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《王孟英医案》之"因时制宜"与"舍时从证"新解

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[目的]探析晚清浙派中医王孟英的时间医学思想.[方法]利用文献研究法,筛选《王孟英医案》中涉及"时间"因素之条文并研读,从"因时制宜"和"舍时从证"两个角度入手探究"时间"因素的"常"与"变",以把握临床辨证论治的核心内容.[结果]"因时制宜"和"舍时从证"构成了王孟英时间医学的核心内容.当病证性质与时间因素相符时,王氏认为需顺从时间因素辨证论治,其内涵有二:顺四时节律施治,顺人体节律施治.当病证性质与时间因素不符时,须舍弃时间因素,从证施治,其内涵有三:舍四时节律从证,舍人体节律从证,舍运气节律从证.[结论]王孟英对"时间"因素的论述丰富而颇具特色,从"因时制宜"和"舍时从证"两个角度论述了"时间"因素在辨证施治中的"常"与"变",可为当今疾病诊疗工作提供借鉴,并丰富了浙派中医的学术内容.
Discussion on"According to the Time"and"Syndrome Focus Instead of Time"in WANG Mengying's Medical Records
[Objective]To explore the time medical thought of WANG Mengying,a Zhejiang traditional Chinese medicine doctor,in the late Qing Dynasty.[Methods]By means of literature research,WANG Mengying's articles related to time were screened and studied,and studying the"constant"and"change"of"time"factors from the perspectives of"according to the time"and"according to the syndrome instead of time",so as to grasp the core content of clinical syndrome differentiation and treatment.[Results]"According to time"and"syndrome focus instead of time"constituted the core content of WANG Mengying's time medicine.When the nature of the disease was consistent with the time factor,WANG believed that it was necessary to follow the time factor,which had two connotations:following the four seasonal rhythm and following the human rhythm.When the nature of the disease syndrome was inconsistent with the time factor,it must abandon the time factor and make treatment from the syndrome.It had three connotations:following the syndrome instead of the four seasonal rhythm,following the syndrome instead of the human rhythm,following the syndrome instead of the five movements and six Qi.[Conclusion]WANG Mengying's discussion on the"time"factor was rich and distinctive.From the perspectives of"according to the time"and"syndrome focus instead of time",WANG discussed the"constant"and"change"in treatment based on syndrome differentiation,it can provide reference for the current diseases diagnosis and treatment,and enrich the academic content of Zhejiang traditional Chinese medicine.

WANG Mengying's Medical RecordsTCM chronomedicinefour seasonal rhythmbody rhythmaccording to the timesyndrome focus instead of timetreatment based on syndrome differentiationTCM of Zhejiang faction

赵燕、李良松

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北京中医药大学国学院 北京 102488

《王孟英医案》 中医时间医学 四时节律 人体节律 因时制宜 舍时从证 辨证论治 浙派中医

2024

浙江中医药大学学报
浙江中医药大学

浙江中医药大学学报

CSTPCD
影响因子:1.049
ISSN:1005-5509
年,卷(期):2024.48(9)