中医学“是什么”与“为什么”理论的探讨

Theoretical discussion on “what” and “why” in traditional Chinese medicine

研读《伤寒论》的"观其脉证,知犯何逆,随证治之"发现,中医学存在着有关"是什么"与"为什么"的两种理论。"观其脉证"解决的是这组脉证"是什么"的问题,"知犯何逆"研究的是这组脉证"为什么"出现的问题,"随证治之"要解决当出现这组脉证时"怎么办"的问题。"怎么办"涉及证候与方剂的相互关系,其仍可还原为"是什么"关系与"为什么"能发生这种关系。于是乎"观其脉证,知犯何逆,随证治之"这一中医学总则即可接受"是什么"与"为什么"两种角度的问询。"是什么"属于描述性的研究,得出描述性的理论;"为什么"的研究得出因果关系的解释性理论,但中医学这一因果关系是由果析因而得出,这种由果析因得出的"因"是难以检验与核实的,它不是一种事实的"因",而是一种承诺的"因"。中医有关为什么的解释性理论能够指导临床实践的主要原因,是在该理论下聚集了大量的已经检验核实的描述性的理论。

After analyzing the sentence "observe pulse and symptoms to infer their causes and then give treatment accordingly", we believe that theoretical discussions in traditional Chinese medicine fall into two categories: discussions on what and discussions on why. By "observing pulse and symptoms", we try to answer the question "what" a particular combination of pulse and symptoms is like. By "inferring their causes", we try to answer the question "why" such pulse and symptoms appear. By giving treatment accordingly, we try to answer the question "how" to deal with them. The last question involves the relationship between pattern manifestations and prescriptions, which can be further reduced to "what" and "why" is the relationship. Therefore, the general principles of traditional Chinese medicine embodied in the above-mentioned sentence can be analyzed from the two angles of what and why. The study of "what" is descriptive research, which leads to descriptive theory. The study of "why" leads to interpretative theory of causality. However, the causality in traditional Chinese medicine is often based on inferring causes from results. Therefore, it is difficult to test and verify the "cause" derived from such analysis because it is not a factual "cause", but a "cause" in terms of ontological commitment. The main reason why the interpretative theory of traditional Chinese medicine can guide clinical practice is that such interpretative theory is based on a large number of descriptive theories that have been tested and verified.