从《伤寒论》研究“经学化”再视清代医学的寒温之争

Re-inspecting Debate on Cold and Warm Diseases in Qing Dynasty from Perspective of Canonization Studies on Shang Han Lun

在清代仲景圣化的背景下,医家们尊奉《伤寒论》为经典,使得《伤寒论》研究呈现经学化特点,即对仲景原文的注释和回归。这一研究特点也引发了伤寒与温病知识的革新,形成清代医学寒温争鸣的现象。一方面,《伤寒论》虽以论治冬季伤寒为主,但其中的六经辨证可被作为多种外感疾病,乃至所有疾病的治疗体系,包括温病在内;另一方面,温病知识脱离《伤寒论》文本,从而建构出区分于六经辨证、指导温病治疗的独立学说,并且通过突破季节、地域的限制和定义温病概念来拓展其应用范围。寒温争鸣的过程促进了外感病学术理论的进步,而其医学知识的生产、变革则与社会文化密切相关。

In the context of the sanctification of Zhang Zhongjing in the Qing Dynasty,physicians respected Shang Han Lun(《伤寒论》Treatise on Cold-Damage)as a canon,which made the studies of Shang Han Lun present the characteristics of canonization through annotation and adherence to Zhang Zhongjing’s original texts.This research feature also led to the innovation of knowledge on cold damage and warm diseases,forming the debate between cold and warm diseases in Qing medicine.On the one hand,although Shang Han Lun focused on treating cold damage in winter,the six-meridian differentiation can be employed as a treatment system for various exogenous febrile diseases and even all diseases,including warm diseases.On the other hand,the knowledge of warm diseases is separated from the text of Shang Han Lun,so as to construct an independent theory different from the six-meridian system to guide the treatment of warm diseases,and expand its application scope by breaking through the restrictions of seasons and regions and defining new concepts of warm diseases.The process of debate between cold and warm in medicine promotes the development of academic theory on exogenous diseases,and the production and innovation of relevant medical knowledge are closely related to specific social culture.