“形而上学”视角下的中医病机学说——以《诸病源候论·风病诸候》为例

Theory of TCM pathogenesis from the perspective of metaphysics:Taking"General Treatise on Causes and Manifestations of All Diseases·Wind Diseases"as an example

“形而上学”是一种不同于机械唯物论的哲学视野,中国哲学与中医学“形—气—神”人体观具有“形而上学”的认知模式。本文以《诸病源候论·风病诸候》内容为例,分析比较《诸病源候论》对风病的认知演进过程,认为《诸病源候论》建构了一种通过经络系统连属全身以通行气血,以脏腑结构为精气内在所藏之处的具有“形而上学”特色的身体模型。通过对中风病诸病候的分析,揭示该身体模型在病机学说中的具体运用。经筋作为经络系统的络属部分,以一种实体性的存在成为中风病病证阐释的形而下基础。由此,《诸病源候论》完善了病机学说“形而上—形而下”的两层空间的身体构造,为以气血状态为论述重点的病机学说奠定了基础,构建了一种“疾病—症状—病因病机—治疗”的疾病论治模型。

"Metaphysics"is a philosophical perspective different from mechanical materialism,and the Chinese philosophy and traditional Chinese medicine′s view of the human body as"body-qi-spirit"embodies a"metaphysical"cognitive pattern.This paper takes the content of General Treatise on Causes and Manifestations of All Diseases·Wind Diseases as an example to analyze and compare the cognitive evolution process of wind diseases in General Treatise on Causes and Manifestations of All Diseases.It is argued that the General Treatise on Causes and Manifestations of All Diseases constructs a body model characterized by"metaphysics"where the meridian system connects the entire body to facilitate the flow of qi and blood,with the organs serving as the storage places for essence-qi.Through the analysis of the symptoms of stroke,it reveals the specific application of this body model in the theory of disease mechanisms.The meridian tendons,as the subordinate parts of the meridian system,become the physical basis for the explanation of stroke with their substantive existence.It is thus determined that General Treatise on Causes and Manifestations of All Diseases has perfected the two-layer space of"metaphysicalphysical"body structure of the theory of disease pathogenesis,laid the foundation for the theory of disease mechanism with the state of qi and blood as the focus of discussion,and constructed a model of disease diagnosis and treatment,which is"disease-symptom-etiology and pathogenesis-treatment".