從蘭室秘藏的醫論探討李東垣的學術思想

STUDY ON THOUGHT OF LI-DONG-YUAN FROM THE ASPECT OF MEDICAL THEORIES IN LAN-SHI-MI-ZANG

蘭室秘藏一書為金元著名醫家李東垣之醫學著作，本書就現代醫學之分類，分內科、婦科、五官科、外科與兒科五個部份。本文旨在從蘭室秘藏的醫論分析探討李東垣學術思想，主要有四點結論：（1） 百病之源，皆因飲食勞倦，脾胃氣傷；（2） 未病養生，已病溫胃養血，保有天命；（3） 病不執方，隨時隨證加減，隨病制方；（4） 講究服法，謹守飲食宜忌，促進效用。全書醫論以飲食所傷論、勞倦所傷論與脾胃虛損論等三篇為李東垣學術思想的中心，強調飲食與勞倦為引起脾胃元氣虛損的主要因素，也是百病之源。本書醫論，其實為《內外傷辨惑論》及《脾胃論》之延續，即東垣「脾胃元氣陰火學說」的進一步發揮。Lan-Shi-Mi-Zang was a medical writer by Li-Dong-Yuan, who was a famous physician at Jin- Yuan Dynasty in China. On basis of modern medical classification, this book divided to five parts included internal medicine, gynecology, five sensory organ, surgery and pediatrics. The purpose of study intended to discuss Li-Dong-Yuan’s thought from the aspect of medical theories in Lan-Shi- Mi-Zang. Four conclusion as following: (1) Etiology of diseases resulted from spleen-stomach qi injured by diary and taxation. (2) To get long life should be nourishing the life in healthy body, as well as warm the stomach qi and nourishing the blood. (3) Without using one formula treated disease, any time it should be ordered prescriptions by seasons change and identified pattern. (4) In take cooking herbs being need the rules, it should be done on basis of indication and contraindication in dietary foods to improve the efficacy of treatment. In this book among of the aspect of medical theories included diet injured, taxation injured as well as spleen-gastric vacuity and damage are thoughts center of Li-Dong-Yuan. Li’s appreciated that dietary and taxation injure are main factors of spleen-gastric qi vacuity and damage, and also the origin of disease. The aspect of medical theories in Lan-Shi-Mi-Zang at fact is a following writer by Nei-Wai-Sun-Bian-Huo-Lun and Pi-Wei-Lun. The same time it is an intending expansion of Li’s Yuan-Qi-Yin-Fire hypothesis.