Library

How to correctly carry out the work of integrating traditional Chinese medicine (TCM, Traditional Chinese Medicine) and Western medicine, and create a new medicine for our country, is a major topic that awaits continuous practice and discussion. Based solely on clinical practice, I deeply feel that Western medicine indeed has many strengths over TCM; for TCM practitioners to learn from Western medicine is conducive to improving therapeutic efficacy. For example, preeclampsia (an early stage of pregnancy-induced hypertension syndrome) and eclampsia (convulsions and coma during pregnancy) belong to a type of "late-stage pregnancy toxemia" in Western medicine. TCM does not have the disease name "pregnancy toxemia," but judging from the clinical manifestations of this disease, it is similar to "Zi Zhong" (Pregnancy Edema), "Zi Man" (Abnormal Abdominal Distension in Pregnancy), "Zi Yun" (Pregnancy Vertigo), and "Zi Xian" (Eclampsia) as referred to in TCM gynecology. *Zhu Bing Yuan Hou Lun* states: "Fetal Qi causing swelling, Zi Man resembling edema, is due to spleen and stomach deficiency, with retained water between the zang-fu organs, complicated by pregnancy." *Yi Zong Jin Jian* also says: "When a pregnant woman suddenly suffers convulsions and falls into unconsciousness, awakens after a moment, and returns to normal shortly after, this is called Zi Xian." This is the most severe disease during pregnancy; in severe cases, it leads to maternal and infant death. The diagnosis of pregnancy toxemia in modern medicine is based on the presence of at least two of the three symptoms—hypertension, edema, and proteinuria—after twenty-four weeks of gestation, which is diagnosed as preeclampsia. Although the ancients had early knowledge of this disease, limited by historical conditions, the vast majority of TCM literature treated "Zi Zhong," "Zi Man," "Zi Yun," and "Zi Xian" as different diseases. In fact, the aforementioned symptoms are merely different stages in the development of the entire disease process. "Zi Zhong" and "Zi Yun" are often prodromal symptoms of "Zi Xian"; even mild "Zi Zhong" can sometimes develop into critical "Zi Xian." Therefore, we must attach importance to their internal connections. Based on the above understanding, I formulated the main prescription "Muli Longchi Tang" (Oyster Shell, Dragon Tooth, Shi Jue Ming, Du Zhong, Prepared Nv Zhen Zi, Bai Shao, Xia Ku Cao, Sang Ji Sheng, Fu Ling, Ze Xie), which shows significant efficacy in both prevention and treatment. My adoption of integrated TCM and Western medicine in gynecological clinical practice is still in its preliminary stages.

The Ambition of Benevolent Art to Benefit the People Has Been Fulfilled

The ancients said: "A physician cannot be entrusted unless he is a man of benevolence and love; he cannot be relied upon unless he is wise and intellectually clear; he cannot be trusted unless he is honest, pure, and good." The standard for physicians is to be infinitely loyal to patients' health, treating others' illnesses as one's own.

For decades, I have strived to achieve: whenever there is a request for treatment, do not avoid wind, rain, cold, or heat; do not be constrained by distance, morning, or night; do not inquire about nobility, poverty, goodness, badness, closeness, or remoteness. Furthermore, the way of medicine is profound in principle and heavy in responsibility; discussing treatment and prescribing formulas involves life and death. Physicians should not rashly show off their abilities to gain fame and reputation, nor should they hesitate, worry about fortune or misfortune, or protect their own names. For critically ill patients, even if their disease is incurable, one must exhaust all mental and physical efforts to seek a slim chance of survival. There was an eighteen-year-old young woman from Chun'an. During her menstruation, she went out and got caught in the rain. Upon returning home, she was scolded by her father. Her menstruation suddenly stopped, and the illness arose. She was treated locally for over a month, spending hundreds of yuan, yet her condition worsened day by day. Forced to go to Hangzhou to stay with relatives and seek rescue, her friends and relatives, who had been treated by me recently, seeing the patient in extreme danger, brought her to my home that very night upon her arrival in Hangzhou. The patient was carried in on a door plank, foaming at the mouth, unconscious, and breathing faintly. My family members, seeing this, feared she would die instantly. The patient's father repeatedly begged to save his daughter's life. For such a critically ill patient, brought to the house at night, I could have asked them to take her to the hospital for examination and rescue. But delaying time would be equivalent to sending her to her death. As a physician, I have only the responsibility to do my utmost to treat; there is absolutely no excuse for hesitation or bucking the responsibility. I diagnosed the patient as suffering from blood stasis obstructing and confusing the mind, with liver qi stagnation. I prescribed Taohong Siwu Tang added with Shixiao San and Huarui Shi San. She took one dose first, with instructions to decoct and take it that night, and return for consultation the next day. That night, I tossed and turned in thought, daring not sleep. The next morning, the patient's family came to the clinic, saying that after taking the medicine, menstruation had started in the morning, though the amount was not large. Seeing a turn for the better, I felt relieved. I modified the original formula and continued with two more doses. The patient's consciousness gradually cleared, and she escaped danger.

The Way of Scholarship Lies in Learning to "Ask"

Zhao Di, Vice President of Fujian College of Traditional Chinese Medicine and Director of its Affiliated Hospital, Professor

[Author Profile] Zhao Di (1910–), from Fuzhou. In his youth, seeing his family member severely ill with no effect from either Chinese or Western medicines, he later recovered through careful treatment by a famous doctor. Thus, he became extremely interested in national medicine and resolved to study medicine. Although he received five years of initiation from a teacher, he mainly relied on self-study. Because he diligently drilled and bitterly researched, his medical skills were exquisite, yet he remained tireless. Since practicing medicine, he has gained considerable public trust. After liberation, when Fujian College of Traditional Chinese Medicine was established, he took up teaching. For over twenty years, many students have come from under his tutelage, making him highly respected in the medical field. His learning follows the "Tonifying Earth" school, but does not stick rigidly to warming and tonifying methods; he can establish a unique style and has cured many difficult and stubborn cases. He authored *Selected Medical Experiences of Dr. Zhao Di* and edited *Detailed Explanation of TCM Basic Theory*, among other books, which have received good reviews from readers.

In my youth, because my family member was extremely ill, gasping for breath, and on the verge of death, and neither Chinese nor Western medicines were effective, I later recovered through careful treatment by the renowned scholar-physician Zhou Liangqin. Thus, I resolved to study medicine. Besides receiving initiation from a teacher, I studied tirelessly, enduring five changes of seasons and years, before laying a foundation.

Since beginning clinical practice, I have increasingly found many problems in TCM academic theory that are difficult to understand, deeply feeling the regret of "regretting having read too little when needed, and knowing difficulty only after experiencing it." Thinking about ancient and modern physicians, although each had their own lineage transmission, most achieved success through self-study, so-called "understanding without a teacher." Why should I not try imitating this? But thinking about it, self-study requires a set of methods to yield results. I realized that while there are many paths to scholarship, the method of "a good learner must be good at asking questions" is indispensable.

Before studying medicine, I had dabbled in classical literature. Because the wording and characters of Classical Chinese differ from modern writing, often reading an article seemed understandable, but upon deep questioning, it felt difficult to comprehend, especially with poetry. To overcome this hurdle, I adopted the method of setting questions to resolve many doubts myself. I believe this method is fully applicable to studying medicine.

Now, taking an example of learning poetry and using questioning to self-explain the method and process, to illustrate: Li Bai's "Quiet Night Thought," the original text is "Bright moonlight before my bed, I suspect it is frost on the ground. I raise my head to gaze at the bright moon, I lower my head and think of my hometown." It is truly shallow and easy to read, understood at a glance. But further questioning, why is this poem said to be well-written? Where is it good? Since it mentions the bright moonlight before the bed, why suspect it is frost on the ground? Gazing at the moon and thinking of home is known to everyone; what is the deep meaning? Asking layer by layer, one feels unable to answer. After initial reflection, there is slight comprehension. The title of Li's poem is "Quiet Night Thought." Using the five characters "Bright moonlight before my bed," he sets off the scene of late night and quietness. Using the five characters "I suspect it is frost on the ground," he depicts the autumn moonlight white as frost. The last two lines turn to the main topic, stating that gazing at the moon implies thought, thinking of home. But carefully pondering, I still feel it is not deep or thorough; actually, I haven't learned it thoroughly yet. Repeated deep thinking brings further understanding. For example, why does the bright moonlight before the bed indicate the late hour and quietness? Because the time moonlight shines into the room is either the first half of the night or the second half. Since the poem is titled "Quiet Night," only the second half of the night can be called quiet. Why, knowing the bright moonlight, suspect it is frost on the ground? Because frost occurs only with autumn coolness, and falling frost mostly happens in the deep night. Being in the deep night, one should have slept once, woken up feeling cool, and in drowsiness, the white moonlight entering the eyes is suspected to be cold frost. If one stayed awake without sleeping, what would there be to suspect? This also points out the scene of a clear moon in a deep autumn night, generating feelings due to autumn. Autumn is also the time when poets are most easily moved by scenery to generate emotion. The ancients had *Autumn Sound Fu* and works mourning autumn, all expressing emotion through autumn. But gazing at the moon and thinking of home, what is being thought of? It is not pointed out. Knowing that the two characters "bright moon" are often used by poets to mean reunion, it also implies the author enjoying family happiness in dreams. Marking the two characters "lower head" indicates that currently, one is alone in a foreign land, sighing at the inability to reunite with family. Raising the head and lowering the head, two scenes echo in the brain, thoughts continuous. In just twenty characters, time, place, environment, and thoughts are clearly stated. Without thousands of hammerings and refinements, it is impossible to write so implicitly and with shallow words but deep meaning, thus called a masterpiece. Such an explanation might convince people. But I am not a poet; all explanations may not be correct. Here, I merely use this to explain that reading requires "loving to ask and resolving doubts," which is a very important method. Speaking of which, we are discussing medicine; explaining so much poetic meaning, what does it have to do with medicine? I feel that although medicine is not literature, the method of learning "asking" is universal for learning any discipline, especially learning TCM, where one must ask questions layer by layer. At that time, when I studied classical medical texts and explored their mechanisms, following this method yielded many benefits. Now, I will briefly try several examples of problems understood through questioning and introduce them below.

Yin-Yang and Five Elements theory is the foundation of TCM basic theory. It is also the first gate of entry. If its spiritual essence is not clear, it becomes a stumbling block, affecting the learning of the entire TCM theory. Here, I single out one question to ask: Why is Yin-Yang and Five Elements theory called the reasoning tool of TCM, referred to as naive materialism and spontaneous dialectics? If this principle is not resolved, one will doubt that TCM is too old-fashioned and unscientific, and that Yin-Yang and Five Elements have idealistic colors. Originally, Yin-Yang theory lists the character Yin in the first position and Yang in the second. From the perspective that Yin represents matter and Yang represents function, matter comes first, then function, listing matter as primary. This is precisely the viewpoint of materialism. Because idealists list function (spirit) as primary. Using this ideological method as a reasoning tool conforms to objective truth, hence TCM theory can inherit continuously and remain vigorous for thousands of years; the reason lies here.

Five Elements theory originally explained the earth's revolution around the sun, becoming spring, summer, autumn, and winter four seasons. In these four seasons, all living things on earth change with the changes of the four seasons, and the four seasons themselves are also changing. All have matter as a basis and are interconnected. For convenience of reasoning, the ancients used the five characters Wood, Fire, Earth, Metal, Water as nouns, using East, Spring, etc., as Wood; South, Summer, etc., as Fire; West, Autumn, etc., as Metal; North, Winter, etc., as Water; Earth as Central Earth, and Long Summer. Its main spiritual essence is acknowledging that all things are connected, not isolated, and constantly changing. This is precisely the viewpoint of dialectics. TCM cites Yin-Yang and Five Elements theory as a reasoning tool and expands its meaning. Because the guiding ideology largely conforms to dialectical and materialist viewpoints, it stands the test of practice. Once this gate is mastered, the stumbling block in learning TCM can be removed.

Secondly, let us discuss a passage from the chapter "Su Wen: Yin Yang Ying Xiang Da Lun": "Heaven is deficient in the northwest, therefore the northwest direction is Yin, and human right ears and eyes are not as clear as the left. Earth is incomplete in the southeast, therefore the southeast direction is Yang, and human left hands and feet are not as strong as the right." Some annotations of this scripture treat Heaven and Earth as actual heaven and earth, and Southeast and Northwest as the terrain of China's map, considering low-lying, hot climate Southeast as Yang, and plateau, cold climate Northwest as Yin. Explaining it this way, how can it connect with human ears, eyes, hands, and feet? Originally, ancient writers had a habit of not repeatedly using the same noun in one article; they always chose another appropriate noun to replace it, to refresh the reader's senses. This method is not lacking precedent in ancient writings. Therefore, Heaven, Earth, Southeast, Northwest in "Yin Yang Ying Xiang Da Lun" actually still refer to Yin and Yang, i.e., Heaven is Yang, Earth is Yin. According to the ancient custom of defining directions, Up is South, Down is North, Left is East, Right is West. Synthesizing these, Southeast replaces Left, and Left can replace Yang; Northwest replaces Right, and Right can replace Yin. This article mainly discusses Yin and Yang. To avoid overly repetitive use of the characters Yin and Yang, new nouns are replaced. This is understandable. But medicine deals with concrete things. Since Heaven, Earth, Southeast, Northwest all point to Yang (note: the text argues they point to Yin/Yang distinctions mapped to body parts, specifically clarifying the mapping logic), what is the relationship with human ears, eyes, hands, and feet? According to TCM theory, Yin and Yang here should refer to Qi and Blood. Qi is Yang, Blood is Yin. Clear Yang is Heaven (above), Turbid Yin is Earth (below). Yang Qi ascends to the head and eyes and flourishes on the left, so although ears and eyes both receive Clear Yang, the left is clearer than the right. Yin Blood descends to the hands and feet and flourishes on the right, so although hands and feet both receive Turbid Yin, the right is stronger than the left. Hence the saying "Left and Right are the pathways of Yin and Yang." Connecting them this way, one will not find the sentence "Heaven is deficient in the northwest, Earth is incomplete in the southeast" difficult to understand. As for whether the differences in left/right, up/down, flourishing/deficiency of Qi and Blood in the human body are related to the earth's rotation direction or magnetic field? The mysteries within are still difficult to fully explain; one can only keep this doubt, awaiting experts. This is another example of using "why" to explore classic works.

Furthermore, studying pulseology feels very abstract. For example, when discussing Floating Pulse (Fu Mai), it is described as floating on the skin, like wood floating on water. Listening, it seems easy to understand, but questioning its actual standard makes it hard to conclude. In this situation, one must seek answers between the lines. Why did the ancients say "like wood floating on water"? If understood only literally, one can only consider that Floating means floating upwards, pulse floating on the skin, like wood floating on water. Actually, this is half-understood. One must know that TCM speaking of pulse lies in pulse Qi, i.e., the dynamic state of the pulse. To truly understand Floating Pulse, one must deeply ponder its meaning and add experimentation. One can try taking a small piece of wood board, placing it in a basin, filling it with water so the wood floats on top. At this time, gently press down with fingers; the fingers also sink following the wood block. If gently lifting the fingers, the wood block also rises following the fingers. This force of rising upon finger contact is the Floating image. Clinically verifying Floating Pulse, after heavy pressing, immediately gently lift, fingers not leaving the skin, pulse Qi also rises following the fingers; this is Floating Pulse. Ancient texts are concise; one must investigate deeply. Verifying tongue coating is also like this. For example, the thickness of tongue coating, looking at the literal meaning, understanding is not difficult, but how to determine the boundary of thick and thin? I think one should explore from the aspect of tongue papillae. If papillae are covered by coating filth, it counts as thick coating; otherwise, it still belongs to thin coating. Only with such differentiation is there a foothold; one must not swallow whole just because the ancient book didn't say.

Furthermore, regarding the formula "Da Cheng Qi Tang," why is it not named Dahuang Mangxiao Houpo Zhishi Tang, but named Cheng Qi? What is the intention? One must know that the composition of formulas targets the pathogenesis. Da Cheng Qi Tang is used for Stomach House Excess, interior heat internal binding syndromes. Named Cheng Qi, it points out the pathogenesis of fu-organ Qi not descending. *Nei Jing* has the saying: "The six fu-organs transmit and transform substances without storing, thus they are full but not stuffed." Extending this, anything that can make Stomach Qi descend and unblock can be called Cheng Qi. Former people had differing opinions on whether Xiao and Huang's role is Cheng Qi, or Hou and Zhi's role is Cheng Qi. I believe it is still correct that Stomach Qi should descend. This conforms to the pathogenesis.

From the above few examples, all require questioning and exploration to obtain understanding, showing that "a good learner must be good at asking questions" is correct. But the problems I have realized, limited by my level, inevitably contain errors. Because to clarify the process of questioning, detailed narration is unavoidable for explanation. We should also admit that questioning everything and answering it oneself is impossible. Personal knowledge and learning ultimately have limits; one should humbly consult teachers and friends, hoping for help from other stones. If indeed encountering human body mysteries, problems that current scientific knowledge cannot explain, one can only keep doubts, waiting for future resolution. Strive as much as possible to truly understand what should be understood, and have a clear mind about what is not understood. The style of "loving to read but not seeking thorough understanding" is detrimental to studying medicine.

In addition, another function of questioning is to lead people forward on the path of research. Chinese medicine and pharmacy is a great treasure house, indicating that there are many treasures waiting to be excavated, organized, and improved. Therefore, when we learn TCM, encountering key problems, we must hold on tightly and research seriously to innovate. Thus, it can be seen that the process of questioning and doubting is an important method of scholarship. I have tasted some sweetness in learning "asking." Dare not disdain my shallow ignorance, briefly outlining the general idea, for reference by self-learners.

Sixty Years of Hanging the Pot Career

Zhao Bingnan, Vice President of Beijing Hospital of Traditional Chinese Medicine, Director of Beijing Institute of Traditional Chinese Medicine