肺汤,辛凉甘润,为后世医家所称道。
四是将热湿暑三气合而论述。因三气致病,往往杂合而至,不可完全分离。
可见喻昌六气论述内容全面,而且创立医门律例,提出辨证要点,这些内容都是其独创的地方,值得深入挖掘。
第三,论述喻昌定议病式的内容。本章总结了喻昌制订的“议病式”的内容。喻昌制定的“议病式”作为一个工具化的标准,有着其深厚的理论基础,每一条每一款都有经典理论的指导且与医疗实践相结合。对于医案内容的书写要求作详细规定,可视为医门矜式。作为中医病案规范化的书写,对于现在越来越注重中医规范化的今天,将中医进行标准化,探求中医诊断内容中书写病例,在文献追溯源流方面起了作用,至今仍有借鉴意义。
第四,探讨喻昌论治杂病的内容,本章内容包括疟证、痢疾、痰饮、咳嗽、关格、消渴、虚劳、水肿、黄疸及肺痈肺痿等杂病的证治。喻昌对每病首述病因、病理,次论各种律例,分析误诊原因,最后载入常用方剂,体例严谨。在本章节中多基于对《金匮要略》内容的比较与阐述。
第五,通过医案医话,探讨中医理论。本章主要包括四个方面的内容。
一是小儿论辨明“小儿惊风”之误。小儿论分温症一、二、三例,通过具体医案论述小儿治则,须重视脾肺。
二是老年病,需从注重脾胃、补养正气、温补下元、从痰论治四个方面入手进行辨证治疗。
三是血证论治。镇纳肾气,以救吐血;温中健脾治呕血;涤痰生血治痰血兼证;咸寒治胃络损伤之血证等四个方面进行论述。
四是论述潜降法治厥巅疾、肠风下血五证可治、血盅之辨证等内容。
《寓意革》所载医案均为喻昌亲手治疗内科杂病或伤寒等疑难病证的案例。每案详述其病因、病情,尤着力于辨证治疗,推敲设问,层剖缕分,务求精审明晰。由此可以看出,喻昌对医学实践、临床治疗方面极为重视。他的很多医理都是散见于众多的医案、医论中。喻昌善于从这些宝贵的经验中吸取营养,经过思考提出新的理论和方法,从而给喻昌的医学研究赋予了很强的实践特色。
第六,论述《喻昌医学三书》的几个特点:善用人参,喻昌不仅在医著中列专篇讨论用参的问题,而且将人参运用于温补下元、治痢种种及内伤杂病等方面。另外喻昌经历复杂,曾一度削发为僧,所以他的医著中很多地方有引入佛理的内容,本章节从喻昌仿照佛教戒律,为医门立法;将佛教四大与中医阴阳学说相结合,重视阴邪为病;治病注重精神调养:强调饮食清淡并以律戒医等方面进行探讨,分析喻昌引佛入医的内容。
在结语讨论中,本文结合喻昌研究经典、重点突出、注释独特、善于类比等特点,探讨喻昌的学术思想。
总之,喻昌在医学史上具有不可忽视的地位,他的三纲鼎立学说打破传统研究《伤寒论》的局面,引发了争鸣。他所创的医门律例、订立议病式及所主张的医学思想,提炼温症条文,在历史上都着很大的影响,其医学地位不容忽视。喻昌将自己的医学实践与经验著书立说,尤其是书中误诊学的思想,着力于指导临证医生的辨证论治,启迪后学。
Yu Chang(1585-1664),styling himself Jia Yan,alias Xichang Laoren in his late years,Xinjian native people(nanchang city,jiangxi province today),was a celebrated doctor in late Ming dynasty(1368-1644)and early Qing dynasty(1636-1912).Pursuing his studies and researches scrupulously from Neijing and Nanjing to the masters' hundred schools,Yu Chang was specialized in Zhong Jing' s theory. Emphasizing on identification of the disease before prescription and treatment based on syndrome differentiation,he obtained miracle achievements in internal miscellaneous disease and other rare illness by means of classical formula.As the doctor lived in late Ming dynasty and early Qing dynasty,Yu Chang,together with Wu Qian and Zhang Luyu, was noted as one of the three famous doctors in early Qing dynasty in history.He has left over ten precious works for us,such as Yimenfalv, Shanglunpian and Yuyicao,which were also regarded as his masterpieces and laid important contribution to the development of TCM.
Therefore,in order to clarify his position and his contribution, this article starts with Yu Chang' s three masterpieces,Shanglunpian, Yimenfalv and Yuyicao,arrange,generalize,explain and evaluate his medical ideology from six parts as follows:
First,exploration of Shanglunpian
Yu Chang denied the revision of Shanghanlun made by Wang Shuhe and Lin Yi,but agreed to Fang Youzhi' s three principles.Afterwards he recompiled Shanghanlun according to three principles and principles commanded by prescriptions.
Yu Chang holds that Shanghanlun should contain principles and items, in which seasonal exogenous,especially the cold damage must be the primary principle.Three yin and three yang must be the primary principle to differentiate the cold damage syndrome.In Taiyang section, internal,wind damaging defense,cold damaging nutrient,wind and cold damaging both nutrient and defense are the primary principles to analyze the taiyang disease syndrome.That is to say,six meridians are the primary principles to analyze cold damage syndrome,moreover,internal wind damaging defense,cold damaging nutrient,wind and cold damaging both nutrient and defense are the primary principles to differentiate the syndromes.As a result,he established the theory of three principles.In addition,Ramulus Cinnamomi Decoction,Ephedra Decoction and BlueDragon Decoction are considered as the three primary prescriptions under the three principles.
Yu Chang established six sections in accordance with six meridians. In each section,brief syndrome differentiation and treatment were related before prescription,then list clauses and notations after it. Combination of diseases,overlap of diseases,refractory diseases and phlegm diseases were added in the postscript of three yang meridians, while incomplete recovery,easy relapse of yin and yang caused by overexertion after three yin meridians,which make the section a coherence and integrity of principles,therapeutic methods,formulas and prescriptions.Although his revision was controversial,he initiated innovation of compile and analysis about Shanghanlun,which was creative in history and resulted in academic debate between classic-abided school and classic-predigested school,boosted further research of Shanghanlun and invention of classification,such as syndrome classification based on prescription and syndrome classification based on therapeutic method,in terms of methodology, it was influential.
Meanwhile,Yu Chang extracted and classified the clauses of warm syndromes into three parts,which have been mentioned in Neijing.one is if cold damage happens in winter,warm damage must occur in spring; another is if essence isn't stored in winter,warm damage must occur in spring;the third is if cold damage happens but essence isn't stored in winter,both of them must occur in spring.His therapy emphasizing on protecting yin exerted huge effects on ideology of febrile disease doctors.
Second,exploration of etiology of six excesses,four parts included.
Ⅰ)As to treatment of middle cold syndrome,Yu Chang opposed Zhu Danxi' s view of "Yang is usually redundant while yin is frequently deficient",demonstrated his opinions of pathogenesis casused by yin pathogen and its syndrome differentiation and treatment.Comparing and analyzing the statements in Shanghanlun,Jinkuiyaolue and other ancient doctors about the disease caused by yin pathogen,he supplemented the treatment of middle cold syndrome.
Ⅱ) Apoplexy can be caused by external wind and internal wind.The former takes yang deficiency damaging orifices as its rooting reason. If wind pathogen attacks externally,it must hold constant pathogens and takes either fire,evil qi or phlegm as manifestations.Yu Chang was the first to put forward the theory of internal wind which holds that apoplexy is caused by sudden onset of accumulative internal wind.
Ⅲ) Rectify dampness damaging in autumn into dryness damaging because dryness is a major seasonal qi in autumn.Dryness prevalence resultsin thirsty,so a decoction for clearing away dryness and saving lung was invented by means of its flavor-pungent-cool, sweet-moistening,which was appreciated by later doctors.
Ⅳ) Heat,dampness and summer heat are put together because they always interact and are difficult to separate.
From above,Yu Chang' s theory of six excesses,compiling principles and other points are so original and comprehensive that they are worthy exploring.
Third,statement of Yu Chang' s disease-discussion style.As a standard instrumentation,Yu Chang's disease-discussion style has profound theoretic foundation in which every item and clause combine the practice under the guidance of classical theory.Specific regulations were demanded in medical record as a formal pattern.With the increasing attention of standardization,this formal pattern is meaningful at present to trace back ancient literature and explore the record in diagnosis.
Four,discussion of Yu Chang's treatment of miscellaneous diseases include malaria,dysentery,phlegm-fluid retention,coughing,block and repulsion disease,consumptive thirst,consumptive disease,edema, jaundice,lung abscess,lung flaccidity.Each disease was discussed in sequence of etiology,pathogenesis,various medical records,reasons of misdiagnosis and prescription was written strictly.Most of them are based on comparison with Jinkuiyaolue and explained clearly.
Five,exploration of theory of TCM through medical records and notes.Four parts are included as follows:
Ⅰ) Clearing up the misunderstanding of infantile convulsion,which should be divided into three steps.Concluding(discussing?) the therapeutic principles with emphasis on spleen and lung through specific medical records.
Ⅱ) The senile diseases should be treated from the perspective of spleen and lung,refreshing the healthy qi,warming and restoring the lower source and from the angle of phlegm.
Ⅲ) Treatment on blood syndromes from four sections:calm the kidney qi and promote qi reception to suppress hematemesis;eliminate phlegm and engender blood to treat combined syndromes;treat blood vessel damage of stomach with salty and cold medicine.
Ⅳ) Statements include vertex disease treated by descendant and subdued method,five syndromes of hematochezia caused by intestine wind can be cured,and syndrome differentiation of blood tympanites.
All the internal miscellaneous cases or cold damage cases recorded in Yuyicao were treated by Yu Chang himself.Trying to reach prudence and clarity,each case aims at detailed pathogeny and situation, especially syndrome differentiation by means of inference,inquiry and specific analysis.By this token,Yu Chang extremely stressed medical practice and clinical treatment.Most of his ideologies were distributed on various medical records and notes.Yu Chang was apt at putting forward newly theory and method through the precious experiences which endowed his research with strongly practical characteristic.
Six,there are three characteristics in Yu Chang' s book:first, he is expert in prescribing gingseng,not only making an exclusive section discuss it,but also applying gingseng to warm and tonify lower source and treat various dysenteries and other internal miscellaneous cases.Aside from,once he served as a monk in his complicated experience, so Buddhism was frequently induced in his book.Yu Chang established medical law through imitation of Buddhism mitzvah.Last,he combined the four doctrines of Buddhism with the theory of yin-yang in TCM and yin syndrome was stressed as well.He also paid attention to mental nourishment and put emphasis on light diet.
At the end of the article,Yu Chang' s position in medical history was discussed from the perspective of his classical research, prominence of key point,original notation and comparison.
In conclusion,Yu Chang shouldn't be overlooked because the traditional situation in studying Shanghanlun was broken by his view of three principles which aroused discussion.His initiative of medical compiling law and the establishment of disease-discussion style with the extraction of clauses in warm syndrome had a huge influence in history.
Yu Chang' s medical practice and experience turned out to be his book and theory.In particular,his ideology of misdiagnosis aims at guiding clinical syndrome differentiation and enlightening later generations.
基于此,本文对喻昌的医学思想从《尚论篇》、《医门法律》、《寓意草》三部代表著作入手,从以下六个方面进行了整理、归纳、阐释,并评价其医学思想,以明确喻昌在中医学史上的地位和对中医学的贡献。
第一,考察喻昌编次《尚论篇》的内容。
喻昌否定王叔和编次、林亿校订《伤寒论》之功,推崇方有执三纲之说,将《伤寒论》按照三纲鼎立、以法统纲的原则进行重新编次。
喻昌认为《伤寒论》有纲有目,四时外感,尤其是冬伤于寒是《伤寒论》的大纲。三阴、三阳是分辨伤寒病的大纲。太阳篇里风伤卫、寒伤营、风寒两伤营卫,又是分析太阳病的大纲。即六经是分析伤寒病的大纲,风伤卫、寒伤营、风寒两伤营卫又是辨证的大纲,因此他确立伤寒病研究的“三纲鼎立”之说。另外将桂枝汤、麻黄汤、青龙汤作为鼎足三纲的三大治法。
喻昌将伤寒六经各自为篇,每一经之前,都叙述证治大意,再以法为目,法下分列条文,加以注释,并将合病、并病、坏病、痰病四类附于三阳经末,以过经不解、差后劳复阴阳易病等附于三阴经末,这样使得条理清晰,求理法方药于一统。喻昌对《伤寒论》错简重订思想颇受争议,后世对此褒贬不一。但它的提出对《伤寒论》重新编次、归类的方法,从伤寒学史来看,属创举之作,首开《伤寒论》学术争鸣之端,由此而引发的尊经派与错简派之争,促进了《伤寒论》研究的深入与发展,后世以方类证,以法类证等诸多归类法的问世,就方法论言,是受其影响。
同时喻昌将《伤寒论》中有关温症的条文提炼出来,按照三纲鼎立的方法,
将温症也分为三大类,即《内经》所提到的冬伤于寒,春必病温,此一大例;冬不藏精,春必病温,此一大例;既冬伤于寒,又冬不藏精,至春月同时病发,此一大例。他的注重护阴治法,对后世温病学家的思想影响颇大。
第二,探讨喻昌六气为病的思想。本章主要包括以下四个方面的内容
一是喻昌探讨中寒证治的内容,反对朱丹溪“阳常有余,阴常不足”之说,论述阴邪为患的病机、辨证及治法。将仲景《伤寒论》、《金匮要略》及前人有关阴邪为患的论述进行深入剖析与比类,将中寒证治的内容补充完整。
二是中风分外风和内风两种。外风是“阳虚邪害空窍为本,而风从外入者,必挟身中素有之邪,或火或气或痰而为标”;并首创“内风”之说,认为内风是“真中风之风,乃人身自有之风,平素蕴蓄,而一旦内出者也。”
三是纠正《内经》“秋伤于湿”为“秋伤于燥”,认为燥为秋之主气,燥胜而干,创著名清燥救肺汤,辛凉甘润,为后世医家所称道。
四是将热湿暑三气合而论述。因三气致病,往往杂合而至,不可完全分离。
可见喻昌六气论述内容全面,而且创立医门律例,提出辨证要点,这些内容都是其独创的地方,值得深入挖掘。
第三,论述喻昌定议病式的内容。本章总结了喻昌制订的“议病式”的内容。喻昌制定的“议病式”作为一个工具化的标准,有着其深厚的理论基础,每一条每一款都有经典理论的指导且与医疗实践相结合。对于医案内容的书写要求作详细规定,可视为医门矜式。作为中医病案规范化的书写,对于现在越来越注重中医规范化的今天,将中医进行标准化,探求中医诊断内容中书写病例,在文献追溯源流方面起了作用,至今仍有借鉴意义。
第四,探讨喻昌论治杂病的内容,本章内容包括疟证、痢疾、痰饮、咳嗽、关格、消渴、虚劳、水肿、黄疸及肺痈肺痿等杂病的证治。喻昌对每病首述病因、病理,次论各种律例,分析误诊原因,最后载入常用方剂,体例严谨。在本章节中多基于对《金匮要略》内容的比较与阐述。
第五,通过医案医话,探讨中医理论。本章主要包括四个方面的内容。
一是小儿论辨明“小儿惊风”之误。小儿论分温症一、二、三例,通过具体医案论述小儿治则,须重视脾肺。
二是老年病,需从注重脾胃、补养正气、温补下元、从痰论治四个方面入手进行辨证治疗。
三是血证论治。镇纳肾气,以救吐血;温中健脾治呕血;涤痰生血治痰血兼证;咸寒治胃络损伤之血证等四个方面进行论述。
四是论述潜降法治厥巅疾、肠风下血五证可治、血盅之辨证等内容。
《寓意革》所载医案均为喻昌亲手治疗内科杂病或伤寒等疑难病证的案例。每案详述其病因、病情,尤着力于辨证治疗,推敲设问,层剖缕分,务求精审明晰。由此可以看出,喻昌对医学实践、临床治疗方面极为重视。他的很多医理都是散见于众多的医案、医论中。喻昌善于从这些宝贵的经验中吸取营养,经过思考提出新的理论和方法,从而给喻昌的医学研究赋予了很强的实践特色。
第六,论述《喻昌医学三书》的几个特点:善用人参,喻昌不仅在医著中列专篇讨论用参的问题,而且将人参运用于温补下元、治痢种种及内伤杂病等方面。另外喻昌经历复杂,曾一度削发为僧,所以他的医著中很多地方有引入佛理的内容,本章节从喻昌仿照佛教戒律,为医门立法;将佛教四大与中医阴阳学说相结合,重视阴邪为病;治病注重精神调养:强调饮食清淡并以律戒医等方面进行探讨,分析喻昌引佛入医的内容。
在结语讨论中,本文结合喻昌研究经典、重点突出、注释独特、善于类比等特点,探讨喻昌的学术思想。
总之,喻昌在医学史上具有不可忽视的地位,他的三纲鼎立学说打破传统研究《伤寒论》的局面,引发了争鸣。他所创的医门律例、订立议病式及所主张的医学思想,提炼温症条文,在历史上都着很大的影响,其医学地位不容忽视。喻昌将自己的医学实践与经验著书立说,尤其是书中误诊学的思想,着力于指导临证医生的辨证论治,启迪后学。
Yu Chang(1585-1664),styling himself Jia Yan,alias Xichang Laoren in his late years,Xinjian native people(nanchang city,jiangxi province today),was a celebrated doctor in late Ming dynasty(1368-1644)and early Qing dynasty(1636-1912).Pursuing his studies and researches scrupulously from Neijing and Nanjing to the masters' hundred schools,Yu Chang was specialized in Zhong Jing' s theory. Emphasizing on identification of the disease before prescription and treatment based on syndrome differentiation,he obtained miracle achievements in internal miscellaneous disease and other rare illness by means of classical formula.As the doctor lived in late Ming dynasty and early Qing dynasty,Yu Chang,together with Wu Qian and Zhang Luyu, was noted as one of the three famous doctors in early Qing dynasty in history.He has left over ten precious works for us,such as Yimenfalv, Shanglunpian and Yuyicao,which were also regarded as his masterpieces and laid important contribution to the development of TCM.
Therefore,in order to clarify his position and his contribution, this article starts with Yu Chang' s three masterpieces,Shanglunpian, Yimenfalv and Yuyicao,arrange,generalize,explain and evaluate his medical ideology from six parts as follows:
First,exploration of Shanglunpian
Yu Chang denied the revision of Shanghanlun made by Wang Shuhe and Lin Yi,but agreed to Fang Youzhi' s three principles.Afterwards he recompiled Shanghanlun according to three principles and principles commanded by prescriptions.
Yu Chang holds that Shanghanlun should contain principles and items, in which seasonal exogenous,especially the cold damage must be the primary principle.Three yin and three yang must be the primary principle to differentiate the cold damage syndrome.In Taiyang section, internal,wind damaging defense,cold damaging nutrient,wind and cold damaging both nutrient and defense are the primary principles to analyze the taiyang disease syndrome.That is to say,six meridians are the primary principles to analyze cold damage syndrome,moreover,internal wind damaging defense,cold damaging nutrient,wind and cold damaging both nutrient and defense are the primary principles to differentiate the syndromes.As a result,he established the theory of three principles.In addition,Ramulus Cinnamomi Decoction,Ephedra Decoction and BlueDragon Decoction are considered as the three primary prescriptions under the three principles.
Yu Chang established six sections in accordance with six meridians. In each section,brief syndrome differentiation and treatment were related before prescription,then list clauses and notations after it. Combination of diseases,overlap of diseases,refractory diseases and phlegm diseases were added in the postscript of three yang meridians, while incomplete recovery,easy relapse of yin and yang caused by overexertion after three yin meridians,which make the section a coherence and integrity of principles,therapeutic methods,formulas and prescriptions.Although his revision was controversial,he initiated innovation of compile and analysis about Shanghanlun,which was creative in history and resulted in academic debate between classic-abided school and classic-predigested school,boosted further research of Shanghanlun and invention of classification,such as syndrome classification based on prescription and syndrome classification based on therapeutic method,in terms of methodology, it was influential.
Meanwhile,Yu Chang extracted and classified the clauses of warm syndromes into three parts,which have been mentioned in Neijing.one is if cold damage happens in winter,warm damage must occur in spring; another is if essence isn't stored in winter,warm damage must occur in spring;the third is if cold damage happens but essence isn't stored in winter,both of them must occur in spring.His therapy emphasizing on protecting yin exerted huge effects on ideology of febrile disease doctors.
Second,exploration of etiology of six excesses,four parts included.
Ⅰ)As to treatment of middle cold syndrome,Yu Chang opposed Zhu Danxi' s view of "Yang is usually redundant while yin is frequently deficient",demonstrated his opinions of pathogenesis casused by yin pathogen and its syndrome differentiation and treatment.Comparing and analyzing the statements in Shanghanlun,Jinkuiyaolue and other ancient doctors about the disease caused by yin pathogen,he supplemented the treatment of middle cold syndrome.
Ⅱ) Apoplexy can be caused by external wind and internal wind.The former takes yang deficiency damaging orifices as its rooting reason. If wind pathogen attacks externally,it must hold constant pathogens and takes either fire,evil qi or phlegm as manifestations.Yu Chang was the first to put forward the theory of internal wind which holds that apoplexy is caused by sudden onset of accumulative internal wind.
Ⅲ) Rectify dampness damaging in autumn into dryness damaging because dryness is a major seasonal qi in autumn.Dryness prevalence resultsin thirsty,so a decoction for clearing away dryness and saving lung was invented by means of its flavor-pungent-cool, sweet-moistening,which was appreciated by later doctors.
Ⅳ) Heat,dampness and summer heat are put together because they always interact and are difficult to separate.
From above,Yu Chang' s theory of six excesses,compiling principles and other points are so original and comprehensive that they are worthy exploring.
Third,statement of Yu Chang' s disease-discussion style.As a standard instrumentation,Yu Chang's disease-discussion style has profound theoretic foundation in which every item and clause combine the practice under the guidance of classical theory.Specific regulations were demanded in medical record as a formal pattern.With the increasing attention of standardization,this formal pattern is meaningful at present to trace back ancient literature and explore the record in diagnosis.
Four,discussion of Yu Chang's treatment of miscellaneous diseases include malaria,dysentery,phlegm-fluid retention,coughing,block and repulsion disease,consumptive thirst,consumptive disease,edema, jaundice,lung abscess,lung flaccidity.Each disease was discussed in sequence of etiology,pathogenesis,various medical records,reasons of misdiagnosis and prescription was written strictly.Most of them are based on comparison with Jinkuiyaolue and explained clearly.
Five,exploration of theory of TCM through medical records and notes.Four parts are included as follows:
Ⅰ) Clearing up the misunderstanding of infantile convulsion,which should be divided into three steps.Concluding(discussing?) the therapeutic principles with emphasis on spleen and lung through specific medical records.
Ⅱ) The senile diseases should be treated from the perspective of spleen and lung,refreshing the healthy qi,warming and restoring the lower source and from the angle of phlegm.
Ⅲ) Treatment on blood syndromes from four sections:calm the kidney qi and promote qi reception to suppress hematemesis;eliminate phlegm and engender blood to treat combined syndromes;treat blood vessel damage of stomach with salty and cold medicine.
Ⅳ) Statements include vertex disease treated by descendant and subdued method,five syndromes of hematochezia caused by intestine wind can be cured,and syndrome differentiation of blood tympanites.
All the internal miscellaneous cases or cold damage cases recorded in Yuyicao were treated by Yu Chang himself.Trying to reach prudence and clarity,each case aims at detailed pathogeny and situation, especially syndrome differentiation by means of inference,inquiry and specific analysis.By this token,Yu Chang extremely stressed medical practice and clinical treatment.Most of his ideologies were distributed on various medical records and notes.Yu Chang was apt at putting forward newly theory and method through the precious experiences which endowed his research with strongly practical characteristic.
Six,there are three characteristics in Yu Chang' s book:first, he is expert in prescribing gingseng,not only making an exclusive section discuss it,but also applying gingseng to warm and tonify lower source and treat various dysenteries and other internal miscellaneous cases.Aside from,once he served as a monk in his complicated experience, so Buddhism was frequently induced in his book.Yu Chang established medical law through imitation of Buddhism mitzvah.Last,he combined the four doctrines of Buddhism with the theory of yin-yang in TCM and yin syndrome was stressed as well.He also paid attention to mental nourishment and put emphasis on light diet.
At the end of the article,Yu Chang' s position in medical history was discussed from the perspective of his classical research, prominence of key point,original notation and comparison.
In conclusion,Yu Chang shouldn't be overlooked because the traditional situation in studying Shanghanlun was broken by his view of three principles which aroused discussion.His initiative of medical compiling law and the establishment of disease-discussion style with the extraction of clauses in warm syndrome had a huge influence in history.
Yu Chang' s medical practice and experience turned out to be his book and theory.In particular,his ideology of misdiagnosis aims at guiding clinical syndrome differentiation and enlightening later generations.
引文
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