Foreword: It is necessary to think about how traditional Chinese medicine, which has been accumulated for thousands of years, in modern times, and cannot avoid its shortcomings, such as correctly understanding the negative influence of literati on traditional Chinese medicine in history.
The ancients said that "the road is simple", and the biggest problem in Chinese medicine is that it is too complicated!
Among the ancient medical books that are full of sweat, how many of them can really guide clinical treatment? How many medical cases completely restore the actual appearance? How many doctors are really from clinical backgrounds?
Professor Xiong Jibai, the "Master of Traditional Chinese Medicine", said: "I often say that our Chinese medicine is complicated enough, and we now have a lot of Chinese medicine, and even the so-called Chinese medicine scientists, who artificially complicate Chinese medicine. If it is artificially complicated, how can our descendants learn it? As soon as they see it, they are afraid of it, and as soon as they see it, they retreat back and take three steps back, how can they learn it? The ills brought by this artificial complexity to future generations can only bring about a devastating effect on the study of traditional Chinese medicine. ”
"Some people say that the head of theory is the Tao, and they write one book after another, but they can't even read a cold, what kind of Chinese medicine is this? This is the biggest problem of the academic school, including the current master's and doctor's degrees. Therefore, what many of our highly educated people lack is precisely the professional level and clinical ability, which is also the crux of the problem of Chinese medicine talents. ”
The Theory-Practice Disconnect and the "Medicine of Words"
The disconnect between theory and practice, that is, the knowledge in books (including textbook knowledge), cannot fully guide clinical practice, which is the primary problem that the development of TCM has failed to solve.
The factors that form the disconnect between theory and practice are complex, and the author believes that in order to analyze and solve this problem, it is necessary to study the history of the development of traditional Chinese medicine, especially to correctly analyze the influence of literati treatment on traditional Chinese medicine.
With the continuous increase of literati and doctors, the quality of Chinese medicine personnel has been continuously improved, because the emergence of a large number of Confucian doctors has greatly improved the basic cultural level of doctors. The literati treated medicine and prospered traditional Chinese medicine, enhanced academic contention, and promoted academic development. The direct effect of the increase in the number of literati in general medicine on the development of medicine is the formation of a school that mainly collates and compiles medical literature.
The negative effects of literati healing on TCM are as follows:
01 Reverence for the ancient has hindered the innovation and development of traditional Chinese medicine
After the Han Dynasty and the Han Dynasty, an atmosphere of studying scriptures, promoting scriptures, and discussing the ideological norms of ancient sages from the scriptures gradually formed among Confucian scholars and scholars, which was called "the atmosphere of scripture learning" by later generations.
Confucianism's "believing in the ancients" and "describing but not doing" have always been the guiding ideology of medical writing, and this firm convergence mentality has sharpened and curbed the enterprising and innovative of medical scholars. Respecting the scriptures and bringing thousands of horses to the medical world, and the doctors with profound insights did not dare to self-standard new opinions, which greatly imprisoned people's thoughts, led to the difficulty of producing new medical ideas and the susceptibility to suppression after they were generated, and also led to people using outdated forms to accommodate new content that was not commensurate with it, thus limiting the further development of new content and greatly delaying the development of traditional Chinese medicine.
02 Extravagant talk about metaphysics, useless arguments
Ancient Chinese culture and natural philosophy have twice poured into the theoretical system of traditional Chinese medicine on a large scale, the first was in the Spring and Autumn Period and the Warring States Period, which led to the construction and formation of the theoretical framework of traditional Chinese medicine, and the second was in the Song and Ming dynasties. From the doctrine of yin and yang, the five elements, and the essence of qi to Confucianism, Taoism, and Buddhism, cultural terms and philosophical concepts have been grafted and transplanted to each other.
Some medical scientists have blindly exaggerated the status of conscientiousness in medical research, and conducted arbitrary deductive reasoning on medical facts, so that a large number of subjective conjectures and specious contents have been mixed into various theories (before the Song Dynasty, the literature still emphasized practical results, while after the Song Dynasty, it was more exaggerated and biased, extravagant talk about metaphysics, and speculative and critical works).
The method of speculative metaphysics used by doctors in pointless debate makes the extension of certain medical concepts infinitely broadened and circulated indefinitely, but the connotation is reduced and impoverished, and in fact speculation only leads people into solidified empty theories. This theory seems to explain everything, but in reality it doesn't explain everything.
Theories are rigid, academics are lazy to innovate, and some theories constructed through speculative metaphysical methods not only do not arouse the innovative psychology of later doctors, but pull people away from the soil of clinical practice. The battle of fate, mysterious and mysterious, how can the six flavors and eight flavors cure all diseases?
03 moaning without disease, a work of vassal elegance
The concept of "standing up" was deeply ingrained among the literati, and some literati who were slightly involved in medical books were often vassals and elegant, compiling prescription books, some of which were only sporadic experiences, and some of which were just hearsay.
04 Emphasis on literature, light on practice
Under the influence of classics, the research methods of traditional Chinese medicine are mostly limited to the revision, compilation, sorting and compilation of medical books, showing a "snowballing" trend. Although there is a lot of literature, there is little scientific content. In the traditional sense, there is merit, but the price to pay in terms of time is heavy, because such thinking has slowed down the development of Chinese medicine.
In the typhoid system, there are more than 1,000 statistical annotations of "Typhoid Fever", mainly compilations and annotations, but most of them stay in theoretical play and controversy, or even make a big fuss about how to restore the original appearance of Zhongjingquanshu, and then argue and slander endlessly, and there are too few in-depth researchers from a clinical point of view.
It is very obvious that the whole TCM research system emphasizes classical literature and ignores clinical practice.
There are quite a few "literal doctors", and their writings have influenced and influenced the art of Chinese medicine. Some doctors have been practicing medicine before Confucianism, or they have abandoned their careers to become doctors, and most of them are more than old when they systematically study Chinese medicine, and they still have to engage in writing, and they have not had much time to actually engage in clinical practice, and the practical value of their works still needs to be scrutinized.
The author believes that the disconnection between theory and practice is a concentrated embodiment of the negative influence of literati on traditional Chinese medicine.
The complexity of theory, law, prescription and medicine
- The complexity of science
Together, numerous theories have formed the worldview of TCM, guiding thousands of years of clinical practice and less rigorous but life-saving clinical experiments, and giving birth to countless genius ideas.
The basic four-diagnosis (artificial intelligence diagnosis system) model in TCM scientific research has spent a huge amount of money, and there are no obvious results, and the complexity of TCM principles can be imagined.
The Theory of the Five Elements of Yin and Yang, the Theory of Essence and Qi, the Theory of Qi Monism, the Theory of Tibetan Elephants, the Theory of Qi, Blood and Fluid, the Theory of Meridians, the Theory of Five Luck and Six Qi, the Theory of Constitution, the Theory of Etiology, the Theory of Pathogenesis, the Theory of Dialectical Argumentation of the Organs, the Theory of Attacking Evil Spirits, the Theory of Internal Injuries to the Spleen and Stomach, the Theory of One Qi Circulation, the Theory of Fuyang... The more you read medical books, the more confused you become, and people don't know where to start.
- The complexity of the law
The treatment method is one of the processes of syndrome differentiation and treatment, connecting patients and doctors from the past and the future, and the dialectic alone has the differentiation of viscera syndrome, qi, blood and fluid, the eight outlines of syndrome, the six meridians and the blood and blood differentiation, etc., many classic treatment rules are precise and profound, and each can enlighten the wisdom of the doctor in clinical practice, but it is indeed difficult to truly fully grasp it.
- The complexity of the party
Prescription is a prescription, and a prescription is a combination of suitable drugs under the guidance of the treatment method. The "Dictionary of Traditional Chinese Medicine Prescriptions" edited by Nanjing University of Chinese Medicine records 96,592 Chinese medicine prescriptions in the past dynasties, which cannot be exhaustive. In the face of so many prescriptions, how much can the average person master?
- The complexity of the drug
The "Dictionary of Traditional Chinese Medicine" contains a total of 5,767 flavors of traditional Chinese medicine, and different doctors have different discussions on the origin, performance and processing of medicines.
For example, the "Seven Emotions of Traditional Chinese Medicine" and "Medicine have Yin and Yang Cooperation... There are those who walk alone, there are those who have a beard, there are those who make envoys, there are those who fear each other, there are those who are evil, there are opposites, there are those who kill each other, and all these seven emotions are regarded in harmony. According to this, later generations called the seven aspects of single-line, mutual beard, mutual envoy, mutual fear, mutual killing, mutual evil and opposite, as the "seven feelings".
Secondly, the functions of single herbs are diverse, and the "Treatise on the Spleen and Stomach: The Theory of Monarchs and Ministers" clouds: "Within a thing, there is both smell, and in a medicine, there is rationality, and the main treatment comes out of it." Li Dongyuan proposed in the "Treatise on the Prohibition of Medication": "All people who treat diseases and take medicine must know the four prohibitions of time forbidden, menstrual prohibition, disease forbidden, and drug prohibition", and must "investigate the facts, argue the scriptures, examine the disease, and then use the medicine", in order to achieve "the corresponding effect of the drum".
Sun Simiao once said: "Anyone who wants to be a great doctor...... It is necessary to understand the yin and yang life, the methods of all families, and the five trillion of the burning turtle and the six of Zhou Yi, and must be proficient, so that he has to be a great doctor. If not, if you don't have eyes to swim at night, you will be moved upside down. ... I also have to dabble in group books... As for the Five Elements Huking and Qiyao Astronomy, they must be explored. If you can learn it, you will be able to do it without hindrance in the medical path, and you will be perfect!"
To sum up, not to mention becoming a worker, it is also a worker, how easy is it to be a worker? Whose fault is it that studying medicine has become a daunting path? Is it the fault of the Chinese medicine system itself?
As Zhongjing said: Fu Tianbu five elements, in order to transport ten thousand kinds, people are five constants, to have five Tibets, meridians and Fu Yu, yin and yang will pass, Xuan Shen is subtle, change is extremely difficult, since he is not talented and wonderful, how can he explore its reason!