책소개

 

머리말

사상의학이 창안된 지 95년만인 1989년 한의과대학에 사상체질과가 처음 개설되었고, 2009년 20주년을 기 념하여 그동안 교육과 임상에 응용해오던 강의 내용의 요지를 묶어 책으로 발간하기로 뜻을 모았습니다. 그간 경희대학교 부속한방병원 사상체질과 의국에서 이루어졌던 임상실습 교육내용이 여러 차례 증간을 통해 보완이 되어왔으나 제 면모를 갖추지 못한 부분이 아쉬움으로 남아 이번 기회에 부족하지만 지난 20년을 기념하는 의미에서 의국원들이 뜻을 모아 준비하였습니다.
올해가 동무 선생 서거 110주년이 되는 해이고 또한 사상체질의학회의 창립 40주년이 되는 해임을 생각할 때, 이 책이 지니고 있는 의미가 남다르다고 생각합니다.

초창기 기존 중의학적인 내경류의 증치의학적인 시각의 비판이 많았고, 때에 따라서는 이단으로 치부되기도 했던 사상의학이 오늘의 발전을 이룩한 것은 東武 李濟馬 선생의 학문적 예지가 점차 빛을 발했기 때문입니다. 또한 초창기부터 모든 난관을 디디고 의국을 일으켜 세우신 誠泉 宋一炳 교수님의 은공과 초대 의국장인 조용태 선생을 비롯한 박성식 교수 등 우리 의국의 역사를 만들어온 의국원 여러분의 노력과 뒤에서 후원해주신 사상체질의학회의 초대 홍순용 교수님, 최병일, 김진성, 조황성, 김경요, 김달래, 박성식, 장현진 등 역대 회장님의 지원과 학회 회원 여러분의 따뜻한 사랑의 힘이라고 생각합니다.

사상체질의학은 한국의 한의학을 대표하는 학문임은 물론 사람의 타고난 특징을 중시하고 마음을 더불어 관리하는 체질의학이자 사회를 건강하게 이끄는 미래 맞춤의학의 궁극적 목표를 담고 있는 귀중한 한국 민족 문화 유산입니다. 뿐만 아니라 임상에서 고통과 괴로움을 덜어줄 수 있는 실용의학입니다.

우리 후학들은 선배들이 이루어 놓으신 업적을 발판으로 삼아 더욱 노력하여 사상의학이 생활 속에 살아 숨쉬는 실용적 생활의학으로 진화해갈 수 있도록 노력해야 할 것입니다.
이 책을 통해 사상의학을 공부하는 학생들도 학문의 원리와 뜻을 제대로 익히고 임상에 응용할 수 있는 실기 내용과 임상의 예를 숙지하여 만전을 기하도록 해야겠습니다.

그동안 의국원들의 작업을 통해 만들어진 관련 서적의 원문 내용과 활투를 위한 사상신편 내용의 재편 작업 결과를 같이 첨부했기 때문에 관심있는 한의사와 연구자들이 많은 도움을 받을 수 있을 것으로 확신합니다.
끝으로 편람 발간을 위해 열과 성을 다해준 이의주, 이수경, 이준희, 황민우 교수를 비롯한 의국원 여러분 의 노고에 깊은 감사의 뜻을 전하고, 책을 엮는 과정에서 만전의 노력을 다했으나 혹시라도 부족한 부분이 눈에 띄거나 발전을 위한 제언이 있으시면 언제라도 저희 교수진과 소속 의국원에게 지도와 편달 바랍니다.
경희대학교 한의과대학 사상체질과 주임교수 고병희

 

 

추천사

그동안 사상체질의학을 학습할 때 동의수세보원, 격치고, 초본권 등, 원문을 통한 방법이 매우 중요함에도 불구하고 학습자들 간에 이해의 차이가 있어온 것이 현실입니다. 그러한 점에서 이제 사상체질의학의 학습을 모든 한의학 교육과정의 필수요소라는 점에 비추어 공통분모를 제시해 나아가야 하는 것이 후학들의 임무이기도 합니다. 기존 ≪사상의학≫ 교과서와 함께 이번 출간된 ≪사상체질과 임상편람≫은 학습의 효율과 더불어 임상교육의 방향을 제시하는 데 큰 의미가 있다고 생각합니다. 특히 체질진단, 체질병증, 체질치료, 체질양생, 증례보고로 구성되어 실질적인 임상응용에 나침반 역할을 수행하는 데 손색이 없다고 봅니다.
교육 현장에서 임상 자료를 축적하고 정리해온 사상체질과 교실 수련의 선생님들과 교수님들께 깊이 감사드리며, 교육 현장뿐 아니라 임상 실제의 현장에서도 유용한 지침서의 역할을 기대하며 많은 분들의 적극적인 활용을 추천하는 바입니다.
사상체질의학회 회장 장현진

 

 

축사

四象醫學 임상편람의 출간을 축하합니다.
사상의학은 한국 한의학이 중국의학과 다르다는 것을 보여주는 대표적인 의학전문 분야입니다. 우리 한의학이 중의학보다 우월하다고 할 때 그 근거로 사상의학의 우수성에 대해 말하지 않을 수 없습 니다.
사상의학의 단초는 靈樞에서 발견할 수 있습니다. 조선말 李濟馬 선생이 역대의 중국의학자들이 밝히지 못한 이치를 발양시켜 한의학의 장점을 극대화시킨 체질의학이 사상의학입니다. 사상의학은 正氣 위주의 발병론과 치료원칙을 가진 한의학의 특징을 잘 살려낸 한의학의 精髓라고도 할 수 있습니다. 그러나 사상의학은 체질 감별에서부터 다소 난해한 점을 가지고 있어서 활용하려 해도 그 보편화에 어려움을 가지고 있었습니다.

이제 임상편람이 나옴으로써 체질의 진단, 병증, 치료, 양생 분야에서 더욱 신뢰할 만하고도 명확한 指針을 가질 수 있게 되었습니다. 이는 수십 년에 걸쳐 우리 대학의 사상의학교실에서 쏟은 집념과 의지가 결실을 본 것이라고 할 수 있습니다. 또한 이를 통해 임상적으로 사상의학은 根據 중심의 의학으로 나갈 수 있는 확고한 기반을 다졌다고 봅니다.
이제마 선생은 돌아가시기 전에 앞으로 백년 후에는 사상의학이 온 세상을 풍미할 것이라고 예언한 바 있습니다. 이제 그 100년이 지나 임상편람의 출간은 이제마의 꿈이 실현되는 구체적인 성과라고 할 수 있습니다.
국내뿐만이 아니라 세계인들이 사상의학의 혜택을 보는 그날까지 계속 정진하시길기를 기원합니다. 다시 한 번 더 심심한 축하와 격려의 말씀을 드립니다.
2010. 2 경희한의대 학장 최승훈

 

 

 목차

 

1권

제1장 體質診斷 1
1.1. 四象體質 診斷의 槪要 3

1.2. 체질진단 6

1.2.1. 明知其人 6

1.2.2. 明知其證 36

제2장 體質病證 49
2.1. 總論 51

2.1.1. 體質病證의 중요성 51

2.1.2. 體質病證의 인식 배경 52

2.1.3. 體質病證의 추구 정신 53

2.1.4. 體質別 病證 診斷 개요 55
2.2. 各論 58

2.2.1. 少陰人 58

2.2.2. 少陽人 64

2.2.3. 太陰人 71

 

제3장 體質治療 79
3.1. 四象人의 藥物과 方劑 81

3.1.1. 四象人 藥物 구분 기준 81

3.1.2. 藥物使用의 原則 85

3.1.3. 四象方劑論 87
3.2. 少陰人 處方用藥 91

3.3. 少陽人 處方用藥 92

3.4. 太陰人 處方用藥 92

3.5. 太陽人 處方用藥 92

3.6. 東武先師四象藥性嘗驗古歌 96
3.6.1. 脾藥 96

3.6.2. 肺藥 100

3.6.3. 腎藥 103

3.6.4. 肝藥 106

3.6.5.『東武遺稿·藥性歌』의 총괄표 107
3.7. 四象醫學에 응용되는 鍼法 108

3.7.1. 四象醫學 문헌에 언급된 針法 관련 내용 108

3.7.2. 이후에 연구된 針法 관련 내용 108

3.7.3. 총괄 116

제4장 體質養生 117
4.1. 槪括 119

4.2. 一般論的 養生論 120

4.3. 體質論的 養生論 124

4.4. 食餌療法에 따른 養生論 128

4.5. 結論 129

 

제5장 證例報告 135
5.1. 太陽人 病證 137

5.1.1. 內觸小腸病 137

5.2. 少陽人 病證 144

5.2.1. 脾受寒表寒病 144

5.2.2. 胃受熱裏熱病 155

5.3. 太陰人 病證 169

5.3.1. 胃脘受寒表寒病 169

5.3.2. 肝受熱裏熱病 174

5.4. 少陰人 病證 187

5.4.1. 腎受熱表熱病 187

5.4.2. 胃受寒裏寒病 195

 

 

2권

格致藁 附 濟衆新編 遺藁抄 ················································· 1
格致藁 卷之一 ·································································3

儒略 ············································································ 3

  1. 事物 ······································································· 3

  2. 觀仁 ········································································6

  3. 志貌 ········································································8

  4. 天下 ·······································································10

  5. 四戒 ·······································································12

  6. 天勢 ·······································································13

  7. 天時 ······································································ 15

  8. 天下索我 ································································· 17

  9. 我止 ······································································ 19

  10. 土氓 ····································································· 20

  11. 遊世箴 ·································································· 21

  12. 大風箴 ···································································22
格致藁 卷之二 ······························································· 23

反誠箴 ········································································ 23 

  (1. 緖) ······································································ 23

  2. 乾箴/乾箴 下截 ························································· 24

  3. 兌箴/兌箴 下截 ························································· 27

  4. 坤箴 ····································································· 30

  5. 艮箴/艮箴 下截 ·························································32

  6. 離箴/離箴 下截 ························································ 36

  7. 震箴 ····································································· 39

  8. 坎箴 ····································································· 41

  9. 巽箴 ····································································· 43
格致藁 卷之三 ······························································ 46

獨行篇(壬午年) ······························································46

濟衆新編(丁酉年) ··························································· 58
  1. 五福論 ····································································58

  2. 勸壽論 ····································································60

  3. 知行論 ····································································61

  附 遺藁抄 ···································································62

東醫壽世保元四象草本卷 ·················································· 63
卷之一 原人 ··································································65
  第一統 ······································································ 65

  第二統 ······································································ 68

  第三統 ······································································ 71

  第四統 ······································································ 74

  第五統 ······································································ 76
卷之二 病變 ··································································79
  第一統 ······································································ 79

  第二統 ······································································ 83

  第三統 ······································································ 87

  第四統 ······································································ 91

  第五統 ······································································ 92

  第六統 ······································································ 98
卷之三 藥方·································································· 104
  第一統 ······································································ 104

  第二統 ······································································ 109

  第三統 ······································································ 115

  第四統 ·····································································  120

  第五統 ······································································ 121

 

東醫壽世保元 甲午舊本 ···················································· 123

復元本 咸山 沙村
東醫壽世保元性命論 卷之一·················································125
  1. 性命論 ··································································· 125

  2. 四端論 ····································································125

  3. 擴充論 ··································································· 125

  4. 臟腑論 ··································································· 125
東醫壽世保元少陰人論 卷之二 ·············································125
  5. 醫源論(6條) ····························································· 125

  6. 少陰人外感膂病論(60條) ···············································127

  7. 少陰人內觸胃病論(64條) ·············································· 134

  8. 少陰人膂胃病篇尾泛論(27條) ········································· 141
東醫壽世保元少陽人論 卷之三 ·············································150
  9. 少陽人外感膀胱病論(31條) ············································ 150

  10. 少陽人內觸大腸病論(33條)············································155

  11. 少陽人膀胱大腸病篇尾泛論(41條) ·································· 160
東醫壽世保元之太陰太陽人論 卷之四······································169
  12. 太陰人外感腦顀病論(23條) ·········································· 169

  13. 太陰人內觸胃脘病論(10條) ·········································· 173
太陽人論 ······································································177
  14. 太陽人 外感腰脊病論 ··················································177

  15. 太陽人內觸小腸病論 ···················································178

  16. 廣濟說 ···································································181

  17. 四象人辨證論 ···························································181

東醫壽世保元 辛丑本 ························································185
東醫壽世保元卷之一 ························································ 187

  1. 性命論(37條) ·····························································187

  2. 四端論(26條) ·····························································191

  3. 擴充論(17條) ·····························································195

  4. 臟腑論(17條) ·····························································198
東醫壽世保元卷之二 ·························································201
  5. 醫源論(9條) ······························································201

  6. 少陰人 腎受熱表熱病論(52條) ········································· 204

  7. 少陰人 胃受寒裏寒病論(67條) ·········································210

  8. 少陰人 泛論(24條) ·······················································217
東醫壽世保元卷之三 ·························································229
  9. 少陽人 脾受寒表寒病論(45條) ········································· 229

  10. 少陽人 胃受熱裏熱病論(29條)·········································236

  11. 少陽人 泛論(23條) ······················································240

  12. 太陰人 胃脘受寒表寒病論(13條) ····································· 248
東醫壽世保元卷之四 ·························································251
  13. 太陰人 肝受熱裏熱病論(40條)·········································251

  14. 太陽人 外感 腰脊病論(4條) ··········································· 261

  15. 太陽人 內觸 小腸病論(11條) ········································· 262

  16. 廣濟說(23條) ··························································· 265

  17. 四象人 辨證論(28條)····················································268

東武遺稿(海東) ·······························································273
東武遺稿(海東) ·······························································275

上篇 ············································································275

  1. 東武先師四象藥性嘗驗古歌 ·············································275

下篇 ··········································································· 286
  2. 四象要目 註解 ····························································286

  3. 治瘇核方文 ·······························································289

  4. 四象人 食物類 ····························································291

  5. 金鳳舜癎病 治癎論 ·······················································292

  6. 戒少陰人 ··································································293

  7. 四臟論 ·····································································293

  8. 四象人氏名 ································································294

  9. 四象人 藥材類 ··························································· 295

  10. 總論 ······································································ 297

  11. 發表藥 ··································································· 300

  12. 泄瀉藥 ····································································300

  13. 淸熱藥 ··································································· 300

  14. 下藥 ······································································ 301

  15. 痢疾藥 ··································································· 301

  16. 卒中風藥 ································································· 301

  17. 眼病藥 ··································································· 302

  18. 四臟之痰藥 ······························································ 302

  19. 禁忌 ······································································ 302

  20. 病症各論 ································································· 303

  21. 傷寒陽證 ································································· 305

  22. 少陽人 淸熱藥 ··························································· 305

  23. 虛勞症 ··································································· 306

  24. 輕粉論 ··································································· 306

  25. 少陽人痢疾及暑症 ······················································ 307

  26. 少陽危症 ································································· 307

  27. 少陽人禁忌 ······························································ 308

  28. 雜藁 ······································································ 308

  29. 太陰病 ··································································· 309

  30. 吐血 ······································································ 309

  31. 關格 ······································································ 309
  32. 雜藁 ······································································ 310

부록 : 四象處方歌 ·····························································311

東武遺稿(藏書閣) ·····························································325
第一卷. 濟衆新編 ······························································327

第一篇. 五福論 ································································ 327

第二篇. 勸壽論 ································································ 329

第三篇. 知行論 ································································ 331
第二卷. 東武遺藁 ····························································· 332

第一篇. 東武遺藁 ····························································· 332

  1. 時色 ········································································332

  2. 言行 ········································································333

  3. 膀胱 ········································································333

第二篇. 孝悌論 薪山社鄕約契跋文 ········································· 334

第三篇. 上大臣書 金炳始 ···················································· 335

第四篇. 辛巳五月元山港問答 ··············································· 336

  1. 初日問答 ·································································· 336

  2. 次日問答 ·································································· 336
  3. 又次日問答 ······························································· 337

  4. 又次日問答 ······························································· 337

  5. 又次日問答 ······························································· 338

  6. 又次日問答 ······························································· 339

  7. 家綱良問答 ······························································· 339

  8. 蛾眉人問答 [彼人有多鬚蛾眉, ········································· 340

            問答未問姓名. 故記其儀表也.]
  9. 人物紹介 ·································································· 340
第五篇. 鎭撫時上疏 ·························································· 341

第六篇. 答中川祐順書 [二月十五日] ······································· 341

第七篇. 傳令本邑捕執綱 ····················································· 342

                     [丙申 二月 初九日]

 

第八篇. 各道風俗 ····························································· 342

第九篇. 遊蹟 [辛未年] ······················································· 343

第十篇. 闡幽草 ································································ 344

第十一篇. 外交論 [一名, 東洋平和策] ····································· 345

第十二篇. 詩賦 ································································ 347
  1. 己未三月念後 元谷柯峙會吟 ············································ 347

  2. 六月旣望 連日陰雨 以詩相和 ··········································· 347

  3. 自警 [四首] ······························································· 347

  4. 癸亥夏 南遊鷄龍 與居昌金生同乞 ······································ 347
     題兩乞

  5. 己巳春 寓居屯地 自警東壁 [四首] ····································· 347

  6. 自警西壁 [四首] ························································· 347

  7. 又自警 [二首 兼呈栗洞] ················································· 347

  8. 又自警 ····································································· 348

  9. 辛未季夏 會于沙村 ······················································· 348
     以生長老人世間爲題 相和

  10. 壬申六月過羅村修正賦 ················································· 348
第十三篇. 敎子平生箴 ························································ 349

 

                      [壬午 四月 十八日]

第十四篇. 八卦箴總論 [見格致藁舊本]······································350

第十五篇. 追錄 ·································································351

第十六篇. 前高原郡守李公濟馬追思臺·······································351

                      [今移竪于墓側]

第三卷. 其他 ···································································352

第一篇. 丁酉元山港問答 ····················································· 352

  1. 첫 번째 문답 ······························································ 352

  2. 두 번째 문답 ······························································ 353

  3. 세 번째 문답 ······························································ 353
  4. 네 번째 문답································································354

  5. 다섯 번째 문답 ····························································355

  6. 여섯 번째 문답·····························································356
第二篇. 性命論 ································································ 357
  1. 天機有四 ·································································· 357

  2. 耳聽天視 ·································································· 357

  3. 肺達事務 ·································································· 357

  4. 頷有籌策 ·································································· 357

  5. 頭有識見 ·································································· 358
  6. 耳目鼻口觀於天也 ······················································· 358

  7. 天時大同也 ······························································· 358
  8. 耳好善聲 ·································································· 359

  9. 善聲順耳也 ································································ 359

  10. 肺惡惡聲 ································································· 359

  11. 惡聲逆肺 ································································· 359
第三篇. 四端論 ································································ 359

第四篇. 知風兆 ································································ 360

第五篇. 陳情 ··································································· 361

第六編. 相牛方 ································································ 362
  1. 相耕牛方 ···································································362

  2. 相母牛方 ···································································362

普濟演說 ·······································································363
普濟演說 ·······································································365
  普濟演說 ······································································365

  人生日用說 ·································································· 371

  天地運氣 ····································································· 372

  臟腑總圖 ····································································· 375

  王叔和의 觀病生死徵候 ···················································· 380

  四象六經歌 ···································································381

  四象相貌及藥種 ······························································382

  四象應用藥方 ·································································384

  經驗方 ········································································ 412

  附錄 ···········································································423

東醫四象新編 李濟馬 著·······················································425
東醫四象新編內篇 ·····························································427
  ❍ 四象經驗 ··································································429

  四象口訣 ······································································432

  通四象臟腑所在圖 ···························································432

  通四象全軆所屬圖 ···························································432

  東醫四象用藥彙分外篇 ······················································435

  東醫四象新編劑方 ···························································464

  ○海松子論 ···································································476

  ○葛茸論 ······································································476

  ○血餘論 ······································································476

  跋 ··············································································477