.
Xiaoming Cheng
Abstract: Shen (spirit) is a concept that is highly representative of traditional Chinese medicine. It refers to the integration of mind and body. The main expression of this concept is “Shen,” which, to a large extent, represents life itself.
“Shen”(Spirit)in Chinese Medicine
Shen is the state of regularity within the universe, nature, and between heaven and earth:〖WTBZ〗 the climate、 environment、 geography, seasonal changes, all orderly activities and in harmonious relationships with humanity. It is a harmonious state of correspondence between man and nature. It operates in an orderly way within its own rules, from the unmanifest to the manifest, and from the manifest back to the unmanifest. It is both change, and maintaining a relative stability within the process of change. This is Shen. The creator, whom we currently do not fully understand, is responsible for creating the universe, nature, and life. We are unaware of the materials and methods used in this creation process. However, what we perceive is a world filled with a divine mechanism.
Shen is the form of existence for living beings: It is generally believed that the form of existence for living organisms is characterized by a “divine mechanism,” which is essentially marked by the dynamic changes of respiration, nutrition, excretion, reproduction, and other processes related to the “ascending and descending, entering and exiting” of vital energy. This represents the metabolic processes of lifes sustenance, as well as the biological consciousness, autonomous perception of the surrounding environment, and adaptive feedback.
When describing the physiological functions of the human body, “Shen” refers to the external manifestation of one’s physical and mental wellbeing： The saying:“on attaining spirit then there is a flourishing of life, when the spirit is lost then ere is death” summarizes the overall state of human life, which is the normal expression of physical and mental activities, as well as the normal functioning of physiological mechanisms. It represents the proper functioning and balanced maintenance of the vital energy qi within the human body, contributing to overall health.
The term “Shen” can represent a person’s spirit, psychological activities, and emotional state: It encompasses ones sensations, perceptions, consciousness, thoughts, psyche, and overall mental and spiritual wellbeing. Modern studies on the nervous system and abstract concepts such as “mental magnetic field” are explorations of the spiritual realm. This includes a series of mental and psychological activities such as spirit, soul, intellect, heart, intention, will, thought, wisdom, consideration, and dreaming, among others. For example, in traditional Chinese medicine, hun refers to a spirit that can exist outside of the body, while po represents cognitive abilities and is described as the capacity for understanding.
Shen is inspiration, it is the manifestation of creative thinking: a kind of guidance from the “higherdimensional world,” also referred to as “intuition” or “mindfulness” in Buddhism. People living in the threedimensional world can occasionally perceive information from the “higherdimensional” world, especially after conscious training, it becomes more evident. We refer to those who can occasionally glimpse the mysteries of the universe as individuals who can sensitively grasp each “inspiration” in the course of time and space, which is an opportunity for success. Whether a person succeeds or not largely depends on whether they pay attention to “inspiration,” whether they can seize it and not give up on it. Interviews with most successful individuals illustrate this point, as many of their initial decisions were derived from “inspiration,” also known as “intuition.”
Spiritual body and material body
In the saying “the heart governs the spirit”, the heart is described as the ruler of a small court, governing all other organs. It is important to perceive the heart as a spiritual entity, the seat of emotions and sentiments, which aligns with the understanding of many cultures all over the world. The same perspective is also prevalent in Western culture, particularly in the expression of love and emotions. When experiencing heartbreak, one would say, “My heart is broken,” rather than “My liver is broken” or “My brain is broken.” It can be said that the “heart” (and the spirit related to it in Chinese medicine) encompasses all the functions of the brain.
The proposition of the heart governing the spiritbrightness means to convey that the spiritual body (soul) is the fundamental ruler of the physical body, and it encompasses the governance of all material aspects of the body. It is the most explicit proposition that highlights the dominance of the spiritual entity over the physical entity. Physiologically, maintaining health and achieving a harmonious unity are under the governance of the “spiritbrightness”, and when it comes to pathological conditions, the focus of treatment should naturally be placed on the spirit. This principle applies particularly in acupuncture therapy:
“The heart governs the spiritbrightness” is a statement about the relationship between the spiritual body and the physical body, which is also a major subject of research in the 21st century (in terms of the integration of mind and body in medicine, etc).
One day, a former student of mine who had graduated over a decade ago came to my house to share his understanding of the “spiritual body” and the physical body. He told me about a case he personally treated: His 46yearold wife was diagnosed with breast cancer during a checkup. When they returned from the hospital, it felt like their world had collapsed. The husband and wife were both in tears, holding their heads in anguish, and even their child, not knowing what to do, voluntarily joined the sorrowful atmosphere. He told me that what made his wife most proud was her beautiful breasts, and she would rather die than undergo any treatment that could harm her body. The husband deeply loved his beautiful wife and embraced her tightly, gently patting her with his hand, comforting her. He told her not to be afraid, assuring her that he would be by her side no matter what happened. However, the fear and worry about the unknown progression of the disease still filled them with apprehension and fear.
He explained to his wife how integrative medicine approaches cancer. The explanation of integrative medicine can be summed up in two maxims:
Holistic perspective: Viewing a person as a whole, this wholeness is referred to as the “complete living organism,” which also encompasses the harmony between heaven and humanity. The content of the complete living organism includes the physical body, the spiritual body, the essence of life, and the independent individual energy attributes (such as theories of gender, and life).
Integrated Therapies: The emergence and occurrence of diseases are not solely attributed to single symptoms; they are inevitably accompanied by various functional disorders and changes. Therefore, the treatment approach cannot be singular either; it involves the integration of various therapies. We can understand this as a combination of mainstream medical practices such as pathological diagnosis, chemotherapy, radiation therapy, with complementary alternative therapies such as traditional Chinese medicine, acupuncture, or other nonmainstream medical treatments (including energy therapy, vibrational therapy, etc.). Additionally, psychological therapy for cancer, dietary therapy for cancer, physical exercise for cancer patients, engagement in social activities, group experiences and interactions, and prayer for cancer patients are also part of the integrative approach. The aim is to promote the improvement of cancer from physiological, mental, and lifestyle perspectives, provide comprehensive care for patients and their families, and reduce side effects and enhance physical strength during mainstream medical treatment.
Of course, he emphasized the relationship between the life system and the survival system (selfhealing system) and explained the understanding of “shen” (spirit). He delved into how traditional Chinese medicine comprehends the collaborative functioning of various body parts under the guidance of “shen,” particularly how the mental and physical bodies mutually regulate and interact with each other.
The wife is a biologist whose work revolves around scientific research. Under the dominant influence of materialism, she had never heard of the concept of the body being a “complete living organism” in her husbands explanation. She was also unaware of the bodys ability to selfbalance and selfregulate, which can enhance its selfhealing capabilities and restore its inherent state of health. As her husband slowly narrated the details, she gradually realized the role of “shen” and the irreplaceable vitality it brings to the physical body. She accepted her husbands explanation and actively cooperated with his proactive treatment. The student shared with me that most of the acupuncture points in his acupuncture treatment prescription were related to “shen,” such as Shen Ting (GV24), Bai Hui (GV20), Si Shen Cong, Shen Men (HT7), Ben Shen (GB13), and the points along the second line of the Bladder meridian, which are all associated with spirit, mind, and consciousness. Its worth noting that the points along the second line of the Bladder meridian exhibit tenderness in cases of breast cancer, and traditional needling techniques such as Bao Ci, Qi Ci, and Yang Ci can exert their unique effects on these points. Of course, he did not forget the principles of traditional Chinese medicine, especially the principles of syndrome differentiation and treatment. The selection of acupuncture points was adjusted based on changes in the overall constitution of the body. Half a year later, a miracle occurred. He told me that ever since his wife understood the concept of a complete living or ganism,she knew how to adjust her emotions, face the situation positively instead of fearing it, and cherish every day of her life. As a result, the family became more harmonious, joyful, and experienced an increased sense of happiness, amplifying the improvement in her condition of breast cancer.
Conclusion
“shen”（spirits) is a substance that exists unmanifested within the human body, and it governs the operations of both the mental and physical aspects. From a materialistic perspective, comprehending this intangible “shen” presents certain difficulties because materialistic thinking constrains us, making it challenging to grasp substances that are invisible but exist in reality.
“shen” is a concept that truly exists and is an unavoidable topic in discussions about health. Traditional Chinese medicine, by elaborating on the significance and manifestations of “shen” in various aspects of life activities from a holistic perspective, holds profound importance in guiding our understanding of mental activities, consciousness, and psychological activities in clinical practice.
Author Introduction:
Professor Xiaoming Cheng, a Chinese medicine physician at the Institute of Integrative Medicine, Harvard Medical School, Executive Associate Editor of New England Journal of Traditional Chinese Medicine, Visiting Professor of Zhejiang Chinese Medicine University, special expert of Shanghai Fudan Medical College and Huashan Hospital, holographic life system integration expert, has been engaged in Chinese medicine teaching, research and clinical work for 45 years at home and abroad.
He is the author of the English version of Acupuncture and Moxibustion Clinical Desk Reference and the Chinese version of Ten Lectures on TCM Methodology.
中醫裡的“神”
程曉明
摘要：“神”是中國醫學中表示“精神身體”的一個非常有代表性的命題， 這個命題的主要表示是 “神”，而 “神”很大程度上代表的就是生命。
中醫裡的“神”
神是宇宙自然天地間一切正常的狀態：
宇宙、 自然、天地之間的氣候、環境、地理、季節變化，一切有序的活動和與人類融洽的生存關係，是一種天人相應的和諧狀態。在各自的規則範圍内有序地運行，從不顯像到顯像，從顯像再回歸到虚無。這就是變化，在變化中維持一個相對的穩定，這就是“神”。就是我們現在不清楚的造物主是如何創造宇宙、自然、生命的，是用什麽材料、什麽方法創造的，但是我們感受到的就是一個充滿“神機”的世界。
神是生物體生命存在的形式：
一般認爲生命體存在形式爲有 “神機”意思是基本標誌是有呼吸、飲食、排泄、繁殖等 “昇降出入”的氣機變化。表示的是生命生存的代謝過程，也是生物意識和對周圍環境自主的感覺並做出適應反饋。
神在描述人體生理功能的時候表示的是人體心身健康的外在表現：
“得神則昌，失神則亡”説的就是人生命總貌的概括是心身活動正常的表現，當然也指生理機能的正常活動。表現的是組成人體氣機（能量）的正常運行并且保持健康的平衡。
神可以表示人的精神、心理活動和情志：
是人的感覺、感應、意識、思維，心理，精神體（靈魂）健康的總稱。現代對神經系統的研究和一些抽象的描述包括“意念磁場”等都是對精神世界的探索。 包括 “神、魂、魄、心、意、志、思、智、慮、夢。”等一系列精神，心理活動的内容。比如，中國醫學認爲，〖JP3〗“魂”是一種可以離體而存在的精神， 而 “魄”就是認知的能力，古代描述爲：“魄者，明白也”。
神是靈感，是創造性思維的表現：
一種來自 “高維空間”的提示，也有人稱爲是 “直覺”，佛學中稱爲“念”。在三維世界的人時不時的可以感受到來自“高維”的信息，尤其是在有意識的訓練以後更爲明顯。我們稱爲那些可以偶爾窺測天機的人，在時空的發展中能敏感地抓住每一次 “靈感”就是成功的機遇。 人的成功與否很大程度上决定於在意不在意 “靈感”，和能不能抓的住并且不放棄“靈感”。对大部分成功人士的訪談説明瞭這個問題，他們重大的决策很多都是來自“靈感”也就是“直覺”。
精神身体与物质身体
“心主神明”這個命題中把“心”描述成一個小朝廷的君主，統治着其它所有的臟腑。重要的是把心看成是一個精神、情志所在，這和世界上很多民族的認識相同，西方也是這樣。在愛情情志的表現中仍然如此，失戀了會説：我的心碎了，没有人説我的肝碎了，我的腦子碎了，可以説“心”包括了所有的大腦的功能。
“心主神明”要表示的就是精神身體（靈魂）是主宰身體一切的根本，同時包括所有的物質身體都屬於“神明”的管轄之内，是精神體主導物質體最明確的命題。
生理上在“神明”的統治下保持健康，完善的統一，病理上治療的側重當然是應該放在“神明”上。在針灸的治療上更是如此。“心主神明”告訴我們精神身體和物質身體之間的關係，也是21世紀研究的主要課題（腦體結合）。
曾經一個畢業了十幾年我以前的學生來我家和我分享了他對“精神身體”和物質身體”的理解， 告訴我一個他親手治療的病例: 46歲的妻子在一次檢查中被診斷爲乳腺癌, 從醫院回來後全家似乎天塌了,夫妻兩抱頭痛哭,孩子在邊上不知所爲也自願加入了悲傷的行列。他告訴我，因爲他妻子最使她驕傲的就是那對美麗的乳房,她寧願死,也不願意任何療法對自己的身體有所傷害。丈夫深愛着自己美麗的妻子,他緊緊地擁抱着她，用手輕輕地拍着,安慰着她。告訴她不要害怕,無論發生什麽他會一直陪伴在她身邊，但是那種對未知的疾病發展還是讓他們充滿了擔憂和恐懼。
他給妻子解釋了整合醫學是如何對待癌症的，“整合醫學”的解釋就是八個字：
整體觀念:把人看成一個整體，這個整體的命名是“完整生命體”。當然，這個生命體還有天人合一的感應。完整生命體包括物質身體、精神身體、生命本源和獨立的個體能量屬性（性，命學説）。
療法集成：疾病的産生和疾病發生後不是單一的症狀，一定是各種機能紊亂和功能的改變。所以治療方法也一定不是單一的，也就是各種療法的整合。我們可以理解爲:主流醫學的各種病理診斷、化療、放療等，同時配合非主流醫學的幫助, 如:中藥、針灸或者其他的非主流醫學治療包括(能量療法、振動療法等)。然後是癌症的心理療法, 癌症的飲食療法,癌症病人的鍛煉,癌症病人的社會活動, 癌症病人的團體經驗交流和癌症病人的祈禱。目的是從生理、精神、生活、家庭關懷各方面促進癌症的好轉和幫助癌症病人在主流醫學治療過程中减少副作用和增加體力。
當然，他着重解釋了生命系統和生存系統的關係（自愈系統），也説對“神”的理解，那就是傳統中醫是如何理解身體各部是如何在“神”的主導下共同工作的，尤其是精神身體和物質身體之間是如何相互調節和相互作用的。
妻子是一個生物學家,工作就是科學研究,在唯物主義學習的主導下從來就没有聽説過，身體居然是一個“完整生命體”，也没有意識到身體可以通過自我平衡、自我調節的功能，可以提高自愈能力的發揮，從而恢復身體本來健康的狀態。在丈夫的慢慢講述中,她慢慢地覺悟到了“神”的作用,以及“神”對物質身體不可取代的生命功效。 她接受丈夫的解釋,并且主動配合丈夫的積極治療。這位學生告訴我,在他的針灸治療處方中大部分的都是與 “神”有關的穴位,比如: 神庭(GV24),百會(GV20),四神聰(Sishenchong),神門(HT7),本神(GB13），以及膀胱經第二側綫那些都是與神、精神、意識有關的穴位。值得指出的是膀胱經第二側綫的穴位在乳腺癌疾患中明顯地有很多壓痛點,應對了胸痛及背的原則，傍刺、齊刺、楊刺等傳統刺法,可以在這些穴位上可以大展其獨特的作用。他當然不會忘了中醫傳統的辨证施治的原則,配穴更是根據全身體質的變化而變。半年後的檢查, 奇迹出現， 他告訴我,自從妻子懂得了什麽是完整生命體以後,就非常知道如何調整自己的情緒，不是害怕而是積極面對，過好和珍惜自己的每一天。隨之而來的是家庭的融洽、快樂、幸福感隨着乳腺癌的好轉更加倍增。
總結
“神”是一種在人體内不顯像存在物質，它主導着精神身體和物質身體的運作。從唯物主義的觀點來看，理解這種無形的“神”是有一定困難的，因爲唯物主義思想限制了我們，很難理解那些看不見但實際存在的物質。
“神”是一個真實存在的概念，也是無法在健康討論中逥避的話題。傳統中醫，通過從整體的角度來論述神在生命活動中各個方面意義和表現，對於指導我們理解精神活動、意識活動和心理活動在臨床上具有極其重要的意義。
作者簡介：
程曉明 教授，哈佛醫學院整合醫學研究所 中醫師；新英格蘭中醫雜誌 主編,浙江中醫藥大學客座教授；上海復旦醫學院、華山醫院特聘專家；全息生命系統集成專家。國內國外從事中醫教學、科研和臨床工作45年。
著有英文版《針灸臨床案頭參考》、中文版《中醫方法論十講》等著作。
