园辈。皆谓腹胀如鼓。中空无物。遵《内经》足太阴虚则鼓胀之旨立言。此为脾虚成臌之一种。然臌胀亦不尽属纯
虚证。就予临证实验。约有五臌。（一）气臌。多因于情志内伤。愤怒抑郁。无不动肝。肝纵乘肺。气逆息粗。
胸满膈塞。腹虽胀大。按之尚软。《内经》所谓诸气 郁。皆属于肺。叶天士所谓初病在气也。每用四七绛覆汤。
送下陈香团散。（陈香团连穣一枚、大胡桃肉连皮二枚、春砂仁去壳二钱各 存性、研为细末、每服一钱、
方载张石顽《本经逢原》。）理气宽膨以消胀。继用陈麦草汤。（陈麦杆草五钱、生麦芽二钱、陈大麦须、莱砂散各
一钱、何廉臣验方。）送下佛手丸。（鲜佛手、用银胡三钱煎汤、拌炒切片、鲜香团去子、用川楝子三钱、煎汤
拌炒、冬桑叶、京川贝、炒枣仁、建神曲、湘莲肉各五两、太子参一钱、另研擂丸、共研细末、先将佛手枣仁
煎浓汁泛丸、再用糯米饮汤泛上、每服一钱、凌氏《饵鹤亭集》方。）舒畅气机以善后。往往十全七八。若失治。
及病患不能戒怒。势必肝横乘脾。脾失健运。腹胀减食。食益 胀。按之如鼓。形瘦肢削。溺涩而急。《内经》所
谓之如鼓。皆属于热。叶天士所谓久必入络也。每用三仁绛覆汤。送下消臌蛛连丸。（白蜘蛛十只、蚕绵灰五
钱、紫 桂、麝香各五分、小川连五钱、共研细匀、藕粉为丸、如小绿豆大、每服一钱、专治气郁成臌、何廉
臣验方。）泄肝运脾以消臌。俾腹胀转软而宽。用五汁一枝煎。送下绿萼梅花丸。（方载夹痛伤寒勘语中）
辛润通补以除根。似此治法。亦可十全一二。（二）疟臌。即疟母成臌。多因于疟邪未净。截之太早。误服甘肥
滋补。留邪入络。腹胀如鼓。按之左边尤坚。此中医所谓疟母。西医所谓脾胀也。治以活血通络。叶氏二仁绛
覆汤。（用马鞭草一两、紫苏嫩枝三钱、煎汤代水。）送下鳖甲煎丸。外贴鳖苋膏以消块。（三）疮臌。多因于
周身疥疮。误用熏法。及凉药涂布。将疮遏进。湿热盘踞膜络。初则腹痛便泄。继则囊肿腹胀。下至少腹。此
王洪绪所谓疮 。叶天士所谓疮蛊。徐洄溪所谓疮臌也。治以解毒发表。银翘败毒散。（薄荷钱半、青连翘三
钱、羌活、独活各八分、柴胡、前胡各一钱、枳壳、桔梗各七分、用银花、杜赤豆各八钱、煎汤代水。）送下
疮臌红枣丸。（白僵蚕、红枣各四两、先用水煮红枣一二滚、取枣汤洗白僵蚕、弃汤、以枣去皮核捣烂、僵蚕晒
干为末二两、同枣捣和为丸四两、丸如小赤豆大、每服二钱、王洪绪《外科全生集》。）使周身仍发疥疮。则疮臌
全消。或用紫苏一两。煮大长脐蟹。约重斤余。饮酒将蟹吃完。覆被而睡。不两时。身仍发疮。更狠于前。而臌
全消。然后再治疥疮。以竟全功。（四）水臌。多因于湿滞肿满。大剂峻逐。频进不休。力求速愈。初服少效。
久必伤残脾阳。始由四肢归腹。腹大如箕。（俗称筲箕胀、）手足反瘦。逐渐坚胀。按之如鼓。旦食不能暮食。
不知增液通络。又用攻坚分消。更损肾阳。重伤气化。腰 足软。溺色淡黄而少。甚至小便癃闭。病势至此。
本不可为。即遇明医。亦惟用加减《金匮》肾气汤。送下桂附理中丸。温补脾肾。以救残阳。尽人事以挽天机而
已。予屡遵嘉言三法。初用辛甘通阳。如桂甘姜枣、麻辛附子汤加味。继用培养元阳。如真武汤送《金匮》肾气
丸。三用转旋大气。如补中益气汤重用 术。送下局方禹余粮丸。外用罨脐法以通溺（大水田螺一个、雄黄甘遂
末各一钱、麝香一分、同捣为饼、罨脐上、）病家虽甚信从。而医者药无一效。无任惭汗。末遵张景岳大补
法。用参附理阴煎仍加于术。送服蜘蛛散。（白蜘蛛十六只焙焦、青化桂一钱。同研极细、每服一钱、《金匮》
方。）终归无功。从此信景岳虚症难医。百补无功之语。真虚损专家之名论也。急嘱病患赴西医处开臌放水。讵
知放水而水全无。但有淡血粘液。西医即将腹皮缝好。劝其速回。后至一旬而毙。于是专觅单方。约有十剂。
一、丑冰散。（先将黄牛粪阴干、微炒黄香为末、每服一两、煎十余滚、滤清、冲入梅冰一厘、乘热顿服。）
二、猪肚煎（雄猪肚子一个、入大蒜头四两、尖槟榔、砂仁末各三钱、广木香二钱、砂锅内河水煮熟、空心但
服猪肚汤。）三、千金散。（千金霜二分半、飞滑石二分、陈芭蕉扇去筋烧灰存性五分、用湿豆腐皮包好开水送
下。）四、黑鱼羹。（乌蠡鱼一尾、重七八两、去鳞甲、将肚剖开去尽肠杂、入好青矾五分、松萝茶三钱、男
子用大蒜八瓣、女用七瓣、同入鱼腹内、放在瓦罐中煮熟、令病患吃鱼、连茶蒜吃更好。）五、葫芦散。（三
五年陈葫芦一个、悬放于炭火上炙热、入酒浸之、如此五次、将葫芦壳 存性为末、每服三钱、酒下。）六、
宽膨散。（大癞虾蟆一只、剖开、用大砂仁填满腹中、黄泥封固、炭火 红、冷定去泥、研末、每服一钱、陈
皮汤调服、至频频矢气而宽。）七、瓜灰散。（西瓜一个、开去盖、挖去子肉、加鸡内金四张、车前子四两、
入西瓜中、仍用旧盖盖好、瓜外遍涂烂泥、在瓦上炙灰存性、去泥研末、每服一钱、用青糖拌好、用陈葫芦壳
一钱。煎汤调下。）八、丝瓜络丸。（丝瓜络一个、用小巴豆十四粒、拌炒巴豆黄色、去豆不用、再用陈仓米、
如丝瓜络之分量、同炒、米黄、研匀、玫瑰膏捣丸、如梧桐子大、每服一钱、用绿萼梅五朵泡汤送下。）九、鸡
矢白散。（腊月用雄鸡五只、饲以煮干大麦一二日、鸡矢中自有白块、逐渐取出、随取随用酒洗、阴干、藏入
瓷瓶、每服三分、和入广木香末一分、随酒送下。）十、败鼓皮丸。（破旧铜鼓皮一张、切碎、河砂拌炒松脆、
研末、陈烧酒和糯米粉糊丸、每服一钱、陈酒送下。）其间临病实验。一旬至二旬间鼓胀。效者颇多。若至一
二月。不效者多。（五）疳臌。多因于失饥伤饱。鱼肉中误服虫子。虫吸血液。生长繁殖。积久而成臌。形如蜘
蛛。故俗称蜘蛛胀。《万氏全书》谓之疳臌。治以驱虫消疳。轻则七味保婴汤。（莱菔子、生麦芽各一钱、薄荷叶
三分、嫩竹叶七片、灯心一小帚、陈仓米二十粒、白蜜一匙、袋盛煮汤。）调下癞蛤散。（癞蛤 一只、酒洗
净、将白豆蔻四十九粒、从口徐徐灌入、外涂酒渣盖泥令遍、炭火烘脆、去泥、研末、筛净、每服三分至五
分、《良方集腋》。）重则加味五香汤。（五灵脂用青糖拌炒五分、醋制香附八分、黑白丑头末炒香各六分、白雷
丸一钱、煨香使君子肉三枚、炒川椒一粒、乌梅肉二分、何廉臣验方。）调下灶马散。（蟑螂肉十只、莱菔子
五钱、拌炒研服五分。）屡奏捷效。综而言之。肿胀蛊臌。皆以病状定病名他。《内经》云。治病必求其本。其本
即中医所谓病源。西医所谓原因也。余临斯证。必先辨其病属何因。继必察其质性何似。更审其有无宿恙。然
后权其先后之宜。对症发药。庶可药到病除。无枘凿之不入矣。至于辨证。尤在泾曰。腹胀属脾胃者。则饮食
少。属他脏腑者。则饮食如常。其胀在皮肤脉之间者。饮食亦如常。其在肠胃盲膜之间者。则饮食亦少。其气
亦壅塞于五脏。则气促急不食而病危矣。是故病在表者易治。在腑者难治。入脏者不治。此亦扼要之论也。
【荣斋按】本节（夹胀伤寒）俞氏治阴水肿主张初起用麻附五皮饮，确是一个合乎理想的好方。廉臣先生在
《全国名医》《验案类编》中加以阐述，他说∶“五皮饮加麻黄、附子、为周雪樵君首创，谓治水肿及风水肿、其人素
无肝火者，投无不效。其妙处全在麻黄一味，非但开肺发汗，使水气从皮肤排泄，而其余力尤能通利水道，使
水气从小便排泄；故日本医家，独推麻黄为治水肿之特效药。惟现下病家，往往畏麻黄而不敢服，就余所验，
凡发风寒之汗，麻黄只用四五分至六七分即能出汗，发风水之汗，非一钱至一钱半不能出；从未犯过亡阳之
弊”。
又按∶本节全文，取材丰富，它的质量超过全书的任何一节，可以说是伤寒夹症中的典型节目。俞氏
把肿、胀、臌、蛊等，分析为四个单元，指出了不同的原因疗法，而重点则在“胀”以下的两个疾患。廉臣
先生又“勤求古训，博采众方。”举出肿、胀、臌、蛊四症的病因、证状和治法；凭借着古医学的壁垒，与
顽痼的疾病展开斗争。从文本里，可以看出他老人家精力是愈战愈强，武器也越来越好。参证学说十六家，
引用方剂八十三个；以将近一百个的历代医学专家的累积经验，加以分析、综合，灵活运用，勤勤恳恳，
显示了二十世纪上半纪卫生任务者“博学多能”的实质，而留作我们钻研。
Yu's disciples. All believe that abdominal distension is like a drum. Hollow inside with no solid matter. Following the principle in *Neijing* (Classic of Internal Medicine) that deficiency of the Foot-Taiyin Spleen Meridian leads to drum-like distension, this theory is established. This is one type of distension caused by Spleen deficiency. However, distension does not entirely belong to pure deficiency syndromes. Based on my clinical experience. there are approximately five types of distension. (1) Qi Distension. Mostly caused by emotional internal injury. Anger and depression. All stir up Liver Qi. Even if Liver overacts on Lung. Qi rebels causing coarse breathing. Chest fullness and diaphragmatic blockage. Although the abdomen is distended. pressing it remains soft. As stated in *Neijing*: all Qi stagnation belongs to the Lung. Ye Tianshi stated: initial illness is in the Qi level. Often use Siqi Jiangfu Decoction. Administered with Chenxiang Tuan Powder. (Chenxiang Tuan including rind one piece; large walnut meat with skin two pieces; Chunsharen husked two qian each preserved for medicinal use; ground into fine powder; take one qian per dose; formula recorded in Zhang Shiweng's *Benjing Fengyuan*.) Regulate Qi and widen chest to eliminate distension. Subsequently use Chenmai Cao Decoction. (Aged wheat stalk grass five qian; raw malt two qian; aged barley awns; Laisan Powder each one qian; He Lianchen's verified formula.) Administered with Foshou Pills. (Fresh Foshou; decoct Yinhu three qian in water; mix-fry and slice; fresh Xiangtu remove seeds; decoct Chuanlianzi three qian in water; mix-fry; winter mulberry leaves; Jingchuanbei; fried Zao Ren; Jian Shenqu; Xianglianrou each five liang; Taizishen one qian; separately ground into paste pills; grind all into fine powder; first decoct Foshou and Zao Ren to thick juice for pill coating; then coat with glutinous rice drink; take one qian per dose; Ling Shi's *Erheting Ji* formula.) Smooth Qi mechanism for aftercare. Often achieves seven or eight successes out of ten. If mismanaged. and patients cannot abstain from anger. inevitably Liver Qi will invade Spleen horizontally. Spleen loses healthy transportation. Abdominal distension decreases appetite. Eating increases distension. Pressing feels like a drum. Emaciated body and wasted limbs. Urination is涩 (astringent/difficult) and urgent. *Neijing* states: drum-like distension belongs to Heat. Ye Tianshi stated: long-term illness enters collaterals. Often use Sanren Jiangfu Decoction. Administered with Xiaogu Zhilian Pill. (White spider ten; silkworm cocoon ash five qian; Zigui; Shexiang each five fen; Xiao Chuanlian five qian; grind evenly; lotus root starch for pills; size of small mung beans; take one qian per dose; specifically treats Qi stagnation forming distension; He Lianchen's verified formula.) Drain Liver and transport Spleen to eliminate distension. Let abdominal distension turn soft and loose. Use Wuzhi Yizhi Decoction. Administered with Lvmei Huamei Pills. (Formula recorded in Jiatong Shanghan Keyu) Pungent-warm unblocking tonification to eradicate root. Such treatment methods. can also achieve one or two successes out of ten. (2) Malaria Distension. i.e., Malaria Mother forming distension. Mostly due to malaria pathogen not cleared. Malaria stopped too early. Mistakenly taking sweet/fatty tonics. Leaving pathogen entering collaterals. Abdominal distension like a drum. Pressing left side especially hard. This is TCM's so-called Malaria Mother. Western medicine's so-called splenomegaly. Treatment focuses on invigorating blood and unblocking collaterals. Ye Shi's Erren Jiangfu Decoction. (Use Mabiancao one liang; Zisu tender branches three qian; decoct water substitute.) Administered with Biejia Jian Wan. External application of Bixian Plaster to dissipate masses. (3) Sores Distension. Mostly due to generalized scabies. Mistakenly using fumigation methods. And cooling medicines applied topically. Suppressing sores inward. Damp-heat entrenches in membrane collaterals. Initially abdominal pain and diarrhea. Subsequently cystic swelling and abdominal distension. Extending down to lower abdomen. This is Wang Hongxu's so-called Chuangu. Ye Tianshi's so-called Chuangu. Xu Huixi's so-called Chuanggu. Treatment focuses on resolving toxicity and releasing exterior. Yinqiao Baidu San. (Bohe half qian; Qing Lianqiao three qian; Qianghuo; Duhuo each eight fen; Chaihu; Qianhu each one qian; Zhike; Jiegeng each seven fen; decoct Yinhua; Du Chidou each eight qian as water substitute.) Administered with Chuanggu Hongzao Pills. (Baijiangcan; Hongzao each four liang. First boil Hongzao once or twice in water; take jujube soup to wash Baijiangcan; discard soup; peel and pit jujubes; mash; dry Baijiangcan into powder two liang; mix with mashed jujube to form four liang of pills; size of small red beans; take two qian per dose; Wang Hongxu's *Waike Quansheng Ji*.) Let generalized scabies reappear. Then Chuanggu completely resolves. Or use Zisu one liang. Boil large navel crab. Weighing about one jin. Drink wine and finish eating crab. Cover with blanket and sleep. Within two hours. body still breaks out in sores. Worse than before. And distension completely resolves. Then treat scabies again. To complete the cure. (4) Water Distension. Mostly due to dampness stagnation edema/fullness. Large doses of harsh purgatives. Frequently administered without stopping. Seeking rapid cure. Initial dose slightly effective. Long-term damages Spleen Yang. Starts from limbs returning to abdomen. Abdomen large like a basket. (Commonly known as Shaoji Distension,) Hands and feet become thin. Gradually hard and distended. Pressing like a drum. Morning food cannot be eaten at night. Not knowing to replenish fluids and unblock collaterals. Again using attacking hardness and separating elimination methods. Further damaging Kidney Yang. Severely injuring Qi transformation. Waist and legs weak. Urine pale yellow and scant. Even urinary retention. Disease progression to this point. Originally incurable. Even encountering a wise physician. Only use Modified *Jinkui* Shenqi Tang. Administered with Guifu Lizhong Wan. Warm and tonify Spleen and Kidney. To save residual Yang. Do human effort to recover heavenly mechanism. I repeatedly followed Jiayan's three methods. Initially use pungent-sweet unblocking Yang. Like Guigan Jiangzao; Maxing Fuzi Tang modified. Subsequently cultivate primal Yang. Like Zhenwu Tang administering *Jinkui* Shenqi Wan. Thirdly rotate great Qi. Like Buzhong Yiqi Tang heavily using Baizhu. Administered with Jufang Yuyuliang Wan. External application of Navel Compress to promote urination (Large water snail one; Xionghuang Gansu powder each one qian; Shexiang one fen; pound together into cake; apply on navel,) Patient family very trusting. But physician's medications ineffective. Deeply ashamed and sweating. Finally follow Zhang Jingyue's major tonification method. Use Shenfu Liyin Jian still adding Baizhu. Administer with Zhizhu San. (White spider sixteen roasted; Qinghuagui one qian. Grind extremely fine; take one qian per dose; *Jinkui* formula.) Ultimately returns to uselessness. Thereafter believing Zhang Jingyue's words that deficiency syndromes are hard to treat. Hundred tonifications ineffective. Truly a famous theory of deficiency experts. Urgently advise patient to go to Western medicine clinic for paracentesis. Unexpectedly draining yields no water. Only pale bloody mucus. Western doctor sews abdominal wall. Advises quick return. Dies after ten days. Thus specifically seeking single prescriptions. Approximately ten formulas. One. Choubing San. (First dry yellow cow dung in shade; lightly fry Huangxiang into powder; take one liang per dose; decoct boiling more than ten times; filter clear; add Meibing one li; take hot in one gulp.) Two. Zhudu Jian (Male pig stomach one; insert garlic cloves four liang; sharp Binglang; Sharen powder each three qian; Guangmuxiang two qian; cook in clay pot with river water; empty stomach only drink pig stomach soup.) Three. Qianjin San. (Qianjin Frost half fen two and a half; Feihuashi two fen; aged banana leaf remove veins burn ash preserve nature five fen; wrap in wet tofu skin take with boiled water.) Four. Heiyu Geng. (Wuli fish one tail. Weigh seven or eight liang. Remove scales and armor. Cut belly open remove all entrails. Insert good Qingfan five fen; Songluo tea three qian. Male use eight garlic cloves. Female use seven cloves. Put into fish belly. Cook in earthen jar. Let patient eat fish. Better to eat with tea and garlic.) Five. Hulu San. (Three to five year aged gourd one. Hang over charcoal fire heat. Immerse in wine. Repeat five times. Preserve nature of gourd shell into powder. Take three qian per dose. With wine.) Six. Kuanpeng San. (Large toad one. Cut open. Fill abdomen with large Sharen. Seal with yellow mud. Roast over charcoal until red. Cool remove mud. Grind into powder. Take one qian per dose. Adjust with Chenpi soup. Until frequent flatulence and relief.) Seven. Guahui San. (Watermelon one. Open remove lid. Dig out flesh and seeds. Add Ji Neijin four sheets; Cheqianzi four liang. Put into watermelon. Replace old lid. Coat outside with rotten mud. Roast on tile until ash preserve nature. Remove mud grind into powder. Take one qian per dose. Mix with green sugar. Use aged gourd shell one qian. Decoct soup to adjust.) Eight. Sigualuo Wan. (Sigualuo one. Mix with fourteen small Badou. Stir-fry until Badou yellow. Remove beans do not use. Then use aged grain rice. Same quantity as Sigualuo. Stir-fry together. Rice yellow. Grind evenly. Rose paste pound into pills. Size of paulownia seeds. Take one qian per dose. Send down with five Lvmei soaked in soup.) Nine. Jishi Bai San. (In December use five male chickens. Feed cooked dry barley for one or two days. White blocks naturally appear in chicken feces. Gradually extract. Wash with wine as extracted. Dry in shade. Store in porcelain bottle. Take three fen per dose. Mix with Guangmuxiang powder one fen. Send down with wine.) Ten. Baigupi Wan. (One broken bronze drum skin. Cut into pieces. Stir-fry with river sand until crisp. Grind into powder. Aged liquor and glutinous rice flour paste into pills. Take one qian per dose. Send down with aged wine.) Among these clinical experiments. For distension within ten to twenty days. Many were effective. If reaching one or two months. Ineffective ones are many. (5) Gan Distension. Mostly due to irregular eating and drinking. Accidentally ingesting worms in fish/meat. Worms absorb blood. Grow and reproduce. Accumulate over time forming distension. Shape like spider. Hence commonly known as Spider Distension. *Wanshi Quan Shu* calls it Gan Distension. Treatment focuses on expelling parasites and eliminating Gan. Mild cases: Qiwei Baoying Tang. (Laifuzi; raw Maoya each one qian; Boheye three fen; tender Zhuye seven leaves; Dengxin one small broom; aged grain rice twenty grains; white honey one spoon. Bagged and decocted soup.) Adjust with Laiha San. (Toad one. Wash clean with wine. Pour forty-nine Baixi Kou grains slowly into mouth. Coat outside with wine residue cover mud thoroughly. Roast brittle over charcoal. Remove mud. Grind powder. Sieve clean. Take three to five fen per dose; *Liangfang Jiye*.) Severe cases: Jia Wei Wuxiang Tang. (Wulingzhi stir-fry with green sugar five fen; Vinegar-processed Xiangfu eight fen; Black/White Chou head powder stir-fried fragrant each six fen; Bai Leiwan one qian; Roasted fragrant Shijunzi meat three pieces; Fried Chuanjiao one grain; Wu Mei meat two fen; He Lianchen's verified formula.) Adjust with Zaoma San. (Cockroach meat ten; Laifuzi five qian. Stir-fry grind take five fen.) Frequently achieving swift effects. Summarizing. Swelling. Distension. Gu. Distension. All named based on symptoms other than *Neijing*. *Neijing* says. Treating disease must seek its root. Its root is what TCM calls disease source. Western medicine calls cause. When facing this syndrome. I must first differentiate which cause the disease belongs to. Then observe what its nature resembles. Further examine if there are chronic ailments. Then weigh the appropriateness of sequence. Prescribe medication according to symptoms. Only then can medicine reach disease removal. No obstruction will not enter. Regarding syndrome differentiation. You Zaijing said. Abdominal distension belonging to Spleen/Stomach. Then diet is scarce. Belonging to other Zang-Fu. Then diet is normal. Distension between skin and vessels. Diet is also normal. Between intestines/stomach and blind membranes. Diet is also scarce. Qi also blocked in five Zang. Then shortness of breath urgent no eating and disease critical. Therefore diseases in exterior easy to treat. In Fu difficult to treat. Entering Zang incurable. This is also an essential argument.
[Rongzhai Note] This section (Shanghan with Distension) Yu's treatment of Yin Edema advocates using Mafu Wupi Yin initially. Indeed a highly ideal good formula. Lianchen Mr. elaborated in *National Famous Doctors* *Verified Cases Compilation*. He said: "Wupi Yin added Mahuang, Fuzi, pioneered by Zhou Xueqiao. Stated treating edema and Fengshui edema. Those without inherent Liver Fire. Administration always effective. Its wonder lies entirely in Mahuang alone. Not only opens Lung releases sweat. Letting water qi excrete from skin. Remaining power especially promotes water passages. Letting water qi excrete from urine; thus Japanese physicians. Exclusively recommend Mahuang as specific drug for edema. Only now patients. Often fear Mahuang dare not take. Based on my verification. Whenever releasing Wind-Cold sweat. Mahuang only uses four-five fen to six-seven fen can induce sweat. Releasing Fengshui sweat. Must be one qian to one-and-a-half qian; Never committed Yang collapse harm."
Also note: The full text of this section. Rich in material. Its quality exceeds any section in the whole book. Can be said to be typical program among Shanghan accompanying syndromes. Yu analyzed swelling, distension, gu, distension etc. Into four units. Pointed out different causes and therapies. Focus lies on the two diseases below "distension". Mr. Lianchen again "diligently sought ancient teachings. Broadly collected prescriptions." Listed etiology, symptoms and treatments for swelling, distension, gu, distension four syndromes; Relying on ancient medical bastions. Fighting stubborn chronic diseases. From the text. Can see his elder's energy grew stronger with battle. Weapons also better. Referenced sixteen schools of thought. Cited eighty-three formulas; Using accumulated experience of nearly one hundred past medical experts. Analyzed, synthesized. Flexibly applied. Diligently. Showing the essence of "learned and versatile" health workers in the first half of the 20th century. Leaving it for our study.