摘要：在医学的浩瀚星空中，中西方医学如同两颗璀璨的星辰，各自闪耀，又相互辉映。它们以不同的哲学基础、思维方式和术语体系，共同探索着生命的奥秘。其中，中医的藏象学说与西医的解剖实体观念，构成了两者最为鲜明的对比与差异。本文将深入剖析中医藏象学说的功能化特征，揭示其与西
在医学的浩瀚星空中，中西方医学如同两颗璀璨的星辰，各自闪耀，又相互辉映。它们以不同的哲学基础、思维方式和术语体系，共同探索着生命的奥秘。其中，中医的藏象学说与西医的解剖实体观念，构成了两者最为鲜明的对比与差异。本文将深入剖析中医藏象学说的功能化特征，揭示其与西医实体化倾向的不同，以及这种差异对医学理论与实践的深远影响。
一、从实体到功能：象思维的飞跃
西方医学，根植于西方哲学的土壤，以实体或存在为出发点，追求名与实的精确对应。在医学术语上，这种实体化倾向表现得淋漓尽致。心脏、肝脏、脾脏……每一个术语都精准地指向解剖结构中的具体实体，其名称与功能之间的关联清晰而明确。然而，中医却走了一条截然不同的道路。
在中医的世界里，“象”是流动的动态，是功能的核心关注点。藏象学说，作为中医理论建构的基石，正是象思维功能化特征的生动体现。肝、心、脾、肺、肾，这些在中医中至关重要的概念，并非简单地对应于现代医学中的解剖脏器。它们超越了实体的束缚，成为了功能化、关系化的象征。如心主神志、肝主情志，这些观念在解剖实体上或许难以找到直接的对应，但在中医的功能体系中却显得合情合理。
二、藏象学说的功能化智慧
藏象学说的功能化特征，源于中医对生命现象的深刻洞察与独特理解。在中医看来，生命是一个整体，是一个动态平衡的系统。五脏六腑，并非孤立的实体，而是相互联系、相互作用的功能单元。它们共同维系着人体的生理机能，调节着气血的运行，保持着内外环境的和谐。
以心为例，中医认为心主血脉，主神志。这一观念不仅涵盖了心脏作为泵血器官的功能，更将其与精神活动紧密相连。在现代医学看来，这或许有些难以理解。但在中医的象思维中，心与神、与情、与志的关联却是自然而然的。因为中医关注的是生命的功能状态，是生命活动的整体表现，而非仅仅局限于解剖结构的分析。
三、实体化执念的困境与挑战
然而，当中医的概念与西医的实体观念相遇时，实体化的执念便成为了一个难以避免的问题。尤其是在某些领域中，中西医的概念含义较为接近，中医概念便容易受到实体化倾向的影响。以“筋”为例，这一在中医筋伤学中至关重要的概念，在现代医学中却难以找到确切的对应。于是，关于“筋是什么”或“筋的实体对应为何”的研究层出不穷，但往往陷入结构实体化的困境。
这种实体化执念的影响是深远的。它不仅导致了中医术语的混淆与误解，更使得中医的理论与实践在一定程度上失去了其独特的价值与意义。当中医的概念被强行套入西医的实体框架时，中医的精髓与智慧便可能被掩盖甚至遗忘。
四、回归象的境域：理解中医的真谛
面对实体化执念的挑战，我们应该如何理解中医的真正含义呢？答案或许就在于回归象的境域。中医的术语与概念，是象思维的产物，是功能化、关系化的表达。只有当我们放下对实体的执着，以开放的心态去感知、去体悟中医的象思维时，才能真正领略到中医的博大精深与独特魅力。
正如文章开头所言，中医与西医是两颗璀璨的星辰，它们以不同的方式探索着生命的奥秘。中医的藏象学说与西医的解剖实体观念，虽然看似截然不同，但实则都是对生命现象的深刻洞察与独特理解。我们应该尊重这种差异，欣赏这种多样性，并在相互学习与交流中共同推动医学的进步与发展。
五、结语：功能与实体的和谐共生
在未来的医学发展中，中医与西医的交融与融合将是不可避免的趋势。我们应该以开放包容的心态，汲取两者的优点与智慧，共同构建更加完善、更加科学的医学体系。在这个过程中，中医的功能化智慧与西医的实体化探索将相互借鉴、相互补充，共同为人类的健康事业贡献自己的力量。
让我们期待那一天的到来——当中医与西医在功能与实体的和谐共生中，共同绘制出生命科学的壮丽画卷。
文献参考：中医杂志2025年6月第66卷第12期《象思维的特征及对中医术语的影响初探》 作者 | 谭燚飞，张其成
作者简介：梁世杰 中医高年资主治医师，本科学历，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。事迹入选《当代科学家》杂志、《中华英才》杂志。
The mystery of Tibetan elephants: Functional wisdom of Chinese medicine and a substantive exploration of Western medicine
In the vast sky of medicine, Chinese and Western medicine are like two bright stars, each shining and reflecting each other. With different philosophical foundations, ways of thinking and terminology, they explore the mysteries of life together. Among them, the Tibetan theory of iodine in Chinese medicine and the concept of anatomical entities in Western medicine constitute the most stark contrast and difference between the two. This article will examine in depth the functional characteristics of TCM Tibetan Ithology, reveal the difference between its substantive tendencies and those of Western medicine, and the profound implications of this difference for medical theory and practice.
I. From Entity to Function: A leap Like Thinking
Taking substance or existence as the point of departure, western medical science pursues the exact correspondence between name and reality. In medical terms, this tendency towards solidification is vividly demonstrated. Heart, liver, spleen... Each term accurately points to a specific entity in an anatomical structure, and the connection between its name and its function is clear and clear. However, Chinese medicine has taken a very different path.
In the world of traditional Chinese medicine, "elephant" is a fluid dynamic and is a core focus of function. Tibetan theory of iodine, as the cornerstone of the construction of traditional Chinese medicine, is a vivid expression of the functional character of ii thinking. The concepts of liver, heart, spleen, lung and kidney, which are crucial in traditional Chinese medicine, do not simply correspond to the anatomy of the organs in modern medicine. They transcend physical boundaries and become functional, relational symbols. For example, heart mastery and liver mastery, these concepts may be difficult to find direct correspondence in anatomical entities, but they appear reasonable in the functional system of Chinese medicine.
II. Functional Wisdom of Tibetan Ithology
The functional character of Tibetan ioism theory stems from the profound insight and unique understanding of life phenomena in traditional Chinese medicine. In traditional Chinese medicine, life is a whole, a dynamic and balanced system. The internal organs are not isolated entities, but functional units that are interconnected and interact with each other. Together, they maintain the physiological function of the human body, regulate the operation of qi and blood, and maintain the harmony of the internal and external environment.
Taking the heart as an example, traditional Chinese medicine believes that the heart is the master of blood and spirituality. This concept encompasses not only the function of the heart as a blood pumping organ, but also its close connection to mental activity. In modern medicine, this may be difficult to understand. But in the elephant mind of Chinese medicine, the connection between the heart and God, between love and ambition is natural. Because traditional Chinese medicine focuses on the functional state of life, the overall manifestation of life activities, rather than being limited to analysis of anatomy.
III. The dilemmas and challenges of substantive obsessions
However, when the concept of traditional Chinese medicine meets the physical concept of Western medicine, the physical obsession becomes an unavoidable problem. Especially in some fields, where the concepts of Chinese and Western medicine are closer to each other, the concept of Chinese medicine is vulnerable to the tendency towards substantiation. Take the concept of "strength," a crucial concept in traditional Chinese healing, but it is difficult to find an exact correspondence in modern medicine. As a result, research on "what is a ham?" or "what is the correspondence of the entity of a ham" has been developed, but has often fallen into the difficulty of structural substantiation.
The effects of this substantive obsession are profound. It not only led to confusion and misunderstanding of traditional Chinese medicine terms, but also caused the theory and practice of traditional medicine to lose its unique value and significance to a certain extent. When the concept of traditional Chinese medicine is forced into the physical framework of Western medicine, the essence and wisdom of traditional medicine may be obscured or even forgotten.
IV. Returning to the elephant territory: Understanding the true meaning of Chinese medicine
In the face of the challenge of substantive obsession, how should we understand what traditional Chinese medicine really means? The answer may lie in returning to the elephant's territory. The terms and concepts of traditional Chinese medicine are products of thinking and are functional and relational expressions. Only when we let go of the obsession with physical objects and feel and understand the implications of traditional Chinese medicine with an open mind can we truly appreciate the great depth and unique charm of traditional medicine.
As stated at the beginning of this article, Chinese medicine and Western medicine are two bright stars that explore the mysteries of life in different ways. Although the Tibetan theory of iodine in Chinese medicine and the concept of anatomical entities in Western medicine seem to be very different, they are both profound insights and unique understandings of life phenomena. We should respect this difference, appreciate this diversity, and jointly promote the progress and development of medicine in learning and communicating with each other.
V. CONCLUSIONS: Harmony between functions and entities
In the future development of medicine, the convergence and integration of traditional Chinese medicine and Western medicine will be an inevitable trend. We should take the advantages and wisdom of both with an open and inclusive mindset, and jointly build a better and more scientific medical system. In this process, the functional wisdom of traditional Chinese medicine and the substantive exploration of Western medicine will learn from each other and complement each other, jointly contributing to the cause of human health.
Let us look forward to that day - when traditional Chinese medicine and Western medicine, in harmony of function and entity, will jointly paint a magnificent picture of life science.
Literature Reference: Journal of Chinese Medicine, June, 65, No. 12: The characteristics of elephant thinking and its impact on traditional Chinese medicine terminology. Author | Yanfei Tan, Zhang Qicheng
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.
来源：首都专家梁世杰一点号
