论司内揣外辨证观.doc

inside-out dialectical viewSpecialty: Clinical Basic-ShangHanLun of TCMAuthor: Peizeng HuTutor: prof Jianguo JiangABSTRACTBy studying LingShu WaiChuai,the author raises the topic on theory of inside-out andoutside-in with a totally new view, discusses it mainly from perspectives of philosophyessence，sum-up of classic books pre-Han Dynasty, theory researches and practical casesetc.This dissertation discusses “inside-out“ on the aspects of“inapparentness““apparentness“,“existence-inexistence“, dialectical relationship of underlying laws andapparent symptoms; points out the study lays emphasis on“nei“ and explores how tounderstand “nei“; as well, raises the criteria of standardizing“inside“should be“inapparentness” .In the company of the relativity and flexibility referred by “nei” “wai”“yuan” “jin”, “nei” is defined as “underlying law”, sometimes termed as “dao”.As for the human being, mastering life’s “underlying law” is the precondition of caringlife and treating potential disease.Only if the internal‘dao’is grasped can we foresee andtake measures of life-and-health care, initiative treatment and after-illness recuperation.Furthermore, this thesis explores the practical implementation of “inside-outdialectical view” within Shang Hang Lun in terms of customary disease name, symptomand pulse palpation diagnosis, treatment principles and solutions.The thinking mode of “inside-out dialectical view” in this thesis contributes positivesignificance to enriching the clinical practices of traditional Chinese medicine in diagnosisandtreatment,disposingthestereotypicalthinkingand,developingflexible,comprehensive and proactive diagnosis and treatment thinking.KeywordsInside-out thinking Outside-in thinking Yin-yang Dao目录引正言 ............................................................................................................................... 1文 ............................................................................................................................... 3一、对《内经》原文及注解的文献梳理 ........................................................................... 3二、“内”“外”“远”“近”“司”“揣”基本含义的研究 ................................... 7（一）传统观点对“内”与“外”的论述 ....................................................................... 7（二） 现代学者对“内”“外”意义的探析 ................................................................. 9（三）传统观点对“远”与“近”的论述 ..................................................................... 11（四）现代学者对“远”“近”意义的探析 ................................................................. 13（五）对“以脉司内”的不同看法 ................................................................................. 14（六）司内揣外的辨证思维特点 ..................................................................................... 18三、内外司揣辨证思维的哲学思想基础 ......................................................................... 20（一）《道德经》之“道”思想与司内揣外辨证观的形成 ........................................... 20（二）《周易》之“变”思想与司内揣外辨证观的形成 ............................................... 20（三）中庸之道与司内揣外辩证观的形成 ..................................................................... 21四、仲景司内揣外辨证思维研究 ..................................................................................... 21（一）病名冠称的司内揣外 ............................................................................................. 21（二）病证辨证的司内揣外 ............................................................................................. 23（三）脉象辨证的司内揣外 ............................................................................................. 24（四）治则治法的司内揣外 ............................................................................................. 25五、司内揣外辨证思维的具体应用 ................................................................................. 27（一）司内揣外与动态辨证观的关系 ............................................................................. 27（二）司内揣外与整体辨证观的关系 ............................................................................. 28（三）司内揣外与治未病的关系 ..................................................................................... 30（四）司内揣外与“方证相应”的关系 ......................................................................... 31结论 ............................................................................................................................. 34参考文献 ............................................................................................................................. 35致谢 ............................................................................................................................. 39发表论文 ............................................................................................................................. 40引言中医传统的辨证论治思维是司外而揣内，即通过望闻问切四诊，将人体表现于外的症状和体征，进行收集、梳理、分析、推理、进而诊断，我们将这个过程称之为司外而揣内。

司外揣内和司内揣外，均出自《灵枢·外揣》篇，云：“故远者，司外揣内，近者，司内揣外，是谓阴阳之极，天地之盖”现今的教科书论述中医的辨证论治，主要是讲司外揣内，很少讲司内揣外，这是极其片面的为了正本溯源，本文仅就“内”与“外”的概念、司内揣外的内涵及其辨证意义，作一探讨天人合一，内外相应，是中医学整体观的重要体现正气存内，邪不可干”，是中医学发病观的基本认识正是在这些理论的指导下，中医提出了“有诸内必形诸外”的疾病认识论，于是才有了通过“司外”而进行“揣内”的临床辨证观所谓天人合一，是说人作为自然界的生灵，生活在大自然中，人体之气与天地之气息息相关，处处呼应人体一小宇宙，天地一大宇宙，在人体则。