.Hongwei Liu
Abstract: Dr. Shi Yi-Ren (1896-1966) was a renowned Chinese medical doctor and educator. He is also one of the pioneers of the integration of Chinese and Western medicine. In 1931, he was appointed as the first Standing member of the Executive Board, and the academic organization committee at the Central Medical Hospital. In 1938, he served as a member of the Chinese Medicine Committee of the Department of Health, a Standing Member of the Chinese Medical Education Society, and a member of the Chinese Medical Textbook Editing Committee; in 1940, he founded the Chinese Medicine School, Society, and Magazine of Fuxing; in 1948, he was appointed as the acting director of Central Medical hospital, and founded the Capital Hospital of TCM; in 1949, he established the Chinese Medicine Specialist Department in the Central Medical Hospital; After 1949, he was the senior professor to train the TCM professional educators’ class at Jiangsu Provincial School of Traditional Chinese Medicine; in 1955, he was assigned as first director of internal medicine at Xi-Yuan Hospital of China Academy of Chinese Medicine Science, served as the professor of “First Class for Western Doctors Learning Chinese Medicine”. For over fifty years, he not only developed his academic insight into Chinese medicine, but also advocated the integration of Chinese and Western medicine, for the complementary nature of Chinese and Western medicine, and the combination of differentiation between disease and syndrome. He also created a new teaching model for the training of Chinese medical professionals. This article systematically analyzes the following “five modernizations” proposed by Dr. Shi, organized for reference by Chinese medicine practitioners.
1. A philosophy of systemization and scientization of TCM theory
2. Clinical experience, concentration and experimentation
3. Pharmacology, physiology, and chemistry of herbal medicines
4. The mechanization and practicality of TCM diagnosis and treatment
5. Political and social aspects of disease prevention
Keywords: Dr. Shi Yi-ren, Reviving Chinese Medicine，Academic Thoughts
The first half of the 20th century was a very sensitive period for Chinese medicine. Starting from the late Qing Dynasty, Chinese medicine gradually lost its mainstream medical status to Western medicine and was impacted by Western medicine on many fundamental and core issues. In addition, at the time, the government did not support traditional medicine, going so far as to try to abolish it at some points. The situation was extremely difficult. At that time, people in the traditional medicine community not only wanted to open up a new world in clinical practice with enthusiasm, but also became more active in founding journals, setting up societies, and running schools to promote their views and ideas in the broader society, and contribute to the medical culture of the Chinese nation, the development of the healthcare industry and the place of traditional Chinese medicine in society. They made contributions to the cause of reviving traditional Chinese medicine in order to better benefit people around the world.
Dr. Shi Yiren was an outstanding representative of this time. Shi Yiren (1896-1966) was originally from Wuxi, Jiangsu Province. He was born in Yizheng and later moved to Zhenjiang. He was famed as a scientist, educator, theorist, clinician and reformer, he was also a pioneer of the integration of traditional Chinese and Western medicine.［1］［2］
Dr. Shi Yiren, early in the early years of the Republic of China, immersed himself in extensive reading of traditional Chinese medical texts, and actively participated in the activities of medical societies of his day. Being young, energetic, and highly intellectually, he developed the idea of organizing medical books, proposing the view that “the more medical books there are, the more confusing medicine becomes.” As he said in his own words: “In the fifth year of the Republic of China, when I first started practicing medicine, I came up with the idea of compiling medical books.”［3］He believed that “medical books from previous generations each had their biases,” and that traditional Chinese medicine had not reached its most refined form, and had various shortcomings. In summary, “There is no standard for the editing of books; no standard scale for diagnosis; no standard method for passing down knowledge; and for any single symptom, there are often a thousand different opinions about the cause. As a result, the overall picture cannot be thoroughly studied. Acupuncture and witch doctoring are lumped together and dismissed as nonsense; traditional medicine’s physiological and pathological principles are not clearly stated.”［4］To this end, he used a unique classification method to study ancient Chinese medicine books. He divided ancient medical books into four categories: one is the “School of Invention” (including seminal texts like the “Huangdi Neijing”, “Shen Nong’s Materia Medica”, etc. which propose and set out the basic theories that later generation followed), the “School of Compilation” (such as “Prescriptions Worth a Thousand Gold”, “Wai Tai Mi Yao”, etc. which accumulate many ideas and clinical insights from various sources), the “School of Study” (such as “Medicine Enlightenment”, and “Must-read for medical practitioners”, etc. which presented cogent collections of ideas for teaching purposes), and the “School of Opinions” (such as the Four Schools of Jin and Yuan Dynasties, Book of Eight Families of Ming and Qing Dynasties, etc. which propose their personal variations on concepts about etiology of disease and the treatment methods which those etiologies entail). His ideas can be described as unconventional. Early on the renowned physician Zhang Zanchen praised him for his emerging talents: “Since the fifth year of the Republic of China, his extensive insights into medicine have been widely seen in publications such as the ‘Shaoxing Medical Journal,’ ‘Yuyao Health News,’ ‘San San Medical News’ in Hangzhou, and the ‘Medical Health News’ in Nanjing. He has authored numerous works and is highly admired in the medical community. He has also contributed to various medical publications in other regions, demonstrating a dedicated pursuit of medical studies, which has led to astonishing achievements.”［5］
In “Declaration of medical Demonstration” by Dr. Shi Yiren in 1919, he systematically expressed his thoughts, attaching importance to the theory of traditional Chinese medicine and reconstructing the theory of traditional Chinese medicine. He believed that there was a theory of traditional Chinese medicine from the earliest times, and books such as “Ling Shu”, “Su Wen”, “Mai Jing” and “Zhu Bing Yuan Hou Lun” were pivotal in laying out this theoretical foundation. But since those early times, medicine has gradually tended away from this theory to treat symptoms without regard for those earlier theoretical frameworks. Especially in recent times, he said, “there are many books of clinical medical records, and the more which are published, the worse they get. The tricks of marketplace doctors are endless, and medicine has deviated from its original path to become mere tricks!” He clearly realized that Traditional Chinese medicine has lacked theoretical innovation and only has techniques that adapt to the world. Expressing deep concern, he pointed out: “Recently, the European style has spread eastward, and scientific innovation has been spreading. The trend is rapid and aggressive. A man of insight understands that without reform, survival is impossible. What is meant by reform? It means advancing to seek out its theories. With the status of traditional Chinese medicine today, if it does not advance, it will regress; if it does not persist, it will perish! Theories are the mother of facts. Only with precise theories can there be precise facts; this is why new knowledge progresses rapidly. Absurd theories lead to absurd facts, which is why old knowledge responds sluggishly. If traditional Chinese medicine does not refine its theories, its errors will be significant. It’s not too late to take action in time. From now on, I understand this.”［6］It can be seen that Shi Yiren was determined to organize and improve traditional Chinese medicine and devoted his life’s energy to implement the ambitions laid out in the “ Declaration of Medical Demonstration ”. Shi Yiren has also published “Organization of the Academic Propositions of Traditional Chinese Medicine”, “Several Tenets for Research on Chinese Medicine”, “Discuss of Advantage and Disadvantage of Historic Chinese Medicine Books”, and “Classification of Chinese Medical Books and Research Procedures”. It fully demonstrates his spirit of hard work for the transmission and development of traditional Chinese medicine. According to the author’s statistics, the works edited and published by Dr. Shi Yiren include: “Shi’s Study of the Neijing”, “Lectures on Physiology”,“ Lectures on the Jin Gui”, “Shi’s Diagnosis”, “Brief Clinical Prescriptions”, “Lectures on Pharmacology”, “Lectures on Chinese Prescriptions”, “Chinese Seasonal Disease Studies”, “Comprehensive Treatise on Warm Diseases”, “Chinese Acute Infectious Disease Studies”, “Cholera”, “Chinese Gynecology”, “Shi’s Smallpox Disease Studies”, “Chinese Internal Medicine”, “Chinese Infectious Disease Studies”, “Chinese Materia Medica”, “Shi’s Pathology”, “Traditional Chinese Medicine for Cold Damage and Warm Diseases”, “Essentials of Treating External Febrile Diseases”, “Shi’s Prescriptions”, “Chinese Pediatrics”, “Practical Handbook of Internal Medicine in Traditional Chinese Medicine”, “Practical Experienced Traditional Chinese Medicine Formulas”, “Chinese Infectious Disease Prevention Methods”, “Selected and Evaluated Formula Essentials”, “Selected and Evaluated Medical Case Essentials”, “Review and Collection of Tested Formulas”, “Shi Yiren’s Medical Cases”, “Chinese Internal Medicine Diagnostic Studies”, “Medical Classic Medication Regulations”, “Yiren Tang Medical Book Series”, “Yiren Medical Talks”, “Jiangzuo Yiren Medical Society Series” , authored over 30 books, covering a wide range of subjects within TCM including fundamental theory, febrile diseases, pharmacology, formulas, internal medicine, gynecology, pediatrics, and infectious diseases. His dedication reflects the realization of the theoretical framework he envisioned in his youth, a pioneering achievement in the history of TCM development. As Professor Zheng Jinsheng, an expert in medical history and literature at the China Academy of Chinese Medical Sciences, remarked: “I have never seen any TCM scholar from the Republic of China era who could write so many and such a comprehensive system of TCM on their own!”［7］Reflecting on Dr. Shi Yiren’s declaration and lifelong accomplishments, he truly embodies the saying “one word carries great weight” and epitomizes perseverance. His steadfast spirit commands deep respect and serves as a model for contemporary TCM practitioners dedicated to serious study and practice.
In the early days of the Republic of China, those in traditional Chinese medicine who faced the pressure concerning the survival of traditional Chinese medicine realized that the medicine itself should be improved. This was basically a consensus at that time. But there were different opinions as to how to improve it. Some believed that improving medical practice should come first, while others thought that improving pharmacology was most urgent. Dr. Shi Yiren believed that “organizing medicine” was the right path. That is to say, “elaborating inherent experience and incorporating scientific methods.” However, the clinical experience of traditional Chinese medicine exists in medical books, so sorting out medical books is the first task to improve traditional Chinese medicine.［8］His academic proposition, that improving traditional Chinese medicine must be based on organization, was put forward at the beginning of the establishment of the Central Medical College and adopted by the hospital. Therefore, he had successively served as a director and executive director of the Central Traditional Chinese Medicine Center, a full-time member of the Academic Compilation Committee, a member of the Textbook Compilation and Review Committee, a standing member of the Traditional Chinese Medicine Committee of the Department of Health, and a director of the China Medical Education Society. He once said: “I am very confident and want to make a considerable contribution to Chinese medicine with my own ability.”［4］Sincerely, it can move heaven and the earth.
In 1940, amidst a highly precarious social environment, Dr. Shi Yiren founded Fuxing Traditional Chinese Medicine School, Fuxing Traditional Chinese Medicine Society and the magazine “Fuxing Traditional Chinese Medicine” in Shanghai. To conduct a large-scale exchange on the organizing of traditional Chinese medicine. Dr. Shi Yiren named it “Reviving Traditional Chinese Medicine” at that time. In fact, as early as 1934 when he was in Shanxi, General Yan Xishan had great aspirations to revive traditional Chinese medicine and asked Mr. Shi Yiren to draft a plan. However, due to the tense national affairs and the turmoil of the current situation, Dr. Shi Yiren’s draft was not implemented. When he founded “Fuxing Traditional Chinese Medicine”, his article “Basic Conditions for Fuxing Chinese Medicine”［9］was published, which systematically expressed his academic opinions. Dr. Shi Yiren believes that the efficacy of traditional Chinese medicine is undeniable. But what makes it difficult for you is “the absurdity of academic theory, the complexity of experience, the misunderstanding of terminology, and the differences among various schools and thought.” If we want to revive Chinese medicine, we must rectify and improve it. He summarized the specific methods for reviving traditional Chinese medicine into “five modernizations” described above, namely: A philosophy for the systemization and scientization of TCM theory, a method for deriving use from the literature of clinical experiences, and experimentation, a thorough investigation of the pharmacology, physiology, and chemistry of herbal medicines, the mechanization and practicality of TCM diagnosis and treatment, and the political and social aspects of disease prevention and public health with a traditional medical outlook.
1. Systematization and Scientification of Theories:
Dr. Shi Yiren believed that since the advancement of science, most academic disciplines have progressed accordingly, resulting in the continuous evolution of Western medicine. However, due to the lack of scientific scrutiny in Chinese medicine, many theories are deficient, and the books are disorganized. For example, some books only talk about symptoms but not pathogens; some books only talk about treatment but lack diagnosis, and so on. Therefore, Dr. Shi Yiren believes that to make the theory of traditional Chinese medicine systematic, it must be based on scientific principles: “Physiology should be used to study medicine’s functions, anatomy should be used to understand its body, pathology should follow its changes, and pharmacology should remedy its disadvantages.” Regarding the method of organization, the basic ideas of traditional Chinese medicine should be organized “based on physics, chemistry, biology, ethnography, eugenics, physiology, anatomy, etc.” “Based on physiology, anatomy, histology, diagnosis, medical chemistry, etc.” organizes the disease theory of traditional Chinese medicine. It should be organized based on two steps: observation and experiment. “If it matches, it will be compiled, if it doesn’t match, it will be discarded.” Then, the diseases of various categories and organs are divided into “definitions, causes, syndromes, pathology, diagnosis, prognosis, treatment methods, prescriptions, etc.” According to scientific methods, new knowledge is compromised to form a systematic theory that is consistent with application in clinical practice.［9］
Dr. Shi Yiren clearly pointed out long ago: “Fundamental medical sciences should primarily rely on the substance of Western medicine, supplemented by the insights of traditional Chinese medicine (TCM); applied medical sciences should prioritize TCM experiences while referring to Western medical methods. In this way, it is based on the essence of Western medicine, and there is no empty talk. The harm of rigidity.”［10］For example, he compiled his “Lecture Notes on Physiology”, “Lecture Notes on Chinese Prescriptions”, “Chinese Acute Infectious Diseases”, etc., which undoubtedly have great differences with traditional Chinese medicine in the classification of basic subjects. He also published many medical papers such as “On Holism” and “On Holistic Physiology” which were relatively strong in Western medicine at that time. Regarding applied and specialized disciplines, he believed: “Western medicine emphasizes the description of syndromes focusing on specific symptoms, while TCM emphasizes comprehensive symptoms. Western medicine prioritizes the focus on lesions, whereas TCM prioritizes the condition… Both perspectives should be integrated in research.” In terms of diagnosis and pathology, he believed that Western medicine was superior to TCM, therefore “Western medicine should be given priority and Chinese medicine should be supplemented.”［11］Therefore, he wrote books such as “Chinese Internal Medicine”, “Chinese Internal Medicine Diagnosis”, “Practical Chinese Internal Medicine Diagnosis and Treatment Manual”, etc., as well as “Chinese Gynecology”, “Chinese Pediatrics”, etc. They are all compiled based on the principles of integrating traditional Chinese and Western medicine and form a system of their own.
In summary, the subject classification advocated by Dr. Shi Yiren: fundamental subjects, applied subjects and specialized subjects have laid a good foundation for the scientific classification of today’s traditional Chinese medicine disciplines.
2. Centralization and the Experimental Confirmation of Clinical Experience:
The richness of Chinese medicine is thru thousands of years of clinical practice and historic scholar’s studies, which have formed its theoretical framework. Its special qualities lie in not only prescription experience, but also flexible differentiation syndrome of disease. Therefore, the significant treatment efficiency is just like floating drum. However, as time passed, specialized texts emerged, and these ancient traditions were not valued by the state. Some scholars, emphasizing the study of body, mind, and life, regarded medicine as a minor pursuit. Moreover, within medical families, their techniques were kept secret, passing down from father to son, or master to disciple. The treatment of medical skills as family heirlooms, and using secret prescriptions for profit, buried much of this experience in the community over the years, resulting in many valuable practices being lost. This is indeed one of the reasons for the decline of Chinese medicine today. There are many doctors in our country who are Either learned by themselves or taught by masters. Although they have different styles, they all have their own experience in the different specific field. For example, for certain diseases are not treated by western medicine, but can be very effectively treated by traditional Chinese medicine practitioners who have a special secret method passed down within a family. Unfortunately, there is no public research institution for Chinese medicine study, such that it could compete with Western medicine. If there were a centralized location for doing research, rewarding those with exceptional results and discarding ineffective methods, there would undoubtedly be astonishing discoveries and significant achievements, which can be confidently asserted.［9］
He also advocated that “Chinese medicine belongs to the Chinese people. Every essence of traditional Chinese medicine (TCM) should be diligently studied by our people. It is crucial to promote domestically produced medicines. This is vital for national development and people’s livelihoods, and not a trivial matter. We should improve domestic medicines, resist foreign products, openly share previously secret techniques, promote traditional Chinese knowledge, and collaborate wholeheartedly. By maintaining and revitalizing TCM, there is great hope for the future, benefiting not only the public but also shining a light on our medical profession.”［12］During his tenure at the Shanxi Institute for TCM Improvement Research, Dr. Shi Yiren served as the principal reviewer and editor. The main person in charge collected a large number of folk prescriptions and organized a specialized agency to review and eliminate many absurd or unscientific treatment methods. He also edited and published 6 volumes of “Review and Collection of Prescriptions”, which included more than 6,000 prescriptions and was rich in content. It is convenient, safe and applicable. (This book is the first official compilation of prescriptions in the modern era.) It is widely promoted in order to further promote the theory and practice of traditional Chinese medicine.
3. Pharmacology, Physiology Standardization, and Chemicalization:
During the Republic of China, there were many proponents of the “discard traditional medicine, keep herbs” perspective. This view was even more popular among those who had received Western medical education. Dr. Shi Yiren repeatedly argued against this perspective, emphasizing the inseparable relationship between traditional Chinese medicine (TCM) and Chinese herbal medicine. He used the serious consequences of the Meiji Restoration in Japan, which led to the destruction of traditional Chinese medicine, as a historical lesson, explicitly stating:“The application of Chinese herbal medicine is the crystallization of the accumulated experience of traditional Chinese medicine over generations. If we abandon the experience of TCM and solely focus on analyzing the efficacy of herbal medicine components, we may gain little and lose much.”［13］
The concept of “Abandoned Traditional medicine and Keep Herbal Medicine Only ” recognizes the usefulness of traditional Chinese herbal medicine, such as ephedra to relieve asthma, angelica root to nourish blood, etc. However, those who hold this view fail to recognize that the effectiveness of these medicines is precisely the achievement of traditional Chinese medicine (TCM). Dr. Shi Yiren once made a poignant analogy: Western medicine says traditional Chinese medicine can be discarded, but Chinese herbal medicine is still useful. This notion is “truly arbitrary slander,” akin to assessing the Chinese military after the victory in the War of Resistance Against Japan, and “calling the Chinese soldiers bad, but the firearms are still useful, and the firearms should be rewarded heavily, while there is no need to comfort the soldiers.” This is a ridiculous notion.［4］In fact, the efficacy of Chinese herbal medicine is derived from the theories and clinical experiences of traditional Chinese medicine. The efficacy of Chinese herbal medicine is mostly derived from its combined application under the guidance of TCM theories. Focusing solely on the components and effects of individual herbs while disregarding the critical practice of herbal compatibility is a grave error of misplaced priorities and material over humanity. This is the most fatal shortsightedness of those who advocate “discard medicine, keep herbs”! Therefore, Dr. Shi Yiren astutely pointed out: “The essence of Chinese herbal medicine lies in compatibility. If there is a methodical approach to compatibility, the results are remarkably successful, with no discovery of side effects. Traditional Chinese medicine has accumulated thousands of years of experience, and the combination of herbs in prescriptions is systematically tested and proven effective.” He believed that the correct approach should be to prioritize the experience of traditional Chinese medicine, supplemented by Western methods of testing and analysis, thus advancing both traditional Chinese medicine and the production of Chinese herbal medicine, ensuring no mistakes.［13］Dr. Shi Yiren promotes inseparable relationship between traditional Chinese medicine and Chinese herbs, His views enlightening today’s society and people who still hold the view of “Abandoned Traditional medicine and Keep Herbal Medicine Only”.
So, how do we study traditional Chinese herbal medicine (TCM)? Dr. Shi Yi-ren believed that despite the thousands of years of evolution and the proven therapeutic effects of Chinese herbal medicine, it still relies heavily on experience without scientific verification or chemical analysis. Without research, it lacks clarity and remains merely empirical. In recent years, countries like Germany, the United States, and Japan have spared no effort in researching Chinese herbal medicine. They have extracted ephedrine from ephedra, considering it a medicine for treating asthma and inducing sweating; aconitine from aconite, believing it to be a medicine for strengthening the heart and relieving pain; and atropine from pinellia, believing it to be a medicine for relieving nausea and eliminating phlegm, among many others. Many Chinese herbal medicines once abandoned by those with a Western medicine background have now become revered after being researched by others. Therefore, the decline of traditional Chinese medicine is not only due to the lack of centralized experience but also because the medicines lack chemical analysis, which leaves it out of line with the principles of modern science. If we could thoroughly study the physiological and chemical aspects of various medicinal herbs, and determine their components, we could formulate prescriptions accordingly. For example, medicines containing colloids, such as hawthorn, angelica, and rehmannia glutinosa, can be made into ointments; medicines containing invariable, such as tangerine peel, citrus aurantium, and sodium salt, can be made into crystals; alum, borneol, sulfur, etc. can be made into powder; medicines containing water can be made into pulp. Medicines containing oil are made into ointment. For herbs such as ginseng and astragalus that are easy to deteriorate, and rot will put into glass jar. His suggestions could refine and popularize the expertise of TCM treatment methods, benefiting people worldwide.［9］Dr. Shi Yi-ren’s advocacy of modern research on Chinese herbal medicine laid the foundation for the modernization of TCM.
4. Mechanization and Practicality in Diagnosis and Treatment:
Since ancient times, medical diagnosis and treatment have been very straightforward, with diagnosis involving observation, listening and smelling, asking, and palpation. Treatment comprised massage, moxibustion, acupuncture, and herbal remedies, which are all very effective. However, later scholars became obsessed with palpation, neglecting observation, listening and smelling, and asking, which led to a lack of material application. The study of herbal remedies continued to advance, leading to it becoming the dominant treatment for organ disorders. The techniques of massage, moxibustion, and acupuncture gradually became lost, resulting in insufficient treatment methods, which is regrettable. Looking back over the past three hundred years in which Western science has developed, and material progress has been made, with medical instruments becoming more complete. Methods of diagnosis and treatment, such as sound, light, electromagnetic, and atomic applications, are all in use. When compared to Western medicine, traditional Chinese medicine appears inadequate. Therefore, regarding methods of diagnosis and treatment, we should employ mechanization. In terms of diagnosis, the effective discernment of traditional Chinese medicine is indeed important, but the use of instruments is also necessary. For example, X-rays can be used to examine bone structure, and tests can be conducted on urine, blood, sputum, pus, stool, and juice, along with bacterial cultures, chemical reactions, and physical examinations, all of which are applied. Regarding treatment, traditional Chinese medicine excels in internal medicine, while Western medicine excels in surgery. The reason traditional Chinese medicine has been abandoned is primarily due to the lack of development in surgery and the absence of equipment. In the future, in addition to using internal medicines like pills and powders, traditional Chinese medicine should utilize instruments such as electrical devices, acupuncture needles, injections, surgical tools, washings, and physical therapies like sun lamps, ultraviolet rays, catheters, and gastric lavage devices. By utilizing Western instruments, traditional Chinese medicine can be greatly improved.［9］
It is evident from the above discussion that Dr. Shi Yiren’s arguments have laid the foundation for the combined clinical research of Chinese and Western medicine. The current state of integration between Chinese and Western medicine further validates Dr. Shi Yiren’s statement that “only sincere cooperation and mutual assistance between Chinese and Western medicine, striving for progress together, can achieve unity and is the only way to save the Chinese medical community at that time,” it is true, and it cannot but be said to be a wise opinion!
5. The socialization and politicization of disease prevention:
Prevention is particularly important in medicine. As the saying goes, an ounce of prevention is worth a pound of cure. In the case of epidemic diseases, preventing them before they happen is relatively easy, while treating the disease after it has occurred will make the symptoms more difficult. This is the way of prevention, a real guarantee of health, and key to becoming ill. The ancients were said to be able to cure diseases without treatment, which is a clear proof that they paid great attention to preventative care in ancient times.
The conditions for preventing diseases in ancient medicine included: not overworking or resting too much, being cautious with diet, maintaining strict daily routines, adjusting to seasonal changes, reducing mental stresses, and abstaining from excessive drinking and indulgence in sensual pleasures. These were immutable laws from antiquity. It is unfortunate that there are no specific books or detailed explanations on this subject, which is a major gap in the Chinese medical literature. Since the discovery of bacteriology, prevention has focused on disinfection and hygiene, with cleanliness being emphasized. Therefore, advanced countries in Europe and America place great emphasis on water purification, food inspection, hygienic construction, lighting arrangements, preventive inoculations, infectious disease isolation, and other medical practices. On the other hand, China lacks specific guidelines, and does not pay much attention to prevention. Hence, phlegm and saliva are all over the ground, feces and urine are everywhere, filth and dirt accumulating, and the sharing of eating utensils and living quarters. The country lacks epidemic prevention policies, the people lack prevention awareness, and medicine lacks isolation techniques – these shortcomings need no concealment. Therefore, it is advisable to compile ideas regarding disease prevention and ensure that the public has the knowledge it needs to implement those practices. Without political oversight, it is difficult to achieve results. The way to prevent disease is to preserve one’s mental hygiene, but physical hygiene cannot be ignored. Measures to prevent bacterial transmission should be applied to individuals, families, cities, villages, factories, schools, shopping centers, theaters, and other public places. Matters such as maternal health care, infectious disease prevention, disease isolation, preventive inoculations, physical examinations, and health education should be integrated into daily life, and published in specialized texts for implementation. This approach can address the shortcomings in medicine and benefit the public.［9］
In 1928, when Dr. Shi Yiren was teaching in Shanghai, he specialized in teaching about approaches to ancient and modern epidemics. He felt that the externally contracted diseases and illnesses related to the four seasons “have never been listed in specialist literature in the past. They may have been appended to the miscellaneous patterns described in internal medicine texts, appended to cold damage discussions in ancient books, or treated by contemporary formula or by Yi Tian Shi School［14］. He carefully studied the academic thoughts and experiences of various schools from the “Nei Jing” and “Treatise on Warm Diseases”, especially the “Warm Disease School” of the Ming and Qing Dynasties, and, combined with a large amount of clinical practice, he had the courage to explore and integrate non-infectious diseases and syndromes of cold damage and warm diseases, and created a new proposition of “seasonal disease”. Combining cold damage and warm diseases in one crucible became a milestone in his academic thought, which he compiled in 1930 and published as “Chinese Seasonal Diseases”, to sort out the disputes between doctors of past dynasties regarding the differences between cold damage and warm diseases. In order to make up for the shortcomings of “Chinese Epidemiology of Seasonal Diseases”, he edited and published China’s first monograph on TCM treatment of infectious diseases, “Chinese Epidemiology of Acute Infectious Diseases” in 1933. As he said: “In 1922, Yu advocated the need for an independent specialty in infectious diseases, which should be compiled into a special book as soon as possible. It can be used as a reference material for traditional Chinese medicine in epidemic prevention work and diagnosis and treatment of infectious diseases. The previous generations of doctors have paid considerable attention and examined methods of diagnosing and treating infectious diseases, and the legacy of ancient history has been clarified with modern scientific theories and combined with modern science to achieve the goal of ‘scientific Chinese medicine’. ”［15］After that, he also edited and published “Chinese Infectious Diseases”, “China’s Infectious Disease Prevention Law”, etc., which laid the foundation for the systematic study of infectious diseases in traditional Chinese medicine. The current global COVD-19 pandemic has further verified Dr. Shi Yiren’s foresight.
Dr. Shi Yiren also concluded: “In general, the above five points are based on facts and must be implemented in order to prepare for the revitalization of traditional Chinese medicine. Some may argue that the situation is as it is, and the ideal is too high and difficult to achieve. Just look at the eighteenth century in Western medicine, the theory of humoral medicine flourished for a while, and it was exactly the same as the Yin and Yang and the Five Elements in the ancient Chinese medicine books. However, after numerous debates, they decisively abandoned the path of inductive science, in today, this is not coincidence. It is necessary to catch up and improve, not to cling to old theories, not to blindly follow new learning, but to use scientific methods to review past mistakes, adopt current strengths, and seek to create a third form of medicine.” Some argue that the brilliance of traditional Chinese medicine lies in its non-scientific aspects, such as the principles of qi transformation, the circulation of Qi and Blood, Differentiation of Syndrome. But, in Opposite, those are all unique features for remarkable effectiveness in treating diseases by Chinese medicine. However, in terms of theory, it lacks organization, is chaotic and filled with empty talk, relies on borrowed terminology, and produces repetitive content that is nauseating to read. If it does not align with global trends, its theories lack systematization, experiences are scattered, medications are not verified, treatments are not improved, and prevention is not widespread.” Indeed, the real fear is not being abandoned, but being abandoned yourself. Others suggest that if traditional Chinese medicine is not scientific, it will be abolished; however, even after becoming scientific, it may still face abolition. This view seems reasonable because traditional Chinese medicine, without scientific improvement, presents complex theories, scattered experiences, lacks systematization, and once it becomes scientific, it may be assimilated by Western medicine. “Therefore, the reform of medicine must go hand in hand with the improvement of pharmacology, not only to safeguard the lives of Chinese people, but also to be adopted by the world’s medicine, making Eastern civilization shine.”［9］
In summary, Dr. Shi Yiren’s long-term clinical practice and systematic study on the theory of traditional Chinese medicine, showed he had a broad vision and far-sightedness. His academic thoughts should be considered the precursor to the integration of various clinical disciplines in modern Chinese and Western medicine. His forward-looking approach to traditional Chinese medicine research, coupled with his aspirations for reform and the great rejuvenation of the Chinese nation, continues to inspire the formulation of healthcare policies in China today. His insights remain valuable and are worth considering in the context of deepening the reform of traditional Chinese medicine. We believe that with the great rejuvenation of the Chinese nation and the hard work of TCM practitioners, the long-cherished wish to revitalize TCM will surely come true.
References
［1］ Zhang Boli 《The Essence of Academic Thoughts on the Establishment of Famous Doctors of the China Academy of Chinese Medical Sciences》 People’s Medical Publishing House 2020-02-01
［2］ Shi Zhensheng 《Shimen Medical Review》 China Medical Science and Technology Press, first edition, June 1994
［3］ Shi Yiren 《What I Want to Say》 Fuxing Chinese Medicine, 1940, Volume 1, Issue 1
［4］ Shi Yiren《On the Purpose, Gains and Losses of Traditional Chinese Medicine Writers in the Past》
［5］ Zhang Zanchen 《A Brief History of President Shi》 Revival of Traditional Chinese Medicine, the first issue of 1940 was published in January 29th of the Republic of China.
［6］ Shi Yiren《Declaration of the Romance of Medicine》 in《Transactions of Shaoxing Medical Journal》 1919
［7］ Wang Mimi 《Shi Yiren Medical Essays》 Xueyuan Press 2011-08-01
［8］ Shi Yiren 《On Improving Traditional Chinese Medicine》 Shanxi, Medical Journal, 1933, Issue 70
［9］ Shi Yiren 《Basic Conditions for the Revival of Traditional Chinese Medicine》 Fuxing Traditional Chinese Medicine, 1940, Volume 1, Issue 1
［10］ Shi Yiren《Collaboration of the Academic Standings of Traditional Chinese Medicine》Ziqiang Medical Monthly, 1940
［11］ Shi Yiren 《Instructing students on the method of studying medical books》 Renaissance Chinese Medicine, 1940, Volume 1, Issue 6
［12］ Shi Yiren ［Introduction］ Shanxi 《Medical Journal》1934, Issue 76
［13］ Shi Yiren《Improving Traditional Chinese Medicine and Manufacturing Traditional Chinese Medicine》 Shanxi Medical Journal, 1933, Issue 71
［14］ Shi Yiren 《Preface to Seasonal Diseases》 Medical Journal, 1934, Issue 80
［15］ Shi Yiren 《Chinese Acute Infectious Diseases》 Shanxi: Chinese Medicine Improvement Research Association, 1933, pages 1 to 5
Author information:
Liu HongWei American Society of Traditional Chinese Medicine and Acupuncture
著名中醫时逸人先生 “復興中醫”學術思想研究
劉宏偉
摘要：時逸人（1896-1966），現代著名中醫學家, 中醫教育家, 理論家，也是現代中醫史上積極提倡中醫科學化的代表人物，民國十大名醫之一。民國初期，中醫面臨巨大的生存壓力，時逸人先生早在1931年中央國醫館成立之初就提出：“改進中醫，必須以整理中醫學術為前提”的學術主張。為此，他先後擔任中央國醫館理事、常務理事、學術整理委員會專任委員、教材編審委員會委員、衛生署中醫委員會常委、中國醫學教育社理事等職。 1940年初時逸人再次在上海創辦“復興中醫學校”、“復興中醫社”以及創刊《復興中醫》雜誌，並提出具體復興中醫的“五化”。
本文就其提出的“五化”，即：“學說系統化、科學化；經驗集中化、實驗化；藥理生理化、化學化；診療機械化、實際化；預防社會化、政治化”進行了系統整理，以供中醫學者參考。
主題詞: 時逸人復興中醫學術思想
二十世紀前半葉對中醫來講是十分敏感的時期，從清末開始，中醫逐漸失去了延續數千年的主流醫學地位，在許多最基本，也是最核心的問題上受到西方醫學的衝擊，加之當時政府的不支持、不作為，甚至妄圖取消中醫，處境極為艱辛。當時的中醫有識之士，不僅要滿腔熱枕地在臨床上開闢一片新天地，而且還要更加積極地創刊、設社、辦學等，在社會上宣傳自己的觀點、想法，為中華民族的醫療衛生保健事業的發展與中醫在社會上的一席之地奔走吶喊。特別是為如何復興中醫大業，以期更好的為中國人民和世界人民造福，他們都做出了卓越的貢獻。時逸人先生就是當時叱吒風雲的傑出代表人物之一。
時逸人（1896-1966），字益人，祖籍江蘇無錫，出生於儀徵，後遷居鎮江。近現代著名中醫學家，教育家、理論家、臨床家、改革家，也是我國中西醫結合事業的先驅與開拓者。［1］［2］
時逸人先生早在民國初期剛出道時就閱讀了大量的中醫書籍，並積極投身到當時的社會醫學活動中，加之年輕有為、精力旺盛、思想非常活躍，從而萌發了整理醫書之主張，提出了“醫書愈多，醫學愈亂”的觀點。正如他自述所說：“鄙於民國五年，初業醫時，即有整理醫書之主張”。［3］他認為，歷代醫書各有所偏”，中醫自身也遠未能登峰造極，存在種種缺點。概而言之：“編輯書籍，無一定體例；診察方案，無一定規模；衣體相傳，無一定教授；以一症之徵，往往聚訟千語。若全體之大，乃竟研究無從。針灸、祝由，嗤為妄涎；生理病理，無此明文”。［4］為此，他運用一種非常獨特的分類方法研究中醫古籍，他將古醫書分為四派：一為發明派（如《黃帝內經》、《神農本草經》等）；二為編集派（如《千金方》、《外台秘要》等）；三為學生派（如《醫學心悟》、《醫宗必讀》等）；四為言論派（如金元四家、明清八家之書等）。他的主張，可謂標新立異。誠如名醫張贊臣先生對其初道就嶄露頭角稱讚有加：“自民五業醫以來，研究醫學，極多心得，曾散見於《紹興醫藥學報》、餘姚《衛生報》、杭州之《三三醫報》、南京之《醫藥衛生報》等。著述甚多，素為醫林所欽佩。並兼任其他各地醫報之撰述，熱心研究醫學，且能持之以恆，故有驚人之成就”。［5］
1919年時逸人先生在其所寫的《醫學演義宣言》中，系統表達了他重視中醫理論以及重新建構中醫理論學說的想法。他認為中醫理論創始最早，《靈樞》、《素問》、《難經》、《脈經》、《諸病源候論》等書，都是理論肇始的重要書籍。但此後醫學逐漸趨於症治，尤其到晚近，“醫案諸書多矣，愈出愈多，愈趨愈下。市醫之伎倆無窮，而醫已離道成術矣！”他明確意識到中醫已經逐漸缺乏理論創新，只有應世之術。為此，他十分感慨地指出：“近來歐風東漸，科學維新。潮流湍急，咄咄逼人。有識之士，知非改進不足以圖存也。改進維何？進而求其理論是也。誠以今日中醫之地位，不進則退，不存則亡！而理論者，乃事實之母。有精確之理論，方有精確之事實，此新學所以進步敏捷也。理論之荒謬，即事實之荒謬，此舊學所以感應遲鈍也。若中醫之不修理論者，則其誤甚矣。及時而圖，猶為未晚。而今而後，吾知之矣”。［6］由此可見時逸人先生早已下定立志整理改進中醫的決心，並為此付出了畢生的精力，去逐一落實《醫學演義宣言》中的志向。此外，時逸人先生也先後發表了《整理國醫學術之主張》、《研究中國醫學的幾個信條》、《論中醫歷代著作家之宗旨與得失》、《中國醫書的分類及研究程序》等論文。充分展現了他全心全意為中醫的繼承、發展而努力地奮戰的精神。另據筆者統計，時逸人先生編輯出版的著作有：《時氏內經學》《生理學講義》《金匱講義》《時氏診斷》《臨症簡訣》《藥物學講義》《中國處方學講義》《中國時令病學》《溫病全書》《中國急性傳染病學》《霍亂》《中國婦科病學》《時氏麻痘病學》《中國內科病學》《中國傳染病學》《中國藥物學》《時氏病理》《中醫傷寒與溫病》《外感熱病證治要義》《時氏處方學》《中國兒科病學》《實用中醫內科診治手冊》《實用經驗中醫驗方》《中國傳染病預防法》《選評驗方精華》《選評醫案精華》《審查徵集驗方》《時逸人醫案》《中國內科疾病診斷學》《醫宗用藥律例》《益人堂醫藥叢書》《益人醫話》《江左益人醫社叢書》等總計達30餘部之多。其內容涉及中醫基礎理論、傷寒、溫病、中藥學、方劑學、內科學、婦科、兒科、傳染病學等多個學科。從以上書目可知，時逸人先生確實按他自己年輕時的設想，矢志不移地完成了他所設想的中醫理論體系的構建，這在中醫發展史上也是個創舉。誠如中國中醫科學院醫史文獻專家鄭金生教授所說：“從來還沒見過哪一位民國間的中醫學者能寫出如此多而且自成體系的中醫之‘學’！”［7］縱觀時逸人先生的宣言與其畢生業績，誠可謂“一言九鼎”、“鈸而不捨”！他的這種執著精神，十分令人肅然起敬，更是今日中醫人認真學習的楷模。
民國初期，面臨生存壓力的許多中醫有識之士，已經意識到應該改進中醫自身，這在當時已基本形成共識。但如何改進，卻有不同的意見。有人認為應改進醫學為先，有人認為改進藥學最急。時逸人先生則認為“整理醫學”才是正道， 即“闡述固有之經驗，參合科學之方法”。但中醫的治療經驗都存在於醫書之中，所以整理醫書，又是改進中醫的首務。［8］他的改良中醫，必須以整理為前提的學術主張，在中央國醫館成立之初就提出來了，並為該館採用。 因此，他先後擔任中央國醫館理事、常務理事、學術整理委員會專任委員、教材編審委員會委員、衛生署中醫委員會常委、中國醫學教育社理事等職。他曾自信滿滿地說：“鄙人自信素強，想以個人之能力，在中國醫學上做相當之貢獻”，“勉竭綿薄，以期挽救醫學於萬一”［4］，其誠其謹，可感天動地。
1940年時逸人先生在當時社會環境十分危機的情況下，在上海創辦復興中醫學校，復興中醫社以及創刊《復興中醫》雜誌。他借《復興中醫》為園地，希望與有誌中國醫學研究者，作一次大規模的有關整理中醫的交流，時逸人先生當時取名“復興中醫”。其實，早在1934年他在山西時，閻錫山將軍有復興中醫之宏願，曾請時逸人先生草擬計劃。但隨後因國事緊張，時局紛擾，時逸人先生的草案未能實施。當他創刊《復興中醫》後，第一期就刊載了他的“復興中醫之基本條件”［9］一文，系統表述了他的學術見解。時逸人先生認為，中醫的療效無可否認。但其困君之處在於“學理之荒疏，經驗之龐雜，假借名詞之羅列，各家學派之不同”。欲復興中醫，則必須整頓改進中醫。他將復興中醫的具體辦法，歸納為“五化”，即：學說系統化、科學化；經驗集中化、實驗化；藥理生理化、化學化；診療機械化、實際化；預防社會化、政治化。
誠可謂“一言九鼎”、“鈸而不捨”！他的這種執著精神，十分令人肅然起敬，更是今日中醫人認真學習的楷模。
民國初期，面臨生存壓力的許多中醫有識之士，已經意識到應該改進中醫自身，這在當時已基本形成共識。但如何改進，卻有不同的意見。有人認為應改進醫學為先，有人認為改進藥學最急。時逸人先生則認為“整理醫學”才是正道，即“闡述固有之經驗，參合科學之方法”。但中醫的治療經驗都存在於醫書之中，所以整理醫書，又是改進中醫的首務。［8］他的改良中醫，必須以整理為前提的學術主張，在中央國醫館成立之初就提出來了，並為該館採用。因此，他先後擔任中央國醫館理事、常務理事、學術整理委員會專任委員、教材編審委員會委員、衛生署中醫委員會常委、中國醫學教育社理事等職。他曾自信滿滿地說：“鄙人自信素強，想以個人之能力，在中國醫學上做相當之貢獻”，“勉竭綿薄，以期挽救醫學於萬一”［4］，其誠其謹，可感天動地。
1940年時逸人先生在當時社會環境十分危機的情況下，在上海創辦復興中醫學校，復興中醫社以及創刊《復興中醫》雜誌。他借《復興中醫》為園地，希望與有誌中國醫學研究者，作一次大規模的有關整理中醫的交流，時逸人先生當時取名“復興中醫”。其實，早在1934年他在山西時，閻錫山將軍有復興中醫之宏願，曾請時逸人先生草擬計劃。但隨後因國事緊張，時局紛擾，時逸人先生的草案未能實施。當他創刊《復興中醫》後，第一期就刊載了他的“復興中醫之基本條件”［9］一文，系統表述了他的學術見解。時逸人先生認為，中醫的療效無可否認。但其困君之處在於“學理之荒疏，經驗之龐雜，假借名詞之羅列，各家學派之不同”。欲復興中醫，則必須整頓改進中醫。他將復興中醫的具體辦法，歸納為“五化”，即：學說系統化、科學化；經驗集中化、實驗化；藥理生理化、化學化；診療機械化、實際化；預防社會化、政治化。
總之，時逸人先生所提倡的學科分類：基礎學科，應用學科和專門學科，為當今中醫學科的科學分類奠定了良好的基礎。
二、經驗集中化、實驗化
中國醫學積數千年之經驗，歷數萬人的探討，從而形成此種專門學說其特長全在於經驗之豐富，而經驗之寶藏，一半在於精神之靈辨，一半在於有效之良方，故能效如浮鼓。降及後世，亦代有專書，惟此前代國家既不器重，而有些講求身心性命之學者，又高自標榜，視醫學為小道，加之世醫之家，父子秘傳，師弟株守，視醫術如傳家寶，夾秘方為斂財具，所有經驗，埋藏民間，年湮代遠，失傳良多，洵今日中醫衰落之原因也。我國醫師眾多，非社會即師授 ，雖學說不佳，而對於各科，均有實地經驗。如對於某一病或某一症，有特別家傳秘法，雖諸醫束手者，亦能藥到病除，歷驗不爽。惜無公開研究之機關，以致未能與西醫競爭，苟能集中一處實地試驗，特效者，褒獎之，無用者，廢棄之，必有驚人收穫，可斷言者。［9］
他也提出“中醫是中國人民之中醫，凡吾國人於國醫精華，應努力研究，國產藥物亟等努力闡述，此則關乎國計民生，誠非淺鮮，應改良國藥，抵制外貨，公開秘術，闡述國學，尤須通力合作，並保復興中醫之途徑，則前程之希望遠大，不獨民眾受益，亦吾醫界之光也。”［12］
他在山西中醫改進研究會工作期間，作為審查和編輯的主要負責人，大量收集民間驗方，並組織專門機構，審查並剔除了其中許多荒誕或不科學的治療方法，併陸續編輯出版《審查徵集驗方》6集，收錄驗方6000餘首，內容豐富，具有方便、安全、適用的特性（該書是近代中國首部官版驗方彙編），廣為推行，以求中醫理論與實踐能夠進一步發揚。
三、藥理生理化、化學化
民國時期對中醫持“廢醫存藥”觀點的人不在少數，尤其是那些曾接受西洋醫藥教育的人士，持這種觀點更為流行。時逸人先生對此反覆論辯，他一再強調中醫、中藥密不可分。他以日本明治維新時殘害漢醫導致的嚴重後果為歷史教訓，明確指出：“中藥之應用，乃中醫歷世相傳經驗之結晶。苟廢除中醫之經驗，惟專求化驗中藥成分之效用，恐所獲者少，而所失者多。”［13］
“廢醫存藥”觀承認中藥有用，如麻黃定喘，當歸補血等等。但他們沒有想到，總結出這些藥物治療的效用，正是中醫的成就。時逸人先生曾打了一個很好的比方：西醫說，中醫可廢，惟中藥尚有可用——此意“實屬任意誣蔑”，恰似抗戰勝利以後，評判中國軍隊，“謂中國士兵不良，惟槍械尚屬可用，應當重賞槍械，不必慰勞士兵”，這“豈非笑談”［4］。
其實，中藥的療效，都是在中醫理論與臨床實務經驗中總結出來的。中藥的取效，更多的是在中醫理論指導下的配伍應用。只重視單味藥的成分與效用，卻置中藥最重要的配伍使用於不顧，實屬本末倒置、重物廢人。可以說這就是“廢醫存藥”者最致命的短視。
因此，時逸人先生一針見血地指出：“中藥重在配合。苟配合有法度，其成績非常圓滿，毫無副作用之發現。中醫歷數千年之經驗，其方藥配合，皆有一定法度，歷試不爽者。”他認為正確的做法應該是：“必以中醫之經驗為重，參用西法化驗之補助，則改進中醫與製造國藥並進，期無誤矣”。［13］時逸人先生關於中醫、中藥密不可分的關係分析，即使在當今社會，對中醫依然持有“廢醫存藥”觀點的人，仍然有其振聾發聵的作用 。
那麼如何研究中藥呢？時逸人先生認為：考中藥經數千年之沿革，治療特效，惟賴經驗豐富，惜未經科學之證實，化學之分析。有經驗而無研究，其理不明，所謂驗方而已。近幾年來，德國、美國、日本研究中藥，不遺餘力。將麻黃製成麻黃鹼Ephedrine,認為定喘發汗聖藥；附子製成 Aconitine，認為強心鎮痛聖藥，半夏製成 Atropin，認為定嘔祛痰聖藥，類此甚多。
中醫所用之中藥，久為西醫所廢止者，已經他人著手，便成為神聖之品。故中醫衰微之原因，不但有經驗不集中，還有藥物缺少化驗，也不符合之正軌科學。若能將各種本草中藥，研究清楚其生理化學公式，定其成分，製成方劑。如含有膠質之藥，像山楂、當歸、熟地……做成膏;如不變性之藥，陳皮、枳實、芒硝，做成結晶;白礬、冰片、硫磺等做成粉;含有水分之藥，做成漿。含有油質之藥，做成油。易變性之藥，仿罐頭食物製之，如人參、黃耆之類，以玻璃置。可變糟泊而為精華，普及中醫原因療法之專長，世界各國均可受其惠也［9］。時逸人先生所提倡的中藥現代研究為當今中藥現代化奠定了基礎。
四、診療機械化、實際化
自古以來我國醫學診療之事，極為簡便，診斷不外望、聞、問、切，治療不出按摩、砭石、針灸、湯劑，運用周而收效速。惟後世學者，神秘於切診，輕於望、聞、問三事，遂缺物質之應用。湯劑學日益發達，得臟器治療之宗師。按摩、砭石、針灸之術漸漸失傳，因而導致治療方法之不充實，十分遺憾。
回顧近三百年來，西方科學發達，物質進展，醫療器械，日見完整。診斷之法，治療之術，聲、光、電磁、原子化合，皆在應用。回視中醫，未免相形見拙。因此，對於診療方法，應藉助機械化之途徑。在診斷上，中醫之精神靈辨，固然重要，而藉助器械也是必須的。如用X-光以查骨形，以及驗尿、血、痰、膿、便、汁，細菌培養，化學反應，物理檢查，無一不在應用之列。關於治療，中醫長於內科，西醫精於手術。
中醫被人拋棄的原因，實因外科沒有發展，缺乏器械設備。以後中醫治療，除內用丸散膏丹之外，宜用器械，如電氣、針灸、注射、刀具、洗滌及物理療法，太陽燈、紫外線、導尿管、洗胃器，能利用西人之器械，則改良之能事備矣。［9］
由此可見，時逸人先生的以上論述為中西醫結合臨床各科研究奠定了基礎，當今中西醫結合的現狀，進一步驗證了時逸人先生所說：“只有中西醫精誠合作，互相扶助，共求進步，抵於大同，才是當時中國醫藥界救亡的唯一出路”，卻是千真萬確的，不能不說是英明之見！
五、預防社會化、政治化
預防一事，在醫學上關係尤其重要。所謂一磅之預防，勝於十磅之治療。因流行性疾病，有不易治者，並無不可防之者，防患於未然，則輕而易舉。治療於既發，則諸感困難，是預防之道，實健康之保障，不病之要則也。古人以上工治未病，此我國古時注重預防之明證。
古代醫學上預防疾病之條件，節勞逸，慎飲食，嚴起居，調寒暑，寡思慮，戒酒色，洵千古不易之定律。惜無專書，語焉不詳，是一大缺點。自細菌學發明以來，預防注重消毒，衛生貴正在清潔。故歐美諸先進國家，對於飲料之力、濾過，食品之檢查，衛生之建築，光線之配合，預防注射，傳染隔離，醫學上最為重視。
我國預防，既無專書，有不重視。故痰唾滿地，糞尿狼籍，塵穢堆積，食同器，居同室，國無防疫之政，人無預防之識，醫無隔離之學，如此缺點，毋庸諱言。故宜將預防疾病之法，整合專書，並使民眾具此常識。然非政治上督促，難以收效也。預防之道，除遵守固有之精神衛生外，而物質衛生，亦不容忽視。如細菌傳染之製止，凡個人、家庭、城市、鄉村、工廠、學校、商場、劇院、公共場所等，衛生設備皆須注重。他如嬰婦保健，傳染預防，疾病隔離，注射預防，身體檢查，衛生教育，均宜匯集，各成專書，逐次實行。如此可以改進醫學上之缺點，造福民眾也。［9］
1928年，時逸人先生在上海任教時，專授古今疫症。他有感於四時外感病證“歷來書籍，從未有列入專科研究者，或為內科雜證之附庸，或為古本傷寒之附屬，或目為時方而抵之，或因其近於葉派而攻之”［14］，為此他認真研究了自《內經》和《傷寒論》以來，特別是明清“溫病學派”的諸家學術思想和經驗，並結合大量的臨床實踐勇於探索，將傷寒與溫病中非傳染性病證進行了整合，創立了“時令病學”的新命題，熔傷寒、溫病於一爐，成為其學術思想的里程碑，並於1930年編撰出版了《中國時令病學》，整理歷代醫家對於傷寒溫病之糾紛。為了彌補《中國時令病學》之不足，他於1933年又編輯出版了中國首部中醫治療傳染病的專著《中國急性傳染病學》。正如他所說：“餘於1922年即主張傳染病學有獨立專科之必要，應盡先編輯，訂成專書，可作為中醫擔任防疫工作及診治傳染病時之參考材料，故對於前代醫家所載診治傳染病之經驗及方法，均有相當之留意與考察，將古代歷史的遺產用近世科學理論予以闡明，並與現代科學相結合，使到達‘中醫科學化’之目的。”［15］
此後，他也編著出版了《中國傳染病學》、《中國傳染病預防法》等，為中醫系統研究傳染病學科奠定了基礎。目前全球COVD-19的大流行，進一步驗證了時逸人先生的先見之明。
時逸人先生並總結指出：“綜上五則，乃就事實言之，必須切實做到，為復興中醫之準備。或謂事故如此，惟理想太高，難期達到。試觀十八世紀之西醫，四液三素之說，盛昌一時，與中醫古書上之陰陽五行如出一轍。然幾經論難，毅然丟下歸納科學之途，而有今日 ，絕非偶然。
目前中醫能迎頭趕上改進整理，不守舊古說，不盲從新學，用科學方法，檢討過去錯誤，採納現在特長，希圖創造第三者之醫學是已”。又有人說，中醫之妙處，正在不科學，如氣化原理，營衛循環，精神靈辨，治療卓效，是其獨到之處。然在學說上而論，凌亂無章，荒涎虛談，名詞假借，牆壁虛響，千篇一律，令人讀之欲嘔，苟不順世界潮流，則學說無系統，經驗不集中，藥品不化驗，診療不改良，預防不普遍，“誠恐不廢而自廢”。
又有人說，中醫不科學，是要被廢，也就是科學化後，也要被廢。斯言似覺有理，蓋因中醫未經科學改進，學說龐雜，經驗渙散，不成體統，既經科學化後，恐被西醫所同化，“未免杞人憂天”。“所以整理醫學必須與改良藥學，相輔而行，非但為國人生命之保障，且可以供世界醫學之採取，為東方文明，放一異彩。”［9］
綜上所述，時逸人先生經過長期的臨床實踐和對中醫理論的系統研究，視野開闊，高瞻遠矚，提出以科學方式整理復興中醫之“五化”，其學術思想被認為是近現代中西醫臨床各科結合的雛形。
可見他對中醫學術研究的前瞻性，其復興中醫改革思想的弘願與中華民族的偉大復興一脈相承，至今仍對我國醫療衛生政策的製定提供啟示，值得在中醫藥深化改革領域借鑒。
我們相信隨著中華民族的大復興，和中醫人的艱苦努力，復興中醫的夙願一定能實現。
參考文獻
［1］張伯禮主編《中國中醫科學院建院名醫學術思想精粹》人民衛生出版社 2020-02-01
［2］時振聲著《時門醫述》中國醫藥科技出版社 1994年6月第一版
［3］時逸人《我要說的話》復興中醫 1940年第1卷1期
［4］時逸人《論中醫歷代著作家之宗旨與得失》
［5］張贊臣《時社長小史》復興中醫 1940年第一期創刊號民國29年1月出版.
［6］時逸人《醫學演義宣言》見《紹興醫藥學報彙刊》1919年
［7］王咪咪《時逸人醫學論文集》學苑出版社 2011-08-01
［8］時逸人《談改進中醫》山西，醫學雜誌 1933年70期
［9］時逸人《復興中醫之基本條件》復興中醫 1940年1 卷1期
［10］時逸人《整理國醫學術之主張》自強醫學月刊1940
［11］時逸人《告學員研究醫書之方法》復興中醫 1940年第一卷6期
［12］時逸人「卷頭言」山西《醫學雜誌》1934年第76期
［13］時逸人《改良中醫與製造國藥》山西醫學雜誌 1933年4月71期
［14］時逸人《時令病學序例》醫學雜誌 1934年12月 80期
［15］時逸人《中國急性傳染病學》，山西：中醫改進研究會， 1933年，第一至5頁
作者簡介:
劉宏偉,美國中醫藥針灸學會
