本文選題：明清 + 學術(shù)�。� 參考：《中國中醫(yī)科學院》2016年博士論文

【摘要】：自宋至清的一千多年里,儒醫(yī)的數(shù)量不斷增長,其臨床聲譽和學術(shù)影響力都日趨增大,逐漸成為中醫(yī)史上的重要群體。由于大量傳世醫(yī)著出自儒醫(yī)之手,顯然,儒學的學術(shù)思想、研究方法發(fā)展,與時代思潮的流變,會對中醫(yī)思想學術(shù)的發(fā)展產(chǎn)生重要影響。這種影響在明清時期的儒醫(yī)著作中表現(xiàn)的尤為明顯。從1368年洪武開國,到1911年辛亥革命,明清兩朝544年歷史,是我國古代思想文化史極大繁榮,學術(shù)輝煌發(fā)展的時代。這五百余年中,不但經(jīng)史之學成就斐然,中醫(yī)學也取得了長足的進展�！秱摗纷鳛橹嗅t(yī)史領(lǐng)域的重要經(jīng)典,其至高無上的學術(shù)地位即奠定于明清時期,而關(guān)于傷寒學的理論和臨床研究也在這時達到了極大繁榮。本文根據(jù)明清時期的傷寒學研究的內(nèi)在學術(shù)理路變遷,將這五百余年的《傷寒論》研究情況大致劃分為明前期、明中晚期、清初、乾嘉時期四個階段,通過以儒學為代表的中國傳統(tǒng)學術(shù)史視角,對每個階段的代表醫(yī)家及其學術(shù)思想做出內(nèi)史層面的歸納總結(jié),考察階段之間的內(nèi)在承接與轉(zhuǎn)折關(guān)系,亦嘗試從外史的角度分析其學術(shù)成就與當時主流學術(shù)風氣、社會思潮及社會文化現(xiàn)象之間的關(guān)系及相互影響情況。明前期是傷寒學術(shù)研究的整理與開創(chuàng)階段。這一時期的醫(yī)家繼承了“金元四大家”的學術(shù)思路影響,同時探索并開辟了明清傷寒學術(shù)的新思路。從《傷寒論》的學術(shù)研究理路看,王履可謂是金元與明清的“承上啟下人”。他較早提出“以法類證”研究《傷寒論》,并對王叔和、林億等人整理編校的《傷寒論》原文內(nèi)容、順序提出質(zhì)疑,開創(chuàng)了明清傷寒學派“錯簡重訂”與“維護舊論”的數(shù)百年爭鳴。許宏的《金鏡內(nèi)臺方議》,是對《傷寒論》做出方劑學研究的重要嘗試,通過以方類證的體裁對經(jīng)方做了詳細的分類和闡述,通過探討經(jīng)方的組成特點,闡釋《傷寒論》的辨證用藥規(guī)律。其嚴整的理論性建立在追本溯源、聯(lián)系臨床的基礎(chǔ)上,與金元諸醫(yī)的學術(shù)風格迥然不同。劉純師將宋儒精研易學的理論成就引入醫(yī)理考述,形成了自己獨特的學術(shù)體系。他重視醫(yī)案,以臨床病情和方藥運用為例,闡述方證關(guān)系,對明代以后的醫(yī)學理論和實踐有重要影響�？傮w上,這一時期的《傷寒論》研究體現(xiàn)出承上啟下的特點,一方面對金元時期諸醫(yī)家爭鳴做出歸納總結(jié),一方面產(chǎn)生新的學術(shù)關(guān)注點,嘗試新的研究思路,從方法上和觀點上,都開辟了后世傷寒學研究的先河。明中晚期是傷寒學術(shù)研究的重構(gòu)與變革時期�！秱摗返膶W術(shù)地位進一步提高,醫(yī)家在語句注疏、文義考證之外,對其內(nèi)在邏輯系統(tǒng)的解釋和重構(gòu)產(chǎn)生濃厚興趣。這一時期,主流學術(shù)史上的重大事件是“心學”對“理學”的對抗和消解。儒學中的質(zhì)疑與重構(gòu)之風影響到醫(yī)家,促進了醫(yī)家對《傷寒論》的歸納、質(zhì)疑和深入探討。方有執(zhí)提出“錯簡論”,并創(chuàng)三綱鼎立說,影響極大。其觀點在后世醫(yī)家中引起了巨大的爭論,掀起了傷寒學研究的新高潮。王肯堂的《傷寒證治準繩》對傷寒學的補充主要體現(xiàn)在疾病、癥狀、診斷、方劑四個方面。王肯堂的《傷寒證治準繩》乃至整個“準繩”系列叢書,是以傷寒方為主來討論、整理內(nèi)科學的嘗試,將《傷寒論》條文和證治的內(nèi)容豐富化、充實化。張介賓的《景岳全書·傷寒典》見解獨到,以陰陽虛實的多層次、多角度反復論述,深化并完善傷寒學的理論體系研究,并將溫病熱病、補法溫法等充實到傷寒學的診療體系中,豐富和發(fā)展傷寒學的診療思路。這一時期的傷寒學研究,以理論化、系統(tǒng)化追求為主要特點,在臨床運用方面則呈現(xiàn)出豐富與多元的嘗試。清初是傷寒學研究的反思與深入期,明清鼎革后,許多士人遁跡山林,他們對明末學風的反思也體現(xiàn)在這一時期的醫(yī)學研究中,注重實學,開辟求知新路徑,經(jīng)世守身并重,理學回歸等學術(shù)思潮對《傷寒論》理論研究的進一步深化有積極影響。同時這一時期《傷寒論》文字考據(jù)研究也發(fā)展起來�！渡姓撈肥怯鞑钪匾膫畬W術(shù)成果,其主要學術(shù)貢獻是對傷寒學術(shù)理論系統(tǒng)化,清初《傷寒論》在中醫(yī)思想學術(shù)領(lǐng)域地位達到空前高度,與喻昌的努力分不開。張志聰十分注重傳統(tǒng)哲學的思辨分析,以陰陽虛實,經(jīng)氣交會,上下調(diào)和等方式來建立病機病因辨析。黃元御的將傷寒中的六經(jīng)病分為太陽經(jīng)絡(luò)表病與其它五經(jīng)臟腑里病兩部分,同時又以六氣統(tǒng)一營衛(wèi)氣血與六經(jīng)辨證,將五運六氣與傷寒六病的緊密結(jié)合,較為系統(tǒng)的整理出一套在臨床上行之有效的理論學說,其對于糾正金元以來中醫(yī)門派林立、各執(zhí)一端的時弊有重要意義。乾嘉時期的《傷寒論》研究,隨著考據(jù)學風的興盛達到了全盛,并很快衰退�！夺t(yī)宗金鑒》是清代官修欽定的醫(yī)學叢書,由清高宗倡議,官方主導,匯集百余位醫(yī)家編纂而成,是清代最重要的醫(yī)學成就之一。該書旗幟鮮明地提出,醫(yī)生教學應(yīng)當也只能以《傷寒論》為最基本、最重要的經(jīng)典。這是對《傷寒論》學術(shù)地位的極大肯定。徐大椿的《傷寒類方》對《傷寒論》按照“不類經(jīng)而類方”的原則重加整理,比柯琴更徹底地擺脫了六經(jīng)分類,直接以方類證,闡發(fā)經(jīng)旨。陳念祖在傷寒學術(shù)研究上的主張,主要是肯定王叔和編訂的《傷寒論》原貌,認同成無己的注釋具有高度學術(shù)價值�！秱t(yī)訣串解》是他一生精研傷寒學術(shù)的精要。在“維護舊論”的大背景下,對傷寒論的理論脈絡(luò)做了學術(shù)梳理,形成自己獨有的傷寒學術(shù)體系。中醫(yī)傷寒一脈至此蔚為大觀。
[Abstract]:In the one thousand years of the song and Qing Dynasties, the number of Confucian doctors has been increasing, its clinical reputation and academic influence are increasing, and gradually become an important group in the history of traditional Chinese medicine. Because of the large number of doctors from Confucianism, it is obvious that the academic thought of Confucianism, the development of research methods and the evolution of the trend of thought of the times will develop the academic development of traditional Chinese medicine. The influence of this influence was particularly evident in the Confucian classics of the Ming and Qing Dynasties. From the opening of Hongwu in 1368 to the revolution of 1911 in 1911 and the two dynasties of Ming and Qing Dynasties, the history of Chinese ancient thought and culture was flourishing and the academic brilliance developed. In these five hundred years, not only the achievements of history and traditional Chinese medicine have been achieved, but the traditional Chinese medicine has also been obtained. As an important classic in the history of traditional Chinese medicine, the supreme academic status of the theory of typhoid fever is established in the Ming and Qing Dynasties, and the theoretical and clinical studies on typhoid fever have also reached a great prosperity. This article, based on the internal learning of the study of typhoid fever in the Ming and Qing Dynasties, has made these five hundred years of "the theory of typhoid fever" The research situation is divided into four stages in the early Ming Dynasty, the late Ming and the late Ming Dynasty, the early Qing Dynasty and the Qianlong and Jiaqing period. Through the traditional Chinese academic history, represented by Confucianism, the author sums up the internal history level of the representative doctors and their academic thoughts in each stage. The relationship between the academic achievements and the prevailing academic atmosphere, the social trend of thought and the social and cultural phenomena and the interaction between them. The early stage was the arrangement and initiation stage of the academic research on typhoid fever. The doctors of this period inherited the influence of the academic thought of "Jin Yuan four", and explored and opened new ideas for the learning of typhoid fever in the Ming and Qing Dynasties. In view of the academic study of the theory of "Treatise on typhoid fever", Wang Lv is a "inheriting man" in Jin Yuan and Ming and Qing Dynasty. He earlier proposed the study of "the theory of law of law", "Treatise on typhoid fever", and questioned the order of the original content of "the treatise of Typhon", which was compiled and edited by Wang Shuhe, Lin Yi and others, and created the "reordering of the error reduction" and "maintaining the old theory" of the Ming and Qing School of typhoid fever. For hundreds of years, Xu Hong's "TaiFang discussion in the golden mirror" is an important attempt to make a prescription for the study of the theory of "Treatise on typhoid fever". Through a detailed classification and exposition of the prescriptions based on the genre of square syndrome, by discussing the composition characteristics of the classics, the law of the syndrome differentiation of "the theory of typhoid fever" is explained. On the basis of this, it is quite different from the academic style of Jin and Yuan Zhu. Liu Chun Shi introduced the theoretical achievements of the song Jing Jing Jing Yi Xue to the medical science examination and formed his own unique academic system. He paid attention to the medical case, took the clinical condition and the prescription of prescription as an example, expounded the relation of the prescription, and had an important influence on the medical theory and practice after the Ming Dynasty. The study of "the theory of typhoid fever" in the first period embodies the characteristics of the preceding and the following. On the one hand, it makes a summary of the contention of all the doctors in the Jin and Yuan Dynasties. On the one hand, it produces a new academic concern and attempts a new research idea. Both methods and views have opened up the first river of research on typhoid fever. The middle and late Ming Dynasty is the reconstruction and reform of the academic research of typhoid fever. The academic status of the theory of "typhoid fever" has been further improved. In addition to the annotation of sentences and textual textual criticism, doctors have a strong interest in the interpretation and reconstruction of the internal logic system. In this period, the major event in the mainstream academic history is the confrontation and digestion of "the philosophy" to "science". We have entered into the induction, question and deep discussion of the theory of "the theory of typhoid fever". Fang has put forward the theory of "error reduction", and creates a three outline and great influence. Its viewpoint has caused great controversy in later physicians and set off a new climax in the study of typhoid fever. Four aspects: Wang Ketang's < typhoid syndrome and treatment guidelines > and even the whole "line" series of books, which are mainly discussed by the typhoid party, collate the attempts of the internal medicine, enrich and enrich the contents of the treatise on typhoid fever and the treatment of the syndrome. Zhang Jiebin's "Jing Yue whole book, typhoid code >" is unique in many levels and multiple angles of yin and Yang. To deepen and improve the study of the theoretical system of typhoid fever, and to enrich and develop the diagnosis and treatment of typhoid fever in the diagnosis and treatment system of typhoid fever, and enrich and develop the diagnosis and treatment of typhoid fever. The study of typhoid fever in this period is characterized by theoretical and systematic pursuit, and presents rich and diverse attempts in clinical application. In the early Qing Dynasty, the study of typhoid fever was reflected and deepened. After the Ming and Qing Dynasties, many scholars fled to the mountain forest. Their reflection on the study style of the late Ming Dynasty was also reflected in the medical research of this period. At the same time, "Shang Han theory > text textual research also developed." Shang Wen > is the most important febrile academic achievement of Yu Chang. Its main academic contribution is to systematize the academic theory of typhoid fever. The position of "Shang Han theory >" in the academic field of traditional Chinese medicine has reached an unprecedented height in the early Qing Dynasty. It is inseparable from the efforts of Yu Chang. Zhang Zhicong pays great attention to the tradition. The speculative analysis of philosophy is to distinguish between yin yang deficiency and reality, the meridian intersection, the down regulation and the way to establish the pathogenesis of the disease. The six meridian diseases of Huang Yuan Royal are divided into two parts of the sun meridian surface disease and the other five meridian viscera diseases. At the same time, the six Qi and the Qi and Wei Qi blood and the six meridians are identified, and the five transport and six gas and the typhoid six diseases are closely combined. A set of theoretical theories which were effective in clinical practice had been made for the system. It was of great significance to the correction of the traditional Chinese medicine school since the Jin Yuan Dynasty. The study of "the theory of typhoid fever" in the period of Qianlong and Jiaqing has reached its heyday with the prosperity of the study style. It is one of the most important medical achievements of the Qing Dynasty, which is one of the most important medical achievements in the Qing Dynasty. The principle of "no analogy" and "class square" was put forward to get rid of the classification of the six classics more thoroughly than that of the six classics. Under the background of "maintaining the old theory", the theoretical context of the theory of typhoid fever was combed and the unique academic system of typhoid fever was formed.
【學位授予單位】：中國中醫(yī)科學院
【學位級別】：博士
【學位授予年份】：2016
【分類號】：R222.2

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