《中国的中医药》白皮书（全文）
White Paper: Traditional Chinese Medicine in China
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| 一、中医药的历史发展 | I. The Historical Development of TCM |
| 1.中医药历史发展脉络 | 1. History of TCM |
| 在远古时代，中华民族的祖先发现了一些动植物可以解除病痛，积累了一些用药知识。随着人类的进化，开始有目的地寻找防治疾病的药物和方法，所谓“神农尝百草”、“药食同源”，就是当时的真实写照。夏代（约前2070－前1600）酒和商代（前1600－前1046）汤液的发明，为提高用药效果提供了帮助。进入西周时期（前1046－前771），开始有了食医、疾医、疡医、兽医的分工。春秋战国（前770－前221）时期，扁鹊总结前人经验，提出“望、闻、问、切”四诊合参的方法，奠定了中医临床诊断和治疗的基础。秦汉时期（前221－公元220）的中医典籍《黄帝内经》，系统论述了人的生理、病理、疾病以及“治未病”和疾病治疗的原则及方法，确立了中医学的思维模式，标志着从单纯的临床经验积累发展到了系统理论总结阶段，形成了中医药理论体系框架。东汉时期，张仲景的《伤寒杂病论》，提出了外感热病（包括温疫等传染病）的诊治原则和方法，论述了内伤杂病的病因、病证、诊法、治疗、预防等辨证规律和原则，确立了辨证论治的理论和方法体系。同时期的《神农本草经》，概括论述了君臣佐使、七情合和、四气五味等药物配伍和药性理论，对于合理处方、安全用药、提高疗效具有十分重要的指导作用，为中药学理论体系的形成与发展奠定了基础。东汉末年，华佗创制了麻醉剂“麻沸散”，开创了麻醉药用于外科手术的先河。西晋时期（265－317），皇甫谧的《针灸甲乙经》，系统论述了有关脏腑、经络等理论，初步形成了经络、针灸理论。唐代（618－907），孙思邈提出的“大医精诚”，体现了中医对医道精微、心怀至诚、言行诚谨的追求，是中华民族高尚的道德情操和卓越的文明智慧在中医药中的集中体现，是中医药文化的核心价值理念。明代（1368－1644），李时珍的《本草纲目》，在世界上首次对药用植物进行了科学分类，创新发展了中药学的理论和实践，是一部药物学和博物学巨著。清代（1644－1911），叶天士的《温热论》，提出了温病和时疫的防治原则及方法，形成了中医药防治温疫（传染病）的理论和实践体系。清代中期以来，特别是民国时期，随着西方医学的传入，一些学者开始探索中西医药学汇通、融合。 | In remote antiquity, the ancestors of the Chinese nation chanced to find that some creatures and plants could serve as remedies for certain ailments and pains, and came to gradually master their application. As time went by, people began to actively seek out such remedies and methods for preventing and treating diseases. Sayings like "Shennong (Celestial Farmer) tasting a hundred herbs" and "food and medicine coming from the same source" are characteristic of those years. The discovery of alcohol in the Xia Dynasty (c. 2070-1600 BC) and the invention of herbal decoction in the Shang Dynasty (1600-1046 BC) rendered medicines more effective. In the Western Zhou Dynasty (1046-771 BC), doctors began to be classified into four categories - dietician, physician, doctor of decoctions and veterinarian. During the Spring and Autumn and Warring States Period (770-221 BC), Bian Que drew on the experience of his predecessors and put forward the four diagnostic methods - inspection, auscultation & olfaction, inquiry, and palpation, laying the foundation for TCM diagnosis and treatment. The Huang Di Nei Jing (Yellow Emperor's Inner Canon) compiled during the Qin and Han times (221 BC-AD 220) offered systematic discourses on human physiology, on pathology, on the symptoms of illness, on preventative treatment, and on the principles and methods of treatment. This book defined the framework of TCM, thus serving as a landmark in TCM's development and symbolizing the transformation from the accumulation of clinical experience to the systematic summation of theories. A theoretical framework for TCM had been in place. The Shang Han Za Bing Lun (Treatise on Febrile Diseases and Miscellaneous Illnesses) collated by Zhang Zhongjing in the Eastern Han Dynasty (25-220) advanced the principles and methods to treat febrile diseases due to exogenous factors (including pestilences). It expounds on the rules and principles of differentiating the patterns of miscellaneous illnesses caused by internal ailments, including their prevention, pathology, symptoms, therapies, and treatment. It establishes the theory and methodology for syndrome pattern diagnosis and treatment differentiation. The Shen Nong Ben Cao Jing (Shennong's Classic of Materia Medica) - another masterpiece of medical literature appeared during this period - outlines the theory of the compatibility of medicinal ingredients. For example, it holds that a prescription should include at the same time the jun (or sovereign), chen (or minister), zuo (or assistant) and shi (or messenger) ingredient drugs, and should give expression to the harmony of the seven emotions as well as the properties of drugs known as "four natures" and "five flavors." All this provides guidance to the production of TCM prescriptions, safe application of TCM drugs and enhancement of the therapeutic effects, thus laying the foundation for the formation and development of TCM pharmaceutical theory. In the late years of the Eastern Han Dynasty, Hua Tuo (c. 140-208) was recorded to be the first person to use anesthetic (mafeisan) during surgery. The Zhen Jiu Jia Yi Jing (AB Canon of Acupuncture and Moxibustion) by Huangfu Mi during the Western Jin time (265-316) expounded on the concepts of zangfu (internal organs) and jingluo (meridians and collaterals). This was the point when theory of jingluo and acupuncture & moxibustion began to take shape. Sun Simiao, a great doctor of the Tang Dynasty (618-907), proposed that mastership of medicine lies in proficient medical skills and lofty medical ethics, which eventually became the embodiment of a moral value of the Chinese nation, a core value that has been conscientiously upheld by the TCM circles. A herbology and nature masterpiece, the Ben Cao Gang Mu (Compendium of Materia Medica) compiled by Li Shizhen in the Ming Dynasty (1368-1644) was the first book in the world that scientifically categorized medicinal herbs. It was a pioneering work that advanced TCM pharmaceutical theory. The Wen Re Lun (A Treatise on Epidemic Febrile Diseases) by Ye Tianshi during the Qing Dynasty (1644-1911) developed the principles and methods for prevention and treatment of pestilential febrile diseases. It represents the theory and results of the practice of TCM in preventing and treating such diseases. Following the spread of Western medicine in China from the mid-Qing Dynasty, especially during the period of the Republic of China (1912-1949), some TCM experts began to explore ways to absorb the essence of Western medicine for a combination of TCM with Western medicine. |
| 2.中医药特点 | 2. Characteristics of TCM |
| 在数千年的发展过程中，中医药不断吸收和融合各个时期先进的科学技术和人文思想，不断创新发展，理论体系日趋完善，技术方法更加丰富，形成了鲜明的特点。 | During its course of development spanning a couple of millennia, TCM has kept drawing and assimilating advanced elements of natural science and humanities. Through many innovations, its theoretical base covered more ground and its remedies against various diseases expanded, displaying unique characteristics. |
| 第一，重视整体。中医认为人与自然、人与社会是一个相互联系、不可分割的统一体，人体内部也是一个有机的整体。重视自然环境和社会环境对健康与疾病的影响，认为精神与形体密不可分，强调生理和心理的协同关系，重视生理与心理在健康与疾病中的相互影响。 | First, setting great store by the holistic view. TCM deems that the relationship between humans and nature is an interactive and inseparable whole, as are the relationships between humans and the society, and between the internal organs of the human body, so it values the impacts of natural and social environment on health and illness. Moreover, it believes that the mind and body are closely connected, emphasizing the coordination of physical and mental factors and their interactions in the conditions of health and illness. |
| 第二，注重“平”与“和”。中医强调和谐对健康具有重要作用，认为人的健康在于各脏腑功能和谐协调，情志表达适度中和，并能顺应不同环境的变化，其根本在于阴阳的动态平衡。疾病的发生，其根本是在内、外因素作用下，人的整体功能失去动态平衡。维护健康就是维护人的整体功能动态平衡，治疗疾病就是使失去动态平衡的整体功能恢复到协调与和谐状态。 | Second, setting great store by the principle of harmony. TCM lays particular stress on the importance of harmony on health, holding that a person's physical health depends on harmony in the functions of the various body organs, the moderate status of the emotional expression, and adaption and compliance to different environments, of which the most vital is the dynamic balance between yin and yang. The fundamental reason for illness is that various internal and external factors disturb the dynamic balance. Therefore, maintaining health actually means conserving the dynamic balance of body functions, and curing diseases means restoring chaotic body functions to a state of coordination and harmony. |
| 第三，强调个体化。中医诊疗强调因人、因时、因地制宜，体现为“辨证论治”。“辨证”，就是将四诊（望、闻、问、切）所采集的症状、体征等个体信息，通过分析、综合，判断为某种证候。“论治”，就是根据辨证结果确定相应治疗方法。中医诊疗着眼于“病的人”而不仅是“人的病”，着眼于调整致病因子作用于人体后整体功能失调的状态。 | Third, emphasis on individuality. TCM treats a disease based on full consideration of the individual constitution, climatic and seasonal conditions, and environment. This is embodied in the term "giving treatment on the basis of syndrome differentiation." Syndrome differentiation means diagnosing an illness as a certain syndrome on the basis of analyzing the specific symptoms and physical signs collected by way of inspection, auscultation & olfaction, inquiry, and palpation, while giving treatment means defining the treatment approach in line with the syndrome differentiated. TCM therapies focus on the person who is sick rather than the illness that the patient contracts, i.e., aiming to restore the harmonious state of body functions that is disrupted by pathogenic factors. |
| 第四，突出“治未病”。中医“治未病”核心体现在“预防为主”，重在“未病先防、既病防变、瘥后防复”。中医强调生活方式和健康有着密切关系，主张以养生为要务，认为可通过情志调摄、劳逸适度、膳食合理、起居有常等，也可根据不同体质或状态给予适当干预，以养神健体，培育正气，提高抗邪能力，从而达到保健和防病作用。 | Fourth, emphasis on preventative treatment. Preventative treatment is a core belief of TCM, which lays great emphasis on prevention before a disease arises, guarding against pathological changes when falling sick, and protecting recovering patients from relapse. TCM believes that lifestyle is closely related to health, so it advocates health should be preserved in daily life. TCM thinks that a person's health can be improved through emotional adjustment, balanced labor and rest, a sensible diet, and a regular life, or through appropriate intervention in the lifestyle based on people's specific physical conditions. By these means, people can cultivate vital energy to protect themselves from harm and keep healthy. |
| 第五，使用简便。中医诊断主要由医生自主通过望、闻、问、切等方法收集患者资料，不依赖于各种复杂的仪器设备。中医干预既有药物，也有针灸、推拿、拔罐、刮痧等非药物疗法。许多非药物疗法不需要复杂器具，其所需器具（如小夹板、刮痧板、火罐等）往往可以就地取材，易于推广使用。 | Fifth, simplicity. TCM doctors diagnose patients through inspection, auscultation & olfaction, inquiry, and palpation. In addition to medication, TCM has many non-pharmacological alternative approaches such as acupuncture and moxibustion, tuina (massage), cupping and guasha (spooning). There is no need for complex equipment. TCM tools, for example, the small splints used in Chinese osteopathy, the spoons used in guasha, or the cups used in cupping therapy, can draw from materials close at hand, so that such treatments can spread easily. |
| 3.中医药的历史贡献 | 3. TCM's Contributions |
| 中医药是中华优秀传统文化的重要组成部分和典型代表，强调“道法自然、天人合一”，“阴阳平衡、调和致中”，“以人为本、悬壶济世”，体现了中华文化的内核。中医药还提倡“三因制宜、辨证论治”，“固本培元、壮筋续骨”，“大医精诚、仁心仁术”，更丰富了中华文化内涵，为中华民族认识和改造世界提供了有益启迪。 | TCM is an important component and a characteristic feature of traditional Chinese culture. Applying such principles as "man should observe the law of the nature and seek for the unity of the heaven and humanity," "yin and yang should be balanced to obtain the golden mean," and "practice of medicine should aim to help people," TCM embodies the core value of Chinese civilization. TCM also advocates "full consideration of the environment, individual constitution, and climatic and seasonal conditions when practicing syndrome differentiation and determining therapies," "reinforcing the fundamental and cultivating the vital energy, and strengthening tendons and bones," and "mastership of medicine lying in proficient medical skills and lofty medical ethics," all concepts that enrich Chinese culture and provide an enlightened base from which to study and transform the world. |
| 中医药作为中华民族原创的医学科学，从宏观、系统、整体角度揭示人的健康和疾病的发生发展规律，体现了中华民族的认知方式，深深地融入民众的生产生活实践中，形成了独具特色的健康文化和实践，成为人们治病祛疾、强身健体、延年益寿的重要手段，维护着民众健康。从历史上看，中华民族屡经天灾、战乱和瘟疫，却能一次次转危为安，人口不断增加、文明得以传承，中医药作出了重大贡献。 | TCM originated in the Chinese culture. It explains health and diseases from a macro, systemic and holistic perspective. It shows how China perceives nature. As a unique form of medicine, TCM exercises a profound influence on the life of the Chinese people. It is a major means to help the Chinese people maintain health, cure diseases, and live a long life. The Chinese nation has survived countless natural disasters, wars and pestilences, and continues to prosper. In this process, TCM has made a great contribution. |
| 中医药发祥于中华大地，在不断汲取世界文明成果、丰富发展自己的同时，也逐步传播到世界各地。早在秦汉时期，中医药就传播到周边国家，并对这些国家的传统医药产生重大影响。预防天花的种痘技术，在明清时代就传遍世界。《本草纲目》被翻译成多种文字广为流传，达尔文称之为“中国古代的百科全书”。针灸的神奇疗效引发全球持续的“针灸热”。抗疟药物“青蒿素”的发明，拯救了全球特别是发展中国家数百万人的生命。同时，乳香、没药等南药的广泛引进，丰富了中医药的治疗手段。 | Born in China, TCM has also absorbed the essence of other civilizations, evolved, and gradually spread throughout the world. As early as the Qin and Han dynasties (221 BC-AD 220), TCM was popular in many neighboring countries and exerted a major impact on their traditional medicines. The TCM smallpox vaccination technique had already spread outside of China during the Ming and Qing dynasties (1368-1911). The Ben Cao Gang Mu (Compendium of Materia Medica) was translated into various languages and widely read, and Charles Darwin, the British biologist, hailed the book as an "ancient Chinese encyclopedia." The remarkable effects of acupuncture and moxibustion have won it popularity throughout the world. The discovery of qinghaosu (artemisinin, an anti-malaria drug) has saved millions of lives, especially in developing countries. Meanwhile, massive imports of medicinal substances such as frankincense and myrrh have enriched TCM therapies. |
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