明代溫補學派醫家對命門理論的闡述與發揮

Elaboration and Play on the Life Gate Theory by the School of Warm and Supplement Medicine in the Ming Dynasty

明代溫補學派之學術觀點以強調溫補為主要特色，而命門學說為其核心議題之一，也影響了溫補學派診察之重點及用藥風格，本文試圖釐清命門學說在溫補學派中形成之歷史脈絡。命門之名詞及概念始於《內經》、《難經》，但相關論述較為零碎。在明代溫補學派的努力下，方形成系統性之論述。命門學說也受到當時儒、道思想的影響，例如宋明理學中《太極圖說》及丹道家對身體結構的觀察，對此學說均有啟發。在溫補學派中，首先專篇討論命門的是孫一奎，他界定了命門的位置及概念，並對經典中部份論述提出修正及補充；而第一位將命門概念具體應用於臨床辨證的則是薛己。此外，張介賓、趙獻可、李中梓等在前兩位的立論基礎上進行補充，使命門學說更具系統性，從其位置、功能、病形、證候、診斷、治療等均有論述。在溫補學派的醫家努力下，命門學說逐漸成為中醫藏象學說中重要的一部分。由於命門的特性「宜補不宜瀉」，溫養命門成為溫補學派的重要議題，也成為其多用溫補的立論依據。

The school of warm and supplement in the Ming dynasty emphasized “warm and supplement” as the primary characteristic of its academic arguments, and the life gate theory is a critical proposition in the school.This theory influenced the focus of the school of warm and supplement in diagnosis and medication style. The goal of this study was to clarify the historical context of the life gate theory in the school of warm and supplement. The term and concept of “life gate” originates from the Yellow Emperor’s Inner Canon and the Classics of Difficult Issues; however, discourses of “life gate” had been fragmented before the Ming dynasty.In the Ming dynasty, the school of warm and supplement formed a systematic discourse on the life gate theory, which was also influenced by the Confucianism and Taoism during that time. Sun Yi Kui was the first warm and supplement scholar to discuss the life gate theory. He defined the positions and concepts of the life gates as well as revised and supplemented the discourses on the classic life gate theory. Xue Ji was the first warm and supplement scholar to apply the life gate theory in clinical practices. Zhang Jie Bin, Zhao Xian Ke, and Li Zhong Zi supplemented the life gate theory on the basis of the arguments by Sun and Xue, reinforcing the systematic structure of the theory regarding the gate positions, functions, types of diseases, diagnoses, syndromes, and treatment. Because the medication based on the life gate theory features supplementary characteristicsinstead of drainage, the warm and supplement life gate theory became a major topic in the school of warm and supplement and influenced the medication style of the school.