Huangdi Neijing, divided into Lingshu and Suwen, is the earliest medical classic in China.
Huangdi Neijing established the theories of "Yin-Yang and Five Elements", "Pulse Condition", "Meridian Theory", "Etiology Theory", "Pathogenesis Theory", "Disease Theory", "Diagnosis Method Theory", "Treatment Theory", "Health Preservation Theory" and "Luck Theory" in traditional Chinese medicine, which revealed the essence of traditional Chinese medicine.
First, "Su Wen":
Su Wen's name was first seen in Zhang Zhongjing's Preface to Treatise on Febrile Diseases in the Eastern Han Dynasty. The old nine-volume system was maintained from the writing of the Warring States Period to the compilation of Su Wen Xun Jie by Qi Liang Yuanquan, but by the time Quan Yuan began to annotate Su Wen, the seventh volume of Su Wen had been lost. ?
Second, "Lingshu"
Lingshu was originally named Needle Sutra. The first article "Nine Needles and Twelve Origins" has the language of "establishing the needle sutra first", which is equivalent to introducing myself. Later it was called Jiujuan, and Huangfu Mi in Jin Dynasty called it Needle Sutra, and later it was named Jiuxu, Jiuling and Huangdi Needle Sutra.
3. Su Wen focuses on viscera, meridians, etiology, pathogenesis, syndromes, diagnosis, treatment principles and acupuncture. Lingshu is an inseparable companion of Su Wen, and its contents are basically the same. In addition to discussing the function, etiology and pathogenesis of viscera, it also focuses on meridians and acupoints, acupuncture, acupuncture methods and treatment principles.
Four. Overview of theoretical system:
1. The basic theoretical spirit of Huangdi Neijing includes: holistic view, Yin-Yang and Five Elements, Zangxiang meridians, etiology and pathogenesis, diagnosis and treatment principles, prevention and health preservation and luck theory.
(1) "Holism" emphasizes that the human body and nature are a whole, and the structure of the human body and its parts are interrelated.
② "Yin-Yang and Five Elements" is a theory to explain the unity of opposites between things.
③ "Zangxiang Jing" mainly studies the physiological functions, pathological changes and their relationships of the five zang-organs, the twelve meridians and Qijing.
④ "Etiology and pathogenesis" expounds whether various pathogenic factors act on human body and the internal mechanism of disease changes.
⑤ "Diagnosis and treatment" is the basic principle for TCM to recognize and treat diseases.
⑥ Prevention and Health Preservation systematically expounds the theory of health preservation of traditional Chinese medicine, which is an important summary of the experience of health preservation and disease prevention.
⑦ "Luck Theory" studies the influence of natural climate on human physiology and pathology, and on this basis guides people to seek advantages and avoid disadvantages.
Physicians in past dynasties classified Huangdi Neijing. Among them, Yang Shangshan is the most complicated one, which is divided into 18; The simplest one is Shen Youpeng, which is divided into four volumes. There are four theories: viscera (including meridians), pathogenesis and diagnosis and treatment. These four theories are the main contents of the theoretical system of Huangdi Neijing.
2. Dirty image theory:
Fold 2, Zang 2, Zangxiang theory is a theory to study the physiological functions of the meridian system of human organs, their relationship, their appearance and even their relationship with the external environment.
The theory of Zangxiang is based on the twelve meridians, five zang-organs. Of course, the content of anatomy is far more than that, but it is more important to enrich this theory step by step through a lot of medical practice and repeated argumentation, and finally reach the height of guiding clinic.
Huangdi Neijing fully realized the dialectical principle that "the inside must be shaped outside" and made the theory of Tibetan images systematic and perfect. Zangxiang theory mainly includes three parts: viscera, meridians and essence. Zang-fu organs are composed of five internal organs and six internal organs.
Five internal organs, namely liver, heart, spleen, lung and kidney.
Six fu organs, namely gallbladder, stomach, large intestine, small intestine, bladder and triple energizer.
Strange and constant fu-organs also belong to fu-organs, but they are different from normal fu-organs. Refers to the brain, marrow, bone, pulse, gallbladder and daughter cells. The gallbladder here is one of the big fu-organs, belonging to the odd and constant fu-organs.
Although the zang-fu organs are divided according to different shapes and functions, they are not isolated, but cooperate with each other and use each other.
The meridian system can be divided into meridians, collaterals and acupoints. The twelve meridians: Hand Taiyin Lung Meridian, Hand Yangming Large Intestine Meridian, Foot Yangming Stomach Meridian, Foot Taiyin Spleen Meridian, Hand Shaoyin Heart Meridian, Hand Taiyang Small Intestine Meridian, Foot Taiyang Bladder Meridian, Foot Shaoyin Kidney Meridian, Hand Jueyin Pericardium Meridian, Hand Shaoyang Sanjiao Meridian, Foot Shaoyang Gallbladder Meridian and Foot Jueyin Liver Meridian. The twelve meridians is connected from beginning to end, and it is endless, and menstrual qi is popular among them. Different from the classics, there are eight strange meridians: Du Meridian, Ren Meridian, Chong Meridian, Dai Meridian, Yinqiao Meridian, Yangqiao Meridian, Meridian and impotence Meridian. (Note: The name of Eight Veins in the Strange Classics began with Twenty-seven Difficult Classics)
The communication between meridians is called collaterals. The youngest is countless Sun Luo; The largest is fifteen, which is called fifteen collaterals. Lingshu meridian is very detailed.
Acupoints are places where meridians and qi and blood go in and out, just like transportation, hence the name. Those who talk about acupoints in Huangdi Neijing first saw Su Wen's Qi-assisted Theory, and then saw Su Wen's Qi-assisted Theory. Both theories say 365 points. In fact, the theory of cavitation contains 342 points, and the theory of qi symbol contains 386 points.
Spirit is the three treasures of human body. Essence, including essence, blood, body fluid and body fluid; Qi refers to clan spirit, honor and obedience; God refers to god, soul, spirit, ambition and ambition. Essence and qi are the basic substances that constitute the human body, and qi and spirit are the complex functions of the human body. It can also be considered that qi is the royal of essence, essence is the home of God, and God is the use of essence.
Pathogenesis theory: the theory that studies the occurrence, development, outcome and change of diseases within the mechanism is called pathogenesis theory.
The content of this theory is "it is appropriate to observe the pathogenesis without losing qi" and "to observe the pathogenesis and do their duties".
1). Etiology: There are many reasons why people get sick, which are divided into two categories in Huangdi Neijing. Wind, rain, cold and summer heat are really the generalization of "six evils"; Emotion of yin and yang is the generalization of "seven emotions"; Eating and drinking is "eating and drinking fatigue". It can be considered that this is the origin of the theory of three causes in later generations.
2) Incidence: The contrast between the strength of good and evil determines the occurrence and development of the disease, that is, "healthy qi exists in the interior, and evil cannot be done". This point has been proved by Su Wen's ancient naive theory that "God is included, and illness is always in peace" and Su Wen's theory of commenting on fever that "pathogenic factors must be deficient".
3) Lesions: The changes of diseases are complicated, and the lesions summarized in Huangdi Neijing are various, including those from yin and yang, from inside and outside, from cold and heat, from excess and deficiency, referring to excess of pathogenic factors and decline of healthy qi. Generally speaking, there are positive and false, evil and true, positive and false without true and evil, and positive and false without true and evil.
3. Diagnostic theory
The four diagnostic methods of looking, listening, asking and cutting originated from Huangdi Neijing.
1). Observation: including looking up, looking up and distinguishing tongue coating.
Inspection methods, such as Lingshu five colors, Lingshu Wu Yuewu's and Lingshu five colors, have important clinical significance.
The physical observer, observing the skin of human flesh and blood, infers the illness. Clinically, excess and deficiency are complex, and only by understanding their regularity can we realize their changes.
Those who distinguish tongue coating, such as Su Wen's theory of fever, Su Wen's theory of fever, Lingshu and so on.
2) Smelling diagnosis: including smelling sound and smell.
Hearing people diagnose diseases by listening to patients' voices.
Followed by smell, as Su Wenjin Kui Yan array said, liver disease stinks, heart disease stinks, spleen disease stinks, lung disease stinks and kidney disease stinks.
3.) Ask: Ask the patient's conscious symptoms to diagnose the disease.
4. Pulse diagnosis: including pulse cutting and skin cutting. The pulse condition in Huangdi Neijing is the most detailed, mainly as follows:
(1) Three-part nine-level method: that is, hands and feet are divided into three parts, and heaven and earth are divided into three parts.
(2) Pulse method of yingcun mouth: the pulse at yingcun mouth and cunkou mouth will be checked and compared.
(3) pranayama: adjust the doctor's breathing and diagnose the patient's pulse.
(4) Stomach qi pulse: Whether there is stomach qi in the pulse condition is very important. If you have stomach qi, you will be born, but if you don't have stomach qi, you will die.
(5) Six types of pulse conditions: The pulse conditions in Huangdi Neijing include floating, sinking, late, counting, virtual, solid, slippery, astringent, long, short, string, thin, slight, wet, soft, weak, scattered, slow, fast, moving, broad, squatting and weak. But it is often summarized with six veins as the key link.
Secondly, skin cutting: skin cutting refers to the whole body skin. According to the skin, there are many things that can help diagnosis, such as "following it" and "bouncing it". But the most detailed theory is peeling. Because the pulse condition is necessarily related to the skin, they can also cooperate with each other when diagnosing diseases.
4. Treatment principle theory
The theory of studying therapeutic principles is called therapeutic principles theory.
1.) Prevention of minor duration: including pre-illness prevention and post-illness prevention. For example, "nourishing yang in spring and summer and nourishing yin in autumn and winter" all say that diseases should be prevented, treated as early as possible and prevented from spreading.
2). According to time, place and person:
People who adapt to time warn doctors not to be cold, hot and cold at four o'clock.
According to local conditions, we can't generalize, we must treat them differently. On the other hand, Su Wenyi's Treatise on Prescriptions and Medicine discusses in detail the local situation of "treating the same disease with different treatments" in the southeast and northwest. For example, in the eastern region, its treatment should be stone; Western territory, cure poison; In the northern territory, moxibustion should be used; In southern China, micro-needle therapy is appropriate; In the territory of the central government, appropriate guidance and pressure.
Those that vary from person to person, such as Su Wen's theory of Wuchang Political University and Su Wen's theory of four losses and expropriation.
3). Specimen sequence: that is, due to the primary disease and secondary disease, they were treated successively. The solution of continuous processing of specimens is described in the most detailed way in Su Wen's Biography of Specimens and Diseases.
4.) Seek the root of the disease: This is the most fundamental rule in Huangdi Neijing. Su Wen's Theory of Yin and Yang should be like a big picture says: "Treatment must be based on this."
5.) Make the best use of the situation: change the situation skillfully on the basis of treating diseases.
6. Harmony between Yin and Yang: This is the essence of treatment.
7.) Corrective treatment and reversal treatment: Corrective treatment, also known as reversal treatment, is a treatment method opposite to the condition. For example, "heat is cold, cold is hot, deficiency is tonic, but actually diarrhea" and so on; Counter-treatment is also called subordinate treatment, such as "cold is used because of cold, heat is used because of heat, general reasons are universal, and factors are used because of factors" and so on.
8.) Appropriate measures should be taken: both strengthening the body resistance and eliminating pathogenic factors should be moderate, especially for diseases with excess and deficiency. Remember "not much, not little", even if you use tonic, you can't get through.
9.) Disease-oriented, work-oriented: Su Wen Tang Yi Lao Lun pointed out: "Disease-oriented, work-oriented." This means that the disease exists objectively and is the root cause; Doctors know that treating diseases is the standard. Doctors must be patient-based, so as to obtain the same samples and cure diseases.
10.) Syndrome Differentiation and Treatment: The word "syndrome differentiation and treatment" was not put forward in Huangdi Neijing, but it was put forward. The above points all contain this meaning, and the book has the connotation of syndrome differentiation of eight categories and six meridians of zang-fu organs.
1 1). Prescription scheduling: Although Huangdi Neijing contains few prescriptions, it has its own principles.
12) Acupuncture and Moxibustion: There are many people who talk about meridians, acupoints and acupuncture in Huangdi Neijing, and only the reinforcing and reducing methods include respiratory reinforcing and reducing, prescription reinforcing and reducing, deep reinforcing and reducing, Xu reinforcing and reducing, and light and heavy reinforcing and reducing. These methods were used by later generations.
Five, the theory holds that:
Huangdi Neijing accepted the materialistic philosophy of China's ancient monism of Qi, holding that man is a part of the whole material world, and everything in the universe is formed by its original material "Qi". Under the guidance of the concepts of "man is related to heaven and earth" and "corresponding to the sun and the moon", man and nature are closely linked.
1, "Qi" is the origin of everything in the universe.
Laozi said in the Tao Te Ching: "Things are mixed and born naturally." Lonely, independent, walking around without danger, can be the mother of the world. It is believed that the original material that constitutes the world is metaphysical "Tao". Song Shuo and Yin Wen called this primitive substance "Qi". Influenced by these theories, Huangdi Neijing also holds that "Qi" is the origin of all things in the universe, and that "the vastness is too empty, starting from the origin and transforming into the Yuan, starting from all things and ending in Five Blessingg". Before the formation of heaven and earth, there was air, full of emptiness and movement, and then everything in the universe came into being. This is actually to reveal the natural laws of celestial evolution and biogenesis. Before the universe was formed, it was too empty. Space is full of primitive qi, which is the beginning of the metaplasia of everything in the world. Due to the movement of qi, there are the Milky Way and Seven Obsidian, Yin and Yang are cold and hot, and everything is created. The movement of Yin-Yang and Five Elements affects the movement and change of the earth and the occurrence and development of all things.
2. The relationship between man and nature
Huangdi Neijing holds that man and nature are closely related, nature and man are interrelated, and the movement and change of nature have an impact on human body all the time. Su Wenbao's Theory of Quan Ming Xing said: "Man is born with the spirit of heaven and earth, and is formed by the method of four seasons". It means that people, like everything in the universe, are born of the qi of heaven and earth and grow according to the law of the four seasons. Between heaven and earth, we must rely on the movement and nourishment of yin and yang to survive.
The internal environment of human body must be in harmony with the external environment of nature, which requires people to have strong adaptability to nature. "Ling Shu Wu Yi Jin Bie Ye" said: "In summer, clothes are thick, so you sweat. ..... Cold weather leads to stagnation, and humidity is not good. If you stay in the underwater bladder, you will be angry for drowning. " This is obviously the adaptation of water-liquid metabolism to the external environment. People's pulse is characterized by spring string, summer flooding, autumn hair and winter stone, which is also due to the adaptive response of human qi and blood to different climate changes in spring, summer, autumn and winter, thus achieving harmony with the external environment. People may get sick if they violate the way of keeping in good health in spring, summer, autumn and winter. Even within a day, between day and night, the human body will change accordingly with the rise and fall of the sun's qi. If it violates the objective laws, it will also be damaged.
The relationship between man and nature can be seen everywhere in Huangdi Neijing. Whether it is physiology or pathology, whether it is health preservation prevention or diagnosis and treatment, it is inseparable from the guidance of this theory.
Man is the unity of opposites of Yin and Yang.
Man is the unity of opposites of Yin and Yang, which has been decided at the beginning of life. The essence of parents' life, namely yin and yang, forms a living body. After the life form, Yin and Yang exist in it, which is the condition for each other's existence. Contact with each other, cultivate each other, transform each other and struggle with each other.
Based on the organizational structure of the human body, Huangdi Neijing regards the human body as the unity of opposites of Yin and Yang at all levels, and further divides Yin and Yang into every viscera and every viscera, thus forming the unity of opposites of Yin and Yang at all levels, regardless of the whole and parts, organizational structure and physiological functions.
4. The human body is the harmonious unity of five systems: liver, heart, spleen, lung and kidney.
The five internal organs mentioned in Huangdi Neijing actually refer to five systems with liver, heart, spleen, lung and kidney as the core.
Take the heart as an example: the heart resides in the chest, which is the yang in the yang. Communicate with summer qi, master the spirit, master the blood vessels, and combine the heart and small intestine into one. It produces blood and glory, and its beauty lies in its face, hidden pulse, spirit, open tongue and joy. When talking about physiology and pathology, at least the above aspects should be considered systematically so as not to lose one-sidedness. Therefore, each zang-fu organ is a large system, and the five systems are linked together through meridians and qi and blood to form a whole. These five systems coordinate, nourish and restrict each other according to the law of five elements producing grams. Under relatively stable conditions, each system engages in various life activities according to its inherent laws.
5. Outlook on life
Huangdi Neijing denies the existence of supernatural and metamaterial gods, and admits that the phenomenon of life comes from the contradictory movement of life itself. People think that Yin and Yang are the beginning of everything. For the whole biological world, it is believed that everything in heaven and earth and people are the products of the intersection of Yin and Yang. Yin and Yang are eternal movements, and the basic way is up and down. Huangdi Neijing holds that essence is the basic substance of life and the driving force of life. "Lingshu Jing" also describes the development process of embryonic life: "People begin to live, first become essence, then become essence, and the brain is born. The bones are dry, the pulse is strong, the muscles are just, the meat is the wall, the skin is firm, and the hair is long. " This understanding of the material properties of life and embryo development is basically correct.
6. The concept of unity of form and spirit
Huangdi Neijing explains the dialectical unity of form and spirit, and points out that god is unified in form, and god is a life movement produced by form.
Among the pre-Qin philosophers, no one has a clearer and closer understanding of the relationship between god and form and spirit than Huangdi Neijing. There are many discussions about the unity of form and spirit, such as the spiritual pivot and the ancient naive theory of Su Wen. If the form and spirit are not unified and incompatible, people will die. For example, Tang Yi Lao He's inverse sound theory. The viewpoint of unity of form and spirit in Huangdi Neijing has made great contributions to China's ancient philosophy.
Huangdi Neijing, with the framework of five behaviors and the human body as the main research object, has formed a unique ideological system of harmony between man and nature.
Five elements, orientation, time sequence, five qi, biochemistry, viscera, orifices, body color, taste, sound and sound valley.
The spring breeze of Woody Winter produces liver, gallbladder, eyes, tendons, anger, green and sour horns, calling for rice.
Southern fire, summer heat, long heart and small intestine, red and bitter tongue pulse, laughing millet.
Growing in the soil, nourishing the spleen and stomach in summer, thinking about the Huang Gan Palace.
Autumn dryness in the west of Shanxi collects fur from the lungs, large intestine and nose, worrying about white incense and crying about wheat.
Six, life sciences:
Huangdi Neijing is the first classic of TCM theory. As an academic system, TCM started from Huangdi Neijing, so Huangdi Neijing is recognized as the cornerstone of TCM.
Huangdi Neijing is the first book for keeping in good health. Huangdi Neijing talks about how to cure diseases, but more importantly, it talks about how not to get sick and how to make people healthy and live longer without taking medicine. There is a very important idea in Huangdi Neijing: "Prevention of disease". Huangdi Neijing said: "If you don't treat a disease, you can't treat it. If you don't treat it, you will be treated indiscriminately. "
Huangdi Neijing is the first encyclopedia about life. Huangdi Neijing focuses on life and talks about medicine, astronomy, geography, psychology, sociology, philosophy and history. This is an encyclopedia about life problems. The core of Chinese studies is actually the philosophy of life, and Huangdi Neijing is an influential classic of Chinese studies named after Huangdi.
Seven, philosophy science:
Huangdi Neijing also contains many philosophical sciences, such as the enlightenment to talent management. Huangdi Neijing advocates showing humanity and morality with medical ethics.
Morality, as an important category of China's ancient view of nature, its extension is finally transformed into the objective law of the operation of all things and natural phenomena in the world, and the "virtue" of talents is externalized into the "burden" of talents, which is also a kind of internal and external unity in line with natural harmony. The emergence of Huangdi Neijing made the medical ethics of traditional Chinese medicine have the earliest written expression and explanation. Neijing summarized the physicians' understanding of medical ethics at that time, formed a relatively perfect medical ethics thought, and announced the birth of China's medical ethics theory.
The medical ethics thought in Neijing is rich in connotation and extensive in extension, which can be divided into four aspects: medical health preservation morality, medical prevention morality, medical treatment morality and medical nursing morality. Man's body, mind and behavior are isomorphic to life, and the integration of the three can make man develop harmoniously. "Morality" is about mind, which is incompatible with body and mind, and there is no way to "strengthen the body and eliminate evil". The selection and appointment of talents should also follow the principles of having both ability and political integrity, putting morality first, advancing with the times and harmonious development, which is also the standard for selecting and appointing talents in modern society.
1. Neijing is the basic work of TCM theory and a medical theory work.
Neijing is divided into Su Wen and Ling Shu. Su Wen emphasizes the basic theories of human physiology, pathology, disease treatment, health preservation and disease prevention, and the relationship between man and nature. Lingshu focuses on human anatomy, viscera, meridians and acupoints. This book contains a lot of knowledge about philosophy, humanities, astronomy, geography and so on. However, it obviously focuses on medical content, and the contents of other disciplines also serve its medical theory, so it should belong to medical theory works, which is the summary of medical achievements at that time, the theoretical source of traditional Chinese medicine, and the symbol that medicine began to separate from philosophy and other disciplines.
2. Neijing is the collective wisdom of doctors, but it does not represent the highest theoretical level of Chinese medicine.
Neijing was written in the middle and late Western Han Dynasty. This was the collective wisdom of many medical scientists and philosophers at that time. This was undoubtedly advanced at that time and of great value in history. It combined the achievements of other disciplines at that time, such as the philosophy of Yin-Yang and Five Elements and the indifferent Taoist concept of health preservation, which all represented the highest level of people's understanding of health and disease at that time. Even now, there are many correct conclusions in the book. It is worth noting that although Neijing represented the highest theoretical level of medicine at that time, it could not represent the highest level of traditional Chinese medicine at present. Any discipline and academic level as a whole is constantly advancing, and Chinese medicine is no exception. It is not in line with the scientific spirit to regard Neijing as the Bible and take every word of it as truth or evidence.
3. Neijing is a theoretical hypothesis of traditional Chinese medicine, which does not represent the theoretical standard.
Although Neijing is the source of TCM theory, it summarizes and finds many laws and conclusions that are in line with objective reality and has made great contributions to the development of TCM. However, it is undeniable that there are many wrong guesses and far-fetched explanations in the book, and many theories are just hypotheses to be confirmed or falsified by future generations. Neijing was written more than 2000 years ago. Due to the limitation of the scientific and technological level at that time, it was impossible to conduct in-depth and detailed research on the nature of the human body. Only by comparing images with categories can we understand the objective world from a macro perspective, that is, to explain the problems of natural science with the theory of natural philosophy. In this way, although many objective laws and correct guesses can be found, there are bound to be many wrong guesses and distorted explanations. Today, we don't have to and can't regard Neijing as a treasure, but we must take its essence and discard its dross.
By roughly refining Huangdi Neijing, we can understand the original value of Huangdi Neijing, which can also be a guide for future study. (The content is taken from the online circulating version)