日本“安政霍乱”时期汉方医家的研究与心得  

Research and Experience of Kampo Medicine Practitioners during the"Ansei Cholera"Pandemic in Japan

作　　者：曾毅 肖永芝[1] ZENG Yi;XIAO Yongzhi(China Institute for History of Medicine and Medical Literature,China Academy of Chinese Medical Sciences,Beijing 100700,China;Postdoctoral Research Station,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院中国医史文献研究所,北京100700 [2]中国中医科学院博士后流动站,北京100700

出　　处：《中医药导报》2024年第7期6-11,共6页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家社会科学基金重大项目(20&ZD222)。

摘　　要：1858-1860年日本霍乱大流行时期,長松文忠、奥田実、浅田宗伯、大村宽、高嶋久貫、马杉质、菅間元章、和爾子譲、尾台榕堂等9位汉方医家通过临床探索、参阅中国医籍、实地调研,研究和总结了霍乱的病因、病机,成功治愈霍乱并撰写了相关著作。9位汉方医家均意识到霍乱有别于《黄帝内经》等典籍中的传统“霍乱”。他们主张,霍乱源于非常之气;霍乱为外感病,多见实证,临床采用汗、吐、泻、温、清、外治等法。9位汉方医家在著作中总结各自的心得,展示他们诊疗霍乱的独到经验,主要包括:以患者的腹泻物性状、发热与否、是否腹痛区分霍乱与一般急性胃肠道疾病;尺泽及委中穴有血络隆起是霍乱将要发作的征兆,急以刺络法令泻其血,减少患者病重的可能;患者尺脉洪大,是当用生石膏之脉,尺脉沉实且腹部胀满,则是应用大黄之脉;患者剧烈的呕吐是治疗霍乱的一大难点,可用葛根加半夏汤倍生姜,或以罂粟壳为君药的济世饮,或冷服小半夏加茯苓汤,以期减缓呕吐症状,令患者能够接受后续治疗。During the cholera pandemic in Japan from 1858 to 1860,nine Kampo medicine practitioners,including Nagamatsu Bunchuu,Okuda Minoru,Asada Souhaku,Omura Hiroshi,Takashima Hisatsura,Masugi Shichi,Sugama Motoaki,Wani Tadatane,and Odai Youdou,studied and summarized the etiology and pathogenesis of cholera through clinical exploration,reference to Chinese medical records,and field research.They successfully cured cholera and wrote related works.The nine Kampo medicine practitioners all realized that cholera was different from Huoluan(gastrointestinal diseases with symptoms such as severe vomiting,diarrhea,and abdominal pain)in classics such as the Huangdi Neijing.They advocated that the causes of cholera were extraordinary qi;Cholera was exogenous disease and mainly sthenia syndrome.It should be eliminated pathogens or treated with methods like diaphoresis,emesis,purgation,warming,clearing,or external therapy.The nine Kampo medicine practitioners summarized their own experiences and demonstrated their unique experience in diagnosing and treating cholera.Cholera can be distinguished from general acute gastrointestinal diseases based on the patient's excrement,fever,and abdominal pain.The swelling of congestive collaterals at the Chize(LU 5)and Weizhong(BL 40)was a sign that cholera was about to attack.Bloodletting immediately can reduce the likelihood of severe illness in patients.If the patients'chi pulse were large and bounding,they should be treated with Shigao(gypsum).If the patients'chi pulse were sunken and forceful,with abdomen distending,they should be treated with Dahuang(rhubarb root and rhizome).Severe vomiting in patients was a major challenge in the treatment of cholera.It can be treated with Gegen Jiabanxia decoction(葛根加半夏汤)with doubled Shengjiang(fresh ginger),or Jishi Yin(济世饮)with Yinsuqiao(opium poppy shell)as the sovereign drug,or cold Xiaobanxia Jiafuling Decoction(小半夏加茯苓汤)to alleviate vomiting symptoms and enable patients to receive subsequent treatment.

关 键 词：霍乱 “安政霍乱” 汉方医学 文献研究 

分 类 号：R254.7[医药卫生—中医内科学]