【作者】 吴娅娜；

【导师】 易法银；

【作者基本信息】 湖南中医药大学 ， 中医医史文献， 2012， 博士

【摘要】 湖湘疫病史研究是一次以考察湖湘古疫情及相关史实为基础的涵盖疫病流行、医学发展、社会人文等内容的区域疾病史研究。通过考察湖湘古代地方文献,总结民国以前湖湘疫病流行概况,分析其时空分布特点、疫情病种以及影响因素。发现湖湘历史上疫情高发时段为明末清初以及清嘉庆、道光之后；西南靖州湘南郴永等地为湖湘传统疫病高发区域,在清以前湖湘疫病流行历史上应占主要位置；清代中期以后,受全国连年疫病大流行的影响,湖南亦出现大范围较严重的疫情流行,除了四次全省范围的大流行,其余区域按疫情严重程度依次为湘中、湘南、湘西；民国以前,湖湘疫情爆发流行的疾病种类,应主要包括霍乱、天花、白喉、疟疾、痢疾等。从疾病社会史的角度,考察官医民三个阶层在大疫中的应对与作为,揭示出湖湘疫病流行史中官方整体反应消极,只有少数官员做出有限的个人努力；民间医生是医疗救治的主角,但也存在良莠不齐、人员不足等客观现实；随着时代的变化,民众对疫病由恐惧逃避的心态逐渐转变为一定程度的理性认知；整体来说,民间自助是最主要的疫病救疗力量,尽管实际效果并不突出。严重的疫病灾难激发着湖湘医家不断实践,务实进取,各医家在尊崇吴又可《温疫论》和张仲景《伤寒论》疫病治疗学术主旨思想的基础上,结合丰富的疫病临证经验,以寒温立论,注意顾护胃气,注释发挥,创论新思,涌现出了一批专业优秀的医家和疫病著作,在疫病证治理论、医著刊刻发行、种痘术推广普及、白喉中医理论创新及治疗等方面作出了卓越贡献。最后从疾病文化史的角度,考证橘井泉香典故,揭示故事中蕴含着的历史真切感与合理性,橘井典故对中医药文化产生的深远影响,湖湘橘井修己济天下的精神是湖湘中医文化精髓之所在。并以清代地方志民俗资料为主要对象,揭示以行傩逐疫、端午祛瘟辟毒为代表的传统祛疫民俗在古代湘民生活中承载的社会防疫功能,并且以公开的集体的方式维护了区域群体的价值观,从而起到在长期疫病侵袭的历史环境中稳定湖湘区域社会的作用。更多还原

【Abstract】 Research on history of epidemic diseases in Hunan is a regional disease history investigation covering the prevalence of epidemic diseases, medical development and social humanities.By studying the prevalence of epidemic diseases from ancient local literature of Hunan, we analyzed its spatial and temporal distribution,epidemic disease species and some influencing factors. We found out that epidemic diseases occurred most frequently in two periods,which were from late Ming Dynasty to early Qing Dynasty and after Jiaqing and Daoguang years of Qing Dynasty. Jingzhou, Chenzhou and Yongzhou were the predominate traditional high-occurrence epidemic areas in the epidemic history before Qing dynasty. After mid-Qing Dynasty,influenced by national epdemic diseases in successive years, serious epidemics also outbroke in Hunan including four province-wide epidemics,and other areas in proper sequence according to the order of severity were the central,the southern and the west of Hunan. The major types of epdemic diseases were cholera, smallpox, diphtheria, malaria, dysentery, and so on. From the angle of social histroy of diseases,we observed and studied the reactions of three stratums:officals,doctors and people.It was revealed that the overall officials were negative to epidemics,and only a few made limited individual efforts.Folk doctors were the major force for epidemic treatment, but they varied greatly and were short-staffed. As times went by, people gradually changed from fearing and running away from epidemic to a certain degree of rational cognition. In whole,Folk self-help was the the main force for epidemics rescue and therapy, although the actual result was not obvious.Serious epidemic disasters stimulated physicians to do constant practices and make progress. In the basis of classic epidemic diseases doctrine On Pestilence written by Wu Youke and Zhang Zhongjing’s Treatise on Febrile Diseases,combined with abundant clinical experiences,they emphasized theories of coldness and heat,payed attentions to protect stomach qi,and wrote a lot of excellent books on epidemics. They made outstanding contributions on the theory of epidemic diseases, publishing and distribution of medical books, the promotion of vaccination, the innovation of diphtheria in Chinese medical theory as well as treatment, Lastly,from the angle of culture history of diseases,we did textual research on the orange well story and revealed the real and rational part o f the story. The orange well allusion had profound influence on Chinese medicine culture. The spirit of self-cultivation and helping others is the essence of Hunan TCM culture. By studying the folk customs about epidemic disease in Hunan local chorography of Qing Dynasty,we revealed the social epidemic prevention function of traditional customs on driving away epidemics,which preserved the group value of the area in public and atabilized Hunan area which was under the the long-term epidemic attack in historical inviroment.更多还原