清代名医雷逸仙临证经验管窥

Restricted view on the clinical experience of famous doctor LEI Yi-xian in Qing dynasty

雷逸仙为浙江清代名医,著有《逸仙医案》,其医案叙述虽简明,却能将医之至理蕴含其中,一言以蔽之。其古文辞功底深厚,弃儒习医后深窥轩岐之奥,熟稔《黄帝内经》理论,善用、活用经典条文阐释疾病的病因病机,先明析其医理,进而从容立治法、处方药。其四诊尤重诊脉,详窥证型预后,尝以脉象统四诊、以脉象定治则、以脉象测预后;明察六淫病因,细罗治法方药,治风温以清轻疏透为纲、治春温以解表透邪为先、治热病以甘寒护津为要。其处方药少量轻,但效如桴鼓,值得后世医家学习。

LEI Yi-xian,a famous doctor in Qing dynasty in Zhejiang,wrote of Yixian Medical Case.Although his medical case description was concise,it contained the supreme principles of medicine and always summed up in a word.LEI had a deep foundation in ancient poetry and prose,after abandoning confucianism and practicing medicine,he deeply saw Xuanqi’s mystery,and he was familiar with the theory of Huangdi Neijing,and made good use of the classic articles to explain the cause and pathogenesis of diseases.First analyzed the medical theory,then calmly determined the treatment and prescribed drugs.In his view,the four diagnoses were especially important for pulse diagnosis.And his prognosis of the syndrome type was detailed.He often based on the pulse condition to determine the four diagnostic criteria,the treatment principle and the prognosis.This book shows that LEI’s etiology of the six erosions was examined,and the treatment methods and prescriptions of his were detailed.He treated wind-warm syndrome with clear and light medicine to expel pathogenic factors and disperse wind-heat,which was the most important method,while in his opinion to curing spring-warm syndrome firstly was to induce sweat and eliminate evil.And he treated fever using sweet and cold medicine to protect fluid as the most important method.A small amount of prescription drugs were light,but their effects was as effective as hiting drums,which is worth learning by later doctors.