袁鹤侪幼承庭训，攻读经史，渐习诗文。其父名琥，为前清昌平学正官。家庭的影响，为先生后来的学习，打下了良好的基础。十四岁时，父母皆染热病而相继去世，因生活所迫，学业未竟，颠沛流离，又身染重病，儿至作古，幸亲邻资助，始渐得康复。先生思双亲病故之情，感身染重疾之苦，遂以不知医为恨事，故立志学医，以济世活人。然其时年少，家境贫寒，学无门径，只得自谋生路，以书为师。自学之初，茫然不知由何起始，只好将父母生前服用之药方带在身边，四处询求，以明究竟。此后，听人说，父母所患之热病，属伤寒之类。于是，到处奔走，索寻有关伤寒之医书。每借到一部医书，攻读尚嫌不足，还用蝇头小楷抄录于粗绵纸上。为了维持生活，保证自学，先生曾去富有人家教家馆。一边任教，一边习医。
光绪二十九年(一九零三)，先生考入京师大学堂医学馆，开始了正规系统的学习。在老师的指导下，他废寝忘食，孜孜以求，潜研经典，博览诸家，对祖国医学理论的源流、沿革，发展及诸家学说的形成，有了深刻的认识。同时，也受到西方医学及其他自然科学的影响，开扩了思路，增长了见识，打下了深厚的医学基础。在先生治学道路上，这是关键的一步。一九零六年，他以优异的成绩，毕业于医学馆，出而问世，以擅治伤寒，精于《内》《难》而初露锋芒。同年，二十七岁投考前清太医院而名列前茅，遂成为太医院御医。据《太医院晋秩纪实碑》碑文所载：除蒙恩特赏御医之员不计外，其挨次递升至御医者，非年过五十不克到班。显然，先生是以品学兼优而获特赏，被破格任用的。当时的太医院使(即院长)张午樵先生对其十分器重，在理论和临床上不断加以指点，影响着他的学业进展。为清皇室医病，不仅要理、法、方，药妥贴，而且要药性平和，效果显著。否则，随时有杀身之危。这迫使先生摸索出一套用药平和、法度严谨、药少力宏、出奇制胜的医疗经验。正因如此，先生被选为那拉氏(慈禧)随侍御医，兼太医院医学馆教习。
辛亥革命后，先生悬壶京门。不图名利，不事逢迎，不投机钻营，以医技精良,品端术正而名誉一时。
其间，先生曾任京都内城官医院内科医长，每日求诊者盈门。但先生并不自恃骄矜，依然虚怀若谷，精益求精。对许多疑难大症，积累了丰富的经验。正因如此，在华北国医学院任教授期间，深为后学所敬仰。
纵横驰骋博中求约
先生治学，法度严谨。对后学循循善诱，诲人不倦；对自己严格刻苦，身体力行。他常说：初学入门，可以选读诸如陈修园的《伤寒论浅注》，《金匮浅注》、《医学从众录》、《医学实在易》、吴鞠通的《温病条辨》及《频湖脉学》、《本草备要》等书，如此在医理上虽未深通，而在临床应用上,苟能灵活运用，亦颇小道可观。然欲达到精通医理，则相去尚远。仍须溯本求源，从根本做起。要认真研讨《内经》、《难经》、《脉经》等经典。此后，宜进一步学习《伤寒》、《金匮》、《千金》、《外台》、《本草经》、《本草纲目》等，参以金元四大家及各种医籍。这样才能较全面、系统地掌握中医理论。此须假以时日，方能得其精髓，明其灵活变通之妙。
对《内》、《难》的研究，先生认为应看到诸篇之间的内在联系，只有前后相参，才能系统地、完整地理解其深意，窥及其理论全貌。中医理论涉及到文、史、哲，天文，地理、四时、方宜诸方面。人生于气交之中，得天地之气以生，故阴阳之气与天地之阴阳相合。在天地有积阳积阴之不同，在人则有气血之各异；在天地，积阳为天，积阴为地，在人身，以气为阳，以血为阴……所以，必明于阴阳之理，然后方能调其阴阳，俾其归于阴平阳秘也。故先生读书，每每纵观历史，涉猎经史子集，横贯流派，洋参各家论说，逐句剖析，反复研讨。其至要之处，则录于《先哲格言》之内，且能上口成诵，有所领悟之时，则书于《管窥小语》之中。这样，数十年如一日，孜孜不倦，昼以医人，夜以读书，锲而不舍。因而对《内》，《难》之经义，有较深的造诣和独到的见解。尤其重视气化说,对天人相应及燮理阴阳等观点有所阐发，注重其指导临床的实际意义。其学识之广博，见地之精深，历来为同道所赞佩。
对仲景《伤寒论》，他不仅在理论上有所建树，在临床上也积累了丰富的经验。正如其自述云：余潜心研讨者，伤寒也……自习医以来，每于医籍中涉及伤寒者，则必加意研究。及读《伤寒论》，更详参各家论说，以期明晰。故自问世以来，经诊此病最多，而治愈者亦最夥。惟经诊即愈，不待其剧而后救之，亦所谓曲突徙薪也。先生博览群书，集先贤诸家之长，孜孜以求，从不牵强敷衍。对疑难之处，或求教
于前贤，或切磋于同道，必反复思索，以求真诠。积数十年临床经验，参以已见，先后编著了《太医院伤寒论讲草》和《伤寒方义辑粹》等著作。
《伤寒论讲草》是先生在前清太医院讲授《伤寒论》时所著，其论述精辟，条理清晰，深入浅出，言简意赅。故在当时即以讲课理精而深，意简而明著称，深受后学所拥戴。如论述阳明篇概要时，先生云：伤寒邪在太阳之时，有中风、伤寒之不同。及至邪犯中州，则无论风、寒之邪，得阳明之燥气，悉当化热。故不必论其风寒营卫，只须以在经在府为则。且又须详其为传，为直中，为转属。即经中:太阳阳明，正阳阳明、少阳阳明也。夫阳明者胃也。以胃实为阳明府之正病，即为应下之正病也。其由太阳病循经传入阳明者，为太阳阳明。虽阳明证见八九，而太阳证有一二未罢者，仍当从太阳而不从阳明，以邪在阳明之经而未入府，故不得指为胃实，即不可用下法也。伤寒按经递传，自太阳传阳明，而少阳。足少阳为阳明邪之去路，然凡阳明病，纵有阳明证八九，而已见少阳证之一二者，即当从少阳而不从阳明(汗，下法皆不可用)。以伤寒之传，由经传经，若入阳明之府，则不得复传于他经。故知由阳明传少阳者，亦未成胃家实而未可攻也。所谓少阳阳明者，乃由少阳之经传于阳明之府也。少阳之传阳明者，因误下伤津而胃受其邪为实故也。更有太阴转属阳明者，亦由脏而府故也。故凡由少阳，太阴病而见阳明府证，而少阳、太阴病罢者，则可下。其正阳阳明者，则由阳明受邪，非由传及也。然正阳阳明亦先经而后府，必有府证乃可下之。其府证之确不确，则以胃家实与不实为断。盖阳明为传化之府，当更实更虚。食入胃实而肠虚，食下肠实而胃虚。若食而不下，则但实不虚，斯为胃实，亦为阳明病根矣。此只因证论治，更不可拘泥传经日数，致失机宜也。此阳明病之大略。以上仅五百余字，阳明大要囊括其中，使人得其要，可执简驭繁。
《伤寒方义辑粹》是在上述《讲草》基础上写成的，文字洗练，论理精深，关键之处复加按语。所以称辑粹者，是因为集诸家之精华而冶于一炉。如先生论桂枝汤之变法时云：桂枝汤以桂、芍分治荣卫。卫出下焦，太阳火弱而卫虚者，则加桂，荣出中焦，脾阴不足而荣虚者，则倍芍，下焦阳衰而寒甚者，则加附子；中州阴虚而邪热者，则加大黄。此数方加减之妙也。寥寥数语，宗经旨而集众长，将桂枝汤及其变方的立意及内在联系，豁然纸上，使人耳目一新。
先生谓：苓桂术甘、苓桂枣甘、茯苓甘草汤，三方所异者，只术、枣、姜三味，而所治迥别。盖白术苦温而燥，健脾而化饮。中州有停饮，以致土不制水，下焦寒水因而为病者，宜用之培其本，则土崇面水伏矣。大枣甘而多脂，有益脾之功，而燥湿化饮则非其所能，故土虚而水上冲者，为所当也。茯苓甘草汤与五苓散对举，曰:汗出而渴者，与五苓散，不渴者，与茯苓甘草汤。盖汗出而渴者，太阳之气不化也；汗出不渴者，太阳之阳气虚于表而中州留饮，胃阳不宣，故用生姜以宣胃阳，而不取术，枣补土之法也。加减变通，明之以理，使人知其殊而触类旁通。
先生对论中桂麻各半汤条(原文第23条)的理解，与众不同。曰：此节经文前贤多作三段解，愚谓非也。此荣中寒邪外达于卫之治法也。盖寒邪凝固而伤于荣，若寒邪久郁，其凝滞之性减，而将外达，则荣气亦随之出于卫分而为汗，则邪解矣。表气虚不能作汗，则其邪出入于荣卫间而不得去，故作面赤，身痒、恶寒、发热各证。推其原，则由荣卫阴阳之气虚，故脉微不得小汗也。其首系之以太阳病，明其邪未离乎太阳也。然阴阳俱虚，发散不可过峻，故合两方而取其半，以通表气而祛微邪也。伤寒表证不用芍，兹用芍者，以阴阳已虚，且寒邪已化其凝固为流通，药复多辛甘发散之品，故可用芍，取以固护荣阴，而邪得随发散之品外出，固不至为此少许之芍药留恋而不去也。前贤多主风寒两感之轻证解，似未允协。若果为两感，至八九日之久，则已变证百出矣，岂能以小汗而愈乎?况若为两感，则芍药在所当去矣。可见，先生研讨学术，或是或非，从不牵强，而是论之以理，求之以实。自此可略见先生治学之一斑。虽然此稿本当时已为医界传诵，争相传抄，但先生并不以此满足，仍反复推敲，不断修改，精益求精，力求其更合经旨以示后学。使人读后可得其要，用之即得心应手。这是先生治学，力求纵横驰骋、博中求约的具体体现。
审慎求实宗古创新
先生临证诊病，一丝不苟。详察病情，究其要害，制方严谨，用药精当，师古而有创新，药味平淡而有出奇制胜之妙，对许多疑难大症，颇多建树。及至先生晚年，德高望重，工作甚忙，求诊者众多，依然审慎为之，不论患者地位高低，亲疏远近，同样认真诊治。常见他因一味药的取舍，或用量的增减而斟酌再三。凡遇疑难重症，诊病之余，必沉思良久，甚至深夜查阅文献者，亦为常事，足见其审慎求实的科学态度。
积数十年之经验，先生对温病、痨瘵、疟疾、妇科诸门，皆有精研。早在三十年代，先生即据临证实践，著有《痨瘵概要》，阐明其病因病机，并归纳出清心养肺、益肺补心、养血疏肝、滋补肝肾、益阴清热、温补肾阳、健脾除湿、培土生金，清胃滋脾、益气补肺等治疗法则，每法均列有临证验方、药物化裁等具体内容，并强调空气疗养的重要作用。在抗痨药未产生的当时，据此而治愈者众多，起到了积极治疗的作用。至今看来，其遣方用药，加减化裁，独具匠心，仍有重要的实用价值。
先生治疟，虽宗经旨，但加减变通之中亦有新意。例如论小柴胡汤之临床应用时云：此方治疟，最为有效……依我之治验，为如下加减法；若寒多者，加柴胡至912克，青皮912克，余同前。惟柴胡加多，则可照西药之服法，一剂三服，如下午五点发病者，则晨时第一服，十一时第二服，下午二、三时第三服，余依此类推。热多寒少者，重用黄芩而减柴胡；又有不头痛而腹胀者，则于方内加白术9～12克，草果6克，茯苓9克……若但热无寒之温疟，则此方不适用矣。
先生治疗结石症，创立了开郁清肺、甘缓和中、养血清热、温通止痛等法。提出了欲降先升、欲利先清、欲排石先疏通、欲祛邪先扶正等治疗原则，治愈了国内外肾结石、胆结石患者多例，使免于手术而得以康复。开郁清肺法多用于肾结石，以莪术，乌药，赤芍为主药，佐以川贝、厚朴、茯苓之属，药少力宏，其清肺者，乃病在下而求治于上之谓。早在三十年代，先生以此法治愈肾结石而惧于手术治疗之患者多人，使西洋医生惊叹不已。甘缓和中法多用于胆结石，以生、炙甘草为君，佐以杭芍、蔻仁、乌药之属。此乃肝苦急，急食甘以缓之之意。在五十年代初期，先生即以此治愈胆结石患者多例。据病例载，患者就诊多则十余次，少则仅四次，即以石下症除而告痊愈。观其用药，每方仅寥寥六、七味，然于加减变通之间，补中有泻，散中有收，行气与敛阴柔刚相济，治本与治标相兼得当，立法正而用药精，虽未用排石重剂，但阴阳和，气机通，中州斡旋之力得复，少阳升发之气得行，排石则成为必然。此乃先生治病求本，燮理阴阳之妙用。这些经验，扩展了人们的思路，为治疗结石症提供和积累了可贵的资料。
先生对药物配伍、加减用量颇为重视，指出遣方用药尤为第一要者，则只求中病，力戒庞杂。因而对方药配伍之微细差别，用量多少之作用异同，皆有精辟的见解。诸如对参附、术附、芪附三方配伍主治之异同，对小承气汤、厚朴大黄汤、厚朴三物汤，药同而量异，主治各殊之见解等，其见地之精深，足以启人智慧。对相似中药的异同，诸如柴胡、升麻、葛根在配伍应用上的差异，缩砂仁、白蔻、草蔻，肉蔻所治之不同，芩、连、柏、大黄在应用上的微妙之处等，皆有具体、详细的阐述，不仅使后学能得其要领，也便于人们明了其具体应用，颇为后人称道。
正是在此基础上，先生编著了《温病概要》、《温病条辨选注》，《中医诊疗原则》、《医术经谈》、《袁氏医案》等，皆是他数十年经验的结晶。遗憾的是，因时间流逝，时局动荡，原稿或有缺残，至今未得收集完整,殊可惋惜。
虚怀若谷精益求精
Yuan Hechai received family instruction in his early years, studying the classics and history, and gradually became familiar with poetry and prose. His father, named Yuan Hu, served as the Director of Education (Xuezheng) for Changping during the late Qing Dynasty. The influence of his family environment laid a solid foundation for Mr. Yuan's later studies. At the age of fourteen, both his parents contracted febrile diseases and passed away successively. Forced by livelihood concerns, he was unable to complete his education, wandered destitute, and fell seriously ill, nearly dying. Fortunately, with financial assistance from relatives and neighbors, he gradually recovered. Grieving the loss of his parents and suffering from severe illness, Mr. Yuan regarded his lack of medical knowledge as a regret and thus resolved to study medicine to save lives and help the world. However, being young and poor at the time, with no formal path to learning, he had to find his own way, taking books as his teachers. At the beginning of his self-study, feeling lost about where to start, he carried the prescription formulas his parents had used while alive, seeking answers everywhere. Later, he heard that the febrile diseases his parents suffered from belonged to the category of Shanghan (Cold Damage). Consequently, he ran around everywhere, searching for medical books related to Shanghan. Whenever he borrowed a medical book, reading it alone was insufficient; he also copied it in small regular script onto coarse cotton paper. To sustain himself and ensure his self-study, Mr. Yuan once worked as a private tutor in wealthy households. While teaching, he studied medicine.
In the 29th year of Guangxu (1903), Mr. Yuan entered the Medical Hall of the Imperial University of Peking, commencing formal and systematic study. Under the guidance of his teachers, he worked tirelessly, immersing himself in classics and extensively reading various schools of thought. He gained profound insights into the origins, evolution, development, and formation of theories within Chinese medicine. Simultaneously, influenced by Western medicine and other natural sciences, he broadened his horizons and accumulated deep medical foundations. This was a crucial step in his academic journey. In 1906, he graduated with excellent honors from the Medical Hall and entered practice, initially gaining recognition for his expertise in treating Shanghan and his mastery of the Huangdi Neijing (Yellow Emperor's Inner Canon) and Nanjing (Classic of Difficult Issues). That same year, at twenty-seven, he took the examination for the Imperial Medical Bureau of the late Qing Dynasty, ranking among the top candidates, and subsequently became an Imperial Physician. According to the inscription on the "Record of Promotion Ranks in the Imperial Medical Bureau," aside from those specially appointed directly due to imperial favor, individuals promoted sequentially to Imperial Physicians typically did not reach this rank before the age of fifty. Clearly, Mr. Yuan was specially rewarded and exceptionally appointed due to his outstanding moral character and scholarly achievements. Zhang Wuqiao, the then Director of the Imperial Medical Bureau (equivalent to Dean), highly valued him, providing continuous guidance in theory and clinical practice, which significantly influenced his academic progress. Treating patients for the Qing royal family required not only appropriate principles, methods, prescriptions, and herbs but also mild medicinal properties and significant efficacy. Otherwise, there was always the risk of death. This compelled Mr. Yuan to develop a set of medical experiences characterized by mild medications, strict adherence to rules, few ingredients with potent effects, and unexpected victories. Consequently, he was selected as the Attending Imperial Physician for Nala Shi (Empress Dowager Cixi) and concurrently served as an instructor at the Medical Hall of the Imperial Medical Bureau.
After the Xinhai Revolution, Mr. Yuan practiced medicine in Beijing. He sought neither fame nor profit, did not flatter others, and avoided opportunism. Renowned for his exquisite medical skills, upright character, and orthodox techniques, he enjoyed great prestige.
During this period, Mr. Yuan served as the Chief Physician of Internal Medicine at the Capital Inner City Official Hospital, with doors crowded daily by patients seeking consultation. Yet, he remained humble and pursued excellence without arrogance. He accumulated rich experience in treating many difficult and critical cases. For this reason, while serving as a professor at the North China College of Traditional Chinese Medicine, he was deeply respected by junior scholars.
**Mastering Breadth and Seeking Conciseness**
Mr. Yuan’s approach to scholarship was rigorous. He guided juniors patiently and tirelessly, while being strict and diligent with himself, leading by example. He often said: Beginners can select books such as Chen Xiuyuan's *Shallow Notes on the Treatise on Cold Damage*, *Shallow Notes on the Golden Cabinet*, *Medical Records Following Public Consensus*, *Medical Essentials Made Easy*, Wu Jutong's *Treatise on Warm Diseases*, *Pinhu Pulse Studies*, and *Essential Materia Medica*. Although one may not deeply understand medical principles through these, flexible application in clinical practice yields considerable results. However, to achieve mastery of medical principles, one is still far off. One must trace back to the source and start from the fundamentals. It is necessary to seriously study classics such as the *Huangdi Neijing* (Yellow Emperor's Inner Canon), *Nanjing* (Classic of Difficult Issues), and *Maijing* (Pulse Classic). Thereafter, one should further study the *Shanghan Lun* (Treatise on Cold Damage), *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), *Qianjin Fang* (Thousand Gold Formulas), *Waitai Miyao* (Secret Essentials from the Outer Cabinet), *Shennong Bencao Jing* (Divine Farmer's Materia Medica), and *Bencao Gangmu* (Compendium of Materia Medica), incorporating the teachings of the Four Masters of Jin and Yuan dynasties and various medical texts. Only then can one comprehensively and systematically master TCM theory. This requires time to grasp the essence and understand the subtleties of flexible adaptation.
Regarding the study of the *Neijing* and *Nanjing*, Mr. Yuan believed that one should perceive the internal connections between different chapters. Only by cross-referencing them can one systematically and completely understand their profound meanings and glimpse the full picture of their theories. TCM theory involves literature, history, philosophy, astronomy, geography, seasons, and regional suitability. Humans are born within the intersection of Qi, deriving life from the Qi of Heaven and Earth; thus, the Yin-Yang Qi in humans harmonizes with the Yin-Yang of Heaven and Earth. In Heaven and Earth, there are differences between accumulated Yang and accumulated Yin; in humans, there are differences between Qi and Blood. In Heaven and Earth, accumulated Yang becomes Heaven, and accumulated Yin becomes Earth; in the human body, Qi is Yang and Blood is Yin... Therefore, one must clearly understand the principles of Yin-Yang to regulate it, restoring the state of Yin-Ping Yang-Mi (balanced Yin and firm Yang). Thus, when reading, Mr. Yuan would survey history, browse through classics, histories, masters, and collections, traverse different schools, and reference various arguments. He analyzed sentences word by word and discussed them repeatedly. Key points were recorded in *Maxims of Sages*, memorized orally, and written in *Small Observations* when insights occurred. Day after day for decades, he worked tirelessly, treating patients by day and reading by night, persevering without giving up. Consequently, he achieved profound attainments and unique insights into the canonical meanings of the *Neijing* and *Nanjing*. He particularly emphasized the theory of Qi transformation, elaborated on concepts such as the correspondence between Heaven and Humanity and the regulation of Yin-Yang, and focused on their practical significance in guiding clinical practice. His broad knowledge and profound insights have long been admired by peers.
Regarding Zhang Zhongjing's *Shanghan Lun*, he made contributions not only theoretically but also clinically. As he stated: "My concentrated research has been on Shanghan... Since I began studying medicine, whenever I encountered references to Shanghan in medical texts, I studied them carefully. Upon reading the *Shanghan Lun*, I further consulted various commentaries to clarify my understanding. Since its publication, I have diagnosed this disease most frequently and cured the most patients. I treat them upon diagnosis, curing them before they become severe, which is what is meant by 'moving the chimney and removing the firewood' (preventing disaster before it happens)." Mr. Yuan read widely, integrating the strengths of sages and various schools, striving diligently without forcing interpretations. For difficult issues, he either consulted former sages or discussed with peers, thinking repeatedly to seek true explanations. Accumulating decades of clinical experience and adding his own views, he successively compiled works such as *Lecture Drafts on Shanghan Lun from the Imperial Medical Bureau* and *Collected Essence of Shanghan Prescription Meanings*.
*Lecture Drafts on Shanghan Lun from the Imperial Medical Bureau* was written by Mr. Yuan while lecturing on the *Shanghan Lun* at the Imperial Medical Bureau during the late Qing Dynasty. Its discussions were incisive, logical, accessible, and concise. It was famous at the time for its profound yet simple explanations, winning the admiration of junior scholars. For example, when summarizing the Yangming chapter, Mr. Yuan stated: When the Shanghan pathogen is in the Taiyang stage, there are differences between Wind Strike and Cold Damage. Once the pathogen invades the Central Region (Middle Jiao), regardless of whether it is Wind or Cold, it will transform into Heat upon encountering the Dryness Qi of Yangming. Therefore, there is no need to discuss Wind-Cold or Ying-Wei; one should only judge based on whether the pathogen is in the Meridian or the Fu Organ. Furthermore, one must detail whether it is transmitted, direct invasion, or transferred. These include Taiyang-Yangming, Zhengyang-Yangming, and Shaoyang-Yangming mentioned in the text. Yangming refers to the Stomach. Stomach Excess (Wei Shi) is the primary disease of the Yangming Fu organ and thus the primary indication for purgation. Cases where Taiyang disease transmits along the meridian to Yangming are called Taiyang-Yangming. Even if Yangming symptoms appear in eight or nine out of ten cases, if one or two Taiyang symptoms remain unresolved, one should still follow the Taiyang approach rather than Yangming, because the pathogen is in the Yangming Meridian and has not entered the Fu organ, so it cannot be classified as Stomach Excess, and purgative methods should not be used. Shanghan transmits sequentially along meridians: from Taiyang to Yangming, then to Shaoyang. Foot-Shaoyang serves as the exit route for Yangming pathogens. However, in all Yangming diseases, even if Yangming symptoms dominate, if Shaoyang symptoms appear in one or two cases, one should follow Shaoyang rather than Yangming (neither sweating nor purging methods should be used). Regarding transmission, if the pathogen moves from meridian to meridian and enters the Yangming Fu organ, it cannot transmit to other meridians again. Thus, knowing that transmission from Yangming to Shaoyang indicates that Stomach Excess has not yet formed, attack/purgation is not yet applicable. What is called Shaoyang-Yangming refers to transmission from the Shaoyang Meridian to the Yangming Fu organ. Transmission from Shaoyang to Yangming occurs because improper purging damages fluids, allowing the stomach to receive the pathogen and become excess. Additionally, cases transferring from Taiyin to Yangming also involve transmission from Zang to Fu organs. Therefore, whenever Shaoyang or Taiyin diseases present with Yangming Fu organ symptoms, and the original Shaoyang or Taiyin diseases have resolved, purgation is permissible. Zhengyang-Yangming arises from Yangming receiving the pathogen directly, not through transmission. However, Zhengyang-Yangming also passes through the meridian stage before the Fu organ stage; only when Fu organ symptoms appear can purgation be used. The certainty of Fu organ symptoms is determined by whether Stomach Excess exists. Yangming is a transmitting and transforming Fu organ, alternating between excess and deficiency. After food enters, the Stomach is excess and the Intestines are deficient; after digestion, the Intestines are excess and the Stomach is deficient. If food enters but does not pass down, resulting in persistent excess without deficiency, this constitutes Stomach Excess and is the root of Yangming disease. Treatment should be based solely on symptoms, and one must not rigidly adhere to the number of days of meridian transmission, lest opportunities be missed. This is a general overview of Yangming disease. In just over five hundred words, the essentials of Yangming are encompassed, allowing readers to grasp the key points and manage complexity with simplicity.
*Collected Essence of Shanghan Prescription Meanings* was written on the basis of the aforementioned *Lecture Drafts*. The language is refined, the reasoning profound, and annotations added at key points. It is called "Collected Essence" because it integrates the essences of various schools into one furnace. For instance, when discussing variations of Guizhi Tang (Cinnamon Twig Decoction), Mr. Yuan stated: Guizhi Tang uses Cinnamon Twig and Peony to separately regulate Wei (Defensive) and Ying (Nutritive) Qi. Wei Qi originates from the Lower Jiao; if Solar Fire is weak and Wei Qi is deficient, add Cinnamon Twig. Ying Qi originates from the Middle Jiao; if Spleen Yin is insufficient and Ying Qi is deficient, double the amount of Peony. If Lower Jiao Yang is depleted and cold is severe, add Aconite; if the Middle Jiao Yin is deficient and evil heat exists, add Rhubarb. These are the subtleties of modifying these prescriptions. In just a few words, adhering to canonical principles and gathering diverse strengths, the intent and internal connections of Guizhi Tang and its variations are revealed on paper, refreshing the mind.
Mr. Yuan stated: Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction), Linggui Zaogan Tang (Poria, Cinnamon Twig, Jujube, and Licorice Decoction), and Fuling Gancao Tang (Poria and Licorice Decoction) differ only in the three herbs Atractylodes Macrocephala, Jujube, and Ginger, yet their indications are vastly different. Atractylodes Macrocephala is bitter, warm, and drying, strengthening the Spleen and resolving fluid retention. If there is fluid retention in the Middle Jiao, causing Earth to fail to control Water, and Cold Water in the Lower Jiao becomes pathological, it is appropriate to use this herb to cultivate the root, thereby stabilizing Earth and subduing Water. Jujube is sweet and fatty, benefiting the Spleen, but cannot dry dampness or resolve fluid retention; thus, it is suitable for cases where Earth is deficient and Water rushes upward. Fuling Gancao Tang is contrasted with Wuling San (Five-Ingredient Powder with Poria): "For sweating with thirst, prescribe Wuling San; for sweating without thirst, prescribe Fuling Gancao Tang." Sweating with thirst indicates failure of Taiyang Qi to transform; sweating without thirst indicates deficiency of Taiyang Yang Qi at the exterior and fluid retention in the Middle Jiao, with Stomach Yang failing to circulate. Therefore, Ginger is used to circulate Stomach Yang, avoiding the Earth-nourishing methods of Atractylodes and Jujube. Modifications are explained with logic, enabling practitioners to understand differences and apply knowledge analogously.
Mr. Yuan's understanding of the Guima Ge Ban Tang (Half-Guizhi Half-Ephedra Decoction) clause (Original Text Clause 23) differed from others. He stated: Previous sages mostly interpreted this section in three parts, which I believe is incorrect. This is a treatment method for Cold Pathogens trapped in Ying Qi reaching outward to Wei Qi. Cold pathogens congeal and injure Ying Qi. If Cold pathogens stagnate for a long time, their congealing nature diminishes, and they tend to move outward. Consequently, Ying Qi follows them out to the Wei level to produce sweat, resolving the pathogen. If Exterior Qi is deficient and cannot produce sweat, the pathogen oscillates between Ying and Wei levels without departing, causing symptoms such as facial redness, body itching, aversion to cold, and fever. Tracing the origin, this is due to deficiency of Ying-Wei Yin-Yang Qi, resulting in a faint pulse and inability to produce slight sweat. The initial association with Taiyang Disease clarifies that the pathogen has not left the Taiyang stage. However, since both Yin and Yang are deficient, dispersing methods should not be too harsh. Therefore, combining two formulas and taking half doses allows for circulating Exterior Qi and dispelling minor pathogens. Typically, Shaoyao (Peony) is not used in Shanghan exterior syndromes; here it is used because Yin and Yang are already deficient, and the Cold Pathogen has transformed from congealed to flowing. Given that the medication contains many pungent-sweet dispersing agents, Shaoyao can be used to protect Ying Yin, ensuring the pathogen exits with the dispersing agents without lingering due to the small amount of Peony. Previous sages mostly interpreted this as a mild case of simultaneous Wind-Cold infection, which seems inappropriate. If it were indeed simultaneous infection lasting eight or nine days, myriad complications would have arisen; how could it be cured by slight sweating? Moreover, if it were simultaneous infection, Shaoyao should have been removed. This shows that in academic research, Mr. Yuan never forced interpretations whether right or wrong, but reasoned with logic and sought reality. From this, one can glimpse a fraction of his scholarly attitude. Although this manuscript was circulated and copied avidly in the medical community at the time, Mr. Yuan was not satisfied, constantly refining and revising to pursue excellence, striving to align more closely with canonical principles to instruct future generations. This enables readers to grasp the essentials and apply them skillfully. This embodies his scholarly pursuit of mastering breadth and seeking conciseness.
**Prudent and Realistic, Honoring Antiquity and Innovating**
Mr. Yuan was meticulous in clinical diagnosis. He carefully observed conditions, investigated key issues, formulated prescriptions rigorously, and selected medications precisely. Honoring antiquity while innovating, using plain herbs to achieve unexpected victories, he made significant contributions to many difficult and critical cases. In his later years, despite his high prestige, busy schedule, and numerous patients, he remained prudent. Regardless of a patient's status or closeness, he treated everyone with equal seriousness. It was common to see him deliberating over the selection of a single herb or adjusting dosages. Whenever encountering difficult or severe cases, after diagnosis, he would ponder for a long time, even consulting literature late at night, demonstrating his scientific attitude of prudence and realism.
Accumulating decades of experience, Mr. Yuan conducted in-depth studies on Warm Diseases, Tuberculosis (Lao Zhai), Malaria, and gynecology. As early as the 1930s, based on clinical practice, he authored *Overview of Tuberculosis*, elucidating its etiology and pathogenesis. He summarized treatment principles such as Clearing Heart and Nourishing Lung, Benefiting Lung and Tonifying Heart, Nourishing Blood and Soothing Liver, Tonifying Liver and Kidney, Benefiting Yin and Clearing Heat, Warming Kidney Yang, Strengthening Spleen and Draining Dampness, Cultivating Earth to Generate Metal, Clearing Stomach and Nourishing Spleen, and Benefiting Qi and Tonifying Lung. Each principle included specific clinical verified formulas and herbal modifications, emphasizing the important role of air therapy. Before the advent of anti-tuberculosis drugs, many were cured based on these principles, playing a positive therapeutic role. Today, his prescription strategies and modifications remain highly practical and ingenious.
In treating malaria, although following canonical principles, Mr. Yuan introduced innovations in modifications. For example, regarding the clinical application of Xiaochaihu Tang (Minor Bupleurum Decoction), he stated: "This formula is most effective for malaria... Based on my clinical experience, the following modifications apply: For cases with more chills, increase Chaihu (Bupleurum Root) to 9–12 grams and Qingpi (Green Tangerine Peel) to 9–12 grams, keeping others the same. With increased Chaihu, administer according to Western medicine dosage methods: one dose taken in three parts. If onset is at 5 PM, take the first part at morning, second at 11 AM, third at 2–3 PM, and so on. For cases with more heat and fewer chills, heavily use Huangqin (Scutellaria Root) and reduce Chaihu; for cases without headache but with abdominal distension, add Baizhu (Atractylodes Macrocephala) 9–12 grams, Caoguo (Black Cardamom) 6 grams, and Fuling (Poria) 9 grams... If it is Wenre (Warm Malaria) with heat only and no chills, this formula is not applicable."
In treating lithiasis (stone diseases), Mr. Yuan established methods such as Opening Depression and Clearing Lung, Sweetening and Harmonizing the Middle, Nourishing Blood and Clearing Heat, and Warming and Unblocking to Stop Pain. He proposed treatment principles such as "Rise first to descend, Clear first to drain, Unblock first to expel stones, Support Righteousness first to Expel Pathogens." He cured numerous domestic and international patients with renal and biliary calculi, sparing them surgery. The "Opening Depression and Clearing Lung" method was mainly used for renal calculi, using Ezhu (Curcuma Zedoaria), Wuyao (Lindera Root), and Chishao (Red Peony Root) as main herbs, assisted by Chuanbei (Fritillaria Bulb), Houpo (Magnolia Bark), and Fuling (Poria). Few ingredients with potent effects; clearing the Lung represents treating the upper to address pathology in the lower. As early as the 1930s, he cured multiple renal calculus patients fearful of surgery with this method, astonishing Western doctors. The "Sweetening and Harmonizing the Middle" method was mainly used for biliary calculi, using Raw and Roasted Gancao (Licorice Root) as sovereign herbs, assisted by Hangshao (Hangzhou Peony Root), Kouren (Cardamom Seed), and Wuyao (Lindera Root). This reflects the principle that "Liver dislikes tension; eat sweet to relieve tension." In the early 1950s, he cured multiple biliary calculus patients with this method. Case records show patients visited between four and ten times, recovering completely with stone expulsion. Observing his prescriptions, each contained only six or seven herbs. Within modifications, tonification included draining, dispersion included收敛 (astringency), Qi-moving balanced with Yin-nourishing softness, and treating root combined with treating branch appropriately. Principles were correct, medications precise. Although heavy stone-expelling agents were not used, harmony of Yin-Yang, circulation of Qi mechanism, restoration of Middle Jiao pivot function, and promotion of Shaoyang ascending Qi made stone expulsion inevitable. This exemplified Mr. Yuan's subtle application of seeking the root in treatment and regulating Yin-Yang. These experiences expanded minds and provided valuable data for treating lithiasis.
Mr. Yuan placed great emphasis on herb compatibility and dosage adjustments, pointing out that prescribing is the primary concern, aiming only for hitting the target, strictly avoiding complexity. Thus, he had incisive insights into subtle differences in herb compatibility and varying effects of dosages. For instance, his views on the similarities and differences in indications for combinations of Shenfu (Ginseng and Aconite), Shufu (Atractylodes and Aconite), and Qifu (Astragalus and Aconite), and his understanding of Xiao Chengqi Tang, Houpo Dahuang Tang, and Houpo Sanwu Tang—where herbs are the same but dosages differ, leading to distinct indications—demonstrate profound insight capable of inspiring wisdom. Regarding similarities and differences among similar Chinese medicines, such as differences in compatibility applications of Chaihu (Bupleurum Root), Shengma (Cimicifuga Rhizome), and Gegen (Kudzu Root); differences in indications for Suosharen (Amomum Villosum Fruit), Baiko (White Cardamom), Cao Kou (Black Cardamom), and Roukou (Nutmeg); and subtleties in applications of Qin (Scutellaria Root), Lian (Coptis Rhizome), Bo (Phellodendron Bark), and Dahuang (Rhubarb Root), he provided concrete and detailed explanations. This not only helped junior scholars grasp essentials but also facilitated understanding of specific applications, earning praise from later generations.
On this basis, Mr. Yuan compiled *Overview of Warm Diseases*, *Selected Annotations on Treatise on Warm Diseases*, *Principles of TCM Diagnosis and Treatment*, *Discussions on Medical Arts*, and *Case Records of Mr. Yuan*, all crystallizations of his decades of experience. Regrettably, due to the passage of time and political turmoil, original manuscripts were damaged or incomplete, and have not been fully collected to date, which is truly lamentable.
**Humble as a Valley, Pursuing Excellence**