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Fakun Wen
Abstract: With the advancement of science and technology and the deepening of macro and micro cognition, the study of Chinese medicine and the Zhou Yi ［The Book of Changes］ has gradually heated up. However, the misuse and abuse of Yi and medicine have been frequent in the traditional cultural boom, leading to misunderstanding. Based on the “Xiang（image）” thought in ［Manifestation Numerology and Yi Jing Theory］ this article elaborates on the correspondence between the eight trigrams（the Bagua） and the five organs and reveals the importance of the theory of viscera and images in the theory of traditional Chinese medicine. Emphasizing the study of Zang Xiang (organ image) theory from the perspective of ［Manifestation Numerology and Yi Jing Theory］ will not only help to deeply understand the core theory of traditional Chinese medicine, but also promote cross-field research. This article aims to provide a new perspective on the inheritance and development of traditional Chinese medicine, as well as the intersection of natural science and social science.
Keywords: traditional Chinese medicine; I Ching / Yi Jing; hieroglyphics; trigrams and internal organs; yin and yang, five elements; heaven and man correspond; figurative thinking; abstract thinking; taking analogies and comparing images; deducing figurative thinking; Yi and medicine are of the same origin; ideology of Yi science.
In the battle to prevent and control the COVID-19 pandemic, TCM has made significant contributions. We have to rediscover the value of traditional Eastern culture as we face an oncoming wave of interest in studying TCM and researching Yi Jing ［The Book of Changes］. This is the inevitable result that has emerged in the wake of contemporary scientific and technological advancement, along with new developments in people’s understanding of the macrocosm and microcosms. A new scientific and technological revolution is now underway. Uncovering the secrets of Yi Jing, as well as passing on and developing the essence of traditional culture, will have an immeasurable impact on this.
Yi Jing and medicine share the same origin. Using the concept of “manifestations” from Xiang Shu Yi Xue ［Manifestation Numerology and Yi Jing Theory］and methods of observing and choosing manifestations, the manifestations of yin, yang, and the 5 phases of the human body may be deduced through observation of human physiological and pathological manifestations, in accordance with the principle that heaven and man are mutually responsive. Through targeted research on the unified relationships among heaven, earth, humans, and seasons, a systematic theoretical framework was established that covers the abstract concepts of yin, yang, and the 5-phase theory using manifestation numerology and Yi Jing theory. The classification and comparison of manifestations serves as the fundamental figurative thinking model for intuitive thought and inference. The reason why TCM formed such uniquely advantageous theoretical systems and methods for diagnosis and treatment is that its specific mode of thought involves drawing analogies between the target of research and targets that are already known; extracting the points they share in common, or those that are similar or approximations; and then finding their common characteristics, which are symbolized by “manifestations”. Manifestations are discussed in Yi Jing as images, which are categorized and subsequently expressed. For instance, the liver, heart, spleen, lung, and kidneys in the human body are analogized to wood, fire, earth, metal, and water, respectively. This mode of thought has evolved to become the holistic view of TCM.
Huangdi Neijing ［The Yellow Emperor’s Inner Canon］ maintains the Yi Jing mindset that “the manifestation is that which is suitable”. “Manifestation thinking” permeates the understanding of life in Huangdi Neijing from beginning to end, and becomes the most central and fundamental mindset through which life activities are understood in this text. Its applications include the simulation of internal physiological functions of the viscera and bowels, deductions about why disease occurs, the expression of diagnostic signs, and the confirmation of therapeutic concepts and health cultivation principles. The manifestations that are chosen include signs from the natural world and society, among which heaven and earth are major signs with the broadest and most numerous applications, as represented in chapter 3 (“Treatise on Vital Qi Connecting with Heaven”), 4 (“Treatise on the True Doctrine of the Golden Coffer”), and 5 (“Great Treatise on the Correspondences and Manifestations of Yin and Yang”) of the Su Wen ［Plain Questions］. For instance, chapter 3 of Su Wen uses heaven, earth, yin, and yang to infer the importance of yang qi in the human body, stating, “The yang qi is like the sun and heaven; if it loses its place, life is cut short and obscured.” Chapter 5 of Su Wen not only makes deductions about yin and yang in the human body using the characteristics, locations, functions, and trends in the movements of yin and yang in heaven and earth, but also applies them in various domains; it is an article about the complete application of the yin-yang mindset in the human body. Other manifestations, such as heaven and earth, clouds and rain, day and night, cold and summerheat, insects and beasts, and social structures, are all important signs that are used to simulate and make comparisons with the human body in Huangdi Neijing. In addition, imagery extracted and formed from ancient philosophy is thoroughly applied throughout Huangdi Neijing, including the 5 phases, Hetu Yellow River Map］, Luoshu ［Inscription of the River Luo］, trigrams and hexagrams, and heavenly stems and earthly branches. For example, the 5 phases are used to infer the functions of the 5 viscera in chapter 10 of Su Wen, entitled “Treatise on Engenderment of the 5 Viscera”, which states that “the manifestations of the 5 viscera can be deduced by analogy”. Wang Bing commented: “‘Manifestations’ refers to manifestations of qi. ［The text］ says that although the 5 viscera are hidden from view, the manifestations of their qi can be used as characteristics. Moreover, one can use material things to deduce by analogy. What are these? The liver’s manifestation is wood, and thus it can be bent and straightened. The heart’s manifestation is fire and thus it flames upward. The spleen’s manifestation is earth, and thus it is quiet and tranquil. The lung’s manifestation is metal, and thus it is unyielding and decisive. The kidneys’ manifestation is water, and thus they moisten and descend. These are all overarching classes of omens, some of which may change according to the situation. One who is skilled in the manifestation method can use it to draw inferences from ［things of］ the same category.” Another example is the statement that “3, 8, and wood are on the left; 4, 9, and metal are on the right; 5 resides in the central palace” from Luoshu. This parallels the theory about visceral qi distribution in chapter 52 (“Treatise on Needling Contraindications”) of Su Wen, which states, “the liver is engendered on the left and the lung stores on the right; the spleen acts as their envoy and the stomach acts as their market”.
On this basis, chapter 5 of Su Wen draws analogies between the upbearing and downbearing of the qi of heaven and earth and that of the human body’s qi: 〖JP2〗“The clear yang acts as heaven and the turbid yin acts as earth. Earth qi rises as clouds and heaven qi descends as rain. Rain emerges from earth qi and clouds emerge from heaven qi. Therefore, the clear yang emerges from the upper orifices and the turbid yin emerges from the lower orifices; the clear yang effuses from the interstices and the turbid yin runs through the 5 viscera; the clear yang makes the 4 limbs replete and the turbid yin returns to the 6 bowels.” Chapter 12 of Ling Shu ［The Magic Pivot］, entitled “The Channel Rivers”, uses 12 river channels from the natural world to make inferences about the 12 channel vessels of the human body.
Manifestation numerology and the theory of visceral manifestations further clarify the concepts that heaven and humankind are mutually responsive, and medicine and Yi Jing are mutually connected. The formation of the ideological system of TCM itself was influenced by Yi Jing theory. The visceral manifestation theory centered on the 5 viscera is an important component of TCM. Therefore, the visceral manifestation theory further reflects the fact that researching this theory using the TCM Yi Jing mindset requires one to explore it from the perspective of manifestation numerology and Yi Jing theory in order to find its source and currents. 〖JP2〗For instance, the 51st hexagram zhen ［shake］ corresponds to the following: “The east direction ［and］ green-blue color. It enters and connects with the liver, opens an orifice in the eyes, and stores essence in the liver. The disease it brings out is fright. Its flavor is sour. Its category is herbs and trees. Its domestic animal is the chicken. Its grain is wheat. In correspondence with the 4 seasons, Jupiter is above it. Thus, the spring qi is in the head. Its tone is jue ［a note on the traditional Chinese pentatonic scale］. Its number is 8. Thus, one knows its diseases are in the sinews. Its odor is ［that of］ an animal ［or urine］.”
Likewise, the hexagrams below correspond to the following categories of manifestations.
The 30th hexagram, li ［radiance］: “The south direction ［and］ red color. It enters and connects with the heart. It opens an orifice in the ears. It stores essence in the heart. Therefore, ［its］ disease is in the 5 viscera. Its flavor is bitter. Its category is fire. Its domestic animal is the sheep. Its grain is broomcorn millet. In correspondence with the 4 seasons, Mars is above it. Thus, one knows its diseases are in the vessels. Its tone is zhi. Its number is 7. Its odor is burnt.”
The 2nd hexagram, kun ［field］: “The center ［and］ yellow color. It enters and connects with the spleen. It opens an orifice in the mouth. It stores essence in the spleen. Thus, ［its］ disease is in the root of the tongue. Its flavor is sweet. Its category is earth. Its domestic animal is the ox. Its grain is non-glutinous broomcorn millet. In correspondence with the 4 seasons, Saturn is above it. Thus, one knows its diseases are in the flesh. Its tone is gong. Its number is 5. its odor is fragrant.”
The 58th hexagram, dui ［open］: “The west direction ［and］ white color. It enters and connects with the lung. It opens an orifice in the nose. It stores essence in the lung. Thus, ［its］ disease is in the back. Its flavor is acrid. Its category is metal. Its domestic animal is the horse. Its grain is rice. In correspondence with the 4 seasons, Venus is above it. Thus, one knows its diseases are in the skin and body hair. Its tone is shang. Its number is 9. Its odor is fishy.”
The 29th hexagram, kan ［gorge］: “The north direction ［and］ black color. It enters and connects with the kidneys. It opens an orifice in the 2 yin. It stores essence in the kidneys. Thus, ［its］ disease is in the ravines. Its flavor is salty. Its category is water. Its domestic animal is the pig. Its grain is the bean. In correspondence with the 4 seasons, Mercury is above it. Thus, one knows its diseases are in the bones. Its tone is yu. Its number is 6. Its odor is putrid. Thus, one who is good at taking the pulse ［and diagnosis in general］ carefully examines the 5 viscera and 6 bowels; that which is in counterflow and that which follows ［its normal flow］; and the principles of yin, yang, exterior, interior, feminine, and masculine. Store them in ［your］ heart and combine the heart with essence. If ［a prospective student］ is not this kind of person, do not teach ［them］. If it is not this kind of truth, do not teach ［it］. This is called the attainment of the way.”
In summary, the ideas that “medicine and Yi Jing are mutually connected” and “medicine and Yi Jing share a common origin” have existed since ancient times. The idea that “medicine and Yi Jing are mutually connected” reveals that TCM and Yi Jing possess a common way of thinking and mindset, while the idea that “medicine and Yi Jing share a common origin” reflects the fact that both TCM and Yi Jing share the same experiential foundation and epistemological basis. In the history of TCM, many great practitioners were also Yi Jing experts. The integration of medical and Yi Jing reasoning brought about numerous breakthroughs in TCM theory. In the words of the Tang dynasty “king of medicine” Sun Simiao, “one who does not understand Yi Jing cannot be called a supreme physician”. Therefore, the use of concepts from manifestation numerology and Yi Jing theory played an important role in the construction of TCM models, as well as the development of TCM theory and modes of thought. This way of thinking prioritizes grasping changes in things from a holistic perspective and emphasizes rhythms and cycles of development, in pursuit of harmony among things and a unified pattern diagnosis. Our modern study of the relationships between TCM and Yi Jing manifestation numerology remains the key that opens the treasury of Chinese medical knowledge.
Author information:
Fakun Wen, researcher, Executive Director of Chinese Medical Qigong; Director of Medical Technology Service, Clinical Nuclear Medicine Center, Nanjing Hospital Affiliated to Nanjing Medical University; Vice Chairman of China Medical Qigong Education Committee; Awarded by Chinese Scientists Forum: “TCM Health Innovation Figure”; Member of China Taiji Think Tank Committee; Great power pharmaceutical think tank researcher.
References:
Huangdi Neijing［The Yellow Emperor’s Inner Canon］
淺談中醫的易學取象模式
溫發坤
摘要：隨著科技的進步與宏觀和微觀認知的深化，中醫與《周易》的研究也逐漸升溫。但在傳統文化熱潮中，易與醫的誤用與濫用現象頻現，導致對其的誤解。本文基於《 象數易學》的“象”思想，詳細闡述八卦與五臟的對應關係，揭示臟象學說在中醫理論中的重要性。強調從像數易學角度研究臟象學說，不僅有助於深入理解中醫核心理論，更能促進跨領域研究。本文旨在為中醫傳承與發展，及自然科學與社會科學交叉領域提供新視野。
關鍵詞:中醫藥；易經； 象數易學；卦與臟腑；陰陽五行；天人相應；形象思維；抽象思維；取類比象；推演形象思維；易醫同源；易學思想。
在新冠肺炎疫情防控阻擊戰中，中醫藥作出了不可磨滅的貢獻。我們不得不重新認識東方傳統文化的價值，一個學習中醫和研究《周易》的熱潮正撲面而來。
這是隨着當代科學技術的進步，隨着人們對宏觀世界和微觀世界認識的日新月異的發展而產生的必然結果。一場新的科學技術革命正在進行中，揭開易醫奧秘，繼承和發展傳統文化的精華，將對此產生難以估量的影響。
而易與醫是同源，是通過《象數易學》的“象”的思想；通過觀象、取象的方法；通過對人體生理、病理之象的觀察，根據天人相應的原理推導出人體的陰陽、五行之象。把天、地、人、時的統一關係作為研究對象，建立了系統的理論框架，涵蓋了陰陽五行學說的象數易學的抽象思維，以取類比象作為直覺思維和推演形象思維的基本模式。
中醫之所以形成富有特色優勢的理論體系和診療方法，它的具體思維方式是將所研究對象與已知對象進行類比，取其共同點、相似點或近似點，從中找出它們共同特徵，以“象”為標志，易經中講象，象者也。”進行歸類，繼而表達，如將人體的肝心脾肺腎比擬為木火土金水，依思維方式而演變為中醫學的整體觀。
在《黃帝內經》承接《周易》“象其所宜”的思維模式，將“象思維”貫穿於《黃帝內經》對生命認識的始終，成為《黃帝內經》認識生命活動最核心、最基本的思維模式。
其應用包括內在臟腑生理功能的模擬、疾病發生的推演、診斷徵象的表達、治療思想以及養生原則的確定等等。
所取之象：
一是自然與社會徵象，其中以天地為大象，應用最多最廣。以《素問》的《生氣通天論》《金匱真言論》《陰陽應象大論》為代表。如《素問·生氣通天論》借助天地陰陽推演人體陽氣的重要性，言“陽氣者，若天與日，失其所則折壽而不彰。”《素問·陰陽應象大論》不僅以天地陰陽的屬性、地位、功能、運轉趨勢，推演人體陰陽，而且將之應用之各個領域，是陰陽思想在人體全面應用的文章。其它如天地雲雨、晝夜寒暑、飛蟲走獸、社會結構等，皆是《黃帝內經》模擬比附人體的重要徵象。
二是古代哲學抽提、形成的意象，包括五行、河圖、洛書、卦象、干支等，皆在《黃帝內經》中有深入應用。如以五行推演五臟功能，即《素問·五臟生成篇》言“五臟之象，可以類推。”王冰注：“象，謂氣象也。言五臟雖隱而不見，然其氣象性用，猶可以物類推之，何者？肝象木而曲直，心象火而炎上，脾象土而安靜，肺象金而剛決，腎象水而潤下。如是皆大舉宗兆，其中隨事變化，象法傍通者，可以同類而推之爾。”河圖之“三八木在左，四九金在右，五居中宮”與《素問·刺禁論》“肝生於左，肺藏於右，脾為之使，胃為之市”的藏氣分佈理論，等等。
《素問·陰陽應象大論》在此基礎上，根據天地之氣的升降之象，類推人體之氣的升降。“清陽為天，濁陰為地；地氣上為雲，天氣下為雨；雨出地氣，雲出天氣。故清陽出上竅，濁陰出下竅；清陽發腠理，濁陰走五臟；清陽實四肢，濁陰歸六腑。”
《靈樞·經水》用自然界十二經水，類推人體十二經脈。象數學與臟象學進一步明確天人相應，醫易相通的道理。
中醫學思想體系形成的本身，就是受易學思想影響的。以五臟為中心的臟象學說，是中醫學的重要組成部分。
因此，臟象學說就進一步體現了中醫的易學思想研究中醫的臟象學說，就必須從象數易學的角度去探討它,才能找到研究臟象的源和流。
如震卦：東方青色，入通於肝，開竅於目，藏精於肝，其病發驚駭。其味酸，其類草木，其畜雞，其穀麥，其應四時，上為歲星，是以春氣在頭也，其音角，其數八，是以知病之在筋也，其臭臊。
如卦的類象：
離卦：南方赤色，入通於心，開竅於耳，藏精於心，故病在五藏，其味苦，其類火，其畜羊，其穀黍，其應四時，上為熒惑星，是以知病之在脈也，其音徵，其數七，其臭焦。
坤卦：中央黃色，入通於脾，開竅於口，藏精於脾，故病在舌本，其味甘，其類土，其畜牛，其穀稷，其應四時，上為鎮星，是以知病之在肉也，其音宮，其數五，其臭香。
兌卦：西方白色，入通於肺，開竅於鼻，藏精於肺，故病在背，其味辛，其類金，其畜馬，其穀稻，其應四時，上為太白星，是以知病之在皮毛也，其音商，其數九，其臭腥。
坎卦：北方黑色，入通於腎，開竅於二陰，藏精於腎，故病在溪，其味咸，其類水，其畜彘，其穀豆，其應四時，上為辰星，是以知病之在骨也，其音羽，其數六，其臭腐。故善為脈者，謹察五藏六府，一逆一從，陰陽表裏雌雄之紀，藏之心意，合心於精，非其人勿教，非其真勿授，是謂得道。
綜所上述，自古以來就有“醫易相通”、“醫易同源”之說。“醫易相通”揭示了中醫學與《周易》具有共同的思想方法和思維模式;“醫易同源”則反映了中醫與《周易》理論具有共同的經驗基礎和認識論根據。
在中醫學史上，許多中醫大家同時又是易學家。
醫理與易理的融匯，使中醫理論產生了一次次飛躍，正如唐代藥王孫思邈提出了“不知易不足以言太醫”。
所以，用象數易學思維對中醫模式的建構、中醫理論思維的發展都起了重要作用。這種思維方法重視從整體上把握事物的變化，注重發展的節律與周期，追求事物之間的和諧與辯證統一。
我們今天學習象數易學與中醫的關係，仍然是打開祖國醫學寶庫的一把鑰匙。
作者簡介：
温發坤，研究員，中國醫學氣功學會常務理事；南京醫科大學附屬南京醫院臨床核醫學中心 醫療技術服務主任；中國醫學氣功教育專業委員會副主任委員；中國科學家論壇授予：“中醫養生創新人物”；中國太極智庫委員會委員；大國醫藥智庫研究員。
參考文獻
黃帝內經
