王孟英是清代著名的溫病大家,王氏不僅總結(jié)自己臨證醫(yī)案,而且還注重學(xué)習(xí)借鑒前人醫(yī)案,并將其心得體會(huì)以評(píng)注 / 按語方式附在醫(yī)案之中或案末。王氏評(píng)析古人醫(yī)案以俞震的《古今醫(yī)案按》為主,兼及徐大椿的《洄溪醫(yī)案》、沈又彭的《沈氏女科輯要》,現(xiàn)將王氏評(píng)選醫(yī)案匯集成冊(cè),按內(nèi)科(肺系、心系、脾胃、肝膽、腎系、氣血津液、肢體經(jīng)絡(luò)、其他)、婦科(月經(jīng)病、帶下病、妊娠病、生產(chǎn)與產(chǎn)后病、乳房疾。、兒科(十四歲及十四歲以下)、外科(瘡瘍、斑疹、麻疹、面赤)、五官科(眼、耳、鼻、口齒、咽喉)分類,整理成《王孟英評(píng)點(diǎn)古今醫(yī)案》,冀期對(duì)于研究王孟英學(xué)術(shù)思想與臨證思路有所裨益。
從王孟英評(píng)點(diǎn)醫(yī)案中,讀出臨床大家的診療思路
王士雄(1808 1868), 字孟英 , 號(hào)潛齋 , 又號(hào)夢(mèng)隱、半癡山人、睡鄉(xiāng)散人、隨息居隱士 , 海昌野云氏 , 清代浙江海寧人 , 咸豐年間徙居上海。王氏出身中醫(yī)世家 , 學(xué)有淵源。曾祖王學(xué)權(quán)倡導(dǎo)中西醫(yī)匯通 , 著《重慶堂隨筆》;祖父王國(guó)祥、父親王升均為良醫(yī)。王氏十四歲喪父 , 家境貧寒 , 后蒙父親摯友金履思幫助 , 到金華充任鹽行會(huì)計(jì) , 因酷嗜醫(yī)學(xué) , 稍有余暇輒披閱方書。治學(xué)主張博采眾長(zhǎng),究心《靈》《素》, 晝夜考察 , 直造精微。(《海寧州志》)編纂《溫?zé)峤?jīng)緯》《隨息居重訂霍亂論》《四科簡(jiǎn)要方》《潛齋簡(jiǎn)效方》《乘桴醫(yī)影》《隨息居飲食譜》《歸硯錄》《王氏醫(yī)案》《王氏醫(yī)案續(xù)編》《王氏醫(yī)案三編》,并評(píng)注沈堯封的《女科輯要》、裴一中的《言醫(yī)選評(píng)》、史縉臣的《愿體醫(yī)話》、徐大椿的《洄溪醫(yī)案》,還將魏玉璜的《續(xù)名醫(yī)類案》中按語評(píng)注后易名為《柳洲醫(yī)話》、徐大椿的《慎疾芻言》評(píng)注后易名為《醫(yī)砭》、俞震的《古今醫(yī)案按》評(píng)注并加以增補(bǔ)發(fā)揮輯為《古今醫(yī)案選》。
王氏學(xué)術(shù)上闡發(fā)暑病辨治規(guī)律,辨析伏氣溫病,探討霍亂發(fā)病機(jī)制,詳究飲食療法。強(qiáng)調(diào)理論與臨床實(shí)踐相結(jié)合,重視臨床 , 擅長(zhǎng)辨治內(nèi)科、婦科、兒科及溫病,尤其是注重總結(jié)臨證醫(yī)案,編寫醫(yī)案專著《王氏醫(yī)案》(原名《回春錄》)、《王氏醫(yī)案續(xù)編》(原名《仁術(shù)志》)、《王氏醫(yī)案三編》,醫(yī)案記錄完備,包括患者姓名、年齡、就診時(shí)間或發(fā)病季節(jié)、臨床證候與特征、失治誤治原因、辨證 / 病思路、方藥加減、療程與療效等。如 :仲冬大雪連朝,積厚丈許,嚴(yán)寒久凍,西湖可行車馬。斯時(shí)也,盛少云患痰嗽夜熱,自汗不寐,左脅痛如針刺,肌削不饑,自問不起矣。請(qǐng)孟英托以后事,及診其脈,許以可生。蓋病來雖惡,未經(jīng)誤藥也。與固本加龜板、鱉甲、蓯蓉、知、柏、青黛、石斛、花粉、白芍、楝實(shí)、海石、旋覆、貝母、蛤殼、牛膝,出入為大劑,投之即效。連服四五十帖而痊。予謂斯證患于斯時(shí),若經(jīng)別手,未有不投溫補(bǔ)者,而少云能與孟英游,其亦具眼之人乎?此真所謂患難交,不可不留心于平日也。然亦不能人人而遇之,殆佛氏所謂有緣存乎其間歟?(王士雄《王氏醫(yī)案·卷二》)有患陰虛火炎者,面赤常如飲酒之態(tài)。非戴陽證。孟英主一味元參湯,其效若神,而及試皆驗(yàn)。(王士雄《王氏醫(yī)案·卷一》)王氏不僅總結(jié)自己臨證醫(yī)案,而且還注重學(xué)習(xí)借鑒前人醫(yī)案,并將其心得體會(huì)以評(píng)注 / 按語方式附在醫(yī)案之中或案末。王氏評(píng)析古人醫(yī)案以俞震的《古今醫(yī)案按》為主,兼及徐大椿的《洄溪醫(yī)案》、沈又彭的《沈氏女科輯要》,并分別命名為《古今醫(yī)案選》《洄溪醫(yī)案按》《沈氏女科輯要按》,F(xiàn)將王氏評(píng)選醫(yī)案匯集成冊(cè),按內(nèi)科(肺系、心系、脾胃、肝膽、腎系、氣血津液、肢體經(jīng)絡(luò)、其他)、婦科(月經(jīng)病、帶下病、妊娠病、生產(chǎn)與產(chǎn)后病、乳房疾。、兒科(十四歲及十四歲以下)、外科(瘡瘍、斑疹、麻疹、面赤)、五官科(眼、耳、鼻、口齒、咽喉)分類,整理成《王孟英評(píng)點(diǎn)古今醫(yī)案》,冀期對(duì)于研究王孟英學(xué)術(shù)思想與臨證思路有所裨益。
李成文,55歲,教授,博士研究生導(dǎo)師。河南中醫(yī)學(xué)院中醫(yī)各家學(xué)說教研室主任,河南省中醫(yī)醫(yī)史文獻(xiàn)重點(diǎn)學(xué)科帶頭人。中華中醫(yī)藥學(xué)會(huì)名醫(yī)學(xué)術(shù)思想研究分會(huì)副主任委員。從事《中醫(yī)各家學(xué)說》《歷代名醫(yī)醫(yī)案選》《中醫(yī)論文寫作》教學(xué)與中醫(yī)藥防治神經(jīng)疾病工作30余年。主編《中醫(yī)各家學(xué)說》《科技論文寫作》等全國(guó)教材。出版《現(xiàn)代版中醫(yī)古籍目錄》《神經(jīng)內(nèi)科中西醫(yī)結(jié)合治療手冊(cè)》《中醫(yī)古籍醫(yī)案輯成》等30部,發(fā)表學(xué)術(shù)論文160篇。主要研究方向:中醫(yī)防治神經(jīng)內(nèi)科疾病、歷代名醫(yī)經(jīng)驗(yàn)及中醫(yī)古籍挖掘整理。
第一章內(nèi)科醫(yī)案.........................................001
感冒醫(yī)案...................................................001
傷寒醫(yī)案..................................................003
畏風(fēng)醫(yī)案..................................................008
溫病醫(yī)案..................................................009
發(fā)熱醫(yī)案...................................................013
真熱假寒醫(yī)案...........................................017
中暑醫(yī)案...................................................017
咳嗽醫(yī)案...................................................021
喘證醫(yī)案...................................................025
哮喘醫(yī)案..................................................030
肺癰醫(yī)案...................................................031
肺脹醫(yī)案...................................................032
心悸醫(yī)案...................................................032
胸痛醫(yī)案..................................................034
胸膈脹痛醫(yī)案............................................035
神昏醫(yī)案..................................................036
驚病醫(yī)案..................................................039
祟病醫(yī)案..................................................039
癇證醫(yī)案..................................................040
狂證醫(yī)案...................................................041
胃脘痛醫(yī)案................................................041
痞滿醫(yī)案..................................................046
嘈雜醫(yī)案..................................................047
嘔吐醫(yī)案..................................................048
翻胃醫(yī)案...................................................052
不食醫(yī)案...................................................053
呃逆醫(yī)案..................................................054
噎膈醫(yī)案...................................................055
腹痛醫(yī)案...................................................057
泄瀉醫(yī)案..................................................063
便秘醫(yī)案..................................................069
痢疾醫(yī)案..................................................076
脅痛醫(yī)案..................................................083
黃疸醫(yī)案..................................................083
積聚醫(yī)案..................................................085
眩暈醫(yī)案..................................................092
中風(fēng)醫(yī)案..................................................094
癱瘓醫(yī)案...................................................107
水腫醫(yī)案...................................................107
淋證醫(yī)案...................................................108
白濁醫(yī)案....................................................111
癃閉醫(yī)案...................................................113
小便艱難醫(yī)案............................................115
遺尿醫(yī)案...................................................115
陽痿醫(yī)案...................................................117
血證醫(yī)案...................................................127
瘀血醫(yī)案...................................................138
痰飲醫(yī)案...................................................139
消渴醫(yī)案...................................................142
汗證醫(yī)案...................................................145
虛損醫(yī)案...................................................147
痹證醫(yī)案...................................................149
痙證醫(yī)案...................................................153
痿證醫(yī)案...................................................153
腰痛醫(yī)案...................................................154
腿痛醫(yī)案...................................................157
背痛醫(yī)案...................................................158
瘧病醫(yī)案...................................................159
腸癰醫(yī)案...................................................162
麻木醫(yī)案...................................................164
奔豚醫(yī)案...................................................165
身左冷右熱醫(yī)案........................................166
附子中毒醫(yī)案............................................167
死亡醫(yī)案...................................................168
第二章婦科醫(yī)案........................................172
月經(jīng)不調(diào)醫(yī)案............................................172
閉經(jīng)醫(yī)案...................................................173
崩漏醫(yī)案...................................................175
熱入血室醫(yī)案............................................178
經(jīng)行音啞醫(yī)案............................................180
經(jīng)行外陰腫毒醫(yī)案....................................181
帶下病醫(yī)案................................................181
妊娠惡阻醫(yī)案............................................182
試胎/胎動(dòng)不安醫(yī)案.................................185
墮胎醫(yī)案...................................................186
死胎醫(yī)案...................................................187
子懸醫(yī)案...................................................188
子嗽醫(yī)案...................................................191
子喘醫(yī)案...................................................191
子癇醫(yī)案...................................................192
轉(zhuǎn)胞醫(yī)案...................................................193
妊娠痢疾醫(yī)案............................................194
妊娠舌腫醫(yī)案............................................195
妊娠帶下病醫(yī)案........................................195
產(chǎn)后胞衣不下醫(yī)案....................................195
產(chǎn)后血暈醫(yī)案............................................196
產(chǎn)后狂證醫(yī)案............................................198
產(chǎn)后惡露不下醫(yī)案....................................199
產(chǎn)后惡露不絕醫(yī)案...................................200
產(chǎn)后發(fā)熱醫(yī)案............................................201
產(chǎn)后喘證醫(yī)案............................................201
產(chǎn)后痞滿醫(yī)案............................................202
產(chǎn)后腹痛醫(yī)案............................................202
產(chǎn)后泄瀉醫(yī)案...........................................204
產(chǎn)后頭痛醫(yī)案............................................205
產(chǎn)后小便淋漓醫(yī)案...................................206
難產(chǎn)醫(yī)案...................................................207
乳癰醫(yī)案...................................................207
陰挺醫(yī)案..................................................208
陰癢醫(yī)案..................................................209
陰門不閉醫(yī)案...........................................209
陰戶寒冰醫(yī)案............................................210
第三章兒科醫(yī)案.........................................211
神呆醫(yī)案...................................................211
神昏醫(yī)案...................................................212
抽搐醫(yī)案...................................................214
痘癥醫(yī)案...................................................214
腸癰醫(yī)案...................................................215
瘡瘍醫(yī)案...................................................215
流注醫(yī)案...................................................219
第四章外科醫(yī)案........................................220
瘡瘍醫(yī)案...................................................220
瘙癢醫(yī)案...................................................225
流注醫(yī)案...................................................225
斑醫(yī)案......................................................226
痔瘡醫(yī)案...................................................227
脫肛醫(yī)案...................................................227
陰囊腫脹醫(yī)案............................................228
疝氣醫(yī)案...................................................228
下疳醫(yī)案...................................................230
交腸醫(yī)案...................................................230
脫發(fā)醫(yī)案...................................................233
痘癥醫(yī)案...................................................234
第五章五官科醫(yī)案.....................................235
面黑醫(yī)案...................................................235
目赤腫醫(yī)案................................................236
眼痛醫(yī)案..................................................238
鼻贅醫(yī)案...................................................238
音喑醫(yī)案...................................................239
喉痹醫(yī)案...................................................241
骨鯁醫(yī)案...................................................241
牙緊不開醫(yī)案............................................242
牙齒日長(zhǎng)醫(yī)案............................................243
口唇干燥醫(yī)案............................................243