中(zhong)(zhong)醫(yi)傷(shang)(shang)科(ke)(ke)學(xue)(xue)(xue)是(shi)祖國醫(yi)學(xue)(xue)(xue)的(de)重(zhong)要(yao)組成(cheng)部分,是(shi)研究防治皮(pi)肉(rou)、筋骨(gu)、氣血、經(jing)絡、臟腑損傷(shang)(shang)疾(ji)患的(de)一門科(ke)(ke)學(xue)(xue)(xue)。歷史上(shang)稱為瘍醫(yi)、金(jin)鏃、正體、正骨(gu)科(ke)(ke)等。在(zai)祖國醫(yi)學(xue)(xue)(xue)中(zhong)(zhong),中(zhong)(zhong)醫(yi)傷(shang)(shang)科(ke)(ke)學(xue)(xue)(xue)歷史悠久,積累了豐富的(de)、比(bi)較(jiao)完整的(de)理論(lun)和(he)經(jing)驗,并逐漸形成(cheng)了一門獨立的(de)科(ke)(ke)學(xue)(xue)(xue)。
科學的(de)(de)(de)發生(sheng)(sheng)和發展從開(kai)始(shi)起(qi)便(bian)(bian)是(shi)(shi)由生(sheng)(sheng)產所決定(ding)的(de)(de)(de)。中醫傷(shang)(shang)科學的(de)(de)(de)起(qi)源與形成(cheng),也與勞動(dong)人(ren)民長(chang)期的(de)(de)(de)勞動(dong)生(sheng)(sheng)活、生(sheng)(sheng)產實踐(jian)緊密相(xiang)關(guan)。距今(jin)100多萬年(nian)前,我(wo)們的(de)(de)(de)祖先(xian)為了生(sheng)(sheng)存。便(bian)(bian)依靠著集體(ti)的(de)(de)(de)智(zhi)慧和力量,用原始(shi)的(de)(de)(de)勞動(dong)工具(ju),有限(xian)的(de)(de)(de)勞動(dong)經(jing)(jing)驗,簡單的(de)(de)(de)勞動(dong)互助。來對付自然(ran)界的(de)(de)(de)各種災難,抗擊猛獸(shou)的(de)(de)(de)頻繁侵(qin)襲,以(yi)獲取必要的(de)(de)(de)食物,同時(shi)也相(xiang)應(ying)地(di)逐步積累(lei)了原始(shi)的(de)(de)(de)醫藥知識。原始(shi)社(she)會的(de)(de)(de)早期,人(ren)們大都住在(zai)洞(dong)穴或窩棚里(li),以(yi)避(bi)風雨(yu)寒暑,防備猛獸(shou)蟲蛇(she),這(zhe)是(shi)(shi)人(ren)類(lei)最(zui)早的(de)(de)(de)預防外(wai)傷(shang)(shang)措施。但人(ren)類(lei)在(zai)與毒(du)蛇(she)、猛獸(shou)搏斗(dou)和部(bu)落之間發生(sheng)(sheng)戰爭時(shi),也常常發生(sheng)(sheng)外(wai)傷(shang)(shang)。原始(shi)人(ren)就在(zai)損傷(shang)(shang)疼痛、腫脹處撫摸(mo)、按壓(ya),以(yi)減(jian)輕痛苦(ku)。經(jing)(jing)過長(chang)期的(de)(de)(de)反復實踐(jian),摸(mo)索出一些能醫治(zhi)損傷(shang)(shang)性疾病的(de)(de)(de)方法(fa)和一些簡單的(de)(de)(de)治(zhi)傷(shang)(shang)手法(fa),如對傷(shang)(shang)口(kou)用泥土、樹葉(xie)、草(cao)莖等(deng)進行涂裹。這(zhe)便(bian)(bian)是(shi)(shi)外(wai)治(zhi)法(fa)的(de)(de)(de)起(qi)源。
公元前11世紀的周代,在醫療分工上已有專人掌管骨科疾病的治療。《周禮》中記載。的“瘍醫”,就是負責“腫瘍、潰瘍、金瘍、折瘍”的治療。這里所說的“金瘍”,即“金創”。指由金屬器刃損傷肢體所致創傷;“折瘍”概括了擊、墮、跌、撲所致的骨斷筋傷等疾病。其治療辦法也比較豐富,除內服中藥外,還有敷藥(祝藥)和手術(刮殺)等治療措施。那時雖無傷科專著,但在同時期現存最古老的幾本醫學文獻中都有記載這方面的內容。如《內經》中,就有對跌打損傷的癥狀、診斷和治療的論述。《神農本草經(jing)(jing)(jing)》收(shou)集(ji)的(de)(de)(de)(de)(de)(de)(de)“主(zhu)金(jin)(jin)創續(xu)絕筋(jin)(jin)(jin)骨(gu)(gu)傷”藥(yao)物(wu)達數(shu)(shu)十(shi)種之(zhi)(zhi)多(duo)。《金(jin)(jin)貴要略》載有治“金(jin)(jin)瘡”的(de)(de)(de)(de)(de)(de)(de)王不(bu)(bu)(bu)留行散及(ji)治馬墮(duo)及(ji)一(yi)(yi)(yi)些(xie)筋(jin)(jin)(jin)骨(gu)(gu)損傷方。可見當時(shi)傷科(ke)(ke)學(xue)已(yi)取(qu)得了(le)一(yi)(yi)(yi)定的(de)(de)(de)(de)(de)(de)(de)發(fa)展。《內經(jing)(jing)(jing)》是我國醫(yi)學(xue)文獻中現存最:早(zao)的(de)(de)(de)(de)(de)(de)(de)一(yi)(yi)(yi)部(bu)典籍,它比較系統、全面(mian)地闡述了(le)人體解剖(pou)、生(sheng)理(li)、病(bing)(bing)理(li)、診斷、治療(liao)等(deng)基(ji)本理(li)論(lun)。《靈(ling)(ling)(ling)樞(shu)(shu)·經(jing)(jing)(jing)水篇(pian)》指出(chu):“若夫八(ba)尺之(zhi)(zhi)士,皮肉在此,外可度量,切循而得之(zhi)(zhi),其死(si)可解剖(pou)而視之(zhi)(zhi)”。《靈(ling)(ling)(ling)樞(shu)(shu)·骨(gu)(gu)度篇(pian)》通(tong)過體表測(ce)量人體骨(gu)(gu)骼的(de)(de)(de)(de)(de)(de)(de)長(chang)短(duan)、大小(xiao)、廣(guang)(guang)狹(xia),按(an)頭(tou)顱、軀干、四肢(zhi)各部(bu)折量出(chu)一(yi)(yi)(yi)定的(de)(de)(de)(de)(de)(de)(de)標準分寸。《靈(ling)(ling)(ling)樞(shu)(shu)·經(jing)(jing)(jing)筋(jin)(jin)(jin)篇(pian)》論(lun)述了(le)附屬于一(yi)(yi)(yi)二經(jing)(jing)(jing)脈的(de)(de)(de)(de)(de)(de)(de)筋(jin)(jin)(jin)肉系統。由(you)于解剖(pou)學(xue)、生(sheng)理(li)學(xue)的(de)(de)(de)(de)(de)(de)(de)發(fa)展,也就促(cu)使了(le)傷科(ke)(ke)學(xue)的(de)(de)(de)(de)(de)(de)(de)發(fa)展。《素(su)問(wen)(wen)·繆刺論(lun)篇(pian)》論(lun)述:“人有墮(duo)墜,惡(e)血留內,……此上(shang)傷厥陰之(zhi)(zhi)脈,下傷少陰之(zhi)(zhi)絡”。《素(su)問(wen)(wen)》闡發(fa)的(de)(de)(de)(de)(de)(de)(de)“氣(qi)(qi)(qi)傷痛,形(xing)(xing)傷腫(zhong)”以及(ji)“肝(gan)主(zhu)筋(jin)(jin)(jin),腎主(zhu)骨(gu)(gu),脾主(zhu)肌肉”等(deng)理(li)論(lun),一(yi)(yi)(yi)直指導著(zhu)傷科(ke)(ke)基(ji)礎(chu)理(li)論(lun)研,究和臨床(chuang)醫(yi)療(liao)實踐。《靈(ling)(ling)(ling)樞(shu)(shu)·刺節真邪篇(pian)》記(ji)載“骨(gu)(gu)蝕(shi)”的(de)(de)(de)(de)(de)(de)(de)病(bing)(bing)名病(bing)(bing)因及(ji)其病(bing)(bing)機,均類似現代醫(yi)學(xue)的(de)(de)(de)(de)(de)(de)(de)無菌性骨(gu)(gu)壞死(si)。《素(su)問(wen)(wen)·痿(wei)(wei)(wei)論(lun)》還分別(bie)論(lun)述了(le)痿(wei)(wei)(wei)?、脈痿(wei)(wei)(wei)、筋(jin)(jin)(jin)瘓、肉痿(wei)(wei)(wei)、骨(gu)(gu)痿(wei)(wei)(wei)等(deng)肢(zhi)體畸(ji)形(xing)(xing)的(de)(de)(de)(de)(de)(de)(de)病(bing)(bing)因、病(bing)(bing)理(li)、辨證和治療(liao)。《素(su)問(wen)(wen)·生(sheng)氣(qi)(qi)(qi)通(tong)天論(lun)》指出(chu):“因于濕,首如裹(guo),濕熱不(bu)(bu)(bu)攘(rang),大筋(jin)(jin)(jin)軟(ruan)(ruan)短(duan),小(xiao)筋(jin)(jin)(jin)弛長(chang),軟(ruan)(ruan)短(duan)為(wei)拘,弛長(chang)為(wei)痿(wei)(wei)(wei),”說明(ming)痿(wei)(wei)(wei)癥引(yin)起肢(zhi)體一(yi)(yi)(yi)部(bu)分筋(jin)(jin)(jin)肉癱瘓松(song)弛,另一(yi)(yi)(yi)部(bu)分筋(jin)(jin)(jin)肉痙攣、縮短(duan),繼而可引(yin)起關節畸(ji)形(xing)(xing)。在治療(liao)上(shang),已(yi)廣(guang)(guang)泛采(cai)用針灸、熨(yun)貼、按(an)摩和藥(yao)物(wu)等(deng)方法(fa)。此外,《呂氏春秋·盡(jin)數(shu)(shu)》曰:“流(liu)水不(bu)(bu)(bu)腐,戶樞(shu)(shu)不(bu)(bu)(bu)螻,動(dong)也,形(xing)(xing)氣(qi)(qi)(qi)亦(yi)然(ran)。形(xing)(xing)不(bu)(bu)(bu)動(dong)則精(jing)不(bu)(bu)(bu)流(liu),精(jing)不(bu)(bu)(bu)流(liu)則氣(qi)(qi)(qi)郁,郁處頭(tou)則為(wei)腫(zhong)為(wei)風(feng)……處足則為(wei)痿(wei)(wei)(wei)為(wei)?,”主(zhu)張采(cai)用運動(dong)鍛煉的(de)(de)(de)(de)(de)(de)(de)方法(fa)治療(liao)足部(bu)“痿(wei)(wei)(wei)?”(肢(zhi)體筋(jin)(jin)(jin)脈弛緩,痿(wei)(wei)(wei)軟(ruan)(ruan)無力,行走(zou)不(bu)(bu)(bu)便(bian)的(de)(de)(de)(de)(de)(de)(de)疾病(bing)(bing)),為(wei)后世(shi)傷科(ke)(ke)動(dong)靜結合的(de)(de)(de)(de)(de)(de)(de)功能療(liao)法(fa)奠(dian)定了(le)理(li)論(lun)基(ji)礎(chu)。
漢(han)代(dai)(dai)(公元前206年(nian)至公元220年(nian)),是祖國(guo)醫(yi)學(xue)的隆(long)盛時(shi)代(dai)(dai)。歷史上著(zhu)名的外(wai)傷科(ke)醫(yi)學(xue)家華(hua)佗(tuo),既能用方藥(yao)、針灸治病(bing),更擅長外(wai)科(ke)手術,并創立(li)了(le)(le)“五禽戲”,與現代(dai)(dai)醫(yi)學(xue)中(zhong)的醫(yi)療體(ti)育相似。東漢(han)末年(nian),張仲景所著(zhu)的《傷寒雜病(bing)論》是我國(guo)第一(yi)部臨床醫(yi)學(xue)巨著(zhu)。他總結(jie)了(le)(le)漢(han)代(dai)(dai)以前的醫(yi)學(xue)成就(jiu),并根據自己(ji)的臨床經驗,創立(li)了(le)(le)理、法(fa)、方、藥(yao)一(yi)整套辨(bian)證施治方法(fa)。同時(shi)還記載了(le)(le)牽臂法(fa)人工呼吸、胸外(wai)心臟按摩等復蘇(su)術。
隋代(公元581至618年),巢元方的《諸病源(yuan)候(hou)(hou)論》探求諸病之源(yuan),九候(hou)(hou)之要,列述了1700余(yu)癥(zheng)(zheng),為我國第(di)一部病理專著。該書《金(jin)創(chuang)傷(shang)筋斷骨候(hou)(hou)》中指出:筋傷(shang)后可(ke)引起循(xun)環(huan)障礙(ai)(營衛不通),創(chuang)雖愈(yu)合,但仍可(ke)遺留神經麻痹(bi)和運動障礙(ai)的癥(zheng)(zheng)狀,并提出傷(shang)口必須在(zai)受傷(shang)后立即縫(feng)合的正確觀點。
唐代(公元618至907年(nian)),孫思(si)邈著《千金方(fang)(fang)(fang)》中記(ji)載了顳(nie)頜關節(jie)脫位(wei)的(de)(de)復(fu)(fu)位(wei)手(shou)法(fa)。“一人(ren)(ren)以(yi)手(shou)指(zhi)(zhi)牽其(qi)頤以(yi)漸(jian)推之,則(ze)(ze)復(fu)(fu)入矣,推當疾出指(zhi)(zhi),恐誤嚙(nie)傷人(ren)(ren)指(zhi)(zhi)也”(治(zhi)失(shi)欠頰車磋(cuo)開張(zhang)不(bu)合(he)方(fang)(fang)(fang));并(bing)指(zhi)(zhi)出整復(fu)(fu)后可(ke)采用(yong)(yong)蠟療(liao)(liao)和熱(re)敷(fu),以(yi)助(zhu)關節(jie)功能的(de)(de)恢復(fu)(fu)。這(zhe)是世界上最早(zao)的(de)(de)治(zhi)療(liao)(liao)顳(nie)頜關節(jie)脫位(wei)的(de)(de)復(fu)(fu)位(wei)方(fang)(fang)(fang)法(fa),直(zhi)至現在仍(reng)被普(pu)遍沿用(yong)(yong)。王燾(dao)著《外臺秘(mi)要》,主張(zhang)用(yong)(yong)氈做濕熱(re)敷(fu),以(yi)減輕(qing)損傷肢體(ti)(ti)的(de)(de)疼痛。藺(lin)道人(ren)(ren)著《仙授(shou)理(li)傷續斷秘(mi)方(fang)(fang)(fang)》,是我國第一部傷科(ke)專著,它闡(chan)述(shu)了骨折(zhe)的(de)(de)治(zhi)療(liao)(liao)原則(ze)(ze)為(wei)(wei)正確復(fu)(fu)位(wei),夾板固定,功能鍛煉,藥(yao)物(wu)治(zhi)療(liao)(liao)直(zhi)至骨折(zhe)愈合(he)。指(zhi)(zhi)出復(fu)(fu)位(wei)前要先用(yong)(yong)手(shou)摸傷處,識別(bie)骨折(zhe)移位(wei)情況,采用(yong)(yong)拔伸、捺(na)正等手(shou)法(fa)。骨折(zhe)整復(fu)(fu)后,將軟(ruan)墊加(jia)在肢體(ti)(ti)上,然(ran)后用(yong)(yong)適合(he)肢體(ti)(ti)外形的(de)(de)杉樹皮(pi)夾板固定。對動(dong)靜結合(he)的(de)(de)理(li)論,藺(lin)道人(ren)(ren)較前人(ren)(ren)有更進一步的(de)(de)闡(chan)述(shu)。該書指(zhi)(zhi)出:“凡曲轉,如手(shou)腕(wan)腳(jiao)凹手(shou)指(zhi)(zhi)之類,要轉動(dong)……時時為(wei)(wei)之方(fang)(fang)(fang)可(ke)。”對開放(fang)性(xing)骨折(zhe),他則(ze)(ze)采用(yong)(yong)經過點沸消毒的(de)(de)水沖(chong)洗污染的(de)(de)傷口和骨片(pian),皮(pi)破(po)必須用(yong)(yong)清潔的(de)(de)“絹片(pian)包之”,“不(bu)可(ke)見風著水”等。這(zhe)種原則(ze)(ze)現在仍(reng)為(wei)(wei)處理(li)開放(fang)性(xing)骨折(zhe)的(de)(de)準繩。
元代(公元1279至1368年),蒙族善騎射,對于傷(shang)科(ke)頗有(you)(you)專長,在(zai)(zai)醫制(zhi)十三科(ke)中,就有(you)(you)正骨(gu)(gu)科(ke)。危亦林著《世(shi)(shi)醫得效(xiao)方(fang)(fang)》在(zai)(zai)傷(shang)科(ke)學上(shang)有(you)(you)偉(wei)大的(de)成就。他認為“顛(dian)撲(pu)損(sun)傷(shang),骨(gu)(gu)肉疼(teng)痛,整頓不(bu)得,先用(yong)(yong)(yong)(yong)(yong)(yong)(yong)麻藥(yao)(yao)(yao)服,待(dai)其不(bu)識痛處,方(fang)(fang)可下(xia)手(shou)(shou)(shou)(shou)。”麻醉藥(yao)(yao)(yao)量(liang)按(an)(an)病人(ren)(ren)(ren)(ren)年齡、體質及出(chu)(chu)血情況而定,再(zai)按(an)(an)照病人(ren)(ren)(ren)(ren)麻醉程度逐漸增加或(huo)(huo)(huo)減少,“已倒(dao)便住藥(yao)(yao)(yao),切不(bu)可過(guo)多”。危亦林是(shi)(shi)世(shi)(shi)界上(shang)第(di)一(yi)(yi)次(ci)采(cai)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)懸吊復位(wei)法(fa)治療脊柱骨(gu)(gu)折的(de)人(ren)(ren)(ren)(ren)。該書指出(chu)(chu):“凡挫(cuo)脊骨(gu)(gu),不(bu)可用(yong)(yong)(yong)(yong)(yong)(yong)(yong)手(shou)(shou)(shou)(shou)整頓,須用(yong)(yong)(yong)(yong)(yong)(yong)(yong)軟(ruan)(ruan)繩以腳吊起,墜(zhui)下(xia)身直,其骨(gu)(gu)使自(zi)(zi)歸(gui)(gui)窠,……然(ran)后(hou)(hou)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)大桑(sang)皮一(yi)(yi)片,放在(zai)(zai)背皮上(shang)”杉樹皮兩三片,安在(zai)(zai)桑(sang)皮上(shang),用(yong)(yong)(yong)(yong)(yong)(yong)(yong)軟(ruan)(ruan)物纏夾定,莫(mo)令屈,用(yong)(yong)(yong)(yong)(yong)(yong)(yong)藥(yao)(yao)(yao)治之。”該書還把(ba)髖關節脫位(wei)分為前(qian)后(hou)(hou)兩型,指出(chu)(chu):“此處身上(shang)骨(gu)(gu)是(shi)(shi)臼,腿(tui)根是(shi)(shi)杵,或(huo)(huo)(huo)出(chu)(chu)前(qian),或(huo)(huo)(huo)出(chu)(chu)后(hou)(hou),須用(yong)(yong)(yong)(yong)(yong)(yong)(yong)一(yi)(yi)人(ren)(ren)(ren)(ren)手(shou)(shou)(shou)(shou)把(ba)住患(huan)人(ren)(ren)(ren)(ren)身,一(yi)(yi)人(ren)(ren)(ren)(ren)拽(zhuai)腳,用(yong)(yong)(yong)(yong)(yong)(yong)(yong)手(shou)(shou)(shou)(shou)盡力(li)搦(nuo)歸(gui)(gui)窠,或(huo)(huo)(huo)是(shi)(shi)銼開。又(you)可用(yong)(yong)(yong)(yong)(yong)(yong)(yong)軟(ruan)(ruan)棉繩從腳縛倒(dao)吊起,用(yong)(yong)(yong)(yong)(yong)(yong)(yong)手(shou)(shou)(shou)(shou)整骨(gu)(gu)節,從上(shang)墜(zhui)下(xia),自(zi)(zi)然(ran)歸(gui)(gui)窠。”危氏(shi)又(you)把(ba)踝關節骨(gu)(gu)折脫位(wei)分為內翻、外翻兩型,并按(an)(an)不(bu)同類(lei)型施用(yong)(yong)(yong)(yong)(yong)(yong)(yong)不(bu)同復位(wei)手(shou)(shou)(shou)(shou)法(fa),指出(chu)(chu):“須用(yong)(yong)(yong)(yong)(yong)(yong)(yong)一(yi)(yi)人(ren)(ren)(ren)(ren)拽(zhuai)去,自(zi)(zi)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)手(shou)(shou)(shou)(shou)摸其骨(gu)(gu)節,或(huo)(huo)(huo)骨(gu)(gu)突(tu)出(chu)(chu)在(zai)(zai)內,用(yong)(yong)(yong)(yong)(yong)(yong)(yong)手(shou)(shou)(shou)(shou)正從此骨(gu)(gu)頭拽(zhuai)歸(gui)(gui)外,或(huo)(huo)(huo)骨(gu)(gu)突(tu)向外,須用(yong)(yong)(yong)(yong)(yong)(yong)(yong)力(li)拽(zhuai)歸(gui)(gui)內,則(ze)歸(gui)(gui)窠;若只拽(zhuai),不(bu)用(yong)(yong)(yong)(yong)(yong)(yong)(yong)手(shou)(shou)(shou)(shou)整入窠內,誤人(ren)(ren)(ren)(ren)成疾(ji)。
明代(公元1368至1644年),大醫院(yuan)十(shi)三科(ke),其中就有(you)接骨科(ke)。薛(xue)己(ji)著《正體(ti)類要》指出(chu):“肢體(ti)損于外,則(ze)氣血傷于內,營衛有(you)所不貫,臟腑由之不和。”闡明了傷科(ke)疾病(bing)局部與(yu)整體(ti)的辨證關系。
清代(dai)(公元(yuan)1644至(zhi)1911年(nian)),傷(shang)(shang)(shang)科(ke)又有了新(xin)的(de)(de)發(fa)展。吳(wu)謙(qian)集歷代(dai)傷(shang)(shang)(shang)科(ke)之(zhi)(zhi)大成,著(zhu)(zhu)(zhu)《醫(yi)宗金鑒·正(zheng)(zheng)骨(gu)心法(fa)(fa)(fa)要旨》。該書(shu)系(xi)統(tong)地總結了清代(dai)以(yi)前(qian)的(de)(de)骨(gu)傷(shang)(shang)(shang)科(ke)經驗(yan),對(dui)人體各部位的(de)(de)骨(gu)度,手(shou)(shou)法(fa)(fa)(fa),夾縛器具(ju)及(ji)內(nei)外治(zhi)(zhi)法(fa)(fa)(fa)方藥,記述(shu)最詳,既有理論(lun),尤(you)重實(shi)踐,圖文并茂,是(shi)一(yi)(yi)部較完整的(de)(de)正(zheng)(zheng)骨(gu)書(shu)籍。近(jin)代(dai)學(xue)(xue)者(zhe)多崇(chong)此書(shu)。值(zhi)得(de)注意的(de)(de)是(shi)吳(wu)謙(qian)不(bu)僅把正(zheng)(zheng)骨(gu)手(shou)(shou)法(fa)(fa)(fa)歸納(na)為摸、接、端、提、推、拿、按、摩(mo)八(ba)法(fa)(fa)(fa),并運用(yong)(yong)手(shou)(shou)法(fa)(fa)(fa)治(zhi)(zhi)療膘腿痛等(deng)傷(shang)(shang)(shang)筋疾患,使用(yong)(yong)攀索疊磚(zhuan)法(fa)(fa)(fa)贅復胸腰(yao)椎骨(gu)折脫(tuo)位。而且強(qiang)調了正(zheng)(zheng)確運用(yong)(yong)手(shou)(shou)法(fa)(fa)(fa)的(de)(de)重要性(xing),就是(shi)必須先“知其(qi)(qi)體相,識其(qi)(qi)部位”,才(cai)能(neng)“一(yi)(yi)旦臨癥(zheng),機(ji)觸于(yu)外,巧生于(yu)內(nei),手(shou)(shou)隨心轉,法(fa)(fa)(fa)從手(shou)(shou)出”。如(ru)此則(ze)手(shou)(shou)法(fa)(fa)(fa)運用(yong)(yong)更加具(ju)有科(ke)學(xue)(xue)性(xing)。這一(yi)(yi)觀(guan)點目前(qian)仍為大家所推崇(chong)。在固(gu)(gu)定(ding)(ding)(ding)方面,“愛因身體上下正(zheng)(zheng)側之(zhi)(zhi)象(xiang),制器以(yi)正(zheng)(zheng)之(zhi)(zhi),用(yong)(yong)輔手(shou)(shou)法(fa)(fa)(fa)之(zhi)(zhi)所不(bu)逮(dai),以(yi)冀分者(zhe)復合,欹者(zhe)復正(zheng)(zheng),高者(zhe)就其(qi)(qi)平,陷者(zhe)升其(qi)(qi)位。”并創造和(he)改革了多種固(gu)(gu)定(ding)(ding)(ding)器具(ju),例(li)如(ru),對(dui)脊(ji)柱中(zhong)段采(cai)(cai)用(yong)(yong)通(tong)木固(gu)(gu)定(ding)(ding)(ding),下腰(yao)部損傷(shang)(shang)(shang)采(cai)(cai)用(yong)(yong)腰(yao)柱固(gu)(gu)定(ding)(ding)(ding),四(si)肢長(chang)骨(gu)干(gan)骨(gu)折采(cai)(cai)用(yong)(yong)竹(zhu)簾、杉籬固(gu)(gu)定(ding)(ding)(ding),髕骨(gu)骨(gu)折采(cai)(cai)用(yong)(yong)抱膝器固(gu)(gu)定(ding)(ding)(ding)等(deng)。此外,沈金鰲著(zhu)(zhu)(zhu)《沈氏尊生書(shu),雜病(bing)(bing)源流(liu)犀燭(zhu)》對(dui)內(nei)傷(shang)(shang)(shang)的(de)(de)病(bing)(bing)因病(bing)(bing)機(ji)、辨證治(zhi)(zhi)療有所闡(chan)發(fa);顧世澄(cheng)著(zhu)(zhu)(zhu)《瘍醫(yi)大全》,對(dui)跌(die)打損傷(shang)(shang)(shang)及(ji)一(yi)(yi)些骨(gu)關節疾病(bing)(bing)有進一(yi)(yi)步的(de)(de)論(lun)述(shu);錢秀昌著(zhu)(zhu)(zhu)《傷(shang)(shang)(shang)科(ke)補要》、趙竹(zhu)泉著(zhu)(zhu)(zhu)《傷(shang)(shang)(shang)科(ke)大成》、胡延(yan)光著(zhu)(zhu)(zhu)《傷(shang)(shang)(shang)科(ke)匯纂》等(deng)專(zhuan)著(zhu)(zhu)(zhu)亦系(xi)統(tong)詳述(shu)了各種損傷(shang)(shang)(shang)的(de)(de)證候和(he)治(zhi)(zhi)療,并附有很多治(zhi)(zhi)驗(yan)的(de)(de)病(bing)(bing)案(an),均為學(xue)(xue)習與研究中(zhong)醫(yi)骨(gu)傷(shang)(shang)(shang)科(ke)學(xue)(xue)的(de)(de)重要文獻。
傷(shang)(shang)科(ke)學(xue)在(zai)(zai)我國(guo)(guo)有(you)(you)著數千年(nian)的(de)悠久歷史,我國(guo)(guo)勞動人民長(chang)期與傷(shang)(shang)病作斗(dou)爭的(de)過程中(zhong)(zhong)(zhong),積累了豐富的(de)理(li)論和(he)(he)(he)寶貴的(de)經(jing)驗,其(qi)中(zhong)(zhong)(zhong)有(you)(you)不(bu)少(shao)是世界上最早的(de)發明(ming)創造,代表了當時的(de)世界先進(jin)水平(ping)。但是,到了1840年(nian)鴉片戰(zhan)爭以(yi)后,中(zhong)(zhong)(zhong)國(guo)(guo)淪為(wei)半封建半殖民地的(de)國(guo)(guo)家(jia)。隨著帝(di)國(guo)(guo)主義的(de)文化(hua)侵略(lve),西方醫(yi)學(xue)傳入中(zhong)(zhong)(zhong)國(guo)(guo),使中(zhong)(zhong)(zhong)醫(yi)骨傷(shang)(shang)科(ke)學(xue)受(shou)到了極大(da)的(de)摧(cui)殘(can)。在(zai)(zai)此期間(jian)傷(shang)(shang)科(ke)學(xue)著作甚少(shao),極其(qi)豐富的(de)傷(shang)(shang)科(ke)經(jing)驗散存在(zai)(zai)老一輩的(de)中(zhong)(zhong)(zhong)醫(yi)師和(he)(he)(he)民間(jian)中(zhong)(zhong)(zhong),缺乏整理(li)和(he)(he)(he)提高,甚至幾乎瀕于失傳的(de)邊緣。
新中(zhong)國(guo)(guo)成立后,在中(zhong)國(guo)(guo)共產黨的領導(dao)下,正確地貫徹了(le)(le)黨的中(zhong)醫(yi)政(zheng)策,祖國(guo)(guo)醫(yi)學(xue)猶如枯水(shui)逢春,欣欣向榮。30多年(nian)來、我國(guo)(guo)骨傷(shang)(shang)科(ke)(ke)醫(yi)務工(gong)作(zuo)(zuo)者(zhe),尤其(qi)按(an)摩(mo)推拿醫(yi)務人(ren)員以辯證唯物主(zhu)義(yi)力(li)指(zhi)導(dao),實行(xing)中(zhong)西(xi)醫(yi)結合,積(ji)極開展手法治療骨關節(jie)及其(qi)周圍筋肉(rou)組織損(sun)傷(shang)(shang)的研(yan)究工(gong)作(zuo)(zuo)。國(guo)(guo)內很多省(sheng)、市、自治區先(xian)后辦起了(le)(le)按(an)摩(mo)(推拿)訓(xun)練班及學(xue)校,培養按(an)摩(mo)專業人(ren)員。全國(guo)(guo)和(he)一些省(sheng)市相(xiang)繼(ji)成立了(le)(le)骨傷(shang)(shang)科(ke)(ke)研(yan)究機構(gou),對(dui)傷(shang)(shang)科(ke)(ke)醫(yi)學(xue)的發掘、繼(ji)承(cheng)、提高起到(dao)了(le)(le)積(ji)極作(zuo)(zuo)用。按(an)摩(mo)醫(yi)學(xue)在傷(shang)(shang)科(ke)(ke)領域(yu)中(zhong)的廣泛運用已(yi)取得了(le)(le)新的成就和(he)發展。近年(nian)來我國(guo)(guo)傷(shang)(shang)科(ke)(ke)學(xue)的新進(jin)展越(yue)(yue)來越(yue)(yue)受(shou)到(dao)世界醫(yi)學(xue)界的重視,對(dui)世界醫(yi)學(xue)科(ke)(ke)學(xue)做(zuo)出了(le)(le)一定貢獻。今后,我們一定要用現(xian)代科(ke)(ke)學(xue)知識和(he)方法去整理、研(yan)究、總結極其(qi)豐富(fu)的傷(shang)(shang)科(ke)(ke)醫(yi)學(xue),發揚祖國(guo)(guo)醫(yi)學(xue)遺產,使我國(guo)(guo)醫(yi)學(xue)科(ke)(ke)學(xue)技(ji)術適應(ying)新的形勢(shi)需要,趕超世界先(xian)進(jin)水(shui)平,更(geng)好地為(wei)實現(xian)社(she)會(hui)主(zhu)義(yi)的四個現(xian)代化服務,為(wei)人(ren)類(lei)健康事業做(zuo)出貢獻。
特點不同:道醫(yi)(yi)多(duo)有真傳(chuan)、秘傳(chuan),所學一般都會明師或玄師的(de)傳(chuan)承(cheng),所傳(chuan)的(de)內容不會隨便公開;中(zhong)醫(yi)(yi)可從普及(ji)性的(de)醫(yi)(yi)書去學習提(ti)升,一般沒有秘傳(chuan)的(de)部(bu)份。所以道醫(yi)(yi)更注(zhu)重傳(chuan)承(cheng),并非是簡(jian)單的(de)醫(yi)(yi)學技術。
道門中自古就有十道九醫,醫道同源。道醫是上至道家,下至中醫理論,形成的一套完整的醫學體系。而中醫,則是在歷史發展過程中依據道家之《黃帝內(nei)經》及(ji)陰陽五行學說(shuo)為辨證施治手段。所以道醫(yi)與(yu)中醫(yi)本為一脈,只是(shi)道醫(yi)的體系更為完整。
看中醫注意事項
避免容易染(ran)舌苔的食(shi)物(wu)或藥物(wu),就診前不宜(yi)含化藥物(wu),服用(yong)丸、劑等,容易染(ran)苔。
不要化妝(zhuang),就診者面(mian)色、眼(yan)睛、口唇、皮膚等是醫生(sheng)望診的主要內容(rong),所以化妝(zhuang)會掩蓋“本(ben)來面(mian)目”,同樣也會掩蓋病情(qing)。
不要飯(fan)(fan)后立(li)即就(jiu)診,以飯(fan)(fan)后半(ban)小時就(jiu)診為宜,因(yin)飯(fan)(fan)后脈象(xiang)、舌象(xiang)均有變化,不利于醫生(sheng)的(de)判斷。不要在劇烈(lie)活(huo)動(dong)后立(li)刻就(jiu)診,或者情緒(xu)激動(dong)時就(jiu)診,因(yin)劇烈(lie)活(huo)動(dong)、情緒(xu)激動(dong)會使心率增快,影響(xiang)醫生(sheng)把脈,從而掩蓋疾病的(de)表(biao)現。
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