The Philosophy of DIKWP Active Medicine: Influence of Ancient and Modern Chinese and Western Philosophies on Medical Philosophy

Yucong Duan

International Standardization Committee of Networked DIKWP for Artificial Intelligence Evaluation(DIKWP-SC)

World Artificial Consciousness CIC(WAC)

World Conference on Artificial Consciousness(WCAC)

(Email: duanyucong@hotmail.com)

Abstract (English):Laozi's statement in the Daodejing, "故失道而后德，失德而后仁，失仁而后义，失义而后礼" ("When the Dao is lost, virtue appears; when virtue is lost, benevolence appears; when benevolence is lost, righteousness appears; and when righteousness is lost, ritual appears"), reveals the dynamic process of descending social value hierarchies and moral degradation. This paper takes this as a starting point and, in conjunction with Song-Ming Neo-Confucianism's "Preserve Heaven's principle, eliminate human desires" and Western modern philosopher Baruch Spinoza's rational philosophy emphasizing the understanding of necessity, explores the impact of these philosophical thoughts on ancient and modern Chinese and Western medical philosophies. By examining the diverse philosophical resources from Confucianism, Daoism, Legalism, Neo-Confucianism, and Western rationalism, this study analyzes their influence on medical ethics, holistic concepts, mind-body relationships, and health ideologies. The findings reveal that whether it is Laozi's Daoist naturalism, Neo-Confucianism's emphasis on Heaven's principle and inherent goodness, or Spinoza's rational necessity, these philosophies have significantly shaped the development of medical theories and practices. Through comparative analysis, the paper highlights how, in the context of contemporary globalization and multiculturalism, enhancing internal virtue and rational enlightenment can reduce the overreliance on external enforcement and formal regulations, thereby pursuing higher levels of human harmony and social justice.

Keywords:Daodejing, When the Dao is lost, virtue appears, Preserve Heaven's principle, eliminate human desires, Spinoza, Medical Philosophy, Holistic Concept, Mind-Body Relationship, Medical Ethics

Introduction: The Metaphor of Value Degradation and the Significance of Philosophical Comparison

Laozi's proclamation in the Daodejing, "故失道而后德，失德而后仁，失仁而后义，失义而后礼" ("When the Dao is lost, virtue appears; when virtue is lost, benevolence appears; when benevolence is lost, righteousness appears; and when righteousness is lost, ritual appears"), not only outlines the process of descending social value hierarchies but also metaphorically describes the evolution of medical ethics and health ideologies across different societal stages. Neo-Confucianism's "Preserve Heaven's principle, eliminate human desires" emphasizes the cultivation of inner virtue to return to the innate goodness of Heaven's principle, attempting to reverse the trend of degradation. Meanwhile, the Western modern philosopher Spinoza, from the perspective of rational necessity, advocates for freeing oneself from passive desires through rational understanding, thereby achieving mental freedom. These philosophical thoughts have not only shaped social ethics and political systems in their respective cultures but also profoundly influenced the development of medical philosophy. This paper conducts a comparative analysis to explore the impact of Laozi's, Neo-Confucianism's, and Spinoza's thoughts on ancient and modern Chinese and Western medical philosophies, revealing their profound influence on medical ethics, holistic concepts, mind-body relationships, and health ideologies.

I. Laozi's "When the Dao is Lost, Virtue Appears" — Multifaceted Connotations and Historical Context

During the late Spring and Autumn period, China was undergoing significant social transformations and the flourishing of various philosophical schools. Observing the chaotic societal landscape, Laozi traced back to the origin of the universe—the "Dao," viewing it as the fundamental principle from which all things emanate without deliberate interference. According to Laozi, in an ideal world, the Dao naturally governs, and humans do not need excessive rituals or systems to maintain harmony. However, in reality, human desires have surged, leading to a departure from the pure and simple alignment with the Dao. Consequently, "virtue" is employed to sustain the remaining natural goodness. When "virtue" becomes insufficient, people turn to "benevolence" to emphasize goodwill and care; if "benevolence" fails, they resort to "righteousness" to uphold justice and rules; ultimately, only formalized "rituals" remain as external mechanisms to enforce social order. This hierarchical logic not only serves as a classic metaphor in social and political philosophy but also vividly portrays the degradation of the human spiritual world from its original harmonious state to fragmented regulations.

1.1 Daoist Naturalism and Holistic Medicine

Laozi's concept of the "Dao" as the universe's origin underscores the harmonious integration of the human body with nature, emphasizing the balance of Yin and Yang and the Five Elements to achieve health. Daoist medical philosophy prioritizes prevention, aiming to maintain harmony within the body and its natural environment to prevent disease. Texts such as the Huangdi Neijing embody this holistic view, treating the body as an organic whole influenced by both internal and external environments.

1.2 Wu Wei (Non-Action) and Therapeutic Principles

The principle of "wu wei" (non-action) in medicine advocates for aligning with natural disease processes and avoiding excessive intervention. Daoist medical practice promotes the body's inherent self-healing abilities through dietary regulation, lifestyle adjustments, and emotional balance. This approach emphasizes the body's self-regulation and recovery, reducing reliance on external medications and advocating for the "superior physician treats diseases before they arise."

1.3 Health Preservation and Longevity Philosophy

Daoist health preservation philosophy, closely linked to Laozi's teachings, emphasizes inner cultivation, breath regulation, and practices like qigong to prolong life. Laozi's advocacy for a simple life and reduced desires is reflected in health practices that believe mental tranquility and physical health are inseparable. Through internal cultivation and external regulation, Daoist medicine seeks harmony and longevity.

II. The Spectrum of Confucian Thought: From Mencius and Xunzi to Song-Ming Neo-Confucianism

Confucianism addresses social order and human nature with both divergence and resonance with Laozi's ideas. Mencius emphasizes the inherent goodness of human nature, akin to Laozi's concept of "virtue." If everyone can cultivate their innate moral tendencies, society would require minimal rituals. In contrast, Xunzi posits that human nature is inherently evil, necessitating the use of rituals and laws to regulate desires—aligning more closely with the later stages of Laozi's hierarchy: "righteousness" and "ritual."

2.1 Mencius's Inherent Goodness and Medical Ethics

Mencius advocates that human nature is fundamentally good, believing that by expanding the "four beginnings" (compassion, shame, courtesy, and right and wrong), society can function with minimal reliance on elaborate rituals. This notion influences medical ethics by emphasizing the physician's benevolent heart and moral cultivation, positing that virtuous medical practitioners are essential for healing and maintaining health.

2.2 Xunzi's Inherent Evil and Ritualistic Regulation

Contrasting with Mencius, Xunzi argues that human nature is inherently evil and requires strict rituals and laws to curb desires. In medical practice, this translates to stringent ethical standards and external regulations to govern medical behavior, similar to Laozi's "righteousness" and "ritual" levels. When internal virtues are lacking, external norms are necessary to maintain social order and medical ethics.

2.3 Song-Ming Neo-Confucianism's "Preserve Heaven's Principle, Eliminate Human Desires"

Building on Mencius's belief in inherent goodness, Song-Ming Neo-Confucianism emphasizes the universal and absolute nature of "Heaven's principle" (Tianli). Zhu Xi, a prominent Neo-Confucian thinker, advocated for "Preserve Heaven's principle, eliminate human desires," stressing internal cultivation to restrain personal desires and manifest innate goodness, thereby reducing dependence on external norms. When Heaven's principle cannot be fully realized, reliance on rituals and educational systems becomes necessary to sustain social order, mirroring Laozi's "When the Dao is lost, virtue appears."

2.4 Wang Yangming's "Achieving Knowledge of Goodness"

Wang Yangming further developed Neo-Confucianism by proposing the concept of "achieving knowledge of goodness" (Zhigongzhi), asserting that innate knowledge of goodness exists within individuals and does not require external pursuit. If individuals can realize their inherent goodness, society will not need to heavily depend on external rituals and regulations. This aligns closely with Laozi's ideal state where "benevolence," "righteousness," and "rituals" are merely supplementary, while "virtue" naturally exists.

III. Spinoza's Rational Philosophy and Western Medical Philosophy

Baruch Spinoza (1632-1677), living during the European Reformation and the rise of scientific thought, proposed a philosophy where God and Nature are identical (Deus sive Natura), emphasizing a rational and deterministic structure of the universe. Good and evil are not inherent attributes but are relative judgments arising from human misunderstanding. When individuals use reason to understand the necessity of nature, they achieve harmony and freedom without needing external coercion.

3.1 Rational Necessity and Scientific Medicine

Spinoza's identification of God with Nature underscores a rational structure governing the universe. In Western medical philosophy, this translates to the application of scientific methods, striving for objective diagnosis and treatment based on empirical evidence. Rational understanding of disease mechanisms and the pursuit of precise, individualized treatments reflect Spinoza's emphasis on rational necessity, paralleling Laozi's alignment with the Dao.

3.2 Mind-Body Relationship and Psychological Medicine

Spinoza's mind-body dualism influences Western psychological medicine by highlighting the significant impact of psychological states on physical health. Modern psychology and psychosomatic medicine focus on the interplay between mental and physical health, advocating for integrated approaches that address both aspects, similar to Laozi's emphasis on mental tranquility for physical well-being.

3.3 Ethical Freedom and Medical Autonomy

Spinoza's concept of freedom, achieved through rational understanding, translates into medical ethics as a strong emphasis on patient autonomy. Modern medical ethics prioritizes informed consent, respect for patient privacy, and the equitable treatment of all patients, ensuring that medical decisions are made rationally and justly, aligning with Spinoza's advocacy for reasoned and fair ethical practices.

IV. Comparative Table — The Influence of Laozi, Neo-Confucianism, and Spinoza on Ancient and Modern Chinese and Western Medical Philosophy

The table below provides a detailed comparison of the influences of Laozi, Song-Ming Neo-Confucianism, and Spinoza's philosophies on ancient and modern Chinese and Western medical philosophies across various dimensions:

Comparative Dimension	Laozi ("When the Dao is Lost, Virtue Appears")	Song-Ming Neo-Confucianism ("Preserve Heaven's Principle, Eliminate Human Desires")	Spinoza (Rationality and Necessity)	Additional References: Zhuangzi, Buddhism
Medical Ethics	Emphasizes natural non-action, physicians align with nature, minimize intervention, respect self-regulation of life	Emphasizes physicians' benevolence and moral cultivation, medical ethics as the foundation for healing and maintaining health	Advocates rationality and justice, emphasizes rational basis for medical decisions, respects patient autonomy	Zhuangzi: Emphasizes freedom in medical practice; Buddhism: Emphasizes compassion in medical ethics
Holistic Concept	Focuses on harmony between the body and nature, emphasizes Yin-Yang and Five Elements, views the body as an organic whole	Emphasizes mind-body unity, believes psychological states directly impact physical health, promotes internal cultivation for overall health	Emphasizes mind-body relationship, believes psychological factors play a key role in disease prevention and treatment, advocates for psychosomatic medicine	Zhuangzi: Advocates for freedom through alignment with Dao; Buddhism: Emphasizes dependent origination
Therapeutic Methods	Based on harmonizing Yin-Yang and Five Elements, prioritizes prevention, aligns with natural processes for treatment	Utilizes internal moral cultivation and psychological adjustment to support treatment, emphasizes ethics and morality in medical practice	Advocates scientific methods and rational diagnosis, emphasizes evidence-based treatment, promotes precision and personalized medicine	Zhuangzi: Advocates for natural healing methods; Buddhism: Utilizes meditation and introspection
Mind-Body Relationship	Stresses harmony between mind and body, believes mental tranquility is essential for physical health	Believes psychological states directly affect physical health, promotes moral cultivation and psychological adjustment to achieve mind-body unity	Believes psychological factors are crucial in disease occurrence and treatment, advocates for rational understanding and psychological adjustment to achieve mind-body health	Zhuangzi: Advocates for mental detachment; Buddhism: Emphasizes mental cultivation and mindfulness
Health Ideology	Views health as balance between the body and natural environment, emphasizes lifestyle regulation and internal cultivation	Views health as harmony between internal virtue and external environment, emphasizes moral cultivation and psychological health	Views health as alignment with rational and natural laws, emphasizes scientific and rational understanding to achieve physical and mental balance	Zhuangzi: Advocates for natural state; Buddhism: Aims for nirvana and liberation
Role of Physicians	Physicians seen as harmonizers with nature, minimize over-intervention, respect patients' self-regulation	Physicians must possess high moral qualities, treat patients with benevolence, serve as moral and ethical exemplars	Physicians must possess rational thinking and just spirit, respect patient autonomy, act as practitioners of rationality and science	Zhuangzi: Advocates for free-spirited physicians; Buddhism: Emphasizes compassionate physicians
Prevention and Treatment	Emphasizes prevention through cultivation and health maintenance practices	Emphasizes disease prevention through internal virtue cultivation and psychological adjustment, advocates for "superior physician treats diseases before they arise"	Emphasizes scientific prevention through rational analysis and knowledge dissemination, promotes public health and preventive medicine	Zhuangzi: Advocates for health preservation; Buddhism: Prioritizes prevention over treatment
Relationship with Nature	Emphasizes harmonious coexistence with nature, advocates for adherence to natural laws, minimizes human interference	Emphasizes moral relationship with nature, believes adhering to Heaven's principle aligns with natural laws	Emphasizes understanding natural necessity through rationality to achieve harmony between humans and nature	Zhuangzi: Advocates for adherence to natural Dao; Buddhism: Emphasizes ecological protection
Contemporary Medical Applications	Promotes the development of holistic medicine and natural therapies, such as Traditional Chinese Medicine, qigong, and health preservation practices	Promotes the integration of medical ethics education and psychological health, advocates for moral governance in medicine and compassionate care	Promotes the integration of scientific and psychological medicine, advocates for precision medicine and ethical decision-making	Zhuangzi: Promotes natural healing methods; Buddhism: Advocates for mental health therapies

Table 1: Comparative Influence of Laozi, Neo-Confucianism, and Spinoza's Philosophy on Ancient and Modern Chinese and Western Medical Philosophy

V. Specific Impacts of Laozi, Neo-Confucianism, and Spinoza's Thoughts on Medical Practice5.1 Medical Ethics and Physician Virtue Construction

Laozi's principle of natural non-action in medical ethics manifests as respecting patients' self-regulation abilities, minimizing unnecessary interventions, and emphasizing the humility and adaptability of physicians. Neo-Confucianism's "Preserve Heaven's Principle, Eliminate Human Desires" stresses that physicians must possess high moral qualities and a benevolent heart as the foundation for healing and maintaining health. Spinoza's rational philosophy promotes the systematization and scientificization of medical ethics, emphasizing fairness and justice in medical decisions and respecting patient autonomy.

5.2 Holistic Concepts and Therapeutic Methods

Laozi and Daoist medicine emphasize the harmonious integration of the body with nature, advocating for the balance of Yin-Yang and Five Elements to achieve health. Neo-Confucianism emphasizes mind-body unity, believing that psychological states directly influence physical health and promoting moral cultivation to enhance overall health. Spinoza's rational philosophy drives the development of scientific medicine, emphasizing empirical-based precision treatments and personalized medical care, thus fostering psychosomatic medicine.

5.3 Mind-Body Relationship and Health Ideologies

Laozi highlights the inseparability of mental tranquility and physical health, promoting mental and physical unity through Daoist health practices. Neo-Confucianism emphasizes achieving mind-body unity through internal virtue cultivation, recognizing the critical role of psychological health in physical well-being. Spinoza, focusing on rational understanding, believes that comprehending the necessity of nature can reduce the influence of passive emotions, thereby achieving mental and physical balance.

5.4 Preventive Medicine and Health Management

Daoist and Neo-Confucian philosophies both advocate for preventive medicine. Daoism emphasizes "superior physician treats diseases before they arise" through cultivation and health maintenance practices, while Neo-Confucianism promotes disease prevention through internal virtue cultivation and psychological adjustment. Spinoza's rationalism advances modern preventive medicine by advocating for scientific analysis and knowledge dissemination to reduce disease occurrence.

VI. Cross-Cultural Dialogue and Integration of Chinese and Western Medical Philosophies6.1 Eastern Holistic Views and Western Scientific Rationality

Eastern medical philosophies, with their holistic view and Yin-Yang Five Elements theory, emphasize the harmonious integration of the human body with nature. This complements Western scientific medical practices that focus on precise, localized treatments. Cross-cultural dialogue has fostered the integration of holistic and localized approaches, promoting the development of comprehensive medicine. For example, the integration of Traditional Chinese Medicine (TCM) with Western diagnostic precision offers a more holistic approach to health care.

6.2 Physician Virtue Cultivation and Rational Ethics

Neo-Confucianism's emphasis on physician virtue cultivation aligns with Spinoza's rational ethics, which advocate for fairness and rational decision-making in medical practices. The combination of these philosophies has diversified modern medical ethics, valuing both the moral cultivation of physicians and the rational, scientific basis for ethical judgments. Modern medical institutions, through the establishment of ethics committees, incorporate both moral responsibilities and rational ethical decision-making processes.

6.3 Traditional Health Preservation and Modern Preventive Medicine

Daoist health preservation practices, such as qigong and dietary regulation, align with modern preventive medicine's emphasis on lifestyle adjustments to prevent disease. Cross-cultural integration has enriched health ideologies, promoting a diverse range of health maintenance practices globally. For instance, the acceptance of practices like yoga and meditation in Western health care systems serves as an example of integrating traditional health preservation methods with modern medical approaches.

VII. Contemporary Reflections on Medical Philosophy in the Context of Globalization and Multiculturalism7.1 Global Health Governance and Ethical Norms

Globalization has facilitated international medical collaboration and exchange, but it has also posed challenges for ethical norms across different cultural contexts. Neo-Confucianism's medical ethics and Spinoza's rational ethics offer valuable references for global health governance. By advocating for internal virtue cultivation and rational ethical frameworks, global medical ethics can develop more inclusive and just norms that respect cultural differences.

7.2 Ecological Medicine and Harmony with Nature

Faced with environmental crises and ecological issues, Laozi's "Dao" and Daoist medical philosophies provide philosophical support for the development of ecological medicine. Ecological medicine emphasizes the harmonious coexistence of humans and nature, advocating for sustainable medical practices that minimize environmental impact. Practices such as green medicine and eco-friendly hospital construction exemplify the Daoist health philosophy's influence on modern ecological health initiatives.

7.3 Technological Ethics and Humanistic Care

The rapid advancement of medical technology, including artificial intelligence and genetic engineering, brings significant ethical challenges. Spinoza's rational philosophy offers rational guidance for technological ethics, ensuring that technological progress does not compromise humanistic care and ethical standards. Concurrently, Neo-Confucianism's emphasis on compassion and moral cultivation ensures that technological advancements maintain a focus on human welfare and ethical responsibility.

VIII. Historical Practice and Social Governance Reflection

Throughout Chinese history, the dynamic balance between ritual governance, virtue governance, and law governance has been repeatedly enacted. Initially, dynasties emphasized virtuous governance, hoping that virtuous officials and scholars would possess inherent moral awareness. However, as history progressed and corruption and practical problems accumulated, laws and rituals became increasingly elaborate, leading to formalism and oppressive rule. This historical trend mirrors Laozi's hierarchical sequence, where the loss of higher internal principles leads society to rely excessively on lower-level institutions and regulations.

In the West, after the collapse of church authority, humanity turned to scientific rationality and constitutional law to prevent prejudice and fanaticism. However, when rational enlightenment is insufficient, and the public falls into entertainment-driven consumerism and short-sighted self-interest, extensive legal norms and international conventions are still necessary to maintain order. This scenario aligns with Laozi's prophecy: the ideal state of non-action is unattainable, and the more humanity deviates from the Dao or rational necessity, the more expensive and extensive the rules become to maintain order.

This historical practice indicates that whether in the East or West, when society cannot rely on higher-level internal principles, it resorts to external norms and systems to maintain order. However, this reliance on external norms is not a fundamental solution and may lead to further rigidity and moral degradation.

IX. Contemporary Insights: Value Reconstruction and Rational Enlightenment in the Multi-Dimensional Era9.1 Reducing Reliance on External Regulations

An overemphasis on increasing systems, laws, and regulations traps humanity in an endless web of control, preventing internal tranquility and humanistic improvement. Laozi's principle of natural non-action, Neo-Confucianism's internal cultivation, and Spinoza's rational enlightenment all suggest reducing dependence on external coercion and fostering internal virtue and rational growth to achieve societal order and individual health.

9.2 Returning to Internal Principles

Both Neo-Confucianism's "Preserve Heaven's principle" and Spinoza's rational enlightenment stress the importance of enhancing critical thinking and reflective abilities to establish a more solid moral or rational foundation. Only through internal value enhancement can reliance on superficial rules be minimized, achieving deeper social and personal harmony.

9.3 Ecological Ethics and Global Governance

Facing ecological crises and transnational issues, humanity's lack of profound understanding of natural necessity and intrinsic life value awareness leads to the continual layering of international environmental treaties and institutional constraints with limited effectiveness. By drawing from the Daoist or rational perspectives, reducing greed, and pursuing internal restraint can contribute to a more sustainable future.

9.4 Technological Ethics and Humanistic Care

In the face of ethical challenges posed by advancements in artificial intelligence and genetic engineering, Spinoza's rationalism and Neo-Confucianism's compassionate spirit offer guidance for technological ethics. These philosophies ensure that technological progress maintains humanistic care and ethical standards, finding a balance between technology and humanity to promote healthy medical technological development.

X. Comprehensive Evaluation and Future Reflections

Through the comparative analysis of Laozi's "When the Dao is lost, virtue appears," Song-Ming Neo-Confucianism's "Preserve Heaven's principle, eliminate human desires," and Spinoza's rational philosophy, this paper reveals an underlying logic that transcends ancient and modern, Eastern and Western thought: when humanity cannot resonate with higher foundational principles (Dao, Heaven's principle, rational necessity), it inevitably sinks into lower levels of normative reliance. This is not merely a value judgment but an insightful roadmap, guiding us to consider how through virtue cultivation, rational enlightenment, and reducing desires and unnecessary interventions, individuals and societies can elevate their realms.

In the present day, amidst information overload, consumerism, political polarization, and environmental crises, this path of internal enhancement and returning to the fundamental is particularly crucial. By engaging in a dialogue between ancient and modern philosophical thoughts, humanity has the opportunity to reconstruct internal value consensus atop complex systems, striving towards deeper harmony and freedom.

Furthermore, the detailed comparison table illustrates the similarities and differences in medical ethics, holistic concepts, mind-body relationships, and health ideologies among Laozi, Neo-Confucianism, and Spinoza's philosophies. This provides valuable theoretical support and practical guidance for cross-cultural dialogue and integration in Chinese and Western medical practices. As global medical collaboration deepens, these philosophical thoughts will continue to offer profound wisdom and direction for the development of medical ethics, health governance, and comprehensive medical systems, striving for higher levels of harmony and humanistic care in constructing a more comprehensive and sustainable health framework.

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Through this in-depth exploration, we observe the intricate interplay of ancient and modern philosophical thoughts from both Chinese and Western traditions in shaping medical theories and practices. These philosophies provide profound theoretical foundations for medical ethics, holistic concepts, mind-body relationships, and health ideologies, offering valuable wisdom and guidance for modern medicine in addressing the challenges posed by globalization, multiculturalism, and technological advancements. Future medical developments will continue to seek higher levels of harmony and humanistic care under the guidance of these philosophical insights, building a more comprehensive and sustainable health system.

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