北京御医学派研究

【作者】 徐江雁；

【导师】 鲁兆麟； 谢阳谷；

【作者基本信息】 北京中医药大学 ， 中医医史文献， 2004， 博士

【摘要】 北京御医学派研究旨在对北京宫廷医学发展源流溯考的基础上，比较宫廷医学同御医学派学术之间的关系。通过研究清末御医及其学术传人生平、成就与影响、治学特点、学术思想，构建御医学派的学术特色与其核心学术思想，论证北京御医学派的存在价值。拟从新的角度探讨研究北京御医学派发展的历史沿革、学术特点，揭示其发生发展的规律，开创北京中医学术流派研究的新领域。 研究以文献学方法为主，结合数理统计学和口述史学方法。首先，以二十四史有关医学史料和现存文献稽考为切入点，从内史和外史两个方面，考证御医学派学术发展的源流，确定纳入学派的医家群体，初步归纳学派医家学术思想。其次，设计数理统计研究方案，采用群体样本，选取御医学派医家和北京地方医家、东南地区医家、西南地区医家医案1188个，进行统计学处理，比较、分析御医学派医家的用药特点；运用口述史学方法收集、整理口述史料，佐证与充实文献研究结果。同时，对中医学术流派划分的有关理论问题进行了探讨。 在对大量文字史料、中医文献、口述史料研究的基础上，得出的结果是：北京御医学派不同于北京宫廷医学，是对宫廷医学的继承与发展；御医学派的学术思想具有：突出中医经典理论的指导，强调脏腑气血发病内因，注重脏腑气血的病理机转并运用各种辨证方法整体调理、内治与外治有机结合治疗原则和丰富多彩的治疗方法，形成了四诊合参、以脉为主的诊断思想和组方严谨、平妥轻灵、药少力宏、力求无毒的组方用药特点等，脏腑气血虚实寒热八纲假说为其核心学术思想；“核心分类模式”是划分御医学派的新型模式，并对于划分与评价其他中医学术流派具有适用性；口述史对整理与总结医家学术思想，继承与发掘中医学术有重要意义；御医学派因其独特而庞大的医家群体、特色的诊疗技术与学术思想而成为北京中医学术界的一支重要力量，继承并发展了北京宫廷医学，丰富了中医学术内涵。 北京御医学派，是民国时期，以清末北京御医及御医传人为代表，中医经典理论为指导，继承与发展具有宫廷特色的中医学术为主旨，强调脏腑气血异常是其主因，脏腑气血病理变化是其关键，四诊合参、以脉为主是其重要的诊断依据，整体调理、内外并治是其主要治疗手段，法度严谨、平妥轻灵、药少力宏、力求无毒是其组方用药理念，脏腑气血虚实寒热八纲假说为其核心学术思想的综合性学术流派。其在北京中医教育、医疗和学术方面产生了深远影响，并辐射至中医学术界的一定领域。更多还原

【Abstract】 The study of Beijing Imperial Medical School aimed at its academic relations with the Court Medicine on the basis of tracing back to the origin and development of Beijing Court Medicine. The value of the school has been proved by studying the imperial physicians and their academic inheritors in such aspects as the lives, achievements, influence, scholarship, academic thoughts, academic features in developing the school and its core thoughts. A new prospect has been opened in studying the different schools of TCM in Beijing by investigating the school in its historical development and academic characteristics and revealing the laws governing its development from a new viewpoint.Philology is the main method in the research, together with mathematical statistics and dictation history. Firstly, on the basis of the verification of the existing document and related historical medical material from the Twenty-Four Histories and from the internal and external factors from historical material, textural researches have been done into its origin and development. It has been determined which school was included in the school. A preliminary conclusion of its academic thoughts has been reached. Secondly, study program was designed in mathematical statistics by using group sample and choosing 1,188 medical cases of different physicians from the school and those non-imperial physicians from Beijing, the southeastern area and the southwestern area. Then the data in prescribing were processed, compared and analyzed in mathematical statistics. The research were enriched and proved by collecting and compiling historical material from the viewpoint of dictation of history. Meanwhile, the theories about the classification of schools of TCM were investigated.On the basis of the research into the large amounts of historical material, literature of TCM and historical material from dictation, the results are as follows: Beijing Imperial Medical School was different from Beijing Court Medicine in that it was the inheritance and development of the latter. Its academic thoughts were characterized by paying attention to the classic TCM theories, laying emphasis on internal disease cause such as Zang, Fu, Qi and Blood and interpreting the cause, onset and process of an illness in Zang, Fu, Qi and blood. Thus, a variety of treating methods and principles were formed such as differentiations of wholistic regulation and the integration of internal an external treatments. The diagnostic thoughts were established including comprehensive analysis of the data based on the four diagnostic methods and pulse-taking. The features in prescribing herbs included strict compositions with mild, safe and fewer herbs and seeking to eliminate the toxicity as much as possible. The core of its academic thoughts lied in the eight principal syndromes of Zang and Fu, Qi and Blood, deficiency and excess, cold and heat. "Core classification pattern is a new method in classifying and apprising other academic schools of TCM. Dictating material was of great significance to collecting and concluding academic thoughts of different physicians and inheriting and digging up the inheritance of TCM. The school has developed into an important school in the academic cycle of medicine in Beijing, which inherited and developed Beijing Court Medicine, and hence enriched the theories of TCM.Beijing Imperial Medical School was a comprehensive academic school in the period of Republic of China (1912~1949). Its representatives were the imperial physicians and their successors in the late Qing Dynasty. Its guidance in thoughts was the theories from classics of TCM. It purpose was to inherit and develop the scholarship featured by court medicine. The cause of disease was the abnormal changes of Zang, Fu, Qi and blood. Its diagnostic methods were comprehensive analysis of the data based on the four diagnostic methods and pulse-taking. Its therapeutic methods were wholistic regulation and integration of internal and external treatment. Its prescription principles were strict composition fe更多还原