從病名到病理——論惲鐵樵的中西醫學匯通之路

From Disease Nomenclature to the Disease Pathology – A Discussion on Yun Tie-qiao’s Approach to Merge Traditional Chinese Medicine and Western Medicine

病名與其內涵的不確定性是民國時期的醫家們十分困擾的問題。這個現象隨著中西醫論爭的氣氛，更形成對於中醫學術界的衝擊與挑戰。中央國醫館於是推出統一病名的學術活動，但卻激起中醫界內部對於自身學術存在的危機意識，和對於西醫微菌治病學說的討論與商榷。惲鐵樵先生積極參與了這場討論，他認為病名的統一工作有其中西醫學之條件，非當代的學術界所能輕易成就。在當代科學主義掛帥的輿論氣氛中，他嘗試界定中西醫病因學說在致病結構中所扮演的角色，強調人體自身生理條件對於疾病形成與發展的影響，並以中醫傷寒六經理論統整病理發展的常見途徑。他也從自身臨床經驗出發，觀察到當時西醫常用的灌腸通便法所經常導致的副作用，並從前述的病理結構提出中醫學對於這種副作用的理解與治療。民國時期中西匯通的學術成就，透過惲鐵樵的學術思想達到了一個超乎當代中醫學術界所能理解的高度。

The ambiguous disease nomenclature was a difficult obstacle among the physicians in the early 20th century in China. It became very complicated and challenging, particularly in the academic traditional Chinese medicine communities, as the disagreements of whether to continue practicing traditional Chinese medicine escalated.
Thus, the Central Institute of National Medicine（中央國醫館）arranged academic activities in order to unify the disease nomination. Subsequently; this did not only trigger the survival instinct of traditional Chinese medicine but also promoted the discussions and communications on microbiology and bacteriology in Western medicine. Yun Tie-qiao actively participated in these events. He supported the concept of unifying disease terminology in order to better understand disease pathology and provide treatments to the patients, but he acknowledged the process as a difficult task under given condition in his generation. As modern scientism became the mainstream tendency in the early 19th century, he calmly and composedly identified the role of both traditional Chinese medicine pathology and western medicine pathology in health concepts. He emphasized the impact of the physiological condition of an individual on cause and development of diseases. Based on his clinical experience, he observed the side-effects of enema to treat patients with constipation and then applied traditional Chinese medicine to understand the disease mechanism and provide a treatment for the side-effects. Yun Tie-qiao’s intellectual thoughts were a great milestone for the attempt to unify Eastern and Western medicine.