论李杲医学的易理基础

On the Changes-related Principles in Li Gao’s Theory of Traditional Chinese Medicine

李杲是金元医学四大家之一,易学为其医学提供了哲理依据。在他看来,天地自然的运化法则就是人体生命的生化机制,易理与医理是一致的。首先,他参照《周易》的乾健坤顺、乾刚坤柔和泰卦的乾坤升降之理,并吸收张载易学的相关内容,论述了脾胃升降浮沉的医学思想;其次,他以易学的阴阳互根互用思想解释人体生理的变化机制;再次,他引入具体的卦象来阐释医理,如以坤土统合脾胃、胞、手厥阴心包,以震卦论述荷叶的药理作用,以离卦论肝脏与目之生理;最后,他依据易学的象思维,结合《内经》的药学及相关理论建立了自己的中医药性学及用药理论。

Li Gao(1180-1251)is one of the four masters of TCM(Traditional Chinese Medicine)in the Jin(1115-1234)and Yuan(1271-1368)dynasties,and his study of Zhou yi provided a philosophical basis for his theory of TCM.In his view,the operational law of nature is the producing and transforming mechanism of human life,and the principles of Changes and the principles of TCM are the same.First of all,he discussed the characteristics of spleen and stomach with reference to robust and virile Qian[■]and submissive and gentle Kun[■],the principle of rising and falling of Qian[■]and Kun[■]in hexagram Tai[■],Peace and Communication,[11],and absorbed relevant contents from Zhang Zai’s(1020-1077)study of Changes.Second,he explained the mechanism of human physiological transformations with patterns of mutual interaction attributed to yin and yang in Changes scholarship.Third,he introduced specific hexagram and trigram images to explain TCM principles,such as using attribution of Earth of Kun[■]to integrate spleen,stomach,pericardium,and the heart meridian,using trigam Zhen[■]to discuss pharmacological effects of lotus leaf,applying trigram Li[■]to the discussion of the physiology of liver and eyes.Lastly,on the basis of the imagistic thinking in the Zhou Changes and related theories in the Yellow Emperor’s Canon of Internal Medicine,he established his own theory concerning properties of herbal medicine and pharmacy.