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醫家傳記

醫案日記(ji) 2023-05-14 06:00:12

一、醫緩

醫緩,春秋時期秦(qin)國(guo)(guo)人。據(ju)《左傳》記載,魯成公(gong)(gong)(gong)(gong)(gong)十(shi)年(nian)(nian)(公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)(yuan)前(qian)(qian)(qian)581年(nian)(nian)),晉(jin)國(guo)(guo)國(guo)(guo)君景公(gong)(gong)(gong)(gong)(gong)姬據(ju)(公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)(yuan)前(qian)(qian)(qian)599~公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)(yuan)前(qian)(qian)(qian)581年(nian)(nian))生病(bing)(bing)(bing),先叫桑困巫治療。桑田通過占(zhan)卜,認定景公(gong)(gong)(gong)(gong)(gong)的(de)病(bing)(bing)(bing),是遭晉(jin)景公(gong)(gong)(gong)(gong)(gong)殺害的(de)晉(jin)國(guo)(guo)大夫趙(zhao)同(tong)和趙(zhao)括的(de)鬼魂作祟所致。晉(jin)景公(gong)(gong)(gong)(gong)(gong)聽(ting)說秦(qin)國(guo)(guo)有良(liang)醫,就(jiu)派遣(qian)使(shi)臣求醫于秦(qin)國(guo)(guo)。秦(qin)恒公(gong)(gong)(gong)(gong)(gong)(公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)(yuan)前(qian)(qian)(qian)603~公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)(yuan)前(qian)(qian)(qian)577年(nian)(nian))派遣(qian)醫緩往診(zhen),醫緩即到晉(jin)國(guo)(guo),診(zhen)景公(gong)(gong)(gong)(gong)(gong)病(bing)(bing)(bing)直言不諱說:“疾不可為(wei)(wei)也!”因(yin)為(wei)(wei)病(bing)(bing)(bing)程已發(fa)展(zhan)到“在盲之上(shang),膏(gao)之下”的(de)晚期,而(er)“攻之不可,達之不及(ji),藥(yao)不至焉,不可為(wei)(wei)也。”就(jiu)是說,以砭石、針灸攻治已不可及(ji),服食藥(yao)餌(er)醫治,亦不能至,而(er)醫療無(wu)能為(wei)(wei)力。從引(yin)“病(bing)(bing)(bing)入膏(gao)育(yu)”就(jiu)成為(wei)(wei)一(yi)句(ju)典故與(yu)成語。

二、醫和

醫(yi)和(he)(he),春秋(qiu)時期秦國(guo)人。據《左傳》、《國(guo)語·晉(jin)語》記載(zai),魯(lu)昭公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)年(公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)前(qian)(qian)541年),晉(jin)平(ping)公(gong)(gong)(gong)(gong)(gong)姬彪(公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)前(qian)(qian)557~公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)前(qian)(qian)532年)有(you)(you)疾(ji)(ji)(ji),求(qiu)醫(yi)于(yu)秦國(guo):秦景公(gong)(gong)(gong)(gong)(gong)嬴后(公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)前(qian)(qian)576~公(gong)(gong)(gong)(gong)(gong)元(yuan)(yuan)前(qian)(qian)537年)派(pai)遣醫(yi)和(he)(he)往診,醫(yi)和(he)(he)診病(bing)后說(shuo):“疾(ji)(ji)(ji)不(bu)(bu)可(ke)為(wei)(wei)(wei)也,是謂近(jin)(jin)女(nv)室,疾(ji)(ji)(ji)如蠱,非(fei)鬼非(fei)食,惑(huo)以(yi)喪志”。就是說(shuo),平(ping)公(gong)(gong)(gong)(gong)(gong)的病(bing)已不(bu)(bu)能治(zhi)好,因(yin)為(wei)(wei)(wei)近(jin)(jin)女(nv)室。惑(huo)以(yi)生(sheng)(sheng)蠱!平(ping)公(gong)(gong)(gong)(gong)(gong)問道(dao):“女(nv)不(bu)(bu)可(ke)近(jin)(jin)乎(hu)”?得禁絕情(qing)欲嗎?醫(yi)和(he)(he)答道(dao)“節(jie)之”,要有(you)(you)節(jie)制和(he)(he)限度,還(huan)對(dui)疾(ji)(ji)(ji)病(bing)的機理(li)做了(le)闡釋說(shuo),“天有(you)(you)六(liu)氣,降(jiang)生(sheng)(sheng)五(wu)味(wei),發為(wei)(wei)(wei)五(wu)色(se),征為(wei)(wei)(wei)五(wu)聲,淫生(sheng)(sheng)六(liu)疾(ji)(ji)(ji);六(liu)氣曰陰、陽、風、雨(yu)(yu)、晦(hui)、明也。分(fen)為(wei)(wei)(wei)四時,序為(wei)(wei)(wei)五(wu)節(jie),過則為(wei)(wei)(wei)災。陰淫寒疾(ji)(ji)(ji),陽淫熱(re)(re)疾(ji)(ji)(ji),風淫末(mo)疾(ji)(ji)(ji),雨(yu)(yu)淫腹疾(ji)(ji)(ji),晦(hui)淫惑(huo)疾(ji)(ji)(ji),明淫心疾(ji)(ji)(ji)。”并針(zhen)對(dui)平(ping)公(gong)(gong)(gong)(gong)(gong)的疾(ji)(ji)(ji)病(bing)和(he)(he)提(ti)問,進一步(bu)解釋說(shuo):“女(nv)陰物而晦(hui)時,淫則生(sheng)(sheng)內熱(re)(re)惑(huo)蠱之疾(ji)(ji)(ji)。今君(jun)不(bu)(bu)節(jie)不(bu)(bu)時,能無及此乎(hu)?”

醫(yi)和還把(ba)這話告訴了趙(zhao)孟(meng),趙(zhao)孟(meng)不(bu)解地問(wen)道:“何(he)謂(wei)蠱(gu)?”醫(yi)和解釋說(shuo)(shuo):“淫溺惑亂之(zhi)所生(sheng)也(ye),于文,皿蟲為蠱(gu),谷之(zhi)飛亦(yi)為蠱(gu),在(zai)《周易》,女惑男,落風(feng)山謂(wei)之(zhi)蠱(gu),皆同物也(ye)。”趙(zhao)孟(meng)聽了這話,亦(yi)稱贊說(shuo)(shuo):“良醫(yi)也(ye)!”。

三、醫呴

醫呴(xu),戰國時期秦(qin)國人,事跡出于《尸子》,據(ju)說(shuo)“為(wei)宣王割痤。為(wei)呴(xu)王療痔皆愈(yu)。張子之(zhi)背(bei)腫,命呴(xu)治之(zhi),遂愈(yu)。”從(cong)其所治療的疾病來看,皆為(wei)外(wai)科疾思,醫呴(xu)應是一位醫療技(ji)術高明的外(wai)科醫生。

四、文摯

文(wen)(wen)(wen)摯(zhi)(zhi)(zhi),戰國(guo)時期(qi)(qi)(qi)宋國(guo)人(ren),洞明醫術。事跡出于(yu)《呂(lv)氏春秋·至忠(zhong)篇》,據(ju)說(shuo)齊(qi)(qi)(qi)(qi)王(wang)(wang)(wang)(wang)田地(di)(公元前(qian)(qian)323~公元前(qian)(qian)284年(nian))有病(bing)(bing)(bing),使人(ren)請文(wen)(wen)(wen)摯(zhi)(zhi)(zhi)。文(wen)(wen)(wen)摯(zhi)(zhi)(zhi)診王(wang)(wang)(wang)(wang)病(bing)(bing)(bing),根據(ju)病(bing)(bing)(bing)情(qing)決定采用心理(li)療法治(zhi)療,遂對太子(zi)說(shuo):“王(wang)(wang)(wang)(wang)之疾(ji)必可已也。雖(sui)然王(wang)(wang)(wang)(wang)之疾(ji)已,則(ze)(ze)殺(sha)摯(zhi)(zhi)(zhi)也。”太子(zi)問:“何故”?文(wen)(wen)(wen)摯(zhi)(zhi)(zhi)說(shuo),“非怒王(wang)(wang)(wang)(wang),則(ze)(ze)疾(ji)不(bu)(bu)可治(zhi),怒王(wang)(wang)(wang)(wang)則(ze)(ze)摯(zhi)(zhi)(zhi)必死(si)。”于(yu)是(shi),太子(zi)再三(san)懇求說(shuo):“苛已王(wang)(wang)(wang)(wang)之疾(ji),臣(chen)與臣(chen)之母以死(si)爭(zheng)之于(yu)王(wang)(wang)(wang)(wang),王(wang)(wang)(wang)(wang)必幸(xing)臣(chen)與臣(chen)之母,愿先生之勿患(huan)也。”于(yu)是(shi),文(wen)(wen)(wen)摯(zhi)(zhi)(zhi)應允、愿冒死(si)為齊(qi)(qi)(qi)(qi)王(wang)(wang)(wang)(wang)治(zhi)病(bing)(bing)(bing),便與太子(zi)約(yue)期(qi)(qi)(qi)前(qian)(qian)往,而文(wen)(wen)(wen)摯(zhi)(zhi)(zhi)故意不(bu)(bu)守信譽(yu),三(san)次失約(yue),不(bu)(bu)按約(yue)期(qi)(qi)(qi)為王(wang)(wang)(wang)(wang)治(zhi)病(bing)(bing)(bing),使齊(qi)(qi)(qi)(qi)王(wang)(wang)(wang)(wang)很生氣,當文(wen)(wen)(wen)摯(zhi)(zhi)(zhi)見齊(qi)(qi)(qi)(qi)王(wang)(wang)(wang)(wang)時,又不(bu)(bu)脫鞋就上他(ta)的(de)床(chuang),還故意踐(jian)踏他(ta)的(de)衣服,用很不(bu)(bu)禮貌的(de)語言(yan)詢(xun)問他(ta)的(de)病(bing)(bing)(bing)情(qing),使齊(qi)(qi)(qi)(qi)王(wang)(wang)(wang)(wang)氣得(de)不(bu)(bu)肯答言(yan)。文(wen)(wen)(wen)摯(zhi)(zhi)(zhi)卻(que)反口出陋辭,以激(ji)怒齊(qi)(qi)(qi)(qi)王(wang)(wang)(wang)(wang)。于(yu)是(shi)齊(qi)(qi)(qi)(qi)王(wang)(wang)(wang)(wang)大怒,與文(wen)(wen)(wen)摯(zhi)(zhi)(zhi)爭(zheng)吵起來,使其(qi)病(bing)(bing)(bing)遂愈(yu),而文(wen)(wen)(wen)摯(zhi)(zhi)(zhi)終為齊(qi)(qi)(qi)(qi)王(wang)(wang)(wang)(wang)所烹死(si)。

五、秦越人(附:長桑君、子陽、子豹等)

秦越人(ren)約生(sheng)于(yu)(yu)公元前5~4世紀,是戰國時期的(de)著名醫學家(jia),世稱扁鵲。河(he)北任邱人(ren)。一(yi)說(shuo)(shuo)為山東長清(qing)人(ren)。還有(you)人(ren)據《陳璋(zhang)圓壺》、《陳璋(zhang)方(fang)壺》銘,及古(gu)陶(tao)文等(deng),認為是臨淄(zi)附近(jin)的(de)鄭陽人(ren),秦越人(ren)生(sheng)平事跡出于(yu)(yu)《史記》、《韓詩外(wai)傳》、《戰國策》、《說(shuo)(shuo)苑》等(deng)古(gu)代典籍。

秦越(yue)人(ren)約自(zi)公元前(qian)386年(nian)前(qian)后即“為人(ren)舍(she)長”,隨長桑君(jun)“出入(ru)十(shi)余年(nian)”,承長桑君(jun)授以(yi)《禁方書》,在診(zhen)斷上,他(ta)以(yi)“切脈、望色、聽(ting)聲、寫形”針藥并用(yong)、綜合(he)治療(liao)虢太子的“尸(shi)厥”證(zheng)成功。虢君(jun)感動他(ta)說:“有先(xian)生(sheng)則活,無先(xian)生(sheng)則捐棄溝壑(he),長終而(er)不得反(fan)!”遂“名聞天(tian)下”。他(ta)以(yi)砭石(shi)彈刺(ci),治療(liao)秦武(wu)王(wang)面部癰(yong)腫成功。秦國太醫令李醯“自(zi)知技不如也”,而(er)使人(ren)刺(ci)殺秦越(yue)人(ren)于秦國。

秦(qin)越人(ren)過(guo)邯鄲,聞(wen)貴婦人(ren),即(ji)為帶下(xia)醫;聞(wen)周人(ren)愛老(lao)人(ren),即(ji)為耳目(mu)痹(bi)醫;來人(ren)咸(xian)陽,聞(wen)秦(qin)人(ren)愛小(xiao)兒(er),即(ji)為小(xiao)兒(er)醫;隨俗(su)為變。游歷了(le)今山東、河北(bei)、山西、河南、陜西等省的廣(guang)大地域。從事(shi)過(guo)內科、外科、婦科、五(wu)官科、小(xiao)兒(er)科等多學科的醫療工作。精通湯液、針(zhen)灸、砭石、熨帖(tie)、按摩(mo)、手術等各種(zhong)技術。體(ti)現了(le)為廣(guang)大民(min)眾(zhong)解除(chu)病(bing)痛的優秀品格。

在診齊恒侯(hou)病(bing)(bing)案后,司(si)馬遷對秦越人(ren)評價說(shuo):“使(shi)圣人(ren)預知微(wei),能(neng)(neng)使(shi)良醫(yi)得早從事(shi),則疾可已,身可活(huo)也(ye)。人(ren)之(zhi)所(suo)病(bing)(bing),病(bing)(bing)疾多(duo),醫(yi)之(zhi)所(suo)病(bing)(bing),病(bing)(bing)道少。故醫(yi)有六(liu)不(bu)(bu)(bu)(bu)治(zhi):驕恣不(bu)(bu)(bu)(bu)論于理,一不(bu)(bu)(bu)(bu)治(zhi)也(ye);輕身重財,二不(bu)(bu)(bu)(bu)治(zhi)也(ye);衣(yi)食(shi)不(bu)(bu)(bu)(bu)能(neng)(neng)適,三不(bu)(bu)(bu)(bu)治(zhi)也(ye);陰陽并,藏(zang)氣(qi)不(bu)(bu)(bu)(bu)定,四(si)不(bu)(bu)(bu)(bu)治(zhi)也(ye);形微(wei)不(bu)(bu)(bu)(bu)能(neng)(neng)服(fu)藥,五(wu)不(bu)(bu)(bu)(bu)治(zhi)也(ye);信(xin)巫(wu)不(bu)(bu)(bu)(bu)信(xin)醫(yi),六(liu)不(bu)(bu)(bu)(bu)冶也(ye)。有此一者(zhe),則重難治(zhi)也(ye)。”

三個病例說明,在危重病患面前,秦(qin)(qin)越(yue)人(ren)敢于承擔風險,當(dang)“天下(xia)盡(jin)以扁(bian)鵲為能(neng)生死人(ren)”的評論出現時,秦(qin)(qin)越(yue)人(ren)則實(shi)事求是他說:“越(yue)人(ren)非(fei)能(neng)生死人(ren)也(ye),此自當(dang)生者,越(yue)人(ren)能(neng)使之起耳。”這是一(yi)種科學的態度(du)。

秦越人在醫學上的成(cheng)就(jiu)。主要有以下三個(ge)方面:

1、經(jing)(jing)絡臟(zang)象方面:秦(qin)越(yue)人提出病邪沿(yan)經(jing)(jing)絡循(xun)(xun)行(xing)(xing)與(yu)臟(zang)腑(fu)的(de)深淺(qian),由表(biao)入(ru)里傳(chuan)變。他說:“若太(tai)子病,所謂(wei)‘尸厥(jue)’者(zhe)也(ye),夫(fu)(fu)以(yi)陽(yang)(yang)入(ru)陰(yin)(yin)中,……,中經(jing)(jing)維絡,別(bie)下(xia)(xia)于三(san)焦(jiao)膀(bang)(bang)胱(guang)(guang)(guang)。是(shi)(shi)以(yi)陽(yang)(yang)脈下(xia)(xia)遂,陰(yin)(yin)脈上爭、會(hui)氣閉而(er)(er)(er)(er)不通,陰(yin)(yin)上而(er)(er)(er)(er)陽(yang)(yang)內行(xing)(xing),下(xia)(xia)內鼓而(er)(er)(er)(er)不起(qi),上外絕而(er)(er)(er)(er)不為(wei)使。上有(you)絕陽(yang)(yang)之絡,下(xia)(xia)有(you)破(po)(po)陰(yin)(yin)之紐,破(po)(po)陰(yin)(yin)絕陽(yang)(yang),色廢脈亂,故形靜如死狀,太(tai)子未死也(ye),夫(fu)(fu)以(yi)陽(yang)(yang)入(ru)陰(yin)(yin),支蘭(lan)藏者(zhe)生,以(yi)陰(yin)(yin)入(ru)陽(yang)(yang),支蘭(lan)藏者(zhe)死。凡此數事,皆五臟(zang)厥(jue)中之時暴作也(ye)。良工取之,拙者(zhe)疑殆!”秦(qin)越(yue)人所說的(de)是(shi)(shi)足(zu)陽(yang)(yang)明胃經(jing)(jing)“下(xia)(xia)膈、屬胃、絡脾”的(de)循(xun)(xun)行(xing)(xing)與(yu)臟(zang)腑(fu)的(de)關(guan)系(xi);”別(bie)下(xia)(xia)于三(san)焦(jiao)膀(bang)(bang)胱(guang)(guang)(guang)”,即(ji)手(shou)少陽(yang)(yang)三(san)焦(jiao)經(jing)(jing)“下(xia)(xia)膈,屬三(san)焦(jiao)”的(de)循(xun)(xun)行(xing)(xing)與(yu)臟(zang)腑(fu)的(de)關(guan)系(xi):或足(zu)太(tai)陽(yang)(yang)膀(bang)(bang)胱(guang)(guang)(guang)經(jing)(jing)“絡腎,屬膀(bang)(bang)胱(guang)(guang)(guang)”的(de)循(xun)(xun)行(xing)(xing)與(yu)臟(zang)俯關(guan)系(xi)“乃使弟(di)子子陽(yang)(yang),厲(li)針砥石,以(yi)取外三(san)陽(yang)(yang)五會(hui)”,即(ji)是(shi)(shi)沿(yan)足(zu)陽(yang)(yang)明胃經(jing)(jing)、手(shou)少陽(yang)(yang)三(san)焦(jiao)經(jing)(jing)、足(zu)太(tai)陽(yang)(yang)膀(bang)(bang)胱(guang)(guang)(guang)經(jing)(jing)的(de)循(xun)(xun)行(xing)(xing),循(xun)(xun)經(jing)(jing)取穴,進行(xing)(xing)針刺(ci)治(zhi)療,搶救了(le)垂危病人。

2、四診(zhen)合參方面:秦越(yue)人“特以診(zhen)脈(mo)”為其專長,而有(you)“至今天(tian)下言脈(mo)者,由扁鵲(que)也(ye)”之(zhi)美譽。齊恒侯田午一例,則(ze)是(shi)全憑(ping)望色觀察分析病(bing)情(qing)的(de)發(fa)展過(guo)程(cheng),正確判斷(duan)齊桓侯的(de)發(fa)病(bing)機制,即(ji)從腠理侵入血脈(mo),繼(ji)入腸胃,再入骨髓,說(shuo)明了秦越(yue)人在(zai)望診(zhen)上的(de)造詣。由于秦越(yue)人充分掌握(wo)了診(zhen)斷(duan)方法,在(zai)診(zhen)斷(duan)學上能言病(bing)之(zhi)聽在(zai),聞(wen)病(bing)之(zhi)陽,論得(de)其陰(yin);聞(wen)病(bing)之(zhi)陰(yin),論得(de)其陽。病(bing)應見于大表,不出千里,決者至眾,不可(ke)曲止也(ye)!

3、辨證論治與綜合(he)治療(liao)方面:虢(guo)太子(zi)的(de)“尸厥”證,秦越人(ren)(ren)“乃使弟子(zi)子(zi)陽(yang),厲(li)針砥石(shi),以取外三陽(yang)五(wu)會”,把(ba)病(bing)(bing)人(ren)(ren)從(cong)昏迷中搶救過來(lai)。然后“乃使弟子(zi)子(zi)豹(bao)為五(wu)分之(zhi)(zhi)(zhi)熨,更(geng)以八減(jian)之(zhi)(zhi)(zhi)齊和煮之(zhi)(zhi)(zhi)。以更(geng)熨兩脅下”,為病(bing)(bing)人(ren)(ren)進行(xing)保溫(wen)治療(liao),促使病(bing)(bing)人(ren)(ren)很快恢(hui)復(fu)到能夠自己“起坐”。再“服湯(tang)二旬”,以“更(geng)適陰陽(yang)”,使病(bing)(bing)人(ren)(ren)恢(hui)復(fu)健(jian)康。秦越人(ren)(ren)和弟子(zi)子(zi)陽(yang)、子(zi)豹(bao)等,綜合(he)應用(yong)多種(zhong)療(liao)法,成為中國醫學史上(shang)進行(xing)辯證論治和施行(xing)全身(shen)綜合(he)治療(liao)的(de)奠基人(ren)(ren)。

司馬遷對秦越(yue)人在中國醫學(xue)上(shang)取得的卓越(yue)成(cheng)就作過高度評(ping)價,他(ta)說:“扁鵲言醫,守數精明,為方(fang)者宗,后世循(xun)序,弗能易也。”表明秦越(yue)人對中國醫學(xue)的形成(cheng)做出了(le)杰出的貢獻。

秦(qin)越(yue)人以卓越(yue)的醫療技術和高尚的醫德(de)醫風,在廣大民(min)眾中樹立(li)了崇(chong)高威信,使廣大民(min)眾產生了無(wu)限的敬仰,在全國各地為秦(qin)越(yue)人建立(li)的紀念性墓祠之(zhi)多、歷(li)史(shi)之(zhi)悠久、規模(mo)之(zhi)宏大,是(shi)歷(li)史(shi)罕見的。

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