《御纂医宗金鉴·四诊心法要诀》学术特色浅探

Discussion on the Academic Characteristics of Yuzuan·The Golden Mirror of Medicine·Essentials of Four Diagnostic Methods

清代吴谦领头编纂的《御纂医宗金鉴》是传承数千年的中医药的理论研究精华与前人临床实践经验的集合,其中《四诊心法要诀》将望闻问切四诊的内容编为四言歌诀,内容全面,通俗易懂,能够达到“为医师者,由是而教;为弟子者,由是而学”的目的。其学术特色主要体现在望诊遵循《黄帝内经》之旨,五行配五色,望色以察神,色脉相合断预后;闻诊以五音为主,听声音可辨病性,尤以儿科多用;问诊重在问寒热之喜恶和二便之情况;脉诊以浮沉滑涩迟数作为提纲以应八纲,尤重右关脾胃,并提出妊娠可见代脉。《四诊心法要诀》对初学者不失为一本入门良书,如能“熟读习玩,揣摩日久,自能洞悉其妙”。

Compiled by Wu Qian in Qing Dynasty,the Yuzuan·The Golden Mirror of Medicine is a collection of theoretical research essence of traditional Chinese medicine which has been passed down for thousands of years and previous clinical practice experience.Among them,Essentials of Four Diagnostic Methods compiles the contents of four diagnoses of observation,hearing,asking and touching into four-character ballads,which is comprehensive and easy to understand,and can achieve the goal of“for doctors,teaching by reason”and“for the disciple,learning by being”.Its academic characteristics are mainly reflected in the observation and diagnosis following the purpose of Huangdi Neijing,the five elements matched with five colors,the observation of colors to check the spirit,and the combination of colors and pulse to judge the prognosis.The diagnoses of hearing are mainly based on five tones,and the disease nature can be distinguished by listening to sounds,especially in pediatrics.The diagnoses of asking focuses on the likes and dislikes of cold and heat as well as the two situations of defecation.The diagnoses of touching used floating,sinking,sliding,unsmooth and slow counting as the outline to address the eight cardinal guides,with particular emphasis on righting the spleen and stomach,and put forward that the generation pulse can be seen during pregnancy.Essentials of Four Diagnostic Methods is a good introductory book for beginners.If one can“read it carefully and ponder over it carefully,he will be able to understand its subtleties”.