摘要：八卦与五行作为中华文明的核心哲学体系，分别代表了不同的认知维度。八卦以“天地水火风雷山泽”八种自然元素为基础，构建了人类生存环境的原始框架，其核心在于对自然现象的观察与象征（如乾为天、坤为地）。然而，八卦缺乏对人文因素的直接体现，尤其是金属文明出现前的局限性明

一、五行学说与八卦的哲学内涵及历史演变

八卦与五行作为中华文明的核心哲学体系，分别代表了不同的认知维度。八卦以“天地水火风雷山泽”八种自然元素为基础，构建了人类生存环境的原始框架，其核心在于对自然现象的观察与象征（如乾为天、坤为地）。然而，八卦缺乏对人文因素的直接体现，尤其是金属文明出现前的局限性明显。相比之下，五行学说（木火土金水）不仅涵盖自然元素，更融入了人类劳动与文明成果，形成了一套动态闭环的哲学体系。

五行中的“金”是理解其人文属性的关键。金属冶炼的出现（约5000年前）标志着人类改造自然能力的飞跃，如“金曰从革”体现了工具革新对社会变革的推动作用。金属工具的使用（如农具、武器）使“金克木”“火克金”等相生相克关系具有实践意义，反映了人类劳动对自然规律的主动适应。而八卦诞生于石器时代，其环境属性决定了它难以涵盖金属文明后的人文维度，因而五行学说在解释人与自然互动时更具包容性。

二、五行学说对中医学的方法论意义

中医经典虽鲜见《易经》直接引用，但其理论根基深植于阴阳五行。五行通过时空化与系统化构建了人体与自然的联系：时间上对应四季（春木、夏火、长夏土、秋金、冬水），空间上对应方位（东木、南火、中土、西金、北水），生理上关联五脏（肝心脾肺肾），形成“天人相应”的整体观。这种动态平衡模型超越了八卦的静态象征，通过相生相克解释了生命活动的调节机制（如肝木疏泄与肺金肃降的制约关系）。

五行的人文属性进一步强化了中医的实践性。例如“金生水”不仅指金属工具凿井取水，更隐喻肺气肃降促进肾水收藏的生理过程；“土生金”既描述矿石冶炼，也对应脾胃化生精微以养肺气的理论。这种将自然规律与人体功能类比的方法，使中医摆脱了具象束缚，转向功能关系的抽象把握，成为其区别于其他传统医学的核心特征。

三、中西医认识论的根本差异

西医基于“构成论”，从解剖结构与物质实体出发，通过微观分析（如细胞、分子）解释生命现象，强调“结构决定功能”。这种思维源自西方科学传统（如原子论），注重实证与量化，但暗物质、暗能量的发现揭示了其认知边界的局限性。中医则遵循“生成论”，从“无”到“有”的动态过程理解生命（如“气聚成形”），以阴阳五行为框架，通过象思维（如肝主疏泄、肾主蛰藏）构建功能模型，强调整体关联与动态平衡。

贝塔朗菲的系统论指出，科学最初依赖形象化模型（如原子作为微小实体），后转向数学抽象。中医的“生成论”与之异曲同工：五脏非解剖实体，而是功能集合；经络无解剖对应，却是气血运行的通道。这种大写意的认知方式（如电子云图般的概率描述）更贴近生命复杂系统的非线性特征，而西医的“构成论”则在还原分析中面临整体性缺失的困境。

四、五行学说的文明价值与现代启示

五行体系将自然规律与人文实践熔铸为一，其独特性在于：

1. 闭环动态性：相生相克构成自洽循环，避免单一线性因果的机械性；

2. 时空统一性：季节、方位、生理的跨维度关联，契合复杂系统的全息特征；

3. 人文融合性：金属文明与劳动智慧的纳入，使哲学体系具有历史演进张力。

对比其他文明（如古希腊四元素、佛教四大），五行对“金”的哲学提升彰显中华文明对技术革新的理性认知。在现代语境下，五行学说为系统科学、生态医学提供了传统智慧参照，其“关系优先于实体”的思维模式，与量子纠缠、生态系统理论形成跨时空呼应。

结语

五行学说作为“升级版八卦”，完成了从自然镜像到人文实践的哲学跃迁，使中医学成为“生成论”的典型范式。面对现代医学的挑战，重审五行智慧不仅关乎传统继承，更是对生命复杂性的重新诠释——在构成与生成、实体与关系的辩证中，中医的“升降出入”之道或将为未来医学开辟新的认知路径。

作者简介：梁世杰 中医高年资主治医师，本科学历，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。事迹入选《当代科学家》杂志、《中华英才》杂志。

Cao Dongyi: The theory of five elements and the construction of philosophy of Chinese medicine

I. The Philosophical Consequences and Historical Evolution of the Five-Point Theory and Gossip

As the core philosophical system of Chinese civilization, gossip and the five branches represent different cognitive dimensions. Based on the eight natural elements of "heaven and earth, water, fire, thunder, mountains," gossip has built the original framework of human living environment, and its core lies in the observation and symbolization of natural phenomena (such as dry as heaven and right as earth). However, gossip lacked a direct representation of the human factor, especially the limitations of the pre-metal civilization. In contrast, the Theory of Five Elements (wood, fire, earth, gold, water) not only covers natural elements, but also incorporates the results of human labor and civilization, forming a dynamic closed-loop philosophical system.

The "gold" of the five branches is key to understanding its human nature. The advent of metal smelting (about 5,000 years ago) marked a leap in man's ability to transform nature, as exemplified by the use of tools as a catalyst for social change by the 'gold' stencil. The use of metal restricting wood "and" fire restricting metal "has practical significance, reflecting the active adaptation of human labor to the laws of nature. Because gossip was born in the Stone Age, its environmental attributes make it difficult to encompass the human dimension of post-metal civilization, so the theory of the five rings is more inclusive in explaining human interactions with nature.

II. Methodological significance of the theory of the five branches in Chinese medicine

Although the classical Chinese medicine is rarely directly quoted in the Interpretation of Yin and Yang, its theoretical foundation is deeply rooted in the five branches of yin and yang. The five branches constructed the connection between the human body and nature through space-time and systematization: in time, they correspond to the four seasons (springwood, Summer fire, long summer earth, autumn gold, winter water, correspond in space to the positions (eastern wood, southern fire, medium earth, western gold, north water), and are physiologically related to the five organs (liver, heart, spleen, lung, kidney), forming a holistic view of "heaven and man correspond." This dynamic balance model goes beyond the static symbolism of gossip and explains the regulatory mechanisms of life activities (such as the constraint relationship between hepatic excretion and pulmonary suppression) through interactions.

The human nature of the five branches further strengthens the practical nature of traditional Chinese medicine. For example, "Jin Sheng Shui" not only refers to metal generating water, but also refers to the physiological process of lung qi descending and promoting the accumulation of kidney water; "Native gold" both describes ore smelting and corresponds to the theory that the spleen is produced with trace minerals to support the lungs. This method of analogizing natural laws with human functions has allowed traditional Chinese medicine to move away from symbolic bondage and toward abstract grasping of functional relationships, which has become a core feature that distinguishes it from other traditional medicine.

3. The fundamental differences between Chinese and Western medical epistemologies

Western medicine is based on "constitution theory," which starts from anatomical structure and material entities, explains life phenomena through microscopic analysis (such as cells and molecules), and emphasizes that "structure determines function." This type of thinking, derived from Western scientific traditions (such as the atomic theory), focuses on evidence and quantification, but the discovery of dark matter and dark energy reveals the limits of its cognitive boundaries. Traditional Chinese Medicine (TCM) follows the "theory of formation," in which life is understood as a dynamic process from "nothingness" to "being" (such as "qi gathering and forming"). It is based on yin and yang and the five elements (such as the liver controlling conveyance and dispersion, and the kidney controlling dormancy), and emphasizes the whole connection and dynamic balance.

Bertalanffy's system theory states that science initially relied on imagery models (such as atoms as tiny entities) and then moved to mathematical abstractions. The "generative theory" of Chinese medicine works in a similar way: the five organs are not anatomical entities, but function collections. The meridians have no anatomical correspondence, but are channels through which blood and air travel. This type of large-character cognitive approach (like probability descriptions in electronic cloud graphs) is closer to the nonlinear features of complex systems of life, while Western medicine's "constitution theory" struggles with a holistic deficit in reduction analysis.

IV. Civilizational value of the five-element theory and modern revelation

The five-sphere system fuses the laws of nature and humanistic practices into one, and its uniqueness lies in:

1. closed loop dynamics : interactions constitute a self-regulating cycle, avoiding the mechanical nature of a single cause and effect;

2. Space-time uniformity : the cross-dimensional correlation of seasons, orientation, and physiology corresponds to the holographic characteristics of complex systems;

3. Humanities fusion : The integration of metal civilization and labor wisdom has given the philosophical system a historical evolutionary tension.

Compared with other civilizations (such as the four elements of ancient Greece and the four major religions of Buddhism), the philosophical elevation of the five branches of "gold" demonstrates the Chinese civilization's rational understanding of technological innovation. In the modern context, the pentatonic theory provides traditional intellectual reference for systems science and ecomedicine, and its "relations prioritize entities" mindset resonates across space and time with quantum entanglement and ecosystem theory.

Conclusion

As an "upgraded version of gossip," the theory of the five rays completed the philosophical transition from the mirror image of nature to humanistic practice, making Chinese medicine a typical paradigm for "generation theory." In the face of the challenges of modern medicine, reexamining the wisdom of the five branches is not only about traditional inheritance, but also a reinterpretation of the complexity of life - in the dialectical debate of composition and creation, entity and relationship, traditional Chinese medicine's approach to "rise and fall" may open new cognitive pathways for future medicine.

Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.

来源：首都专家梁世杰一点号