瘰疬方治述略《灵枢·寒热》篇云:“黄帝问于岐伯曰:寒热瘰疬在于颈腋者,皆何气使生?岐伯曰:此皆鼠瘘寒热之毒气也,留于脉而不去者也。黄帝曰:去之奈何?岐伯曰:鼠瘘之本,皆在于脏,其末上出于颈腋之间……”。《外科证治全生集》谓:“小者为瘰,大者为疬,生于项间,初起一小核,在皮里膜外,不觉疼痛,皮色不异,渐大如桃李,旁增不一。诸书辨其名类,曰:形软遇怒则肿甚者,名马刀瘰疬;一包而生数十枚者,名莲子疬;绕项而生者,名蛇盘疬;其形大小不一,连接数枚者,名子母疬;如黄豆结荚一般者,名锁项疬;形小多痒者,名风疬;生项间延至胸腋者,名瓜藤疬;一枚上叠三五枚者,名重台瘰疬;生如鼠形,名鼠疬,又名鼠疮,累累如串,俗名老鼠串。要皆虚损、气结痰凝而成。
主治方药:1.紫玉簪膏:取紫玉簪花,连根、茎、花、叶(不开花时,取根、茎、叶亦可),不论多少,勿洗去根上泥,置石臼中,以石杵杵之(不经铜铁器),使烂如泥,入布袋中绞汁;其渣入臼,量加陈醋再捣,再予绞汁,其渣再加醋捣绞如前。将一、二、三次捣绞之汁,同入一砂锅中,慢火熬如流膏状,待冷封固。用时取毛笔蘸搽患部,日二三次。不论已破、未破,均可外搽,毫无痛苦。轻者二三星期即愈,重者不过一月而愈。此为余屡试屡效的经验方。
2.消串丹:白芍一两白术一两柴胡二钱蒲公英三钱茯苓五钱陈皮一钱附子一片甘草一钱天花粉三钱紫背天葵五钱上水煎服,八剂痰块渐消,又十剂尽化,又一月全愈。
愈后服六君子汤。此方妙在蒲公英、天葵为消串神品,然非佐以芍药,则肝木不平;非助以苓、术,则脾胃不健,又何能攻痰破结者。惟有攻有补,又得附子之力引各药直捣中坚,所以能消风痰于旦夕耳。
3.转败丹:人参、当归各二两白术一两柴胡二钱白芍、金银花各三钱半夏五钱生甘草三钱水煎服,四剂,痰块在胸者尽消;又四剂,颈上溃烂者亦愈。将方减半,再服十剂,疮口尽平,不再发也。此方补多于消,而开郁寓其中,化痰存于内。
4.子龙丸:制甘遂、制大戟、白芥子(炒)各等分上药共研末,炼蜜丸如绿豆大。每服三分,淡姜汤送下,日三次。忌与甘草同服。
5.小金丹:白胶香、草乌、五灵脂、地龙、木鳖各一两五钱,俱为细末乳香、没药(各去油)当归身(俱研末)各七钱半麝香三钱墨炭一钱二分上各研细末,混匀,用糯米一两二钱同上药末糊厚,千锤打融,为丸如芡实大。每料约250粒,每服一丸,陈酒送下,醉盖取汗。如流注将溃及溃久者,以10丸,做五日服完(一日二丸)。
6.犀黄丸:犀黄三分麝香一钱半乳香、没药(均去油)各一两上药共研极细末,用黄米饭一两,捣烂为丸(忌火烘、晒干),陈酒三钱送下。患生上部,临卧服;下部,空心服。
7.内消验方:土贝母、白芷各五钱共为细末,糖霜调陈酒,下三钱。重者三服愈。
8.消疬方:元参(蒸)川贝母(去心,蒸)牡蛎(火煅,醋淬)各四两研细末,炼蜜为丸。每服三钱,温开水送服,日二次。
年谱1900年11月20日,余无言先生诞生于江苏省阜宁县益林镇。
原名余愚,字择民(一作“则民”),别署不平。
1905~1909年家中延请塾师课读文学基础读物及算术等。
1909~1911年先生去淮安县,在淮安高等小学插班读高小,高小毕业时正值逊清·宣统三年。
1911~1914年塾师教读儒家经典、四书五经、《史记》、《汉书》等典籍,在文史方面打下了坚实的基础。
1914~1918年先生随其父余奉仙先生(“晚清苏北三大名医”之一)攻习中医经典名著《黄帝内经》《难经》《伤寒论》《金匮要嗡)《神农本草经》及临床各科医著,并为其父抄方二年。
在数年学习期间,尤为重视医圣张仲景经方的学习与运用,为民国时期成为“经方派”名家奠定了基础。
1918年是年秋,开始在阜宁县益林镇悬壶应诊。由于欧西医学东渐,在诊余之暇,亦选读部分西医临床医籍。
1920~1923年先生受当时医学界“衷中参西”的影响,去上海进一步学习西医内、外科,内科从学于俞风宾博士,外科受教于上海德籍名医维都富尔。在此期间,较为重视中西医学之沟通。
1923~1927年返回苏北故乡,继续行医。在诊疗方面以中医为主,西医为辅,治疗成绩卓著。在此期间并在故里主办阜宁县第三区小学,延请教师讲学,自任校长。
1927~1929年先生应聘担任当时国民政府顾祝同部某军第二师军医官,转战安徽、河南、湖北、江西等省。治疗病员,以外、伤科病证为主。
1929~1930年1929年冬,先生辞去军职,到上海市定居开业,改名余无言,系取自孔子“予欲无言”之意(此名多用于著书立说和对外交流,行医数十年多用“余择明”作为诊所名)。
1930年3月,与张赞臣先生共同主编《世界医报》(每周出一期),力求在中西医学术沟通和诊疗中的取长补短方面多所致意。1930年秋,应包识生先生(当时任上海中国医学院院长)之请,担任该院外科学教授。
1931年除私人诊所外,又与张赞臣先生合组联合诊所,这可谓是上海市比较早期的中医联合诊所。
1932年由当时“中央国医馆”馆长焦易堂先生聘请先生担任该馆名誉理事,为改进中医工作出谋献策。
1934年中央国医馆增聘先生担任该馆编审委员会委员(编审委员会主席是陈无咎),负责起草中医“外科病名表式”,颁布全国中医界采用。在中央国医馆编审委员会起草的临床各科病名表式中,先生的外科病名表式,颇受外界赞赏。是年,先生还编写、出版了《实用混合外科学总论》和《实用混合外科学各论》(中国医药书店刊行)。总论以西说为经、中说为纬;各论则以中说为经、西说为纬,强调诊疗中的“实用”二字。这是中西医外科学术汇通之作,当时是受张锡纯《医学衷中参西录》著述的影响,也可以说是“中西汇通派”较早期的外科著作,有其一定的学术影响,故在建国后,上海中医书局均有重印本刊行。
再者,先生数年来以“改进中医”为素志,在报刊上发表了多篇学术论文,引起中医界的重视。特别是他针对旧国民政府和余云岫等提出.“废止中医中药”的举措与主张,先生以余无言或余不平的名义,多次撰文予以驳斥、声辩,为当时中医界所重视。此外,先生还为《医界春秋》《复兴中医》等刊物撰写多篇学术论文。
1936年章太炎先生主办“苏州国医学校”聘请先生和叶橘泉、章次公等名家任教。先生担任中医外科主任,主讲中医外科学。是年并担任上海新中国医学院教授,主讲《金匮要略》和中医外科学。
1937年上海中国医学院聘请先生主讲《伤寒论》。在此前后的年月中,先生还受聘于中国医学专修馆、中华职业学校(国医专科)等校任教。
是年秋,先生与张赞臣先生合作主办“上海中医专科学校”,敦请谢观担任名誉校长,陈无咎任校长,丁福保、张伯熙(张赞臣先生之父)先后任副校长,先生任教务主任,张赞臣任总务主任。先生除负责教务外,主讲《伤寒论》《金匮要略》和中医外科学。上海中医专科学校为三年制,共主办毕业了三届。先生还将其次女余蕙君于1938年送入该校学习(1941年毕业)。
1939年先生所编著之《伤寒论新义》(图表注释)由中华书局公开出版,由于作者“改进中医”的素志和对待仲景学说及其临床应用等方面,力求精意研殚,该书的图表及论述中均融汇若干西医学说,体现了当时的时代特色。该书并请丁福保、谢观、陈无咎三位老先生分别撰序,向读者介绍该书崭新的学术风貌。《伤寒论新义》自刊行后,曾九次重印,堪称是他学术著作中的代表作。
1942年先生因不屈于日伪政府对院校的登记造册,遂决定停办上海中医专科学校。先生在五年教学中,认真备课讲学,虽大雨滂沱,亦必撑伞赴校、衣湿上台授课,受到学生们的广泛好评。
1943~1946年先生先后编写、出版了新作——《湿温伤寒病篇》和《斑疹伤寒病篇》(上海中医书局出版)二书。所谓“湿温伤寒”系指西医的肠伤寒,“斑疹伤寒”为西医病名。但在介绍治疗方面,主要是采用中医传统治疗与方药,特别是突出经方的临床应用,可明显增强疗效。
1947年余氏在上海创办“大同疗养院”,请丁福保先生担任名誉院长,自任院长。名为疗养院,实际上主要是收治慢性疑难病证,可以说是上海较早期的中医医院。开办不足二年,因经费匮乏而停办。
1948年先生接获多封外界读者来信,建议他编写《伤寒论新义》的姐妹篇——《金匮要略新义》。实际上先生于40年代初即有此意向,多年来在这方面的学术积累也较为充分。是年在繁重的诊务和教学负担下,经常在夜间参阅大量文献、结合临床予以编写。而他在上海执业的30年中,主治病证以内、外科居多。内科则以伤寒、温病、内科杂病、疑难重证为主。所用方治,虽不拘经方、时方,但仲景方仍占转大比例。他对上海的时医诊治热病,动辄以豆豉、豆卷等药施治,至为不满。先生用仲景经方中之石膏、大黄,在辨证确切的情况下,用量相当大而效验卓著,甚至有“起死回生”的多个案例,上海市民以“石膏、大黄先生”(此处之“先生”二字,义同医生)称之,成为民国时期经方派的名家。
关于这一点,读者在阅习他的医案后,当会有更深的体会。
自1929年定居上海后,先生对中医前辈名家多所敬重。
他曾多次表述,在学术上除承父教外,上海的谢观、丁福保、陈无咎等老先生对他亦多所教益,但生平尤为崇敬的则是“南北二张”(“南张”指嘉定张山雷,“北张”系指天津张锡纯)。在学术方面,除主张精读经典名著外,并在一定程度上主张中西医学汇通。故他是民国时期“经方派”名家,也是“汇通派”的成员之一。
1949年是年5月,上海获得解放,并于10月1日建立了中华人民共和国,中医药界从此得到了真正的“解放”。先生诊务较前更为繁忙。在学术上,他更多地和上海同辈名医陆渊雷、秦伯未、章次公、程门雪、张赞臣、章巨膺、严苍山等切磋、研究,为上海市的中医工作发展向卫生部门提出诸多建议,以促使改进中医药工作的顺利发展。
由于在上海的20年,先生的医事活动以临床与教学为主,受教的学生数以千计,招带的生徒亦不下数十人之多,先生开始将过去诊疗的若干病证予以案例记述、整理,他在建国以前已将其父奉仙公遗著——《医方经验汇编》整理刊行(中华书局出版),自己也拟出一本医案著作,定名为《翼经经验录》,书名涵义是以个人的临床经验以羽翼仲圣之经典名著。实际上《翼经经验录》所经治的医案,本书均已予以收录、整理。余氏之医案力求在临床上能取精用宏,并以符合诊疗实用为准则。余氏所主张的“中医科学化,西医中国化”,对外界也有一定的影响。
1952年先生积多年仲景学说的教学、研究,编著了《金匮要略新义》(图表注释),由新医书局出版。书的封面及其扉页,分别由其同道、诗友秦伯未、严苍山先生题写书名,学术特色仍以“图表注释”为主。无言先生针对世传《金匮要略》原文,在理顺经文之错乱、伪文之芜杂方面下了一番功夫。
每论一证,多以西说为参证。全书仍以“发皇古义,融会新知”为其著述思路与方法,出版后亦曾多次重印(台湾省亦据原本重印)。由于《伤寒论新义》与《金匮要略新义》的先后刊行。余氏成为20世纪仲景学术的主要研究者之一。
1954年数年来,先生陆续带徒讲授医经及内、外科,积极参加上海中医界各项学术活动,并经常去西医医院会诊。是年秋,卫生部中医研究院筹备处派出陈邦贤、徐瑞杰先生到上海延请名医赴京工作,曾亲临诊所、住处洽谈,先生答以稍缓时日,考虑进京工作。同年10月5日,华东及上海市召开中医代表会议,讨论卫生部所拟订开展中医工作的种种方案,无言先生作为中医学会和内科学会的特约代表应邀出席大会。此次会议以发掘、整理祖国医药遗产、推进医学教育和纠正过去工作中的偏差作为讨论重点。先生指出:“中医学术得到政府的重视,可以安如磐石。”在会议过程中,先生除作口头即席发言外,并向大会和秘书处专写提案四则,对中央制订的中医政策极为支持。
1955年先生之三子余瀛鳌自北京中央直属机关第二医院报名参加卫生部主办第一届全国西医学习中医研究班系统学习中医,并在医学史前辈名家陈邦贤先生的示意下与其父联系来京工作事,无言先生答以数月后赴京到中医研究院工作(研究院于1955年12月19日正式成立)。
《瘰疬方治述略》
《灵枢·寒热》篇记载:“黄帝问岐伯说:颈腋部位发生的寒热瘰疬,是什么气引起的?岐伯回答说:这都是鼠瘘寒热毒气滞留于血脉中无法去除所致。黄帝问:如何去除它?岐伯说:鼠瘘的根本在于脏腑,其末梢表现于颈腋之间……”。《外科证治全生集》指出:“小的称为瘰,大的称为疬,生于颈部,初起时为一个核,位于皮肤与筋膜之间,不痛,肤色不变,逐渐增大如桃李,旁边增多不一。各书辨别其名目类别说:形状柔软,遇愤怒则肿势加重的,名为马刀瘰疬;一包内生数十枚的,名为莲子疬;绕颈部生长的,名为蛇盘疬;形状大小不一,连接数枚的,名为子母疬;像黄豆结荚一般的,名为锁项疬;形状小且多痒的,名为风疬;生于颈部延伸至胸腋的,名为瓜藤疬;一枚上叠三五枚的,名为重台瘰疬;形状如鼠形的,名为鼠疬,又名鼠疮,累累成串,俗称老鼠串。总之,都是由虚损、气结痰凝而成。
主治方药:
1.紫玉簪膏:取紫玉簪花,连同根、茎、花、叶(不开花时,取根、茎、叶也可以),数量不限,不要洗去根上的泥土,放入石臼中,用石杵捣烂(不经过铜铁器),使其烂如泥状,装入布袋中绞汁;剩下的渣滓放入臼中,适量加入陈醋再捣,再次绞汁,渣滓再加醋捣绞如前法。将一、二、三次捣绞出的汁液,一同倒入砂锅中,用慢火熬制成流膏状,冷却后密封保存。使用时用毛笔蘸取涂抹患处,每天两三次。无论是否破溃,均可外涂,毫无痛苦。轻者两三个星期即愈,重者不超过一个月痊愈。这是我屡试屡效的经验方。
2.消串丹:白芍一两,白术一两,柴胡二钱,蒲公英三钱,茯苓五钱,陈皮一钱,附子一片,甘草一钱,天花粉三钱,紫背天葵五钱。以上药物加水煎服,服用八剂后痰块逐渐消退,又服十剂完全消散,再过一个月全部痊愈。
痊愈后服用六君子汤。此方妙在蒲公英、天葵是消除串珠样肿块的神品,但如果不佐以芍药,则肝木之气不平;如果不辅以茯苓、白术,则脾胃功能不健,又怎能攻逐痰浊、破除结聚呢?只有攻补兼施,再加上附子的力量引导各药直捣病所核心,所以能在一日一夕之间消除风痰。
3.转败丹:人参、当归各二两,白术一两,柴胡二钱,白芍、金银花各三钱,半夏五钱,生甘草三钱。水煎服,服用四剂,胸部痰块全部消除;又服四剂,颈部溃烂处也愈合。将药量减半,再服十剂,疮口完全平复,不再复发。此方补益多于消散,而开郁理气寓于其中,化痰作用存于内部。
4.子龙丸:制甘遂、制大戟、白芥子(炒)各等分。以上药物共研为细末,炼蜜制成如绿豆大小的丸药。每次服用三分,用淡姜汤送下,每天三次。忌与甘草同服。
5.小金丹:白胶香、草乌、五灵脂、地龙、木鳖各一两五钱,均研为细末;乳香、没药(均去油)、当归身(均研为细末)各七钱半;麝香三钱;墨炭一钱二分。以上各药分别研细末,混合均匀,用糯米一两二钱与其他药末一起糊厚,千锤打融,制成如芡实大小的丸药。每料约250粒,每次服用一丸,用陈酒送下,服药后醉盖被子取汗。如果是流注即将溃破及溃破久不愈合者,将10丸分五日服完(每天二丸)。
6.犀黄丸:犀黄三分,麝香一钱半,乳香、没药(均去油)各一两。以上药物共研极细末,用黄米饭一两,捣烂制成丸药(忌用火烘、晒干),用陈酒三钱送下。病生在身体上部,临睡前服用;病生在身体下部,空腹服用。
7.内消验方:土贝母、白芷各五钱,共研为细末,用糖霜调和陈酒,服用三钱。病情重者服用三次即愈。
8.消疬方:元参(蒸)、川贝母(去心,蒸)、牡蛎(火煅,醋淬)各四两,研为细末,炼蜜制成丸药。每次服用三钱,用温开水送服,每天二次。
年谱
1900年11月20日,余无言先生诞生于江苏省阜宁县益林镇。
原名余愚,字择民(一作“则民”),别署不平。
1905~1909年家中延请塾师教授文学基础读物及算术等。
1909~1911年先生前往淮安县,在淮安高等小学插班读高小,高小毕业时正值逊清·宣统三年。
1911~1914年塾师教读儒家经典、四书五经、《史记》、《汉书》等典籍,在文史方面打下了坚实的基础。
1914~1918年先生随其父余奉仙先生(“晚清苏北三大名医”之一)攻习中医经典名著《黄帝内经》《难经》《伤寒论》《金匮要略》《神农本草经》及临床各科医著,并为其父抄方二年。
在数年学习期间,尤为重视医圣张仲景经方的学习与运用,为民国时期成为“经方派”名家奠定了基础。
1918年秋,开始在阜宁县益林镇悬壶应诊。由于欧西医学东渐,在诊余之暇,亦选读部分西医临床医籍。
1920~1923年先生受当时医学界“衷中参西”的影响,去上海进一步学习西医内、外科,内科从学于俞风宾博士,外科受教于上海德籍名医维都富尔。在此期间,较为重视中西医学之沟通。
1923~1927年返回苏北故乡,继续行医。在诊疗方面以中医为主,西医为辅,治疗成绩卓著。在此期间并在故里主办阜宁县第三区小学,延请教师讲学,自任校长。
1927~1929年先生应聘担任当时国民政府顾祝同部某军第二师军医官,转战安徽、河南、湖北、江西等省。治疗病员,以外、伤科病证为主。
1929~1930年1929年冬,先生辞去军职,到上海市定居开业,改名余无言,系取自孔子“予欲无言”之意(此名多用于著书立说和对外交流,行医数十年多用“余择明”作为诊所名)。
1930年3月,与张赞臣先生共同主编《世界医报》(每周出一期),力求在中西医学术沟通和诊疗中的取长补短方面多所致意。1930年秋,应包识生先生(当时任上海中国医学院院长)之请,担任该院外科学教授。
1931年除私人诊所外,又与张赞臣先生合组联合诊所,这可谓是上海市比较早期的中医联合诊所。
1932年由当时“中央国医馆”馆长焦易堂先生聘请先生担任该馆名誉理事,为改进中医工作出谋献策。
1934年中央国医馆增聘先生担任该馆编审委员会委员(编审委员会主席是陈无咎),负责起草中医“外科病名表式”,颁布全国中医界采用。在中央国医馆编审委员会起草的临床各科病名表式中,先生的外科病名表式,颇受外界赞赏。是年,先生还编写、出版了《实用混合外科学总论》和《实用混合外科学各论》(中国医药书店刊行)。总论以西说为经、中说为纬;各论则以中说为经、西说为纬,强调诊疗中的“实用”二字。这是中西医外科学术汇通之作,当时是受张锡纯《医学衷中参西录》著述的影响,也可以说是“中西汇通派”较早期的外科著作,有其一定的学术影响,故在建国后,上海中医书局均有重印本刊行。
再者,先生数年来以“改进中医”为素志,在报刊上发表了多篇学术论文,引起中医界的重视。特别是他针对旧国民政府和余云岫等提出“废止中医中药”的举措与主张,先生以余无言或余不平的名义,多次撰文予以驳斥、声辩,为当时中医界所重视。此外,先生还为《医界春秋》《复兴中医》等刊物撰写多篇学术论文。
1936年章太炎先生主办“苏州国医学校”聘请先生和叶橘泉、章次公等名家任教。先生担任中医外科主任,主讲中医外科学。是年并担任上海新中国医学院教授,主讲《金匮要略》和中医外科学。
1937年上海中国医学院聘请先生主讲《伤寒论》。在此前后的年月中,先生还受聘于中国医学专修馆、中华职业学校(国医专科)等校任教。
是年秋,先生与张赞臣先生合作主办“上海中医专科学校”,敦请谢观担任名誉校长,陈无咎任校长,丁福保、张伯熙(张赞臣先生之父)先后任副校长,先生任教务主任,张赞臣任总务主任。先生除负责教务外,主讲《伤寒论》《金匮要略》和中医外科学。上海中医专科学校为三年制,共主办毕业了三届。先生还将其次女余蕙君于1938年送入该校学习(1941年毕业)。
1939年先生所编著之《伤寒论新义》(图表注释)由中华书局公开出版,由于作者“改进中医”的素志和对待仲景学说及其临床应用等方面,力求精意研殚,该书的图表及论述中均融汇若干西医学说,体现了当时的时代特色。该书并请丁福保、谢观、陈无咎三位老先生分别撰序,向读者介绍该书崭新的学术风貌。《伤寒论新义》自刊行后,曾九次重印,堪称是他学术著作中的代表作。
1942年先生因不屈于日伪政府对院校的登记造册,遂决定停办上海中医专科学校。先生在五年教学中,认真备课讲学,虽大雨滂沱,亦必撑伞赴校、衣湿上台授课,受到学生们的广泛好评。
1943~1946年先生先后编写、出版了新作——《湿温伤寒病篇》和《斑疹伤寒病篇》(上海中医书局出版)二书。所谓“湿温伤寒”系指西医的肠伤寒,“斑疹伤寒”为西医病名。但在介绍治疗方面,主要是采用中医传统治疗与方药,特别是突出经方的临床应用,可明显增强疗效。
1947年余氏在上海创办“大同疗养院”,请丁福保先生担任名誉院长,自任院长。名为疗养院,实际上主要是收治慢性疑难病证,可以说是上海较早期的中医医院。开办不足二年,因经费匮乏而停办。
1948年先生接获多封外界读者来信,建议他编写《伤寒论新义》的姐妹篇——《金匮要略新义》。实际上先生于40年代初即有此意向,多年来在这方面的学术积累也较为充分。是年在繁重的诊务和教学负担下,经常在夜间参阅大量文献、结合临床予以编写。而他在上海执业的30年中,主治病证以内、外科居多。内科则以伤寒、温病、内科杂病、疑难重证为主。所用方治,虽不拘经方、时方,但仲景方仍占较大比例。他对上海的时医诊治热病,动辄以豆豉、豆卷等药施治,至为不满。先生用仲景经方中之石膏、大黄,在辨证确切的情况下,用量相当大而效验卓著,甚至有“起死回生”的多个案例,上海市民以“石膏、大黄先生”(此处之“先生”二字,义同医生)称之,成为民国时期经方派的名家。
关于这一点,读者在阅习他的医案后,当会有更深的体会。
自1929年定居上海后,先生对中医前辈名家多所敬重。
他曾多次表述,在学术上除承父教外,上海的谢观、丁福保、陈无咎等老先生对他亦多所教益,但生平尤为崇敬的则是“南北二张”(“南张”指嘉定张山雷,“北张”系指天津张锡纯)。在学术方面,除主张精读经典名著外,并在一定程度上主张中西医学汇通。故他是民国时期“经方派”名家,也是“汇通派”的成员之一。
1949年是年5月,上海获得解放,并于10月1日建立了中华人民共和国,中医药界从此得到了真正的“解放”。先生诊务较前更为繁忙。在学术上,他更多地和上海同辈名医陆渊雷、秦伯未、章次公、程门雪、张赞臣、章巨膺、严苍山等切磋、研究,为上海市的中医工作发展向卫生部门提出诸多建议,以促使改进中医药工作的顺利发展。
由于在上海的20年,先生的医事活动以临床与教学为主,受教的学生数以千计,招带的生徒亦不下数十人之多,先生开始将过去诊疗的若干病证予以案例记述、整理,他在建国以前已将其父奉仙公遗著——《医方经验汇编》整理刊行(中华书局出版),自己也拟出一本医案著作,定名为《翼经经验录》,书名涵义是以个人的临床经验以羽翼仲圣之经典名著。实际上《翼经经验录》所经治的医案,本书均已予以收录、整理。余氏之医案力求在临床上能取精用宏,并以符合诊疗实用为准则。余氏所主张的“中医科学化,西医中国化”,对外界也有一定的影响。
1952年先生积多年仲景学说的教学、研究,编著了《金匮要略新义》(图表注释),由新医书局出版。书的封面及其扉页,分别由其同道、诗友秦伯未、严苍山先生题写书名,学术特色仍以“图表注释”为主。无言先生针对世传《金匮要略》原文,在理顺经文之错乱、伪文之芜杂方面下了一番功夫。
每论一证,多以西说为参证。全书仍以“发皇古义,融会新知”为其著述思路与方法,出版后亦曾多次重印(台湾省亦据原本重印)。由于《伤寒论新义》与《金匮要略新义》的先后刊行。余氏成为20世纪仲景学术的主要研究者之一。
1954年数年来,先生陆续带徒讲授医经及内、外科,积极参加上海中医界各项学术活动,并经常去西医医院会诊。是年秋,卫生部中医研究院筹备处派出陈邦贤、徐瑞杰先生到上海延请名医赴京工作,曾亲临诊所、住处洽谈,先生答以稍缓时日,考虑进京工作。同年10月5日,华东及上海市召开中医代表会议,讨论卫生部所拟订开展中医工作的种种方案,无言先生作为中医学会和内科学会的特约代表应邀出席大会。此次会议以发掘、整理祖国医药遗产、推进医学教育和纠正过去工作中的偏差作为讨论重点。先生指出:“中医学术得到政府的重视,可以安如磐石。”在会议过程中,先生除作口头即席发言外,并向大会和秘书处专写提案四则,对中央制订的中医政策极为支持。
1955年先生之三子余瀛鳌自北京中央直属机关第二医院报名参加卫生部主办第一届全国西医学习中医研究班系统学习中医,并在医学史前辈名家陈邦贤先生的示意下与其父联系来京工作事,无言先生答以数月后赴京到中医研究院工作(研究院于1955年12月19日正式成立)。
Brief Description of Formulas for Treating Scrofula (Luoli)
The chapter "Cold-Heat" (Hanye) in the *Ling Shu* (Spiritual Pivot) records: "The Yellow Emperor asked Qibo, saying: What qi causes cold-heat scrofula occurring in the neck and axilla? Qibo replied: These are all toxic qi of rat fistula and cold-heat, which remain stagnant in the vessels and cannot be expelled. The Yellow Emperor asked: How to expel them? Qibo said: The root of rat fistula lies within the Zang organs, while its branches manifest between the neck and axilla..." The *Waike Zhengzhi Quansheng Ji* (Complete Collection of External Disease Treatment) states: "Small ones are called 'Luo', large ones are called 'Li'. They arise in the neck region. Initially, there is a single nodule located between the skin and fascia, painless, with normal skin color, gradually enlarging like a plum or peach, with multiple nodules appearing nearby. Various texts distinguish their names and categories: those that are soft and swell more upon anger are named 'Madao Luoli' (Horse Knife Scrofula); those where dozens of nodules form in one cluster are named 'Lianzi Li' (Lotus Seed Scrofula); those growing around the neck are named 'Shepan Li' (Snake Coil Scrofula); those of varying sizes connected in series are named 'Zimu Li' (Mother-Child Scrofula); those resembling soybean pods are named 'Suoxiang Li' (Neck-Locking Scrofula); those small and very itchy are named 'Feng Li' (Wind Scrofula); those arising in the neck and extending to the chest and axilla are named 'Guateng Li' (Melon Vine Scrofula); those with three to five nodules stacked on one are named 'Chongtai Luoli' (Double-Tier Scrofula); those shaped like rats are named 'Shu Li' (Rat Scrofula), also known as 'Shu Chuang' (Rat Sore), forming a chain, commonly called 'Mouse String'. All these are caused by deficiency damage, Qi stagnation, and phlegm coagulation.
Main Treatment Formulas:
1. Zi Yuzi Gao (Purple Hosta Ointment): Take flowers of Purple Hosta (Hosta ventricosa), including roots, stems, flowers, and leaves (if not flowering, roots, stems, and leaves may be used). Quantity is unrestricted. Do not wash off the mud from the roots. Place in a stone mortar and pound with a stone pestle (avoid copper or iron utensils) until mushy like paste. Put into a cloth bag and squeeze out the juice. Return the dregs to the mortar, add aged vinegar appropriately, pound again, and squeeze out juice. Repeat this process. Combine the juices from the first, second, and third extractions into a clay pot. Simmer over low heat until it becomes a flowing paste-like consistency. Seal tightly after cooling. When using, dip a brush in the ointment and apply to the affected area two to three times daily. It can be applied externally whether the lesion is ulcerated or not, causing no pain. Mild cases heal in two to three weeks; severe cases heal within a month. This is an empirical formula I have tested repeatedly with consistent efficacy.
2. Xiao Chuan Dan (Formula to Dissolve Chains): Bai Shao (Radix Paeoniae Alba) 1 liang, Bai Zhu (Rhizoma Atractylodis Macrocephalae) 1 liang, Chai Hu (Radix Bupleuri) 2 qian, Pu Gong Ying (Herba Taraxaci) 3 qian, Fu Ling (Sclerotium Poriae Cocos) 5 qian, Chen Pi (Pericarpium Citri Reticulatae) 1 qian, Fu Zi (Radix Aconiti Lateralis Preparata) 1 slice, Gan Cao (Radix Glycyrrhizae) 1 qian, Tian Hua Fen (Radix Trichosanthis) 3 qian, Zi Bei Tian Kui (Herba Oldenlandiae Diffusae) 5 qian. Decoct these herbs in water and take orally. After eight doses, the phlegmatic masses gradually diminish; after another ten doses, they completely dissolve; full recovery occurs after one month.
After recovery, take Liu Jun Zi Tang (Six Gentlemen Decoction). The brilliance of this formula lies in Pu Gong Ying and Tian Kui being divine agents for dissolving chain-like masses. However, without the support of Bai Shao, the Liver Wood qi will not be balanced; without the assistance of Fu Ling and Bai Zhu, the Spleen and Stomach function will not be robust, and how could they attack phlegm and break accumulations? Only by combining attack and tonification, aided by the power of Fu Zi to guide the herbs directly to the core of the disease, can wind-phlegm be eliminated in a day or night.
3. Zhuan Bai Dan (Formula to Reverse Defeat): Ren Shen (Radix Ginseng) and Dang Gui (Radix Angelicae Sinensis) each 2 liang, Bai Zhu 1 liang, Chai Hu 2 qian, Bai Shao and Jin Yin Hua (Flos Lonicerae Japonicae) each 3 qian, Ban Xia (Rhizoma Pinelliae Preparatum) 5 qian, Sheng Gan Cao (Raw Radix Glycyrrhizae) 3 qian. Decoct in water and take orally. After four doses, phlegmatic masses in the chest are entirely eliminated; after another four doses, ulcerations on the neck heal. Reduce the dosage by half and take for ten more doses; the wound surfaces flatten completely, and recurrence is prevented. This formula emphasizes tonification over dispersion, incorporating methods to open depression and resolve phlegm internally.
4. Zi Long Wan (Dragon Pill): Zhi Gan Sui (Prepared Radix Kansui), Zhi Da Ji (Prepared Radix Euphorbiae Humifusae), and Bai Jie Zi (Semen Mustardae, stir-fried) in equal parts. Grind the above herbs into fine powder, mix with refined honey, and make pills the size of mung beans. Take 3 fen per dose, washed down with light ginger soup, three times daily. Avoid taking concurrently with Gan Cao.
5. Xiao Jin Dan (Little Golden Pill): Bai Jiao Xiang (Resina Commiphorae), Cao Wu (Radix Aconiti Kusnezoffii), Wu Ling Zhi (Faeces Troglodytis), Di Long (Pheretima), and Mu Bie (Semen Strychnos) each 1.5 liang, all ground into fine powder. Ru Xiang (Olibanum) and Mo Yao (Myrrha) (both defatted) and Dang Gui Shen (Radix Angelicae Sinensis Root End) (all ground into powder) each 7.5 qian. She Xiang (Moschus) 3 qian. Mo Tan (Carbonized Ink Stick) 1.2 qian. Grind each ingredient separately into fine powder, mix uniformly. Use 1.2 liang of glutinous rice flour mixed with the herb powders to form a thick paste. Pound thoroughly for a thousand strikes until melted and homogeneous. Make pills the size of Euryale seeds. Each batch yields approximately 250 pills. Take one pill per dose, washed down with aged wine. Cover warmly to induce sweating. For Liuzhu (flowing abscesses) about to ulcerate or chronic non-healing ulcers, take 10 pills divided over five days (two pills daily).
6. Xi Huang Wan (Rhino Horn Pill): Xi Huang (Calculus Bovis) 3 fen, She Xiang 1.5 qian, Ru Xiang and Mo Yao (both defatted) each 1 liang. Grind all herbs into extremely fine powder. Mix with 1 liang of yellow rice, pounded into a paste, to form pills (avoid drying by fire or sun). Take with 3 qian of aged wine. If the lesion is in the upper body, take before bed; if in the lower body, take on an empty stomach.
7. Neixiao Yanfang (Internal Resolution Empirical Formula): Tu Bei Mu (Bulbus Fritillariae Thunbergii) and Bai Zhi (Radix Angelicae Dahuricae) each 5 qian. Grind into fine powder. Mix with rock sugar and aged wine, take 3 qian. Severe cases heal after three doses.
8. Xiao Li Fang (Scrofula Resolving Formula): Yuan Shen (Radix Scrophulariae) (steamed), Chuan Bei Mu (Bulbus Fritillariae Cirrhosae) (core removed, steamed), and Mu Li (Concha Ostreae) (calcined, quenched in vinegar) each 4 liang. Grind into fine powder, mix with refined honey to make pills. Take 3 qian per dose, washed down with warm boiled water, twice daily.
Chronology
On November 20, 1900, Mr. Yu Wuyan was born in Yilin Town, Funing County, Jiangsu Province.
His original name was Yu Yu, courtesy name Zemin (also written as Zemin), pseudonym Buping.
From 1905 to 1909, he studied basic literature and arithmetic under a private tutor at home.
From 1909 to 1911, he attended Huai'an Higher Primary School as a transfer student. He graduated during the third year of the Xuantong reign of the declining Qing Dynasty.
From 1911 to 1914, his tutor taught him Confucian classics, the Four Books and Five Classics, *Records of the Grand Historian* (*Shiji*), and *Book of Han* (*Hanshu*), laying a solid foundation in literature and history.
From 1914 to 1918, he studied classic TCM texts such as *Huangdi Neijing* (Yellow Emperor's Inner Canon), *Nanjing* (Classic of Difficult Issues), *Shanghan Lun* (Treatise on Cold Pathogenic Diseases), *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), and *Shennong Bencao Jing* (Divine Farmer's Materia Medica), along with clinical works from various specialties, under his father, Yu Fengxian (one of the "Three Great Physicians of Northern Jiangsu in the Late Qing"). He also copied prescriptions for his father for two years.
During these years of study, he placed particular emphasis on learning and applying the classical formulas of Zhang Zhongjing, laying the foundation for becoming a renowned master of the "Classical Formula School" during the Republic of China era.
In autumn 1918, he began practicing medicine in Yilin Town, Funing County. With the introduction of Western medicine to the East, he also selected some Western clinical medical texts to read in his spare time.
From 1920 to 1923, influenced by the contemporary medical trend of "integrating Chinese and Western medicine," he went to Shanghai to further study Western internal and external medicine. He studied internal medicine under Dr. Yu Fengbin and external medicine under the German physician Weidu Fu'er in Shanghai. During this period, he paid considerable attention to communication between Chinese and Western medicine.
From 1923 to 1927, he returned to his hometown in Northern Jiangsu to continue practicing. His treatment approach prioritized TCM with Western medicine as an auxiliary, achieving remarkable results. During this time, he also founded the Third District Primary School in Funing County, invited teachers to lecture, and served as principal.
From 1927 to 1929, he was appointed as a military surgeon for the Second Division of a certain army under Gu Zhutong of the Nationalist Government, campaigning in Anhui, Henan, Hubei, and Jiangxi provinces. He treated patients primarily with external and traumatic conditions.
From 1929 to 1930: In winter 1929, he resigned from his military post, settled in Shanghai to open a clinic, and changed his name to Yu Wuyan, derived from Confucius's phrase "I wish to say nothing." (This name was mostly used for writing books and external exchanges; for decades of medical practice, he mostly used "Yu Zheming" as the clinic name.)
In March 1930, he co-edited *World Medical Journal* (published weekly) with Mr. Zhang Zanchen, striving to contribute to the academic communication between Chinese and Western medicine and the mutual learning of strengths and weaknesses in diagnosis and treatment. In autumn 1930, at the invitation of Mr. Bao Shisheng (then Dean of Shanghai China College of Medicine), he served as a professor of surgery at the college.
In 1931, besides his private clinic, he formed a joint clinic with Mr. Zhang Zanchen, which was one of the earlier joint TCM clinics in Shanghai.
In 1932, he was invited by Mr. Jiao Yitang, director of the Central National Medical Hall, to serve as an honorary councilor, offering advice to improve TCM work.
In 1934, the Central National Medical Hall appointed him as a member of the Editorial Review Committee (chaired by Chen Wujiu). He was responsible for drafting the "External Disease Nomenclature Table" for TCM, which was promulgated for adoption by the national TCM community. His external disease nomenclature table was highly praised by outsiders among the various specialty tables drafted by the committee. That year, he also wrote and published *General Theory of Practical Mixed Surgery* and *Specific Theory of Practical Mixed Surgery* (published by China Medical Bookstore). The general theory used Western theories as the warp and Chinese theories as the weft; the specific theory used Chinese theories as the warp and Western theories as the weft, emphasizing "practicality" in diagnosis and treatment. This was a work integrating Chinese and Western surgical academics, influenced at the time by Zhang Xichun's *Medical Records of Integrating Chinese and Western Medicine*. It can be considered an early surgical work of the "Integration School," having a certain academic impact. Therefore, after the founding of the People's Republic of China, Shanghai Traditional Chinese Medicine Bookstore reprinted it.
Furthermore, Mr. Yu had long held the aspiration to "improve TCM." He published many academic papers in newspapers and magazines, attracting attention from the TCM community. Especially regarding the proposals by the old Nationalist Government and Yu Yunxiu to "abolish TCM and Chinese herbal medicine," he refuted and defended against them multiple times under the names Yu Wuyan or Yu Buping, which was highly valued by the TCM community at the time. Additionally, he wrote numerous academic papers for journals such as *Medical World Spring and Autumn* and *Revive TCM*.
In 1936, Mr. Zhang Taiyan, who founded the "Suzhou National Medical School," invited Mr. Yu, Ye Juquan, Zhang Cigong, and other masters to teach. Mr. Yu served as the Director of TCM Surgery, lecturing on TCM Surgery. That year, he also served as a professor at Shanghai New China Medical College, lecturing on *Jingui Yaolue* and TCM Surgery.
In 1937, Shanghai China College of Medicine invited Mr. Yu to lecture on *Shanghan Lun*. Around this time, he was also hired to teach at institutions such as China Medical Specialization Hall and Zhonghua Vocational School (TCM Department).
In autumn of that year, Mr. Yu cooperated with Mr. Zhang Zanchen to host the "Shanghai TCM Professional School." He invited Xie Guan to serve as Honorary Principal, Chen Wujiu as Principal, Ding Fubao and Zhang Boxi (father of Mr. Zhang Zanchen) as Vice Principals in succession, Mr. Yu as Director of Academic Affairs, and Mr. Zhang Zanchen as Director of General Affairs. Besides managing academic affairs, Mr. Yu lectured on *Shanghan Lun*, *Jingui Yaolue*, and TCM Surgery. The school was a three-year program, graduating three cohorts. Mr. Yu also sent his second daughter, Yu Huijun, to study there in 1938 (graduating in 1941).
In 1939, Mr. Yu's compiled work *New Interpretations of Shanghan Lun* (with charts and annotations) was publicly published by Zhonghua Book Company. Due to the author's long-standing aspiration to "improve TCM" and his meticulous research on Zhang Zhongjing's theories and their clinical application, the book's charts and discussions integrated several Western medical theories, reflecting the characteristics of the times. The book included prefaces by three senior scholars: Ding Fubao, Xie Guan, and Chen Wujiu, introducing its new academic style to readers. Since publication, *New Interpretations of Shanghan Lun* has been reprinted nine times, making it a representative work of his academic writings.
In 1942, refusing to comply with the registration requirements of the Japanese puppet government for educational institutions, Mr. Yu decided to close the Shanghai TCM Professional School. During his five years of teaching, he prepared lessons seriously and lectured diligently. Even in heavy rain, he would carry an umbrella to school, often arriving with wet clothes to teach, earning widespread praise from students.
From 1943 to 1946, Mr. Yu successively wrote and published two new works: *Chapter on Damp-Warmth Typhoid Fever* and *Chapter on Epidemic Typhus* (published by Shanghai Traditional Chinese Medicine Bookstore). "Damp-warmth typhoid" refers to Western medicine's enteric fever, and "epidemic typhus" is a Western disease name. However, in terms of treatment introduction, it mainly adopted traditional TCM treatments and formulas, particularly highlighting the clinical application of classical formulas, which significantly enhanced therapeutic effects.
In 1947, Mr. Yu founded the "Datong Sanatorium" in Shanghai, inviting Mr. Ding Fubao to serve as Honorary Director and appointing himself as Director. Although named a sanatorium, it primarily admitted patients with chronic and difficult diseases, making it one of the earlier TCM hospitals in Shanghai. It operated for less than two years before closing due to lack of funds.
In 1948, Mr. Yu received letters from readers suggesting he write a companion volume to *New Interpretations of Shanghan Lun* titled *New Interpretations of Jingui Yaolue*. Actually, he had this intention since the early 1940s, and his academic accumulation in this area had been quite sufficient. Under the heavy burden of clinical duties and teaching, he often consulted extensive literature at night and combined it with clinical practice to write. During his 30 years of practice in Shanghai, most of his treated conditions were internal and external medicine. Internal medicine focused on Shanghan, warm diseases, miscellaneous internal diseases, and critical difficult cases. Although he did not strictly adhere to either classical or contemporary formulas, formulas from Zhang Zhongjing accounted for a large proportion. He was very dissatisfied with contemporary physicians in Shanghai who routinely used fermented soybean (Dou Chi) and soybean sprouts (Dou Juan) to treat febrile diseases. Mr. Yu used Shi Gao (Gypsum Fibrosum) and Da Huang (Radix et Rhizoma Rhei) from Zhang Zhongjing's classical formulas. Under accurate syndrome differentiation, he used substantial doses with remarkable efficacy, even having multiple cases of "reviving the dying." Shanghai citizens nicknamed him "Mr. Gypsum and Rhubarb," making him a renowned master of the Classical Formula School during the Republic of China era.
Readers will gain deeper insights into this point after studying his medical cases.
Since settling in Shanghai in 1929, Mr. Yu respected many senior masters of TCM.
He expressed multiple times that, academically, besides inheriting his father's teachings, senior scholars in Shanghai such as Xie Guan, Ding Fubao, and Chen Wujiu also provided him with much guidance. However, the figures he revered most throughout his life were the "Two Zhangs of North and South" ("Southern Zhang" referring to Zhang Shanlei of Jiading, "Northern Zhang" referring to Zhang Xichun of Tianjin). Academically, besides advocating intensive reading of classic texts, he also advocated for the integration of Chinese and Western medicine to a certain extent. Thus, he was a master of the "Classical Formula School" during the Republic of China era and also a member of the "Integration School."
In 1949, Shanghai was liberated in May, and the People's Republic of China was established on October 1st. The TCM community thus achieved true "liberation." Mr. Yu's clinical workload became busier than before. Academically, he engaged more in discussions and research with contemporaries in Shanghai such as Lu Yuanlei, Qin Bowei, Zhang Cigong, Cheng Menxue, Zhang Zanchen, Zhang Juying, and Yan Cangshan. He proposed numerous suggestions to health departments to promote the development of TCM work in Shanghai, facilitating the smooth progress of improving TCM practices.
Due to his 20 years in Shanghai, where his medical activities focused on clinical practice and teaching, he taught thousands of students and personally supervised dozens of apprentices. Mr. Yu began to record and organize cases of previously treated conditions. Before the founding of the PRC, he had already organized and published his father Fengxian's posthumous work, *Compilation of Experience in Medical Formulas* (published by Zhonghua Book Company). He also planned a medical case book titled *Yi Jing Jing Yan Lu* (Record of Experiences Supporting the Classics), implying that his personal clinical experience would support the classic works of Sage Zhang. Actually, the medical cases treated in *Yi Jing Jing Yan Lu* have all been collected and organized in this book. Mr. Yu's medical cases strive for precision and breadth in clinical application, adhering to the criterion of practical utility. His advocacy of "Scientization of TCM and Sinicization of Western Medicine" also had a certain influence on the outside world.
In 1952, accumulating years of teaching and research on Zhang Zhongjing's theories, Mr. Yu compiled and published *New Interpretations of Jingui Yaolue* (with charts and annotations) by Xin Yi Shu Ju. The cover and title page featured calligraphy by his colleagues and poet friends, Mr. Qin Bowei and Mr. Yan Cangshan. The academic feature remained centered on "chart annotations." Mr. Wuyan put considerable effort into rectifying textual errors and removing spurious content in the traditionally transmitted text of *Jingui Yaolue*.
When discussing each syndrome, he often used Western theories as references. The whole book still followed the思路 (approach) and method of "developing ancient meanings and integrating new knowledge." It was reprinted multiple times after publication (Taiwan also reprinted based on the original). With the successive publication of *New Interpretations of Shanghan Lun* and *New Interpretations of Jingui Yaolue*, Mr. Yu became one of the main researchers of Zhang Zhongjing's academics in the 20th century.
In 1954, for several years, Mr. Yu successively took apprentices to teach medical classics and internal/external medicine, actively participated in various academic activities of the Shanghai TCM community, and frequently consulted at Western hospitals. In autumn of that year, the preparatory office of the Institute of Chinese Materia Medica under the Ministry of Health sent Mr. Chen Bangxian and Mr. Xu Ruijie to Shanghai to invite famous doctors to work in Beijing. They visited his clinic and residence for negotiations. Mr. Yu replied that he would consider working in Beijing after a short delay. On October 5th of the same year, the East China and Shanghai regions held a TCM Representative Conference to discuss various plans formulated by the Ministry of Health for developing TCM work. Mr. Wuyan attended the conference as a special representative of the TCM Society and the Internal Medicine Society. The conference focused on discovering and organizing the heritage of Chinese medicine, promoting medical education, and correcting past deviations in work. Mr. Yu pointed out: "With the government's attention to TCM academics, it can stand firm as a rock." During the conference, besides giving impromptu oral speeches, he submitted four specific proposals to the congress and secretariat, showing strong support for the central government's TCM policies.
In 1955, Mr. Yu's third son, Yu Ying'ao, enrolled in the First National Class for Western Doctors Learning TCM organized by the Ministry of Health while working at the Second Hospital of Directly Affiliated Institutions of the Central Government in Beijing. Under the suggestion of the senior expert in medical history, Mr. Chen Bangxian, he contacted his father regarding moving to Beijing for work. Mr. Wuyan replied that he would go to Beijing to work at the Institute of Chinese Materia Medica a few months later (the Institute was officially established on December 19, 1955).