儒学化与地域化:明清温病学说的建构

Confucianization and Regionalization: The Construction of the Theory Concerning Febrile Diseases in the Ming and Qing Dynasties

在宋元以来中医发展儒学化的背景下,明清医家借由文献散亡之说,来解读张仲景《伤寒论》治疗温病的缺失;通过师仲景之法而不拘泥于具体的方药之说,来维护仲景的医圣地位和《伤寒论》的经典价值。以吴鞠通为代表,明清温病医家对中医学术发展史进行了全新的梳理,构建了自张仲景直接到明清医家的温病学术传承脉络,其间的晋唐宋元医家虽有启迪之处,但并未真正承接仲景之学。这与宋儒重新梳理儒学脉络,进而建构由孔孟直至宋儒的新道统,其背后的思维模式是相类似的。地域的南北差异,是明清温病医家阐发温病证治应当有别于伤寒的重要立论点。但温病学说若想获得更大的应用空间,增强学说应用的南北普适性,就必须突破地域化的束缚,才能获得更大的认可。尽管并非所有明清温病医家都拥有消解地域化的宏图,但不少医家也作出了一些努力和尝试。

In the Confucianization of traditional Chinese medicine(TCM)since the Song and Yuan Dynasties,medical practitioners interpreted and justified the deficiency and failures to cure febrile diseases in Zhang Zhongjing’s The Treatise on Cold Damage Diseases(伤寒论)by arguing the loss of documents.They attempted to defend the status of Zhongjing as a medical sage as well as the classical value of the treatise by learning his macro therapeutic principle,but not sticking to specific prescriptions.With Wu Jutong as the representative,the medical practitioners of febrile diseases in the Ming and Qing Dynasties offered a new description about the historical academic development of TCM,and constructed the academic heritage of febrile diseases from Zhang Zhongjing to the medical practitioners of the Ming and Qing Dynasties.Although the medical practitioners of the Jin,Tang,Song and Yuan Dynasties had provided some enlightening ideas about these developments,in reality,they didn’t genuinely inherit Zhang Zhongjing’s scholarship.This was similar to the way in which the Confucians in the Song Dynasty reconstructed the historical development of Confucianism,and then constructed the new orthodoxy from Confucius and Mencius.Additionally,the regional difference between the North and the South was an important factor for the medical practitioners of febrile diseases in Ming and Qing Dynasties to clarify that the syndrome and treatment of febrile diseases should contrast from those of the cold damage diseases.However,if the theory concerning febrile diseases sought to gain greater application space and enhance the universality for its application in China’s North and South,it had to eliminate the constraints of regionalization in order to obtain greater recognition.Although not all the medical practitioners of febrile diseases in the Ming and Qing Dynasties shared the ambition to eliminate regionalization problems,many of them made attempts.