传统文化里没有实验,这个问题杨振宁教授只说对了一半。确实,在中国文化里我们看不到像现代的这样一类实验研究。就医学而言,运用人体以外的东西,如用大白兔、小白鼠或其他动物所进行的一系列实验,这样的实验的确没有。但是,在传统文化里,存在很细微、很精深的内证实验,却是不可否认的事实。正是因为这个内证实验和理性思考的结合,才产生了传统文化,才构建了中医理论。当内证实验是然,内证实验这样一个问题确实不容易说清楚,为什么呢?任何一个有因为这个内证实验不是摆在我们面前的小白鼠,你看得见,志于研究中摸得着,它完全是通过自身修炼来实现的一种能力。一旦医的人所不具备了这一能力,就可以自在地进行各种有别于在机体之能回避的。外进行的各种实验。所以,这个问题不好谈,但是,不谈不行。如果讲传统文化回避了这个问题,那么,我们就要按照上面的路子理解传统文化。这就会出现两种情况,要么,中医是不具备理论结构的经验医学,要么,中医的理论是仅凭思考得出来的结果。大家可以想想,光凭一个思考得出的理论,值不值得我们完全地去信受?大家也可以想想,中医的许多理论,中医的许多事实,光凭一个思考行吗?比如经络、穴位这样一些东西,你能够思考出来吗?比如风池、风府这个问题,你凭什么思考可以得出这样一个特定的穴位要叫做风池、风府?你凭什么思考出少阳经是这样一个循行,太阳经又是那样一个循行?我想无论你如何聪明,这些东西也是思考不出来的。不信,你就思考出来一个看看。显然,如果没有内证实验的参与、没有非常精微实验的参与,是不可能的。所以,我们完全有理由相信,在传统文化,特别像中医这样的学问,在其理论的构建过程中,是既有思考,又有实验的。传统文化中没有实验的说法是站不住脚的。我们只有理由来区分内证实验与现代的外证实验,而根本没有理由来否定内证实验。这个问题不应该含糊。因此,理性思考和精微实验是传统的基础,在这个基础上建立起来的理论是完全可以信受的。问题在于为什么现在很多人都不认为传统文化里有试验。因为我们很难想象内证实验是个什么东西,比如说经络,李时珍曾经说过,经络隧道,若非内视返观者,是难以说出道道的。内视返观是什么呢?内视返观就是典型的内证实验。具备这个内证能力,经络穴位都是看得见的东西,可是在现有的科学实验那里看不见,甚至动用最先进的科技手段也难以看见,那你完全可以不相信,所以,困难就在这里。要进行上述的内证实验,需要主体具备一定的素养,一定的能力,在我们本身不具备这种内证实验的条件与能力的情况下,你有没有这样一个直觉?科学也需要直觉。爱因斯坦在很大程度上就是一个直觉的信奉者。离开直觉,科学研究就少了一条腿。我想在我们许多人里,也许会有人具备这样一种内证的能力,也许一个也没有。但你相不相信呢?这是学中医一个很重要的方面。有人问我,学中医需要什么条件?我想就是需要这个条件,在你做不出来的情况下,你相不相信有这么一个存在?内证实验究竟是什么一个情况呢?梁启超的一句话说得很好:“心明便是天理。”这也是杨振宁教授在讲座中引用过的一句话。心明不是普通的心里明白,要获得这样一个心明是很不容易的。心明实在的就是已经具备了内证实验的这么一种状态。心明就可以内视,就可以返观,经络隧道就可以一目了然。你就可以进行内证实验的操作。为什么说这是内证实验呢?因为它不是在人体外部进行的。大家知道,张仲景在《伤寒论》序言中提到过一本书,这本书的名字叫做《胎胪药录》。过去认为,既然有一本《颅囟经》是讲小儿疾病的,现在又用一个胎字,所以,《胎胪药录》自然应该是讲小儿用药的书。如采用现代的语言来翻译,或者可以叫做《儿科用药全书》吧。但是,我们翻开历史就会清楚,东汉以前会不会有一本专讲小儿用药的书呢?《神农本草经》只分上、下、中三品,而不分内科、外科、妇科、儿科,就是到明代的《本草纲目》也只分木部、草部、石部、兽部,等等。所以,有这些常识,就不应该这样来思维《胎胪药录》。那么,《胎胪药录》究竟是一部什么样的书呢?胎,不是指胎儿,而是讲的胎息,是一种回复到胎儿时期的特殊呼吸状态。人一旦进入到胎息的状态,心明的状态也就自然产生了,内证的条件也就具备了,这个时候内证实验室就可以建立起来。此时,你对药物的感受是实实在在的,药物服下去以后,它的气味如何,它先走哪一经,后走哪一经,在这些部位发生什么作用,这些都是清清楚楚、明明白白的。所以,古人讲药物的气味,讲药物的归经,并不都是思考出来的,而是真正试验出来的。所以,《胎胪药录》就是在能够进行内证实验的条件下,对药物在体内运行作用过程的一个记录。因此,传统文化,特别是中医理论的构建,完全是在理性思考与内证实验的结合下产生的。所以,光有思考,没有实验这样一种认识是不能接受的。可以接受的是,中医确实没有像现代一样的外证实验。
(4)理论的运用
中医理论产生以后,它是怎么应用的呢?理论应用就有一个技术问题。在现代科学领域里,我们可以划分为三大块,就是基础学科、技术学科、应用学科。技术学科是什么呢?就是基础理论与应用之间的一个桥梁,一个中介。为什么现代科学往往是科学技术并称呢?就是因为这两者相互影响太大,有些时候科学决定技术,有些时候技术决定科学。比如物质结构的研究,没有理论不行,但是要突破,没有高速度、高能量的碰撞机也不行。所以,科学与技术是相辅相成的。但在传统文化里,有一个非常奇怪的现象,就是在理论与应用之间,缺少一个现代意义上的技术,理论与应用之间没有中介,没有桥梁。我们看现代医学,理论与应用之间有一个庞大的技术中介,整个现代科学的物理学、化学、生物学都在为这个中介服务,这使得医学理论的应用变得非常方便。现在,医生很少再用望触叩听去诊断疾病,而代之的就是上面这个庞大的技术中介,这是一门系列的理化检测手段。而中医呢?我们没有这样一个技术学介。理论的应用,理论价值的实现,这一切都得靠我们自己去心领神会,靠我们自己去把握,这就带来了很大的困难。所以,要谈传统文化与现代科学的差别,我想最大的差别就在这里。现代科学里,理论与应用之间有一个技术中介来帮助实现理论的价值,而传统文化,特别是中医,完全没有这个中介。理论的应用只有靠主体直接来把握,主体能够把握多少呢?像现代科学这个技术的过程完全可以由科学精英来创造,而技术一旦创造出来,就可以进行大批的复制,这个过程是可以由普通技术工人来进行的。钱学森搞原子弹,并不需要他亲自去造原子弹,电脑的专家发明电脑后,也不需要他一台一台地去造电脑,技术就可以帮助他们完成这个过程。所以,现代技术是很方便的东西,它可以帮助我们,使再高深的理论都能够变成现实。所以,在现代科学面前,精英是可以复制的。但是,在传统的领域里就没有这样一个方便。这样一个理论再好,如果你不能把握的话,还是等于零。就像我们现在拿到相对论,我们能搞出什么明堂?大家可以想想,一个相对论摆在你面前,你可以搞出些什么东西?我很难想象这个问题。如果你搞不出什么,是否就能说这个相对论太落后,爱因斯坦太糟糕呢?所以,中医所面临的就是这样一个问题,它落后就落后在这样一个环节上。并不是说它理论真正的落后了。因为历史上已经有非常多的精英成功地运用了这个理论,成功地运用它造出了“原子弹”,造出了“计算机”。所以,我们应该有一个很清醒的头脑,要好好地思考上面的问题。思考清楚以后,我们就会发现问题出在什么地方,是出在理论的环节上,还是出在其他的环节上。通过上面这些讨论,大家是不是能建立这样一个认识,中医这门学问,现在并不是理论出了问题,并不是理论滞后于临床,实际上完全不是这么回事。中医的理论,你一旦进去了,你就会有感觉,你就会有受用,怎么还会说她滞后呢?现在,如果我们有了这样一个共识:中医的问题没有出在理论上面。既然没有出在理论上,那为什么会出现我们今天的这个局面呢?这就需要从我们自身上去找原因。我们对中医理论的领悟如何?我们是否真正把握了中医理论的临床运用?记得 1987年,我的师父曾经接治过一例血气胸的病人,患者经过一周的西医保守治疗,病情不见缓解,仍高热不退,呼吸困难,左肺压缩 2/3。在这种情况下,西医只有求诸手术治疗。但患者本人及家属并不愿放弃保守治疗的希望,于是转而求治于我的师父。师父诊后,认为这是阳明病,属阳明不降所致,只要设法恢复阳明之降,血气胸的问题就可以解决。于是处了玉竹 120 克、陈皮 120克、白芷 120 克、大枣 120 克,共四味药。服药以后出现大量腹泻,自觉症状迅速缓解,第四天,体温恢复正常,治疗一周血气全部吸收,左肺复原。血气胸与阳明又有什么关系呢?看来这完全是一个领悟和运用技巧的问题,而不是理论本身的问题。经典的这个理论不但能够解决 20 世纪的问题,而且能够解决 21世纪的问题。
二、学问的传承
接下来我们要谈一谈学问的传承,具体地说就是中医这门学问的传承。我们在这里用“传承”这个词,可以说比较的古典,一门学问要流传下去,它靠的什么呢?靠的就是这个传承。所以,学问的传承是一个重要的问题。下面我们分两部分来讨论。
1.现代中医教育的模式
Traditional culture does not lack experiments; Professor Yang Zhenning's view on this issue is only half correct. Indeed, within Chinese culture, we do not see a type of experimental research like that in modern science. Regarding medicine, a series of experiments utilizing substances external to the human body (such as white rabbits, white mice, or other animals) indeed did not exist in traditional Chinese medicine. However, it is an undeniable fact that within traditional culture, there exists a subtle and profound "internal verification experiment" (Neizheng Shiyan, internal verification experiment). It is precisely the combination of this internal verification experiment and rational thinking that gave rise to traditional culture and constructed the theoretical framework of Traditional Chinese Medicine (TCM).
When discussing internal verification experiments, this issue is indeed difficult to explain clearly. Why? Because the internal verification experiment conducted by anyone possessing this ability is not like a white mouse placed before us, visible and tangible; it is entirely a capability realized through personal cultivation. Once a medical practitioner possesses this ability, they can freely conduct various experiments distinct from those performed externally on the organism. Therefore, this issue is hard to discuss, yet it cannot be ignored. If we claim that traditional culture avoids this issue, then we must understand traditional culture according to the logic above. This leads to two possibilities: either, TCM is an empirical medicine lacking a theoretical structure; or, the theories of TCM are results derived solely from thinking. Everyone can ponder this: is a theory derived solely from thinking worthy of our complete acceptance? Everyone can also consider: for many theories and facts in TCM, is relying solely on thinking sufficient? For instance, can you deduce things like meridians (Jingluo, channels and collaterals) and acupoints (Xuewei, acupuncture points) merely through thinking? On what basis could you deduce through thinking that a specific acupoint should be named Fengchi (GB20) or Fengfu (GV16)? On what basis could you deduce through thinking that the Shaoyang Meridian (Hand-Shaoyang Sanjiao Meridian and Foot-Shaoyang Gallbladder Meridian) follows one pathway, while the Taiyang Meridian (Hand-Taiyang Small Intestine Meridian and Foot-Taiyang Bladder Meridian) follows another? I believe that no matter how intelligent you are, these things cannot be deduced through thinking alone. If you don't believe me, try to deduce one yourself. Obviously, without the participation of internal verification experiments and very subtle experiments, it is impossible. Therefore, we have every reason to believe that in traditional culture, especially in a discipline like TCM, its theoretical construction process involved both thinking and experimentation. The assertion that traditional culture lacks experiments is untenable. We have reasons to distinguish between internal verification experiments and modern external verification experiments, but absolutely no reason to deny the existence of internal verification experiments. This issue should not be vague. Therefore, rational thinking and subtle experiments form the foundation of tradition, and the theories built upon this foundation are fully credible.
The question is why many people today do not believe that traditional culture contains experiments. Because it is difficult for us to imagine what an internal verification experiment is. For example, regarding meridians, Li Shizhen once said: "Regarding the tunnels of the meridians, unless one practices inner vision and introspection, it is difficult to speak of them properly." What is inner vision and introspection (Neishi Fanguan)? Inner vision and introspection are typical forms of internal verification experiments. Possessing this internal verification ability makes meridians and acupoints visible things. However, they cannot be seen in existing scientific experiments, and even with the most advanced technological means, they remain difficult to detect. In such cases, one might completely disbelieve their existence, which is where the difficulty lies. To conduct the aforementioned internal verification experiments, the subject needs to possess certain qualities and abilities. Under circumstances where we ourselves do not possess the conditions and abilities for such internal verification experiments, do you have such intuition? Science also requires intuition. Albert Einstein was largely a believer in intuition. Without intuition, scientific research loses a leg. I think among us, perhaps some possess this kind of internal verification ability, perhaps none do. But do you believe in it? This is a very important aspect of learning TCM. Someone asked me, what conditions are needed to learn TCM? I think it is precisely this condition: when you cannot achieve it yourself, do you believe in the existence of such a phenomenon?
What exactly is the situation with internal verification experiments? A sentence by Liang Qichao states it well: "A clear mind is Heavenly Principle." This is also a quote cited by Professor Yang Zhenning in his lecture. A "clear mind" is not ordinary mental clarity; attaining such a clear mind is very difficult. Essentially, a clear mind represents a state where one has already possessed the capacity for internal verification experiments. With a clear mind, one can practice inner vision and introspection, making the tunnels of the meridians clear at a glance. One can then perform operations of internal verification experiments. Why is this called an internal verification experiment? Because it is not conducted outside the human body.
As everyone knows, Zhang Zhongjing mentioned a book in the preface of *Shanghan Lun* (*Treatise on Cold Pathogenic Diseases*), titled *Tailu Yaolu* (*Record of Fetal Breath and Materia Medica*). In the past, it was believed that since there is a *Luxin Jing* (*Classic of Cranium and Fontanelle*) dealing with pediatric diseases, and now using the character "Tai" (Fetal), *Tailu Yaolu* naturally should be a book about pediatric medication. Translated into modern language, it might be called *Complete Book of Pediatric Medication*. However, if we look at history, would there have been a book exclusively about pediatric medication before the Eastern Han Dynasty? *Shennong Bencao Jing* (*Divine Farmer's Materia Medica*) only classified herbs into Upper, Middle, and Lower categories, not distinguishing Internal Medicine, Surgery, Gynecology, or Pediatrics. Even in the Ming Dynasty's *Bencao Gangmu* (*Compendium of Materia Medica*), classification was based on Wood, Grass, Stone, Beast sections, etc. Therefore, with this common sense, one should not interpret *Tailu Yaolu* in this manner. So, what kind of book is *Tailu Yaolu* really? "Tai" here does not refer to a fetus, but to Taixi (Fetal Breathing), a special breathing state returning to the fetal period. Once a person enters the state of Taixi, the state of a clear mind naturally arises, the conditions for internal verification are met, and an internal verification laboratory can be established. At this time, your perception of drugs is real and substantial. After taking the medicine, you clearly know its aroma, which meridian it enters first, which later, and what effects occur in these areas. Everything is clear and explicit. Therefore, when ancients spoke of drug aromas and drug tropism (Guijing, meridian affinity), it was not all deduced through thinking, but truly tested. Thus, *Tailu Yaolu* is a record of the process of drug operation and effect within the body, created under conditions where internal verification experiments were possible. Therefore, the construction of traditional culture, especially TCM theory, was produced entirely through the combination of rational thinking and internal verification experiments. Hence, the view that there is only thinking without experimentation is unacceptable. What can be accepted is that TCM indeed lacks external verification experiments like those in modern science.
(4) Application of Theory
After the generation of TCM theory, how is it applied? The application of theory involves a technical issue. In the field of modern science, we can divide it into three major blocks: basic disciplines, technical disciplines, and applied disciplines. What is a technical discipline? It is a bridge and intermediary between basic theory and application. Why are science and technology often mentioned together in modern science? Because the mutual influence between the two is too great; sometimes science determines technology, and sometimes technology determines science. For example, in the study of material structure, theory is indispensable, but to make breakthroughs, high-speed, high-energy colliders are also necessary. Thus, science and technology complement each other. However, in traditional culture, there is a very strange phenomenon: between theory and application, there is a lack of technology in the modern sense. There is no intermediary or bridge between theory and application. Looking at modern medicine, there is a massive technical intermediary between theory and application. The entire modern sciences of physics, chemistry, and biology serve this intermediary function, making the application of medical theories very convenient. Nowadays, doctors rarely use inspection, palpation, percussion, and auscultation to diagnose diseases, replacing them with this massive technical intermediary—a series of physical and chemical detection methods. And TCM? We lack such a technical intermediary. The application of theory and the realization of theoretical value all depend on our own intuitive understanding and grasp, which brings great difficulties. Therefore, when discussing the differences between traditional culture and modern science, I think the greatest difference lies here. In modern science, there is a technical intermediary between theory and application to help realize the value of theory, whereas in traditional culture, especially TCM, there is completely no such intermediary. The application of theory relies solely on the subject's direct grasp. How much can the subject grasp? In modern science, the technical process can be created by scientific elites, and once the technology is created, it can be mass-reproduced, a process that can be carried out by ordinary technical workers. Qian Xuesen working on the atomic bomb did not need to build the atomic bomb himself; computer experts inventing computers did not need to build them one by one; technology helps them complete this process. Therefore, modern technology is very convenient; it helps us turn even the deepest theories into reality. Thus, in front of modern science, elites are replicable. However, in the traditional domain, there is no such convenience. No matter how good a theory is, if you cannot grasp it, it equals zero. Just as if we were given Relativity Theory today, what could we accomplish? Everyone can ponder this: if Relativity Theory is placed before you, what can you produce? I find it hard to imagine the answer. If you cannot produce anything, can you say that Relativity Theory is too backward or that Einstein was terrible? Therefore, TCM faces such a problem: its backwardness lies in this specific link. It is not that its theory is truly backward. Historically, many elites have successfully used this theory to create "atomic bombs" and "computers." Therefore, we should have a clear head and carefully reflect on the issues above. After thinking clearly, we will discover where the problem lies: is it in the theoretical link, or in other links? Through the discussions above, can everyone establish the following understanding: the current issue with TCM is not that the theory has problems, nor that the theory lags behind clinical practice; in fact, it is completely not so. Once you enter TCM theory, you will feel it and benefit from it; how could one say it lags? Now, if we reach a consensus: the problem with TCM does not lie in the theory. Since it does not lie in the theory, why does the current situation exist? We need to find the cause within ourselves. How is our comprehension of TCM theory? Have we truly grasped the clinical application of TCM theory?
I remember in 1987, my master treated a patient with hemopneumothorax. After one week of Western medicine conservative treatment, the condition did not improve; the patient still suffered from persistent high fever, dyspnea, and left lung compression of 2/3. Under these circumstances, Western medicine had only resorted to surgical treatment. However, the patient and family were unwilling to give up hope for conservative treatment, so they turned to my master. After diagnosis, my master considered this Yangming Disease (Yangming Bing, disease caused by pathogen affecting the Yangming channel), resulting from the failure of Yangming Qi to descend. As long as the descent of Yangming Qi was restored, the problem of hemopneumothorax could be resolved. He prescribed Yuzhu (Polygonatum Odoratum Rhizome) 120g, Chenpi (Citri Reticulatae Pericarpium) 120g, Baizhi (Angelicae Dahuricae Radix) 120g, and Dazao (Jujubae Fructus) 120g, totaling four herbs. After taking the medicine, the patient experienced severe diarrhea, and subjective symptoms rapidly relieved. By the fourth day, body temperature returned to normal. After one week of treatment, the blood and gas were completely absorbed, and the left lung recovered. What is the relationship between hemopneumothorax and Yangming? It appears this is entirely a matter of comprehension and application skill, not a problem with the theory itself. This classic theory can not only solve problems of the 20th century but also those of the 21st century.
II. Inheritance of Learning
Next, we will discuss the inheritance of learning, specifically the inheritance of TCM. Using the word "inheritance" here can be considered relatively classical. What does a discipline rely on to be passed down? It relies on this inheritance. Therefore, the inheritance of learning is an important issue. We will discuss this in two parts below.
1. The Model of Modern TCM Education