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辨證傷寒派擅用仲景方治雜病的余聽鴻

佚名 2023-11-11 05:13:25

余聽鴻

余聽鴻(hong)(1847-1907),名景和,江蘇宜(yi)興人(ren)。童年(nian)在孟(meng)河(he)當藥店學(xue)徒,而(er)入孟(meng)河(he)名醫費蘭(lan)泉門下。業(ye)成(cheng)后懸壺家鄉,中年(nian)赴(fu)常熟,時有“余仙人(ren)”之美譽。

余氏(shi)私(si)淑柯韻伯(bo)之(zhi)學(xue),嘗謂(wei)時醫(yi)(yi)治(zhi)(zhi)醫(yi)(yi)不(bu)讀《傷寒(han)(han)》《金(jin)匱》漢唐諸書(shu),反讀淺近之(zhi)書(shu)以為(wei)捷徑,仲(zhong)(zhong)圣之(zhi)法(fa)(fa)廢(fei)之(zhi)日久,遂注釋柯韻伯(bo)《傷寒(han)(han)論翼》一書(shu),意欲為(wei)初學(xue)之(zhi)士遵《傷寒(han)(han)》之(zhi)范圍。余聽鴻十分(fen)強(qiang)調(diao)(diao)《傷寒(han)(han)論》辨證論治(zhi)(zhi)的(de)(de)精神實質。他(ta)說:“余讀仲(zhong)(zhong)景原序曰(yue)勤求古訓、博(bo)采眾(zhong)(zhong)方(fang),知(zhi)非(fei)仲(zhong)(zhong)圣杜(du)撰,是(shi)集(ji)上古經(jing)(jing)方(fang)也。又云為(wei)《傷寒(han)(han)雜(za)病(bing)論》一十六卷(juan),雖未能(neng)(neng)盡愈(yu)諸疾(ji),庶可見癥(zheng)(zheng)知(zhi)源,若能(neng)(neng)尋余所集(ji),思過半矣。知(zhi)非(fei)是(shi)拘經(jing)(jing)、拘法(fa)(fa)、拘方(fang)之(zhi)書(shu),即傷寒(han)(han)雜(za)病(bing)可概而變(bian)化治(zhi)(zhi)之(zhi)矣”。他(ta)認為(wei),仲(zhong)(zhong)景之(zhi)方(fang),只有(you)表里寒(han)(han)熱虛實之(zhi)眾(zhong)(zhong),并無傷寒(han)(han)雜(za)病(bing)之(zhi)別,作為(wei)醫(yi)(yi)者,能(neng)(neng)將此(ci)六字分(fen)清(qing),自然能(neng)(neng)夠變(bian)化無窮。而且(qie),“仲(zhong)(zhong)景原文分(fen)桂枝癥(zheng)(zheng)、麻黃癥(zheng)(zheng)、葛根癥(zheng)(zheng)、柴胡癥(zheng)(zheng)、枙(e)子癥(zheng)(zheng)、白虎癥(zheng)(zheng)、瀉心癥(zheng)(zheng)、承氣癥(zheng)(zheng)、五芩(qin)癥(zheng)(zheng)、四逆(ni)癥(zheng)(zheng)、理中(zhong)癥(zheng)(zheng),汗、吐、下、溫、清(qing)、補六法(fa)(fa)俱在其中(zhong)。一百一十三方(fang),方(fang)方(fang)有(you)法(fa)(fa),《內經(jing)(jing)》七方(fang)十劑無所不(bu)備,即雜(za)病(bing)亦豈外?”他(ta)還(huan)在其醫(yi)(yi)案《診余集(ji)》中(zhong)發(fa)出這樣的(de)(de)感嘆:“人云仲(zhong)(zhong)景之(zhi)法(fa)(fa)能(neng)(neng)治(zhi)(zhi)傷寒(han)(han),不(bu)能(neng)(neng)治(zhi)(zhi)調(diao)(diao)理者,門(men)外漢也”。

臨證余氏能靈活運用《傷寒(han)(han)》方(fang)(fang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)雜(za)病(bing),他(ta)說(shuo)(shuo)(shuo):“仲(zhong)(zhong)景(jing)方(fang)(fang)人(ren)皆畏(wei)難(nan)不用,然病(bing)至危(wei)險,非仲(zhong)(zhong)景(jing)方(fang)(fang)不能挽回耳”。如(ru)以黃連湯(tang)(tang)(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療噎膈、反胃嘔吐(tu),真武湯(tang)(tang)(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)腎虛痰升氣(qi)喘,烏梅丸治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)肝氣(qi)厥逆、久(jiu)痢、嘔吐(tu),桂枝加龍骨牡(mu)蠣治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)久(jiu)癥寒(han)(han)熱(re)往來和自汗、盜汗,白虎湯(tang)(tang)(tang)、竹葉石膏湯(tang)(tang)(tang)、豬苓湯(tang)(tang)(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)療消渴,豬膚湯(tang)(tang)(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)久(jiu)咳音(yin)瘖(yin)下(xia)(xia)痢,黃連阿膠湯(tang)(tang)(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)風熱(re)下(xia)(xia)痢便(bian)(bian)血,五苓散治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)濕加腳氣(qi),炙(zhi)甘草湯(tang)(tang)(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)肺疼、秋燥,附(fu)子理中(zhong)湯(tang)(tang)(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)大便(bian)(bian)陰結冷秘,理中(zhong)湯(tang)(tang)(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)中(zhong)虛單腹(fu),旋復代赫湯(tang)(tang)(tang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)噫噯等。他(ta)說(shuo)(shuo)(shuo):“是知仲(zhong)(zhong)景(jing)經方(fang)(fang)如(ru)神龍變化出沒,下(xia)(xia)方(fang)(fang)窺測,欲得其寸(cun)鱗(lin)片甲亦難(nan),茍(gou)能融(rong)會貫通,人(ren)間何病(bing)不治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)?若言(yan)《傷寒(han)(han)》方(fang)(fang)治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)表而不及里,是不但未識仲(zhong)(zhong)景(jing)立(li)方(fang)(fang)之旨,藥性亦不能明(ming)矣(yi)”。他(ta)又(you)說(shuo)(shuo)(shuo)“今時治(zhi)(zhi)(zhi)(zhi)(zhi)(zhi)病(bing)往往發(fa)表消導(dao),克伐攻下(xia)(xia),雜(za)湊一方(fang)(fang),毫(hao)無(wu)章法,此另有(you)別派所(suo)傳,余不敢(gan)質辭矣(yi)”,言(yan)辭雖和緩,實是對(dui)時俗之弊端作了捍擊。

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