中医养生学的基本理论 – The Basic Theory of Life Cultivation of Chinese Medicine

Translated by XU Zhi-jun & J. Heaverlo

第三章 中医养生学的基本理

        中医养生学继承了传统中医学的理论和古代哲学思想的精华,以“天人相应”和“形神合一”的整体观为出发点.主张从综合分析的角度去看待生命和生命活动。养生方法以保持生命活动的动静互涵、平衡协调为基本准则。主张“正气为本”,提倡“预防为主”,强调辨证思想。要求人们用持之以恒的精神,自觉地、正确地运用养生保健的知识和方法,通过自养自疗,提高身体素质和抗衰防病的能力,达到延年益寿的目的。

Chapter Three:  The Basic Theory of Life Cultivation of Chinese Medicine

The Chinese Medicine study of life cultivation inherited the essence of traditional Chinese medicine theories and ancient philosophical thoughts. It originates from a holistic view that “heaven and man are mutually interactive”, and “the body and the spirit are the unity of opposites”. It holds that life and life’s activities should be treated from the perspective of a comprehensive analysis. The basic principles of life cultivation is to keep life’s activities balanced, coordinated, and in an interdependent state of movement and stillness. It takes “the upright  as the foundation”, advocates “prevention first in medical work”, and emphasizes dialectical thinking. It requests that people apply the life cultivation knowledge and methods persistently, consciously, and correctly, so as to improve their constitution and ability to defy debilitation and prevent disease, and thus, to realize the goal of prolonging life.

第一节 生命

生命是具有生长、发育活力,并按自然规律发展变化的过程。“生、长、壮、老、已”,是人类生命的自然规律。探索生命的规律,对于中医养生学来说,有着极为深远的意义。

一、生命的起源

《内经》认为,生命物质是宇宙中的“太虚元气”,在天、地、日、月、水、火相互作用下,由无生命的物质演变化生出来的。天地之间所以有品类无限多样的物种,都 是物质自己的运动和变化,在时间进行中形成的。《素问·天元纪大论》所说:“太虚廖廓,肇基化元……生生化化,品物咸章”,就是这个意思。人是最高等的动 物,但也不过是“物之一种”,是从万物群生中分化出来的。所以《素问·宝命全记沦》说:“人以天地之气生,四时之法成”。

“人以天地之气生”,是说人类生命的起源,源于天地日月,其中主要源于太阳的火和地球的水。太阳是生命能量的源泉,地球的水(凡其所溶解的各种营养物质)是生命形质的原料。有生命的万物必须依靠天上的太阳和地上的水才能生存,人类当然也不例外。

“四 时之法成”,是说人类还要适应四时阴阳变化的规律才能发育成长。因为人生天地之间,自然界中的一切运动变化、必然会直持或间接地对人体的内环境产生影响, 而人体的内环境的平衡协调和人体外界环境的整体统一,是人体得以生存的基础。在正常情况下,通过人体内部的调节可使内环境与外界自然环境为变化相适应,保 持正常的生理功能。如果人的活动违反自然变化的规律,或外界自然环境发生反常的剧变,而人体的调节功能又不能适应时,人体内、外环境的相对平衡都会遭到破 坏而产生疾病。这说明“适者生存”,仍是生物界不可逾越的客观规律。人类只有认识自然,才能更好地适应自然,改造自然,成为自然的主人。

Section One: Life

Life is a process of growing and developing according to the laws of nature. “Birth, growth, maturity, decline, and death” is the natural law of life. Thus, it is profoundly significant for the Chinese Medicine study of life cultivation to explore the law of life.

  1. The Origin of Life

According to “The Yellow Emperor’s Inner Canon”, the materials of life evolved from inert matter within the universe, under the interactions of the heavens, the earth, the sun, the moon, the water, the fire, etc. The origins of all the immeasurable and diversified species between heaven and earth are attributed to the movements and evolution of the materials themselves. They formed into their current shapes through the course of time. This accords with what was expressed in “Plain Questions: Great Treatise on the Origins and Principles of Heaven” , “The original motive power exists among The Boundless Great Void…the original  produces and evolves (all of the ten thousand things), which will naturally become prosperous.” Although human beings are the top-level animals, they are still no more than “one of the species”, and similarly, evolved from the ten thousand things. This is why “Plain Questions: Treatise on Treasuring [Heaven’s] Mandate to Preserve the Body” says, “Human beings come into existence by receiving the  between heaven and earth, and mature by following the laws of the four seasons”.

The quote, “Human beings come into existence by receiving the  between heaven and earth”, means that human life originates from the heavens, the earth, the sun and the moon.  Among these, the fire of the sun and the water of the earth are of most importance. The sun is the source of the life energy, and the earth’s water (and the various nutrients dissolved by water) is the raw materials for the matter of life. All the ten thousand living creatures must rely on the sun and the water of the earth for survival. Human beings are certainly not an exception.

The statement, “Human beings mature by following the laws of the four seasons”, means that human beings must adapt themselves to the laws of the yīn yáng changes of the four seasons in order to sustain development and growth. Because human beings exist between heaven and earth, all the movements and changes of the natural world will inevitably influence the inner environment of the human body, directly or indirectly. Therefore, the existence of the human body is based on the holistic unity of its inner and outer environment. Under normal conditions, by adjusting the human body, the inner environment can adapt to the changes of the outside natural environment, and thus to maintain normal physiological functions. If human activities go against the laws of natural change, or the outside natural environment has extreme abrupt changes, and the regulatory function of the human body cannot adjust, the relative balance of the inner and outer environment of the body will be destroyed and thus fall ill. This proves that “the survival of the fittest” is still the impassable, objective law of the natural world. Only by knowing nature can mankind better adapt to nature, transform nature, and to become the master of nature.

二、生命的运动形式

《庄 子·知北游》说:“人之生,气之聚也,聚则为生,散则为死”。这就是说,生命活动是自然界最根本的物质-—气的聚、散、离、合运动的结果,生命是物质运动 的形式。活着的人体,是一个运动变化着的人体。《素问·六微旨大论》进一步指出物质运动的基本形式是“升降出入”,“出入废则神机化灭,升降息则气立孤 危,故非出入,则无以生长壮老已;非升降,则无以生长化收藏,是以升降出入,无器不有”。这就说明,只有运动,才能化生万物,宇宙间的一切吻质,尽管有大 小和生存的时间长短不同,但运动是一致的。

升降出入运动,是人体气化功能的基本形式,也是脏腑经络、阴阳气血矛盾的基本过程。因此,在生理 上人体脏腑经络的功能活动无不依赖于气机的升降出入,如肺的宣发与肃降,脾的升清与胃的降浊,心肾的水火相济,都是气机升降出入运动的具体体现。在预防疾 病方面,同样要保持人体气机升降正常,才能抗御邪气侵犯,免生疾病。

  1. The Form of Life

In the classic“Zhuāng Zĭ:。ZhĪ Běi Yóu”it is put forth, “Human life is the gathering of . Once  gathers together, people live; once  scatters and disappears, people die”. This is to say; life’s activities result from the gathering, scattering, separation and combination of —the most fundamental substance in nature. The living human body is always changing. “Plain Questions, Great Treatise on the Subtleties of Six” further points out that the basic movement of substance is “upbearing, downbearing, inward and outward movement”, “If the inward and outward movement stops, the spirit mechanism (life) will die out; if upbearing and downbearing stops, the established  is in peril. Therefore, without inward and outward movement, there will be no birth, growth, maturity, decline, and death; without upbearing and downbearing, there will be no birth, growth, transformation, receiving, and storage. Thus, no substance is without the movements of upbearing, downbearing, inward and outward.” This is to say that only movement can give birth to the ten thousand things. The most consistent attribute of all matter in the universe, regardless of its size or time of existence, is movement.

Upbearing, downbearing, inward and outward movement is the basic function of  transformation within the human body. It is also the basic process of movement for the viscera, channels and network vessels, yīn, yáng, qì and blood. All the physiological activities of the viscera and the channels and networks vessels rely on the upbearing, downbearing, inward and outward movement of . For instance, the diffusion and downbearing of the lungs, the upbearing of the clear by the spleen, the downbearing of the turbid by the stomach, the mutual assistance between the water and fire of the heart and the kidney…all of these are specific illustrations of the upbearing, downbearing, inward and outward movement of . In terms of disease prevention, only by maintaining a normal state of the upbearing, downbearing, inward and outward movement of  can the human body resist the invasion of evil  and avert the onset of disease.

三、生命的维持和死亡

《素 问·生气通天论》里说:“生之本,本于阴阳”,这就是说,生命的根本,就是阴阳。究其原因,是由于“阳化气,阴成形”,而生命过程就是不断的化气与成形的 过程,即有机体同外界进行不断的物质交换和能量交换的过程。化气与成形,是生命本质自身中的矛盾,两个对立面是不断斗争的,又是统一的。化气与成形,互为 消长;任何一方的太过或不及,均可导致另一方受损。但二者又结合于生命的统一体内,互相依存,互相转化。阳气化为阴精,阴精又化为阳气,否则“孤阳不生, 独阴不长”。

人之所以有生命,在于构成人体的“气”具有生命力。人体生命力的强弱,生命的寿夭,就在于元气的盛衰存在;新陈代谢的生化过 程,称之谓气化生理;生命的现象,本源于气机的升降出入等等,这都反映出气既是构成人体的基本物质,又是人体的生命动力。正因为气是生命活动的根本和动 力。宋《圣济总录》提出:“万物壮老,由气盛衰”的观点,并认为“人之有是形也,因气而荣,因气而病”。张景岳则反复强调气在防病延年中的重大意义,指出 气是人体盛衰寿夭的根本。他说;“盖以大地万物皆由气化;气存数亦存,气尽数亦尽,所以生者由乎此,所以死者亦由乎此,此气不可不宝,能宝其气,则延年之 道也”。同样,精、血、津液亦是构成人体及促进人体生长发育的基本物质,如《灵枢·经脉》篇说:“人始生,先成精,精成而脑髓生,骨为十、脉为营、筋为 刚、肉为墙、皮肤坚而毛发长”,这就说明人体的产生必先从精始,由精而后生成身形五脏,皮肉筋骨脉等。不仅如此,人出生之后,犹赖阴精的充盈,从而维持人 体的正常的生命活动,故《素问·金匮真言论》说:“精者,身之本也”。若阴精充盈,则生命活动旺盛,身健少病;若阴精衰虚,则生命活动减退,早衰多病。

还 有,生命的维持还依赖于神的健康,《灵枢·天年》说:“失神者死,得神者生”。可见,神的得失关系到生命的存亡。从人体来说,神是机体生命活动的总称,整 个人体生命活动的外在表现,无不属于神的范围。它包括精神意识,运动、知觉在内,以精血为物质基础,是气血阴阳对立的两个方面共同作用的产物。

综上所述,人体的生命活动,是以体内脏腑阴阳气血为依据的。脏腑阴阳气血平衡,人体才会健康无病,不易衰老,寿命才能得以延长。这就是《素问·生气通天论》中“阴平阳秘,精神乃治;阴阳离决,精气乃绝”的理论。

但有生必有死,这是不以人们的意志为转移的客观规律。恩格斯说:“生命首先就在于:生命在每一瞬间食它自身,但却又是别的什么。所以生命也是存在于物体和过程本身中的不断自行产生和自行解决的矛盾;这一矛盾一停止,生命亦即停止,于是死就来到”。

  1. The maintenance and life and death

“Plain Questions, Treatise on Vital QÌ Connecting with Heaven” says, “Life is rooted in yīn and yáng”.  This is to say, the root of life is yīn and yáng because “yáng transforms into , yīn becomes form”. The process of life is that of constantly transforming into  and becoming form, in other words, the process in which the organism constantly exchanges matter and energy with the outside world. The transformation of  and materialization are two opposites within the nature of life.  Both are opposing as well as interdependent. Their interaction consists of waxing and waning. The excessiveness or insufficiency of any one side may lead to the injury of the other. However, the two sides combine within the body to form the unity of life, they are mutually interdependent as well as mutually transforming.  The yáng qì transforms into yīn essence and the yīn essence  transforms into yáng qì. Otherwise, “The solitary yáng cannot survive, the solitary yīn cannot grow”.

Life can exist because of the vitality of qì. The exuberance or debilitation of the original  of the human body will dictate whether one’s life is stronger or weaker, longer or shorter. is not only the essential matter constituting human body, but it is also the motive force of life. Just for this reason, “Sages’ Salvation Records” of the Sòng Dynasty puts that “The maturity and death of the ten thousand things all depends on the exuberance and debilitation of ”, and believes that “The human shape becomes healthy or ill because of .” Zhāng  Jǐngyuè repeats again and again the great significance of  in preventing diseases and prolonging life. He points out that  is the root cause of exuberance and debilitation, longer or shorter life. He says, “All the ten thousand things between the Heaven and Earth come into being from . Where there is  there is life, here there is no  there is no life. Life and death are determined by . The  must be treasured, which is the secret of prolonging life”. Similarly, essence, blood, and body fluids are also considered the essential matter that constitutes the human body and promotes its growth and development. “Magic Pivot: Channels” puts, “When a human body comes into being, first to form is the essence,  then brain-marrow develops. The skeleton is the support; the arteries and veins are the places for managing and storing  and blood; the sturdy sinews and joints work to restrain and strengthen the skeleton; the muscles and flesh are the walls to protect the internal organs, sinews, bones, and blood vessels; after the skin becomes firm and tenacious, hair will grow”. This is to say that the forming of human body starts with the essence, followed by the body frame, the five viscera, skin, flesh, sinews, bones, vessels, etc. After birth, the human body still relies on abundant yīn essence to maintain normal life activities. That’s why “Plain Questions, Treatise of the True Doctrine of the Golden Coffer” says, “essence is the root of human body”.  If the yīn essence is abundant, life activities will be vigorous, the body will be strong and healthy; if the yīn essence is feeble and weak, the life activities will decline, and the body will decay early with poor health.

The maintenance of life also relies on a sound spirit. “Magic Pivot:  Natural Life-Span” says, “Those who lose spirit die, those who gain spirit live”. It is thus clear that the gain or lose of spirit is related with life or death. In terms of the human body, spirit is the general name of the activities of all organic life. The external manifestation body belongs to the spirit, which includes spiritual awareness, movement, and consciousness. Based on the essence and the blood, it is the outcome of the interaction of yīn and yáng.

In summation, life activities of the human body are based on the viscera, yīn, yáng, and blood. Only by keeping the balance of the viscera, yīn, yáng, and blood can the human body be healthy and life be prolonged. This accords with the theory in “Plain Questions, Treatise on Vital Qì Connecting with Heaven”, “If the yīn is calm and yáng is sound, the spirit can be vigorous; if yīn and yáng are separated from each other and cannot combine, the spirit and  will be exhausted.”

第二节 天年

一、天年的概念

“天年”,是我国古代对人的寿命提出的一个有意义的命题。天年,就是天赋的年寿, 即自然寿命。人的生命是有一定期限的。古代养生家、医家认为在百岁到百二十岁之间。如《素问·上古天真论》:“尽终其天年,度百岁乃去。”;如《尚书·洪 范篇》:“寿、百二十岁也”,《养身论》亦说:“上寿百二十,古今所同”。此外,老子、王冰也都认为天年为120岁。西德著名学者H.Franke在 1971年提出:“如果一个人既未患过疾病,又未遭到外源性因素的不良作用,则单纯性高龄老衰要到120岁才出现生理性死亡”。事实上,120岁的天年期 限与一般的长寿调查资料相符,自古至今超过这一生理极限的例子,也是不少的。

Section Two:  The Natural Life Span

  1. The Concept of the Natural Life Span

The course of the natural life span is a significant proposition put forward by ancient Chinese people. It refers to the life span endowed by nature, i.e., natural life span. Human life has a time limit. Doctors and ancient experts in life cultivation believed this time limit is between one hundred and one hundred and twenty years. For example, “Plain Questions. Treatise of Heavenly Truth from Remote Antiquity” puts, “(The people from remote antiquity) lived their full span until one hundred years old”; “The Book of History. The Fundamental Laws of Government” puts, “The natural life span is one hundred and twenty years”; “Treatise of Life Cultivation” also says, “The highest life span is one hundred and twenty years. This has been a truth at all times”. Furthermore, both Lǎozǐ and Wáng Bìng believed that the natural life span was one hundred and twenty years. The German scholar, H. Franke, put forward in 1971, “If a person suffers from neither any illness nor any harmful effects by external factors, the physiological death will take place at the age of 120”. As a matter of fact, the life span of 120 conforms with corresponding research materials. From ancient times to present, there have been quite a few examples that went beyond this time limit.

二、寿命

寿命是指从出生经过发育、成长、成熟、老化以至死亡前机体生存的时间,通常以年龄作为衡量寿命长短的尺度。

一 般计算年龄的方法又可分为两种,一种是时间年龄,又称历法年龄,是指人出生以后经历多少时期的个体年龄,我国常配以生肖属性,以出生年份来计算其岁数,一 般由虚岁或足岁计算年龄。另一种是生物学年龄,是表示随着时间的推移,其脏器的结构和功能发生演变和衰老情况。在生物学上又可分为生理年龄与解剖年龄。国 外在确定退休准则时,设想应用生理年龄作为指标,可能比时间年龄更胜一筹。因为时间年龄和生物年龄是不完全相同的,前者取决于生长时期的长短,而后者取决 于脏器功能及结构的变化过程。由于每个人的先天性遗传因素与后天性环境等因素不同,因此时间年龄和生物学年龄有时不完全相同。此外,还有“心理年龄”,所 谓“心理年龄”是指由社会因素和心理因素所造成的人的主观感受的老化程度。即主观感受年龄,也称“社会心理年龄”,用以表示随着时间的推移,机体结构和功 能的衰老程度。

由于人与人之间的寿命有一定的差别,因此在比较某个时期、某个地区或某个社会的人类寿命时,通常采用平均寿命。平均寿命常用来反映一个国家或一个社会的医学发展水平。

随着时代的发展,社会的进步,人类的寿命不断增长,但人类的寿命值究竟是多少?还是一个尚未彻底解决的问题。因为它与先天禀赋的强弱,后天的给养、居住条件、社会制度、经济状况、医疗卫生条件、环境、气候、体力劳动、个人卫生等多种因素的影响有关。

  1. Life Span

Life span refers to the time period of the organic existence, which starts with birth, undergoes growth, maturity, aging, and ends with death. It is usually measured by age.

There are two common methods of counting age: one is called chronological age, or calendar age, which counts how many periods (years) a person goes through after birth. In China, this often goes together with the 12 symbolic animals. Age is counted by the year of birth. Age can be counted by nominal age (reckoned by the traditional method, i.e. considering a person one year old at birth and adding a year each lunar new year) or the actual age. The other method of counting age is called biological age, which reflects how the viscera develop and decline in the course of time. It can be further divided into physiological age and anatomical age. Some foreign countries take physiological age as the standard of retirement, which is more reasonable than chronological age. The reason is that chronological age and biological age are not completely identical with each other: the former depends on the length of life, while the latter depends on the changes of the viscera’s functions and structures. “Psychological age” is another dimension. It is the perception of how old one feels due to social and psychological elements.

Because the life span of different individuals vary, average life span is usually adopted to measure the life span during a specific period, in a specific area or society. The average life span is often used to reflect the medical development of a country or society.

With the development and progress of the times, the life span of human beings has been constantly increasing. However, the question how many years can human beings live has not yet been satisfactorily answered. An individual’s life span is influenced by various elements, such as natural endowment, provisions after birth, living conditions, social system, economic conditions, medical conditions, environment, climate, physical labor, personal hygiene, etc.

三、健康人的生理特征

迄 今为止,人们发现,影响人类尽终其天年的因素虽然很多,但有两个是非常重要的,其一是衰老;其二是疾病。那么,推迟衰老的到来,防止疾病的产生是延年益寿 的重要途径。因此,研究健康人的生理特征,就显得很有必要。一般地说,一个健康无病,没有衰老的人,应该具备下列生理特征:

  1. The Physiological Characteristics of Healthy People

Among various elements that prevent people from living their full life span, two have been found to be very important. One is aging, the other one is illness. Thus, postponing aging and preventing illness becomes important to prolonging life. It is quite necessary to study the physiological characteristics of healthy people. Generally speaking, a healthy individual should have the following physiological characteristics:

(一)生理健康特征

1、眼睛有神  眼精是脏腑精气汇集之地,眼神的有无反映了脏腑的盛衰。因此,双目炯炯有神,是一个人健康的最明显表现。

(1)   The characteristics of physiological health

  1. The eyes have spirit

The eyes are where the essence of the viscera converge. Whether the eyes are bright and with spirit is a reflection of the exuberance or debilitation of the viscera. The most evident way of determining an individual’s health is whether the eyes are bright and full of spirit.

2、呼吸微徐 微徐,是指呼吸从容不迫,不疾不徐。《难经》认为:“呼出心与肺,吸入肝与肾”,说明呼吸与人体脏腑功能密切相关。

  1. The breath is slightly unhurried.

“The Classic of Difficult Issues” holds, “Exhalation mainly depends on the heart and lungs; inhalation mainly depends on the liver and kidneys”. This points out that breath is closely related to the functions of the viscera.

3、 二便正常  《素问·五脏别论》说:“魄门亦为五脏使,水谷不得久藏”,是说经过肠胃消化后的糟粕不能藏的太久,久藏则大便秘结。而大便通畅则是健康的反 映。小便是排除水液代谢后糟粕的主要途径,与肺、肾、膀胱等脏腑的关系极为密切。小便通利与否,直接关系着人体的功能活动。

  1. The bowels and urination are normal.

“Plain Questions. A Separate Treatise on the five Viscera” says, “The gate of the corporeal soul (the anus) also functions as an excretory organ, which prevents the grain and water from remaining inside the body for prolonged periods.” This means if the waste from the digestive process remains for prolonged periods within the body, the stool will become bound. Unobstructed bowel movements are considered a reflection of one’s health. Urination is closely related with the lungs, the kidneys, the urinary bladder, plus other viscera. It is the primary route to rid the body of metabolic waste. Whether the urination is uninhibited has a direct relationship with the functions of the human body.

4、脉象缓匀  此指人的脉象要从容和缓,不疾不徐。“脉者,血之腑也”,气血在脉道内运行,所以脉象的正常与否,能够反映气血的运行。

  1. The pulse is moderate and even.

This means that the pulse should be unhurried, moderate, not too slow and not too fast. “The pulse is the house of the blood”, meaning the  and blood move through the pulse channels. Whether the pulse is normal or not, can reflect the movement of the  and blood.

5、形体壮实 指皮肤润泽,肌腠致密,体格壮实,不肥胖,亦不过瘦。因为体胖与体瘦皆为病态,常常是某些疾病带来的后果。

  1. The body is robust.

This means the skin should be moist and glowing, the interstices are fine and compact, and the body is neither too fat nor too thin. Both obesity and excessive thinness are abnormal states, which usually result from some sort of illness.

6、面色红润 面色是五脏气血的外荣,而面色红润是五脏气血旺盛的表现。

  1. The facial complexion is rosy.

The facial complexion is the outward manifestation of the  and blood of the five viscera.  A rosy complexion indicates the  and blood of the five viscera are exuberant.

7、牙齿坚固 因齿为骨之余,骨为肾所主,而肾为先天之本,所以牙齿坚固是先天之气旺盛的表现。

  1. The teeth are strong and firm.

The teeth are considered a surplus of the bones. The kidneys govern the bones.  The kidneys serve as the root of the former heaven essence. Henceforth, strong and firm teeth are a reflection the congenital essence is exuberant.

8、双耳聪敏 《灵枢·邪气脏腑病形篇》说:“十二经脉,三百六十五络……其别气走于耳而为听。”说明耳与全身组织器官有密切关系,若听力减退、迟钝、失听、是脏器功能衰退的表现。

  1. The hearing is acute.

“Magic Pivot:  Forms of Disease from Evil Qi in the Bowels and Viscera” says, “The twelve channels and three hundred and sixty five vessels…through which the  travels to the ears, which makes them able to hear.” This means that the ears are closely related to all organs throughout the body. If the hearing has been lost or is failing, it indicates the functions of the viscera are declining.

9、腰腿灵便 肝主筋、肾主骨、腰为肾之腑、四肢关节之筋皆赖肝血以养,所以腰腿灵便、步履从容,则证明肝肾功能良好。

  1. The lumbar and legs are agile.

The liver governs the sinews, and the kidneys govern the bones. The lumbar is the house of the kidneys.  The liver blood supports the sinews of the four limbs and joints. Therefore agility in the lumbar and legs plus stability in walking can prove the liver and kidneys are functioning properly.

10、声音宏亮 声由气发,《素问·五脏生成篇》说;“诸气者,皆属于肺”,声音宏亮,反映肺的功能良好。

10. The voice is resonant.

The voice comes from the qì. According to “Plain Questions: Treatise on the Engenderment of the Five Viscera”, “The  of the body belongs to the lungs.” A resonating voice indicates that the lungs are functioning well.

11、须发润泽 发的生长与血有密切关系,故称“发为血之余”。同时,又依赖肾脏精气的充养。《素问·六节胜象论》说:“肾者……其华在发”。因此,头发的脱落、过早颁白,是一种早衰之象,反映肝血不足,肾精亏损。

11. The beard and hair are moist and glowing.

The growth of hair is closely related to blood. “Hair is the surplus of the blood.” At the same time, hair relies on the support of the kidneys. “Plain Questions: Treatise on the six Periods and Visceral Manifestation” says, “the kidneys, its bloom is in the hair”. Therefore, hair loss and premature graying is the manifestation of premature debility, which reflects the insufficiency of liver blood and depletion of the kidney essence.

12、食欲正常 中医学认为,“有胃气则生,无胃气则死”,饮食的多少直接关系到脾胃的盛衰。食欲正常,则是健康的反映。

12. The appetite is normal.

According to Chinese medicine, “The body lives by the stomach , the body dies without the stomach ”. The amount of food and drink taken in directly influences the exuberance or debilitation of the stomach. Thus, a normal appetite is a reflection of health.

(二)心理健康特征

1、 精神愉快 《素问·举痛论》说:“喜则气和志达,营卫通利”,可见良好的精神状态,是健康的重要标志。七情和调、精神愉快,反映了脏腑功能良好。现代医学 亦认为,人若精神恬静,大脑皮层的兴奋与抑制作用就能保持正常状态,从而发挥对整体的主导作用,自能内外协调,疾病就不易发生。

(2)  The characteristics of psychological health.

  1. Happy state of mind

“Plain Questions: Treatise on Pain” says, “Happiness leads to harmonious , and the yíng qì and wèi qì will be unblocked”. A happy state of mind is an important sign of one’s health. When the seven affects are harmonious and the state of mind is happy it is a reflection of properly functioning viscera. Modern medicine also believes that a tranquil mind can maintain a normal state within the excitatory and inhibitory function of the cerebral cortex, which plays a leading role in the function of the whole body. Once the interior and exterior are in concert and harmony, it will difficult for the body to contract an illness.

2、记忆良好 肾藏精、精生髓,而“脑为脑之海”。髓海充盈,则精力充沛,记忆力良好;反之肾气虚弱,不能化精生髓,则记忆力减退。

  1. Good memory

The kidneys store essence. The essence produces marrow, and “the brain is the sea of marrow”. If the sea is full, a person will be full of energy and exhibit a good memory. If the kidney  is weak and cannot transform the essence into marrow, the memory will decline.

第三节 衰老

衰老是人类正常生命活动的自然规律,人类的机体在生长发育完成之后,便逐渐进入衰老(或称衰退)的过程。探讨衰老的概念、原因和衰老时的生理、病理改变,以至防止衰老的措施,是十分重要的。

衰 老可分为两类,即生理性衰老及病理性衰老。生理性衰老系指随年龄的增长到成熟期以后所出现的生理性退化,也就是人体在体质方面的年龄变化,这是一切生物的 普遍规律。另一类为病理性衰老,即由于内在的或外在的原因使人体发生病理性变化,使衰老现象提前发生,这种衰老又称为早衰。

Section Three: Aging

Aging is a normal human life activity within the laws of nature. After the human body reaches maturity, it gradually enters the process of aging. It is therefore, very important to explore the concepts and causes of aging, as well as the physiological and pathological changes, so as to prevent the process of aging.

Aging can be divided into two types: physiological and pathological. Physiological aging refers to the physiological decline that takes place after the maturity of the body, namely, the constitutional changes of the human body with age. This is common to all living creatures. Pathological aging refers to the pathological changes of the human body due to internal or external elements, which causes aging to occur earlier than normal. It is also called premature aging.

一、衰老的原因

中医学在对衰老原因的认识上,非常重视脏腑功能和精气神的作用,又很强调阴阳协调对人体健康的重要意义。兹简述如下。

1、肾阳亏虚 肾为先天之本,人的生长发育衰老与肾脏的关系极为密切。《素问·上古天真论》中“女子七七”、“丈夫八八”的一段论述,即是以肾气的自然盛衰规律,来说明人体生长、发育、衰老的过程与先天禀赋的关系,从而提示衰老的关键在于肾气的盛衰。

肾属水,主藏精,为元气之本,一身阴阳生化之根。肾的盛衰影响着元气的盛衰和生化功能的强弱,肾虚则元气衰,元气衰则生化功能弱,人的衰老就会加速到来。

  1. The reasons of aging

In terms of aging, Chinese medicine attaches great importance to the functions of the viscera and the roles of the essence, , and spirit. It also emphasizes the significance of balancing yīn and yáng for the health of human body.

  1. Kidney vacuity

The Kidneys are the root of the former heaven essence. The growth, maturity, and aging of the human body have an exceedingly close relationship with the kidneys. “Plain Questions:  Treatise of Heavenly Truth from Remote Antiquity” expounds “The essence  becomes exhausted at the age of 49 for females and 64 for males.” This tells the relationship between the process of growth, maturity, and aging of the human body and the former heaven essence through discussing the natural exuberance and debilitation of the kidney , so as to reveal that the key reason of aging lies in the exuberance and debilitation of the kidneys.

The kidney belongs to water and governs the storage of the essence. It is the root of the original , and of yīn and yáng engenderment and transformation. The exuberance or debilitation of the kidneys influences the exuberance and debilitation of the original  and its engendering and transformation functions. Thus, kidney vacuity leads to original  vacuity, which further weakens engenderment and transformation, and therefore the body experiences premature aging.

2、 脾胃虚衰 脾胃为后天之本,水谷皆入于胃,五脏六腑皆禀气于胃。若脾胃虚衰,饮食水谷不能被消化吸收,人体所需要的营养得不到及时补充,便会影响机体健 康。从而加速衰老,甚至导致死亡。《内经》明确指出阳明为多气多血之经,而“阳明脉衰,面始焦、发始堕”是衰老的开始表现。

脾胃属土,为一身气机升降之中枢,脾胃健运,能使心肺之阳降,肝肾之阴升,而成天地交泰。若脾胃虚损,五脏之间升降失常,就会产生一系列的病变,从而影响健康长寿。

  1. Spleen and Stomach vacuity debilitation

The spleen and stomach are the root of the latter heaven essence. All grains and water enter the stomach. The five viscera and six bowels receive  from the stomach. If the spleen and stomach become vacuous and debilitated, food and drink will not be properly digested, the nutrition required by the body will not be properly provided, and the health of the physical body will be affected, In this way the aging process will accelerate and may even lead to death. “The Yellow Emperor’s Inner Canon” clearly points out that the yáng brightness channel has copious  and copious blood, and “if the yáng brightness pulse becomes debilitated, the face begins to turn sallow, and the hair begins to fall”, this marks the beginning of aging.

The spleen and stomach belong to earth.  They serve as the body’s pivot for governing the upbearing and downbearing of the  mechanism throughout the body. When the spleen and stomach’s function of movement is fortified it will be able to assist the heart and lung yáng  to downbear, and the liver and kidney yīn qì to upbear.  This will promote a peaceful interaction between heaven and the earth. If the spleen and stomach vacuity-detriment leads to abnormal upbearing and downbearing of the five viscera, it will produce a series of diseases thus affecting the health and life span.

3、心脏虚衰 心藏神,主血脉,《素问·灵兰秘典论》称其为“君主之官”。心为生命活动的主宰,协调脏腑、运行血脉。心气虚弱,会影响血脉的运行及神志功能,从而加速衰老,故中医养生学尤其重视保护心脏。认为“主明则下安,以此养生则寿,……主不明则十二官危”。

  1. Heart Vacuity and Debilitation

The heart stores the spirit and governs the blood vessels. The heart is named “the office of the monarch” in “Plain Questions: Treatise of the Arcane Book of the Orchid Chamber of the Spirit Tower”. The heart governs the life activities, coordinates the viscera, and propels the blood through the vessels. Heart  vacuity affects the movement of the blood through the vessels and the spirit-mind thus accelerating the aging process. For this reason Chinese Medicine life cultivation studies pay special attention to the protection of the heart. According to Chinese Medicine, “if the monarch is sagacious, the subjects will be secure”. If one follows this principle of life cultivation the life will be long.  If the monarch is not sagacious, the twelve officials (the twelve organs) will be in danger”.

4、肝脏衰惫 肝藏血,主疏泄,在体为筋,关系到人体气机的调畅,具有贮存和调节血量的作用。如《素问·上古天真论》说:“七八,肝气衰,筋不能动”,即说明人体衰老的标志之一——活动障碍,是由肝虚而引起的。

  1. Liver Debilitation and Exhaustion

The liver stores the blood and governs free coursing. It manifest within the sinews of the body. The liver is related to the unimpeded regulation of the body’s  dynamic.  It also possesses the ability to store and regulate the blood. As “Plain Questions: Treatise of Heavenly Truth from Remote Antiquity” says, “at the age of 56, the liver  declines, and the sinews cannot move”. This illustrates that hindered movement may result from liver vacuity.

5、肺脏衰弱 肺主一身之气,《素问·六节藏象论》说:“肺者,气之本”。肺气衰,全身机能都会受到影响,出现不耐劳作,呼吸及血液循环功能逐渐减退等衰老表现。

  1. Lung Debilitation and Weakness

The lungs govern the  of the whole body. “Plain Questions: Treatise on the Six Periods and Visceral Manifestation” says, “The lungs are the root of  ”. Lung  debilitation will affect the function of the whole body, which may manifest such aging signs as decreased stamina, a gradual decline of respiration and blood circulation, etc.

6、 精气衰竭 精气是人体生命活动的基础,人的四肢、九窍和内脏的活动以及人的精神思维意识,都是以精气为源泉和动力的。因此,尽管人体衰老的因素繁多,表现 复杂,但都必然伴随着精气的病变,精气虚则邪凑之,邪势猖獗则精损之,如此恶性循环则病留之。《素问·阴阳应象大论》曰:“年四十,而阴气自半也,起居衰 矣;年五十,体重、耳目不聪明矣;年六十,阴痿、气大衰、九窍不利、下虚上实、涕泣俱出矣”。具体阐述了由于阴精阳气的亏损,人体会发生一系列衰老的变 化。

  1. Exhausted  and Essence

The  and essence are the basis of life activities. They are the motive source of the limbs, the nine orifices, the internal organs, the spirit, thoughts and consciousness. Although there are various factors for ageing, all are inevitably accompanied by a pathology of the  and essence. Where there is vacuity of the  and essence evil collects; rampant evil further depletes the essence; the disease compounds within this vicious cycle. “Plain Questions: Great Treatise on the Correspondences and Manifestations of Yīn and Yàng ” says, “at the age of 40, half of the yīn qì has waned, and the activities of daily life start to decline; at the age of 50, the body feels heavy, the ears and eyes are no longer acute and bright; at the age of 60, the yīn wilts, the kidney  greatly declines, the nine orifices are inhibited, the lower body becomes deficient and the upper body becomes replete.  There will be frequent tearing and nasal discharge”. This expounds that the body will undergo a series of changes due to the yīn essence and yàng qì depletion.

7、阴阳失调 阴阳的盛衰是决定寿命长短的关键,保持阴阳运动平衡状态是延年益寿的根本。《素问·阴阳应象大论》中就明确指出人的衰老 同阴阳失调有关,即“能知七损八益,则二者可调,不知用此,则早衰之节也”。可见,阴阳失调能导致衰老,而调节阴阳就有抗衰老的作用,人到中年以后,由于 阴阳平衡失调,机体即可受到各种致病因严的侵袭,从而疾病丛生,出现衰老。

  1. Yīn Yàng Disharmony

The exuberance or debilitation of yīn and yàng is the key to one’s life span. Maintaining a balanced state within the movements of yīn and yàng is at the root of prolonging life. “Plain Questions: Great Treatise on the Correspondences and Manifestations of Yīn and Yàng clearly points out that aging has a direct relationship with the disharmony of yīn and yàng. It states, “If the sevenfold reduction and eightfold boost is realized, yīn and yàng can be regulated; ignorance of this will lead to premature senility”. It can be seen that a yīnyàng disharmony can lead to aging, and harmony between yīn and yàng can resist aging. Because of a yīnyàng disharmony, middle-aged people are susceptible to the attack of various diseases, which further results in aging.

二、早衰的原因

(一)社会因素

《素问·疏五过论》指出:“故贵脱势,虽不中邪,精神内伤,身必败亡”。由于社会地位的急剧变化,会给人带来精神和形体的衰老。

现 代医学研究表明,很多精神疾病和躯体疾病,都与激烈的竞争,过度紧张的社会生活有直接关系,如美国综合医院门诊部对病人进行随机研究,发现65%的病人, 与社会逆境、失业、工作不顺利、家庭不和等因素有关。不合理的社会制度、恶劣的社会习俗、落后的意识形态,以及人与人之间种种斗争矛盾等,都可使人体代谢 功能紊乱,导致早衰。

II.  Reasons of early aging.

  1. Social factors

“Plain Questions: Treatise Explaining the Five Errors” points out, “When high-ranking officials lose their power, even without contraction of evil, their spirits will be internally damaged and their bodies are bound to be destroyed”. This illustrates that drastic changes within social positions can influence premature aging in both body and spirit.

Modern medical research has proved that many diseases, mentally and physically, are directly related with intense competition and excessive stress. According to the statistics by an American general hospital outpatient clinic, 65% of patients are associated with factors such as adverse social circumstances, unemployment, work conflicts, family disharmony, etc. Unreasonable social systems, contemptible social customs, regressive ideologies, and various conflicts amongst people can cause metabolic disorders that lead to premature aging.

二,自然环境

《素问·五常政大论》中指出:“高者其气寿,下者其气夭”。高,是指空气清新,气候寒冷的高山地区;下,是指平原地区。因为“高者气寒”,生物生长缓慢,生长期长,寿命也就长。而“下者气热”,生物生长较快,寿命就相应短促。

现 代研究认为,自然环境对人体健康影响很大。当有害的环境因素长期作用于人体,或者超过一定限度,就要危害健康,促进早衰。如空气污染造成空气中过氧化物增 加,衰老是和体内过氧化脂质的生成同时发展的。此外,污染的空气中可含有功多的致癌物质,如苯胼蓖、朕苯胺、α-萘胺等。有些工业废水上百万吨倾入江湖, 以致出现鱼类大量死亡;严重水污染造成人慢性铅、砷、镉中毒等。

  1. Natural environment

Plain Questions: Great Treatise on the Five Normal Rules” points out, “Those who live in high places have longer life; those who live in low places have shorter life”. High places refer to the high mountainous areas where the air is fresh and the climate is cold; low places refer to the plains. Because “it is cold in high places”, living beings will have a slower and longer growth  period, and thus will have prolonged life. Because “it is hot in low places”, living beings will mature more rapidly and thus have a shorter life span.

According to modern research, the natural environment has a tremendous influence on the health of the human body. It can be harmful to one’s health if one endures detrimental environmental factors for an extended amount of time or exceeds certain limits. For example, while air pollution increases peroxide levels, ageing takes place with the generation of lipid peroxidation. Furthermore, polluted air may contain large amounts of carcinogens, such as benzopyrene,benzidine,and α-naphthylamine。Millions of tons of industrial waste water is dumped into the rivers and lakes, which results in the death of multitudes of fishes. Serious water pollution can lead to chronic lead, arsenic and cadmium poisoning, plus others.

三,遗传因素

大量事实证明,人类的衰老和遗传有密切关系, 因遗传特点不同,衰老速度也不一样。正如王充在《论衡·气寿篇》中所说;“强寿弱夭,谓禀气渥薄也……夫禀气渥则其体强,体强则寿命长;气薄则其体弱,体 弱则命短,命短则多病寿短”,“先天责在父母”,先天禀赋强则身体壮盛,精力充沛,不易变老。反之,先天禀赋弱则身体憔悴,精神萎靡,变老就提前或加速。

  1. Hereditary factors

A host of facts indicate that aging is closely related to hereditary factors. The rate of aging varies due to different hereditary characteristics. As Wángchōng says in “Lùn Héng: Treatise on Life Span”, “If the body is strong, the life is longer; if the body is weak, the life is shorter. This depends on how much  one has been endowed …the body is strong with more , which results in a longer life; the body is weak with less , which results in a shorter life”, “all these are congenitally decided by the parents”. If the natural endowment is strong, the body is strong and energetic; if the natural endowment is weak, the body is weak and the spirit is dejected, and thus the aging process arrives early.

四,七情太过

此 指长期的精神刺激或突然受到剧烈的精神创伤,超过人体生理活动所能调节的范围,就会引起体内阴阳气血失调,脏腑经络的功能紊乱,从而导致疾病的发生,促进 衰老的来临。我国民间有“笑一笑,十年少”,“愁一愁,白了头”的谚语,就是这个道理。正如《吕氏春秋》中所说的:“年寿得长者,非短而缓之也,毕其数 也。毕数在乎去害。何谓去害?……大喜、大恐、大忧、大怒、大衰,五者损神则生害矣”。

  1. Excess of the seven affects

Long-term mental stimuli or a sudden traumatic experience, if exceeding the range the human body’s regulatory capabilities, will lead to the disharmony of yīn, yàng , , and blood, plus the functional disorder of the viscera and channels, and thus result in illness and ageing. There is a popular saying in China that “laughter can make people ten years younger”, “Worry can make people’s hair turn gray”. “Lǚ’s Spring and Autumn” says, “Long life means being able to live out one’s full span instead of trying to prolong a short life. The key to living one’s full span is to get rid of harm. How can one rid the self of harm?  Excessive joy, fear, worry, anger, and sorrow, these five can injure one’s spirit and produce harm”.

五,劳逸失度

《素问·上古天真论》曰:“以妄为常……故半百而衰也”,这里明确指出,把妄作妄为当作正常的生活规律,只活到五十岁就已显得很衰老了。所谓妄作妄为,是指错误的生活方式,它包括范围很广,如劳伤过度,房劳过度,过于安逸等等。

  1. ­Imbalance of work and rest

Plain Questions: Treatise of Heavenly Truth from Remote Antiquity” says, “Taking an irregular life as normal, that’s why the present people become old and feeble at the age of 50”. “Taking an irregular life as normal” refers to the living an improper life style, which includes many aspects, such as damage from over exertion, excessive sexual taxation, or excessively easy and comfortable living, etc.

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One comment on “中医养生学的基本理论 – The Basic Theory of Life Cultivation of Chinese Medicine

  1. Andy Lininger says:

    very clear and concise.

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