Library

My ancestral home is in Hongjia Dakwa, Echeng County, Hubei Province. Our family has practiced medicine for three generations. My grandfather, Mr. Kunchen, was proficient in the *Shanghan Lun* (Treatise on Cold Damage). My father, Mr. Yunqing, inherited the family profession but specialized in *Wenbing* (Warm Disease Theory), gaining a prominent reputation in our locality after middle age. As the eldest son and grandson, I inherited the family's love for medicine, but my upbringing was strict: loved but not spoiled, raised but not pampered, with particularly rigorous guidance. At seven, I entered school and began reciting the *Three Character Classic*. As I grew older, I studied the works of various philosophers and also poetry and prose. Initially, while my grandfather was alive, he was busy with clinical duties during the day and checked my studies at night. If I could recite the day's lessons and write them from memory, he would comfort me; otherwise, he would reprimand me severely, insisting that I complete the task that night before allowing me to rest. Later, my father supervised my studies even more strictly. Although our family was poor, he spared no expense on lamp oil, so I often sat studying until the rooster crowed and read until the fifth watch of the morning. This continued for ten years, and I gained a basic understanding of literature. By the time I left school, I had reached adulthood. Influenced by years of family education, I resolved to become a doctor. My father taught me medical classics, instructing me personally. For content where theory could be verified by practice, he ensured clarity in every word. Where he had personal insights, he integrated them into his teaching with passion. For obscure or missing parts, he avoided forced explanations to prevent misleading me. Regarding the *Huangdi Neijing* (Yellow Emperor's Inner Canon), besides requiring fluent reading and comprehension, he specified certain passages for intensive study and memorization. As for the *Shanghan Lun* and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), he required whole-book memorization, termed "bao ben" (covering the whole book). Although Wenbing texts were not considered classics, due to my father's deep interest, I was also required to memorize Ye Tianshi's *Wenre Lun* (Discourse on Warm Heat) and Wu Jutong's *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases), along with selected refined mnemonic verses. Though it seemed bitter then, its sweetness became apparent when needed. Human physiology dictates that age passes with time, and memory declines with age. Without hard study in youth and repeated reinforcement, I would now, in old age, be empty-headed and ignorant. Some laugh and say: rote memorization is an old custom; we have entered the electronic age, where understanding the spirit is sufficient, and memorization is outdated. I reply: Even in the electronics of the electronic age, there are countless formulas, laws, theories, and data that require both understanding and memorization. If one knows much when opening the book but nothing when closing it, appearing knowledgeable but lacking firm views, how can one apply knowledge? Therefore, I advise future scholars to still memorize, as memorization deepens understanding, and understanding promotes memorization. Memorization is not easy, but advancing despite difficulties and repeating thus brings infinite joy.

During my studies, I often attended consultations with my father, linking theory with practice. For each case, I first analyzed the pathogenesis and prescribed herbs, then my father reviewed them one by one, determining correctness, which benefited me greatly. After three years of attendance, at age twenty, I was allowed to consult independently. Seeing initial efficacy, I was complacent. Little did I know that all cases I treated were known to my father, who either pointed them out explicitly or investigated secretly without slackening. One day, my father asked, "How is the treatment for a certain patient in a certain village?" I replied, "Cured." My father said angrily, "You only saw high fever and dry tongue and used cold-natured herbs, without observing the overall exterior-interior and cold-heat patterns. Although the patient had high fever, he also had aversion to cold, no sweating, and irritability, fitting the pattern of Da Qing Long Tang (Major Blue Green Dragon Decoction). Fortunately, I noticed this and changed the prescription in time, leading to recovery. Your experience is shallow, and your reading insufficient. From today, stop consulting and focus solely on reading medical books." This was like a sudden blow to the head. Though young and spirited, I dared not disobey and studied even harder. Within two years, my prescribing privileges were revoked and restored three times, termed "tempering the will to purify the mind." While this method may not suit modern youth, I believe self-discipline should be encouraged. Zengzi said, "I examine myself three times a day." I believe young medical workers should work during the day and reflect at night. Whenever deficiencies are found, literature should be consulted to deepen understanding. Insights should be summarized promptly for future reference. The medical path is difficult, but for those unyielding and dedicated, overcoming obstacles step by step is possible.

My grandfather and father accumulated decades of medical experience, writing many manuscripts, especially medical records, which I read carefully and treasured. On his deathbed, my father pointed to various manuscripts and said, "Han Yu once said, 'Excellence in learning comes from diligence but is ruined by play; success in conduct comes from thinking but is destroyed by following others.' There is no record of anyone mastering their field relying on ancestors. Therefore, all manuscripts should be destroyed, relying entirely on your independence." I was heartbroken and wanted to keep them, but he said, "If descendants are useful, what use are they? If useless, what use are they?" Tears streaming, I obeyed and destroyed them. Shortly after, my father passed away, and I was twenty-two. I realized that while the medical path is hard, striving relentlessly and persevering to the end is even harder. I suddenly understood: my father burning the manuscripts was meant to spur me, with good intentions. Remembering this stirs my emotions. I often say that today's youth are privileged, receiving care from the Party, education from teachers, and help from comrades, with superior learning conditions. Thus, youth must surpass the elderly, promoting the art of Qi Bo and Huang Di. I place my hope in the youth.

Integrating "Cold" and "Warm"

Medicine is vast as the sea, and literature is abundant. Human energy is limited; seeking breadth is relative, and mastering everything is impossible. Since my father mastered both Shanghan and Wenbing, I developed a strong interest in both from childhood. After building a solid foundation in TCM basics, I specialized in Shanghan and Wenbing and applied them clinically. My study method was to first read Shanghan to understand the source of external febrile diseases, then study Wenbing to understand its flow. Reading Shanghan involved three steps. 1. Read and memorize thoroughly to grasp the general spirit, using Cheng Wuji's *Zhushi Shanghan Lun* (Commentary on the Treatise on Cold Damage) as a main reference. Do not seek quantity, but proficiency. 2. Intensively study the three "Collected Works" by Ke Qin, You Zaijing, and Qian Huang, *Yizong Jinjian Corrected Complete Works of Zhang Zhongjing*, *Shanghan Yiyi*, and interpretations by Zhang Yin'an, Zhanglingshao, and Chen Xiuyuan, browsing others to broaden horizons. Based on extensive reading, synthesize, analyze, compare, and appreciate each clause, integrating and differentiating. For example, regarding "epigastric fullness and obstruction," besides the five Xixin Decoctions patterns, search relevant clauses, analyze and compare to find similarities and differences in syndrome differentiation and treatment, keeping them clear in mind for application. Years of practice prove this step greatly aids clinical diagnosis and differential diagnosis. 3. Link theory with practice. Maintain a relationship with books that is both close and distant. "Close" means using books to improve theoretical levels. "Distant" means not being bound by books, thinking independently, actively recognizing disease progression and treatment laws, not limited to text. Summarize and improve based on practice. This cycle forms unique academic views. For instance, Clause 157 of the *Shanghan Lun* mentions "epigastric fullness, hardness, and pain radiating to the hypochondrium" in the Shizao Tang (Ten Dates Decoction) pattern. Commentators usually follow the text without deep investigation. In clinical practice, I found many patients complained of epigastric pain, but few of hardness/fullness. Checking the body, I realized that when pressing the epigastrium, resistance felt strong, resembling hardness/fullness. Patients rarely complained of epigastric pain but often mentioned pain radiating to the hypochondrium, especially with severe fluid retention causing suffocation. Thus, "hardness/fullness radiating to the hypochondrium" is an objective sign. The sentence should be punctuated as "Epigastric obstruction, hardness/fullness radiating to the hypochondrium." This fits clinical reality and aids teaching. Similarly, Clause 22 states, "Taiyang disease, after purgation, if pulse is rapid and chest is full, Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction minus Peony Root) governs." Views on "rapid pulse" vary. Some interpret it as "rapid and short," others as "rapid with intermittent pauses." Clinically, "rapid and short" is common and accepted by most. "Rapid with intermittent pauses" is also seen, e.g., in viral myocarditis, resembling external contraction initially, with rapid pulse (intermittent pauses) appearing even after external symptoms resolve. For cases with heart yang deficiency, modified Guizhi Qu Shaoyao Tang often yields good results. Thus, both views can be accepted without theoretical debate.

Studying Wenbing requires gradual progress, step by step. Reference books should start with *Wenre Jingwei* (Source and Coordinate of Warm Heat) and *Wenbing Tiaobian* to build a solid foundation, then expand. Regarding integrating "Cold" and "Warm," many experts have contributed, but I merely practice what I preach without new creations. I believe the "Cold" and "Warm" schools complement each other in origin and flow, never opposing.

Due to space limits, I illustrate only with the Jueyin chapter. The Jueyin chapter of *Shanghan Lun* has many cold and mixed cold-heat patterns, but few heat patterns. Although Baihu Tang (White Tiger Decoction) and Chengqi Tang (Order the Qi Decoction) appear, they are not primary Jueyin patterns. This does not mean Jueyin lacks heat patterns, but that Zhang Zhongjing did not cover them. Wenbing experts excel here, clarifying heat sinking into the pericardium, phlegm-heat blocking the pericardium, excessive heat stirring wind, and deficiency wind stirring internally, all belonging to Jueyin, supplementing Zhang Zhongjing's omissions. Thus, Jueyin diseases should include cold, heat, deficiency, excess, mixed cold-heat, and mixed deficiency-excess patterns. Analyzing via Wei-Qi-Ying-Blood differentiation, Jueyin Qi, Ying, and Blood level patterns become clear. Regarding Sanjiao (Triple Burner), heat sinking into the pericardium belongs to Upper Jiao, while excessive heat stirring wind and Jueyin cold patterns belong to Lower Jiao, with evidence. Therefore, I advocate using Six Channels as the longitudinal axis and Wei-Qi-Ying-Blood and Sanjiao as the transverse axis for external febrile diseases, recognizing diseases realistically and abandoning sectarianism to see the full picture.

Theory applies to practice too. For example, lobar pneumonia generally falls under Wenbing, using Wei-Qi-Ying-Blood differentiation. However, special cases exist. In severe winter, internal heat may be heavy but bound by external cold, treatable like Taiyang with internal heat using modified Da Qing Long Tang. If early internal heat is latent, presenting with pale face, cold limbs, weak pulse, and low blood pressure, urgently restore yang and rescue from collapse, then discuss further after yang returns. If yang collapses suddenly during intense heat or after heat burns, decisively administer yang-restoring agents. With current TCM injection reforms, combining heat-clearing detoxifying injections with Shenfu Injection or Sini Tang Injection can be effective. For example, last year I treated a damp-warmth patient (Western diagnosis: allergic subacute sepsis) with lingering fever, intermittent intervals of days to weeks, cool limbs, and long duration. Initial damp-heat resolving agents failed. Recognizing similarity to Jueyin cold-heat alternation, I realized damp-heat hiding in Jueyin. Adding Wumei (Mume Fruit), Caoguo (Black Cardamom), Zhimu (Anemarrhena Rhizome), and Chaihu (Bupleurum Root) to the previous formula worked lightly. After improvement, spontaneous and night sweats persisted. Diagnosing Ying-Wei disharmony, I used Guizhi Tang (Cinnamon Twig Decoction) plus Huangqi (Astragalus Root) for recovery. Spirit and diet normalized, no recurrence since. This shows that in special circumstances, cold-heat changes and deficiency-excess shifts occur rapidly within one person or disease. One cannot limit treatment by Cold or Warm school affiliation. Thus, Shanghan practitioners must master Wenbing, and Wenbing practitioners must master Shanghan.

In 1955, I was appointed to the Hubei Provincial TCM Advanced Training School, and in 1958 to Hubei College of Traditional Chinese Medicine. Although I always taught *Shanghan Lun*, I never relaxed my study and clinical application of Wenbing, regretting my shallow understanding. Near twilight, facing many difficulties, I wish to contribute my modest efforts to welcome innovations from young scholars.

Paying Attention Everywhere

The proverb says, "Things fear the attentive person." Guided by this simple dialectical thought, I observed carefully in study and work. Especially with difficult cases, I searched ancient and modern treatments, reflected, and applied them. Persisting in this, everywhere one pays attention becomes learning. For example, treating a male patient over fifty with glaucoma and blindness, supported by his daughter. Long illness, liver excess and spleen deficiency, poor appetite. Previous prescriptions were kidney-nourishing and liver-softening herbs with little effect. Recalling *Bencao Gangmu* citing *Yiyu Lu*: "Someone had red swollen painful eyes, spleen deficiency unable to eat, liver pulse strong, spleen pulse weak. Cooling herbs for liver worsened spleen; warming herbs for spleen worsened liver. But adding double cinnamon to warm-neutral herbs kills liver and benefits spleen, achieving both. Legend says: wood withers with cinnamon." Mimicking this, I prescribed: Guizhi (Cinnamon Twig), Baishao (White Peony Root), Shengdi (Rehmannia Root), Zhigancao (Prepared Licorice Root), Tusizi (Dodder Seed), Fupenzi (Raspberry), Yemingsha (Bat Droppings), Gujingzhu (Eyebright Flower), Poguzhi (Cibotium Rhizome). After a month, the patient walked without support, recognized large characters, achieving ideal results. He took the prescription home, and I lost contact. Learning generally focuses on the big picture, but clinical experience accumulates in details. Over years, small streams form great rivers.

Take Li Shizhen's *Bencao Gangmu* (Compendium of Materia Medica). It is not just a materia medica but a巨著 involving clinical differentiation, prescription, empirical formulas, biology, minerals, etc., containing treasures. It should be essential reading for doctors. Read precisely, not just knowing properties and functions, but exploring "Inventions" and "Attached Formulas." The book is voluminous, so read leisurely to leave impressions. When needed, browse purposefully based on past impressions, often finding inspiration to solve problems.

For example, treating a young female patient with polymorphic erythema. Red patches covered the body, high fever lasted over a month, worsening condition, patches rising and falling, blisters forming. Initial warm disease maculae treatment failed. Realizing standard methods ineffective, I considered alternative methods. Patches were widespread with obvious pain and itching; high fever for a month without crimson tongue, coma, or convulsions. Heat-toxin郁怫 (stagnant) in blood collaterals, unable to vent externally or sink internally. Cooling blood and resolving maculae failed; clearing collaterals and venting might work. Treating with *Chuan Ya Nei Bian*'s Zhi Huodan (Luffa Fruit, Scrophularia Root, Angelica Root, Cimicifuga Rhizome, Bupleurum Root), increasing heat-clearing and venting herbs like Jinyinhua (Honeysuckle Flower) and Lianqiao (Forsythia Fruit). Result: heat subsided, body cooled, maculae faded, rash stopped. Using this method again cured another case smoothly. Medical experience is sometimes hidden in minor books. Proverb: "Small single prescriptions baffle famous doctors" is not baseless. First, emphasize solid basic skills, then pay attention everywhere for synergy. Conversely, ignoring basics and seeking lucky prescriptions wastes effort.

Courageous Practice

Practice is the sole criterion for testing truth. To verify or develop medical theory, serious practice is required. To enrich clinical experience, courageous and skilled practice is necessary. In my youth, I often doubted my prescriptions and wanted to observe patients at home but was restrained by the old idea "doctors do not knock on doors." I inquired indirectly, even standing secretly outside patients' windows to listen. When discovered, patients were grateful rather than disdainful. I frequently visited homes to observe changes, finding it important for clinical work. After participating in national TCM education, hospital settings facilitated observation. Regardless of shifts, I observed critically ill patients multiple times daily, even late at night. Some experiences were gained through such painstaking observation.

During the Anti-Japanese War, "Dengue Fever" was prevalent, with aversion to cold and high fever, life-threatening in severe cases. Standard external febrile disease differentiation yielded poor results. Literature offered no precedents, yet incidence was widespread. Patients were anxious, doctors lacked strategies, forcing careful thought. Considering the war period, people suffered war and famine, with poor hygiene, the etiology resembled miasma or epidemic pestilence. Symptoms of aversion to cold and high fever, fluctuating, resembling malaria but not, suggested...