山东儿科名医张銮及其《幼科诗赋》的价值

Shandong Renowned Pediatrician ZHANG Luan and Value of His Poems on Pediatrics

《幼科诗赋》是清代张銮的著述,该书以诗赋论小儿疾病为特色。缕述了张銮生平及其著述,考证出《幼科诗赋》成书于1750年到1764年间,并分析了现存青山堂抄本、积善堂刻本及淄博市图书馆藏清抄本,发现其共同祖本应为已佚的乐善堂写样本。张銮在咽喉治法方面,提出上病下治的诊疗观点,并总结出了灶底抽薪、引龙入海、引火归元三种治疗方法;在急惊风方面,张銮指出小儿急惊风的核心病理机制为热邪,治疗上,当以退热为先;在小儿脉法方面,张銮根据诊病小儿多哭闹的特点,主张以脉力强弱判断小儿的虚实寒热;在危重症方面,张銮以“赋”的形式,探析了小儿危重症候与脏腑之间的关系。最后,从诗赋可人、浅显易诵、津逮后学三个角度论述了该书的传播价值。

Poems on Pediatrics,written by ZHANG Luan in the Qing Dynasty,is characterized by poems on children’s diseases.This paper gave a detailed account of ZHANG Luan’s life and works,and found out that Poems on Pediatrics was written between 1750 and 1764,and analyzed the common ancestor of the existing Qingshantang codex,Jishantang codex and the Qing codex collected in Zibo City Library.In terms of treatment of throat and larynx ailments,ZHANG Luan put forward the diagnosis and treatment viewpoint of focusing on the lower body to treat upper disorders,summarized as three therapeutic methods of taking away firewood from under cauldron,guiding dragon into sea,and returning fire to its origin.In terms of acute convulsions,ZHANG Luan pointed out that the core pathogenesis of acute convulsions in children is pathogenic heat,and reducing heat should be the priority in the treatment.In terms of children’s pulse diagnosis,ZHANG Luan advocated that the strength of the pulse should be used to judge children’s deficiency,excess,cold and heat according to the characteristics of children who cry often.In terms of critical syndrome,ZHANG Luan analyzed the relationship between children’s critical syndrome and Zangfu organs in the form of“Fu”.Finally,this paper discussed the communication value of this book from three aspects:charming poems,simple and easy to read,and guiding the later scholars.