天人合一的中医文化特点
中医药学和养生学在其发展的历史长河中,逐渐形成了一套独具特色的医疗原则。这些原则充分体现出中国传统文化的背景与特点:
1.“人命至重,有贵千金”的救死扶伤精神。
中医学家在千百年的行医实践中形成了良好的医德医风。他们把不为名利,全力救治,潜心医道,认真负责作为自己的医德标准。对此,唐代名医孙思邈在《千金要方》中作了全面总结。他指出,名利思想“此医人之膏育也”,是医生最应忌讳的,如果行医以收取绮罗财物,食用珍肴佳酿为目的,那就是一种无视“病人苦楚”的“人所共耻”、“人所不为”的行为。他认为,医生的首要任务,应当是维护和保障病人的健康与生命,把人的生命价值看作是医学的出发点和归宿,把挽救病人的生命,看作是医生的最可宝的贵财富。所以,他反复强调,作为一名医生必须“无欲无求”、“志存救济”,对任何一个病人都要一视同仁,要有高度的同情心,处处为病人着想。对“有疾厄来救者,不得问其贵贱贫富,长幼妍娃,怨亲善友,华夷智愚”,都要把他们看作是自己的亲人;对治疗中的风险,“不得赡前顾后,自虑吉凶”,考虑个人的利害得失;对病人的痛苦,“若己之心,深心凄枪”,不避“昼夜寒暑,饮渴疲劳,一心赴救”;对“有患疮痰下痢,臭秽不可瞻视,人所恶见者”,要不嫌脏臭。他说:“如此,可谓苍生大医,反之,则为含灵巨贼。”这种医学上的人道主义,正是对儒家的“恻隐之心”、道家的“无欲无求”、墨家的“兼爱”、佛家的“慈悲”等人文观念的具体体现。
2.防重于治、未老养生的治未病思想。
中医古典医著《黄帝内经》中就提出“不治已病,治未病”的观点。喻示人们从生命开始就要注意保健防衰和防病于未然。《淮南子》说:“良医者,常治无病之病,故无病;圣人者,常治无患之患,故无患也。”金元时期朱震亨亦说:“与其治疗于有病之后,不如摄养于先病之前。”人不可能长生不老,也不可能“返老还童”,但防止未老先衰、延长生命是可以办到的,这种预防为主的医学思想告诉人们必须自幼注意调养,平时注意调养,尤其在生命的转折关头,尤应高度注意调养。如能持之以恒,即可防衰抗老,预防衰老疾病的发生,这种防病抗衰思想与中国文化中的忧患意识一脉相承,《周易·系辞下》说:“安不忘危,存不忘亡。”这种注重矛盾转化、防微杜渐的辩证哲学思想是中国文化的精华。
3.天人合一,形神一体的整体观。
中国传统哲学十分强调自然界是一个普遍联系着的整体,提出天人相应,天人感应等思想。认为天地万物不是孤立存在的,它们之间都是相互影响,相互作用,相互联系,相互依存着的。中医文化中亦体现出这种原则。
中医学主张把天文、地理、人事作为一个整体看待。人既是自然的人,又是社会的人。人生活在自然界又生存在人类社会之中,不能离开社会群体而生存。影响健康和疾病的因素,既有生物因素,又有社会和心理的因素,这是自古以来人们已经感觉到了的客观事实。中医学从“天人相应”和“七情六欲”等观点出发,从人与自然,人与社会的关系中去理解和认识人体的健康和疾病,十分重视自然环境和心理因素的作用,并贯穿在病因考查、诊断治疗以及保健预防的各个环节中,强调要“顺四时而适寒暑”
同时中医认为人体本身也是有机整体。把人的五脏与五体,九窍、五声、五音、五志、五液、五味等联系起来,组成整个人体和五个系统,在此基础上又根据脏腑的表里关系通过经络联系起来,共同协调地完成人的生命活动。这种形神合一,以神统形的整体观来源于中国传统文化的大统一的整体观。
4.注意调整阴阳的平衡观。
《素问·至真要大论》“谨察阴阳之所在而调之,以平为期。”中医学认为阴阳分别代表人体内相对的双方。《内经》说:“生之本,本于阴阳”,说明人的形成和生长发展的规律离不开阴阳。在人体正常生理状态下,保持阴阳相对平衡,如果出现一方偏衰,或一方偏亢,就会使人体正常的生理功能紊乱,出现病理状态。人无论是饮食起居,精神调摄,自我锻炼,药物作用都离不开协调平衡阴阳的宗旨,人的衰老,或为阴虚,或为阳虚、或阴阳俱虚。阴虚则阳亢,阳盛则阴虚,阴盛则阳病,阳盛则阴病。故防治衰老,贵在调和阴阳,使阴平阳秘,精神乃治。这说明中国传统文化注重对称,强调平衡的哲学根底。
5.动静结合的恒动观。
中国哲学对动静的辩证关系认识很早,《周易》中就提出“动静有常”,《吕氏春秋》提出“流水不腐,户枢不蠢”。自然界的物质是不断运动变化着的,只有运动,才发生变化,只有运动才产生万物。中医认为人的生命活动,从发生、发展到消亡的全部过程,始终贯穿着一系列内部矛盾运动,这种运动就是升降出人。《内经》提出“高下相占,升降相因,而变化矣。”运动是自然规律,也是维持人体健康最基本的因素。生命运动的规律就是新陈代谢的过程。如果人体的升降出人运动发生障碍就是患病。所以中医学非常重视用运动变化的观点来指导防病治病。生命在于运动,因为运动是生命的特征,人体的每个细胞无时无刻不在运动着,只有保持经常运动,才能增进健康,预防疾病,以求延年益寿。
中国哲学亦有“主静”说。老子说:“清静为天下正”,“不俗以静”;明蔡清说:“天地之所以久者,以其气运于内而不泄耳,故仁者静而寿”,中国的道家、佛家思想都是主静的,禅宗的坐禅,道家气功都对中国文化影响巨大。中医学也受此影响,发展成养性,修身理论,吸收了道有气功为医疗气功。这里的“静”不是绝对的静止,而是另一种运动形式,运动是绝对的,静止是相对的,动静结合,相辅相成,是保健之大旨。
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