《三十六计》与邪气致病方式之探讨

【作者】 侯志旺；

【导师】 陈家旭；

【作者基本信息】 北京中医药大学 ， 中医诊断学， 2010， 博士

【摘要】 任何专业学科的研究必然包含两项重点：一为归原,一为博观。无论学术如何发展演变,他不能偏离本源,也就是所谓的核心思想。而归原便是对学科核心思想作追溯式的研讨。至于从核心思想衍生出的各类学术领域,尽管彼此之间专业层次不同,然而基于核心思想的贯穿,这些学科多能相互借镜参考,从而达到相辅相成的功效,是故多方涉猎不同学术理论,汲取当中可用精华,以免沧海遗珠之憾,此乃博观之重点意义所在。中医亦是一门专业学科,而他的核心思维根源自传统中华文化,诸如阴阳观点、五行生克概念等等,因此从中医学的源头探索其他同样承续于传统文化的专门学科,正是归原与博观的体现。为此,笔者选择古代兵家思想作为研究的方针,以期能够更加完善医、兵结合在传统医学理论中的发挥。言至于此,则笔者要来说明本课题所选定的兵学著作—《三十六计》。全书虽仅列述三十六条计策,当中却涵盖了孙子所言“兵者,诡道也”的整体思想发挥,因此《三十六计》被誉为兵家奇书不是没有他的道理。然而参考现代中医学运用《三十六计》的相关文献资料,笔者发觉不少研究者多把重心摆在“中医治疗学”的范畴,例如张介眉老师主编的《三十六计与中医学》一书,基本体现了徐灵胎“用药如用兵”的医、兵结合思想。但兵家讲求知已知彼,方能百战不殆,我们不妨假设邪气在侵犯人体的过程当中,也是在施展计谋以致病,从而诸证纷起,换言之《三十六计》犹如剑的双刃,其适用于剖析中医治疗思维,同时也能阐述邪气害病模式。因此笔者重点掌握从《三十六计》探讨医学常见三十六例邪淫致病理论,以作为本课题的研究方针,并思索破解之道,使传统医学从辨证到论治、从敌军(邪气)到援军(药物),其整体过程在《三十六计》的结合参考及运用上能够更加完备。本论文笔者仍以《三十六计》为纲目,分“胜战计”、“敌战计”、“攻战计”、“混战计”、“并战计”、“败战计”六个部分编排讨论：其主体内容如依“瞒天过海”分析传统医学中“大实有赢状,至虚有盛候”的概念；循“借刀杀人”探讨六淫概念里“热邪为盛”的观点；按“趁火打劫”描述病证学上“或然证与并发症”之间的关系；以“无中生有”阐释现代医学内“肿瘤和癌症”的发生,还有假“美人计”寻思“亚健康”诸多状态；借“连环计”分述朱丹溪倡导的“六郁证”之重要学说等等。此外更将内经学、伤寒学、金匮学、温病学这四部医典中某些重点理念,结合《三十六计》的内容详加剖析,例如从“笑里藏刀”研讨《素问》所云“喜则气缓”之因果；从“李代桃僵”概述《伤寒论》当中“太阳腑证”诸条文的解析；从“调虎离山”统整《伤寒论》与《金匮要略》提及之妇人“热入血室,,的观念；以及从“擒贼擒王”描绘《温热论》里“逆传心包”的逻辑等等。有别于以往研究中医学与《三十六计》的诸多文献记载,则笔者将内容着重在我方如何思忖邪气之行《三十六计》时料敌机先,或防患未然、或亡羊补牢,以谋求破解之道,最终祈求能在传统医学领域里对于医、兵结合的发展但尽一己之贡献。笔者认为兵法辅佐辨证的主要特质之一,就是阻止邪气传变,不论是未病先防,亦或及时治疗,有效遏阻敌邪继续深入人体,其重点工作都在于了解贼邪传变的途径。在兵家的智慧里,掌握敌军动向乃是胜败关键不可或缺的一环,同理应用在诊断上,若能正确辨明邪气下一步动作为何,适时遏阻其传变发展,则病证亦能早一步治愈,斯乃医学应用兵理最为广泛的思想之一,而《三十六计》的结合参考就具备如此成效。今笔者依据是书各计的特点,概略提出三十六个诊断学上常见的病证及其传统医学之相关理论,从而辅以《三十六计》书中阐释的兵学观念结合探讨,藉由“病机”作为贯穿中医学与兵学之间的主轴,望诸位读者专家不吝赐教。更多还原

【Abstract】 Researches of any professional subjects definitely included two important points:"researching into the origin" as one and "getting knowledge widely" as another. No deviation from the origin(so-called "the core thought") was allowed no matter how the academic development was evolving. Researching into the origin was a trace-back discussion for the core thought of any subjects. Various academic fields, despite how different their professional levels were, originated from the core thought. Based on the penetration of the core thought, these subjects could be relevant to each other in which to reach the effect of helping others in a mutual way. Therefore, in order to avoid overlooking, it was the major point of getting knowledge widely by gaining the essence through learning more different academic theories. Chinese medicine was also a professional subject. Its core thought originated from the traditional Chinese culture, such as the theory of Yin-Yang, the mutual generation or counteraction among the five elements, etc. Thus, it was the manifestation of researching into the origin and getting knowledge widely from the origin of the Chinese medicine to discover other professional subjects which inherited the traditional cultures. Based on this, the researcher selected ancient military theories as the study to hope to perfect the combination of Chinese Medicine and military in the development of the traditional medical theories.The "Thirty-six Stratagems", selected by the author, though only listed thirty-six stratagems, it connoted the overall thought of Sun Wu’s "All warfare is based on deception." Therefore, it was no doubt that the "Thirty-six Stratagems" was honored as the wonderful works about military theories. However, referring to relevant literatures about modern Chinese Medicine using the "Thirty-six Stratagems", it was found that quite a few researchers put emphasis on the range of "Chinese Medicine illness curing science." Take the book "Thirty-six Stratagems and the science of Chinese Medicine" edited by Zhang jiemei for example, it basically manifested the thought of the combination of Chinese Medicine and military of Xu Lingtai’s "Using drugs is like commanding soldiers" concept. But military strategists emphasized the concept of "If you know the enemy and know yourself, then you need not fear the result of every battle". Presumably we thought that during the process of the pathogenic factors infringing the human body, it was also utilizing stratagems to cause diseases. Various proofs were then presented. In other words, the "Thirty-six Stratagems" was like a double-edged sword. On one hand, it applied to analyze the thinking of the Chinese Medicine curing. On the other hand, it also described the pathogenic factors’disease modes as the study subject. It pondered on the way of solution to make traditional medicine better, either from the differentiation of syndromes to the determination of treatment, or from the enemies to the reinforcement. It could make it even better on the combination of the "Thirty-six Stratagems" its reference and utilization during the whole process.The "Thirty-six Stratagems" was still the compendium of this thesis. It was divided into six parts for discussion. They were "Stratagems When in a Superior position", "Stratagems for Confrontation", "Stratagems for Attack", "Stratagems for Confused Situations", "Stratagems for Gaining Ground" and "Stratagems for Desperate Situations." The major contents included concepts of analytical Chinese medicine’s "Pseudo-deficiency Symptoms Appearing in an Extreme Excess Condition and Pseudo-excess Symptoms Appearing in an Extreme Deficiency Condition" through that of "Cross the Sea under Camouflage"; "Intense and Pathogenic Heat’s" viewpoints of adverse environmental conditions of wind, cold, dryness, dampness, fire and summers-heat through that of "Borrow Others’Hand to Kill"; the relationship between "Probable Syndrome and Complications" of the science of disease and syndrome through that of "Loot a Burning House"; using "Creating Something out of Nothing" to interpret the occurrence of "Tumor and Cancer" in contemporary medicine; thinking of "sub-health" by using "sex trap" stratagem and utilizing "Making Use of a Series of Tactics" to describe individually the major theory of "Six kinds of Stagnancy" what Zhu Zhenheng was proclaiming. Other than these, major concepts of the four classics of Chinese Medicine—the science of "Yellow Emperor’s Internal Classic", the science of "Treatise on Febrile Diseases", the science of "Synopsis of Prescriptions of the Golden Chamber" and the science of "Epidemic Febrile Diseases", combined with the contents of the "Thirty-six Stratagems", were analyzed in detail. Examples such as to explore the cause and effect of "Overjoy Leads to a Mild Situation of Heart-qi" mentioned in "Plain Questions" from "Hide a Dagger in a Smile"; to describe in general the analyses of the articles of "Taiyang fu-organ Disorder" in the "Treatise on Febrile Diseases" from "Palm Off a Substitute for the Real Thing"; to unify the concepts of women’s "Invasion of Blood Chamber by Heat" mentioned in the "Treatise on Febrile Diseases" and "Synopsis of Prescriptions of the Golden Chamber" from "Lure the Tiger out of His Den"; to depict the logic of "Reverse Transmission to Pericardium" in the "Treatise on Epidemic Febrile Diseases" from "Capture the Ringleader First in Order to Capture All His Followers." Different from many literatures written before studying about Chinese medicine and the "Thirty-six Stratagems", it was focused on pondering on speculating in advance what the enemy will do, taking precautions against a calamity or mending the sheepfold after a sheep is lost in the pathogenic factors in order to seek a way of solution and eventually to make a contribution to the combination of Chinese Medicine and the military in the field of traditional medicine.It was thought that the prime characteristics of assisting dialectics of the art of war was to prevent the pathogenic factors from making further development, no matter what prevention first before the onset of disease or curing in time. It was to effectively keep the pathogenic factors from penetrating the human body. The major task of all these was to know the access of the pathogenic factors making further development. In the wisdom of the military, it was always the secret of winning to be able to keep control of what the enemy was going to do. It went the same to diagnosis that the disease could be cured earlier and the next move of the pathogenic factors could be correctly detected to stop the pathogenic factors from making further development. That was one of the commonest thoughts when the science of medicine practiced the theory of war. The "Thirty-six Stratagems" had such a result. According to the characteristics of each stratagem in the book, thirty-six commonly-seen diseases and related theories of traditional science of medicine in the science of diagnosis were presented in general to help interpret and explore the concepts of the science of war.By using "Pathogenesis", it was made to penetrate the main axis between the science of Chinese Medicine and the science of war.更多还原