北京四大名医研究

【作者】 李岩；

【导师】 鲁兆麟；

【作者基本信息】 北京中医药大学 ， 中医医史文献， 2004， 博士

【摘要】 北京是历史名城,独特的政治、经济、文化环境,造就了无数的名医。北京地区历代多出名医,在 20 世纪也出现了许多名医,而在民国时期最有影响的是民间俗称的“四大名医”:萧龙友、孔伯华、施今墨、汪逢春。但是目前对他们的学术思想、中医教育思想等系统研究尚属阙如。目的:研究四大名医办中医院校的历史背景、办学模式及教育思想,从历史的高度对四大名医对中医教育的贡献做出评价;对四大名医的学术思想,从其渊源、形成、发展、传承做一系统的研究,动态研究其学术思想的发展状况。方法:主要采用文献整理和口述史相结合的研究方法。论文首先对四大名医产生的历史背景和四大名医的生平进行了考证和论述。然后着重论述了四大名医对中医教育的贡献和四大名医的学术思想、四大名医的治学特点以及四大名医学术思想的传承。1 四大名医对中医教育的贡献四大名医所处的时代,正是西学东渐对中医学产生很大影响的时代。在北京地区,清朝灭亡后,宫廷医学教育也随之消失,北洋政府和国民政府则极力要废止中医,造成这一时期北京地区的中医教育处于青黄不接的状态。而南方的上海、广东等地都已经率先办起了中医学校,北方地区则无影响较大的中医学校。四大名医办学起到了承上启下的作用,填补了北京这一时期中医教育的空白。北京四大名医创建了北平国医学院(1930～1944)和华北国医学院(1932～1950),这两个学院从学制、教师、课程、管理、制度等方面均称得上是正规化中医高等教育机构,已经具备高等教育的特点,由这两个学院培养了大批优秀中医药人才,为中医药教育和中医药事业的发展做出了巨大的贡献。2 四大名医的学术思想(1)萧龙友学术思想与临床经验。萧龙友重视医德伦理,注重医学修养;临证主张四诊合参,最重问诊;立法因人而宜,主张老少应予不同治法;调理虚证,善用育阴培本法;临证用药,注意形神并治;治疗虚损重视调补脾胃,又防过中;无门户之见,提倡中西医汇通;精研中药学,处方用药独到。(2)孔伯华学术思想与临床经验。孔伯华衷《内经》运气学说,倡河间“六气皆从火化”说;重视湿热致病,提出“肝热脾湿”说;衷丹溪“阳常有余、阴常不足” 论,提出先有“阳常有余、阴常不足之人”、后有“阳常有余、阴常不足之病”说;重视人体之本,提出“肾为本中之本”的观点;重视脏腑辨证,提出辨证论治的两纲六要;临证善用石膏、知母和黄柏、旋复花和代赭石,并善在汤剂中用中成药、善用鲜药。<WP=6>IV 北京四大名医研究(3)施今墨学术思想与临床经验。施今墨力主中西医汇通;崇尚李杲脾胃学说,重视后天之本;重视气血辨证,创立十纲辨证;临证精于组方配伍,创施氏对药;分析其早年与晚年医案,发现其用药规律有不同,说明其学术思想形成有一个发展的过程;临证治外感热病注重解表清里,给邪以出路;重视审表里,详查表里比重,创七解三清、六解四清、五解五清、四解六清、三解七清说;用药平稳,忌寒凉、攻伐;善于调理气机升降;善用通络药。(4)汪逢春学术思想与临床经验。汪逢春重视后天之本脾胃,临证善用醒脾开胃消食药、益气健脾药、养胃阴药、曲类药、健脾利湿药、理气药;擅长治疗湿温病,治湿温善用三焦辨证,辨湿温以脉舌色症互参,治湿温用药轻灵;临证重视人体气机升降的调节;重视滋养肝血、温补肝肾;善用通络药;精于药物炮制和配伍;善用粉剂、成药入汤剂;善用鲜药。3 四大名医的治学特点北京四大名医在治学特点上具有许多共同之处,首先他们都具有高尚的医德,高尚的医德也是他们被誉称为“四大名医”的原因之一。四大名医所处的时代正是“西学东渐”对中医持怀疑、否定的年代,为了维护中医的合法地位,他们做出了巨大的贡献,而为了证明中医的科学性,就要求中医家首先要有科学、严谨的治学态度,四大名医均治学严谨、态度科学。他们还熟悟经旨、勤求古训,自幼熟读经典为他们成为名医打下了深厚的中医理论基础,但是他们反对死读古书,强调要古为今用。四大名医无门户之见、博采众长,汲取各家之长在他们学术思想的形成中起了很大的作用。4 四大名医学术思想的传承北京四大名医是中医教育家、中医临床家,更是中医理论家。他们的学术思想深深地影响了他们的学生、弟子和门人,在北京地区乃至全国产生了深远的影响。白啸山、杨润芳继承与发展了萧龙友的学术思想,屠金城、姚五达、宋祚民、刘春圃、步玉如继承和发展了孔伯华的学术思想,祝谌予、李介鸣、董德懋、翟济生继承与发展了施今墨的学术思想,赵绍琴、李鼎铭、谢子衡继承与发展了汪逢春的学术思想。5 结语北京四大名医治学特点是广采博学、反对门户之见,所以在他们的学术思想中体现的并不是一门一派的学术观点,而是互相交融、互相贯穿的;北京四大名医又各有学术特点,用药各有所长,而且其学生、弟子深受他们的影响,且多有发挥,互相补充,形成了各自独特的学术流派;所以北京的老百姓习惯将四大名医划分为四派,即:萧派、孔派、施派、汪派。北京四大名医是近代北京地区中医药发展的一个缩影,对北京四大名医的研究,不仅是对四位名医个人的研究,同时也反映了近代北京地区更多还原

【Abstract】 Purpose: To carry out investigation into the four prestigious physicians of Chinesemedicine, namely: Xiao Longyou, Kong Bohua, Shi Jinmo and Wang Fengchun, toevaluate their contributions to education of Chinese medicine by researching theirhistorical background of founding medical schools, studying their modes of runningschools as well as their educational thoughts, and to conduct systematic research ontheir academic thoughts from their origin, formation, development and heritage.Method: To combine literature trimming together with dictation record.I. The four prestigious physicians’ contributions to education of Chinese medicine Royal court type of medical education faded away in Beijing area after theperdition of the Qing Dynasty. The Beiyang and Guomin governments then tried hardto abolish Chinese medicine, which led to a temporary shortage in the education ofChinese medicine. Therefore, the four prestigious physicians played a link-connectingrole between the preceding and the following to found medical schools in that situation.They established the Beiping College of National Medicine(1930～1944)and theHuabei College of National Medicine(1932～1950). Judging from educational system,teaching staff, curriculum, management and system, both the two colleges could beranged among normalized higher learning institutions of Chinese medicine, whichhelped bring up large quantities of excellent personnel of Chinese medicine, and madegreat contributions to development of the Chinese medicine cause.II. Academic thoughts of the four prestigious physicians Xiao Longyou paid great attention to medical ethics and culture. He stressedcomprehensive analysis of the data based on the four diagnostic methods, especiallythe method of asking. For treatment, he argued for different treating principles fordifferent persons. He was good at regulating deficiency syndrome by replenishing yinand building up body resistance. For prescription, he emphasized combination of bothform and spirit. For treatment of deficiency and impairment, he suggested harmonizingand nourishing the spleen and the stomach. He advocated integration of Chinesemedicine with Western medicine. He had profound knowledge of Chinese pharmacyand was known for unique ways of forming recipes. Kong Bohua had rich knowledge in the doctrine of the five circuit phases and sixatmospheric influences, believing that the six atmospheric influences may welltransform “fire”. He brought forward the theory of liver heat and spleen dampness<WP=8>VI 北京四大名医研究from disease due to damp heat. He agreed with Danxi’s opinion that yang was oftenabundant while yin was often deficient in human body, and further advanced that therewere first people who suffered from abundant yang and deficient yin, and then therewere diseases of abundant yang and deficient yin. He paid close attention to bodyresistance, holding the view that the kidney was the foundation of body resistance. Healso attached great importance to zang-fu syndrome differentiation. For treatment, hewas good at using Gypsum, Anemarrhena and Phellodendron, Flos Inulae, and was alsogood at prescribing patent Chinese medicine and fresh herbs into decoctions Shi Jinmo believed in integration of Chinese medicine with Western medicine,advocating Li Gao’s theory of the spleen and the stomach which stressed postnatalbasis. He attached importance to qi-blood syndrome differentiation, instituting tenprinciples syndrome differentiation. For treatment, he was good at herbal composition,and created Shi type of paired herbs. Heat diseases due to exogenous factors wereoften treated by relieving the superficial and clearing the interior to let evils out of thebody. For prescription, he suggested calming herbs against those cold and cool inproperty. He was good at regulating ascending and descending of qi mechanism, andwas also good at using herbs that served to p更多还原