论文标题:晋唐时期岭南医家医著及医药文献整理研究
Literature Arrangement of Lingnan Medical Masters & Masterpieces in Jin & Tang Dynasty
论文作者
论文导师 刘小斌,论文学位 博士,论文专业 中医医史文献
论文单位 广州中医药大学,点击次数 104,论文页数 100页File Size9026K
2008-04-01论文网 http://www.lw23.com/lunwen_615522597/
Lingnan area;; medical masters & masterpieces;; literature arrangement
一、研究目的及方法 晋唐时期是岭南地区中医药开发与发展的重要历史时期。晋朝南渡,岭南得到第一次开发,中原内地学者及医家也随之进入,改变了岭南地区晋以前无专门医学著作局面,岭南地区开始出现一批有影响的医学人物与医学著作及医学文献资料,对于其后宋元时期岭南第二次的开发及医学发展起着承前启后作用。 目前研究现状,对岭南地区医学断代史的研究如晋唐时期医学专门研究仍然不够深入,处于文献阙如零散,未经系统整理状态。本论文从医史文献研究的角度,综合运用文献研究、历史研究、比较研究、中医学术研究、理论评述及实地调研考察等方法,通过对晋唐时期岭南医家医著及医药文献进行系统整理,探讨晋唐时期岭南医学的成就、学术地位及其影响,探讨岭南地区历史上常见病、多发病的发生及其防治规律,为下一步更深入开展岭南医学史研究打下基础,为《岭南中医药文库》的建设提供参考素材,同时对医学地理学、医学社会学等医学分支学科的形成也是一个有力的推进。 二、研究内容 研究内容主要包括:(一)晋唐时期岭南医家医著资料的收集及整理;(二)从晋唐时期的医学名著如《诸病源候论》、《外台秘要》、《新修本草》、《备急千金要方》等,辑录和整理与岭南医学有关的文献资料,其中《外台秘要》与现行本《肘后备急方》进行比较分析研究。论文分为五个章节来撰写: 第一章,晋唐以前岭南地区医药概况(远古～两汉公元265年) 第二章,晋唐时期岭南医家医著(晋～五代公元265年～960年) 第三章,岭南医学史著名人物葛洪 第四章,晋唐医籍有关岭南医药资料辑录整理与分析 第五章,晋唐以后宋元岭南医药进步(宋～元公元960年～1368年) 三、研究结果 (一)晋唐时期岭南地区医家著作及医学文献整理研究 晋唐时期岭南医学,接续先秦两汉,可溯源至13万年前广东曲江马坝智人原始的卫生保健。秦朝方士安期生等在罗浮山采药炼丹学道的传说,以及西汉南越王墓葬出土医药卫生文物等证明,岭南地区医药学历史至少已有两千年之久。但文献可资徵引者寡。晋朝南渡与唐朝大庾岭古道开通使南北联系更加密切,中原文化对岭南的影响愈加明显,医家医著开始出现。有史载的医家7人,医学文献29种,其中有影响者为葛洪、支法存、仰道人、鲍姑、轩辕述等。现存岭南医著两部:《肘后备急方》《抱朴子》。现存岭南本草专著一部:《南方草木状》。论文对上述五位岭南医家生平传记进行研究。西晋广州刺史嵇含《南方草木状》,书中介绍的80种岭南植物,是我国现存最早的植物文献之一,向来被视为岭南中草药的重要著作。论文重点对其中50多种药用植物进行分析,并在附篇中全文收载《南方草木状》,以供学者们研读。 (二)晋唐时期岭南地区医家著作中主要防治的病种 晋唐时期岭南出现了一批医家,初显岭南医学简约、实用的特点,医学资料详于方而略于论,对一些岭南特发病和多发病,包括瘴疟、脚气病、各种传染性感染性疾病如恙虫病、结核、狂犬病、麻风、天花等疾病的认识及防治,具有一定科学性,不但反映岭南地区、同时也反映了晋代以前的我国医学成就和民间疗法,其以葛洪《肘后备急方》为代表。在现存的古代医著中,此书首次明确地将“疠气”作为温病的病因提出来:“其年岁中有疠气,兼挟鬼毒相注,名为温病”。又如青蒿治疗疟疾的方法:“青蒿一握,以水二升渍,绞取汁,尽服之”而不予煎煮,这是从临床实践中总结出来的宝贵经验。书中还描述了中沙虱毒(恙虫病)的症状:“初得之皮上正赤,如小豆、黍米、粟粒,以手摩赤上,痛如刺,三日之后,令百节强,疼痛寒热,赤上发疮,此虫渐入至骨则杀人。”书中对“虏疮”(天花)也有记载:“头面及身,须臾周匝,状如火疮,皆戴白浆,随决随生,不即治,剧者多死。治得差后,疮瘢紫黑,弥岁方灭。”这是世界上对天花最早的症状描述。在“猘犬所咬毒”(狂犬病)中创造性地提出主动免疫治法,用狂犬脑敷创口“后不复发”,可谓是中医学中“以毒攻毒”之人工免疫思想的先驱,对后世有效用于预防天花的人痘接种法的产生不无影响。脚气病在晋代日渐流行,此书载述“脚气之病,先起岭南,稍末江东。得之无渐,或微觉疼痹,或两胫小满,或行起忽弱,或小腹不仁,或时冷时热,皆其候也"。《肘后备急方》所列疾病,有传染病及内、外、妇、儿、五官各科和虫毒伤等,均详论病证,略述病源,因证取方,具有便、廉、验的特点。书中对常见传染病疟疾、恙虫病、狂犬病、麻风、天花等疾病的认识及防治,具有岭南地方特色并有一定先进性与科学性,是葛洪将中原医学理论与所收集的岭南医药相结合之作,反映了晋代以前的医学成就和民间疗法。是书兼之以灸,创用了隔物灸,灸但言其分寸,不名孔穴,故虽不精易者,习之亦能了其所用。 (三)形成晋唐时期医学著作中关于岭南医学资料汇编数据库 晋唐时期医学著作记述大量岭南医学资料,如《诸病源候论》:“夫岭南青草、黄芒瘴,犹如岭北伤寒也。南地暖,故太阴之时,草木不落黄,伏蜇不闭藏,杂毒因暖而生。故岭南从仲春讫仲夏,行青草瘴;季夏讫孟冬,行黄芒瘴。量其用药体性,岭南伤寒,但节气多温,冷药小寒于岭北。”笔者对上述著作岭南内容进行资料长编分类辑录,研究发现:①《诸病源候论》与岭南有关的记载不少于九处,有价值者为“三瘴气候”、“山瘴疟候”、“脚气病诸候”等疾病的论述。②《新修本草》说明唐代收集药物地域范围已经包括岭南,与岭南有关条目达49条。③《外台秘要》,辑录了直接引用岭南医著《肘后备急方》的条文共193处,与现行本《肘后方》的内容进行比较,发现有相同、不相同、不见这三种情况。内容相同的共62条,药方131首;内容不相同的共59条,药方105首;在今本《肘后备急方》中找不到的有133条,药方370首,是对当代研究葛洪学术经验重要补充。④《备急千金要方》,有关资料包括“岭南”4处、“岭表”4处、“支法存”2处、“抱朴子”2处、“葛氏”6处、“《肘后方》”112处。笔者对以上文献进行辑录,汇编成为近10万字结构化数据库,可资岭南医学研究者参考。此项工作为前人所未做,可以认为是论文创新点之一。 (四)晋唐时期岭南医学对宋元发展之影响 晋唐以后,宋代中原族人又一次大规模南迁,岭南得到二次开发。宋元时期岭南医药学发展也体现了学术的传承性,例如对瘴疟论述。南海名医陈昭遇被荐为翰林院医官,参编《太平圣惠方》,对岭南验方与药材多所著录,卷第五十二治山瘴疟诸方曰:“夫山瘴疟,生于岭南带山水之处。其状发而寒热。休作有时。皆因游溪源。中于湿毒气故也。其病重于伤暑之疟也。”元·释继洪纂修《岭南卫生方》三卷,是现存最早的研究岭南流行性疾病瘴疟的专著,是研究岭南地区宋元以前流行病瘴疟的重要文献。宋元时期岭南地区逐渐涌现了一批有影响的本土医家,如刘昉编《幼幼新书》四十卷,共分547门,载论1207条,广集宋代以前有关儿科资料而成,取材广博,并保存了宋以前大量儿科佚书和古佚医籍,对后世儿科学的发展有较大的影响。 四、结论 晋唐时期是岭南地区中医药开发与发展的关键时期,它改变了晋以前岭南地区无医家医著资料历史现状,起着承前启后的重要作用。晋唐以后的宋元时期,岭南医学有较大发展,及至明清岭南医学逐渐形成各种学术流派,都不能忽视晋唐时期医学的影响,尤其是葛洪《肘后备急方》打下的坚实基础。 晋唐时期的许多重要的医学名著都收录有岭南医学资料,足以证明岭南医学是我国传统中医药学不可缺少的组成部分。我国幅员辽阔,由于地理环境的差异和历史上开发的先后,各个地区的情况千差万别,医学发展也表现出明显的不平衡性,岭南医学就有地方与时代的特色,它是祖国医学的普遍原则和岭南地区医疗卫生保健实践相结合的产物,它既有传统医药学的共性,又有其地方特性。 晋唐时期岭南医学发展虽然不及中原黄河江浙长江流域,但也卓有学术成就,为岭南人民卫生保健作出巨大贡献。岭南医学重视南方炎热多湿、地处卑下,植物繁茂,瘴疠虫蛇侵袭等环境因素,着眼于南方多发、特有疾病的防治,勇于吸取民间经验和医学新知,充分利用本地药材资源,这就逐渐形成了以研究岭南地区医疗保健药物资源为主要对象的岭南医学。因此,继承和发扬岭南医学文化遗产,不仅可以表现岭南地区医学发展的特殊性,通过对这些特殊性的研究,反过来也有助于认识整个中国医学历史发展的全过程,这正是岭南医学史研究的学术魅力所在。
The era of Jin and Tang dynasty was an important historical period for the development of TCM in Lingnan area.The south migration of Jin dynasty lead to the first development of Lingnan.The scholars and well-known physicians came into Lingnan area and altered the situation that there was no special medicinal works in this area.A group of influential medical figures and medical masterpieces emerged,which served as a link between past and the second development of medicine in Lingnan area during the period of Song and Yuan dynasty. Current study situation,medical study for dynastic history of Lingnan area,eg the era of Jin and Tang dynasty is not profound,at the state of lack and scattered literature without systematic arrangement.This paper from the perspective of medical history literature,methods of literature study, history study,comparative study,academic study of TCM,systematic review, etc was used comprehensively to approach the medical achievement and academic influence of Lingnan,discuss the law of occurence,prevention and cure of common diseases in the history of Lingnan area,through arranging medical masters,medical works and literature of TCM of Lingnan in Jin and Tang dynasty systematically,making a foundation for further study the medical literature of Lingnan,providing references for Traditional Chinese Medicine Library of Lingnan,it is a potent promotion for the medical branches such as geography, social medicine. Contents of study: It concludes mainly:(1)Collection and arrangement of well-known medical masters,medical masterpieces of Lingnan area in Jin and Tang dynasty.(2) Explore and analysis by comparing medical literature related to Lingnan which abstracted and arranged from medical masterpieces compiled in Jin & Tang dynasty,such as General Treatise on the Etiology and Symptomatology of Diseases and Essential Formulas Worth A Thousand Ducats For Emergency,etc with the versions of medical masterpieces of Lingnan that still existed today. There is a compartive research between 2 book,one is The Medical Secrets from the Lmperial Library,the other one is A Handbook of Prescriptions for Emergencies. This study consist five chapters: The first chapter:general introduction on medicine of Lingnan area before Jin and Tang dynasty(ancient times～Han dynasty,265years AD.) The second chapter:medical masters of Lingnan in Jin and Tang dynasty The third chapter:predecessor of Lingnan medicine-Gehong The fourth chapter:arrangement and analysis of medical literature related to medical masterpieces of Lingnan area in Jin and Tang dynasty The fifth chapter:the medical progress of Lingnan after the dynasty of Jin and Tang(Song dynasty～Yuan dynasty,960～1368 years AD. Results: 1.Arrangement of medical masters,medical masterpieces and medical literature of Lingnan area in Jin & Tang dynasty Lingnan medicine in Jin & Tang dynasty consistent with the era before Qin & Han dynasty,it can derive from primitivehealth care of Guangdong Qujiang Maba before 130,000 years.The legend of that wizards such as An Qisheng etc in Qin dynasty picking herbs,refining dan,studying Taoism and medical products of a culture were unearthed from the tomb of Nanyue King who lived in Western Han dynasty proves a long history of two thousand years at least in Lingnan area.But little literature can be conferred.The south migration of Jin dynasty and the open of the Dayuling ancient road trip in Tang dynasty connected the Southern & the Northern more closely,the economic and culture of Central China influenced the Lingnan more obviously,medical masters & medical masterpieces started to emerge.There were seven medical masters and twenty nine medical masterpieces recorded in the history,some influential masters of them were Gehong,Facun Zhi,Wizard Yang,Baogu,Shu Xunyuan,etc. Two medical masterpieces that still existed today are Emergence Prescriptions to keep up One"s Sleeve&BaoPuZi.A masterpiece on materia medica that still existed today is Southern China herbosa form.Jihan who lived in West Jin dynasty wrote the masterpiece of Southern China herbosa form,is the first masterpiece to record medicinal plants of Lingnan,it introduces 80 kinds of herbs,the medical value of fifty herbs in this book is mentioned,such as BinLang,etc,it conserves lots of medication experience of Lingnan people in the early stage,is one of the earliest literatures of plant that still existed today,it is regarded as an important masterpiece of Lingnan Chinese herb all the time. 2.Diseases to be prevented and cured mainly in the medical masterpieces of Lingnan area in the period of Jin & Tang dynasty Lots of medical masters emerged in the era,this indicates the concise and practical feature of Lingnan medicine,medical information details about the formula and simplifies on the explanation.The opinion,prevention and treatment of special and common diseases such as malignant malaria,beriberi, all kinds of contagious infection e.g.flood fever,tuberculoses,rabies, leprosy,smallpox,etc are scientific in certain parts.It reflects not only the medical achievement and the civil recipe of the Lingnan area,but also that of our country before the Jin dynasty,it was represented by Emergence Prescriptions to keep up One"s Sleeve wrote by Gehong especially.This book proposes the view that pestilential pathogen is the cause of febrile disease for the first time among the books that still existed today,such statement as "There is pestilential pathogen in the year,combining with evil poison, it is called febrile disease." Take another example,the method of the treating malaria with QinHao:"a grasp of QinHao soaked in the water of two liter,making juice by twisting it,then drink up all juice",without boiling, this is valuable experience from the clinical practice.It describes the symptom of the disease of sand lice poison(flood fever,ie scrub typhus): "It is red in the early stage,looking like red bean,broomcorn millet fruit, foxtail millet grain,patients feels painful like being sticked when touching the red surface:joints of the whole body become stiff,feeling painful as well as getting fever and cold,the red surface ulcerates,the pest invades the bone gradually then leads to death of patient." The description is at least a thousand years earlier than the report made by Boshou Hashimoto in eighteen ten.It also records lu ulcer(smallpox)in this book:"It looks like flame sore with white plasma,first appearing in the face,then spreading all over the body soon,it disappears in someplace while breaking out in other place of the body.Severe patients without receiving instant treatment will die soon.While curing the disease,leaving black voilet scar in the skin, it require years for the scar to disappear." This is the earliest symptom description of smallpox all over the world.It raises the treatment of passive immune therapy creatively in the statement of the poison caused by the mad dog(rabies),it is the predecessor of the thought on artificial immunity in the traditional Chinese Medicine,i.e.treating the malignant with poisonous agent,influencing the method of inoculation for preventing the smallpox in later generations.Beriberi spreads gradually in Jin dynasty,the book records:"the disease of beriberi originates in Lingnan area firstly,then spreading to Jiangdong.It occurs gradually,the patients feel a bit painful and get arthralgia,or the shin becomes thicker,or suffering from fatigue when walking and standing,or feeling numb in the lower abdomen,or getting fever and cold at times,all the description above is the indication of the disease." The diseases listed in A Handbook of Prescrfptions for Emergencies, including contagious diseases as well as internal medicine,surgery, gynecology,pediotrics,five senses organs and insects bites,all have detailed descriptions on syndrome differentiation,etiology,formula,etc. They are convenient,cheap and experienced.Especially the realization and prevention on the contagious diseases such as malaria,rabies,small pox in the book are developing and scientific,it is the classic of the integration on TCM theory and local medicne of Lingnan area by Gehong while reflecting the medical achievement and folk therapy before Jin dynasty. 3.Medical masterpieces of Jin & Tang dynasty related to Lingnan Medicine forming data base There are lots of medical masterpieces expound Lingnan medical literatures, such as General Treatise on the Etiology and Symptomatology of Diseases recorded:"Lingnan miasma of green grass and HuangMang like cold-induced disease of Lingbei.The climate of Lingnan is warm,so the leaves of vegetations and woods neither being yellow nor falling when it is TaiYin,creatures do not hide when the winter comes.Mixed poison generate due to the warm.As a result,miasma of green grass prevails from mid-spring to mid-summer,miasma of HuangMang spreads from latter summer to early winter.Weighting the feature of the drug and body constitution,the temperature is higher in Lingnan area than in the north,so patients suffered cold-induced diseases in Lingnan area require less cold natured drug than the patients in Lingbei area." Through investigation,we abstracted 193 clauses from Seorets of a Frontier Official, which quotes from Lingnan medical masterpiece Emergence Prescriptions to keep up One"s Sleeve directly,and compared the clauses with the edition of A Handbook of Prescriptions for Emergencie that still existed today.Three status appeared,clauses and prescriptions that are same to each other,clauses and prescriptions that are different from each other,clauses and prescriptions that have been missed in the book of A Handbook of Prescriptions for Emergencie that still existed today,there are 62 clauses and 131 prescriptions that are same to each other,59 clauses and 105 prescriptions that are different from each other,133 clauses and 370 prescriptions that have been missed in the book of A Handbook of Prescriptions for Emergencie that still existed today.Essential Formulas For Emergence Worth A Thousand Ducats records four places in Lingnan area,four places in Lingbiao area,two places in Zifacun,two places in Bao Pu Zi,six places in Clan Ge,A Handbook of Prescriptions for Emergencie records one hundred and twelve localities. The New Devised Materia Medica logs 49 kinds of medical materials related to Lingnan area.General Treatise on the Etiology and Symptomatology of Diseases notes nine articles related to Lingnan area.The author compiled above literature which had been done by nobody before,completed the dissertation through arranging the literature.The content is rather integrated and has been compiled into a database containing nearly one hundred thousand characters,which can be conferred by the researchers who study Lingnan medicine,it is really one of innovations in this study. 4.The influence of Lingnan medicine in the period of Jin & Tang dynasty for the medical development of Song and Yuan dynasty. After the Jin & Tang dynasty,the people of Central China migrated to the South on large scale in Song dynasty,Lingnan area was developed for the second time.The development of Lingnan medicine in Song & Yuan dynasty indicates the academic consistency,eg,the statement about malignant malaria. Well-known physician Zhaoyu Chen in Nanhai was recommended as physician official of Hanlin Yuan,attending the compilation of Tai Ping Sheng Hui Formula,recording lots of empirical formula and medical material of Lingnan, eg,formulas treating mountain malignant malaria in the second fifty chapter:"Mountain malignant malaria originates in the mountains and rivers of Lingnan area.It outbreaks with cold and fever and the period of quiescent and onset is regular indicates this disease.It is caused by suffering the damp poison gas due to swimming in the source of the river.It is more severe than the malaria suffered from sunstroke." Three volumes of Lingnan Formulas for Sanitation compiled by Jihong Shi in the Yuan dynasty is the earliest monograph existed today which study the epidemic disease malignant malaria of Lingnan,is a important literature which study the epidemic disease malignant malaria of Lingnan area before Song & Yuan dynasty.The book illuminates the influence of the geographic & climatic features as well as the habit of diet to the body constitution,demonstrating the pathogen and pathogenisis,clinical manifestation,environment-concernedly proposing the methods of syndrome differentiation and treatment variation for malignant malaria that warming mid-jiao & soliding the lower-jiao as well as removing dampness with herbal aromatics,harmonizing healthy qi.A group of influential native medical masters gradually emerged in Lingnan aera in the period of Song & Yuan dynasty,eg,Liu Fang compiled A New Book Of Pediatrics forty volumes, classifying 547 sects,recording 1207 clauses of treatment.It generally gathers the literature related to pediatrics before Song dynasty,drawing the material widespread,preserving lots of pediatric lost books and ancient medical masterpieces,influencing the latter pediatric development greatly. Conclusion: The era of Jin & Tang dynasty is the key period for the development of traditional Chinese medicine in Lingnan area,altering the historical situation that there is no medical masters nor medical masterpieces in Lingnan area before Jin dynasty,serving as a link between past and future.The influence of the medicine in the period of Jin & Tang dynasty can not be neglected in the era of Song & Yuan dynasty after Jin & Tang dynasty when Lingnan medicine developes rather greatly,even up to Ming & Qing dynasty when Lingnan medicine gradually evolves into all kinds of academic schools,especially, A Handbook of Prescriptions for Emergencie compiled by Gehong laid a stable foundation. A great deal of important medical masterpieces in the period of Jin & Tang dynasty include medical literature of Lingnan,it demonstrates Lingnan medicine is an indispensable components to traditional Chinese medicine in our country.The territory of our country is vast,due to the geographic environments and different processes of exploitation,different districts own different features,the medical development also show conspicuous unbalance. Lingnan medicine with local and historical features is the product of that general principle of traditional Chinese medicine as well as the practice of Lingnan medical treatment and health care.It has commonness of traditional medicine and regionalism. The development of Lingnan medicine in the period of Jin & Tang dynasty were inferior to that of the Yellow River and the Yangtze River drainage area, nevertheless,it had great academic achievements,contributing a lot to the health care of Lingnan people.Lingnan medicine emphasizes the environmental factors of Southern China that the climate is very heat and damp,the topography is inferior,there is lush plants as well as the attack of malignant malaria, pest & serpent,viewing from the angle of treating common and special diseases of Southern China,imbibing civil experiences and new medical knowledges bravely,utilizing local medical material thoroughly,which formed Lingnan medicine gradually that studied medical treatment & medical care resource of Lingnan area as the major object.Thus,inheriting and developing the legacy of Lingnan medicine can not only display the specificity of the development of Lingnan area medicine,but also conduce to recognize the whole process on the development of Chinese medicine in reverse,through studying those specificity. This dissertation is just the initiation of the study,not the termination. We expect more scholars to participate in the study,communicate the experience of the research and share the achievements of the study collectively,this is the expectation of the author.
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