岭南医家妇科学术源流及临证经验整理研究

【作者】 严峻峻；

【导师】 黄景泉；

【作者基本信息】 广州中医药大学 ， 中医医史文献， 2001， 硕士

【摘要】 本文主要对清代至民国时期保存比较完整的岭南妇科学文献进行了收集、整理、阅读，对在妇科方面有较大贡献的岭南医家妇科学术经验进行了研究并加以总结、归纳。同时也回顾了清以前岭南有关妇科的一些资料，调查了中华人民共和国成立初期广州妇科的一些情况，并查阅了当时在妇科方面有较大贡献的两位岭南名医的资料。 清代以前，本文主要收集、整理了支法存、葛洪、罗浮山人有关妇科的一些文献。通过研究，认为当时岭南医家在妇科疾病的治疗上已经积累了一定经验，总结了一些验方和治法。 清代，本文主要整理了三位医家的妇科经验及其妇科医著：何梦瑶与《妇科良方》、刘渊与《医学纂要．妇科摘要》、何守愚与《广嗣金丹》。 何梦瑶《妇科良方》现存版本有两种：一九八一年两广图书局铅印本、广州拾芥园藏板光绪十二年木刻本。《妇科良方》主要内容分为经期、胎前、临产、产后、乳证、前阴诸证、种子论、诸方八门。此书是以《医宗金鉴．妇科心法要决》为蓝本编写的，吸收了张子和、朱丹溪、王肯堂、喻嘉言等人的观点，并参以己见。何梦瑶妇科学术思想主要有：①善于根据经、脉和腹痛之性质辨证；②认为妇科病多与情志相关③在妇科方面立论比较平正又能突出岭南特色。 刘渊《医学纂要》现存四种版本：清.乾隆四年己未（1793年）瀚宝楼刻本，只存五卷；清.咸丰七年丁巳（1857年）福文堂藏板刻本，全；清.同治十二年癸酉（1873年）金石楼刻本，只存五卷；1999年中国中医药出版社出版的校注本，以福文堂藏板刻本为底本，由赖畴主校。《医学纂要》卷四利集为《妇科摘要》，主要内容包括经脉论、经脉证治论、妊娠病、保胎、胎产要法、产后调理、产后症治、乳证、带浊遗淋、癥瘕食积、前阴疾病和“妇科汤方补遗”。刘渊继承了张景岳之学术思想，他的妇科学术经验主要有：①治疗妇科病擅长用温补；②情志致病，从治疗脾胃肝肺着手；③论胎产要诀，推崇《达生编》。 何守愚《广嗣金丹》现存两种版本：一种是光绪十二年新镌，由青 岭南医家妇科学术源流及临证经验整理研究 湘阁书坊刻印；另一种是光绪二十二年佛山天禄阁重刻本。《广嗣金 丹》是一部妇产科、儿科学普及读物，以妇产科为主，全书分为四编： 种于编、安胎编、保产编、福幼编。各编内容，以汇集前人文献为主， 略加评述。何守愚之妇科学术思想主要有：①妇人种子应调经、寡欲、 择时：②保胎要慎举动，节饮食：③临产用力要适时：④产后戒躺、戒 厚味、戒交合。 民国时期主要研究了吕楚白与《妇科纂要讲义》、谢泽霖与《妇科学 讲义》以及吕安卿、郭梅峰的妇科学术经验。 吕楚白的《妇科纂要讲义｝）现存广东光汉中医专科学校铅印本。实 际应有二册，笔者只见到上册。此册分调经门、经闭门、崩漏门、带下 门和不孕门。吕楚白推崇《傅青主女科》，他的妇科学术思想主要有：① 认为治妇人病以调经为第一要务，而调经又以调气为主：②判断妊娠， 以关脉为准；③疗治妇病，善用花药。 谢泽霖《妇科学讲义》现存广东中医药专门学校铅印本。是书以汇 集前人妇产科精辟论述为主，上穷《内经》、仲景之言，下至张景岳、傅 山等明清诸家之论，很少夹杂自己的见解。全书分为经事门、胎孕门、 产子门、杂治门四大篇。谢泽霖的妇科学术思想主要有：①论治妇病， 重视冲任与脾胃肝；②多论及阴虚火旺、痰湿垄滞的证型；③临产戒早 用力。 吕安卿的妇科学术经验主要有：①闭经多有血虚，不可妄用攻破： ②经前腹痛应调气清郁热，经后腹痛应养血散寒，痛在腰部，以调养肝 肾为主；③当归、川【穹不宜用于以出血为主诉的妇科病人。 郭梅峰主要妇科学术经验有：①论治妇科，注重冲任；②顾护真元， 擅长养血；③善用花药，疗妇人疾。 民囚木年至中华人民共和国成立初期，本文主要研究了罗元悄教授、 蔡仰高主任医师在妇科方面的一些经验。罗元悄教授提出了肾气－天癸－ 冲仟－于宫轴的概念，并指出大癸可能相当于垂体、卵巢、翠丸等性腺的 内分泌素。罗教授在崩漏的治疗上还具有岭南地方特色。蔡仰高主仟医 帅介N人脉诊方面丫］－较深的研究，并善于将地方草药与中药结合治疗妇 3广州中医药大学硕士研究生学位论文科疾病。 经过整理研究，总结?更多还原

【Abstract】 Having studied the TCM works on gynecology & obstetrics written by the famous doctors in South China from the Jin Dynasty (about 1700 years ago) to the initial stage of P.R.China, this article sums up their experience in diagnosis and therapy of women diseases, and describes the origin and development of gynecology & obstetrics in South China during that period. The article has systematized the TCM works of three doctors in South China before the Qing Dynasty (357 years ago), who are Zh~facun, Gehong and Luofushangren and researched into the parts of gynecology & obstetrics of their books, then realizes that the doctors have summarized some efficacious prescriptions and remedies to cure women diseases at that time. During the Qing Dynasty (357 yeav ago) there were three famous doctors who made a great contribution to gynecology & obstetrics. They were Hemengvao, Liuyuan and Heshouyu. Hemengyao wrote the book 揈ffective prescriptions of gynecology & obstetrics? He was good at the differential diagnosis by analyzing women’s menses, pulses and the characters of abdominal pain and considered that the state of mind was in great relation to women’s health and his opinions on gynecology & obstetrics had a local colour. Liuyuan wrote the book ardinal principles of medicine? of which the volum 4 was about gynecology & obstetrics. He was expert in using the method of warming & recuperating and thought that regulating the functions of the spleen, the stomach, the liver and the lung could cure women diseases caused by unnatural emotions and he highly praised the treatments in the book rinciples of gestation, parturition and puerperiurn? Heshouyu wrote the book he gold method of conception? He considered that regulating menstruation, reducing the frequency of coitus and choosing the right time for sexual intercourse were important methods of conception and being careful in movement, taking light food were good hygienic methods during pregnancy. He also thought that exertion should be at the right moment at childbirth and the lying-in woman should not lie down, take rich food or do sexual intercourse right after parturition. Luchubai, Luanqing, Xiezelin and Guome~feng were famous TCM doctors in South China during the Minguo period (90 years ago). The preceding three doctors were experts in gynecology & obstetrics and Guome~feng also had some experience in treating women diseases. Luchubai wrote the textbook ardinal Principles of gynecology & obstetrics of TCM? and he thought that the most important thing to treat women diseases was to regulate menstruation by adjusting Qi. He diagnosed gestation by feeling the Guan Pulse and was good at using flowers to teat women diseases. Luanqing considered the common cause of amenorrhea was deficiency of blood so it was not properly always treating the disease by elimination. He also thought that periodic pain prior to menstrual flow should be treated by regulating Qi & clearing away stagnant heat, periodic pain post menstrual flow should be treated by expelling coldness and nourishing the blood, periodic pain affecting the lumbosaceral region should be teated by regulating & nourishing the liver and the kidney. He pointed out that Angelica sinensis and Ligusticum wallichii should not be used to treat a female patient whose main symptom was bleeding. Xizelin wrote the ynecology & Obstetrics of 1CM? which was the first TCM gynecology & Obsitetrics textbook used by Guangdong 1CM college. He paid great atte更多还原