楊(yang)介(jie),字(zi)吉老,又(you)字(zi)克(ke)一(yi),生(sheng)于1060年(nian)(北宋(song)嘉祐五年(nian)),卒(zu)于1130年(nian)(南宋(song)建炎(yan)四年(nian)),江蘇(su)泗(si)州(今淮(huai)安(an)盱(xu)眙)人,寓居(ju)楚州(今淮(huai)安(an)),為(wei)宋(song)代(dai)文(wen)學(xue)家、蘇(su)門(men)四學(xue)士張(zhang)耒之外甥。楊(yang)家世代(dai)行醫,名聞遐邇(er)。楊(yang)介(jie)幼承庭(ting)訓,攻(gong)(gong)讀經學(xue),廣交文(wen)壇俊彥,善繪畫,尤擅畫竹。后舉孝廉不就(jiu),乃(nai)發奮攻(gong)(gong)讀醫典,繼承家技,又(you)受業于張(zhang)耒門(men)下(xia),盡得其醫學(xue)真(zhen)傳,醫術大有(you)長(chang)進,任州太醫生(sheng)。楊(yang)介(jie)曾以(yi)奇方異法治(zhi)愈宋(song)徽宗等(deng)的疑難病癥,名震京師(shi)。他在臨證之余(yu),精研(yan)臟(zang)腑內景,形體(ti)骨度,厘正宋(song)以(yi)前有(you)關(guan)臟(zang)腑圖形資料,實(shi)圖繪制了(le)我國最早(zao)的人體(ti)解剖圖譜——《存真(zhen)圖》,對中醫學(xue)作(zuo)出了(le)突出貢獻。南宋(song)建炎(yan)四年(nian)回泗(si)州,不幸為(wei)盜賊所害,享年(nian)70歲。
繪解剖圖 厘正謬誤
楊介治病每求其本,嘗曰:“黃帝時(shi),醫(yi)有(you)(you)俞跗,一撥見(jian)病因,能(neng)(neng)割(ge)皮解(jie)(jie)肌,湔(jian)浣(huan)胃(wei)(wei)腸,以(yi)(yi)(yi)祛百病。今醫(yi)者,若(ruo)能(neng)(neng)洞悉臟(zang)(zang)腑,見(jian)病知源(yuan),則起(qi)效(xiao)更(geng)速,苦無(wu)專(zhuan)書(shu)(shu)(shu)可證。雖(sui)有(you)(you)吳簡(jian)之(zhi)(zhi)《歐(ou)希范(fan)(fan)五臟(zang)(zang)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》《松蘿(luo)子(zi)五臟(zang)(zang)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》,但(dan)所(suo)繪(hui)臟(zang)(zang)腑每多謬誤或語焉不(bu)詳。”于(yu)是(shi)(shi)楊介參(can)考(kao)諸書(shu)(shu)(shu),厘(li)正謬誤,結合所(suo)見(jian)五臟(zang)(zang)之(zhi)(zhi)真(zhen)(zhen)(zhen),于(yu)政(zheng)和(he)三年(nian)繪(hui)成《存(cun)(cun)(cun)真(zhen)(zhen)(zhen)環中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》(以(yi)(yi)(yi)下簡(jian)稱(cheng)《存(cun)(cun)(cun)真(zhen)(zhen)(zhen)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》)。僧幻云(yun)《史(shi)記標注》曰(yue):“宜賊歐(ou)希范(fan)(fan)被刑(xing)時(shi),州吏吳簡(jian)令(ling)畫工(gong)就圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)之(zhi)(zhi)記,詳得其(qi)狀。或以(yi)(yi)(yi)書(shu)(shu)(shu)考(kao)之(zhi)(zhi),則未完。崇寧中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)(1102—1106),刑(xing)賊于(yu)市,郡守李夷(yi)行遣醫(yi)并畫工(gong)往視,抉膜摘膏,曲折圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)之(zhi)(zhi),得盡纖悉。介取以(yi)(yi)(yi)校之(zhi)(zhi),其(qi)自喉(hou)而(er)下,心、肺、肝、脾、膽、胃(wei)(wei)之(zhi)(zhi)系屬小腸、大(da)(da)腸、腰、腎、膀胱之(zhi)(zhi)營壘其(qi)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong),經(jing)絡聯附(fu)(fu),水谷泌別,精血運輸,原委留(liu)連,悉如古(gu)書(shu)(shu)(shu),無(wu)少異者。”日本丹波(bo)元胤(yin)《中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)國醫(yi)籍(ji)考(kao)》載(zai):“政(zheng)和(he)三年(nian),洛陽賈(jia)偉節《存(cun)(cun)(cun)真(zhen)(zhen)(zhen)環中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》序(xu)曰(yue):楊君介吉(ji)老,以(yi)(yi)(yi)所(suo)見(jian)五臟(zang)(zang)之(zhi)(zhi)真(zhen)(zhen)(zhen)繪(hui)而(er)為(wei)(wei)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu),取煙(yan)蘿(luo)子(zi)所(suo)畫條析(xi)而(er)厘(li)正之(zhi)(zhi),又益之(zhi)(zhi)以(yi)(yi)(yi)十二經(jing),以(yi)(yi)(yi)《存(cun)(cun)(cun)真(zhen)(zhen)(zhen)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》名(ming)之(zhi)(zhi),惜(xi)已佚。”但(dan)施沛撰《臟(zang)(zang)腑指掌圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)書(shu)(shu)(shu)》稱(cheng):“余得宋時(shi)楊介所(suo)繪(hui)《存(cun)(cun)(cun)真(zhen)(zhen)(zhen)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》原本,互(hu)相參(can)考(kao)纂(zuan)為(wei)(wei)是(shi)(shi)編(bian)。”邱(qiu)培刊(kan)《明(ming)(ming)堂經(jing)絡前(qian)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》,復以(yi)(yi)(yi)《存(cun)(cun)(cun)真(zhen)(zhen)(zhen)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》附(fu)(fu)系于(yu)內(nei),命工(gong)重繪(hui)而(er)刻之(zhi)(zhi)。說明(ming)(ming)《存(cun)(cun)(cun)真(zhen)(zhen)(zhen)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》在明(ming)(ming)代(dai)(dai)尚存(cun)(cun)(cun)。此后(hou),元代(dai)(dai)孫煥(huan)《玄門脈內(nei)照圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》、宋代(dai)(dai)朱肱《內(nei)外二景(jing)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》、明(ming)(ming)代(dai)(dai)高武《針灸聚英》、明(ming)(ming)代(dai)(dai)楊繼洲《針灸大(da)(da)成》等書(shu)(shu)(shu),均引用(yong)《存(cun)(cun)(cun)真(zhen)(zhen)(zhen)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)不(bu)少內(nei)容。從中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)可以(yi)(yi)(yi)知道該書(shu)(shu)(shu)所(suo)繪(hui)臟(zang)(zang)腑的(de)解(jie)(jie)剖(pou)位置和(he)形態大(da)(da)體是(shi)(shi)正確的(de)。《存(cun)(cun)(cun)真(zhen)(zhen)(zhen)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》盡管(guan)有(you)(you)疏漏或部(bu)分謬誤,但(dan)在我(wo)國解(jie)(jie)剖(pou)學資料極其(qi)匱乏的(de)年(nian)代(dai)(dai),能(neng)(neng)有(you)(you)這樣的(de)專(zhuan)業(ye)書(shu)(shu)(shu)籍(ji)是(shi)(shi)難能(neng)(neng)可貴的(de),也說明(ming)(ming)解(jie)(jie)剖(pou)學已為(wei)(wei)中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)醫(yi)學所(suo)實際應用(yong)。方春陽在《中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)國歷代(dai)(dai)名(ming)醫(yi)碑傳(chuan)集》中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)說:“楊介對中(zhong)(zhong)(zhong)(zhong)(zhong)(zhong)醫(yi)學最(zui)大(da)(da)的(de)貢獻為(wei)(wei)繪(hui)制《存(cun)(cun)(cun)真(zhen)(zhen)(zhen)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)》。此圖(tu)(tu)(tu)(tu)(tu)(tu)(tu)實體繪(hui)制,乃真(zhen)(zhen)(zhen)正之(zhi)(zhi)解(jie)(jie)剖(pou)圖(tu)(tu)(tu)(tu)(tu)(tu)(tu),是(shi)(shi)解(jie)(jie)剖(pou)史(shi)上之(zhi)(zhi)名(ming)作,影響(xiang)深(shen)遠。”
施奇方異法 起痼疾沉疴
楊介(jie)(jie)以醫術立世,用(yong)藥遣(qian)方自成(cheng)一格,奇方異(yi)治不同凡響。故診疾問(wen)病,辨(bian)證審(shen)因,每藥到病除,妙手回春。其醫名遠播大江南北,乃至(zhi)京師。宋(song)代(dai)黃庭堅《山谷別集·楊子建通神論序》稱:“余(yu)有(you)方外之友曰楊介(jie)(jie),嘗(chang)為余(yu)言《素問(wen)》《本草》之意(yi)。且曰:五運六氣,視其歲而為藥石,雖(sui)仲(zhong)景猶(you)病之也(ye)。至(zhi)于本草,則仲(zhong)景深矣(yi)。余(yu)涉世故多(duo),未能從介(jie)(jie)學之,衰老鼠逐戍審(shen),瘴癘侵陵,生意(yi)無幾(ji),恨(hen)不早從楊君(jun)學也(ye)。”
明代(dai)徐春(chun)甫《古今醫統(tong)》載:“宋徽(hui)宗(zong)日飲水過甚(shen),苦于腹疾,太醫治(zhi)以理中(zhong)(zhong)丸,不效。召楊介治(zhi)之,楊介仍用理中(zhong)(zhong)丸。帝曰:此藥已服(fu)用多次。楊介曰:皇帝之病因食(shi)水而起,臣(chen)以冰(bing)水煎此藥,是治(zhi)受病之原。服(fu)后果(guo)痊愈。”
宋代(dai)蕭存禮《百一(yi)(yi)選方(fang)》載:“王(wang)定(ding)國患頭風(feng)痛,至都梁求名醫(yi)楊介診治。連進三丸,病失。懇求其(qi)方(fang),則是用香白芷(zhi)一(yi)(yi)味(wei),洗曬研末(mo),煉蜜(mi)丸如彈(dan)子(zi)大,每嚼(jiao)一(yi)(yi)丸,以清(qing)茶或(huo)荊芥湯化(hua)下(xia),遂名都梁丸。此藥治頭風(feng)眩(xuan)暈,女人胎前產(chan)后傷風(feng)頭痛、血虛(xu)頭痛有效。”
清代《盱眙縣(xian)志稿·人物(wu)》載:“有(you)富家子忽病,視正物(wu)皆(jie)以(yi)(yi)為(wei)斜,幾案(an)書席,以(yi)(yi)至(zhi)書寫尺(chi)牘,莫(mo)不(bu)為(wei)然(ran)。父(fu)母甚憂之(zhi)(zhi),更歷數醫(yi),皆(jie)不(bu)諳其疾,或以(yi)(yi)吉老告,遂以(yi)(yi)子往求治(zhi)。既(ji)診脈(mo)后,令其父(fu)先(xian)歸。留(liu)其子,設樂(le)開宴,酌勸無算,至(zhi)醉乃罷(ba)。扶(fu)病者坐轎中,使人舁(yú)之(zhi)(zhi),高下其手,常令顛倒轉側,久之(zhi)(zhi)方(fang)令坐榻而(er)臥,達旦(dan)酒醒,遣之(zhi)(zhi)歸家,前(qian)日(ri)斜視之(zhi)(zhi)物(wu)皆(jie)理正之(zhi)(zhi)。父(fu)母躍然(ran)而(er)喜,且(qie)詢治(zhi)之(zhi)(zhi)之(zhi)(zhi)方(fang),吉老云:令嗣無他病,醉中嘗(chang)閃(shan)倒,肝(gan)之(zhi)(zhi)小葉搭肺上不(bu)能下,故視物(wu)斜。今(jin)復(fu)飲之(zhi)(zhi)醉,再輾(zhan)轉,肝(gan)復(fu)位(wei)矣。”
楊(yang)介謙(qian)虛好學,嚴于律(lv)己。每有診誤(wu),必反躬自(zi)省。宋代洪邁《夷堅志·支(zhi)景·茅山(shan)(shan)道(dao)士(shi)》載:“名(ming)(ming)醫楊(yang)吉老,其(qi)(qi)術甚著。某(mou)郡一士(shi)人狀(zhuang)若(ruo)有疾,厭(yan)厭(yan)不聊賴(lai),莫能名(ming)(ming)其(qi)(qi)何等(deng)疾苦,往謁之,楊(yang)曰:君(jun)熱證己極,氣血消灼且盡(jin),自(zi)此三年,當以(yi)發背死(si),不可(ke)為矣(yi)。士(shi)人不樂(le)而退(tui)。聞(wen)親(qin)識間說茅山(shan)(shan)觀中一道(dao)士(shi),于醫術通神(shen),乃詣(yi)山(shan)(shan)拜之……道(dao)士(shi)診視而笑曰:汝便(bian)可(ke)下山(shan)(shan),日日買好梨(li)一顆吃之,其(qi)(qi)疾當自(zi)平。士(shi)人歸,僅如其(qi)(qi)戒。經(jing)一歲,楊(yang)介見(jian)之,驚其(qi)(qi)顏貌腴澤(ze),脈息和平,謂之曰:君(jun)必遇異人,不然豈有安痊之理?士(shi)人以(yi)告,楊(yang)介立具衣冠,焚香往茅山(shan)(shan)設,蓋自(zi)咎其(qi)(qi)學之未(wei)至也。”
楊介(jie)治病奇聞(wen),散見于醫(yi)話和筆記(ji)(ji)雜(za)著。史書(shu)記(ji)(ji)載(zai)(zai)繼承其醫(yi)術(shu)者為孺生李氏子(zi),如清代陸心(xin)源(yuan)《宋史翼》載(zai)(zai):“李子(zi)執師(shi)禮甚恭,后入(ru)贅(zhui)為婿(xu)。介(jie)盡以(yi)精微授(shou)之,李子(zi)盡承其傳,亦以(yi)醫(yi)術(shu)鳴(ming)世,后以(yi)醫(yi)科及第至博(bo)士。李植(zhi)元(yuan)秀(xiu)即其從(cong)子(zi)也。”
交文壇俊彥 著醫藥方書
文(wen)(wen)壇杏(xing)苑雖屬不同領域,但由于傳統文(wen)(wen)化諸(zhu)多(duo)分支的共生性和整體性,古(gu)代先(xian)賢(xian)往(wang)往(wang)亦(yi)(yi)文(wen)(wen)亦(yi)(yi)醫(yi)(yi),醫(yi)(yi)文(wen)(wen)兼通(tong)。所以(yi),古(gu)代醫(yi)(yi)家(jia)無不具備精(jing)深(shen)的文(wen)(wen)學(xue)修養,使言而多(duo)文(wen)(wen),行(xing)之甚(shen)遠。楊介家(jia)學(xue)淵源,早年就(jiu)通(tong)讀經(jing)史,博(bo)覽百家(jia)之書,又與當時文(wen)(wen)壇張(zhang)耒、賀鑄、吳(wu)則禮、呂本(ben)中等(deng)俊彥交游(you),投贈詩文(wen)(wen),得益良(liang)多(duo),為(wei)他(ta)以(yi)后以(yi)文(wen)(wen)載(zai)道、著書立(li)說(shuo)奠定(ding)了深(shen)厚的基(ji)礎。從以(yi)下(xia)幾首贈詩中,可以(yi)窺知其醫(yi)(yi)理精(jing)湛,醫(yi)(yi)技(ji)高超,醫(yi)(yi)德高尚與其醫(yi)(yi)文(wen)(wen)結緣之淵藪。
“間坊遠市聲,終(zhong)(zhong)日掩衡門。唯有(you)風中(zhong)葉,蕭騷終(zhong)(zhong)日聞(wen)。午枕不成(cheng)寐,起坐無(wu)與言。喜開故人書(shu),珍(zhen)(zhen)藥幸見存。其(qi)方受(shou)仙(xian)圣,其(qi)效(xiao)未易論。豈為蠲沉疴,庶可輔本根。珍(zhen)(zhen)重復(fu)珍(zhen)(zhen)重,厥價萬(wan)筠(yun)墻。永年未可冀,庶保無(wu)天昏(hun)。”休代張末《秋日喜楊(yang)介吉老(lao)寄(ji)藥》)
“我以無作語,刊彼月(yue)面(mian)背。遣似(si)呂(lv)南山(shan),未要馀子會。平生太玄(xuan)雄,唯有一語在。只憐粥(zhou)飯和,已(yi)復不驚樁。”(宋代吳則禮(li)《百湖集》寄馮少有詩并示楊吉老)
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