《医林改错》一书的学习与活血化瘀方药的运用

Study of Yilin Gaicuo and Applicatioin of Drugs and Prescriptions of Activating Blood Circulation and Removing Stasis

关键词:  《医林改错》  活血化瘀  临床应用

Key words:  Yilin Gaicuo  Huoxu Huayu  clinical application

摘要:

《医林改错》是清代医家王清任的著作。该书的主要学术特点及对临床指导意义在于:1)业医诊病,当先明脏腑;2)阐发气血理论,创立脑髓学说;3)理论联系实际,创立多首名方。学习该书,首先要学习王清任师古不泥,学有创意,从实践中寻求真知的精神;其次,要学习王清任善于在临证观察中发现问题和解决问题的方法;再者,要认真领悟王清任最为擅长的活血化瘀方药的立法和组方思路。笔者以脑窍通方、清脑通络方、通脉舒络汤、血府逐瘀汤、膈下逐瘀汤、少腹逐瘀汤和身痛逐瘀汤为例略述活血化瘀方药在临床的应用。

Abstract:

Yilin Gaicuo(Correction on the Errors of Medical Works)is a work of WANG Qing-ren in Qing dynasty.The main academic characteristic and clinical guiding effect consist in three aspects:1)putting the differentiation of ZANG-FU Organ on the first place in diagnosis of disease,2)elucidating the Qi-Xue(vital energy and blood)theory and creating a theory of brain-spinal cord,3)associating the theory and practice to set up several famous prescriptions.In the study of the book we should learn the spirit of seeking after the truth from the practice and learning from the teachings of the ancient medical master without adhering to them at first.Secondly,learn the methods of discovering and resolving the problem from the clinical observation.Finally,earnestly understand the working out a principle of therapy and train of thought of the drugs and prescriptions of Huoxu Huayu(activating blood circulation and removing stasis),which is the forte of WANG Qing-ren.Taking Naoqiao-tong(dredging brain-orifice)prescription,Qingnao Tongluo(clearing brain and dredging collateral)prescription,Tongmai Shuluo(dredging the meridian and dispersing collateral)prescription,Xuefu Zhuyu(removing blood stasis in the house of blood)decoction,Gexia Zhuyu(removing blood stasis below diaphragm)decoction,Shaofu Zhuyu(removing blood stasis in lower abdomen)decoction and Shentong Zhuyu(removing blood stasis for treating pantalgia)decoction as the examples the clinical application of the drugs and prescriptions of Huoxue Huayu has been described briefly.