“心开窍于舌”理论的源流及发展

Source and development of the theory of‘heart opening at tongue’

“心开窍于舌”是中医基础理论的精髓之一,随着时代不断的变迁与发展。秦汉时期,各医家从生理及经络循行角度描述了心与舌的联系;晋隋医家根据理论提出了舌下给药的新方法;宋元时期,舌诊应用于临床,标志着“心开窍于舌”理论的形成体系;明清时期,“心为舌之苗”等各种说法丰富发展了这一理论,医家们通过观察舌象推导病机,解释病变;同时,舌针的出现,为“心开窍于舌”理论提供有力依据;新中国成立后,“心开窍于舌”理论被作为普遍接受的观点编写入教材中,并被更广泛地研究。当前,许多现代研究围绕“心开窍于舌”理论展开,并证实心与舌存在密切联系,但其与中医理论的结合程度和对临床的指导价值有待进一步提升。简言之,“心开窍于舌”从形而上的观点发展为可被切实有效地应用于临床并被广泛接受的理论体系,值得更深入的探讨与创新发展。

‘Heart opening at tongue’is one of the essence of the basic theory of traditional chinese medicine,which is developing with the changes of the times.In the Qin and Han dynasties,medical experts described the relationship between heart and tongue from the point of physiology and meridian circulation.Accrding to the theory,medical experts in Jin and Sui dynasties put forward a new method of sublingual administration.During the Song and Yuan dynasties,tongue diagnosis was applied to clinical practice,marking the formation system of the theory of‘heart opening at tongue’.In Ming and Qing dynasties,the theory was enriched and developed by various statements such as‘tongue reflecting sign of heart’,medical experts deduced pathogenesis and explained pathological changes by observing tongue manifestation.Meanwhile,the appearance of tongue needle provided a strong basis for the theory of‘heart opening at tongue’.After the founding of the people’s republic of China,the theory of‘heart opening at tongue’has been compiled into textbooks as a generally accepted point of view,and has been studied more widely.At present,many modern researches focus on the theory of‘heart opening at tongue’,and the close relationship between the heart and the tongue has been proven,but the degree of its combination with the theory of traditional Chinese medicine and its clinical guiding value need to be further improved.In a word,‘heart opening at tongue’from the metaphysical point of view has developed into a theoretical system that can be effectively applied in clinical practice and widely accepted,which is worthy of further discussion and innovative development.