《中國的中醫藥》白皮書（全文）
White Paper: Traditional Chinese Medicine in China
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| 一、中醫藥的歷史發展 | I. The Historical Development of TCM |
| 1.中醫藥歷史發展脈絡 | 1. History of TCM |
| 在遠古時代，中華民族的祖先發現了一些動植物可以解除病痛，積累了一些用藥知識。隨著人類的進化，開始有目的地尋找防治疾病的藥物和方法，所謂“神農嘗百草”、“藥食同源”，就是當時的真實寫照。夏代（約前2070－前1600）酒和商代（前1600－前1046）湯液的發明，為提高用藥效果提供了幫助。進入西周時期（前1046－前771），開始有了食醫、疾醫、瘍醫、獸醫的分工。春秋戰國（前770－前221）時期，扁鵲總結前人經驗，提出“望、聞、問、切”四診合參的方法，奠定了中醫臨床診斷和治療的基礎。秦漢時期（前221－公元220）的中醫典籍《黃帝內經》，系統論述了人的生理、病理、疾病以及“治未病”和疾病治療的原則及方法，確立了中醫學的思維模式，標志著從單純的臨床經驗積累發展到了系統理論總結階段，形成了中醫藥理論體系框架。東漢時期，張仲景的《傷寒雜病論》，提出了外感熱病（包括溫疫等傳染病）的診治原則和方法，論述了內傷雜病的病因、病證、診法、治療、預防等辨證規律和原則，確立了辨證論治的理論和方法體系。同時期的《神農本草經》，概括論述了君臣佐使、七情合和、四氣五味等藥物配伍和藥性理論，對于合理處方、安全用藥、提高療效具有十分重要的指導作用，為中藥學理論體系的形成與發展奠定了基礎。東漢末年，華佗創制了麻醉劑“麻沸散”，開創了麻醉藥用于外科手術的先河。西晉時期（265－317），皇甫謐的《針灸甲乙經》，系統論述了有關臟腑、經絡等理論，初步形成了經絡、針灸理論。唐代（618－907），孫思邈提出的“大醫精誠”，體現了中醫對醫道精微、心懷至誠、言行誠謹的追求，是中華民族高尚的道德情操和卓越的文明智慧在中醫藥中的集中體現，是中醫藥文化的核心價值理念。明代（1368－1644），李時珍的《本草綱目》，在世界上首次對藥用植物進行了科學分類，創新發展了中藥學的理論和實踐，是一部藥物學和博物學巨著。清代（1644－1911），葉天士的《溫熱論》，提出了溫病和時疫的防治原則及方法，形成了中醫藥防治溫疫（傳染病）的理論和實踐體系。清代中期以來，特別是民國時期，隨著西方醫學的傳入，一些學者開始探索中西醫藥學匯通、融合。 | In remote antiquity, the ancestors of the Chinese nation chanced to find that some creatures and plants could serve as remedies for certain ailments and pains, and came to gradually master their application. As time went by, people began to actively seek out such remedies and methods for preventing and treating diseases. Sayings like "Shennong (Celestial Farmer) tasting a hundred herbs" and "food and medicine coming from the same source" are characteristic of those years. The discovery of alcohol in the Xia Dynasty (c. 2070-1600 BC) and the invention of herbal decoction in the Shang Dynasty (1600-1046 BC) rendered medicines more effective. In the Western Zhou Dynasty (1046-771 BC), doctors began to be classified into four categories - dietician, physician, doctor of decoctions and veterinarian. During the Spring and Autumn and Warring States Period (770-221 BC), Bian Que drew on the experience of his predecessors and put forward the four diagnostic methods - inspection, auscultation & olfaction, inquiry, and palpation, laying the foundation for TCM diagnosis and treatment. The Huang Di Nei Jing (Yellow Emperor's Inner Canon) compiled during the Qin and Han times (221 BC-AD 220) offered systematic discourses on human physiology, on pathology, on the symptoms of illness, on preventative treatment, and on the principles and methods of treatment. This book defined the framework of TCM, thus serving as a landmark in TCM's development and symbolizing the transformation from the accumulation of clinical experience to the systematic summation of theories. A theoretical framework for TCM had been in place. The Shang Han Za Bing Lun (Treatise on Febrile Diseases and Miscellaneous Illnesses) collated by Zhang Zhongjing in the Eastern Han Dynasty (25-220) advanced the principles and methods to treat febrile diseases due to exogenous factors (including pestilences). It expounds on the rules and principles of differentiating the patterns of miscellaneous illnesses caused by internal ailments, including their prevention, pathology, symptoms, therapies, and treatment. It establishes the theory and methodology for syndrome pattern diagnosis and treatment differentiation. The Shen Nong Ben Cao Jing (Shennong's Classic of Materia Medica) - another masterpiece of medical literature appeared during this period - outlines the theory of the compatibility of medicinal ingredients. For example, it holds that a prescription should include at the same time the jun (or sovereign), chen (or minister), zuo (or assistant) and shi (or messenger) ingredient drugs, and should give expression to the harmony of the seven emotions as well as the properties of drugs known as "four natures" and "five flavors." All this provides guidance to the production of TCM prescriptions, safe application of TCM drugs and enhancement of the therapeutic effects, thus laying the foundation for the formation and development of TCM pharmaceutical theory. In the late years of the Eastern Han Dynasty, Hua Tuo (c. 140-208) was recorded to be the first person to use anesthetic (mafeisan) during surgery. The Zhen Jiu Jia Yi Jing (AB Canon of Acupuncture and Moxibustion) by Huangfu Mi during the Western Jin time (265-316) expounded on the concepts of zangfu (internal organs) and jingluo (meridians and collaterals). This was the point when theory of jingluo and acupuncture & moxibustion began to take shape. Sun Simiao, a great doctor of the Tang Dynasty (618-907), proposed that mastership of medicine lies in proficient medical skills and lofty medical ethics, which eventually became the embodiment of a moral value of the Chinese nation, a core value that has been conscientiously upheld by the TCM circles. A herbology and nature masterpiece, the Ben Cao Gang Mu (Compendium of Materia Medica) compiled by Li Shizhen in the Ming Dynasty (1368-1644) was the first book in the world that scientifically categorized medicinal herbs. It was a pioneering work that advanced TCM pharmaceutical theory. The Wen Re Lun (A Treatise on Epidemic Febrile Diseases) by Ye Tianshi during the Qing Dynasty (1644-1911) developed the principles and methods for prevention and treatment of pestilential febrile diseases. It represents the theory and results of the practice of TCM in preventing and treating such diseases. Following the spread of Western medicine in China from the mid-Qing Dynasty, especially during the period of the Republic of China (1912-1949), some TCM experts began to explore ways to absorb the essence of Western medicine for a combination of TCM with Western medicine. |
| 2.中醫藥特點 | 2. Characteristics of TCM |
| 在數千年的發展過程中，中醫藥不斷吸收和融合各個時期先進的科學技術和人文思想，不斷創新發展，理論體系日趨完善，技術方法更加豐富，形成了鮮明的特點。 | During its course of development spanning a couple of millennia, TCM has kept drawing and assimilating advanced elements of natural science and humanities. Through many innovations, its theoretical base covered more ground and its remedies against various diseases expanded, displaying unique characteristics. |
| 第一，重視整體。中醫認為人與自然、人與社會是一個相互聯系、不可分割的統一體，人體內部也是一個有機的整體。重視自然環境和社會環境對健康與疾病的影響，認為精神與形體密不可分，強調生理和心理的協同關系，重視生理與心理在健康與疾病中的相互影響。 | First, setting great store by the holistic view. TCM deems that the relationship between humans and nature is an interactive and inseparable whole, as are the relationships between humans and the society, and between the internal organs of the human body, so it values the impacts of natural and social environment on health and illness. Moreover, it believes that the mind and body are closely connected, emphasizing the coordination of physical and mental factors and their interactions in the conditions of health and illness. |
| 第二，注重“平”與“和”。中醫強調和諧對健康具有重要作用，認為人的健康在于各臟腑功能和諧協調，情志表達適度中和，并能順應不同環境的變化，其根本在于陰陽的動態平衡。疾病的發生，其根本是在內、外因素作用下，人的整體功能失去動態平衡。維護健康就是維護人的整體功能動態平衡，治療疾病就是使失去動態平衡的整體功能恢復到協調與和諧狀態。 | Second, setting great store by the principle of harmony. TCM lays particular stress on the importance of harmony on health, holding that a person's physical health depends on harmony in the functions of the various body organs, the moderate status of the emotional expression, and adaption and compliance to different environments, of which the most vital is the dynamic balance between yin and yang. The fundamental reason for illness is that various internal and external factors disturb the dynamic balance. Therefore, maintaining health actually means conserving the dynamic balance of body functions, and curing diseases means restoring chaotic body functions to a state of coordination and harmony. |
| 第三，強調個體化。中醫診療強調因人、因時、因地制宜，體現為“辨證論治”。“辨證”，就是將四診（望、聞、問、切）所采集的癥狀、體征等個體信息，通過分析、綜合，判斷為某種證候。“論治”，就是根據辨證結果確定相應治療方法。中醫診療著眼于“病的人”而不僅是“人的病”，著眼于調整致病因子作用于人體后整體功能失調的狀態。 | Third, emphasis on individuality. TCM treats a disease based on full consideration of the individual constitution, climatic and seasonal conditions, and environment. This is embodied in the term "giving treatment on the basis of syndrome differentiation." Syndrome differentiation means diagnosing an illness as a certain syndrome on the basis of analyzing the specific symptoms and physical signs collected by way of inspection, auscultation & olfaction, inquiry, and palpation, while giving treatment means defining the treatment approach in line with the syndrome differentiated. TCM therapies focus on the person who is sick rather than the illness that the patient contracts, i.e., aiming to restore the harmonious state of body functions that is disrupted by pathogenic factors. |
| 第四，突出“治未病”。中醫“治未病”核心體現在“預防為主”，重在“未病先防、既病防變、瘥后防復”。中醫強調生活方式和健康有著密切關系，主張以養生為要務，認為可通過情志調攝、勞逸適度、膳食合理、起居有常等，也可根據不同體質或狀態給予適當干預，以養神健體，培育正氣，提高抗邪能力，從而達到保健和防病作用。 | Fourth, emphasis on preventative treatment. Preventative treatment is a core belief of TCM, which lays great emphasis on prevention before a disease arises, guarding against pathological changes when falling sick, and protecting recovering patients from relapse. TCM believes that lifestyle is closely related to health, so it advocates health should be preserved in daily life. TCM thinks that a person's health can be improved through emotional adjustment, balanced labor and rest, a sensible diet, and a regular life, or through appropriate intervention in the lifestyle based on people's specific physical conditions. By these means, people can cultivate vital energy to protect themselves from harm and keep healthy. |
| 第五，使用簡便。中醫診斷主要由醫生自主通過望、聞、問、切等方法收集患者資料，不依賴于各種復雜的儀器設備。中醫干預既有藥物，也有針灸、推拿、拔罐、刮痧等非藥物療法。許多非藥物療法不需要復雜器具，其所需器具（如小夾板、刮痧板、火罐等）往往可以就地取材，易于推廣使用。 | Fifth, simplicity. TCM doctors diagnose patients through inspection, auscultation & olfaction, inquiry, and palpation. In addition to medication, TCM has many non-pharmacological alternative approaches such as acupuncture and moxibustion, tuina (massage), cupping and guasha (spooning). There is no need for complex equipment. TCM tools, for example, the small splints used in Chinese osteopathy, the spoons used in guasha, or the cups used in cupping therapy, can draw from materials close at hand, so that such treatments can spread easily. |
| 3.中醫藥的歷史貢獻 | 3. TCM's Contributions |
| 中醫藥是中華優秀傳統文化的重要組成部分和典型代表，強調“道法自然、天人合一”，“陰陽平衡、調和致中”，“以人為本、懸壺濟世”，體現了中華文化的內核。中醫藥還提倡“三因制宜、辨證論治”，“固本培元、壯筋續骨”，“大醫精誠、仁心仁術”，更豐富了中華文化內涵，為中華民族認識和改造世界提供了有益啟迪。 | TCM is an important component and a characteristic feature of traditional Chinese culture. Applying such principles as "man should observe the law of the nature and seek for the unity of the heaven and humanity," "yin and yang should be balanced to obtain the golden mean," and "practice of medicine should aim to help people," TCM embodies the core value of Chinese civilization. TCM also advocates "full consideration of the environment, individual constitution, and climatic and seasonal conditions when practicing syndrome differentiation and determining therapies," "reinforcing the fundamental and cultivating the vital energy, and strengthening tendons and bones," and "mastership of medicine lying in proficient medical skills and lofty medical ethics," all concepts that enrich Chinese culture and provide an enlightened base from which to study and transform the world. |
| 中醫藥作為中華民族原創的醫學科學，從宏觀、系統、整體角度揭示人的健康和疾病的發生發展規律，體現了中華民族的認知方式，深深地融入民眾的生產生活實踐中，形成了獨具特色的健康文化和實踐，成為人們治病祛疾、強身健體、延年益壽的重要手段，維護著民眾健康。從歷史上看，中華民族屢經天災、戰亂和瘟疫，卻能一次次轉危為安，人口不斷增加、文明得以傳承，中醫藥作出了重大貢獻。 | TCM originated in the Chinese culture. It explains health and diseases from a macro, systemic and holistic perspective. It shows how China perceives nature. As a unique form of medicine, TCM exercises a profound influence on the life of the Chinese people. It is a major means to help the Chinese people maintain health, cure diseases, and live a long life. The Chinese nation has survived countless natural disasters, wars and pestilences, and continues to prosper. In this process, TCM has made a great contribution. |
| 中醫藥發祥于中華大地，在不斷汲取世界文明成果、豐富發展自己的同時，也逐步傳播到世界各地。早在秦漢時期，中醫藥就傳播到周邊國家，并對這些國家的傳統醫藥產生重大影響。預防天花的種痘技術，在明清時代就傳遍世界。《本草綱目》被翻譯成多種文字廣為流傳，達爾文稱之為“中國古代的百科全書”。針灸的神奇療效引發全球持續的“針灸熱”。抗瘧藥物“青蒿素”的發明，拯救了全球特別是發展中國家數百萬人的生命。同時，乳香、沒藥等南藥的廣泛引進，豐富了中醫藥的治療手段。 | Born in China, TCM has also absorbed the essence of other civilizations, evolved, and gradually spread throughout the world. As early as the Qin and Han dynasties (221 BC-AD 220), TCM was popular in many neighboring countries and exerted a major impact on their traditional medicines. The TCM smallpox vaccination technique had already spread outside of China during the Ming and Qing dynasties (1368-1911). The Ben Cao Gang Mu (Compendium of Materia Medica) was translated into various languages and widely read, and Charles Darwin, the British biologist, hailed the book as an "ancient Chinese encyclopedia." The remarkable effects of acupuncture and moxibustion have won it popularity throughout the world. The discovery of qinghaosu (artemisinin, an anti-malaria drug) has saved millions of lives, especially in developing countries. Meanwhile, massive imports of medicinal substances such as frankincense and myrrh have enriched TCM therapies. |
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