Case Records as Medical Stories: A Song-dynasty Doctor’s Narration of His Own Medicine-Xu Shuwei (1080-1154)

The key point in studying or teaching the history of Chinese medicine is on the doctrines underlying it and on its perception of the body,physiology,pathology,and its treatment.Namely,there is often a tendency to focus on reading and analysing the classical canons and therapy-related texts including formularies and materia medica collections.However,focusing on these sources provides us with a one-sided presentation of Chinese medicine.These primary sources lack the clinical down-to-earth know-how that encompasses medical treatment,which are represented,for instance,in the clinical rounds of modern medical schools.Our traditional focus on the medical canons and formularies provides almost no clinical knowledge,leaving us with a one-sided narrative that ignores how medicine and healing are actually practiced in the field.This paper focuses on the latter aspect of medicine from a historical perspective.Using written and visual sources dating to the Song dynasty,clinical encounters between doctors and patients including their families are depicted based on case records recorded by a physician,members of the patient’s family,and bystanders.This array of case records or case stories will enable us to narrate the interaction between physicians and patients both from the clinical perspective and from the social interaction.This paper will also discuss visual depictions of the medical encounter to provide another perspective for narrating medicine during the Song dynasty.Medical case records and paintings depicting medical encounters are exemplary of the potential of Chinese primary sources for narrative medicine.

Looking up Prescriptions to Treat Infectious Disease:Anti-epidemic Books of Medical Formularies and Epidemic Prevention and Control in the Qing Dynasty

Copying,compiling,publishing,disseminating,and referencing anti-epidemic books of medical formularies were common activities during the outbreak of epidemics in the Qing dynasty.Its emergence,motivated by epidemic disease again and again,was important component parts of epidemic prevention and control.They played a unique role as media on affairs such as treating patients suffering from infectious diseases,mobilizing peoples to make contributions to anti-epidemic activities,integrating and popularizing knowledge of epidemic prevention.Anti-epidemic books of medical formularies were important to link peoples,things,and substances related with epidemic prevention and control,and were a kind of motivation to actively deal with the infectious disease,control the epidemic,and maintain health.Compared to other common measures,anti-epidemic books of medical formularies participated in many prevention and control practices deeply,which actually built a low cost,spontaneous,dispersed and non-institutional system to respond to epidemic,and the system had characteristics of stronger conductibility,bigger coverage area,and better external benefits.

Acquisition and Dissemination of Anti-Epidemic Medical Prescriptions During the Outbreaks in the Qing Dynasty of China

During the epidemics in the Qing dynasty,many medical professionals,nonprofessionals,and social organizations collected and sorted medical prescriptions related to infectious diseases.These people also compiled,published,disseminated,and consulted related medical formularies.The above historical event can be viewed as the construction and dissemination of medical knowledge.They edited and published medical formularies on infectious diseases with lower cost and in flexible ways by taking the initiative and giving full scope to creativity.Diverse anti-epidemic medical prescriptions from these medical formularies can be used for infectious diseases in the event of the outbreaks.However,the therapeutic effects of classical prescriptions and folk recipes cannot be regarded as the same.The wide circulation of anti-epidemic medical prescriptions and medical formularies was essentially a process of epidemic prevention resource allocation.Not only did it enable many nonprofessionals to participate in epidemic prevention and control,but it also enhanced awareness,knowledge,and capacity for epidemic prevention at the individual level.At the same time,due to the uneven quality and individual differences in the physical fitness and condition of the prescriptions and formularies,they had the capacity of causing inconveniences to the readers or patients.

Tributary Medicine System of the Qing Dynasty: A Preliminary Study

Medicine was one of the articles of tribute paid by other countries and kingdoms to the imperial court of the Qing dynasty(1644–1912).The act of paying tributes and the rituals associated with it enhanced communication and helped establish relationships between ancient China and other nations or territories.The imperial court was generous in return,which attracted many countries to pay tributes.This paper analyzes how medicines as tributes played an important role in consolidating the dominant status of ancient China,and in promoting the exchange of knowledge between Chinese and Western medicine.

东方魔橱:1698年The China Cabinet里的中国医疗俗物

1698年,一只庋藏了众多医疗俗物及其他东方博物展品的中国橱柜(The China Cabinet)被捐赠予英国皇家学会,汉斯·斯隆在《哲学汇刊》上发表了对此柜的四篇解说。The China Cabinet内存储的“外科”用刀,修甲、采耳、按摩工具为重构明清中国民俗医疗器物史提供了宝贵的一手资料。在《哲学汇刊》大传统指引下,汉斯·斯隆借助“了解”“同情”的活态叙述、细致严谨的图像语言两项叙述技法成功地全景呈现了The China Cabinet所见中国民俗医疗图景。在表达过程中,包容互鉴的文明对话心态起到了基础而积极的效应。

医社、药市、信仰:明清杭州吴山的医疗社会

明清时期,经历代沿传累积,以杭州吴山及周边街区为中心,形成一个以医者、药商、民众为主体,包括医学、诊疗、药市、信仰等多维空间在内的医疗社会。在杭州的城市空间中,吴山处西湖东南之畔,又临杭州商业中心清河坊街,为人口密集、商业繁盛、文社汇聚之地。尤其特别之处,吴山为城中之山。山上庙宇林立,山顶平升处有药王庙矗立,既是药商同业祭祀聚会之处,又是民众祈拜安康之所。山间有侣山堂,是张志聪、高世栻等行医讲学处,亦为后人所言钱塘医派的主要活动地。吴山之侧还有名医汇集。在山下及坊街上,诸多知名药堂、药铺开设于此。时间序列上的累积,街区空间上的汇集,体现了医、病、药之间紧密的市场和社会关联,构建起以吴山为中心的医疗社会。这一医疗社会既呈现了以医者、药商为主体的医疗行业之链,也是杭州社会系统的重要构成部分,根植并嵌合于杭州的历史进程及民众的生活空间中。它既为在地民众提供公共医疗服务,也维系着医疗共同体的存续发展。明清杭州吴山的医疗社会的构成及其功能表明,“医疗社会”不只具有学科及认知意义,在一定时空范围内也是具化可见的历史实态。

清代河南刊刻医籍情况与种类特点研究

研究已发现的清代河南刊刻的医籍共19部,其中官刻医籍2部、坊刻医籍12部、私刻医籍5部。书籍内容全面,涉及临床各科,《经验救急良方》为方书著作,《豫医双璧》为伤寒类和攻邪派医家著作,《针灸易学》为针灸类著作,《七十二翻症》为中医内科急症著作,《胎产心法》《达生编纂要》《庄氏福幼编遂生编》《傅青主男女科全编》为中医妇科、儿科、男科著作,《寿亲养老新书》《生生理言》《卫生易筋经》为中医养生学著作,《瘟疫条辨摘略》为温病学著作,《外科证治全书》《外科证治全生集》为中医外科著作,《保赤推拿法》为推拿学著作,《加减回生第一仙丹经验良方》为骨伤科著作,《洄溪医案》《笔花医镜》则涉及中医内、外、妇、儿各科。但与同时代刊刻的其他书籍相比,医籍的刊印数量相对较少,刊刻地主要在开封,以坊刻本居多,著者以省外医家为主,虽然未能全面勾勒出清代河南籍医家著作的整体风貌,但仍然起到了保存中医著作文本,促进中医学术传承,推动中医学科发展,丰富中原医学文化,普及中医科学知识的作用,是了解清代河南中医药事业发展的重要载体。

明清小说情节涉医描写的叙事意义

医学与叙事关系密切,中国古代小说有诸多涉医描写,在故事中发挥重要作用,成为情节展开的叙事动力。《金瓶梅》中的李瓶儿、《红楼梦》中的秦可卿之死,情节结构呈现因果链条,但前者显露、后者隐微;而不少明清小说的涉医情节是由巧合和偶然行为组合而成,出人意料的情节发展往往是某种观念的图解。生老病死是人的生命历程,也是小说常见内容,涉医叙事在小说中意义重大。

明清时期白山土司官族教育的多维透视——以《白山司志》为中心的考察

《白山司志》作为一部专门记述白山司域自然和社会的历史与现状的综合性著作,其中部分史料真实反映出明清时期白山土司官族教育的历史情形。白山司域统治者对官族子弟的教育极为重视,通过派送子弟入官学学习、培养崇文重教家风和营造人文环境等方式对官族子弟进行教育,旨在提高整个白山司域官族的文化素养,进而逐渐融入汉文化知识体系中,构建国家认同意识。明清时期白山司域官族教育的发展具有明显的社会等级特征,对官族的教育侧重提升土司承袭人的文化水平,而将科举取士作为次要目的。以《白山司志》为中心对明清时期白山土司的官族教育进行多维度探析,不仅为区域教育史研究开拓了新的领域,而且还为中华民族交流交往交融史研究提供了一个新的视角和微观切入点,因而具有相当重要的学术价值和现实意义。

清代木匠索欠纠纷及其日常生活——以乾嘉刑科题本为基本资料

木匠作为“打工人”,是清代社会重要的群体,木匠手艺也是人们重要的谋生手段。清朝刑科题本土地债务类档案,有关于木匠的纠纷多发生在债务的索欠方面。木匠往往在家工作,为乡民服务。木匠到外地谋生,开张木匠铺,也是流动性较大的职业。木匠既会与房东产生纠纷,也会与雇主和产品的买主发生纠纷。木匠师傅往往带徒或找帮手工作,他们之间也会发生纠纷。木匠与他人的交往中也会产生纠纷。中年木匠未婚者可能收入微薄,经济能力有限。木匠往往兼营农业。

RECONSTRUCTION OF THE EIGHTEENTH CENTURY SUMMER MONTHLY PRECIPITATION SERIES OF NANJING,SUZHOU,AND HANGZHOU USING THE CLEAR AND RAIN RECORDS OF QING DYNASTY”

In this study the Qing weather records 'Clear and Rain Records' were used to reconstruct the 18th century summer (June-August) precipitation and monthly precipitation series of May, June, July, and August. The nature of these records and the techniquc of transforming them into numerical codes are described. The procedure of converting these descriptive records into quantitative monthly precipitation and its scientific basis are given in detail. The reliability of the obtaind precipitation series is also ex- amined.

基于数据挖掘技术探讨《清宫医案集成》治疗不寐的用药规律

目的:以数据挖掘技术为基础,探讨《清宫医案集成》中治疗不寐的用药和配伍规律。方法:将《清宫医案集成》中治疗不寐的处方进行整理,在古今医案云平台提供的Excel 2010软件模板上建立处方数据库,通过古今医案云平台对数据进行频数统计、关联规则分析、聚类分析及复杂网络分析。结果:共筛选出345首处方、275味药物;经关联规则分析,对纳入的中药数据进行中药配伍关联分析,筛选出共现频次≥40次的中药,同时设置置信度≥0.6、支持度≥0.2,最终得到13条关联规则数据。高频药物间生成5组聚类组合,核心处方包括白术、白芍、茯神、当归、甘草。结论:《清宫医案集成》中清代宫廷御医治疗不寐,具有气血同治、调心安神、重视肝脾的用药特点。

明清齐鲁针灸发展特点及背景探究

明清时期,齐鲁医家众多,著述宏富,其中包含《经络汇编释义》《经穴解》《针灸阐岐》等针灸专著;针灸治疗范围拓宽,涉及临证各科;针灸学传承与创新并举,且注重知识普及。这一时期,古籍文献的整理与保护、医学教育的推动、印刷技术的推广应用、医学书籍的普及以及传统思想文化的影响对齐鲁针灸的发展起到了有力的支持和促进作用。参考文献39篇。

秦伯未与《清代名医医案精华》诊治咳嗽的经验挖掘与对比研究

目的探析中医名家秦伯未与其所编著的《清代名医医案精华》中诊治咳嗽的经验,通过对比尝试寻求其学术渊源及特点,并为现代临床提供参考。方法查阅、筛选并录入现存于东直门医院病案室的秦伯未查房记录、出版书籍及《清代名医医案精华》中的咳嗽医案,统计医案与处方数量、临床表现与药物出现频次、频率等信息,并进行关联规则分析、聚类分析及复杂网络分析,再结合清代名医医案文本内容及秦伯未著作中对咳嗽的认识,与挖掘结果互参、互证、互补,从而总结秦伯未与清代名医诊治咳嗽的思路与经验。结果共获得秦伯未治疗咳嗽的医案51份,处方81首以及《清代名医医案精华》中7位医家治疗咳嗽的医案73份,处方91首。通过挖掘分析结合内容分析,可将秦伯未诊治咳嗽的主要思路总结为:咳分外内脏腑,治需标本兼顾;标在痰阻气逆,宣肺降气化痰;本于外感内伤,尚应审因论治。清代名医诊治咳嗽则亦重顺气化痰,多用培土生金;亦分外内脏腑,重视五行生克。结论秦伯未与清代名医诊治咳嗽均重视外邪、内伤、脏腑咳的分类以及顺气化痰法的使用,秦伯未以理气化痰止咳为核心,并细分病因而治;清代名医则多用培土生金之法,并重视五行生克。二者的诊疗经验对现代临床较少关注的伤暑、伤湿及外寒内热等外感咳嗽,食积、瘀血、心火、肝气、胃寒、肾虚等内伤咳嗽以及脏腑咳的辨治可提供有益启发。

《清宫医案集成》中熏洗方运用初探

[目的]探究《清宫医案集成》中熏洗方治疗疾病的特殊性和有效性,为现代临床外治法提供参考。[方法]以《清宫医案集成》中117首熏洗方为研究对象,运用Excel软件,对清宫熏洗方的组成、剂量、药性、功效进行整理统计,并结合该书中的相关医案及按语,对熏洗方在清宫中的特色运用进行系统整理。[结果]《清宫医案集成》中的117首宫廷熏洗方在遣方用药上展现出种类繁多、质量上乘,方简药精、效专力宏,随证加减、用药灵活,治病为先、不拘药量,善用风药、不避毒药等多种特色;且另有受众广泛、方式独特、器具考究、药液制备过程细致等其他优势。[结论]《清宫医案集成》中的熏洗方颇具宫廷特色及优势,对其运用展开探索能够获得独特的见解和启示,有助于发扬宫廷用药特色,促进中医药外治疗法的发展,具有较高的研究价值。

宋校本《备急千金要方》对校法校勘记探析

以《新雕孙真人千金方》(简称“新雕本”)为参照,对北宋校正医书局所校的《备急千金要方》(简称“宋校本”)中的对校法校勘记(记述校勘情况的文字)进行探析,发现宋校本的校勘记漏注、误注之处较多,其对异文学术价值的判断及对异文注存取舍的标准有待研究;宋校本部分校勘记与新雕本内容相合,推测宋臣校书时参考了该版本;宋臣整理该书时未确定具体的底本与校本,而是汇集多种唐写本,参考唐及唐以前多部医籍重编而成。结合校正医书局以文士儒臣主导校书工作的特殊性,认为宋校本成书过程中的复杂性及其文本内容的不确定性值得重视;有必要进一步理清宋校本版本源流、基本构成、引用文献及引用方式等基本问题,以期为正确认识其版本特点、有效利用其文献资料等提供参考。

岭南医家刘渊《医学纂要》中风辨治探析

清代岭南医家刘渊所撰的《医学纂要》是一本既言其验、又探其要的综合性医著。《医学纂要》对于中风的辨治既传承了张仲景与张景岳的理论与观点,又在遣方用药中体现了创新。刘渊在辨治中风时,从痰论治,调补脾肾;在仲景六经辨证的基础上,结合自身临证经验,创立了针对中风的六经证治;秉承标本分治的原则,治疗中风区分急缓,辨别急危重症。治疗中风用药时,继承张景岳“补虚不离桂附”之思路,或佐以肉桂与附子以追散失的元阳、生无根之气,或佐以桂枝与附子以通畅血脉,使寒邪自除;遣方用药多采用人参、黄芪、当归、川芎、白芍以补气养血,调补人体气血阴阳。

清后期笔帖式的发展嬗变及其原因探析

笔帖式是清代官僚体系中的一个重要官职。为保障旗人仕进之路的通畅宽裕,清统治者特意为八旗子弟开辟了笔帖式入仕这一选官路径,以提高旗人的入仕数量,确保旗人群体的政治参与度。清后期,清政府官制改革,改笔帖式为录事,使得笔帖式的设置职掌发生了一定的嬗变,对清代的旗人入仕产生了重要影响。

清代南部县衙户房档案俗语词考释四则

《清代南部县衙门档案》为地方手写文献,内中俗语词数量繁多,不利于档案的阅读与研究。“钏”“撇”“提比”“京斗”四则俗语词意义容易误判。据语境、相关文献和历史,“钏”为“串”,“撇”为“耍赖;骗取”,“提比”为“提取犯人到堂审讯”,“京斗”为“明清部颁标准仓斛,即以京城广泛使用的升斗作标准容器计量”。

数字人文视角下语料库在清代黄河问题研究中的应用

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