张元素对《黄帝内经》运气学说的继承与发展

ZHANG Yuansu's Inheritance and Development of the Doctrine of Five Evolutive Phases and Six Climatic Factors in the Inner Canon of Yellow Emperor(《黄帝内经》)

《黄帝内经》中“运气学说”篇幅宏大,约占《素问》篇幅的近1/4,其所涉病机、治疗等内容具有极高的指导价值与实践意义。基于易水学派张元素医学著作《医学启源》,运用考据学的方法,探讨其对《黄帝内经》运气学说的继承与发展。认为张元素在充分继承运气学说的基础上,敢于突破、勇于创新,以“六气主治要法”统括运气学说中“六气为病”之繁,以“气味厚薄寒热阴阳升降之图”阐明运气学说之气味升降理论,以“五行制方生克法”统括运气学说之五味治法,并据此创立了以“脏腑议病制方”与“药类法象”为特色的“理-法-方-药”论治体系,由此开创了对后世影响至深的易水学派。

The doctrine of five evolutive phases and six climatic factors(abbreviated as the doctrine)is described in large amount of text in the Inner Canon of Yellow Emperor(《黄帝内经》),accounting for nearly 1/4 of the length of Basic Questions(《素问》).The description of pathological mechanism,treatment and others have extremely high value for guiding the clinical practice.Based on the classic Origins of Medicine(《医学启源》)by ZHANG Yuansu of the Yishui(易水)School,this paper discussed his inheritance and development of the doctrine in the Inner Canon of Yellow Emperor,using the method of textual research.It is believed that ZHANG Yuansu not only takes full advantages of the doctrine,but dares to break through and innovate.He uses the“the main treatment method of six qi”to unify the complexity of“six qi as a disease”in the doctrine,and clarifies the ascending and descending theory of qi and flavor in the doctrine with“the diagram of the ups and downs of yin and yang,the thick and the thin,the cold and the hot”,and uses“preparation based on five phases and generation and restriction cycles”to govern the treatment method of the five flavors in the doctrine.Based on these,he establishes the system of theory-law-prescription-medicine,which is characterized by“differentiation of the diseases and prescription of the formulas based on zang-fu(脏腑)organs”and“understanding the herbal medicine with analogy”,and has created the Yishui School with a profound influence on later generations.