1、从文化和惟象理论理解中医,杨晓达 北京大学药学院,中医的囧境,废除中医运动 1879年，俞樾：废医论 1914年，汪大燮（教育总长）：废止中医，不用中药 1929年，余云岫-第一届中央卫生委员会会议：通过废止旧医以扫除医事卫生之障碍案 1950年代，余云岫、王斌（卫生部副部长）：再度提出废止中医方案 从1998年开始，方是民、罗永浩、张功耀：“告别中医中药”,到药学院学中医的美国学生,中医现代化的困境,传统中医： 挂羊头卖狗肉 玄学和神秘主义的泥潭 其他民族医学的渗透 中医现代化： 中医=传统文化或医学经验 中药=植物药 评论：现在方式的中医现代化=“废除中医”,钱学森谈中医,中医理论不是现代
2、意义上的科学 中医现代化，是中医的未来化 用西医来化中医，我认为那是错误的 开展唯象的中医学研究，使中医学成为能用现代语言表达的系统体系,“我一直宣传中国的传统医学有许多人认为这与现代科学对不上号。实际上如果把西方的科学同中医所总结的理论以及临床实践结合起来，那将是不得了的”,中医系列讲座,从文化和惟象理论理解中医“周易参同契”-浅谈作为中医理论基础的易经“新概念中医学”-惟象中医理论概述解密气功和道家修炼法,中医的现代价值何在？ Why is TCM interesting,Increasing needs for “feeling good” To cure sometimes; to r
3、elieve often; to comfort always -E.L. Trudean (a nameless American physician )Medicine is thus not a science but a learned profession that attempts to blend affairs of the spirit and the cold objectivity of science -Dr. McDermott (co-editor of The Cecil-Loeb Textbook of Medicine)TCM: Sensation-based
4、 medicine emphasizing prevention and individual medicine successful for Chinese health for at least 4000yrs,TCM is interesting for,Drug innovation based on natural compounds TCM: thousands of useful herbalsThe future predictive and preventive medicine TCM: many practical concepts and methodsOverall:
5、 great opportunities in TCM!,TCM has to be understood in views of both culture and science！,1: Who are Chinese？,China is just a name of dynasty: 秦 (the first) or 清 (the last) dynastyIn communication with western countries, Chinese used “中国(The central country/the middle state)” “唐人(people of Tang dy
6、nasty)” or “汉人(people of Han dynasty)” Traditional name for Chinese and China: 华夏“the country of flourish summer” 华人,The first dynasty of China,The 1st ancient kingdoms/dynasties in the historyEgypt: 3100BCMiddle east: 2700BC,2697BCThe United states of China黄帝(Yellow Emperor) “天子”：Son of GodKing of
7、the kings,王,King - the one who links together heaven, earth and people,Unification of “the country of flourish summer”,An huge animal who can fly without wings A bizarre animal resemblying many animals: cows head, hares eyes, horses neck, snakes body, alligators belly, fishs squama, tigers paw, eagl
8、es nail, deers horn,Note: the Yellow Emperor was actually from the Bear tribe (有熊氏),“龙” Dragon: the emblem for a strong and multination kingdom”,4500 B.C.,Current image,Existing bizarre animals,OKAPI, an animal looking like jigsaw of a giraffe and a zebra.,PLATYPUS, an egg-laying, venomous, duck-bil
9、led, beaver-tailed, otter-footed mammal, having a sense of electro- reception.,The emblem for modern Chinese:,Dragon,or,Panda,2: Basic philosophy： “易经”(The Book of Evolution),Heaven,Earth,Wind,Fire,Swamp,Mountain,Water,Thunder,“3”,“ ”,“ ”,FUHSI: the founder of eight diagrams.,Yin (Moonage),Yang (Sun
10、age),“Space”,Full-moon -Wet,Half-Moon -Wind,Sunrise -Fire,Bright-light -Dry,New-moon -Heat,High-noon -Cold,Five phases,Six Climates,Fire (2/7),Earth (5/5),Metal (4/9),Water (1/6),Wood (3/8),The human structure in western medicine -major functional systems,Circulation system,Nervous system,Reproducti
11、ve system,Repiratory system,Endocrine system,Musculoskeletal system,Digestive system,The mind-body interactions,Human structure in TCM view -Position and dynamic correlations,Inner organs,hallway organs,external organs(sensing organs + exhibitory tissues,Topo transfig,Human structure in view of TCM
12、-classification by position in the body,Pulmo,Thymus,Thyroid,Lung,Inner-hallway-external Systems,Time and “stars”,A star map of 2500yr ago,North,A kings tomb of 6500yr ago,Princess,Prince 2,Prince 1,Prince 3,Big Dipper,Constellation (1) - dragon for east,Alligator,Constellation(2) - white tiger for
13、west,White tiger,Constellation (3) - Pheonix for south,Ostrich,Constellation (4) - “Great turtle” for north,Plesiosaur,The rhythm of a day,“Combination”,恒 Staying,益 Advancing,mate,apart,The principle for exercises,Yoga is derived from the Sanskrit root “yuj,“ meaning “to control,“ “to yoke“ or “to u
14、nite.“ Translations include “joining,“ “uniting,“ “union,“ “conjunction,“ and “means.“,Thunder,Wind,Nerve/Brain,Liver,Muscle/tendon,Joined physical and mental exercises,益 Advancing,3: Establishment of TCM,Established in 2000-2500 BC Documented by 200 BC “黄帝内经” (anonymous): fundamental principles Man
15、uals for physicians were established 200 AD “伤寒杂病论” (ZHANG, Zhongjing): medical manual “神龙本草” (anonymous): collection of medicinal herbals“千金方” (SUN, Simiao): collection of prescriptions and formulas “本草纲目Compendium of Materia Medica ” LI, Shizhen (1518 1593 AD ) 2,000 herbal species in 60 categorie
16、s 11,000 prescriptions,“黄帝内经(The Yellow Emperor Textbook of Medicine)”,The best physician avoids diseases Health policy and life style are most important for a government Good physicians prevent diseases Average physicians treat disease Bad physicians make use of disease,4: Medicinal herbals,Shennon
17、g (the great farmer) is believed to taste the herbals and discover herbal medicine.,Shennong mountain, which is in Hubei province and famous for various white animals, is believed to be the home of Shennong,Drugs (藥) and music (樂),藥 = 艸 + 樂,情动于中，故形于声；声成文，谓之音；乐以和其声。 “Voice is the expression of our se
18、nsation. Music makes harmony of the voice through a rhythm.” -乐记(The Book of Music),Drug,Herbal,Music,Medicines help to bring the body back to balanced state,Pathological stresses, e.g. virus, germs, toxins, etc,Medicines,The relationship between drugs and toxins,Compounds,Rational use,Improper use,
19、Drugs,Toxins,High efficacy Low toxicity,High efficacy high toxicity,Low efficacy high toxicity,Low efficacy Low toxicity,Western medicine,Safe for daily use Disease prevention,Low toxicity/high or low efficacy Treatment of common situation,High efficacy/High toxicity Treatment of emergencies,Chinese
20、 medicine,Top grade,In goods,Inferior,Efficacy of herbals?,+,+,Efficient,Not efficient?,5: Sensation-based medicine,Six excesses causing diseases,Cold Heat Dry Wet Wind Fire/Inflammation,Five tastes of drugs,Four methods,Eight senses of the body,Sore Pain Numbness Swell Itch Flounce Warm Cold,Look S
21、mell Touch Ask,Sour Sweet Bitter Hot Salty,Physiology,Pathology,Diagnosis,Medicine,A parallel of computer,Software,Hardware,Mind,Body,The notion of QI,Nothing over heart,Air breath,Flowing force,Burning energy,“Qi” - A sense with control; An expression of mind-body interaction,“QI”,How to generate “
22、QI” getting control of our body,Maintaining the functions of heart and kidney Sleeping/meditation QI is generated when heart and kidney are coordinated,既济 Energetic/Comfort,6: The bodys own medicine,Our body can produce everything needed to cure the diseases. Psychological health is the ground for t
23、he body health. One can direct his/her body by: Prayer/meditation Guided acrobatic exercises, e.g. Yoga,Taiji. Skin stimulations, e.g. acrupuncture,Acupuncture points,Acupuncture point: true or false?,In “Book of Huangdi (黄帝内经)”, only connection tunnel is recorded Study done by Ruhr-Universitaet Boc
24、hum, DeutchEfficacy for 1162 patients with chronic pain on sacral 71.1 (at acupuncture point) 67.7 (not at acupuncture point) 57.6 (standard treatment) Efficacy for 1039 patients with chronic pain on knee 35 take medicine within 3 Mon (acupuncture point) 35 (not at acupuncture point) 56 (standard tr
25、eatment)Effective point is the key other than the written “point”,7: The medical procedures,Diagnostic methods: Look (望) Smell (闻) Touch (切) Ask (问) For medical decision: Yin or Yang阴阳: which organ has problems Empty or solid虚实: Pathological entity or metabolic disorder. Inner or outer表里: the progre
26、ss of the disease Cold or heat寒热: bodys responses to the disease - the reasons why we feel sick,Pulse Diagnosis,?,Cant sleep!,Bad smell!,Sb is dirty,What is going to do?,Block the nose,Cover it,Take a bath,Sleeping pills,Holistic, individual, and dialectical treatments,Therapeutic strategy-Western m
27、edicine,Symptoms and cures,CONTACTM: for treatment of common coldPseudoephedrine hydrochloride Chlorpheniramine maleate (night caplet)Acetaminophen (non-Drowsy remedy),Pain reliever/Fever reducer,Nasal decongestant,Antihistamine,Therapeutic strategy-Western medicine,Antiviral treatment Oseltamivirph
28、osphate,IUPAC name: ethyl (3R,4R,5S)-5-amino-4-acetamido-3- (pentan-3-yloxy)cyclohex-1-ene-1-carboxylateA neuraminidase inhibitor,TCM Therapeutic strategy,Type 1 Remedy: green onion 3 piece, fermented soybean 10g, ginger 75g, pueraria radix 100g, peony 75g (adjust cold response),Type 2 Remedy: Isati
29、s root 6g, dyers woad leaf 6g (antiviral and anti-inflammation treatment)Compound bezoar pill (安宫牛黄丸) (stop high fever),Cold /Flu,TCM versus MWM,Sensation based,Science based,Individual,Public,Self cure,Cure by medical treatment,Life style,Technology,8: Chinese traditional virtue and values,Health s
30、tands on healthy life style!,Unity and Peace(和) Body and Soul（精神内守） People in the world （世界大同） Human and Nature（天人合一）,和,We are the World! -MJWe are one! -“Lion King II”,Basics for “礼” (Sell-discipline),畏天知命Trust in nature and its fortune 日新厥德Update everyday 止于至善 “Be ye therefore perfect, even as you
31、r father which is in heaven is perfect.” -MATTHEW 5:48 始于足下Starting point be always at me 允执厥中Hold in potential and measure,Sum:,1: 华夏中国，神龙传人； 2: 阴阳周易，八卦五行； 3: 黄帝立医，上治未病； 4: 神农尝草，药取偏性； 5: 灵肉相守，心肾气生； 6: 针砭导引，自愈疾病； 7: 望闻问切，八纲辩证； 8: 天人合一，礼乐中庸。,Thank you!,谢谢！,兰之猗猗，扬扬其香。众草与茂，无人而芳。 幽幽栖谷，馨配君王。不采而佩，于兰何伤。 时人暗蔽，贤者埋藏。以日以年，逍遥四方。 奕奕荠麦，贸贸雪霜。君子之道，闇然日彰。,幽籣操,
