华北国医学院是私立大学，学生毕业后须经政府考核，发给开业执照，始能挂牌行医。但个体开业，收入不定，生活毫无保障，更兼反动政府对中医处处限制，摧残破坏，因之开展业务，十分困难。由此念及，在旧中国学生毕业即失业，前途茫茫，生活无着，枉有报国凌云志，「十扣柴扉九不开」。而今，学生毕业后由国家分配工作，有党的关怀，老一辈的诱掖，良好的工作条件，个人之才能智慧能得以充分发挥，正是「海阔凭鱼跃，天高任鸟飞」，今昔对比，不啻霄壤之别。因此，寄语青年一代，应该发奋图强，振兴中华，肩负起发展中医学术之重任，为四化建设多做贡献，庶不负党和人民之培养，老一辈之殷望。
我在国医学院子一九三五年毕业，一九三三年底提前考取了中医执照，毕业后即在津与先父同室执业，因能继续得到先父之教诲，在执业中又蒙留法医学博士陈绍贤有关西医学方面的指导，受益良多。不数载，先父以年事日高而引退，我独任其事，诊务不衰，门常如市。
先父临床尚用气分药，并据《内经》「气之不得无行也，如水之流，如日月之行不休，如环之无端，莫知其纪，．终而复始」之旨，认为气在人体内沿着经络血脉运行不息，循环往复，若有一毫壅塞，则气机不畅，脏腑失和，气血不词，百病丛生，此即《内经》「百病生于气」之意。并认为气实则多郁，气虚盘兼滞，气寒则多凝，气热见流急不顺，因此针对证情之寒热虚实，在大法确立之前题下，每喜佐用适当之气分药，以调畅气机，运行气血，调和脏腑，如阴虚之用香橼、绿萼梅、合欢花等，取其理气而不伤阴』血虚之用小量柴胡、荆芥等清芳流动之品，以舒发肝气；气虚之用陈皮、佛手、砂仁理脾和胃，取其补而不滞。它如降气之朴、枳、苏梗等，疏气之青皮、桔叶等，行气之乌药、术香、陈皮等，升气之柴胡、升麻、川芎等，以及香附醋炒以入肝，盐炒以入肾，炒黑以止血等等，皆为临床之所习用。我承继先父这一经验，临床数十年，渐达其妙，用药范围也有所发展。如藁本、细辛等，虽非气分药，但我常作气分药用。按《索问脏气法时论》说：「肝苦急，急食辛以散之。」细辛色青入盱，质轻宣散；藁本辛温通络，兼入厥阴，二药用治心胃气痛，或痛经等病每获捷效。我在继承家学，参究古人，今人医疗经验的同时，也注意搜集、整理、实验民间的单方、验方，如抽葫芦或向日葵根煎服疗水肿、小便癃闭；牛膝、乳香等分为末，每服6克治遗精，涂搽煤油疗斑秃；拉拉秧点瘊子等等，均采自民间验方而确有效果。此外，我亦重视单味药的治疗特效，及现代药理学对中医研究之成果，如青黛之消瘤，猫爪草之治结核，猪毛菜降压，苍耳于之疗过敏性皮炎，蜂房、全蝎之兴奋性机能以及外用熏洗疗法等等，在辨证用药的同时，每每参酌应用，常能提高疗效。
我体会，做学问主观勤奋、刻苦固为首要，而良师益友之指导、帮助也不可或缺。然此种指导和帮助常非主动「赐」我者，必须自己多方争取，或不耻下问直接请教，或敏而好学问接观摩，如能集众美于一身，则术之精良可必矣。
学而无厌勤而毋怠
先父生前以长于妇科而负名，我临证数十年，遵循家学，师古酌今，对于妇科病的治疗，不断总结、总考，疗效逐渐提高。如子痫病，我依据《内经》「诸暴强直皆属于风」、「诸风掉眩皆属于肝」、「血之与气并走于上，则为大厥」等论述，认为本病基本属于本虚标实之证，乃由肝肾阴虚，肝阳化风，气血逆乱，筋脉失养，挛急不舒所致。因筋脉挛急则血循不畅，络中血瘀，而瘀血阻脉更碍血行，遂形成恶性循环。因此，我治疗子痫症，在平肝熄风、滋阴潜降的同时，每加用活血化瘀之品，如桃仁、红花、寄奴，茜草、泽兰、牛膝等，以调畅血脉，舒缓挛急，多能收到良好效果，而无堕胎之虞。又如子宫功能性出血，属中医「崩漏」范畴，我在临床并不墨守古人「塞流、澄源、复旧」之顺序，而在出血期间，恒据「瘀血不去，新血不行」之旨，采用活血化瘀之法，俟血暂止则调补牌胃，以滋化源。使患者食眠转佳，体力渐复后，再予滋补肝肾，而顾先天，以提高远期疗效。
前人谓，妇女以衄为体，以气为甩。然气血之化生、运行、敷布、施泄等，无不与脏腑之功能活动有关，其中尤以肝、脾，肾三脏在妇女生理、病理上占有重要地位。王肯堂指出「女子童幼天癸未行之前，皆属少阴天癸既行，皆属厥明，天癸既绝，乃属太阴经也。」强调了肝、脾，肾三脏在妇女生理、病理上的重要意义，因此，在调治妇科疾病中，需重视肝、脾、肾三脏的作用，并宜注意三者之间的相互影响，互为因果的关系，不可顾此失彼。
(一)调肝肝藏血、主疏泄，性喜条达舒畅，在妇女病理、生理特点上占有重要地位，故有「肝为女子先天」之说。肝与冲任二脉通过经络互相联属，肝之生理功能正常，则藏血守职，气血调畅，冲任通盛，月事得以时下，胎孕产乳诸皆正常。若蠲情志抑郁，肝失疏泄，不能遂其条达之性，或肝不藏血，肝血耗伤，则可导致多种妇科疾病的发生，因有「万病不离乎郁，诸郁皆属于肝」之说。肝病用药原则，如《素问·藏气法时论》指出：「肝欲散，急食辛以散之，用辛补之，酸泄之」。肝苦急，急食甘以缓之。」故肝郁宜芳香辛散，肝燥宜甘润柔缓。临床凡月经不调，痛经、闭经、不孕、产后腹痛等症，见有精神抑郁，胸胁满闷、乳房胀痛等症者，我每以柴胡疏肝散舒肝解郁为基本方，兼寒则加乌药、小茴、吴萸、桔核等暖肝散寒，肝热则去川芎之升动，加丹皮、生地、黄芩、白薇等凉肝清热。但肝为刚脏，体阴用阳，故舒肝解郁不可一味仗恃辛燥劫阴之品，否则易造成肝郁化燥，气逆化火的病理变化，因此，在应用香燥辛散药物时，应适当佐以肝经血分之药，如归、芍、桃仁等，以缓肝急。另如，肝血不足或肝肾阴虚之月经涩少，经闭、痛经、不孕等病症，由于肝木失养，难遂条达之性，也每见有少腹作胀、胁肋隐痛等肝郁症状，可仿魏玉璜「一贯煎」之意，于大队养血柔肝、益肾填精药中，佐以香附、川楝、柴胡等舒肝之品，以助其升发之机。
(二)健脾胃脾胃功能正常与否，也是妇女生理病理特点的主要反映之一。如薛立斋说：「血者水谷之精气也，和调五脏，洒陈六腑，在男子则化为精，在妇人则上为乳汁，下为月水，故虽心主血，肝藏血，亦皆统摄于脾，补脾和胃，血自生矣。」但脾与胃的生理特点不同，用药则宜顺应其性。如脾司中气，其性主升，又为阴土，易损阳气，故治脾应针对其特点，用药多以温阳，益气，升清，化湿，辟秽等法为主。温阳药如炮姜、艾叶等，益气药如党参、黄芪，白朮、扁豆等}升清如柴胡、葛根、升麻等}化湿悦脾药如苍朮、厚朴、半夏、陈皮、苡米、藿香、佩兰等。常用方剂如补中益气汤、参苓白朮散、升阳益胃汤等等。而胃主受纳、其性主降，又为阳土，其性主燥，最易受热邪影响而耗伤胃沣，故治胃之法多应和胃降逆，清热养阴为主，前者如清半夏、竹茹、枳壳、佛手、苏梗等，后者如沙参、麦冬、花粉、石斛、知母、黄连等。常用方如温胆汤、麦门冬汤、沙参麦冬汤、左金丸等。
脾与肝关系甚为密切，脾主运化可以散精于肝，肝主疏泄可助脾胃之升降，在病理上肝病可以传脾，脾病亦每能及肝，故治脾又宜兼予舒肝，以期土木相安，和平与共。如脾虚所致之月经不调、痛经、闭经等病，见有面色淡黄，精神疲倦，心悸气短，食少膜胀，大便溏薄，甚则肢面浮肿，舌淡苔白等症状者，常用四君子汤加当归、川芎、柴胡、香附等药，培土疏术，或用逍遥散加党参、扁豆等从肝治脾。又如白带，多因脾虚气郁，湿热下注所致，故缪仲淳说：「白带多是脾虚，肝气郁则脾受伤，脾伤则湿土之气下陷，是脾精不守，不能输为荣血而下白滑之物。」治疗白带我常用理气化湿之法，谪肝以治脾。如以白朮、茯苓，车前子、清半夏、陈皮等燥湿健脾，加当归、．柴胡、香附、木香等舒肝解郁，每有较好疗效。
脾与胃之间在生理病理上的关系也十分密切。如脾胃的升降纳运功能，必得肾阳，命火的温煦作用，才能得以不断进行，倘肾阳不足，火不生土，则可导致脾胃升降失司；反之脾附久虚也必影响及肾阳不足，故治脾尚需兼予温肾。如子宫脱垂多因脾虚下陷，清阳不升所致，我以补中益气加巴戟，杜仲、续断等益气补肾，每获效果。又如脾不统血之崩漏症，我以举元煎加减治疗，药如参、芪，术等补气培元固冲，阿胶，熟地、枸杞、女贞等养血止血}并以杜仲、川断、菟丝、萸肉等大队益肾之品，从肾治脾，以期脾肾相生，效果甚好。
(三)补肾肾主藏精而寓元阳，为水火之脏，主生殖而系胞脉，与妇女之月经、胎孕关系至为密切。补肾包括滋补肾阴(精)，温补肾阳(气)两方面。
滋补肾阴常宜兼为益肝、涩精。《张氏医通》说：「气不耗，归精于肾而为精；精不泄，归精于肝而化清血。」说明精血之间具有相互资生、相互转化的关系。故有精血合一，肝肾同源之说。义肝为肾子，肾精既损，肝血当也不充，所谓「母虚及予」，故滋补肾阴每需兼予益肝。我恒以二至丸为基础方，加杜仲、枸杞、首乌、当归等，俾血能化精，子令母实。又因肾主封藏，肾阴亏损封藏失职，则精易走泄，故又常加五味、菟丝、寄生、萸肉之类补肾涩精，以固封藏。临床凡由肝肾阴虚所致之经闭、不孕、崩漏带下、滑胎等病症，每以上述方药为主，视具体病情加减，疗效不爽。若肾阴虚损，阳失制约，相火失潜而致之月经先期、量多，崩漏等病，伴见颧红盗汗，五心烦热，午后潮热等证者，则宗壬太仆。壮水之主，以制阳光」之旨，常用二至丸加生地，丹皮、元参、麦冬，自芍、骨皮等滋阴凉营，并鳖甲、龟板，牡蛎等介类潜降之品，而不主张用知，柏等苦寒损阴之药。
对于肾阴虚者，据「精能化气」之旨，宜温补肾阳兼用温润填精之品，诸如鹿角胶、紫河车、巴戟天、金狗脊、菟丝子、川续断等，若兼见四末不温，小腹冷痛等虚寒之症，贝8加仙茅、淫革藿、故纸、艾叶≮吴萸等温阳散寒之品，而对辛热劫津之千姜、附子、肉桂等，一般较少应用，即使确有下元虚冷，寒湿不化，见有面白肢厥、重衣不暖、肢面浮肿、脉象沉迟等症，而必须应用时，亦不可重用久用。又肾阳虚，火不生土，也每使脾阳不振，脾运失健，脾不能助肺益气，故肾阳虚叉常见脾肺气虚之症，如气短乏力、自汗、便溏等，故在温阳填精的同时，尚须辅以参，术、芪等益气健脾之药，以从气中补阳。以上仅是述其涯略，以见三脏治法之原则，学者当举一反三焉。
又在妇科临床倘辅以现代检查方法尤属必要。
语云，「学如逆水行舟，不进则退」。今值中医、西医、中西医结合三种力量都要大力发展的大好形势下，个人学识也应不断提高，不断更新，否则便有落伍之虞。宋代理学家朱熹在「读书有感」一诗中，有「问渠那得清如许，谓有源头活水来」之句，表明了不断学习的重要意义。如今青年人的学习条件，比之老一代好得多，应该不负春光，苦下功夫，在扎扎实实搞好基本功训练的前提下，尚应兴趣广泛，如学习自然辩证法及其它学科的知识，所谓「诗在功夫外」。我自一九五五年以来，由于工作需要，一直担任着地方卫生部门的领导职务，虽会议多，工作繁忙，但仍要抽暇读书与临证，即在十年浩劫中，寒家被毁，身处逆境，但有可能我自然要为患者治疗，在实践中继续学习。毛泽东同志说；「学习的敌人是自己的满足，要认真学习一点东西，必须从不自满开始。对自己『学而不厌』，对人家『诲人不倦』，我们应取这种态度。」我如今虽然已经垂垂老矣，但仍要倍加努力，「学而不厌」，争取为党、为人民、为祖国医学事业多做些贡献。活到老、学到老、干到老，我愿以此自勉，并与后学俊彦共勉。
满目青山夕照明湖
北中医学院院长、教授洪子云
【作者简介】洪子云(1916～)，湖北鄂城人。医学得自家传，从事中医工作五十年。长于内科，尤长于伤寒、温病。一九六三年参与审订全国中医学院试用教材《伤寒论讲义》(上海科技出版社1964年版)。先后主编该院《伤寒论讲义》、《伤寒论教学参考数据》。现任湖北省人大常务委员、湖北省政协常务委员，中华全国中医学会常务理事等职。
余幼读儒书，少年学医，侧身杏林，凡五十寒暑。虽学业渐进，然菲一帆风顺。对于迂回曲折之中，勉得一进，时于艰苦竭蹶之际，有所收获。是以每进一步，深知其难；愈知其难，愈以求进。余天资驽钝，学无妙法；医术不精，鲜有良方。今能告青年后学者惟「难」与「进」二字而已。
谨承庭训
Huabei College of Traditional Chinese Medicine was a private university. After graduation, students had to pass government examinations and obtain a license to practice medicine before they could open their own clinics. However, individual practice meant unstable income and no guarantee of livelihood. Moreover, the reactionary government imposed restrictions on traditional Chinese medicine (TCM) at every turn, suppressing and destroying it, making business development extremely difficult. Reflecting on this, in old China, graduates faced unemployment upon leaving school, with bleak prospects and no means of support. They possessed lofty aspirations to serve the country but encountered rejection everywhere, much like "knocking on a wooden door nine times out of ten without success." Today, graduates are assigned jobs by the state, cared for by the Party, guided by senior practitioners, and provided with favorable working conditions where their talents and wisdom can be fully utilized. It is truly like "the vast ocean allows fish to leap, and the high sky lets birds fly." The contrast between then and now is as different as heaven and earth. Therefore, I entrust words to the younger generation: strive hard to revitalize China, shoulder the heavy responsibility of developing TCM academic research, and contribute more to the Four Modernizations, so as not to let down the cultivation of the Party and the people, nor the earnest expectations of the older generation.
I graduated from Huabei College of TCM in 1935. At the end of 1933, I passed the TCM licensing examination early. After graduation, I practiced jointly with my late father in Tianjin. Because I could continue to receive his teachings, and also received guidance from Dr. Chen Shaoxian, a medical doctor who studied in France, regarding Western medicine, I benefited greatly. Within a few years, my father retired due to advanced age, and I took over the practice alone. The clinical workload remained steady, and our clinic was often bustling with patients.
My late father still used Qi-regulating herbs in clinical practice. Based on the principle in *Huangdi Neijing* (Yellow Emperor's Inner Canon): "Qi must flow; like water flowing, like the sun and moon moving ceaselessly, like a circle without beginning or end, its cycle is unknown, ending and beginning again," he believed that Qi circulates endlessly along the meridians and blood vessels within the human body. If there is even a slight obstruction, Qi mechanism becomes stagnant, Zang-Fu organs lose harmony, Qi and Blood become discordant, and myriad diseases arise. This aligns with the meaning of "all diseases originate from Qi" in *Huangdi Neijing*. He believed that excess Qi tends to stagnate, deficient Qi is prone to blockage, cold Qi tends to congeal, and hot Qi flows rapidly and irregularly. Therefore, under the premise of establishing major treatment principles, he often added appropriate Qi-regulating herbs according to the cold, heat, deficiency, and excess of the syndrome, to smooth the Qi mechanism, promote Qi and Blood circulation, and harmonize Zang-Fu organs. For example, for Yin deficiency, he used Citrus medica (Xiangyuan), Camellia sinensis var. reticulata 'Lü'e Mei' (Green Calyx Plum), and Albizia julibrissin flower (Hehuanhua), taking advantage of their ability to regulate Qi without damaging Yin. For Blood deficiency, he used small doses of Bupleurum chinense (Chaihu) and Schizonepeta tenuifolia (Jingjie), aromatic and mobile herbs to soothe and disperse Liver Qi. For Qi deficiency, he used Tangerine peel (Chenpi), Bergamia fruit (Foshou), and Amomum villosum (Sharen) to regulate Spleen and Stomach, benefiting from their tonifying yet non-stagnating properties. Other examples include Houpo (Magnolia bark), Zhishi (Immature Bitter Orange), and Perilla stem (Sugeng) for descending Qi; Qingpi (Green Tangerine Peel) and Citrus reticulata leaf (Jieye) for dispersing Qi; Lindera aggregata (Wuyao), Costus root (Muxiang), and Chenpi for promoting Qi movement; Chaihu, Cimicifuga foetida (Shengma), and Ligusticum chuanxiong (Chuanxiong) for ascending Qi; and Cyperus rotundus (Xiangfu) stir-fried with vinegar to enter the Liver, salted to enter the Kidney, or charred to stop bleeding. These were all commonly used in clinical practice. Inheriting my father's experience, after decades of clinical work, I gradually mastered these techniques and expanded the scope of my herbal usage. For instance, although Ligusticum jeholense (Gaoben) and Asarum heterotropoides (Xixin) are not typically classified as Qi-regulating herbs, I often use them as such. According to *Suwen: Zangqi Fashi Lun*: "The Liver dislikes tension; eat pungent foods to disperse it." Xixin is green, enters the Liver, and has a light quality that promotes dispersion; Gaoben is pungent and warm, unblocks collaterals, and enters the Jueyin channel. Both herbs are effective for treating epigastric pain or dysmenorrhea. While inheriting family learning and studying the medical experiences of ancient and modern masters, I also paid attention to collecting, organizing, and experimenting with folk single prescriptions and verified formulas. For example, decocting Cucurbita ficifolia root or Helianthus annuus root for edema and urinary retention; grinding Achyranthes bidentata (Niuxi) and Frankincense (Ruxiang) into powder, taking 6 grams per dose for seminal emission; applying kerosene for alopecia areata; using Urtica dioica (Lalayang) to remove warts, etc. All were effective folk remedies. Additionally, I valued the specific therapeutic effects of single herbs and the achievements of modern pharmacological research on TCM. For example, Indigo naturalis (Qingdai) for tumors, Ranunculus ternatus (Maozhao Cao) for tuberculosis, Suaeda glauca (Zhumotai) for lowering blood pressure, Xanthium sibiricum (Cang'erzi) for allergic dermatitis, Apis cerana nest (Fengfang) and Scorpio (Quanxie) for stimulating sexual function, and external fumigation/washing therapies. When prescribing based on syndrome differentiation, I often incorporated these methods, which frequently improved efficacy.
I realize that subjective diligence and hard work are primary in scholarship, but guidance and help from good teachers and friends are indispensable. However, such guidance is rarely given proactively; one must strive for it oneself, either by asking questions without shame or by keenly observing and learning from others. If one can gather these strengths, excellence in skill is guaranteed.
Learn without satiety, work without laziness.
My late father was famous for his expertise in gynecology. In my decades of clinical practice, following family traditions and combining ancient wisdom with contemporary insights, I continuously summarized and reflected on the treatment of gynecological diseases, gradually improving efficacy. For eclampsia, based on *Huangdi Neijing* statements such as "All sudden stiffness belongs to Wind," "All wind-induced tremors and dizziness belong to the Liver," and "When Blood and Qi rush upward together, it is called Great Jue," I believe this disease essentially involves root deficiency and branch excess. It is caused by Liver-Kidney Yin deficiency, transformation of Liver Yang into Wind, chaotic reversal of Qi and Blood, malnourishment of sinews and vessels, leading to spasms and discomfort. Sinew spasms impair blood circulation, causing blood stasis in collaterals, which further obstructs blood flow, creating a vicious cycle. Therefore, in treating eclampsia, while calming the Liver and extinguishing Wind, and nourishing Yin and subduing Yang, I often add blood-invigorating and stasis-resolving herbs such as Peach kernel (Taoren), Safflower (Honghua), Liuji Nu (Lysimachia), Rubia cordifolia (Qiancao), Lycopus lucidus (Zelan), and Niuxi, to smooth blood vessels and relieve spasms. This usually yields good results without risking miscarriage. Regarding functional uterine bleeding, belonging to the TCM category of "Beng Lou" (flooding and spotting), I do not rigidly follow the ancient sequence of "stopping flow, clearing source, restoring foundation." During bleeding, adhering to the principle "if stasis is not removed, new blood cannot form," I employ blood-invigorating and stasis-resolving methods. Once bleeding temporarily stops, I regulate and tonify the Spleen and Stomach to nourish the source of Qi and Blood. This improves appetite and sleep, restores physical strength, and subsequently, I tonify Liver and Kidney to address the congenital root, thereby improving long-term efficacy.
Predecessors stated that women take Blood as their substance and Qi as their function. The production, circulation, distribution, and excretion of Qi and Blood are all related to Zang-Fu organ activities, among which the Liver, Spleen, and Kidney play crucial roles in female physiology and pathology. Wang Kentang pointed out: "Before menarche, girls belong to Shaoyin; after menarche, they belong to Jueyin; after menopause, they belong to Taiyin." This emphasizes the importance of the Liver, Spleen, and Kidney in female physiology and pathology. Therefore, in treating gynecological diseases, one must value the roles of these three organs and pay attention to their mutual influence and causal relationships, avoiding partiality.
(1) Regulating the Liver: The Liver stores Blood and governs free flow, preferring smoothness and comfort. It plays a significant role in female pathology and physiology, hence the saying "The Liver is the先天 (innate foundation) of women." The Liver connects with the Chong and Ren vessels through meridians. Normal Liver function ensures proper Blood storage, smooth Qi and Blood circulation, abundant Chong and Ren vessels, timely menstruation, and normal pregnancy, childbirth, and lactation. Emotional depression causes Liver Qi stagnation, preventing its free-flowing nature, or Liver fails to store Blood, leading to various gynecological diseases. Hence, "all diseases involve stagnation, and all stagnation belongs to the Liver." Treatment principles for Liver diseases, as stated in *Suwen: Zangqi Fashi Lun*: "The Liver desires dispersion; eat pungent foods to disperse it, use pungent to tonify, sour to drain. The Liver dislikes tension; eat sweet foods to relax it." Thus, Liver stagnation should be treated with aromatic and pungent dispersants, while Liver dryness requires sweet and moistening softeners. Clinically, for menstrual disorders, dysmenorrhea, amenorrhea, infertility, and postpartum abdominal pain accompanied by mental depression, chest and hypochondriac fullness, and breast distension, I use Chaihu Shugan San (Bupleurum Powder to Soothe the Liver) as a base formula to soothe the Liver and resolve stagnation. If cold is present, I add Lindera (Wuyao), Fennel (Xiaohui), Evodia (Wuyu), and Apricot kernel (Jiehe) to warm the Liver and dispel cold. If heat is present, I remove Ligusticum (Chuanxiong) for its ascending nature and add Moutan cortex (Danpi), Rehmannia glutinosa (Shengdi), Scutellaria baicalensis (Huangqin), and Anemarrhena asphodeloides (Baiwei) to cool the Liver and clear heat. However, the Liver is a rigid organ with Yin substance and Yang function. Soothing the Liver should not rely solely on pungent-dry herbs that consume Yin, as this may cause Liver stagnation to transform into dryness and Qi reversal to transform into fire. Therefore, when using aromatic-pungent dispersants, one should appropriately add Blood-level herbs of the Liver meridian, such as Angelica sinensis (Danggui), White Peony Root (Baishao), and Taoren, to ease Liver tension. For cases of insufficient Liver Blood or Liver-Kidney Yin deficiency presenting with scanty menstruation, amenorrhea, dysmenorrhea, and infertility, where Liver Wood is malnourished and cannot achieve free flow, often accompanied by lower abdominal distension and hidden hypochondriac pain (symptoms of Liver stagnation), I imitate Wei Yuhuang's "Yiguan Jian" (One Glance Decoction). Among large doses of herbs that nourish Blood, soften the Liver, and benefit the Kidney, I add Cyperus (Xiangfu), Melia toosendan (Chuanlian), and Chaihu to assist the ascending mechanism.
(2) Strengthening Spleen and Stomach: Whether Spleen and Stomach functions are normal is a main reflection of female physiological and pathological characteristics. Xue Lizhai said: "Blood is the essence of food and water, harmonizing the Five Zang and spreading to the Six Fu. In men, it transforms into Essence; in women, it goes up to become milk and down to become menstrual blood. Although the Heart governs Blood and the Liver stores Blood, both are controlled by the Spleen. Tonifying the Spleen and harmonizing the Stomach generates Blood naturally." However, the Spleen and Stomach have different physiological characteristics, so medication should conform to their natures. The Spleen governs Middle Qi, its nature is ascending, and it is Yin Earth, easily damaging Yang Qi. Therefore, treating the Spleen should focus on warming Yang, tonifying Qi, ascending Clear Qi, resolving Dampness, and eliminating turbidity. Warming Yang herbs include Paojiang (Processed Ginger) and Aiye (Mugwort Leaf); tonifying Qi herbs include Codonopsis pilosula (Dangshen), Astragalus membranaceus (Huangqi), Atractylodes macrocephala (Baizhu), and Lablab purpureus (Baidou); ascending Clear Qi herbs include Chaihu, Pueraria lobata (Gegen), and Shengma; resolving Dampness and pleasing the Spleen herbs include Cangzhu, Magnolia officinalis (Houpo), Pinellia ternata (Banxia), Chenpi, Coix seed (Yimi), Houttuynia cordata (Huoxiang), and Eupatorium fortunei (Peilan). Common formulas include Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), Shenling Baizhu San (Codonopsis, Poria, and Atractylodes Powder), and Shengyang Yiewei Tang (Raise Yang and Benefit the Stomach Decoction). The Stomach governs reception, its nature is descending, it is Yang Earth, and its nature is dry, easily affected by Heat pathogens damaging Stomach fluids. Thus, treating the Stomach focuses on harmonizing the Stomach and directing rebellious Qi downward, clearing heat, and nourishing Yin. Former includes Banxia (Pinellia), Zhu Ru (Bamboo Shavings), Zhike (Aurantium Fruit), Foshou, Sugeng; latter includes Glehnia littoralis (Shashen), Ophiopogon japonicus (Maidong), Trichosanthes kirilowii (Huafen), Dendrobium nobile (Shihu), Anemarrhena (Zhimu), and Coptis chinensis (Huanglian). Common formulas include Wendan Tang (Warm the Gallbladder Decoction), Maidong Men Dong Tang (Ophiopogon and Asparagus Decoction), Shashen Maidong Tang (Glehnia and Ophiopogon Decoction), and Zuojin Wan (Left Metal Pill).
The relationship between Spleen and Liver is close. The Spleen governs transportation and can distribute essence to the Liver; the Liver governs free flow and assists Spleen-Stomach ascending and descending. Pathologically, Liver disease can transmit to the Spleen, and Spleen disease can affect the Liver. Thus, treating the Spleen should also include soothing the Liver to ensure harmony between Wood and Earth. For menstrual disorders, dysmenorrhea, and amenorrhea caused by Spleen deficiency, presenting with sallow complexion, fatigue, palpitations, shortness of breath, poor appetite, abdominal distension, loose stools, limb and facial edema, pale tongue with white coating, I commonly use Sijunzi Tang (Four Gentlemen Decoction) plus Danggui, Chuanxiong, Chaihu, and Xiangfu to strengthen Earth and disperse Wood, or Xiaoyao San (Free Wanderer Powder) plus Dangshen and Baidou to treat the Spleen via the Liver. Leukorrhea is often caused by Spleen deficiency with Qi stagnation and downward pouring of Damp-Heat. Miu Zhongchun said: "Leukorrhea is mostly due to Spleen deficiency. Liver Qi stagnation injures the Spleen; Spleen injury causes Damp-Earth Qi to sink, meaning Spleen essence does not guard itself and cannot transport to form nutritious Blood, instead leaking white slippery matter." To treat leukorrhea, I use methods to regulate Qi and resolve Dampness, draining the Liver to treat the Spleen. Using Baizhu, Poria cocos (Fuling), Plantago asiatica (Cheqianzi), Banxia, and Chenpi to dry Dampness and strengthen the Spleen, plus Danggui, Chaihu, Xiangfu, and Muxiang to soothe the Liver and resolve stagnation, often yields good results.
The relationship between Spleen and Stomach in physiology and pathology is also very close. The ascending-descending and receiving-transforming functions of Spleen and Stomach require the warming action of Kidney Yang and Mingmen Fire to proceed continuously. If Kidney Yang is insufficient, Fire fails to generate Earth, leading to Spleen-Stomach dysfunction. Conversely, chronic Spleen deficiency affects Kidney Yang. Thus, treating the Spleen often requires warming the Kidney. Uterine prolapse is often caused by Spleen deficiency sinking and failure of Clear Yang to ascend. I use Buzhong Yiqi Tang plus Morinda officinalis (Bajitian), Eucommia ulmoides (Duzhong), and Dipsacus asper (Xuduan) to tonify Qi and benefit the Kidney, often achieving results. For flooding and spotting due to Spleen failing to control Blood, I use Juyuan Jian (Raise Yuan Decoction) modified. Herbs like Renshen, Huangqi, and Baizhu tonify Qi, strengthen the origin, and secure the Chong vessel; Ejiao (Donkey-hide Gelatin), Shudi (Prepared Rehmannia), Gouqi (Goji Berry), and Nvzhenzi (Ligustrum Lucidum Fruit) nourish Blood and stop bleeding; combined with Duzhong, Chuan Duan, Tusizi, and Shanzhuyu to benefit the Kidney, treating the Spleen via the Kidney to promote Spleen-Kidney mutual generation, yielding excellent results.
(3) Tonifying the Kidney: The Kidney stores Essence and houses Primordial Yang, is the Water-Fire organ, governs reproduction and connects to the uterus, and is closely related to female menstruation and pregnancy. Tonifying the Kidney includes nourishing Kidney Yin (Essence) and warming Kidney Yang (Qi).
Nourishing Kidney Yin often benefits the Liver and secures Essence. *Zhangshi Yitong* states: "If Qi is not consumed, Essence returns to the Kidney to become Jing; if Jing is not leaked, Essence returns to the Liver to transform into clear Blood." This explains the mutual generation and transformation between Essence and Blood, hence "Essence and Blood are one, Liver and Kidney share the same source." Since the Liver is the child of the Kidney, if Kidney Essence is damaged, Liver Blood is also insufficient ("Mother deficiency affecting Child"). Thus, nourishing Kidney Yin often requires benefiting the Liver. I constantly use Erzhi Wan (Two Winter Decoction) as a base, adding Duzhong, Gouqi, He Shou Wu (Polygonum multiflorum), and Danggui, so Blood can transform into Essence, and the Child strengthens the Mother. Since the Kidney governs sealing and storing, Kidney Yin deficiency leads to loss of sealing function, causing Essence to leak easily. Therefore, I often add Wuweizi (Schisandra), Tusizi (Cuscuta), Duzhong, and Shanzhuyu (Cornus) to tonify the Kidney and secure Essence, solidifying the seal. Clinically, for amenorrhea, infertility, flooding/spotting, leukorrhea, and habitual abortion caused by Liver-Kidney Yin deficiency, I mainly use the above formulas, modifying them according to specific conditions, with consistent efficacy. If Kidney Yin deficiency leads to unconstrained Yang, unrestrained Minister Fire, causing early menstruation, heavy flow, or flooding, accompanied by malar flush, night sweats, five-palm heat, and afternoon tidal fever, I follow Zhu Danxi's principle: "Strengthen the master of Water to control the sunlight." I commonly use Erzhi Wan plus Shengdi, Danpi, Xuanshen (Scrophularia), Maidong, Baishao, and Mutan Pi (Moutan Bark) to nourish Yin and cool Camp, along with turtle shell (Guiban), oyster shell (Muli), and abalone shell (Biejia) to anchor and descend, avoiding bitter-cold herbs like Zhimu and Huangbai that damage Yin.
For those with Kidney Yin deficiency, based on "Essence can transform into Qi," one should warm Kidney Yang while using moist and warm herbs to fill Essence, such as Lu Jiao Jiao (Deer Antler Glue), Zi He Che (Placenta Humanum), Bajitian, Jin Gouji (Morinda officinalis root), Tusizi, and Chuanxuduan. If accompanied by cold extremities and lower abdominal cold pain (deficiency-cold symptoms), I add Xianmao (Curculigo), Yin Yang Huo (Epimedium), Guye Zhi (Aconite lateral root processed), Aiye, and Wuyu to warm Yang and dispel cold. Pungent-hot herbs that consume fluids like Ganjiang (Dried Ginger), Fuzi (Prepared Aconite), and Rougui (Cinnamon Bark) are generally used less. Even if there is definite lower Yuan deficiency-cold with failure to transform Cold-Damp, presenting with pale face, cold limbs, need for heavy clothing, edema, and deep-slow pulse, requiring their use, they should not be used heavily or for long durations. Furthermore, Kidney Yang deficiency failing to generate Earth often causes Spleen Yang weakness and impaired Spleen transportation. The Spleen cannot assist the Lung in generating Qi, so Kidney Yang deficiency often presents with Spleen-Lung Qi deficiency symptoms like shortness of breath, fatigue, spontaneous sweating, and loose stools. Therefore, while warming Yang and filling Essence, I supplement with Renshen, Baizhu, and Huangqi to tonify Qi and strengthen the Spleen, tonifying Yang through Qi. The above outlines the general principles of treating these three organs; students should apply this knowledge flexibly.
In gynecological clinical practice, assisting with modern examination methods is particularly necessary.
As the saying goes, "Learning is like sailing against the current; if you do not advance, you retreat." In the current favorable situation where TCM, Western Medicine, and Integrated Chinese and Western Medicine are all vigorously developed, personal knowledge should also continuously improve and update, otherwise there is a risk of falling behind. Song Dynasty Neo-Confucianist Zhu Xi wrote in "Thoughts on Reading": "How can the canal be so clear? Because there is a source of living water coming." This indicates the importance of continuous learning. Young people today have much better learning conditions than the older generation. They should make the most of their youth, work hard, and while solidly mastering basic skills, broaden their interests, such as studying dialectics of nature and other disciplines, as the saying goes, "Poetry lies beyond the craft." Since 1955, due to work needs, I have held leadership positions in local health departments. Despite many meetings and busy work, I still find time to read and practice clinically. Even during the Cultural Revolution, when my home was destroyed and I was in adversity, whenever possible, I naturally treated patients and continued learning in practice. Comrade Mao Zedong said: "The enemy of learning is self-satisfaction. To seriously learn something, one must start without being complacent. Be 'tireless in learning' for oneself, and 'tireless in teaching' for others; we should adopt this attitude." Although I am now old, I will still strive加倍, "be tireless in learning," striving to contribute more to the Party, the people, and the motherland's medical cause. Live until old, learn until old, work until old. I wish to encourage myself with this and exhort young scholars to do the same.
Full view of green mountains illuminated by evening sunset.
Dean and Professor Hong Ziyun, Beijing University of Chinese Medicine
[Author Profile] Hong Ziyun (1916–), from Echeng, Hubei. Medical knowledge inherited from family tradition, engaged in TCM work for fifty years. Expert in Internal Medicine, especially Shanghan and Wenbing. Participated in reviewing the national TCM college trial textbook *Shanghan Lun Jiangyi* (Shanghai Science and Technology Press, 1964 edition). Successively edited the college's *Shanghan Lun Jiangyi* and *Shanghan Lun Teaching Reference Data*. Currently serves as Standing Committee Member of Hubei Provincial People's Congress, Standing Committee Member of Hubei Provincial CPPCC, and Executive Director of the Chinese Medical Association.
In my youth, I studied Confucian classics; in adolescence, I learned medicine. Entering the apricot forest (medical profession), fifty winters and summers have passed. Although my studies progressed gradually, it was not smooth sailing. Amidst twists and turns, I managed to advance, gaining some harvest during hardships. Thus, each step forward made me know its difficulty; the more I knew its difficulty, the more I sought to advance. My natural talent is dull, with no clever methods in learning; my medical skills are not refined, with few good prescriptions. What I can tell young learners now is only two characters: "Difficulty" and "Advance."
Respectfully inheriting family instructions.