《中國(guó)的中醫(yī)藥》白皮書（全文）
White Paper: Traditional Chinese Medicine in China
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| 一、中醫(yī)藥的歷史發(fā)展 | I. The Historical Development of TCM |
| 1.中醫(yī)藥歷史發(fā)展脈絡(luò) | 1. History of TCM |
| 在遠(yuǎn)古時(shí)代，中華民族的祖先發(fā)現(xiàn)了一些動(dòng)植物可以解除病痛，積累了一些用藥知識(shí)。隨著人類的進(jìn)化，開始有目的地尋找防治疾病的藥物和方法，所謂“神農(nóng)嘗百草”、“藥食同源”，就是當(dāng)時(shí)的真實(shí)寫照。夏代（約前2070－前1600）酒和商代（前1600－前1046）湯液的發(fā)明，為提高用藥效果提供了幫助。進(jìn)入西周時(shí)期（前1046－前771），開始有了食醫(yī)、疾醫(yī)、瘍醫(yī)、獸醫(yī)的分工。春秋戰(zhàn)國(guó)（前770－前221）時(shí)期，扁鵲總結(jié)前人經(jīng)驗(yàn)，提出“望、聞、問、切”四診合參的方法，奠定了中醫(yī)臨床診斷和治療的基礎(chǔ)。秦漢時(shí)期（前221－公元220）的中醫(yī)典籍《黃帝內(nèi)經(jīng)》，系統(tǒng)論述了人的生理、病理、疾病以及“治未病”和疾病治療的原則及方法，確立了中醫(yī)學(xué)的思維模式，標(biāo)志著從單純的臨床經(jīng)驗(yàn)積累發(fā)展到了系統(tǒng)理論總結(jié)階段，形成了中醫(yī)藥理論體系框架。東漢時(shí)期，張仲景的《傷寒雜病論》，提出了外感熱?。ò匾叩葌魅静。┑脑\治原則和方法，論述了內(nèi)傷雜病的病因、病證、診法、治療、預(yù)防等辨證規(guī)律和原則，確立了辨證論治的理論和方法體系。同時(shí)期的《神農(nóng)本草經(jīng)》，概括論述了君臣佐使、七情合和、四氣五味等藥物配伍和藥性理論，對(duì)于合理處方、安全用藥、提高療效具有十分重要的指導(dǎo)作用，為中藥學(xué)理論體系的形成與發(fā)展奠定了基礎(chǔ)。東漢末年，華佗創(chuàng)制了麻醉劑“麻沸散”，開創(chuàng)了麻醉藥用于外科手術(shù)的先河。西晉時(shí)期（265－317），皇甫謐的《針灸甲乙經(jīng)》，系統(tǒng)論述了有關(guān)臟腑、經(jīng)絡(luò)等理論，初步形成了經(jīng)絡(luò)、針灸理論。唐代（618－907），孫思邈提出的“大醫(yī)精誠(chéng)”，體現(xiàn)了中醫(yī)對(duì)醫(yī)道精微、心懷至誠(chéng)、言行誠(chéng)謹(jǐn)?shù)淖非螅侵腥A民族高尚的道德情操和卓越的文明智慧在中醫(yī)藥中的集中體現(xiàn)，是中醫(yī)藥文化的核心價(jià)值理念。明代（1368－1644），李時(shí)珍的《本草綱目》，在世界上首次對(duì)藥用植物進(jìn)行了科學(xué)分類，創(chuàng)新發(fā)展了中藥學(xué)的理論和實(shí)踐，是一部藥物學(xué)和博物學(xué)巨著。清代（1644－1911），葉天士的《溫?zé)嵴摗?，提出了溫病和時(shí)疫的防治原則及方法，形成了中醫(yī)藥防治溫疫（傳染病）的理論和實(shí)踐體系。清代中期以來，特別是民國(guó)時(shí)期，隨著西方醫(yī)學(xué)的傳入，一些學(xué)者開始探索中西醫(yī)藥學(xué)匯通、融合。 | In remote antiquity, the ancestors of the Chinese nation chanced to find that some creatures and plants could serve as remedies for certain ailments and pains, and came to gradually master their application. As time went by, people began to actively seek out such remedies and methods for preventing and treating diseases. Sayings like "Shennong (Celestial Farmer) tasting a hundred herbs" and "food and medicine coming from the same source" are characteristic of those years. The discovery of alcohol in the Xia Dynasty (c. 2070-1600 BC) and the invention of herbal decoction in the Shang Dynasty (1600-1046 BC) rendered medicines more effective. In the Western Zhou Dynasty (1046-771 BC), doctors began to be classified into four categories - dietician, physician, doctor of decoctions and veterinarian. During the Spring and Autumn and Warring States Period (770-221 BC), Bian Que drew on the experience of his predecessors and put forward the four diagnostic methods - inspection, auscultation & olfaction, inquiry, and palpation, laying the foundation for TCM diagnosis and treatment. The Huang Di Nei Jing (Yellow Emperor's Inner Canon) compiled during the Qin and Han times (221 BC-AD 220) offered systematic discourses on human physiology, on pathology, on the symptoms of illness, on preventative treatment, and on the principles and methods of treatment. This book defined the framework of TCM, thus serving as a landmark in TCM's development and symbolizing the transformation from the accumulation of clinical experience to the systematic summation of theories. A theoretical framework for TCM had been in place. The Shang Han Za Bing Lun (Treatise on Febrile Diseases and Miscellaneous Illnesses) collated by Zhang Zhongjing in the Eastern Han Dynasty (25-220) advanced the principles and methods to treat febrile diseases due to exogenous factors (including pestilences). It expounds on the rules and principles of differentiating the patterns of miscellaneous illnesses caused by internal ailments, including their prevention, pathology, symptoms, therapies, and treatment. It establishes the theory and methodology for syndrome pattern diagnosis and treatment differentiation. The Shen Nong Ben Cao Jing (Shennong's Classic of Materia Medica) - another masterpiece of medical literature appeared during this period - outlines the theory of the compatibility of medicinal ingredients. For example, it holds that a prescription should include at the same time the jun (or sovereign), chen (or minister), zuo (or assistant) and shi (or messenger) ingredient drugs, and should give expression to the harmony of the seven emotions as well as the properties of drugs known as "four natures" and "five flavors." All this provides guidance to the production of TCM prescriptions, safe application of TCM drugs and enhancement of the therapeutic effects, thus laying the foundation for the formation and development of TCM pharmaceutical theory. In the late years of the Eastern Han Dynasty, Hua Tuo (c. 140-208) was recorded to be the first person to use anesthetic (mafeisan) during surgery. The Zhen Jiu Jia Yi Jing (AB Canon of Acupuncture and Moxibustion) by Huangfu Mi during the Western Jin time (265-316) expounded on the concepts of zangfu (internal organs) and jingluo (meridians and collaterals). This was the point when theory of jingluo and acupuncture & moxibustion began to take shape. Sun Simiao, a great doctor of the Tang Dynasty (618-907), proposed that mastership of medicine lies in proficient medical skills and lofty medical ethics, which eventually became the embodiment of a moral value of the Chinese nation, a core value that has been conscientiously upheld by the TCM circles. A herbology and nature masterpiece, the Ben Cao Gang Mu (Compendium of Materia Medica) compiled by Li Shizhen in the Ming Dynasty (1368-1644) was the first book in the world that scientifically categorized medicinal herbs. It was a pioneering work that advanced TCM pharmaceutical theory. The Wen Re Lun (A Treatise on Epidemic Febrile Diseases) by Ye Tianshi during the Qing Dynasty (1644-1911) developed the principles and methods for prevention and treatment of pestilential febrile diseases. It represents the theory and results of the practice of TCM in preventing and treating such diseases. Following the spread of Western medicine in China from the mid-Qing Dynasty, especially during the period of the Republic of China (1912-1949), some TCM experts began to explore ways to absorb the essence of Western medicine for a combination of TCM with Western medicine. |
| 2.中醫(yī)藥特點(diǎn) | 2. Characteristics of TCM |
| 在數(shù)千年的發(fā)展過程中，中醫(yī)藥不斷吸收和融合各個(gè)時(shí)期先進(jìn)的科學(xué)技術(shù)和人文思想，不斷創(chuàng)新發(fā)展，理論體系日趨完善，技術(shù)方法更加豐富，形成了鮮明的特點(diǎn)。 | During its course of development spanning a couple of millennia, TCM has kept drawing and assimilating advanced elements of natural science and humanities. Through many innovations, its theoretical base covered more ground and its remedies against various diseases expanded, displaying unique characteristics. |
| 第一，重視整體。中醫(yī)認(rèn)為人與自然、人與社會(huì)是一個(gè)相互聯(lián)系、不可分割的統(tǒng)一體，人體內(nèi)部也是一個(gè)有機(jī)的整體。重視自然環(huán)境和社會(huì)環(huán)境對(duì)健康與疾病的影響，認(rèn)為精神與形體密不可分，強(qiáng)調(diào)生理和心理的協(xié)同關(guān)系，重視生理與心理在健康與疾病中的相互影響。 | First, setting great store by the holistic view. TCM deems that the relationship between humans and nature is an interactive and inseparable whole, as are the relationships between humans and the society, and between the internal organs of the human body, so it values the impacts of natural and social environment on health and illness. Moreover, it believes that the mind and body are closely connected, emphasizing the coordination of physical and mental factors and their interactions in the conditions of health and illness. |
| 第二，注重“平”與“和”。中醫(yī)強(qiáng)調(diào)和諧對(duì)健康具有重要作用，認(rèn)為人的健康在于各臟腑功能和諧協(xié)調(diào)，情志表達(dá)適度中和，并能順應(yīng)不同環(huán)境的變化，其根本在于陰陽的動(dòng)態(tài)平衡。疾病的發(fā)生，其根本是在內(nèi)、外因素作用下，人的整體功能失去動(dòng)態(tài)平衡。維護(hù)健康就是維護(hù)人的整體功能動(dòng)態(tài)平衡，治療疾病就是使失去動(dòng)態(tài)平衡的整體功能恢復(fù)到協(xié)調(diào)與和諧狀態(tài)。 | Second, setting great store by the principle of harmony. TCM lays particular stress on the importance of harmony on health, holding that a person's physical health depends on harmony in the functions of the various body organs, the moderate status of the emotional expression, and adaption and compliance to different environments, of which the most vital is the dynamic balance between yin and yang. The fundamental reason for illness is that various internal and external factors disturb the dynamic balance. Therefore, maintaining health actually means conserving the dynamic balance of body functions, and curing diseases means restoring chaotic body functions to a state of coordination and harmony. |
| 第三，強(qiáng)調(diào)個(gè)體化。中醫(yī)診療強(qiáng)調(diào)因人、因時(shí)、因地制宜，體現(xiàn)為“辨證論治”?！氨孀C”，就是將四診（望、聞、問、切）所采集的癥狀、體征等個(gè)體信息，通過分析、綜合，判斷為某種證候?！罢撝巍保褪歉鶕?jù)辨證結(jié)果確定相應(yīng)治療方法。中醫(yī)診療著眼于“病的人”而不僅是“人的病”，著眼于調(diào)整致病因子作用于人體后整體功能失調(diào)的狀態(tài)。 | Third, emphasis on individuality. TCM treats a disease based on full consideration of the individual constitution, climatic and seasonal conditions, and environment. This is embodied in the term "giving treatment on the basis of syndrome differentiation." Syndrome differentiation means diagnosing an illness as a certain syndrome on the basis of analyzing the specific symptoms and physical signs collected by way of inspection, auscultation & olfaction, inquiry, and palpation, while giving treatment means defining the treatment approach in line with the syndrome differentiated. TCM therapies focus on the person who is sick rather than the illness that the patient contracts, i.e., aiming to restore the harmonious state of body functions that is disrupted by pathogenic factors. |
| 第四，突出“治未病”。中醫(yī)“治未病”核心體現(xiàn)在“預(yù)防為主”，重在“未病先防、既病防變、瘥后防復(fù)”。中醫(yī)強(qiáng)調(diào)生活方式和健康有著密切關(guān)系，主張以養(yǎng)生為要?jiǎng)?wù)，認(rèn)為可通過情志調(diào)攝、勞逸適度、膳食合理、起居有常等，也可根據(jù)不同體質(zhì)或狀態(tài)給予適當(dāng)干預(yù)，以養(yǎng)神健體，培育正氣，提高抗邪能力，從而達(dá)到保健和防病作用。 | Fourth, emphasis on preventative treatment. Preventative treatment is a core belief of TCM, which lays great emphasis on prevention before a disease arises, guarding against pathological changes when falling sick, and protecting recovering patients from relapse. TCM believes that lifestyle is closely related to health, so it advocates health should be preserved in daily life. TCM thinks that a person's health can be improved through emotional adjustment, balanced labor and rest, a sensible diet, and a regular life, or through appropriate intervention in the lifestyle based on people's specific physical conditions. By these means, people can cultivate vital energy to protect themselves from harm and keep healthy. |
| 第五，使用簡(jiǎn)便。中醫(yī)診斷主要由醫(yī)生自主通過望、聞、問、切等方法收集患者資料，不依賴于各種復(fù)雜的儀器設(shè)備。中醫(yī)干預(yù)既有藥物，也有針灸、推拿、拔罐、刮痧等非藥物療法。許多非藥物療法不需要復(fù)雜器具，其所需器具（如小夾板、刮痧板、火罐等）往往可以就地取材，易于推廣使用。 | Fifth, simplicity. TCM doctors diagnose patients through inspection, auscultation & olfaction, inquiry, and palpation. In addition to medication, TCM has many non-pharmacological alternative approaches such as acupuncture and moxibustion, tuina (massage), cupping and guasha (spooning). There is no need for complex equipment. TCM tools, for example, the small splints used in Chinese osteopathy, the spoons used in guasha, or the cups used in cupping therapy, can draw from materials close at hand, so that such treatments can spread easily. |
| 3.中醫(yī)藥的歷史貢獻(xiàn) | 3. TCM's Contributions |
| 中醫(yī)藥是中華優(yōu)秀傳統(tǒng)文化的重要組成部分和典型代表，強(qiáng)調(diào)“道法自然、天人合一”，“陰陽平衡、調(diào)和致中”，“以人為本、懸壺濟(jì)世”，體現(xiàn)了中華文化的內(nèi)核。中醫(yī)藥還提倡“三因制宜、辨證論治”，“固本培元、壯筋續(xù)骨”，“大醫(yī)精誠(chéng)、仁心仁術(shù)”，更豐富了中華文化內(nèi)涵，為中華民族認(rèn)識(shí)和改造世界提供了有益啟迪。 | TCM is an important component and a characteristic feature of traditional Chinese culture. Applying such principles as "man should observe the law of the nature and seek for the unity of the heaven and humanity," "yin and yang should be balanced to obtain the golden mean," and "practice of medicine should aim to help people," TCM embodies the core value of Chinese civilization. TCM also advocates "full consideration of the environment, individual constitution, and climatic and seasonal conditions when practicing syndrome differentiation and determining therapies," "reinforcing the fundamental and cultivating the vital energy, and strengthening tendons and bones," and "mastership of medicine lying in proficient medical skills and lofty medical ethics," all concepts that enrich Chinese culture and provide an enlightened base from which to study and transform the world. |
| 中醫(yī)藥作為中華民族原創(chuàng)的醫(yī)學(xué)科學(xué)，從宏觀、系統(tǒng)、整體角度揭示人的健康和疾病的發(fā)生發(fā)展規(guī)律，體現(xiàn)了中華民族的認(rèn)知方式，深深地融入民眾的生產(chǎn)生活實(shí)踐中，形成了獨(dú)具特色的健康文化和實(shí)踐，成為人們治病祛疾、強(qiáng)身健體、延年益壽的重要手段，維護(hù)著民眾健康。從歷史上看，中華民族屢經(jīng)天災(zāi)、戰(zhàn)亂和瘟疫，卻能一次次轉(zhuǎn)危為安，人口不斷增加、文明得以傳承，中醫(yī)藥作出了重大貢獻(xiàn)。 | TCM originated in the Chinese culture. It explains health and diseases from a macro, systemic and holistic perspective. It shows how China perceives nature. As a unique form of medicine, TCM exercises a profound influence on the life of the Chinese people. It is a major means to help the Chinese people maintain health, cure diseases, and live a long life. The Chinese nation has survived countless natural disasters, wars and pestilences, and continues to prosper. In this process, TCM has made a great contribution. |
| 中醫(yī)藥發(fā)祥于中華大地，在不斷汲取世界文明成果、豐富發(fā)展自己的同時(shí)，也逐步傳播到世界各地。早在秦漢時(shí)期，中醫(yī)藥就傳播到周邊國(guó)家，并對(duì)這些國(guó)家的傳統(tǒng)醫(yī)藥產(chǎn)生重大影響。預(yù)防天花的種痘技術(shù)，在明清時(shí)代就傳遍世界。《本草綱目》被翻譯成多種文字廣為流傳，達(dá)爾文稱之為“中國(guó)古代的百科全書”。針灸的神奇療效引發(fā)全球持續(xù)的“針灸熱”?？汞懰幬铩扒噍锼亍钡陌l(fā)明，拯救了全球特別是發(fā)展中國(guó)家數(shù)百萬人的生命。同時(shí)，乳香、沒藥等南藥的廣泛引進(jìn)，豐富了中醫(yī)藥的治療手段。 | Born in China, TCM has also absorbed the essence of other civilizations, evolved, and gradually spread throughout the world. As early as the Qin and Han dynasties (221 BC-AD 220), TCM was popular in many neighboring countries and exerted a major impact on their traditional medicines. The TCM smallpox vaccination technique had already spread outside of China during the Ming and Qing dynasties (1368-1911). The Ben Cao Gang Mu (Compendium of Materia Medica) was translated into various languages and widely read, and Charles Darwin, the British biologist, hailed the book as an "ancient Chinese encyclopedia." The remarkable effects of acupuncture and moxibustion have won it popularity throughout the world. The discovery of qinghaosu (artemisinin, an anti-malaria drug) has saved millions of lives, especially in developing countries. Meanwhile, massive imports of medicinal substances such as frankincense and myrrh have enriched TCM therapies. |
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