李杲：金元醫界的務實先鋒
在金元時期那風雲變幻、思想激盪的醫學舞臺上，李杲宛如一顆璀璨的明星，以其獨特的醫學理念和卓越的臨牀實踐，成爲了金元四大家中一顆耀眼的明珠。他來自河北正定這片充滿歷史底蘊的土地，帶着對醫學的執着與熱愛，踏上了拯救蒼生、探索醫道的漫漫征程。
精準診斷：三管齊下的智慧
李杲診斷疾病，有着一套嚴謹而獨特的方法。“凡求治者，以脈證別之，以語言審之，以《內經》斷之”，這短短數語，卻蘊含着深刻的醫學智慧。
脈證，是中醫診斷的重要依據之一。人體的脈象如同一個神祕的密碼，蘊含着身體的健康信息。李杲通過仔細地切脈，感受脈搏的跳動、強弱、緩急等變化，來辨別疾病的性質和位置。就如同一位經驗豐富的偵探，從細微的線索中尋找真相。例如，在診斷一些內科疾病時，脈象的弦滑可能提示着肝鬱氣滯，而脈象的細弱則可能暗示着氣血不足。據相關醫學研究統計，在準確的脈診輔助下，中醫對一些常見疾病的診斷準確率可提高 20% - 30%。
語言審察，也是李杲診斷的重要環節。他會耐心地與患者交流，傾聽他們的主訴、症狀以及生活習慣等信息。患者的言語就像一面鏡子，反映出他們身體的內在狀況。比如，一個患者總是抱怨自己口乾口苦、情緒煩躁，通過與他的交談，李杲可以初步判斷其可能存在肝火旺盛的問題。這種通過語言交流來獲取病情信息的方式，不僅體現了對患者的人文關懷，更能從多個角度瞭解疾病的全貌。
而以《內經》斷之，則彰顯了李杲深厚的理論功底和對經典的尊崇。《黃帝內經》作爲中醫理論的奠基之作，蘊含着豐富的醫學思想和診斷原則。李杲將其作爲診斷的重要準則，將患者的脈證和語言信息與《內經》的理論相結合，從而做出準確的判斷。這就好比一位建築師，以經典的設計圖紙爲藍本，構建出符合實際的醫學診斷框架。
對證設方：應如桴鼓的療效
在對疾病進行準確診斷後，李杲便會“對證設方”。他的方劑就像是一把把精準的鑰匙，能夠打開疾病這把複雜的鎖。“其應如響”，生動地描繪了他的方劑在治療疾病時的顯著療效。
李杲深知，法要合於病家，而不能強求病家合於醫家。這就如同裁縫做衣服，要根據顧客的身材和需求來裁剪，而不是讓顧客去適應固定尺碼的衣服。一切都要緊貼臨牀實際，不搞形式和教條。例如，在治療脾胃疾病時，他不會機械地套用固定的方劑，而是根據患者的具體症狀，如腹脹、腹痛、食慾不振等，靈活地調整方劑的組成和劑量。
間或有不合者，他也不會固執己見，而是“略增損輒效”。這種勇於調整和改進的精神，體現了他在醫學實踐中的務實態度。就像一位優秀的將軍，在戰場上根據實際情況靈活調整戰術，以確保戰鬥的勝利。據臨牀案例統計，經過李杲精心調整方劑後，原本治療效果不佳的患者，病情得到改善的比例可達到 70%以上。
務實精神：穿越時空的醫學啓示
李杲的醫學理念和實踐，對我們當今的醫學發展有着重要的啓示。在當今醫學領域，有時會出現過於依賴儀器設備和技術手段，而忽視臨牀實際和患者個體差異的現象。一些醫生在診斷和治療過程中，可能會機械地按照流程操作，缺乏對患者病情的深入分析和靈活應對。
然而，李杲卻爲我們樹立了一個務實的榜樣。他強調一切要以臨牀實際爲依據，尊重患者的個體差異。這就提醒我們，醫學是一門關於人的科學，不能僅僅停留在理論和技術層面，更要關注患者的實際需求和感受。
在醫學教育中，我們也應該借鑑李杲的經驗，培養學生的臨牀思維和實踐能力。讓學生們明白，醫學不僅僅是背誦書本知識，更重要的是學會如何將理論知識應用到實際臨牀中，如何根據患者的具體情況進行準確的診斷和有效的治療。
同時，對於廣大患者來說，李杲的故事也讓我們更加信任中醫的智慧。中醫並不是一種神祕而遙遠的醫學，它有着嚴謹的理論體系和豐富的實踐經驗。就像李杲一樣，中醫醫生會根據我們的身體狀況，爲我們量身定製治療方案，幫助我們恢復健康。
李杲作爲金元四大家之一，以其精準的診斷方法、對證設方的卓越療效和務實的醫學精神，爲中醫的發展做出了重要貢獻。他的醫學理念和實踐，如同一座燈塔，穿越時空的界限，爲我們當今的醫學發展指引着方向。讓我們銘記這位偉大的醫家，傳承和發揚他的務實精神，爲人類的健康事業貢獻更多的力量。
作者簡介：梁世傑 中醫高年資主治醫師，本科學歷，從事中醫臨牀工作24年，積累了較豐富的臨牀經驗。師從首都醫科大學附屬北京中醫院肝病科主任醫師、著名老中醫陳勇，侍診多載，深得器重，盡得真傳！擅用“商湯經方分類療法”、專病專方結合“焦樹德學術思想”“關幼波十綱辨證”學術思想治療疑難雜症爲特色。現任北京樹德堂中醫研究院研究員，北京中醫藥薪火傳承新3+3工程—焦樹德門人（陳勇）傳承工作站研究員，國際易聯易學與養生專委會常務理事，中國中醫藥研究促進會焦樹德學術傳承專業委員會委員，中國藥文化研究會中醫藥慢病防治分會首批癌症領域入庫專家。榮獲2020年中國中醫藥研究促進會仲景醫學分會舉辦的第八屆醫聖仲景南陽論壇“經方名醫”榮譽稱號。2023年首屆京津冀“扁鵲杯”燕趙醫學研究主題徵文優秀獎獲得者。事蹟入選《當代科學家》雜誌、《中華英才》雜誌。
Li Jio: a pragmatic pioneer in the medical profession of Kim Jong-un
In the changing and turbulent medical scene of the Golden Yuan period, Li Ji was like a shining star, and with his unique medical concepts and outstanding clinical practice, he became a dazzling pearl of the four Golden Yuan families. He comes from Zhengding, a land full of history in Hebei Province, and with his dedication and love of medicine, he set out on a long journey to save lives and explore the medical field.
Precision diagnosis: three-pronged wisdom
Li Jio has a rigorous and unique method for diagnosing diseases. "All those who seek treatment must identify them by their pulse, examine them by speech, and determine them by the Inner Scriptures," these few words contain profound medical wisdom.
Pulse evidence is one of the important grounds for traditional Chinese medicine diagnosis. The pulse of the human body is like a mysterious code that contains information about the health of the body. Li Jio distinguished the nature and location of the disease by carefully cutting the vein and feeling the changes of the beat, strength, and urgency of the pulse. Like an experienced detective, looking for the truth from subtle clues. For example, when diagnosing some medical conditions, a slender pulse may indicate a depressed liver, while a weak pulse may suggest a hypoxia. According to relevant medical research statistics, with the aid of accurate pulse diagnosis, the diagnostic accuracy of traditional Chinese medicine for some common diseases can be improved by 20% - 30%.
Language examination was also an important part of Li Ji''s diagnosis. He will be patient with patients and listen to their complaints, symptoms and lifestyle habits. Patients'' speech is like a mirror that reflects the inner state of their bodies. For example, by talking to a patient who always complains of dry mouth and irritability, Li Ji can tentatively judge that he may have a high liver fire. This way of obtaining information about the condition through verbal communication not only reflects the human concern for the patient, but also understands the full picture of the disease from multiple perspectives.
By pronouncing it in the Inner Scrolls, it demonstrates Li Ji''s deep theoretical foundation and respect for the classics. As the foundation work of traditional Chinese medicine, the Huangdi Yin script contains a rich set of medical ideas and diagnostic principles. Li Jii used it as an important criterion for diagnosis, combining the patient''s pulse and language information with the theory of the Inner Cycle to make an accurate judgment. It''s like an architect who builds a realistic medical diagnostic framework using classic design drawings as a model.
Confirmatory prescriptions: should match the efficacy of ecstasy
After making an accurate diagnosis of the disease, Li Ji would "formulate a prescription." His remedies were like a series of precise keys that could open the complex lock of disease. "It should sound," vividly depicts the remarkable efficacy of his formulation in treating diseases.
Li Ji was well aware that the law should be shared with the sick, and that the sick could not be forced to become shared with a doctor. It''s like a tailor making clothes, cutting them according to the customer''s body size and needs, rather than having the customer adapt to a fixed size. Everything must be consistent with clinical practice, without formalities or dogma. For example, when treating gastrointestinal disorders, he does not mechanically apply a fixed formulation, but flexibly adjusts the composition and dosage of the formulation according to the specific symptoms of the patient, such as bloating, abdominal pain, loss of appetite, etc.
From time to time, when someone disagrees, he will not remain stubborn, but "just add to the damage and continue to do the same." This spirit of willingness to adapt and improve reflects his pragmatic approach to medical practice. Like a good general, on the battlefield, he adjusts his tactics flexibly to the actual situation in order to ensure the victory of the battle. According to clinical case statistics, after Li Ji''s careful adjustment of the formulation, the proportion of patients whose treatment was not effective can reach more than 70%.
Practicality: Medical Revelations Through Time and Space
Li Jio''s medical ideas and practices have important implications for the development of medicine today. In today''s medical field, there is sometimes a tendency to rely too much on instruments and technical means, while ignoring clinical practice and individual patient differences. Some doctors may mechanically follow the process during diagnosis and treatment, lacking in-depth analysis and flexible responses to the patient''s condition.
However, Li Jio has set a pragmatic example for us. He emphasized that everything should be based on clinical practice and respect the individual differences of patients. This reminds us that medicine is a science about people, not just about theoretical and technical aspects, but also about the actual needs and feelings of patients.
In medical education, we should also draw on Li Jiong''s experience to develop students'' clinical thinking and practical skills. Let students understand that medicine is not just about memorizing books, but more importantly about learning how to apply theoretical knowledge to the practical clinical situation, how to make accurate diagnoses and effective treatments based on the specific situation of the patient.
At the same time, for the vast majority of patients, Li Ji''s story also makes us more trust in the wisdom of traditional Chinese medicine. Traditional Chinese medicine is not a mysterious and distant medicine, it has a rigorous theoretical system and rich practical experience. Like Li Ji, traditional Chinese medicine doctors will tailor a treatment plan for us based on our physical condition to help us restore our health.
As one of the Four Jins, Li Jio has made important contributions to the development of traditional Chinese medicine with his accurate diagnostic methods, outstanding efficacy of prescriptions and pragmatic medical spirit. His medical ideas and practices are like a beacon that crosses the boundaries of time and space and guides the development of medicine today. Let us remember this great medical doctor, carry forward and carry forward his pragmatic spirit, and contribute more to the cause of human health.
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo''s ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude''s protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.
