華岡青洲《乳岩辨證》、《乳岩辨》古籍抄本探析

The Researchof Hanaoka Seishu’s Medical Classic Nyuganbenshoand Nyuganben

日本醫家華岡青洲（Hanaoka Seishu, 1760-1835）於1804年以自創中草藥口服麻醉藥完成世界首例全身麻醉的乳腺癌切除手術而著名，其融合傳統醫學醫理與荷蘭醫學外科技術開創「華岡流」醫學，治療過156位乳腺癌病人，乳腺癌治療照護方法獨樹一格。華岡青洲口述其臨床治療經驗並由門生抄錄成書的日文古籍《乳岩辨證》、《乳岩辨》，成為十九世紀前期，結合西醫外科手術與傳統醫學術後照護的重要乳腺癌手術照護治療專書。本文探究華岡青洲古籍抄本《乳岩辨證》、《乳岩辨》兩書所論及的乳腺癌術前、術後臨床照護實踐，從辨證、術後傷口綁縛包紮法、局部腫塊腐蝕法運用、湯方調養與膏貼應用的照護特色，發現華岡青洲師法明代中醫外科名醫陳實功（1555-1636）的治則，承續其中醫外科治法精神之新創性照護方法。

Japanese surgeon Dr. Hanaoka Seishu(1760-1835) is renowned for performing the first breast cancer surgery under general anesthesia in the world using his own oral herbal anesthetics. He combined traditional medical theory with western surgical techniques from the Netherlands and developed his own medical style. He treated 156 breast cancer patients, usingthe treatment methods he developed himself. In the early 19th century, disciples transcribed Hanaoka Seishu’s dictation into the Japanese medical classic Nyuganbenshoand Nyuganben. They combine specialized knowledge about western surgical treatment and traditional Chinese medicine (TCM) post-operative care for breast cancer patients. This study looks into the practice of pre-and post-operative care for breast cancer patients regarding syndrome differentiation, post-operative wound bandage, local tumor erosion, decoction nursing and the application of ointment and strips described in Hanaoka’s classic Nyuganbenshoand Nyuganben. We discover Hanaoka’s unique treatment and care methods are base on TCM guidelines and influenced by the Ming dynasty TCM surgeonChen Shi Gong (1555-1636).