李中梓學術思想之研究

STUDY ON LI CHANG-TSU’s MEDICAL THOUGHTS

本研究旨在探討明末清初著名溫補派醫家李中梓的學術思想，研究材料以李氏所著《醫宗必讀》和《刪補頤生微論》為主。結果顯示，李氏臨證治病主張治病求本，注重臟腑病機辨證，氣機升降平衡，為易水學派的代表人物之一。其學術思想為治虛羸久病，脾腎並重，補氣溫陽為先；辨疑似之證，採脈證合參。李氏學古而不泥古，師眾而取其所長，宗薛立齋，張介賓而重視先天，然補腎不專乎地黃；宗張元素，李東垣而重視後天，然補脾不膠於升、柴。李氏對前人的經驗，既能兼收並蓄，又能揚長避短，可謂淹貫眾家之長，其學術思想在中醫學發展史上佔有重要的地位。This paper studies the medical thought of Chang-Tsu Li who was one of most famous doctors who were skilled in tonic and nourishing treatment at the end of Ming dynasty. From studying his book “Yi-Zone-Bi-Dou” and “Shan-Bu-Yi-Sheng-Wei-Lun”, he said that they were important in treatment of diseases to find out the etiology, to verify the pathology of viscera and to balance the regulation of Qi. Dr. Li was also one of the great figures in the “Yi-Shuei”(易水) school since he strongly believed in that the tonic of the “chi” and the nourishing of the “yang” must be firstly and equally applied to patients for their “kidney” and “spleen” for asthenic and chronic diseases. For similar syndromes, he referred pulse and symptom to differential diagnosis. Dr. Li learned from Masters “Li-Zhai Xue (薛立齋)” and “Jie-Bin Zhang (張介賓)” who paid much attention to congenital essence. However, the “Radix Rehmanniae” (地黃) was not the only tonic drug used by Dr. Li to improve the “kidney”. Dr. Li also followed Masters “Yuan-Su Yuan” (張 元素) and “Dong-Yuan Li” (李東垣) to lay stress on acquired essence. But, Dr. Li believed that Rhizoma Cimicifugae (升麻) and Radix Bupleuri (柴胡) were not the only way to nourish the ”spleen”. In conclusion, Dr. Li collected all the Masters’ knowledge but abandoned their deficiencies. No wonder he plays a very important role in Chinese medical history.