ToRemovetheDependency

ofCultureinTCM

—TCMStudyinthefieldsofPhilosophyandScience中醫(yī)學(xué)的文化依存性解蔽

——在哲學(xué)和科學(xué)之間的中醫(yī)學(xué)研究

程偉張浩黑龍江中醫(yī)藥大學(xué)哈爾濱

ChengWei&ZhangHaoHeilongjiangUniversityofChineseMedicine,Heilongjiang,Harbin150040

中醫(yī)藥學(xué)何以值得高度關(guān)注

WhyTCMisremarkable中醫(yī)學(xué)是否科學(xué)，是中醫(yī)學(xué)界內(nèi)外久盛不衰論戰(zhàn)不休意見常常尖銳對立的話題。WhetherTCMisscientificornotisacontroversialtopicwhichhasbeendisputedinalongtimeincommunity.就多元文化視角下的中國科技史研究這一主題來說，中醫(yī)問題值得深入討論。

TheissueofTCMisworthytobediscussedintheviewofmulticulturalbackgroundofhistoryofscienceandtechnologyinChina.中醫(yī)藥學(xué)何以值得高度關(guān)注

WhyTCMisremarkable中醫(yī)學(xué)在臨床醫(yī)學(xué)領(lǐng)域有不可替代的重要價值。TCMisincomparableinclinicalmedicine.但其豐富的實踐經(jīng)驗與其古樸的傳統(tǒng)理論之間存在著復(fù)雜的內(nèi)在關(guān)系。Therearecomplexrelationsbetweentherichclinicalexperienceandclassicaltraditionaltheory.中醫(yī)學(xué)理論以其特有的方式把握著某種尚未被現(xiàn)代科學(xué)研究說明的規(guī)律性的東西,其潛在的科學(xué)價值不容忽視。TCMhavesomeregularitywhichhasn’tbeenprovedbymoderntechnologyyetinuniqueway,andthescientificvalueofTCMcannotbeignored.對中醫(yī)科學(xué)性的質(zhì)疑往往與中醫(yī)理論的民族化的表達(dá)形式有關(guān)。ThedisputeinthescienceofTCMalwaysfocusontheoryofTCM.

一、自然哲學(xué)形態(tài)理論的不徹底性

TheUn-thoroughnessoftheoryabouttheNaturalPhilosophyForm中醫(yī)學(xué)的基本理論核心概念并非生命現(xiàn)象、疾病現(xiàn)象專屬的確切概念ThebasictheoryofTCMisnotspecificconceptionofLifeandDiseases.其理論框架、邏輯結(jié)構(gòu)、推理方式受制于其理論核心陰陽五行的學(xué)說體系Thetheoryframe,logicstructureandreasoningmethodsareconfinedbythecoreofTCM.實際經(jīng)驗雖被系統(tǒng)化說明，但其各個組成部分之間并不存在嚴(yán)格的邏輯關(guān)系，常常只是在有限的范圍內(nèi)言之成理Thoughthepracticalvalidityhasbeenprovedsystematically,thereisnostrictlylogicrelationshipamongconstituents.Usuallythepracticalexperiencesonlyarereasonableinlimitedfield.作為自然哲學(xué)的理論體系，中醫(yī)理論解釋生命世界的模型并非由核心概念、基本原理、基本規(guī)律逐級展開的嚴(yán)格的層級性邏輯系統(tǒng)。Asnaturalphilosophy,theinterpretationoflifeworldinTCMisnotastrictlogicsystemincludinglevelsofcoreconcept,basictheoryandbasicregularity.理論模型中不同構(gòu)件間的關(guān)系有些是虛構(gòu)而成InthetheoreticalmodelofTCM,someoftherelationshipamongdifferentelementsisimaginary.陰陽五行、臟腑經(jīng)絡(luò)、氣血津液及各種辨證方法等等不同層級的學(xué)說、概念的內(nèi)涵及其現(xiàn)實相關(guān)度有很大差異ThecontentsofYinyangandfiveelements,fuorgansandmeridian,Qiandbloodandsomereasoningmethodsarefarfromthemechanismofbody.看似相同的概念在不同層級上的含義，如陰陽、陰虛陽虛、腎陰腎陽、腎陰虛腎陽虛分屬不同層級Someconceptsseemedlikeeachotherareindifferentlevelofmeanings,suchasyinandyang.概念內(nèi)涵只有在某種變動不居的關(guān)系中動態(tài)性把握Conceptsandconnotationsonlycanbedynamicacknowledgedinsomerelationship.

類比推理的或然邏輯未必表達(dá)得出真實世界的必然性聯(lián)系ProbablelogicofAnalogyreasoningimprobablyshowsinevitabilityofrealworld.臨床實踐成功經(jīng)驗表述方式受到這種理論語言的局限常常難于確切把握Theexpressionofthesuccessfulexperiencesinclinicalpracticeislimitedbythetheoreticallanguage,therefore,it’shardtograspprecisely.不同層級理論概念現(xiàn)實相關(guān)度差異很大

There’smuchdifferencebetweenthepracticalcorrelativedegreeofeachdifferentlevel.概念的理論來源與經(jīng)驗的組織、呈現(xiàn)方式、理論概念與經(jīng)驗的交互作用、經(jīng)驗究竟如何檢驗著理論都需要給出更透徹的說明Itneedmoreclearexplainaboutthetheoreticalsourceoftheconceptandtheorganization,modesofpresentationofexperience,interactionbetweentheoreticalconceptsandexperienceandhowexperienceexaminethetheory.哲學(xué)化化的語語言如如不改改變形形態(tài)便便難于于轉(zhuǎn)化化成可可以進(jìn)進(jìn)入現(xiàn)現(xiàn)代體體系的的公共共語言言，難難于成成為確確切的的研究究對象象Ifthephilosophilizednarrationdidn’ttransformintopubliclanguagethatcanadaptitselftomodernsystem,TCMwillbedifficulttobeaspecificstudysubject.對以舊舊有方方式表表達(dá)的的各種種經(jīng)驗驗的本本質(zhì)的的揭示示，不不能固固守傳傳統(tǒng)理理論，，而應(yīng)應(yīng)專注注于特特定表表達(dá)方方式背背后的的真實實經(jīng)驗驗Torevealtheessenceoftheexperiencesinterpretedwitholdexpression,insteadofadheretotraditiontheory,weshouldfocusontherealexperiencesbehindthespecificexpression.文化依依存性性放大大與疆疆界迷迷失Toextendthedependencyofcultureandtoblurtheboundary何為中中醫(yī)學(xué)學(xué)理論論？正正統(tǒng)教教科書書式的的表述述并未未全面面清晰晰界定定WhatisTCMTheory?Thereisnocomprehensiveandcleardefinitionintheorthodoxtextbooks.各類中中醫(yī)古古籍所所涉內(nèi)內(nèi)容幾幾乎無無所不不包ThecontentsofancientbooksanddocumentsofTCMalmostincludesallaspects.近年，，中醫(yī)醫(yī)學(xué)的的傳統(tǒng)統(tǒng)文化化依存存性被被有意意無意意地放放大，，使中中醫(yī)學(xué)學(xué)幾乎乎迷失失了自自身疆疆界,養(yǎng)生生亂象象與此此有關(guān)關(guān)。TheculturaldependencyofTCMstudyhasbeenexaggeratedconsciouslyorunconsciously,whichmakesTCMstudyalmostloseitsownboundarytoalargerextent.魚龍混混雜的的復(fù)雜雜局面面侵蝕蝕著中中醫(yī)學(xué)學(xué)的機(jī)機(jī)體，，中醫(yī)醫(yī)藥學(xué)學(xué)依然然需要要長期期的文文化解解蔽。。Themixed-upcomplexityhasbeenerodingTCMstudy,andtheprocessofde-shieldingTCMwithhighlyculturedependencywillbeforlong.如何從從獨特特的文文化傳傳統(tǒng)成成果中中開掘掘出可可資當(dāng)當(dāng)今醫(yī)醫(yī)學(xué)科科學(xué)借借鑒的的再生生資源源，研研究仍仍處于于起步步階段段We’’restillattheinitialstageofstudyinghowcanweminingrenewresourceswhichmodernmedicinecanbeabsorbingfromthroughresearchingouruniquetraditionalculture.二、中醫(yī)學(xué)學(xué)整體觀念念及其經(jīng)驗驗載體ThewholeconceptofTCManditscarrierexperience中醫(yī)學(xué)整體體觀念確實實體現(xiàn)著中中醫(yī)學(xué)的某某種獨特性性。ThewholeconceptofTCMembodytheuniquenessofTCM.但整體觀念念的實現(xiàn)始始終只能依依賴于具體體的醫(yī)療經(jīng)經(jīng)驗。However,itcanonlydependonthedetailedclinicalexperiencetoachievethewholeconcept.強(qiáng)調(diào)中醫(yī)研研究不能脫脫離臨床蓋蓋緣于此。。That’’swhythestudyonTCMcannotbeseparatedfromclinicalpractice.醫(yī)療實踐的的整體性Theintegrityofmedicalpractice醫(yī)學(xué)始于對對疾病的認(rèn)認(rèn)識而非始始于健康觀觀念。Medicineoriginatefromcognitionofdiseaseratherthanconceptofhealth.疾病現(xiàn)象總總會伴生某某種整體狀狀態(tài)，至少少是患者的的心身感受受。Diseasealwaysproducesomekindofwholestate,atleast,thephysicalandmentalfeelingofpatients.即便某種疾疾病的產(chǎn)生生有著相對對局限、單單一或者確確定的內(nèi)在在根源，其其外在表現(xiàn)現(xiàn)也會呈現(xiàn)現(xiàn)出某種整整體性。Eveniftheproductionofsomediseasehastherelativelimitation,soleorthedeterminationintrinsicroot,theexternalperformancewillalsopresentsomekindofintegrity.在沒有通過過實體結(jié)構(gòu)構(gòu)變化理解解疾病根由由的條件下下，細(xì)致觀觀察外在狀狀態(tài)就是醫(yī)醫(yī)生的唯一一手段。Intheconditionofunderstandingdisease’soriginwithoutthesolidstructurechange,theonlymethodthatadoctorcouldtakeistocarefullyobservetheexternalcondition.醫(yī)療實踐的的整體性Theintegrityofmedicalpractice在相對特異異性的疾病病中，規(guī)律律性地表現(xiàn)現(xiàn)出來的狀狀態(tài)就被規(guī)規(guī)定為某種種證候。Intherelativespecificitydisease,theconditionwhichregularlydisplaysisdefinedassomekindofsymptoms(ZhengHou).同一疾病在在不同時期期或在不同同情況下，，其不同狀狀態(tài)間存在在某種演化化關(guān)系，使使人們在對對其內(nèi)在根根源的推測測中也建立立了某種聯(lián)聯(lián)系。Thereisaevolutionaryrelationshipsbetweendifferentstatesofthesamediseaseatdifferenttimesorindifferentsituations,whichestablishalinkinpeople’sinferenceofitsunderlyingcauses.捕捉到某種種其他認(rèn)識識方式尚未未把握到的的內(nèi)在規(guī)律律是中醫(yī)學(xué)學(xué)的獨到之之處。TocapturetheinternallawthatothermeansofcognitionfailedtograspistheuniquenessofTCM.得到一定程程度系統(tǒng)化化說明的舊舊經(jīng)驗在新新的現(xiàn)實面面前可以引引出某種新新嘗試并可可能不斷導(dǎo)導(dǎo)致某種成成功。Infrontofnewreality,theoldexperienceswhicharedescriptinsystematicwaytosomeextentcanleadtoanewattemptandmaycauseaseriousofsuccess.但中醫(yī)作為為經(jīng)驗科學(xué)學(xué),實踐基基礎(chǔ)是經(jīng)驗驗而還不具具有系統(tǒng)的的實驗研究究的證據(jù)基基礎(chǔ)；Asascienceofexperience,TCMpracticeisbasedontheexperienceratherthantheevidenceprovedbythesystematicexperimentalstudy.它在現(xiàn)今的的知識增長長方式仍然然主要靠在在具體的醫(yī)醫(yī)療實踐過過程中摸索索積累。Itsknowledgedevelopmentmainlydependontheexploringandaccumulationofspecificmedicalpractice.而難于借助助現(xiàn)代技術(shù)術(shù)引入實驗驗研究領(lǐng)域域深入探索索，就不能能較快轉(zhuǎn)化化為具有普普遍意義的的規(guī)律性知知識。Itcannotbequicklytransformedintotheuniversalknowledgeinlawwithdifficultyinintroducingexperimentalstudytoexplorethedomainthoroughlywiththeaidofmoderntechnology.強(qiáng)調(diào)整體性性經(jīng)驗的價價值不應(yīng)一一味歌頌舊舊整體觀Emphasizethevalueofintegrityexperiences,butshouldnotblindlypraisetheoldwholeconcept.由于缺少對對實體內(nèi)部部結(jié)構(gòu)的深深入了解，，缺少對結(jié)結(jié)構(gòu)與功能能的關(guān)系的的追索，對對生命活動動和疾病現(xiàn)現(xiàn)象的把握握只能著眼眼于現(xiàn)象表表層，以推推究內(nèi)在狀狀態(tài)。Wecoulddeducetheinternalsituationonlyfromthesuperficialleveloflifeactivitiesanddiseasephenomenawiththelackofdeepinsightintotheinternalstructureofentitiesandtheabsenceofexploringtherelationshipbetweenstructureandfunction.這種情況況在以連連續(xù)性、、不可分分割性、、自我化化生性為為特征的的氣論哲哲學(xué)思想想體系中中得到強(qiáng)強(qiáng)化。ThissituationhasbeenstrengthenedbythephilosophyofQiwhichischaracterizedbycontinuous,indivisibleandself-metaplastic.中醫(yī)的整整體觀從從非結(jié)構(gòu)構(gòu)性實體體認(rèn)識來來說是無無奈的，，而從氣氣一元論論哲學(xué)來來說是自自覺的。。ThewholeviewofTCMfromnon-structuralentityunderstandingiscompelledtodo,butfromQimonismphilosophyitisconscious.三、新整整體觀可可否重生生于分析析性研究究Cannewwholeconceptrebirthintheanalyticalstudy在中醫(yī)學(xué)學(xué)界的自自我辯護(hù)護(hù)中，作作為中國國傳統(tǒng)文文化性格格表征的的整體論論一直被被反復(fù)強(qiáng)強(qiáng)調(diào)。Inself-defenseofChineseacademiccircles,wholismhasbeenunderlinedrepeatedlyastherepresentingtheChinesetraditionalculture.在當(dāng)今世世界整體體論思想想受到空空前關(guān)注注的情況況下，中中醫(yī)學(xué)界界對自身身優(yōu)長評評價很高高且期望望甚殷。。Undertheconditionthatwholismdrawsunprecedentedattentioninnowadays,theChineseacademichighlyevaluatetheirownsuperiority.實際上，，對一種種哲學(xué)傳傳統(tǒng)的關(guān)關(guān)注主要要在于它它倡導(dǎo)的的思維方方式、思思想導(dǎo)向向和概念念模型Infact,theconcernofaphilosophicaltraditionisthatitinitiatedthewaysofthinking,thoughtguidanceandconceptionalmold.研究實踐踐需要清清晰的路路線和具具體的工工具與方方法。Studypracticeneedaclearline,specificmethodsandinstruments.當(dāng)今對現(xiàn)現(xiàn)代醫(yī)學(xué)學(xué)某些局局限的強(qiáng)強(qiáng)烈關(guān)注注使中醫(yī)醫(yī)界出現(xiàn)現(xiàn)了對所所謂還原原分析方方法的嚴(yán)嚴(yán)重懷疑疑Nowadays,there’’sgenerateseriousdoubtsbyconcerntocertainlimitationsofmodernmedicineontheso-calledreductionanalysismethodinTCM.以致忽視視了中醫(yī)醫(yī)、西醫(yī)醫(yī)研究對對象原本本一致、、只是由由于方法法與手段段的不同同走上了了不同的的道路。。SothatignoringthesamesubjectofChineseandWesternmedicine,differentmethodsandmeansleadtodifferentroads.二者雖各各有所長長，但傳傳統(tǒng)中醫(yī)醫(yī)經(jīng)驗方方法在確確切把握握認(rèn)識對對象的有有效性方方面，缺缺少必要要技術(shù)工工具因而而成長緩緩慢。Bothofthemhaveadvantages,intheaspectofeffectivenessoftheknowingobject,traditionalChineseexperiencemethodgrowslowlyduetolacksoftheessentialtechnicaltools.中醫(yī)藥現(xiàn)現(xiàn)代研究究為時尚尚短，成成就有限限，使有有些人將將現(xiàn)代分分析研究究方法斥斥之為還還原論局局限而多多方懷疑疑。ModernStudyofTCMstartsnotforlongwithlimitedachievement,somodernanalysismethodsisusedinTCMthatcausedmuchmoredoubtsaboutReductionism.在復(fù)雜性研究究正在興起的的背景下，更更有人直接給給中醫(yī)冠以復(fù)復(fù)雜性科學(xué)的的美稱，夸大大著獨立發(fā)展展的意義。Underthebackgroundofcomplexresearch,somepeopletookthecomplexscienceforgranted,andexaggeratedthesignificanceofindependentdevelopmentofTCM.生命科學(xué)及醫(yī)醫(yī)學(xué)面對至為為復(fù)雜的生命命現(xiàn)象和人類類疾病，中醫(yī)醫(yī)學(xué)的確以特特有的方式觸觸及到某種尚尚未被現(xiàn)代科科學(xué)研究說明明的規(guī)律性的的東西。Thelifescienceandmedicinefacingthecomplexbiologicalphenomenaandhumandisease,TCMmedicineindeedisrelatedtoregularthingsintheuniquewaywhichhadn’tbeenindicatedbythemodernscience.然而，要深化化這些認(rèn)識，，做出更為深深刻的說明，，則非借助現(xiàn)現(xiàn)代分析研究究不可。However,todeepentheunderstandingandtomakeamoreprofoundnoteshoulddependonthemodernanalysis.中醫(yī)的所有可可貴發(fā)現(xiàn)都應(yīng)應(yīng)成為研究對對象AllthevaluablediscoveryofTCMshouldbestudied.而進(jìn)一步研究究就需要借助助日益強(qiáng)大的的現(xiàn)代研究手手段，研究仍仍然主要靠分分析。Furtherstudyaskforthesupportofscientificmethod,andstudydependsonanalysis.以科學(xué)工具解解文化之蔽至至為重要。It’simportanttogetridofthefalsebyscientificmethod.透過成功經(jīng)驗驗，直接面對對現(xiàn)實中具體體對象展開研研究，才有望望取得可持續(xù)續(xù)深化的成果果。It’spossibletohaveachievementsthroughthestudyofthesuccessfulexperienceandthespecificrealobjects.因為隨著現(xiàn)代代科學(xué)技術(shù)的的高速發(fā)展，，人們認(rèn)識生生命現(xiàn)象和疾疾病的能力大大大增強(qiáng)，幾幾乎每一項相相關(guān)技術(shù)的進(jìn)進(jìn)步都在改變變著現(xiàn)代醫(yī)學(xué)學(xué)的面貌。Withtherapiddevelopmentofmodernscienceandtechnology,people’sabilitytoknowthebiologicalphenomenaanddiseaseenhancedgreatly.Almosteveryrelatedtechnologyadvanceschangethewayofmodernmedicinemoreorless.中醫(yī)學(xué)要在現(xiàn)現(xiàn)代人的知識識體系中處于于應(yīng)有位置，，成為現(xiàn)代知知識譜系的分分支，采用現(xiàn)現(xiàn)代科學(xué)技術(shù)術(shù)手段，運(yùn)用用現(xiàn)代社會、、國際社會共共有的表述方方式。TCMwi