理解中医i从文化开始ppt课件

从文化和惟象理论理解中医 杨晓达 北京大学药学院 中医的囧境 废除中医运动 1879年，俞樾：废医论 1914年，汪大燮（教育总长）：废止中医，不 用中药 1929年，余云岫-第一届中央卫生委员会会议 ：通过废止旧医以扫除医事卫生之障碍案 1950年代，余云岫、王斌（卫生部副部长）： 再度提出废止中医方案 从1998年开始，方是民、罗永浩、张功耀：“ 告别中医中药” 到药学院学中医的美国学生 中医现代化的困境 传统中医： 挂羊头卖狗肉 玄学和神秘主义的泥潭 其他民族医学的渗透 中医现代化： 中医=传统文化或医学经验 中药=植物药 评论：现在方式的中医现代化=“废除中医” 钱学森谈中医 中医理论不是现代意义上的 科学 中医现代化，是中医的未来 化 用西医来化中医，我认为那 是错误的 开展唯象的中医学研究，使 中医学成为能用现代语言表 达的系统体系 “我一直宣传中国的传统医学 有许多人认为这与现代科学对不 上号。实际上如果把西方的科 学同中医所总结的理论以及临床 实践结合起来，那将是不得了的” 中医系列讲座 1. 从文化和惟象理论理解中医 2. “周易参同契”-浅谈作为中医理论基础的 易经 3. “新概念中医学”-惟象中医理论概述 4. 解密气功和道家修炼法 中医的现代价值何在？ Why is TCM interesting Increasing needs for “feeling good” To cure sometimes; to relieve often; to comfort always -E.L. Trudean (a nameless American physician ) Medicine is thus not a science but a learned profession that attempts to blend affairs of the spirit and the cold objectivity of science -Dr. McDermott (co-editor of The Cecil-Loeb Textbook of Medicine) TCM: Sensation-based medicine emphasizing prevention and individual medicine successful for Chinese health for at least 4000yrs TCM is interesting for Drug innovation based on natural compounds TCM: thousands of useful herbals The future predictive and preventive medicine TCM: many practical concepts and methods Overall: great opportunities in TCM! TCM has to be understood in views of both culture and science！ 1: Who are Chinese？ China is just a name of dynasty: 秦 (the first) or 清 (the last) dynasty In communication with western countries, Chinese used “中国(The central country/the middle state)” “唐人(people of Tang dynasty)” or “汉人(people of Han dynasty)” Traditional name for Chinese and China: 华夏“the country of flourish summer” 华人 The first dynasty of China The 1st ancient kingdoms/dynasties in the history Egypt: 3100BC Middle east: 2700BC 2697BC The United states of China 黄帝(Yellow Emperor) “天子”：Son of God King of the kings 王 King - the one who links together heaven, earth and people Unification of “the country of flourish summer” An huge animal who can fly without wings A bizarre animal resemblying many animals: cows head, hares eyes, horses neck, snakes body, alligators belly, fishs squama, tigers paw, eagles nail, deers horn Note: the Yellow Emperor was actually from the Bear tribe (有熊氏) “龙” Dragon: the emblem for a strong and multination kingdom” 4500 B.C.Current image Existing bizarre animals OKAPI, an animal looking like jigsaw of a giraffe and a zebra. PLATYPUS, an egg-laying, venomous, duck-billed, beaver-tailed, otter-footed mammal, having a sense of electro- reception. The emblem for modern Chinese: Dragon or Panda 2: Basic philosophy： “易经”(The Book of Evolution) Heaven Earth Wind Fire Swamp Mountain Water Thunder “3” “ ”“ ” FUHSI: the founder of eight diagrams. Yin (Moonage) Yang (Sunage) “Space” Full-moon -Wet Half-Moon -Wind Sunrise -Fire Bright-light -Dry New-moon -Heat High-noon -Cold Five phasesSix Climates Fire (2/7) Earth (5/5) Metal (4/9) Water (1/6) Wood (3/8) The human structure in western medicine -major functional systems Circulation system Nervous system Reproductive system Repiratory system Endocrine system Musculoskeletal system Digestive system The mind-body interactions Human structure in TCM view -Position and dynamic correlations Inner organs hallway organs external organs (sensing organs + exhibitory tissues Topo transfig Human structure in view of TCM -classification by position in the body Pulmo Thymus Thyroid Lung Inner-hallway-external Systems Inside organs (five phases) Hallway organs (six climates) Window organs HeartSmall IntestineTongue + face/pulse LungLarge intestineNose + body hair/skin Spleen/pancreas StomachMouth + lip/fat LiverGallbladderEyes + fingers/muscle KidneyBladderEar + hair/bone Brain/nervesSensation/feeling Time and “stars” A star map of 2500yr ago North A kings tomb of 6500yr ago Princess Prince 2 Prince 1 Prince 3 Big Dipper Constellation (1) - dragon for east Alligator Constellation(2) - white tiger for west White tiger Constellation (3) - Pheonix for south Ostrich Constellation (4) - “Great turtle” for north Plesiosaur The rhythm of a day HoursNameConstitutively active inner organ Health notes 11:00pm- 1:00am 子（sprout）Galbladder Sleeping 1:00-3:00am丑（stretch）Liver 3:00 -5:00am寅（transform ） Lung 5:00 -7:00am卯（morning）Large intestineGet up 7:00 -9:00am辰（growing）StomachPrinciple meal 9:00 -11:00am巳（done）Spleen/pancreas 11:00am - 1:00pm 午（turning）HeartSmall meal and a nap 1:00 -3:00pm未（ease）Small intestine 3:00 -5:00pm申（shine）Bladder 5:00 -7:00pm酉（agitation ） KidneyHappy meal “After lunch sit a while; After supper walk a mile” 7:00 -9:00pm戌（evening）Brain/neural systerm 9:00pm - 11:00pm 亥（seed）Nerve-spinal cord “Combination” 恒 Staying 益 Advancing mate apart The principle for exercises Yoga is derived from the Sanskrit root “yuj,“ meaning “to control,“ “to yoke“ or “to unite.“ Translations include “joining,“ “uniting,“ “union,“ “conjunction,“ and “means.“ Thunder Wind Nerve/Brain LiverMuscle/tendon Joined physical and mental exercises 益 Advancing 3: Establishment of TCM Established in 2000-2500 BC Documented by 200 BC “黄帝内经” (anonymous): fundamental principles Manuals for physicians were established 200 AD “伤寒杂病论” (ZHANG, Zhongjing): medical manual “神龙本草” (anonymous): collection of medicinal herbals “千金方” (SUN, Simiao): collection of prescriptions and formulas “本草纲目Compendium of Materia Medica ” LI, Shizhen (1518 1593 AD ) 2,000 herbal species in 60 categories 11,000 prescriptions “黄帝内经(The Yellow Emperor Textbook of Medicine)” The best physician avoids diseases Health policy and life style are most important for a government Good physicians prevent diseases Average physicians treat disease Bad physicians make use of disease 4: Medicinal herbals Shennong (the great farmer) is believed to taste the herbals and discover herbal medicine. Shennong mountain, which is in Hubei province and famous for various white animals, is believed to be the home of Shennong Drugs (藥) and music (樂) 藥 = 艸 + 樂 情动于中，故形于声；声成文，谓之音；乐以和其声。 “Voice is the expression of our sensation. Music makes harmony of the voice through a rhythm.” -乐记(The Book of Music) DrugHerbalMusic Medicines help to bring the body back to balanced state Pathological stresses, e.g. virus, germs, toxins, etc Medicines The relationship between drugs and toxins Compounds Rational use Improper use Drugs Toxins High efficacy Low toxicity High efficacy high toxicity Low efficacy high toxicity Low efficacy Low toxicity Western medicine Safe for daily use Disease prevention Low toxicity/high or low efficacy Treatment of common situation High efficacy/High toxicity Treatment of emergencies Chinese medicine Top grade In goods Inferior Efficacy of herbals? + + EfficientNot efficient? 5: Sensation-based medicine Six excesses causing diseases Cold Heat Dry Wet Wind Fire/Inflammation Five tastes of drugs Four methodsEight senses of the body Sore Pain Numbness Swell Itch Flounce Warm Cold Look Smell Touch Ask Sour Sweet Bitter Hot Salty PhysiologyPhysiologyPathologyPathologyDiagnosis Diagnosis MedicineMedicine A parallel of computer SoftwareSoftware HardwareHardware MindMind BodyBody The notion of QI Nothing over heart Air breath Flowing force Burning energy “Qi” - A sense with control; An expression of mind-body interaction “QI” How to generate “QI” getting control of our body Maintaining the functions of heart and kidney Sleeping/meditation QI is generated when heart and kidney are coordinated 既济 Energetic/Comfort 6: The bodys own medicine Our body can produce everything needed to cure the diseases. Psychological health is the ground for the body health. One can direct his/her body by: Prayer/meditation Guided acrobatic exercises, e.g. Yoga,Taiji. Skin stimulations, e.g. acrupuncture Acupuncture points Acupuncture point: true or false? In “Book of Huangdi (黄帝内经)”, only connection tunnel is recorded Study done by Ruhr-Universitaet Bochum, Deutch Efficacy for 1162 patients with chronic pain on sacral 71.1 (at acupuncture point) 67.7 (not at acupuncture point) 57.6 (standard treatment) Efficacy for 1039 patients with chronic pain on knee 35 take medicine within 3 Mon (acupuncture point) 35 (not at acupuncture point) 56 (standard treatment) Effective point is the key other than the written “point” 7: The medical procedures Diagnostic methods: Look (望) Smell (闻) Touch (切) Ask (问) For medical decision: Yin or Yang阴阳: which organ has problems Empty or solid虚实: Pathological entity or metabolic disorder. Inner or outer表里: the progress of the disease Cold or heat寒热: bodys responses to the disease - the reasons why we feel sick Pulse Diagnosis ? Cant sleep! Bad smell! Sb is dirty What is going to do? Block the nose Cover it Take a bath Sleeping pills Holistic, individual, and dialectical treatments Therapeutic strategy-Western medicine Symptoms and cures CONTACTM: for treatment of common cold Pseudoephedrine hydrochloride Chlorpheniramine maleate (night caplet) Acetaminophen (non-Drowsy remedy) Pain reliever/Fever reducer Nasal decongestant Antihistamine Therapeutic strategy-Western medicine Antiviral treatment Oseltamivirphosphate IUPAC name: ethyl (3R,4R,5S)-5-amino -4-acetamido-3- (pentan-3- yloxy)cyclohex-1-ene-1-carboxylate A neuraminidase inhibitor TCM Therapeutic strategy Type 1 Remedy: green onion 3 piece, fermented soybean 10g, gin