In recent years, developing Chinese medicine through “sublation” — selectively keeping what is useful while discarding the rest — has become the prevailing view in intellectual circles. This process of sublation may appear, from a philosophical standpoint, to offer a lofty method of dialectical selection, but in reality it is fundamentally flawed — like building a skyscraper on sand. It is neither advisable nor credible.
How traditional Chinese medicine (TCM) can be effectively inherited in modern society has become one of the most difficult questions of our time. Almost everyone agrees that inheritance must come before development; the key lies in how to inherit. After Professor Tu Youyou won the 2015 Nobel Prize, TCM was once again thrust into the spotlight. In summarizing the lessons of her achievement, some reached this conclusion:
The advent of artemisinin offers us this启示: for traditional resources, we must not only preserve but also innovate, subjecting them to sublation within the perspective of modern civilization.
So the question arises: how exactly does one sublate?
Some have offered this answer:
Seek truth from facts. Promote the rational and essential elements of TCM. Correctly handle the incorrect and unscientific aspects. Absorb the advanced achievements of world medicine, discard the outdated to bring forth the new, and make foreign medicine serve China and ancient medicine serve the present. Accept criticism with an open mind, have the courage to uphold truth, and be willing to correct errors. Encourage academic debate and let TCM grow through contention. TCM has survived for millennia — this alone speaks to its rationality. The development of TCM should proceed with urgency toward reform. Reform does not mean Westernization, nor does it mean keeping only the herbs while discarding the medical theory. It means applying modern science and technology to study traditional Chinese medicine. The modernization of TCM is a process of sublation. Advancing with the times and striving ceaselessly should become the soul of TCM’s survival and development.
I am utterly baffled. What does it mean to “correctly handle” the “incorrect and unscientific” content of TCM? Science is not a conductor’s baton, still less is it truth itself — it is a spirit of questioning. Some of today’s TCM researchers understand neither TCM nor science; they are merely porters of outdated Western technology.
TCM has accumulated vast riches over thousands of years of development. No matter how turbulent history has been, it has always left behind a heritage. What we must do first is protect this heritage. Whatever our ancestors left us — even a broken shard of pottery — has weathered a thousand years of wind and rain; if it has earned no merit, it has at least earned our respect. Yet the prevailing practice today is to “sublate” anything we cannot understand, or anything we presumptuously deem useless, backward, or feudal. “Sublation” is putting it kindly — in truth, it means throwing things away. This is nothing short of criminal. How can you possibly know that this information won’t prove invaluable someday?
Consider the prescription called Shao Kun San from the Shanghan Lun (Treatise on Cold Damage). Because its composition seems utterly implausible to modern sensibilities, it has been banished to the category of feudal superstition. Many contemporary publications on the Shanghan Lun omit it entirely. This approach is deeply wrong and thoroughly unscientific — we have never tested the validity of this prescription, yet we consign it to the discard pile based solely on “experience.”
Consider another example. If Professor Tu Youyou had never read the Zhouhou Beiji Fang (Handbook of Prescriptions for Emergencies), or if she had dismissed the instruction — “take a handful of sweet wormwood, soak it in two sheng of water, and wring out the juice” — as a primitive, backward method to be sublated, would we have artemisinin today? Or suppose she had not used the inexpensive “low-temperature cold extraction method” but instead designed an elaborate industrial process to extract artemisinin — would it have become a “luxury drug,” unable to solve the malaria crisis affecting hundreds of millions of people in Africa?
One final example. When Mr. Yu Yunxiu led the campaign against TCM in the early twentieth century, the most fiercely debated topic between him and the TCM establishment was the theory of the Five Movements and Six Qi (Wuyun Liuqi). For reasons both obscure and well-known, this theory was cast into the dungeon of feudal superstition, languishing for decades, nearly lost to history. To this day, it has not been incorporated into the main text of national standardized textbooks, and many TCM university students have never even heard of it. Little do people know that after the SARS outbreak in 2003, far-sighted TCM scholars drew upon the Five Movements and Six Qi theory to help formulate sound national prevention and control strategies, giving rise to an entire school of thought. Whether the Five Movements and Six Qi theory is “scientific” is beside the point — that question cannot yet be settled. What is certain is that this theory constitutes the true theoretical foundation and logical framework of TCM. The reason textbooks only cover Yin-Yang, Five Elements, and the Zang-Fu and meridian systems is simply that the discipline’s founders were not sophisticated enough, and their successors were too enamored of antiquity on the one hand and too worshipful of the West on the other. This is the real face of “sublation.”
If this kind of sublation is allowed to continue unchecked, TCM will undoubtedly become a tomb raider’s gold mine — the glittering gold will be carried away, while priceless treasures that don’t gleam, or that the raiders simply don’t want, will be trampled underfoot, dissolved into the mud of history, and buried forever beneath the weight of human greed and ignorance.
TCM is a great treasure house. Its inheritance should not proceed through sublation but through a cautious and reverent attitude toward the existing heritage. We should preserve as much as we can. If our generation cannot fully inherit it, we can pass it on to the next. If we cannot inherit it, we can pass it to others. Only when inheritance is secure can development follow. Why is it that we so often hear people say, “Such-and-such foreign research actually anticipated what TCM said long ago”? Why are we always firing retrospectives? Isn’t it precisely because we have neither properly inherited nor properly developed?
What I want to say is this: regarding the various branches of TCM knowledge, we should neither casually dismiss nor casually affirm. The TCM education our generation received has been castrated — severely limited. Unless we can set aside the rigid frameworks of our textbooks, it will be exceedingly difficult to grasp the profound intentions of the ancients as we study the classics and practice clinical medicine.
中文原文 / Chinese Original
近年来，在扬弃中发展中医成为了思想界的主流。”扬弃”的过程看似是从哲学角度高屋建瓴地给出了一种辨证取舍方法，实质上是先天不足，沙漠中盖大楼，不仅不可取，而且不可信。
传统中医如何在现代社会得到有效的继承已经成了难中之难的一个问题，几乎所有人都认为要先继承后发展，关键在于如何继承。屠呦呦老师在获得2015诺贝尔奖后，中医又被推到了风口浪尖，有人在总结获奖启示中得到了这样一条结论：
青蒿素的问世给予我们的一个启示就是，对于传统资源，我们要传承更要创新，要将其置于现代文明视野中加以扬弃。
那么问题来了，怎么扬弃？
有人给出了这样的回答：
实事求是，发扬中医合理的部分，精华内容。正确对待中医不正确、不科学的内容。吸收世界医学先进内容，推陈出新，使洋为中用，古为今用。正确对待批评意见，勇于坚持真理。勇于纠正错误，开展学术争鸣，让中医在争鸣、辩论中成长。中医能存在千年不衰，有其合理性。中医药发展，应该尽快革新。革新不是西化，不是弃医存药，而是应用现代科学技术研究传统中医药学。中医现代化是扬弃的过程。与时俱进，自强不息，应该成为中医生存与发展的灵魂。
我百思不得其解，什么叫正确对待中医”不正确、不科学的内容”？科学不是指挥棒，更不是真理，而是一种质疑的精神。现在的一些中医研究人员，不仅不懂中医，更不懂科学，他们只是西方落后技术的搬运工而已。
中医历时了千年发展，积淀甚多，无论历史上怎么折腾，总也留下了一些遗产。我们对于这些遗产，首先要做的是保护好，无论祖先给我们留下了什么，哪怕是一个碎瓦片，那也是历经了千年风雨，没有功劳也有苦劳。可是现在的通行做法是，某些我们现在理解不了的事物，或者我们想当然地认为没有用的、落后的、封建的东西，都会被”扬弃”，说扬弃是好听点，其实就是扔了不要了，这简直就是犯罪，你怎么知道这些信息在以后没有用武之地？
举个例子，伤寒论中有个处方叫烧裩散，这个方子由于其组成非常不可思议，直接被打入了封建落后迷信的范畴，现代许多伤寒论文献出版物中都不会看到这个内容。这种做法是十分错误的，是不科学的，因为我们没有验证这个处方的正确性，而是直接凭借”经验”把他归结到应该被扬弃的范围内。
再举个例子，如果屠呦呦老师没有读肘后备急方，或者把”青蒿一握，以水二升渍，绞取汁”当作一种朴素的落后的方法加以扬弃，我们现在还会看到青蒿素么？或者说如果屠老师没有应用价格低廉的”低温冷萃法”，而是设计应用了一种非常复杂的工艺提取了青蒿素，那么青蒿素会不会成为”贵族药”，还能不能解决数亿非洲人民的疟疾问题？
最后举个例子，余云岫先生当年在反中医的时候，与中医界争论最激烈的就是五运六气的问题，由于众所不知和众所周知的原因，运气学说从此被打入封建迷信思想的冷宫，几十年不得翻身，几近失传，至今仍未被编入国家统编教材正文，许多中医大学生甚至完全没听说过。岂不知2003年SARS疫情发生后，中医界有识之士借鉴运气学说为国家制订了正确的防控策略，并以此为基础造出了某某学派。先不说五运六气科学不科学，这个暂时无法证明，但是无论如何五运六气理论才是中医学的真正的理论基础和推演逻辑，教科书中之所以只讲阴阳五行和脏腑经络无非是当年的学科奠基人水平不够，后继的人又过于”尚古崇西”，这便是”扬弃”的真实表现。
如果任由现在这样扬弃下去，中医无疑会成为盗墓者的掘金场，闪闪发亮的金子自然会被取走，其他的无价之宝、不发光的、或者他们不想要的东西，都会在盗墓者脚下被踩碎，化入历史的青泥，永远淹没在人们的贪婪和无知之中。
中医药是一个伟大的宝藏，中医的继承不应该扬弃，而应该以审慎的态度对待现有的遗产，能继承多少就继承多少，这一代继承不了可以留给下一代，我们继承不了可以留给别人。继承好了还能发展，为什么我们现在老说国外的某某研究其实中医早就说过了，为什么总爱放马后炮呢，不就是因为我们既没有好好继承，更没有好好发展么？
我想说的是，对于中医的各种知识，既不能轻易否定，更不能轻易肯定，我们这代人接受的中医教育都是阉割过的，非常局限，如果不能放下教科书中的条条框框，就很难在读经典做临床的过程中体会到古人那些别有用心的意图。
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