象症辨证是中医辨证思维的关键

Key of TCM syndrome differentiation thinking:syndrome differentiation of xiang and symptom

中医辨证思维的特点是以形象思维为主、逻辑思维为辅的意象思维。证是从系统功能角度对整体生命状态的一种认识,也就是整体生命活动状态之象。舌象、脉象等诊察之象不是症状,而是整体生命活动状态的缩影,也就是证的缩影。每个方剂有象,每味药有象。辨证论治、理法方药的思维过程是一个以象诊象,以象治象的过程。外感病中,有病才有症状,才有相应的象,然后才能进行辨证,因此辨证应当从病辨证,抓主症辨证。内伤病中,诊察之象和证先于病和症状出现,因此辨证思维应当采取以形象思维为主、逻辑思维为辅的意象思维,象症结合辨证。

The quality of thinking of TCM syndrome differentiation is the imagery thinking, which is dominanted by Concrete thinking and supplemented by logical thinking. Syndrome is a kind of cognition about condition of the whole life from the aspect of system function, i.e. xiang of life. Tongue demonstration, pulse tracings and so on, they are the epitome of the whole life condition and syndrome, not just the symptom. Every prescription has the only xiang, so does every Chinese traditional medicine. The thought process of determination of treatment based on differentiation of symptoms and signs and principle-method-recipe-medicines is the process of diagnosis xiang based on xiang, treating xiang based on xiang. In exopathic disease, there is disease at fi rst, then the symptoms, and then the corresponding xiang, and the syndrome differentiation can be carried. So, syndrome differentiation bases on disease and the main symptomes. In internal damage diseases, the xiang and syndromes appear before the disease and symptoms. Therefore the thought of TCM syndrome differentiation ought to adopt the imagery thinking, which is dominanted by Concrete thinking and supplemented by logic thinking, and differentiating syndrome based on xiang and symptoms.