- 期刊
臟象論等非屬五行學說而是臟腑之五類規範－其非關診療故不能作為中醫理論
Viscera-state Doctrine is the Regulation of Five Zang Viscera Not the Theory of Five Elements (Wuxing)-It Isn't Related to Diagnosis or Treatment and Can't be Used as a TCM Theory
摘要
《素問》五象之五色、五味、五液、五音、五時、五方與《禮記•月令》相同，後者依日照季節分作五類，以規範生活作息之準則。強調生活作息須與外在天地相協調，配屬五臟是祭祀之牲畜五臟，此五類月令“月序活動計劃”抄自《呂氏春秋》仲春、仲夏、仲秋、仲冬篇。五行學說源於循環不已之天體行星運轉，將每年仲春（春分）、仲夏（夏至）、仲秋（秋分）、仲冬（冬至）四點分作行星縱橫座標，加上中央點之永恆運轉。其以日夜分陰陽，互為矛盾又合為統一，日夜陰陽消長互有制衡而整體向前運轉。用此規範作季節之生活作息，就是前述之“月序活動計劃”。五行（五星）與五行（五類）兩者呈主客關係。《素問》作者藉此主客關係規範人體五臟生理之“月序活動計劃”。又將臨床觀察諸病狀與脈象藉推測安排於各象，以求圓滿哲理上之規範。後人不察，誤認五臟規範即為中醫理論。《靈樞》作者透過針灸之感傳經驗而發明經脈系統與各有臟俯相歸屬。針灸治療時，經脈間之生剋補瀉關係可模擬為天體之五行（五星）運轉，命為五象，各象所屬之臟俯互為陰陽又合為統一，五象之間相生相剋而整體向前運轉，此稱五行學說，係基於針灸臨床之生剋補瀉而立，其循環為模擬而設，並可滿足帝王追求生命永恆之長生思想。《素問》酸入肝、肝主筋、風屬肝木、肺主魄、色紅入心、面黃屬脾、腎主水…等臟象論為《禮記•月令》五行規範之擴大延伸，不能作為中醫理論，臟俯之規範安排不能作為辨證基礎。《素問》多屬五臟規範，部分篇章出於先秦或西漢早期，定本時間約與倉公同年代。《靈樞》內容較為成熟，其經脈之論述多來自針灸臨床，定本時間晚於《素問》。今本《黃帝內經》是皇甫謐強將《素問》與《鍼經九卷》相合而得，並非《漢書•藝文志》之《黃帝內經》。台灣醫家朱木通《中醫臨床二十五年》：有一派所謂後世醫方派竟直接採取《素問》的學說為治療之原則，則為使人啼笑皆非之事…。
並列摘要
The meanings of ”five colors”, ”five flavors”, ”five kinds of secretions” ”five notes”, ”five seasons”, and ”five directions” of five Xiang in the TCM classic ＜Su Wen＞ are the same as the viewpoint of the classic ＜Li Chi Yueh Ling＞. According to ＜Li Chi Yueh Ling＞, the lunar months can be divided into five categories based on sunlight and seasons in order to be as the regulation of live and work. It was emphasized that live and work has to coordinate with the nature. The corresponsive five Zang-organs are the five organs of the domesticated animals for sacrificial rites. These five categories of lunar months, ”activities schedules depending on lunar months”, were derived from the chapters of ”Mid Spring” ”Mid Summer”, ”Mid Autumn”, ”Mid Winter” in the classic ＜Lu Shi Chun Qiu＞. Based on the continual revolution of the heavenly spheres, the Wuxing (five elements) theory emphasizes the eternal revolution depending on a central point and the vertical-horizontal coordinates which were formed at the four pints of ”Mid Spring (spring equinox)”, ”Mid Summer (summer solstice)”, ”Mid Autumn (autumn equinox)”, ”Mid Winter (winter solstice)”. Ying and yang, the rhythm of their inaction is harmonious as day & night. Since the functioning of celestial sun and moon, yin and yang of nature in the rise and fall of changes, their performance for the alternating day and night, day-to-yang, night is yin. This regulation is used to plan our live and work in seasons. It is the so-called ”activities schedules depending on lunar months”. There is a subject-object relationship between five-plants-Wuxing and five-categories-Wuxing. The author of ＜Su Wen＞ created the ”activities schedules depending on lunar months” in order to regulate the physiology of five Zang viscera in a human body. He also arranged the clinical symptoms and pulse conditions in medicine into five ”Xiang” in order to get a successfully accomplished philosophy. Due to the misunderstanding of the generations, the regulation of five Zang viscera has been mistaken as a kind of traditional Chinese medicine. With the transmission experience of acupuncture, the author of the classic ＜Ling Shu＞ found that the meridian system and zhang-organs are correspondent and belong to each other. In the acupuncture treatment, the relationship of generation-restriction and reinforcing-reducing can be seen as the Wuxing (five plants) revolution of the heavenly spheres. It is named as Five Xiang. Each Xiang has its corresponsive Zang-organs. All Zang organs construct the interdependence of yin and yang. While having a smooth revolution, there is a generative and restrictive relationship between five ”Xiang” s. This Wuxing theory was established for the clinical reinforcing and reducing of acupuncture. The concept of circulation also satisfied the emperors' thought about pursuing long-life. The viscera-state doctrine in ＜Su Wen＞, which talked about ”sour flavor associating with liver, liver governing tendons, wind is ascribed to liver, lung governing inferior spirit, red color is ascribed to heart-fire, yellow face is ascribed to spleen, kidney governing water…” was the extension of the Wuxing regulation of ＜Li Chi Yueh Ling＞. It can't be used as a kind of TCM theory. The regulation and arrangement of Zang organs can't be used as the basis of syndrome differentiation. Most parts of ＜Su Wen＞ are related to five Zang organs regulation. Some chapters were written in Pre-Chin Dynasty or Early Western Han Dynasty. The finalized time of ＜Su Wen＞ was about the period of Canggong. The contents of ＜Ling Shu＞ are more improved. Most of the meridian theories derived from clinical experience of acupuncture treatment. The finalized time of ＜Ling Shu＞ was later than ＜Su Wen＞. The latest edition of ＜Huang Di Nei Jing＞ was a combination of ＜Su Wen＞ and ＜Zhen Jing Jiujuan＞ by Huang Fumi, not the original ＜Huang Di Nei Jing＞ of ＜Hanshu-Yiwen Literature＞. The document ＜Twenty Five Years of Clinical TCM＞ which was written by Taiwanese physician Chu Mu-tung states that it is ridiculous of the scholars in favor of classical prescription to take the theory of ＜Su Wen＞ as the treatment principles.