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        1. 《黃帝內經》寫了哪些內容?《黃帝內經》的作者是誰?

            《黃帝內經》分《靈樞》、《素問》兩部分,是中國最早的醫學典籍,傳統醫學四大經典著作之一(其余三者為《難經》、《傷寒雜病論》、《神農本草經》)。

          image.png

            《黃帝內經》是一本綜合性的醫書,在黃老道家理論上建立了中醫學上的“陰陽五行學說”、“脈象學說”、“藏象學說”、“經絡學說”、“病因學說”“病機學說”、“病癥”、“診法”、“論治”及“養生學”、“運氣學”等學說,從整體觀上來論述醫學,呈現了自然、生物、心理、社會“整體醫學模式”(另據現代學者考證,認為今本中的黃老道家痕跡是隋唐時期的道士王冰竄入)。 其基本素材來源于中國古人對生命現象的長期觀察、大量的臨床實踐以及簡單的解剖學知識。

            《黃帝內經》奠定了人體生理、病理、診斷以及治療的認識基礎,是中國影響極大的一部醫學著作,被稱為醫之始祖。

            名稱由來

            《漢書·藝文志·方技略》載有“醫經”、“經方”、“神仙”和“房中”四種中醫典籍,《黃帝內經》被收錄于“醫經”中。

            所謂“醫經”,就是闡發人體生理、病理、診斷、治療和預防等醫學理論之著作。之所以稱之為“經”,是因為其重要性。古人把具有一定法則、一般必須學習的重要書籍稱之為“經”,如儒家“六經”,老子的“道德經”以及淺顯的“三字經”等。之所以稱“內經”,并非像吳昆《素問注》、王九達《內經合類》所稱“五內陰陽之謂內”,也不是張介賓《類經》所說“內者,生命之道”,而僅僅是與“外”相對為言。這和“韓詩內傳”、“韓詩外傳”,“春秋內傳”、“春秋外傳”,《莊子》的《內篇》、《外篇》,《韓非子》的《內儲》、《外儲》之意相同,只是《黃帝外經》及扁鵲白氏諸經均已散佚不傳。

          image.png

            成書時代

            《黃帝內經》又稱《內經》,是中國最早的典籍之一,也是中國傳統醫學四大經典之首。相傳為黃帝所作,因以為名。但后世較為公認此書最終成型于西漢,作者亦非一人,而是由中國歷代黃老醫家傳承增補發展創作而來。正如《淮南子·修務訓》所指出的那樣,冠以“黃帝”之名,意在溯源崇本,藉以說明中國醫藥文化發祥之早。實非一時之言,亦非一人之手。

            《黃帝內經》成書時代,古人主要有三種觀點:

            先秦時期

            持這種觀點的人有晉代的皇甫謐 ,宋代的林億、高保衡等。他們認為像黃帝內經這樣科學巨著,非通曉智慧的圣賢大智不能為之,所以必定是黃帝所作。

            戰國時期

            持這種觀點的人有宋代的邵雍、程顥 、司馬光 、朱熹明代的桑悅、方以智、方孝儒、清代魏荔彤等。其主要理由是:首先,將《黃帝內經·素問》與同樣是戰國時代的《周禮》相比較,有許多相同之處,足以充分證明兩書是同一時代、同一思想體系的作品;其次,《史記·扁鵲傳》中有關醫理的內容,與《黃帝內經·素問》的內容相類似,但卻樸素、原始得多,而《史記·倉公列傳》中有關醫理的內容卻比《黃帝內經·素問》有所進步,由此推斷:《黃帝內經》應當是扁鵲時代以后、倉公時代之前的作品,也就是戰國時代的作品。最后,以《黃帝內經》的文體為例,也可以說明這一點:先秦之文,多作韻語,而《素問》中韻語的文字特別多。

            清代《四庫全書簡明目錄》進一步肯定了這一說法,因為《四庫全書》在中國古代學術界有相當高的地位,這種說法也就被許多人所接受。

          image.png

            西漢時期

            明代郎瑛從夏禹時儀狄造酒的傳說和“羅”出現于漢代等證據推斷《素問》產生于西漢時期。

            現代中醫學專家劉長林 [23] 、吳文鼎 [24] 等人也持這種意見。其主要理由是:其一,《黃帝內經》全書約計20萬字,這在2000多年前可以說是一部巨著。編著這樣的醫籍需要有一個安定的社會環境,需要花費巨大的人力、物力,這在戰事連年、七雄割據的戰國時代是不可能辦到的。只有在西漢時期,隨著政治的穩定,經濟的發展,才為醫學家編著醫籍提供了現實的條件;其二,西漢初淮南王劉安的《淮南子·修務訓》曰:“世俗人多尊古而賤今,故為道者必記之神農、黃帝而后能入說。”《黃帝內經》在書名和思想內容上與“黃老學派”的密切聯系,也為只有在西漢“黃老學派”鼎盛時期才能成書提供了佐證;其三,西漢司馬遷在《史記·倉公列傳》中,記述了西漢初年名醫淳于意在接受老師公乘陽慶傳授給他的十種醫書中,竟沒有《黃帝內經》,這也足以說明《黃帝內經》不可能成書于西漢之前。

            以上觀點可以看出,古人認為《黃帝內經》成書為戰國時期較為可信。但也不能認為《素問》、《靈樞》所有篇章盡出戰國。元末明初醫學家呂復對此發表過中肯的見解,認為內經非一時之言,亦非一人之手。姚際恒《古今偽書考》、周木《素問糾略序》、程敏政《新安文獻集·運氣說》、黃省曾《五岳山人集·內經注辨序》等人也贊同呂復。

            比較科學的觀點是,《黃帝內經》并不是由一個作者完成于一個短時間內,是多個作者跨越了一個較長的時間段集結而成:

            一、先秦文體多韻語,而《黃帝內經》中一些篇章亦有不少韻語,這些章節可能是先秦時期的作品。

            二、與1973年長沙馬王堆的帛書《足臂十一脈灸經》、1972年甘肅武威漢墓出土的壓藥簡牘、1977年安徽阜陽雙古堆西漢汝陰侯墓出土的“六王斌盤”和“太乙九宮占盤”相比較,可知《靈柩》中有些篇章成書于春秋戰國時,有些成書于西漢更早。

          image.png

            三、《黃帝內經》中引用的一些文獻,如《上下經》、《睽度》等是戰國甚至更早的著作。

            四、《素問·寶命全形論》中用的“黔首”一詞,是戰國及秦代對國民的稱呼,而《素問·靈蘭秘典論》中的“相傅之官”和“州都之官”則是曹魏時期出現的官名。

            五、《靈樞》中個別篇章晚出,如《陰陽系日月篇》有“寅者,正月之生陽也”句,故可斷定成于漢武帝太初元年(前100 )頒布太初歷之后。

            六、《素問》中一些篇章用干支紀年,而采用干支紀年是東漢之事。《素問》第七卷亡佚已久,唐王冰據其先師張公秘本補入《天元紀大論》、《五運行大論》、《六微旨大論》、《氣交變大論》、《五常政大論》、《六元正紀大論》和《至真要大論》,實際上是另一部醫書《陰陽大論》。以其用甲子紀年,便可斷定必在東漢漢章帝元和二年(085 )頒布四分歷之后;以其曾被張仲景撰寫《傷寒雜病論》時所引用,因此一定在張仲景之先。

            七、《素問》中第七十二篇《刺法論》和第七十三篇《本病論》,在王冰次注《素問》時已是有目無文,宋劉溫舒著《素問入式運氣論奧》時卻將該二篇作為《素問遺篇》陳列于后。可以認為這兩篇系唐宋間的偽作。

            綜合論之,《黃帝內經》成書亦非一時,作者亦非一人。其筆之于書,應在戰國,其個別篇章成于兩漢。至于王冰之所補與劉溫舒之所附不應視為《黃帝內經》文,但依慣例認為屬于內經亦無不可。

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