谈到中华传统文化，大家首先想到的莫过于以孔子思想为代表的儒学思想，但中华传统文化绝不止这些；谈到中医药，大家第一印象可能是针灸、按摩，因为她们已经走向全球，但中医药也远不止如此。医学、生物学飞速发展的21世纪，中医药学这一古老学科为什么还有生命力？她与现代医药学有何不同？为什么很多人觉得中医药知识体系不容易学习和掌握？因为：中医药学具有深厚的中华传统文化背景，如果不了解中华传统文化，就难以深入理解中医药学的思想和知识。 本课程就是希望通过剖析中医药与中华传统文化的密切联系，使大家了解中医药学的中华传统文化的背景，更容易理解中医药的思维特征、思想特色和知识体系。通过本课程的学习，不仅能掌握一些中医药的基本知识、中医药养生的原理和方法，还能从中医药的视角认识中华传统文化的精髓。
中医“致中和”思想 "
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From the course by Shanghai Jiao Tong University
中医药与中华传统文化
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From the lesson
易文化与中医药 & 儒学思想与中医药
古老而神秘的易文化，有人觉得很难理解，有人觉得博大精深，究竟易文化对中医产生了哪些影响呢？儒学思想作为主流思想文化之一，又是如何与中医药学相互渗透、相互影响？让我们跟随彭老师的讲解一起开启中医药的传统文化基因之旅，从文化角度理解中医药知识体系的特征。
Meet the Instructors
Peng ChongshengAssociate Professor
School of Pharmacy
Hello, every one.
Last class we have discussed the benevolent basis of the Chinese Medicine ethics
then this class I will talk about the moderate ideology (zhizhonghe)of traditional Chinese medicine
in the review of Confucianism
we once talked about that "neutralization and mean" is one of the core ideas
so what is "neutralization"?
it is called "zhong" when people do not express his feelings,
while called "he" when express out his feelings but control it
let us read the definition in the Book of Rites·Mean
Zhong is the root of all human
He is the universal rules followed by people
when reached Zhong and He, everything will develop properly
what is it mean?
Zhong is the foundation of social stability
He is the methods of interaction with others
when reaches Zhong and He
everything will in its proper place
and develop naturally
therefore, it is a very good state
an ideal state
when understanding this thought
the mistake that people always made is to pursue absolute neutralization
but in fact it should be harmonious as a whole and unification of diversity
from social angle
the development with absolute mean and without difference is lack of motivation
from human himself, even the healthy person
yin and yang in the body(briefly understood as substance,energy etc. in western medicine) are constantly changing
if you do not quite understand yin and yang
I can say some index of modern medicine for your understanding
such as blood sugar, blood fat, blood pressure and so on are all in the dynamic change
I once made an electrocardiogram named 24 hours
it is very interesting
I found my heart rate is constantly changing
it is probably around seven clock,
the heart rate changes most rapidly
and it is most slowly at three or four clock at night
many people may not image how frequent it is
just over twenty times
that is to say these index are changing dynamically in one day
however in fact, he is a healthy man at that time
so it is a dynamic balance
from the perspective of nature
there are the change of four seasons, temperatures and the movement of sun and moon
they are all changing in a certain range
therefore, Zhi Zhong He is a kind of dynamic trend and stability in time and space
the idea of Zhi Zhong He has already permeated in many areas of traditional Chinese medicine and pharmacy
then let us see the first effect of Zhi Zhong He on TCM Etiology
let's see the unbalance of emotions
Chinese Medicine considers that,seven human emotions are happy, anger, worry, love,sorrow, fear,and hate
happy comes from heart,anger from liver, love from lungs, fear from kidney
in the normal condition, the change of seven emotions is normal and will not bring disease
over the degree will hurt the body, namely when spirit boost is too intensively or lasts too long
beyond the ability of self-control
these parameters I just said is changing everyday
but it has a certain range
for example, your blood pressure cannot over 160
it is generally considered that over 150、160 is hypertension
and your diastolic pressure can not over 90
it has a limit
when beyond the ability of human self-control
it will cause the imbalance of human system
and affect human health
the imbalance of seven emotions will lead to the air loss and disorder of five organs
I just said seven emotions are related to the function of five organs
so," diseases are all from pneuma, it is caused by anger, smoothed by joy and removed by sorrow
down by fear, chaotic by surprise and heal by love
it is referred in Huangdi Nei jing·plain questions
the up, down, removed, smooth, chaotic and heal discussed here
is referred to the disorder of pneuma caused by over emotions
the doctor of tradition Chinese medicine thinks qi movement is important
it is an manifestation of normal human body function
so it is said joy and surprise make heart-broken
when said this, can you think about in Chinese ancient stories
is there a story in which
some character has this condition
joy、surprise make heart-broken
maybe many people think of immediately
oh, it is Fanjin
the story is about Fanjin whose family members are all poor common people,
but he, surprisingly passed the provincial civil service examination
this was the biggest good news for his whole family 82
however,he was over joyful,and became sick
joy, surprise damage heart
then how to understand anger impairing liver
you maybe see many people get angry
do you ever notice their action when they fly into a rage
someone may cover the lower right rib after their anger
because they feel the liver uncomfortable
and contemplation hurts spleen is also the crucial reason
nowadays many people like thinking
contemplation hurts spleen also causes disease
dose anyone can recall in the Chinese history
is there any character in the novel having spleen hurt by contemplation
you may think about the Dream in Red Mansions
there is a character named Lin Daiyu
she got lovesickness
she felt sorrow when she heard Jia Baoyu would engage soon
then she got sick
at last she pined away for eating nothing
Lin is very slim, right?
It has something to do with lovesickness which hearts the spleen.
She doesn't want to eat.
surely, besides the lovesickness, her sadness also hurts the lungs.
she is in a depression for a long period.
of course there is another saying that may be she has the phthisis.
all in all, her body degenerated in the end.
you may have some other thinking while mentioning sadness hurts the lungs.
when someone is in great sadness or depression
he may behave some manner unconsciously
i don't know whether you have noticed
what the behaviour is
alas, he sighed
then why he sighed? because his sadness has hurt his lungs
and the sigh made him feel smooth and comfortable
then he will feel relax
what's more, fear hurts kidney
perhaps you have seen some cases like
in some spy TV series, when the betrayers were caught, they might too frighten to pee in their trousers
that means fear hurts kidney
kidney controls the water in our body, that makes sense
too many emotional fluctuation will hurt the heart
therefore, one that good at preserving his health would keep a balance between one's happiness and sadness
this is the highest realm
so anyone who knows this knows how to keep his health in a good state
besides the influence of emotion, some diseases may caused by losing control
such as the abnormal of air, the failure of controlling diets, the imbalance of rest and tired
these are all embodies of losing control
it means the changes of seasons and climates go beyond people's ability of adjusting
the huge decrease of temperature and so on
or the lack of self regulation
makes people couldn't adapt to the climate changes, thus to arouse sickness
secondly, let's take a look at the influence of attaining a state of harmony to our health
as mentioned in the book "Su Wen Tiao Jing Lun"
then yin and yang are balanced, the body becomes robust, the nine indicators of the body's pulses will also be concert. this occurs in a normal, healthy person.
the normal, healthy person means a person has a balanced yin and yang
a professor said in a funny way that
a person without yin and yang means a person with a balanced yin and yang
"Su Wen Sheng Qi Tong Tian Lun" says, the most importance of yin and yang is the gather of yang
if the relationship between yin and yang are messed, then people's body will be messed too
therefore the balance between them is the ideal realm
what does the ideal realm mean here?
it means the golden mean, the saints' realm
then what does "five kinds of impairments caused by overstrained" in Huangdi Neijing mean?
it means that use your eyes overtime hurts your blood.
today many of us may stare at the computer screen for a whole day
then it will hurt our blood
lie in the bed for long time may hurt our qi
if a healthy person always lies in bed, he will be sick in the long run
what is qi? it is our body function in Chinese medicine
his body function is losing
sit to much hurts our body
if a person always sit there without doing some exercise, finally it will hurt the body shape
standing too much hurts the bone
if one always stand, his bone may hurts
of course, modern medicine tells us people couldn't always stand
out skeletal system may bear much pressure
walking too much hurts our tendon
always running and walking outside may hurts our tendon
then what about balance on diet
food may benefit people at the same time hurt people
in normal cases food benefits people
but when you take it wrongly, it hurts.
hence, the mean is catch the balance and take control
confucianism emphasizes not eating too much
modern medicine proves that a low energy intake is good for health
but besides not eating too much, we also emphasizes not eating too little, but to have a good balance
surely, today's many diseases are caused by food
Huangdi Neijing Plain Questions says, eating twice as usual hurts the intestines and stomach
you may know that many Chinese are suffering from intestines and stomach diseases
especially after the reform and opening up policy, people's living condition improved
more people suffered from this kind of disease
that is because people eat too much, not too little
in the old poor days, people don't have enough to eat, and thus suffering from malnutrition
as Sun Simiao says,"if one eat all the five flavors, then he must has a control of not eating too much."
that means one could not eat without control, the same knowledge
therefore, "a person good at keeping healthy eats while hungry and drink while thirsty"
that means you eat when you feel hungry
this is mentioned in Qianjin Fangyao
Chinese medicine says eating five flavors may nourish our five organs
but when one tends to one particular flavor, which means the partial eclipse
that hurts five organs too
partial eclipse is normal in us too
that means you could't tend to one particular flavor
you need to keep a balance
modern medicine also requires the balance of nutrition
one must eat vegetables, fruits, staple food and so on
thirdly, let's take a look at the thought of golden mean's influence to Pharmacology of traditional Chinese medicine
here i take two examples
in the first example, there is a kind of soup, called the soup of neutralization
it is made by Rhizoma Atractylodis Macrocephalae,orange peel, ginseng,liquorice,Poria cocos and Mangnolia officinalis
it could adjust our yin and yang, benefits our spleen and stomach, increasing our appetite
so each medicine in the soup benefit our spleen and stomach in a balanced way, not too little nor too much
then reach the aim of the golden mean
it has the medicine of repair our qi
it also has medicine to excreting dampness and promoting the circulation of qi
that is a nutritional supplement without an overtake
as to the influence of the medicine
Xu Dachun in Qing dynasty once said a funny sentence
saints made the prescription for him to nurse one's health
it may useful to one particular disease, or all kinds of problems, it may coordinate with each other, or opposite, or control each other.
so a prescription not only can preserve each medicine's function, but also lose them
making prescription is tricky.
you have to be careful, or it will lose all their respect functions
if done it properly, it will have the combined function of all the medicines
Cheng Jiamo said we should also pay attention to the balance of the medicines.
the key is mean, less is useless, more the medicine will backfire.
pay attention, if you go home to brew medicines
usually, stems should be heated for a longer time
this way it can perform its functions
as for the leafy medicines
such as those for curing flu, you should not brew them too long.
or they will lose their functions
they are all of the same reason
during the process of prescription
we just mentioned the need for cooperation
Chinese traditional medicine is quite tricky
take ephedra decoction for example
ephedra decoction is made up of four medicines
including ephedra, Cassia twig, apricot and liquorice
its function is to induce perspiration and relieve asthma
such as to treat common cold
i believe many of you have been caught up with the flu
that is the result of sudden temperature drop
or the decrease of body resistance
so what are the symptoms of the flu? aversion to cold with fever
aversion to cold means the patient will be extremely sensitive to cold
which means even covered with two blankets, he will still feel cold
but according to his temperature, he is actually burning up. This is aversion to cold with fever.
ache all over the body, including the limbs
the patient will have trouble breathing, but unable to sweat.
but once ephedra decoction successfully induce the perspiration, these symptoms will disappear gradually
in this prescrption, ephedra serves as the main medicine to induce perspiration
like the king ruling the world in the old times
he is the main medicine in this prescription
and Cassia twig mainly serves to help ephedra to perform its function
adding apricot is because apricot could help ephedra to relieve asthma
it tackles the lesser symptom of asthma
it is helpful in that way
lilquorice is also very important. it was called conductant drug, serves to balance the medicines.
monarch drug is the main element while ministerial drug serves to help
and limit its functions
namely prevent it inducing too much perspiration to create a balanced state
and conductant drug is the backup to finish what's been missed by monarch drug and ministerial drug
or balance the two
this is a reflection of traditional Chinese thought.
Fourth, the idea of mean's influence on treatment principle
Chinese traditional medicine believes too much Yin and too much yang are both excessive
too little yin and yang are both insufficient
both excessiveness and insufficiency will cause trouble to our body, as we have mentioned
the so-called yin and yang in equilibrium is not too excessive or too insufficient
the book concise exposition on febrile disease says typhoid fever on the surface will appear as sweat
typhoid fever on the inside will be dealt by the body. those not on the outside or in the inside are not too easy to induce perspiration
or be relieved from the body, in this circumstance, a balanced way is recommanded.
so what is their suggestion, when the problem is not in the body or on the surface,
but in between?
deal with it properly. both perspiration or diarrhoea aim to create the state of balance.
to adopt this kind of treatment
is the result of the idea to attain a state of harmony in medicine field
attaining a state of harmony equals the perfect state of yin and yang in a state of equilibrium
when not, it's called discord
which will lead to sub-health, even serious symptoms.
prevention, treatment, prescription and making are all permeated with this thought
besides personal health, the relationship between man and nature, man and society and interpersonal relationships are all the same
no woner 75 nobel prize winners since 1988 made their co-speech in Paris
that if man were to live in the 21st century, we must back to 2500 years ago and seek wisdom from Confucius,
that's the same reason
that's all for this class
next time we will talk humanistic care in Confucianism thought.
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