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Old Master Chen practiced medicine for over sixty years. For every medical case, he insisted on the integrity of theory, principles, formulas, and herbs, being rigorous and meticulous in his approach. His medication was concise and refined, primarily based on classical formulas (Jingfang), while also incorporating insights from various schools; for contemporary formulas (Shifang), he frequently used those from *Tiaobian* (Annotations on Treatise on Cold Damage), rarely fabricating or creating new ones arbitrarily. Every formula had a source, and every modification had a rationale. This was because he was renowned throughout his life for diagnosing and treating severe complications (Huai Zheng) and adverse conditions (Ni Zheng) caused by misdiagnosis or mistreatment, many of which resulted from prior errors. Witnessing the suffering of patients firsthand and deeply lamenting the obscuring of the true path of medicine, he held himself to extremely high standards. To encourage himself and educate others, he named his clinic "Shizhi Tang" (Hall of True Knowledge), deriving its meaning from the *Analects*: "To know what you know and know what you do not know—that is true knowledge." Old Master Chen embodied this philosophy throughout his life, establishing a unique medical style.

Academically, Old Master Chen advocated for classical formulas (Jingfang), identifying as a proponent of the Jingfang school, yet he also appreciated the achievements of physicians after the Han Dynasty. Although he greatly admired the *Shanghan Zabing Lun* (Treatise on Cold Damage and Miscellaneous Diseases), he also affirmed the theory of warm diseases (Wenbing). He believed that diseases have no fixed form but present in myriad ways; thus, the choice of formula should depend on the specific situation rather than mechanically following textual descriptions. How could one harm patients by blindly adhering to bookish条文 (textual clauses)?

In the 1930s, when I first began studying medicine, there was a patient named Tang Ruicheng, a male in his fifties, who was obese and fond of alcohol. One day, while sitting idly in a teahouse, he suddenly suffered flaccid paralysis (Chi Huan Xing Tan Huan - flaccid paralysis) in all four limbs, collapsing to the ground. However, his spirit was clear, and his speech was fluent. Other physicians could not diagnose the condition. Old Master Chen diagnosed it as Feng Fei (Wind Paralysis), one of the four major syndromes of stroke, and prescribed the Xuming Decoction (Xuming Tang) from *Jinkui Yaolue Fanglun* appended with *Gujin Luyan*. After one dose, he could walk the next day. Later, I frequently observed my late master using this formula with excellent results, saving many lives. I subsequently applied this formula to treat several cases of modern medical diagnoses such as myelitis, polyneuritis, and barium chloride poisoning, achieving good effects. Sometimes describing it as "effective as a drumstick striking a drum" is not an exaggeration. For example, Lei XX, male, eighteen years old, a worker from a commune in Emei County, Sichuan, hospital number 18472, admitted on August 2, 1965. Two days before admission, upon waking up in the morning, he suddenly heard a cracking sound in his cervical spine, followed by numbness and motor impairment in the right upper and lower limbs. Within one to two hours, numbness spread to the whole body, accompanied by shortness of breath, palpitations, dyspnea, and urinary retention. He was immediately sent to the local commune hospital for two days without improvement, then transferred to the county hospital for rescue. After anti-infection and symptomatic treatments failed, he was transferred to our hospital. Western medicine diagnosed him with acute myelitis and ascending paralysis, admitting him to the internal medicine ward. At that time, besides numbness and incomplete paralysis of the limbs, the most urgent symptoms were severe difficulty in breathing and swallowing. In addition to anti-infection therapy, intravenous fluids, and vitamins, Lobeline, camphor water, and oxygen inhalation were continuously administered for rescue. However, the patient still experienced recurrent paroxysmal dyspnea, adopting a swallowing-type respiration, with occasional loss of pupillary reflexes and superficial reflexes throughout the body, leading to coma. This occurred multiple times a day for six days. Rescue efforts were futile, and critical signs were fully manifested. The family had repeatedly telegraphed their hometown to prepare for funeral arrangements. To meet the family's request, Traditional Chinese Medicine (TCM) consultation was invited on the morning of August 9. Upon examination, after the crisis passed, the patient was conscious, had no language barriers, felt a tight sensation in the throat and chest, had severe difficulty breathing and swallowing, whole-body numbness, left upper limb paralysis, dry throat, red tongue body, thin yellow coating, and a surging, wiry, and rapid pulse. The diagnosis was Feng Fei (Wind Paralysis), treated with *Gujin Luyan* Xuming Decoction: Ganjiang (Dried Ginger) 3g, Sheng Shigao (Raw Gypsum Fibrosum) 12g, Danggui (Angelicae Sinensis Radix) 9g, Lu Dangshen (Codonopsis Radix) 12g, Guizhi (Cinnamon Twig) 4.5g, Gancao (Licorice Root) 3g, Mahuang (Ephedrae Herba) 6g, Chuanxiong (Ligusticum Chuanxiong Rhizoma) 3g, Xingren (Prunus Armeniaca Semen) 6g. Acupuncture points Fengfu (GV16), Dazhui (GV14), Feishu (BL13), and Neiguan (PC6) were needled, retaining needles for fifteen minutes. On the second day (August 10), after one dose of the above prescription, movement in the left upper limb returned, oral and whole-body numbness decreased, and breathing and swallowing became less difficult. Western rescue measures and medications were discontinued. Continuing with the same formula, after another dose, the left upper limb became more flexible, the left hand could grasp objects, oral and whole-body numbness disappeared, breathing and swallowing were smooth, and he could eat biscuits. Only a tight sensation remained in the chest. The original formula was continued with modifications based on symptoms for four doses, eliminating all symptoms. Subsequently, regulation of Qi and Blood concluded the treatment, and he was discharged cured on August 23.

I also witnessed my teacher using Shizao Tang (Ten Jujube Decoction) and Kongxian Dan (Phlegm-Draining Pill) to treat stubborn, severe generalized edema, massive ascites, and very little urine, cases where multiple treatments had failed. First, he strengthened Spleen Qi transport. When gastric appetite normalized, he combined Shizao Tang or Kongxian Dan to attack and drain. After administration, nausea, vomiting, and purgative water-draining effects did not appear; instead, urine volume increased sharply, and edema and ascites subsided rapidly. With the cooperation of Western medicine, applying my late master's experience, I found that for chronic nephritis or nephrotic syndrome patients presenting with stubborn severe edema and massive ascites, this approach often achieved good diuretic effects, and renal function improved accordingly. I have introduced these experiences in my article "Experience in Using Shizao Tang and Kongxian Dan for Diuresis and Reducing Edema in Nephrotic Syndrome," published in *Henan TCM*, Issue 6, 1981, so I will not elaborate here.

Although Old Master Chen was famous for his precise insight, courage, and adept use of classical formulas (Jingfang), he harbored almost no sectarian prejudice and could skillfully apply effective formulas from various schools. For instance, in 1934, my late mother suffered from Datou Wen (Big Head Plague), characterized by swelling and burning pain in the head and face, unbearable discomfort, shiny skin, and inability to open her eyes. She lay in bed for ten days, and local treatments were ineffective. At that time, I was studying under Old Master Chen. A letter from home requested his consultation. Upon arrival, Old Master Chen prescribed: Yinhua (Flos Lonicerae Japonicae) and Juhua (Flos Chrysanthemi Indici) 30g each, Xian Dideng (Viola Herba cum Radice) 120g, Sheng Gancao (Raw Licorice Root) 15g (named Sanhua Yin / Three-Flower Drink). One dose showed significant effect, and three doses led to recovery. Due to my inherent frailty, when I was in my teens, I occasionally caught a cold. Symptoms included coughing, pulling pain in the hypochondrium exacerbated by turning, twisting, or deep breathing, alternating chills and fever occurring dozens of times a day, each episode lasting minutes. During attacks, my back felt like cold water was poured on it, instantly followed by a burning sensation. Modifications of Xiaochaihu Tang (Minor Bupleurum Decoction) were ineffective. Bedridden and unable to eat, my late master diagnosed me and prescribed Xiangfu Xuanshenhua Tang (Cyperi Rhizoma and Inula Flower Decoction) from *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases). After taking it, I vomited about a bowl of sticky saliva. Half a day later, the chills, fever, and hypochondriac pain disappeared. Later, I contracted another external pathogen with cough and profuse sputum, causing pulling pain in the chest. Liu'an Jian (Six-An Decoction) was ineffective. Switching to Xiangfu Xuanshenhua Tang also failed. Several subsequent formula changes were unsuccessful, and the illness worsened. Breathing and movement pulled at the chest causing pain; lying supine, I could not move slightly. Panting and wheezing were present, with thick, sticky sputum resembling syrup strands, stuck at the mouth requiring manual removal. Within seven days, my spirit was exhausted, nearing death. My late master diagnosed this as Phlegm-Heat injuring Body Fluids, with Dry Phlegm obstructing the airway. This aligns with Tang Rongchuan's statement: "When Upper Jiao Blood deficiency and Fire excess occur, Body Fluids are refined and condensed into Phlegm, causing the Lung to wither, leading to cough, reverse Qi, fever, and thick, sticky obstruction. This occurs because Blood deficiency fails to nourish the Heart, causing Heart Fire to flourish and suppress Lung Metal, preventing Body Fluids from dispersing, thus condensing into Phlegm." It should be treated with Huotan Wan (Phlegm-Expelling Pill). He prepared Huotan Wan as a decoction. Since Bamboo Juice (Zhuli) was unavailable late at night, Radish Juice (Laifu Zhi) was used temporarily. After two doses, there was no progress. After dawn, several bowls of Bamboo Juice were prepared. Huotan Wan was decocted again, mixed half with herbal juice and half with Bamboo Juice. The first dose was taken at 3 PM, the second at dusk. By midnight, phlegm decreased, panting and chest pain lessened, and I could turn over. After the third dose, symptoms significantly reduced the next morning. The phlegm in the chest disappeared invisibly, neither vomited nor purged, and hunger returned. Continuing the formula for one more dose allowed me to stand holding the bed; two days later, I could go out. Switching to formulas tonifying both Qi and Yin and regulating the Spleen and Stomach led to complete recovery. Based on my late master's experience, I use Huotan Wan to treat acute bronchitis, acute exacerbations of chronic bronchitis, bronchial asthma, pneumonia, especially pulmonary infections following abdominal surgeries presenting with cough, reverse Qi, throat discomfort, thick sticky sputum, difficult expectoration, chest tightness, panting, dry mouth wanting to drink, choking on water, red dry tongue, yellow greasy coating, and slippery rapid weak pulse, achieving good results. (For details, refer to "Experience of Chen Dingsan and Jiang Erxun in Using Huotan Wan to Rescue Critical Cases of Phlegm-Heat Injury to Fluids and Airway Obstruction," *Henan TCM*, Issue 2, 1982.)

Hearing is inferior to seeing; seeing is inferior to doing.

When my late master mentored apprentices in clinical practice, he emphasized the integration of theory, principles, formulas, and herbs. Most valuable was his habit of reviewing and summarizing with students the same evening after consultations, explaining difficulties. He frequently cited classics, combined them with reality, shared his insights, and never hoarded his decades of hard-won clinical experience ("passing through and touching pulses"). He feared students would not learn enough. Whenever encountering difficult or strange cases, he always used joint master-apprentice discussions to inspire and improve students' ability in pattern differentiation and treatment. My late master had a strong memory and excelled at using actual cases to explain classics, strengthening students' understanding and memorization. Through vivid clinical verification of classics, he often sparked intense interest in otherwise dry theories among students.

Liu Xiang of the Western Han Dynasty stated in *Shuo Yuan · Zhengli*: "Hearing is inferior to seeing; seeing is inferior to practicing." My late master centered his teaching on this principle, often elevating students' theoretical understanding to a breakthrough level through actual clinical cases. This left a profound impression not only on his students but also on colleagues and junior scholars who interacted with him. Mr. Chen Zefang, Vice President of the Jiajiang County Medical and Health Association and a renowned local TCM physician, is one such example. Mr. Zhou XX in Jiajiang County suffered from a Warm Disease. Onset was sudden; after two days of high fever and sweating, he suddenly developed incessant diarrhea, cold limbs, profuse sweating like pearls, confusion, flushed cheeks, occasional restlessness, closed eyes, and weak breathing. Family members were devastated, preparing for funerals while urgently requesting my late master. Pulse was undetectable in all six positions. Diagnosis: Decline of Primordial Yang, Life Fire about to extinguish. Emergency large-dose Yang-returning and rescue prescription (Baitong Tang added with Pig Bile Soup, Fupian/Aconite processed lateral root used up to one tael). After one dose, Yang returned, diarrhea stopped, pulse appeared, and limbs warmed. The next day, panting, cough, profuse sputum, white slippery tongue coating, and chest fullness appeared. Su Zi Jiang Qi Tang (Perilla Fruit Descending Qi Decoction) combined with Sanzi Yang Qin Tang (Three Seeds Nourishing Parents Decoction) was prescribed. This combination seemed strange because Baitong Tang for warming Yang and rescuing collapse is hard for the Shifang school to accept. If effective, why change to a Qi-descending, Phlegm-resolving, pantle-relieving formula? After this formula, cough and panting subsided. Then, dribbling painful urination, thirst, irritability, red tongue body, thin yellow coating appeared. Zhongjing's Zhu Ling Tang (Polyporus Decoction) was prescribed. Finally, due to dry mouth and tongue, bright red tongue body, scant coating, nausea, poor appetite, and fine rapid pulse, Zhuye Shigao Tang (Leaf and Gypsum Decoction) was used to conclude treatment. This disease lasted ten days under my late master's care, with four formula changes, yielding remarkable efficacy. Local doctors praised it endlessly but were puzzled. Mr. Chen Zefang asked for the reason. My late master explained: TCM treatment must consider Heaven's timing, Earth's geography, Constitution, and Pathogenic Factors, weighing them comprehensively to determine priority. Mr. Zhou was elderly with Kidney deficiency, accustomed to rich, greasy foods, constituting a Kidney-deficient and Spleen-dampness type. External Warm Pathogen attacked swiftly; vigorous Fire consumed Qi severely in this constitution, leading immediately to Yang collapse. Thus, Baitong Tang was not treating the disease but rescuing the collapse. When Yang slightly recovered, Phlegm-Dampness in Middle and Upper Jiao moved, so Su Zi Jiang Qi Tang was used to relieve panting, resolve Cold Phlegm, and warm Kidney Yang. Since the pathogen was ultimately Warm, once Phlegm-Dampness cleared, Water-Heat intermingling and Internal Heat injuring Yin patterns of Zhu Ling Tang emerged. This pattern confirmed the recovery of Kidney Yang and loosening of Water-Dampness, hence good efficacy. The condition quickly shifted to the common late-stage Warm Disease pattern of Zhuye Shigao Tang, concluding the cure. Mr. Chen Zefang still recalls my late master's voice and presence vividly, feeling deep emotion.

Only with Virtue Governing Talent Can One Be a Good Physician.

My late master's noble medical ethics were widely praised. He despised fame and profit, neglected household affairs, and devoted himself tirelessly to curing diseases, reading, and educating. Even at eighty, he rushed on house calls, responding to all requests regardless of remuneration. Visiting poor families, he often waived fees and gifted medicines. His son, retired senior TCM physician Mr. Chen Mingqiang, spoke of his father's "two attentions and two inattentions": Reading and treating patients were most attended to. Whenever free, he read, loving books like life until past eighty, despite severe myopia (over 1500 degrees), never putting down a book. Only two years before death, blinded, did he reluctantly put books aside. Regarding fee amounts, food quality, and household matters, he was least attentive, never worrying about them.

Throughout his life, my late master detested drug merchants seeking profit and quacks who relied solely on pulse diagnosis to deceive people. Although skilled in pulse diagnosis, he insisted on the sequence of Inspection, Auscultation/Olfaction, Inquiry, and Palpation, paying special attention to Inquiry, placing Palpation last. He sighed that many misunderstood Palpation as merely pulse-taking. He often used his index finger to touch the dryness, moisture, roughness, or slipperiness of the tongue coating to supplement Inspection; he loved feeling the thickness, roughness, temperature of the skin and Chi region, the strength of the Xuli area, and pressing the chest and abdomen as common Palpation methods. He jokingly said: "Heart, Liver, Spleen, Lung, Kidney—no one asks everywhere; Heart, Liver, Spleen, Lung, Ren (Kidney)—selling silver coins everywhere." Critiquing quackery and low medical ethics. Therefore, wherever he diagnosed, he promoted health knowledge and popularized medical principles. In the preface of *Chinese Medical Common Sense*, he wrote: "Everyone must have medical common sense, so positively one can maintain health, and negatively recover safety after illness." He did extensive work popularizing medical knowledge. Accepting new things quickly, for example, in 1952, when vaccination started in Leshan, many masses refused. He led by injecting himself, influencing the public positively.

My late master highly valued medical ethics, believing both ethics and skills affect treatment quality and outcome. Their relationship should be virtue governing talent. He agreed with Qing dynasty famous physician Wu Jutong: "All things in the world succeed through talent but are governed by virtue. Without talent, virtue cannot be formed; without virtue to govern talent, talent becomes arrogant and destructive, failing completely." He believed this brilliantly elucidated the relationship between skill and ethics. Facing critical illnesses, he often quoted Sun Simiao: "Do not look forward or backward, worry about fortune or misfortune, protect oneself or cherish life. Seeing others' suffering as your own, deeply empathizing, do not avoid danger, weather, or fatigue. Save them wholeheartedly, without calculating effort or appearance. Only thus can one be a Great Physician for the People; otherwise, one is a great thief of living beings." He used this to admonish students and encourage himself. He spoke and acted accordingly. Rarely sitting in a clinic, he mostly made house calls, leaving footprints in Emei Mountain, Xikang, etc.

Sensing that most patients he visited suffered from bad conditions (Huai Zheng) and adverse states (Ni Zheng) due to mistreatment, he wrote diligently based on clinical insights, distributing works to colleagues and patients to cure both patients and physicians. He authored *Yixue Tanyuan* (Exploring the Source of Medicine), six volumes, meaning returning to simplicity from complexity and knowing the source of disease. During the Anti-Japanese War, Guo Moruo returned to Leshan and personally inscribed the title for this book. It served as a textbook for his apprentices. Additionally, he wrote *Chinese Medical Common Sense*, *Discussion on Abdominal and Epigastric Pain*, *Chaihu Jijie* (Collected Explanations of Bupleurum), etc., still cherished by TCM practitioners in various counties.

Side Notes on Cao Bingzhang's Scholarly Approach

Chen Tianyang, Cao Youhua

[Biography of Cao Bingzhang] Cao Bingzhang (1878–1956), courtesy name Chidian, also known as Binzhang, Linsheng, from Shaoxing, Zhejiang (originally Yinxian, Zhejiang). Studied under famous physicians Fang Xiaoan and He Lianchen, but mainly self-taught. Rigorous scholarship, profound attainments. Busy with clinical duties, he diligently compiled, annotated, supplemented, and revised over 400 works, influencing the TCM community. Served as Honorary Director of Central National Medical Hall, Director of Zhejiang National Medical Branch, Chairman of Shenzhou Medical Quanzhao Branch, and Honorary Director of Physicians Guilds in Singapore, Thailand, etc. Concurrently honorary editor and contributor to over twenty domestic and international TCM journals. After liberation, served as CPPCC member of Shaoxing City, Editor-in-Chief of *Zhejiang TCM Monthly*, etc.

Mr. Cao was quiet and studious since childhood, diligent beyond measure, but due to poverty, attended private school intermittently for only two years. At fourteen (1892), he traveled to Shaoxing with his father Xianqing to make a living, entering a pharmacy to study, beginning his medical career.

Loving books like treasure all his life, claiming "Rich in Books, Poor in Home."

When entering the pharmacy as an apprentice, he was in his youth, eager to learn. Daytime busy dispensing medicine and settling accounts, nighttime was his prime time for reading. Over four years, he meticulously studied and memorized botanical monographs like *Shennong Bencao Jing* (Divine Farmer's Materia Medica), *Bencao Gangmu* (Compendium of Materia Medica), *Xinxiu Bencao* (Newly Revised Materia Medica), *Bencao Congxin* (Essentials of Materia Medica), often conducting field investigations of medicinal plants outdoors.