探中西结合新门径——议王清任《医林改错》

Exploration of the new path of combination of traditional Chinese and Western medicine:a review of Wang Qingren′s Correction on the Errors of Medical Works

清代著名医家王清任,躬身临床实践四十二载,将其一生的医学理论和实践经验凝结为《医林改错》,成为其唯一的传世之作,并创新性地提出“业医诊病,当先明脏腑”的评述。作为我国医学发展史上中西结合的先行者,王清任在书中一改先前传统中医学的宏观辨证和理论推演模式,基于传统,别开法门,从脏腑结构出发,构建脏腑理论模型,将宏观思辨与微观气化论相结合,以外在脏腑解剖生理功能推断人体内在气血运行的规律,并在此基础上立补气与逐瘀大法,创活血化瘀类名方。王清任凭借批判求实的精神,采取观察、实验、对比等实践方法引导我们从全新的脏腑结构形态角度审视中医机能,打破了中医学仅凭望、闻、问、切诊断疾病的局限,形成以人体解剖为生理基础的辨证特色,创新性地开辟了中医学理论和实践的新领域,为中西医结合治疗相关疾病提供了新思路。

Wang Qingren,a famous doctor of the Qing Dynasty,devotes himself to clinical practice for 42 years and condenses his life′s medical theory and practical experience into Correction on the Errors of Medical Works,which has become his only book handed down from time to time.He innovatively puts forward the comments that the diagnosis of disease should be based on the differentiation and treatment of zangfu organs.Wang Qingren,as the pioneer of the integration of traditional Chinese and Western medicine in the history of Chinese medicine development,changes the traditional Chinese medicine′s emphasis on macroscopic syndrome differentiation and theoretical deduction in the book.Based on the tradition,Wang Qingren creates a new method to construct the zangfu theoretical model from the zangfu′s structure,which combines macroscopic syndrome differentiation with microscopic Qi-transformation theory.Wang Qingren inferres the circulation law of Qi and blood movement based on the anatomical and physiological functions of the zangfu organs.Then he establishes the method of replenishing Qi and removing blood stasis and creates famous formulas for promoting blood circulation and removing blood stasis.With the spirit of being critical and realistic,Wang Qingren guides us to examine the function of TCM from a new perspective of the structure and morphology of zangfu organs by means of observation,experiment and comparison.He breaks the limitation of TCM to treat diseases only by observation,listening and smelling,inquiring and palpation,forms the syndrome differentiation characteristic based on human anatomy,and innovatively opens up a new field of TCM theory and practice.It provides a new idea for the treatment of related diseases with integrated traditional Chinese and Western medicine.