新中國中醫基礎理論的構建:以五行為中心

Forging a Basic Theory of Chinese Medicine in the Early People's Republic of China: An Examination of Wuxing

Student thesis: Doctoral Thesis

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Award date22 Jul 2024

Abstract

晚清民國時期,由於五行理論與現代醫學科學的矛盾性,社會上興起了呼籲「廢止中醫」的思潮。然而,毛澤東及其領導下的中共軍隊和根據地卻主張「團結中西醫」,積極發展中醫中藥、針灸和氣功療法,這一政策在新中國成立後繼續推行。1954年,隨著中蘇關係及國內政治局勢變化,自1949年來由「蘇區黨」、「東北派」推動的中醫學習西醫基礎理論運動被由「白區黨」、「江南派」主導的西醫學習中醫基礎理論運動取代。在此背景下,中醫基礎理論於1954年起由江南醫派主導建構。本研究以五行為中心,探討新中國中醫基礎理論構建的時代背景、建構過程、學術特徴及社會影響。

由於1950年代初國外針灸熱與國內氣功熱,毛澤東對經絡理論改變現代醫學科學的前景持有期待。江蘇省中醫學校校長承淡安基於日本針灸銅人、日本經絡實驗研究和經絡治療派理論構建了「經絡整體觀」,使得配屬五行的經絡循環流注理論成為中醫基礎理論的核心。此後,中醫基礎學教科書以《黃帝內經》為理論來源、《內經知要》為編寫體例,由江南醫派主導的江蘇省中醫學校、北京中醫學院建構。在中醫基礎學教科書中,「唯物」、「辯證」的五角星形五行理論取代了不科學的古代中國中央加四方「五」字形五行。「文革」期間,五角星形五行理論曾因其循環結構受到批判。然而,在「文革」結束後的國外針灸熱與國內氣功熱中,五角星形五行結構再次被納入中醫教科書直至今天。
This dissertation explores the creation process of basic theory for Chinese medicine during the initial years of the People’s Republic of China. Particularly, it investigates how the theory of wuxing 五行 was reinterpreted through the lens of modern science, biomedicine, and materialism. This study aims to understand the interplay between Chinese medical theories and the political and social challenges faced during the early Maoist era in China. This thesis is structured into two main sections. The initial section, encompassing Chapters 1 and 2, delves into the historical background of the basic theory creation from the late Qing dynasty through to the early period of Maoist China. Chapter 1 provides a detailed account of the shift in policy from the Republican era’s stance of "Abolishing Chinese Medicine" to the Red China approach of "Integrating Chinese and Western Medicine," spanning the years 1891 to 1949. It does so by investigating (1.) the debate about wuxing in the late Qing; (2.) the "scientific" acupuncture textbooks translated from Japan; and (3.) the application of Chinese medicine, acupuncture, and qigong 氣功 in CCP’s army and border regions. Chapter 2 highlights the changing attitudes and strategic approaches from the "Chinese medicine doctors should study Western medicine" movement (1949–1954) to the "Western medicine doctors should study Chinese medicine" movement (1954–1958). The chapter explores how this policy shift influenced Chinese medical education and research, and how it affected the relationship between practitioners of Chinese and Western medicine. This pivot in policy is examined within the broader sociopolitical context of early Communist China, particularly Mao Zedong’s reassessment of strategies after the demise of Joseph Stalin and the internal political crisis of the "Gao Gang Affair" in 1953.

The latter section of the thesis, spanning Chapters 3 through 5, investigates the creation process of basic theory for Chinese medicine starting from 1954, focusing on three central issues: 1. By verifying the existence of jingluo 經絡 system through qigong practice, the jingluo system was incorporated into Chinese medicine textbooks, establishing its status as the core theoretical foundation within the discipline. Consequently, two distinct models of jingluo circulation flows were developed, providing a logical explanation for the zangfu 臟腑 and wuxing theories and contributed to the scientification of acupuncture. 2. Huangdi neijing 黃帝內經 was adopted as Chinese medicine’s basic theory textbook. The beginning of this process can be traced back to Neijing zhiyao 內經知要, a condensed and accessible version of Huangdi neijing which was selected as the primary textbook for Western medicine doctors to study in 1955. From 1958 onwards, national textbooks for Chinese medicine were developed based on the Neijing zhiyao framework, which made Huangdi neijing the foundational text underpinning the basic theory of Chinese medicine education. 3. The transformation of the wuxing structure from cruciform to pentagram represents a significant change in its conceptualization. In the first national Chinese medicine textbook, the Outline of Chinese Medicine, a pentagram diagram that was created by Japanese acupuncturist Honma Shohaku in 1941 was included. The Outline served as the blueprint for subsequent Chinese medicine textbooks, paving the way for the pentagram to become the widely recognized representation of wuxing not just in China but also around the globe.

Through a careful study of the historical process of the creation of contemporary Chinese medicine’s basic theory in the 1950s by meticulously analyzing its interplay with political dynamics, ideological shifts, and social movements, this doctoral dissertation presents a new perspective on the understanding of contemporary Chinese medicine. Specifically, it illuminates the process by which traditional Chinese medical practices were synthesized into what is now recognized as "traditional" Chinese medicine (TCM), thereby helping bridge the gap between ancient practices and their modern standardized theoretical framework. Additionally, this dissertation adds to our knowledge of the complex history of traditional medicine in East Asia and its modern adaptation in the 20th century. It highlights the broader implications of this shift for our comprehension of Chinese medicine, as well as the intersections between culture, science, and politics in the East-West encounter.