有关上述问题,我还想从另外一个方面加以申说。理论与实际运用,理论与临床的关系是非常明确的。有关这一点,我们只要回顾一下20 世纪物理学的发展,就会很清楚。19世纪末,经典物理学已经达到了人们想象中的十分完美的程度。人们也许认为,这就是解释世界的最终极、最和谐的理论。但是,时间一跨入20世纪,这种和谐就被打破了。随着1905年狭义相对论的创立,以及后来的广义相对论和量子力学的建立,人们对宏观及微观世界的看法产生了根本的改变。在认识上的这个改变,导致了技术应用上翻天覆地的变化,从宇航技术、原子能技术,到微电子技术,乃至我们今天所能感受到的一切变化,都无不与新理论的建立相关。在经典的物理学框架里,宇航技术、原子弹,以及现代通讯技术,这些都是难以想象的。回顾刚刚过去的这个世纪,我们切实感受到了理论的重要,理论确实制约着技术的应用与发展。而这样的一种感受和经验,能否作为我们提出中医理论滞后于临床的理由呢?我想这个理由应是双重的,正因为我们看到了理论的重要性,它制约着实践和技术的发展,所以,更应该重新来评价我们今天的认识,重新来认识中医的理论。看看经典中医理论的包容性究竟有多大?它的延伸性、超前性究竟有多大?它究竟还能不能给我们今天的临床带来指导?而不应光看到她是两千年前的产物。如果这个理论的确落后了,的确不能适应现代,那就要毫不犹豫地打破她,在中医这个体系里建立起“相对论”。如果这个理论根本没有落后,如果在这个经典的框架里已然具足“相对论”、“量子力学”,那,我们为什么一定要打破她呢?现在在中医界有一个怪现象,也是一个可怕的现象,就是对中医经典的教育逐步在减弱。现在大多数中医院校都已将经典改为选修课,就连成都、南京这些老牌的、原本非常注重经典的学院亦不例外。这种改变是不是一种进步呢?很值得怀疑。在我们没有建立起新的理论前,在我们还没有切实地发现传统理论的破绽前,经典仍然是中医的核心,经典仍然是中医的基础,经典仍然是中医的必修。怎么可以将核心和基础作为选修呢?有人说《中基》不是从《内经》里来的吗?《内科》不是从《伤寒》、《金匮》里来的吗?而且比《内经》、《伤寒》、《金匮》更完善了,怎么不可以用它们来取代经典呢?实在的说,《中基》与《内经》,《内科》与《伤寒》、《金匮》根本就不是一回事,相差太远太远了,怎么可以同日而语呢?我想这个问题今后会有机会谈到的。好比新的力学尚未建立,就将经典力学束之高阁,这是一个什么格局呢?大家可以思考。理论需要实践来检验、来说明,这是普适的,东西方文化都是如此。在现代科学里,由于许多杰出科学家的工作,理论的价值显而易见,如我们从费米的工作里可以充分体会到量子理论的魅力。但是,在我们一般人那里,量子论、相对论又能起到什么作用,所以,理论评价绝不是一件简单的事情。在中医的历史里,出现过许多成功运用经典理论的人,比如张仲景,比如扁鹊。扁鹊运用经典理论成为起死回生的一代神医,而张仲景则因为谙熟经典而最终成为医圣。我们是否可从扁鹊、张仲景及历代名医那里,看到经典理论的价值,就像从费米及许多科学家那里领略到现代物理一样。
2.杨振宁教授所认识的中国文化
1999年 12月 3日,著名物理学家、诺贝尔奖获得者杨振宁教授应香港中文大学之邀,于新亚书院举办了一个题为“中国文化与科学”的讲座。在这个讲座中,杨教授用了相当长的篇幅来阐述中国文化的特征。杨教授是公认的 20世纪最伟大的物理学家之一,在传统文化方面也有相当的造诣。所以,他对传统文化的看法应该具有相当的代表性和影响力。杨振宁教授对中国传统文化的认识,可以归结为以下几个方面:第一,传统文化是求理,而近代科学(包括现代科学)是求自然规律。传统文化所求的理并非自然规律、自然法则,而近代科学追求的是自然规律。这样一种划分就使传统文化与近(现)代科学泾渭分明了。传统文化求理,不求自然规律,那么,这个理又是什么呢?杨教授解释这个“理”就是一种“精神”,一种“境界”。那么,这个“精神”,这个“境界”又是指的什么呢?难道科学没有精神,没有境界吗?第二,杨教授认为在传统文化里只有归纳的方法,而没有逻辑推演(或称演绎)。大家知道,在科学体系里进行研究,需要两种方法,一个是归纳,一个就是推演。所谓归纳,就是把许多现象归纳起来得到一个认识,一个定义,一个理论,把许多事物聚在一点上,一个认识上。原来现象上看似不同,本质上却是这么相近。所以,归纳实际是由外向内的一种认识。逻辑推演则是另一个重要的方法,这个过程非常严密,比如由一到二,由二到三,这个次序只能这样。现代科学既有归纳,又有逻辑推演,而逻辑推演是它的标志。中国文化里只有归纳却没有逻辑推演,这又将传统与现代区别开来了。第三,传统文化里缺少实验,缺少自然哲学。在很多场合,许多人都认为中医与其说是一门自然科学,倒不如说是一门自然哲学。而杨教授在讲演中却以中医为例,认为传统文化中缺少自然哲学,这显然与许多人的观点相左。在现代科学领域里,实验是非常重要的,离开实验几乎寸步难行。即便是审视科学的部门也是如此。当年我读博士的时候,管理博士这一层次的机构就有个不成文的规定,就是除了文献博士外,其余的都要搞实验研究。所以,我这个博士算是侥幸得的,因为我并没有做实验研究,这要得益于我的导师。在中医历史里没有实验,我们没有看到黄帝问岐伯,你的阴阳理论是怎么发现的?是不是通过小白鼠实验发现的?确实没有。所以在中医乃至其他传统科学里没有现代意义上的实验,这是合乎实际的。以上就是杨教授对中国文化的大体认识。
3.传统理论的构建
这一小节的内容主要是杨教授的上述认识是具有代表性的,但是不是很正确就传统文化呢?是否真正表述出了传统文化的内涵呢?这一点我有不与中医的问同的看法。传统文化虽然有许多分支领域,但是,中医是最题跟杨振宁具代表性的。下面就以中医为例,次第讲述我的观点。教授商榷。
(1)何为理?
首先,我们要来认识的问题就是什么是“理”。传统文化孜孜以求的这个“理”,是不是仅仅是一个精神和境界的问题,还是包括了精神和境界?我们可以先从文字的角度来考究这个问题。《说文》曰:“理,治玉也。”所谓治玉,也就是雕刻玉。玉石开采出来以后,经过我们的琢磨,经过我们的精雕细刻,形成我们所需的形状,形成一个艺术品。所以,理的原意,是指的这样一个过程。在古人眼里,所有的物质中最致密的东西是什么呢?是玉。为什么玉看起来很冰清、很细腻呢?就是因为玉的纹理非常细润的缘故。大家知道历史上有一个庖丁解牛的故事,庖丁解牛,目无全牛。为什么呢?因为他非常熟悉牛的理,每一块肌肉的走向他都非常清楚,顺着这个走向、这个纹理去解牛,既快捷,又不费刀。那么,玉的理当然就要比牛的致密多了。所以,治玉更要加倍地细心,更要清楚这个理,顺着这个理去琢磨,去雕刻,就可以弄出我们所喜欢的艺术品,要是逆着这个理去雕刻,玉就会被损坏。理的原意就是这样。引申出来呢,就是你要这样走才行得通,那样走就行不通,为什么呢?因为理在这里发生作用。大家想想看,这样的理不是自然规律又是什么呢?自然规律,自然法则是不能违背的,违背了就行不通。俗话说:有理走遍天下,无理寸步难行。理的意义就在这里。你要顺着走,路子才走得通,这就是理。人理也好,天理也好,自然之理也好,都是这样。自然之理就是我们要顺着这个理与自然相处,才行得通;人理就是我们如何跟人相处才行得通。所以,理不光是精神和境界的问题。理是一个很实在的东西,是看得见、摸得着的。你这样走就行,那样走就会碰壁。而精神有时是虚无的、飘渺的,没办法把握的。我们说在中医里面,更显得上面这个理、这个规律、这个法则的重要,而这个理、这个规律、这个法则是什么呢?就是阴阳四时!所以,在《素问·四气调神大论》里说:“故阴阳四时者,万物之终始也,死生之本也,逆之则灾害生,从之则苛疾不起,是谓得道。”这里为什么要用“得道”这个字眼呢?这是一个很有趣的问题。得道这个词在古人那里用得很多,得道可以升天,连天都可以升,还有什么不能的呢?那因为什么得道呢?因为你明白了这个理,顺着这个理走,当然就得道了,当然就步入坦途了。现在的宇宙飞船为什么能够升天呢?不就是因为我们弄清了相对论这个理吗?所以,这个理,这个道,这个道理都是很有义趣的词语,古如是,今亦如是。
(2)归纳与推演的结合
传统文化的建立是不是只有一个归纳呢?这一点上我也是不同意的,在《素问·上古天真论》里明确指出:“上古之人,其知道者,法于阴阳,和于术数。”这里的知道者,也就是得道者。得道者,当然必须是明理者。这里的理包括两个方面,一个是阴阳,一个是术数。所以,这就有两个问题,阴阳表示的是归纳,《素问·阴阳应象大论》说:“阴阳者,天地之道也,万物之纲纪,变化之父母,生杀之本始,神明之府也。”这里将天地万物,将一切事物的变化、生杀都归结到阴阳里,所以,就归纳的角度而言,天下没有比阴阳更完美的归纳法。那么,术数呢?术数所表述的显然就是推演的一面,显然就是传统意义上的逻辑的一面。谈到推演和逻辑就必须联系数学,所以,杨教授认为在中国古代没有数学产生,只是到 16、17世纪西学传入后,才有了数学的苗子。而真正意义上的数学则到 20 世纪才有,这要以清华、北大于20世纪初开设数学课程为标志。那么,中国文化里究竟有没有数学呢?答案是肯定的,术数就是关于数学的学问。《四库全书总目》在谈到术数的定义时,有下面一段文字:“物生有象,象生有数,乘除推阐,务究造化之源者,是为数”当然,这并不是现代意义上的数理逻辑系统,但是,它属于推演的部分却是可以肯定的。所以,要想成为知道者,要想真正把握传统这门学问,就既要把握阴阳,又要明于术数。因此,传统文化是归纳和推演的结合,二者缺一不可。
(3)理性思考与内证实验
Regarding the aforementioned issues, I would like to elaborate from another perspective. The relationship between theory and practical application, as well as between theory and clinical practice, is very clear. If we review the development of physics in the 20th century, this point becomes evident. By the end of the 19th century, classical physics had reached a degree of perfection imagined by people. One might have thought that this was the ultimate and most harmonious theory for explaining the world. However, once time entered the 20th century, this harmony was broken. With the establishment of Special Relativity in 1905, followed by General Relativity and Quantum Mechanics, people's views on the macroscopic and microscopic worlds underwent fundamental changes. This shift in cognition led to earth-shaking changes in technological applications; from aerospace technology and atomic energy technology to microelectronics technology, and even all the changes we can feel today, none are unrelated to the establishment of new theories. Within the framework of classical physics, aerospace technology, atomic bombs, and modern communication technology were unimaginable. Looking back at the century just passed, we have truly felt the importance of theory; theory indeed constrains the application and development of technology. Can such feelings and experiences serve as the reason for our proposition that "Traditional Chinese Medicine (TCM) theory lags behind clinical practice"? I believe this reason should be twofold: precisely because we see the importance of theory—that it constrains the development of practice and technology—we should re-evaluate our current understanding and re-examine TCM theory. We must ask: How great is the inclusiveness of classic TCM theory? How great are its extensibility and前瞻性 (forward-looking nature)? Can it still provide guidance for today's clinical practice? We should not merely see it as a product from two thousand years ago. If this theory is indeed outdated and cannot adapt to modernity, then we should unhesitatingly break it and establish a "Relativity" within the TCM system. If this theory has not lagged behind at all, if this classic framework already possesses "Relativity" and "Quantum Mechanics," then why must we break it?
Currently, there is a strange and frightening phenomenon in the TCM community: the education regarding TCM classics is gradually weakening. Most TCM colleges and universities have now changed classic courses into electives; even old-established institutions in Chengdu and Nanjing, which originally placed great emphasis on classics, are no exception. Is this change a form of progress? It is highly questionable. Before we establish new theories, and before we have practically discovered flaws in traditional theories, the classics remain the core of TCM, the foundation of TCM, and compulsory courses for TCM. How can the core and foundation be made elective? Some say, isn't *Zhongji* (Basic Theory of Traditional Chinese Medicine) derived from *Huangdi Neijing* (The Yellow Emperor's Inner Canon)? Isn't *Neike* (Internal Medicine of TCM) derived from *Shanghan Lun* (Treatise on Cold Pathogenic Diseases) and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet)? And aren't they more perfect than *Huangdi Neijing*, *Shanghan Lun*, and *Jingui Yaolue*? Why can't they replace the classics? To be honest, *Zhongji* and *Huangdi Neijing*, *Neike* and *Shanghan Lun* / *Jingui Yaolue* are fundamentally different things, with vast differences, so how can they be compared? I believe this issue will have an opportunity to be discussed in the future. It is like shelving classical mechanics before new mechanics have been established; what kind of situation is this? Everyone can ponder. Theory needs practice to verify and explain; this is universal, applicable to both Eastern and Western cultures. In modern science, due to the work of many outstanding scientists, the value of theory is obvious; for example, we can fully appreciate the charm of quantum theory through Fermi's work. However, for ordinary people, what role do quantum theory and relativity play? Therefore, evaluating theory is by no means a simple matter. In the history of TCM, there have been many people who successfully applied classic theories, such as Zhang Zhongjing and Bian Que. Bian Que became a divine physician capable of bringing the dead back to life by applying classic theories, while Zhang Zhongjing ultimately became the Sage of Medicine because he was proficient in classics. Can we see the value of classic theories from Bian Que, Zhang Zhongjing, and famous doctors of past dynasties, just as we appreciate modern physics from Fermi and many other scientists?
2. Professor Yang Zhenning's Understanding of Chinese Culture
On December 3, 1999, Professor Yang Zhenning, a renowned physicist and Nobel Prize laureate, was invited by the Chinese University of Hong Kong to deliver a lecture titled "Chinese Culture and Science" at New Asia College. In this lecture, Professor Yang devoted considerable space to elaborating on the characteristics of Chinese culture. As one of the greatest physicists of the 20th century recognized by the public, and possessing considerable attainments in traditional culture, his views on traditional culture should possess significant representativeness and influence. Professor Yang Zhenning's understanding of Chinese traditional culture can be summarized in the following aspects: First, traditional culture seeks "Li" (Principle/Reason), whereas modern science (including contemporary science) seeks natural laws. The "Li" sought by traditional culture is not natural law or natural rule, whereas modern science pursues natural laws. Such a distinction makes traditional culture and modern science clearly distinct. Since traditional culture seeks "Li" rather than natural laws, what exactly is this "Li"? Professor Yang explains that this "Li" is a kind of "spirit" or "realm." So, what does this "spirit" and "realm" refer to? Does science lack spirit and realm? Second, Professor Yang believes that traditional culture only employs the method of induction, lacking logical deduction (or syllogism). As everyone knows, conducting research within a scientific system requires two methods: induction and deduction. Induction involves summarizing many phenomena to obtain a cognition, a definition, or a theory, gathering many things into one point or one cognition. Although phenomena may appear different superficially, their essence is closely similar. Thus, induction is essentially a cognitive process moving from the outside inward. Logical deduction is another important method; this process is extremely rigorous, such as going from one to two, from two to three, where the sequence must be strictly maintained. Modern science possesses both induction and logical deduction, with logical deduction being its hallmark. Chinese culture has induction but lacks logical deduction, which further distinguishes tradition from modernity. Third, traditional culture lacks experiments and natural philosophy. In many contexts, many people consider TCM less a natural science and more a natural philosophy. However, in his lecture, Professor Yang used TCM as an example to argue that traditional culture lacks natural philosophy, which obviously contradicts the views of many others. In the field of modern science, experiments are crucial; without them, one can hardly make progress. Even departments reviewing science adhere to this. When I was pursuing my doctoral degree, there was an unwritten rule in the institution managing doctoral-level studies: except for literature-based PhDs, all others had to conduct experimental research. Thus, I obtained my PhD somewhat fortuitously, as I did not conduct experimental research, thanks to my supervisor. There are no experiments in the history of TCM; we do not see Huangdi asking Qibo, "How did you discover your theory of Yin and Yang? Was it discovered through mouse experiments?" Indeed, there are none. Therefore, the absence of experiments in the modern sense within TCM and other traditional sciences is consistent with reality. These are Professor Yang's general views on Chinese culture.
3. Construction of Traditional Theory
This section mainly discusses whether Professor Yang's aforementioned views are representative yet incorrect, and whether they truly express the connotation of traditional culture. Regarding this, I hold views different from those of Professor Yang Zhenning. Although traditional culture has many branch fields, TCM is the most representative. Below, taking TCM as an example, I will sequentially present my viewpoints and discuss them with Professor Yang Zhenning.
(1) What is Li?
First, the problem we need to understand is what "Li" is. Is the "Li" that traditional culture strives for merely a matter of spirit and realm, or does it include both? We can investigate this question from a philological perspective first. *Shuowen Jiezi* states: "Li refers to working on jade." Working on jade means carving jade. After jade stones are mined, through our polishing and fine carving, they take the shape we require, becoming artworks. Therefore, the original meaning of "Li" refers to this process. In the eyes of the ancients, among all materials, what is the densest substance? It is jade. Why does jade appear clear and delicate? Because the texture of jade is very fine and moist. As everyone knows, there is a historical story of Cook Ding carving an ox. When Cook Ding carved the ox, he saw no whole ox. Why? Because he was very familiar with the grain of the ox; he knew the direction of every muscle clearly. By following this direction and grain to carve the ox, it was both fast and effortless on the knife. Therefore, the "Li" of jade is naturally denser than that of the ox. Thus, working on jade requires double the care and a clearer understanding of this "Li"; following this "Li" to polish and carve allows us to create the artworks we desire. If we carve against this "Li," the jade will be damaged. This is the original meaning of "Li." Extended, it means that you must proceed in this way to succeed, whereas proceeding otherwise will fail. Why? Because "Li" plays a role here. Think about it: isn't such a "Li" a natural law? Natural laws and rules cannot be violated; violating them leads to failure. As the saying goes: "With principle/reason, one can travel everywhere; without it, one cannot move a step." This is the significance of "Li." You must follow it for the path to be open; this is "Li." Whether it is human principle, heavenly principle, or natural principle, it is the same. Natural principle means we must coexist with nature by following this principle to succeed; human principle concerns how we get along with others. Therefore, "Li" is not merely a matter of spirit and realm. "Li" is a very tangible thing, visible and palpable. Proceeding this way works; proceeding that way hits a wall. Spirit, however, is sometimes void and elusive, difficult to grasp. We say that in TCM, the importance of this "Li," this law, and this rule is even more prominent. What is this "Li," law, and rule? It is Yin-Yang and the Four Seasons! Therefore, in *Suwen: Siqi Tiaoshen Dalun* (Great Treatise on Regulating Spirit According to the Four Qi of Suwen), it says: "Yin-Yang and the Four Seasons are the beginning and end of all things, the root of life and death. Violating them brings disaster; following them prevents severe diseases. This is called attaining the Dao." Why use the term "attaining the Dao" here? This is an interesting question. The term "attaining the Dao" was used frequently by the ancients; attaining the Dao allows one to ascend to heaven. If one can ascend to heaven, what cannot be done? Why does one attain the Dao? Because one understands this "Li" and follows it. Of course, one attains the Dao and enters a smooth path. Why can modern spaceships ascend to heaven? Is it not because we have clarified the "Li" of relativity? Therefore, this "Li," this Dao, and this principle are meaningful terms; they were so in ancient times, and they are so today.
(2) The Combination of Induction and Deduction
Is the construction of traditional culture based solely on induction? On this point, I also disagree. *Suwen: Shanggu Tianzhen Lun* (Treatise on the Heavenly Truth of Antiquity in Suwen) explicitly states: "In ancient times, those who understood the Dao modeled themselves on Yin and Yang and harmonized themselves with Shu-Shu (techniques and numbers)." Here, "those who understood the Dao" refers to those who attained the Dao. Those who attain the Dao must certainly be those who understand the "Li." The "Li" here includes two aspects: one is Yin-Yang, and the other is Shu-Shu. Thus, there are two questions. Yin-Yang represents induction. *Suwen: Yinyang Yingxiang Dalun* (Great Treatise on Yin-Yang Correspondence to Phenomena in Suwen) states: "Yin and Yang are the Dao of Heaven and Earth, the netting of all things, the parents of change, the origin of life and death, and the residence of spiritual brilliance." Here, all things in Heaven and Earth, and all changes, life, and death, are attributed to Yin and Yang. Therefore, from the perspective of induction, there is no more perfect inductive method in the world than Yin-Yang. Then, what about Shu-Shu? Shu-Shu obviously expresses the aspect of deduction, which is logically equivalent to the traditional sense of logic. Discussing deduction and logic necessitates connecting with mathematics. Therefore, Professor Yang believes that mathematics did not emerge in ancient China; it was only after the introduction of Western learning in the 16th and 17th centuries that seeds of mathematics appeared. True mathematics only emerged in the 20th century, marked by the opening of mathematics courses at Tsinghua and Peking Universities in the early 20th century. So, does Chinese culture have mathematics? The answer is affirmative; Shu-Shu is the study concerning mathematics. In the *General Catalogue of the Complete Library of the Four Treasuries*, discussing the definition of Shu-Shu, there is the following text: "When things are born, they have forms; when forms exist, they have numbers. Multiplication, division, deduction, and elaboration, striving to investigate the source of creation, constitute 'Numbers'." Of course, this is not a mathematical logic system in the modern sense, but it undoubtedly belongs to the part of deduction. Therefore, to become one who understands the Dao, and to truly master this traditional scholarship, one must grasp both Yin-Yang and be clear on Shu-Shu. Consequently, traditional culture is a combination of induction and deduction; neither can be omitted.
(3) Rational Thinking and Internal Verification Experiments