《黄帝内经》“脑主神明”与“心主神明”关系探析

An analysis of the relationship between “brain dominating the spirit” and “heart dominating the spirit” in Huangdi Neijing

基于西医学的认知,脑具有感觉、思维、记忆、调控躯体及内脏活动等功能,为人体神机之主。然而《黄帝内经》却明确提出"心主神明",现学界多认为其为哲学模式思维推演下的结果。本团队通过梳理相关内容,发现《黄帝内经》对脑的解剖位置、组织特征以及主司神明的功能已有清晰的认识,而部分篇章之所以将神归属于心,是源于古人在临床实践过程中认识到气血的充盈及通畅与否对脑功能影响较大,基于解剖学心主血脉的认识,即心的功能正常与否对气血是否通畅发挥着至关重要的作用,故将神配属于心,心主血脉为心主神明的理论基础。客观阐释"心主神明"的临床内涵,对于治疗"神"的病变具有重要的指导意义。

According to Western medicine, the brain has the functions of sensation, thinking, memory, and regulation of the body and internal organ activities, and it is “the master of the spirit”. However, the Huangdi Neijing clearly states that “the heart is the master of the spirit”, which is now considered to be the result of a philosophical model of thinking. A thorough analysis of the relevant content, that the Huangdi Neijing shows a clear understanding of the anatomical location and organizational characteristics of the brain, as well as its function as “the master of the spirit”.The reason why some of the chapters attribute the spirit to the heart is that the ancients realized in the course of clinical practice that the fullness and smoothness of qi and blood have a great influence on the function of the brain. It is also based on the anatomical understanding that the heart governs the blood vessels, that is, the heart plays a vital role in the smoothness of qi and blood, and therefore the spirit is assigned to the heart, and “the heart governs the blood vessels” is the basis for “heart dominating the spirit”. An objective interpretation of the clinical connotation of “heart dominating the spirit” is an important guide to the treatment of lesions of the “spirit”.