先父认为肝炎多由过度劳累、情志失调引起,这与肝为罢极之本有关。以脾阳不运为本,湿热则为其标。热重于湿者,其治在胃;湿重于热者,其治在脾。治湿热着重在疏利气机,用苦寒不可过剂,因苦寒易损中阳,中阳伤反使本病加重,出现呕逆、便溏,甚者浮肿。他说:我曾以甘草干姜汤为主,治一小儿肝炎即是这类例子。也有气血两伤用金水六君煎者,亦有用加味甘麦大枣汤者,总要依据病机,不可死守清利一法。
先父曾治一慢性肝炎患者,服苦寒重剂后,不思饮食,肢软神倦,便溏,谷丙转氨酶300~400单位,麝絮(++),为肝病及脾,脾胃虚寒,用理中汤加吴萸、草果,一月而肝功恢复。先父亦曾治一胃溃疡病人,住院二日仍大口吐血不止。询其原因由受寒饮酒致血上溢。用金匮侧柏叶汤(柏叶、炮干姜、艾叶、童便)温通胃阳,消瘀止血,收到捷效。若不知其所因,误用寒凉,必致胃阳更伤,危殆立至。又如先父治沈x发热一案,午后身热,身倦纳少无汗,自服辛凉清解,不惟热不退,反致便溏、尿少、不思食。其脉弦滑,舌质暗而苔稍腻。虽其发病于四月,而时值气候反常,阴雨绵绵,断为寒湿困于中焦,用通阳利湿、芳香化浊,其效甚捷。先父曾经指出:外感六淫皆能化热,治当辨何邪而祛之,不可胶执于季节一端。如乙脑本是热证,清热亦是常法,但不可过剂。临床有服寒凉太早、太过,转为寒中,不得不用参附救逆。老父屡诫:凡用清法,便须考虑胃气,体弱者宁可再剂,不可重剂,否则热病未已,寒证即起,变证百出。
一九六三年二月,我二叔患感冒,头痛,周身骨节痛,脉紧,苔白,我用麻黄汤一剂而愈。事后颇为自得,函告先父,以为必得褒奖。谁知先父来信说;你二叔生平嗜酒,湿热素重,但心中烧灼痛数日方缓解,是一险兆。桂枝汤有若病酒客不可与的告诫,你只注意了桂枝汤的汤而忽略了桂枝,此物用内热之人当先考虑动血之弊。寒热外束身痛者可去桂枝加羌活3克。这是只知读死书缺乏思考之过,而缺乏思考是医生的不治之病。
向民间学习,在实践中学习
先父在其《介寿堂随笔》中录有不少民间老医口述方。如治关节痛方,先父注明;此系张东友老友得自民间草药医口述方,遍传亲友,愈治甚众,故录之以作参考。在他离开梓潼多年后,尚有病者来我处专索此方。他自创的二鲜饮(鲜芦根、鲜竹叶)加鲜茅根、童便名三鲜饮,就是根据梓潼的特点在临床中自创的专治热病肺胃津伤,烧热不退,烦渴,既不可表,亦不可下,唯宜生津退热的良方,而动血者宜三鲜饮。先父说:单方、验方之所以能够流传于世,因为有一个验字。既然有效亦必有理。我们在:临床上就应通过实践加以总结,不要动辄开贵药、补药,因为药无贵贱。这样就能有所进益。
先父相当重视病人的客观反映,从中积累知识,他曾举一脾胃患者,腹胀,胸闷,不思饮食一个多月,形容消瘦,身倦。治疗多次无效,求他诊治。他套用古人消食导滞药如山楂、谷麦芽、鸡内金合阿魏丸,一剂后,病者未再求诊。一个月后在路上碰见,病人面色红润,形体也较前丰满。病者笑着说:上次您那剂药服后并没有什么效果。别人说伤了什么食物就用什么食物烧焦来吃,可以化积。我是吃海参得病的,因此我买了大海参,烧焦服后泻下粘挺不少,胸膈顿觉宽敞,没再服药就好了。先父说;此事对我深有教益。病人讲真话可察知我们治疗上的正确与否。如果病者碍于情面,不讲真话,我们则以非为是,必然不能得到提高。伤于某种食物即以某食物炭为引,大约是同气相求之理,几十年中我用此法确有效果。
我一九六四年侍诊时曾见他治一消渴患者,男性,口渴引饮,饮而复渴,前后半年,服滋阴清热药如六味地黄,玄麦甘桔等五十余剂无寸效。舌苔黄腻,脉沉弱。先父改用茵陈四逆汤,一剂而渴止大半,三剂而基本痊愈,后用参苓白术散小剂煮服以资巩固。事后先父说:虽舌苔口渴属热象,但服滋阴清热药五十余剂无寸效,加之脉象沉弱,显见阳衰不能蒸腾水气,若果系阴亏五十余剂虽不能全好,亦必有所进展;前治者虽未见效,都是我的老师,所谓后车之鉴。放胆用茵陈四逆汤是背水一战,既温中又化湿,湿去热必孤。即使热不去,亦可转属阳明,但实者易治,虚者难为也。
为医者必须重视医德医风
先父不仅毕生勤于医学,精于医学,尤重医德。他谦虚,谨慎,严于律己,宽以待人。对同道、对病人极度负责,不徇情,不逢迎,事败不推卸责任,功成不掠人之美。他的许多言行堪作典范。
早年先父悬壶成都时,梓潼黄某病重,夤夜迎他返梓诊治。其时已先延名医郭代兴先生,郭先生断为阳明腑实,议急下之,而富贵之家畏硝黄如虎狼。不敢服药。先父诊断后,又索郭先生处方,细加推敲,认为药证相符,他说:方药对证,何必犹豫彷徨,如昨日进药,今日病已解大半。如此兴师动众,真是枉费人力。病家经他解说,将郭先生方煎取半杯,服后半日大便解,尽剂后好转十之八九。事隔多年,先父还经常提及,要注意不要掩人之美,夺人之功。他给我寄《余氏父子经验集》时,信中亦明白指出:奉仙夫子,深明医道,曲尽人情,诚为聪明特达之士,凌养吾先生之誉确非太过。其虚心竹有低头叶,傲骨梅无仰面花,好学近乎智,力行近乎仁,知耻近乎勇等语,与先哲之言何异,诚为医界之楷模。而著书立说不仰权贵鼻息,不求达官贵人笔墨以沽名钓誉,确为世风日下之中流砥柱!其中病家隐弊说、尽性篇尤为可贵,临证若不予此处时时留意,往往劳而无功。
在我刚开始行医之时,他就告诫我,不要贪名,不要图利,生活要俭朴。他以先祖为例说:你爷爷在年龄已六旬时,尚无分寒暑,足蹬芒鞋,出入于山间田野,不辞辛劳地为病者治疗。有时病家无钱,他还要帮助解决药钱。我在成都行医近五十年,未穿过一件料子衣服。医生衣著太奢华,穷苦人往往望而却步。这些家风你应好好继承。业师陈新三老中医说:我在蒲老面前拜门时,蒲老反复告诫,不管病人有钱无钱都应尽心治疗。事隔几十年了,我一直设有违背他的教诲,这也是一个医生应有的品德。先父提倡对病者认真负责,他也痛恨一味逢迎病人的不正医风。他常常批评那些开贵药、蛮补药以惊世骇俗的作法。尤其鄙薄那些为迎合某些病者,把营养物品都开在处方上的医生。他曾经说;有人把排骨都开到处方上去了,病家拿去报账,这搞成什么风气了!以后你们千万注意,不要为迎合某些病者而不择手段!
先父尝谓;读古人书宜严,而对时贤宜宽。他很推祟张山雷所著《中风斟诠》一书,在该书不少地方批道:至精至当,至理明言……惜乎他目空四海,言之不逊,语之太过,为其美中不足之处。他又说:张君之国医无一人悟到此理,此非神而明之,别有会心者万不能悟彻此中真理,一犬吠形,百犬吠声等等说法未免骄矜太甚。医者宜惜口德,何况十室之邑有忠信,当虚怀若谷才是。
先父早年在梓潼就兴了会诊磋商之风。梓漳的中医界是伤寒学派占主要地位,涉及温病者尚少。仅有郝氏与薛氏在温病方面颇有心得,先父经常与他们磋商。他认为《伤寒论》讨论的是广义伤寒,已经包括了温病在内。用《伤寒论》的许多方药,也可以治温病,而明清温病学说,是在《伤寒论》治法基础上的发展。从而打破了两个学派互立门户、势同水火的对立态度。业师陈新三老中医曾说:蒲老早年在棒潼就开创了会诊之风,为融合伤寒与温病学派作了不懈的努力,在消除门户之见方面,为我们树立了榜样。
先父在给我的信中,以及与我的日常谈话中,多次谈到关于门户之见的看法。他说:由于时代关系,中医的门户之见根深蒂固。现在时代不同了,年轻一辈应该和睦相处,取长补短,共同提高。这些教导,至今言犹在耳。
他在北京工作近廿年,医德风范,至今仍为同道赞许。在他誉满全国之时,犹谓;如果把医生分作三等,我只能算中等者。我经常翻阅如《中医杂志》之类医学杂志,发现有些公社医院的中医,业务水平也是相当不错的,基层大有人才!对于同道中人,如章次公、冉雪峰,秦伯未、岳美中、任应秋,李翰卿等诸先生,他认为他们各有所长,风雨一堂,切磋砥砺,取长补短,其乐何如。岳美中前辈曾手书一律赠我父亲,我爱其文词佳丽带回梓潼,可惜被毁,我仅能记得其中几句:爱怜真至友兼师,得相追随遂所私。削吾点垩常挥斧,青囊乏术负深期……由此可见友谊之深。记得我和兄长志忠,都曾要求能在他身边学习,他说:易子而教最好。志忠跟李老(斯炽),你跟陈新三,都不错。李老系四川名手,陈新三有多年临床经验,跟他们同跟我学习一样。他对于子女从不偏爱。
先父对病人,无论其职位高低,都是一视同仁。他曾批评一见高干来诊,就是人参、鹿茸的作法,认为这不仅浪费国家钱财,而且是害人害已。他说干部、平民都是人,干部之病和常人之病并无二致。有一次他给周总理看病,药费仅几分钱而疗效很好,周总理十分欣赏这类便宜而有效的方药。
一九七五年四月,先父临终前对我说:我一生行医十分谨慎小心,真所谓如临深渊,如履薄冰。学医首先要认真读书,读书后要认真实践,二者缺一不可。光读书不实践仅知理论,不懂临床,盲目临床,不好好读书是草菅人命。你要牢牢紧记!我的一生就是在读书与实践中度过的。
先父逝世已经五年多了,回首往事,音容宛在,爰作此文,以为纪念。回忆吴棹仙老师
【吴棹仙小传】吴棹仙(18921976),名显宗,四川巴县人。幼承庭训,攻四书五经兼习医学。青少年时代曾先后就读于重庆巴县医学堂、重庆官立医学校,重庆医学研究会公立医校、重庆存仁医学校,精研医学经典,深得内江名医王恭甫器重。后从针灸大师许直乃(立衣旁)游,得子午、灵龟针法秘传。为求中医学术之生存与发展,自奉克俭捐资,先后创办重庆国医药馆、国医传习所、重庆中医院、巴县国医学校、苏生国医院、重庆中华医药科学讲习所等,深受医界赞许。建国后,任教于重庆中匡进修学校,出任过重庆市第一、第二中医院院长以及成都中匡学院医经教研组主任、针灸教研组主任等职,并先后被选为四川省政协第二居委员会委员、四川省第三届人大代表等。毕生治学严谨,崇尚实践,经验丰富,医理精深,长用经方,执医业六十余年,屡起沉疴,为当代知名的经方学家。著有《子午流注说难》,《医经生理学》、《医经病理学》、《灵枢经浅注》等书。一九五五年冬出席全国政协会议期间,献《子午流注环周围》于毛泽东主席,受到主席嘉勉。除精通医学外,又工书法,通音韵,精词章,著有《听秋声馆》、《性灵集》、《养石斋诗稿》等。
吴棹仙老师出生在叫川省巴县一个耕读世家。父名俊生,对经学颇有研究,因不满科举,灰心仕途,中年弃儒从同乡李同庆公习医。学业有成,遂悬壶涪州(今涪陵县)龙潭场,诊余则课子四书五经,兼授医学,以陈修园公余十六种为教材,命先师诵读。如是二年,先师对《伤寒论浅注》正文与注释,皆能背诵,为以后走上医学道路奠定了基础。
一九零五年,光绪帝迫于时势,废科举,兴学校,企能励精图治。官府将重庆巴县字水书院改为巴县医学堂,通知各州、县学生报考,每州县拟录取五名。时值天暑,长江涨水停渡,水退后考试已毕。由于情况特殊,学校准先师补考,题为学医为谋生、为济世而试言其理。先师一挥而就云;学医为济世而后谋生,并引《伤寒论·自序》:上以疗君亲之疾,下以救贫贱之厄,中以保生长全,以养其生等语详加论述。主考陈蔚然公嘉而预取之。复试时,监学唐德府公抽试《伤寒论》第六条,先师不仅背诵了第六条正文,而且将注释亦全部背诵,结果名列前茅,得优先录取。入学后,先师埋头苦读,争分惜秒,不事冶游。时重庆风光秀丽,市场繁华,但先师从不涉足其间,即令节、假日也在学堂图书室中,先后浏览了清朝二百余年间刊行的五十四家医学丛书。一九零八年考试,全校学生成绩皆优,首批结业。府官详阅试卷后,嘉奖该学堂,以每张田契加四厘银子为该学堂经费开支,遂改名为重庆官立医学校以培养师资,先师又升入师范班。其时,课程有《内科》、《外科》、《内经》、《伤寒》、《金匮》、《诊断》、《药物》,还有《新内经》(相当于现代的生理学、解剖学),任教者则为当时省内秀才或儒生而精医之名流。学校尊师重道,课堂讲授,秩序井然。先师对讲授《内经》有多处不同看法,均写成质疑论文,与好友彭笃生等共同讨论分析,直到深刻理解为止。该校附设有治疗所,在老师的指导下,每个学生都要在治疗所实习。应用理,法、方、药,辨证论治。正确者,发给合格证,差者继续跟师临证。先师常说:这种带徒方法最好,理论联系实际,不致出现学医三年,便谓天下无病不治,及至临证三年,又谓天下无药可投的情况。
先父认为,肝炎多由过度劳累、情志失调引起,这与“肝为罢极之本”(肝脏是耐受疲劳的根本)有关。以脾阳不运(脾阳虚弱导致运化功能失常)为本,湿热则为其标(外在表现)。热重于湿者,治疗重点在胃;湿重于热者,治疗重点在脾。治疗湿热着重于疏利气机,使用苦寒药物不可过量,因为苦寒容易损伤中焦阳气,中阳受损反而会使本病加重,出现呕吐逆气、大便溏稀,甚至浮肿。他说:我曾以甘草干姜汤为主方,治疗一名小儿肝炎,就是这类例子。也有气血两伤使用金水六君煎的,也有使用加味甘麦大枣汤的,总要依据病机,不可死守清利一法。
先父曾治疗一名慢性肝炎患者,服用苦寒重剂后,不思饮食,肢体软弱、精神疲倦,大便溏稀,谷丙转氨酶300~400单位,麝絮试验(++),这是肝病及脾,脾胃虚寒,用理中汤加吴茱萸、草果,一个月肝功能恢复。先父也曾治疗一名胃溃疡病人,住院两天仍大口吐血不止。询问原因,是由于受寒饮酒导致血液上溢。用金匮侧柏叶汤(侧柏叶、炮干姜、艾叶、童便)温通胃阳,消瘀止血,收到迅速疗效。如果不知道病因,误用寒凉药物,必然导致胃阳更伤,危险立刻到来。又如先父治疗沈x发热一案,午后身体发热,身体疲倦、食欲少、无汗,自行服用辛凉清解药,不仅热不退,反而导致便溏、尿少、不思食。其脉弦滑,舌质暗而苔稍腻。虽然发病于四月,但时值气候反常,阴雨绵绵,断定为寒湿困于中焦,用通阳利湿、芳香化浊的方法,疗效甚捷。先父曾经指出:外感六淫皆能化热,治疗应当辨别是何种邪气而祛除它,不可固执于季节一端。如乙脑本是热证,清热亦是常法,但不可过量。临床有服寒凉太早、太过,转为寒中,不得不用参附救逆。先父屡诫:凡用清法,便须考虑胃气,体弱者宁可再剂(多次少量),不可重剂(大量猛药),否则热病未已,寒证即起,变证百出。
一九六三年二月,我二叔患感冒,头痛,周身骨节痛,脉紧,苔白,我用麻黄汤一剂而愈。事后颇为自得,写信告诉先父,以为必得褒奖。谁知先父来信说:你二叔生平嗜酒,湿热素重,但心中烧灼痛数日方缓解,是一险兆。桂枝汤有若病酒客不可与的告诫,你只注意了桂枝汤的汤而忽略了桂枝,此物用内热之人当先考虑动血之弊。寒热外束身痛者可去桂枝加羌活3克。这是只知读死书缺乏思考之过,而缺乏思考是医生的不治之病。
向民间学习,在实践中学习
先父在其《介寿堂随笔》中录有不少民间老医口述方。如治关节痛方,先父注明:此系张东友老友得自民间草药医口述方,遍传亲友,愈治甚众,故录之以作参考。在他离开梓潼多年后,尚有病者来我处专索此方。他自创的二鲜饮(鲜芦根、鲜竹叶)加鲜茅根、童便名三鲜饮,就是根据梓潼的特点在临床中自创的专治热病肺胃津伤,烧热不退,烦渴,既不可表,亦不可下,唯宜生津退热的良方,而动血者宜三鲜饮。先父说:单方、验方之所以能够流传于世,因为有一个验字。既然有效亦必有理。我们在临床上就应通过实践加以总结,不要动辄开贵药、补药,因为药无贵贱。这样就能有所进益。
先父相当重视病人的客观反映,从中积累知识,他曾举一脾胃患者,腹胀,胸闷,不思饮食一个多月,形容消瘦,身倦。治疗多次无效,求他诊治。他套用古人消食导滞药如山楂、谷麦芽、鸡内金合阿魏丸,一剂后,病者未再求诊。一个月后在路上碰见,病人面色红润,形体也较前丰满。病者笑着说:上次您那剂药服后并没有什么效果。别人说伤了什么食物就用什么食物烧焦来吃,可以化积。我是吃海参得病的,因此我买了大海参,烧焦服后泻下粘挺不少,胸膈顿觉宽敞,没再服药就好了。先父说:此事对我深有教益。病人讲真话可察知我们治疗上的正确与否。如果病者碍于情面,不讲真话,我们则以非为是,必然不能得到提高。伤于某种食物即以某食物炭为引,大约是同气相求之理,几十年中我用此法确有效果。
我一九六四年侍诊时曾见他治一消渴患者,男性,口渴引饮,饮而复渴,前后半年,服滋阴清热药如六味地黄,玄麦甘桔等五十余剂无寸效。舌苔黄腻,脉沉弱。先父改用茵陈四逆汤,一剂而渴止大半,三剂而基本痊愈,后用参苓白术散小剂煮服以资巩固。事后先父说:虽舌苔口渴属热象,但服滋阴清热药五十余剂无寸效,加之脉象沉弱,显见阳衰不能蒸腾水气,若果系阴亏五十余剂虽不能全好,亦必有所进展;前治者虽未见效,都是我的老师,所谓后车之鉴。放胆用茵陈四逆汤是背水一战,既温中又化湿,湿去热必孤。即使热不去,亦可转属阳明,但实者易治,虚者难为也。
为医者必须重视医德医风
先父不仅毕生勤于医学,精于医学,尤重医德。他谦虚,谨慎,严于律己,宽以待人。对同道、对病人极度负责,不徇情,不逢迎,事败不推卸责任,功成不掠人之美。他的许多言行堪作典范。
早年先父悬壶成都时,梓潼黄某病重,夤夜迎他返梓诊治。其时已先延名医郭代兴先生,郭先生断为阳明腑实,议急下之,而富贵之家畏硝黄如虎狼。不敢服药。先父诊断后,又索郭先生处方,细加推敲,认为药证相符,他说:方药对证,何必犹豫彷徨,如昨日进药,今日病已解大半。如此兴师动众,真是枉费人力。病家经他解说,将郭先生方煎取半杯,服后半日大便解,尽剂后好转十之八九。事隔多年,先父还经常提及,要注意不要掩人之美,夺人之功。他给我寄《余氏父子经验集》时,信中亦明白指出:奉仙夫子,深明医道,曲尽人情,诚为聪明特达之士,凌养吾先生之誉确非太过。其虚心竹有低头叶,傲骨梅无仰面花,好学近乎智,力行近乎仁,知耻近乎勇等语,与先哲之言何异,诚为医界之楷模。而著书立说不仰权贵鼻息,不求达官贵人笔墨以沽名钓誉,确为世风日下之中流砥柱!其中病家隐弊说、尽性篇尤为可贵,临证若不予此处时时留意,往往劳而无功。
在我刚开始行医之时,他就告诫我,不要贪名,不要图利,生活要俭朴。他以先祖为例说:你爷爷在年龄已六旬时,尚无分寒暑,足蹬芒鞋,出入于山间田野,不辞辛劳地为病者治疗。有时病家无钱,他还要帮助解决药钱。我在成都行医近五十年,未穿过一件料子衣服。医生衣著太奢华,穷苦人往往望而却步。这些家风你应好好继承。业师陈新三老中医说:我在蒲老面前拜门时,蒲老反复告诫,不管病人有钱无钱都应尽心治疗。事隔几十年了,我一直设有违背他的教诲,这也是一个医生应有的品德。先父提倡对病者认真负责,他也痛恨一味逢迎病人的不正医风。他常常批评那些开贵药、蛮补药以惊世骇俗的作法。尤其鄙薄那些为迎合某些病者,把营养物品都开在处方上的医生。他曾经说:有人把排骨都开到处方上去了,病家拿去报账,这搞成什么风气了!以后你们千万注意,不要为迎合某些病者而不择手段!
先父尝谓:读古人书宜严,而对时贤宜宽。他很推祟张山雷所著《中风斟诠》一书,在该书不少地方批道:至精至当,至理明言……惜乎他目空四海,言之不逊,语之太过,为其美中不足之处。他又说:张君之国医无一人悟到此理,此非神而明之,别有会心者万不能悟彻此中真理,一犬吠形,百犬吠声等等说法未免骄矜太甚。医者宜惜口德,何况十室之邑有忠信,当虚怀若谷才是。
先父早年在梓潼就兴了会诊磋商之风。梓漳的中医界是伤寒学派占主要地位,涉及温病者尚少。仅有郝氏与薛氏在温病方面颇有心得,先父经常与他们磋商。他认为《伤寒论》讨论的是广义伤寒,已经包括了温病在内。用《伤寒论》的许多方药,也可以治温病,而明清温病学说,是在《伤寒论》治法基础上的发展。从而打破了两个学派互立门户、势同水火的对立态度。业师陈新三老中医曾说:蒲老早年在棒潼就开创了会诊之风,为融合伤寒与温病学派作了不懈的努力,在消除门户之见方面,为我们树立了榜样。
先父在给我的信中,以及与我的日常谈话中,多次谈到关于门户之见的看法。他说:由于时代关系,中医的门户之见根深蒂固。现在时代不同了,年轻一辈应该和睦相处,取长补短,共同提高。这些教导,至今言犹在耳。
他在北京工作近廿年,医德风范,至今仍为同道赞许。在他誉满全国之时,犹谓:如果把医生分作三等,我只能算中等者。我经常翻阅如《中医杂志》之类医学杂志,发现有些公社医院的中医,业务水平也是相当不错的,基层大有人才!对于同道中人,如章次公、冉雪峰,秦伯未、岳美中、任应秋,李翰卿等诸先生,他认为他们各有所长,风雨一堂,切磋砥砺,取长补短,其乐何如。岳美中前辈曾手书一律赠我父亲,我爱其文词佳丽带回梓潼,可惜被毁,我仅能记得其中几句:爱怜真至友兼师,得相追随遂所私。削吾点垩常挥斧,青囊乏术负深期……由此可见友谊之深。记得我和兄长志忠,都曾要求能在他身边学习,他说:易子而教最好。志忠跟李老(斯炽),你跟陈新三,都不错。李老系四川名手,陈新三有多年临床经验,跟他们同跟我学习一样。他对于子女从不偏爱。
先父对病人,无论其职位高低,都是一视同仁。他曾批评一见高干来诊,就是人参、鹿茸的作法,认为这不仅浪费国家钱财,而且是害人害已。他说干部、平民都是人,干部之病和常人之病并无二致。有一次他给周总理看病,药费仅几分钱而疗效很好,周总理十分欣赏这类便宜而有效的方药。
一九七五年四月,先父临终前对我说:我一生行医十分谨慎小心,真所谓如临深渊,如履薄冰。学医首先要认真读书,读书后要认真实践,二者缺一不可。光读书不实践仅知理论,不懂临床,盲目临床,不好好读书是草菅人命。你要牢牢紧记!我的一生就是在读书与实践中度过的。
先父逝世已经五年多了,回首往事,音容宛在,爰作此文,以为纪念。回忆吴棹仙老师
【吴棹仙小传】吴棹仙(1892-1976),名显宗,四川巴县人。幼承庭训,攻四书五经兼习医学。青少年时代曾先后就读于重庆巴县医学堂、重庆官立医学校,重庆医学研究会公立医校、重庆存仁医学校,精研医学经典,深得内江名医王恭甫器重。后从针灸大师许直乃(立衣旁)游,得子午、灵龟针法秘传。为求中医学术之生存与发展,自奉克俭捐资,先后创办重庆国医药馆、国医传习所、重庆中医院、巴县国医学校、苏生国医院、重庆中华医药科学讲习所等,深受医界赞许。建国后,任教于重庆中匡进修学校,出任过重庆市第一、第二中医院院长以及成都中匡学院医经教研组主任、针灸教研组主任等职,并先后被选为四川省政协第二居委员会委员、四川省第三届人大代表等。毕生治学严谨,崇尚实践,经验丰富,医理精深,长用经方,执医业六十余年,屡起沉疴,为当代知名的经方学家。著有《子午流注说难》,《医经生理学》、《医经病理学》、《灵枢经浅注》等书。一九五五年冬出席全国政协会议期间,献《子午流注环周围》于毛泽东主席,受到主席嘉勉。除精通医学外,又工书法,通音韵,精词章,著有《听秋声馆》、《性灵集》、《养石斋诗稿》等。
吴棹仙老师出生在叫川省巴县一个耕读世家。父名俊生,对经学颇有研究,因不满科举,灰心仕途,中年弃儒从同乡李同庆公习医。学业有成,遂悬壶涪州(今涪陵县)龙潭场,诊余则课子四书五经,兼授医学,以陈修园公余十六种为教材,命先师诵读。如是二年,先师对《伤寒论浅注》正文与注释,皆能背诵,为以后走上医学道路奠定了基础。
一九零五年,光绪帝迫于时势,废科举,兴学校,企能励精图治。官府将重庆巴县字水书院改为巴县医学堂,通知各州、县学生报考,每州县拟录取五名。时值天暑,长江涨水停渡,水退后考试已毕。由于情况特殊,学校准先师补考,题为学医为谋生、为济世而试言其理。先师一挥而就云:学医为济世而后谋生,并引《伤寒论·自序》:上以疗君亲之疾,下以救贫贱之厄,中以保生长全,以养其生等语详加论述。主考陈蔚然公嘉而预取之。复试时,监学唐德府公抽试《伤寒论》第六条,先师不仅背诵了第六条正文,而且将注释亦全部背诵,结果名列前茅,得优先录取。入学后,先师埋头苦读,争分惜秒,不事冶游。时重庆风光秀丽,市场繁华,但先师从不涉足其间,即令节、假日也在学堂图书室中,先后浏览了清朝二百余年间刊行的五十四家医学丛书。一九零八年考试,全校学生成绩皆优,首批结业。府官详阅试卷后,嘉奖该学堂,以每张田契加四厘银子为该学堂经费开支,遂改名为重庆官立医学校以培养师资,先师又升入师范班。其时,课程有《内科》、《外科》、《内经》、《伤寒》、《金匮》、《诊断》、《药物》,还有《新内经》(相当于现代的生理学、解剖学),任教者则为当时省内秀才或儒生而精医之名流。学校尊师重道,课堂讲授,秩序井然。先师对讲授《内经》有多处不同看法,均写成质疑论文,与好友彭笃生等共同讨论分析,直到深刻理解为止。该校附设有治疗所,在老师的指导下,每个学生都要在治疗所实习。应用理,法、方、药,辨证论治。正确者,发给合格证,差者继续跟师临证。先师常说:这种带徒方法最好,理论联系实际,不致出现学医三年,便谓天下无病不治,及至临证三年,又谓天下无药可投的情况。
My father believed that hepatitis is mostly caused by overwork and emotional imbalance, which relates to the concept that "the Liver is the root of endurance" (the Liver is the foundation for tolerating fatigue). The root lies in the failure of Spleen Yang to transport (Spleen Yang deficiency leading to impaired transformation and transportation), while damp-heat is its manifestation. When heat predominates over dampness, treatment focuses on the Stomach; when dampness predominates over heat, treatment focuses on the Spleen. Treating damp-heat emphasizes regulating Qi mechanism. Bitter-cold herbs should not be used excessively, as bitter-cold substances easily damage Middle Jiao Yang; if Middle Yang is injured, it may反而 aggravate the disease, leading to vomiting and regurgitation, loose stools, or even edema. He said: I once treated a child with hepatitis using Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) as the main formula, which is an example of this type. There are also cases of both Qi and Blood injury treated with Jinshui Liu Jun Jian (Six Gentlemen Decoction with Metal and Water modifications), or cases treated with Jiawei Ganmai Dazao Tang (Modified Licorice, Wheat, and Jujube Decoction). One must always base treatment on the pathogenesis and not rigidly adhere to the method of clearing and draining.
My father once treated a patient with chronic hepatitis who, after taking heavy doses of bitter-cold medicine, lost appetite, suffered from weak limbs and mental fatigue, had loose stools, and showed ALT levels of 300–400 units and a positive Schistosome Agglutination Test (++). This indicated liver disease affecting the Spleen, resulting in Spleen and Stomach deficiency-cold. He used Lizhong Tang (Regulate the Middle Decoction) added with Wuyu (Evodia Fruit) and Caoguo (Black Cardamom), and liver function recovered within one month. My father also treated a patient with gastric ulcer who was hospitalized for two days and still bleeding heavily from the mouth. Upon inquiry, the cause was identified as blood overflowing upwards due to cold exposure and alcohol consumption. He used Jingui Cebaiye Tang (Cebaiye Decoction from the Golden Cabinet, containing Cebaiye, Pao Ganjiang, Aiyi, and Tongbian/child's urine) to warm and unblock Stomach Yang, resolve stasis, and stop bleeding, achieving rapid results. If the cause is unknown and cold-cooling medicines are mistakenly used, Stomach Yang will be further damaged, leading to immediate danger. For instance, my father treated a case of fever in Shen X. The patient had afternoon fever, body fatigue, poor appetite, and no sweat. After self-medicating with acrid-cool resolving agents, the fever did not subside; instead, loose stools, scanty urination, and loss of appetite occurred. The pulse was wiry and slippery, the tongue body dark with a slightly greasy coating. Although the onset was in April, the climate was abnormal with continuous rain. It was diagnosed as cold-damp encumbering the Middle Jiao. Treatment with methods to unblock Yang, promote diuresis, and use aromatic herbs to transform turbidity yielded excellent results. My father once pointed out: All six exogenous pathogens can transform into heat. Treatment should identify which pathogen is present and dispel it accordingly, rather than being dogmatic about the season. For example, epidemic encephalitis B is essentially a heat syndrome, and clearing heat is a standard method, but it should not be overused. Clinically, some patients take cold-cooling medicines too early or in excessive amounts, transforming into cold-in-the-middle, requiring Shengfu Rescue Decoction (Ginseng and Aconite Rescue Decoction). My father often admonished: Whenever using clearing methods, one must consider Stomach Qi. For weak patients, it is better to administer multiple small doses rather than heavy doses; otherwise, before the heat disease subsides, cold syndromes may arise, leading to myriad complications.
In February 1963, my second uncle contracted a common cold, suffering from headache, pain in all joints, a tight pulse, and a white coating. I prescribed one dose of Mahuang Tang (Ephedra Decoction), and he recovered. Afterwards, I was quite proud and wrote to my father, expecting praise. To my surprise, my father replied: Your second uncle has a lifelong habit of drinking alcohol, so his damp-heat is inherently heavy. However, he experienced burning pain in the chest for several days before relief, which was a dangerous sign. Guizhi Tang (Cinnamon Twig Decoction) has a warning that it should not be given to patients with alcohol-induced pathology. You only focused on the decoction form and ignored the herb Guizhi (Cinnamon Twig); for individuals with internal heat, one must first consider the risk of disturbing the blood. For external constraint of cold and heat causing body pain, one can remove Guizhi and add Qianghuo (Notopterygium Rhizome) 3g. This error stems from rote learning without thinking, and lack of thinking is an incurable disease for doctors.
Learning from the Folk and Learning through Practice
My father recorded many folk prescriptions dictated by old folk doctors in his *Jieshou Tang Essays*. For example, a prescription for joint pain was noted by my father: This prescription was obtained by my old friend Zhang Dongyou from a folk herbalist, passed around among relatives and friends, and cured many people, so I recorded it for reference. Even years after he left Zitong, patients still came to me specifically asking for this prescription. He created Erxian Yin (Two Fresh Drinks, consisting of fresh Luxgen Root and fresh Bamboo Leaf) and added fresh Mugwort Root and child's urine, naming it Sanxian Yin (Three Fresh Drinks). This was self-created based on the characteristics of Zitong for clinical use, specifically treating febrile diseases damaging Lung and Stomach fluids, persistent high fever, irritability, and thirst, where neither sweating nor purging is suitable, making it an excellent formula for generating fluids and reducing fever. For those with bleeding tendencies, Sanxian Yin is appropriate. My father said: The reason single formulas and verified formulas can be passed down is because of the character "Yan" (verified/effective). Since they are effective, there must be a rationale. In clinical practice, we should summarize through practice, rather than routinely prescribing expensive or tonifying herbs, because herbs have no distinction of cheap or expensive. This way, we can make progress.
My father placed considerable importance on patients' objective feedback to accumulate knowledge. He cited a case of a patient with Spleen and Stomach disorders: abdominal distension, chest oppression, loss of appetite for over a month, emaciation, and fatigue. After multiple ineffective treatments, the patient sought his care. He applied ancient food-resolving and stagnation-dispelling herbs such as Shan Zha (Hawthorn Fruit), Gu Ya Mai Ya (Sprouted Barley and Malt), and Ji Neijin (Chicken Gizzard Lining) combined with Awei Wan (Asafoetida Pill). After one dose, the patient did not seek further consultation. A month later, they met on the street; the patient looked rosy and fuller. The patient smiled and said: That last dose of medicine you gave me had no effect. Someone told me that if I ate something that caused indigestion, I should burn that same food and eat it to resolve the accumulation. I got sick from eating sea cucumber, so I bought a large sea cucumber, burned it, and took it. I then passed a lot of sticky stool, felt immediate relief in the chest and diaphragm, and recovered without further medication. My father said: This matter taught me a profound lesson. Patients telling the truth allows us to verify the correctness of our treatment. If patients hesitate to speak the truth due to politeness, we mistake falsehood for truth and cannot improve. Using charred forms of specific foods as guides likely follows the principle of "similar qi seeking each other." I have found this method effective over decades.
In 1964, while attending consultations, I saw him treat a male patient with Xiao Ke (Wasting-Thirst Syndrome). The patient had intense thirst and desire to drink, drank repeatedly but remained thirsty, for half a year. He had taken over fifty doses of Yin-nourishing and heat-clearing herbs like Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) and Xuanmai Ganjie Tang (Scrophularia, Ophiopogon, Licorice, and Platycodon Decoction) with no effect. The tongue coating was yellow and greasy, and the pulse was deep and weak. My father changed the prescription to Yinchin Sini Tang (Artemisia Capillaris and Counterflow Cold Decoction). After one dose, the thirst stopped significantly; after three doses, he was basically cured. Later, Shenling Baizhu San (Poria, Atractylodes, and White Atractylodes Powder) was taken in small doses to consolidate the result. Afterwards, my father said: Although the tongue coating and thirst indicate heat signs, the lack of response to fifty doses of Yin-nourishing and heat-clearing herbs, combined with the deep and weak pulse, clearly shows Yang deficiency failing to vaporize water. If it were truly Yin deficiency, fifty doses would at least show some progress; although previous treatments failed, they are still my teachers, serving as a cautionary tale. Boldly using Yinchin Sini Tang was a desperate battle; it warms the Middle and transforms dampness. Once dampness is removed, heat becomes isolated. Even if heat persists, it may transfer to the Yangming stage, but excess patterns are easier to treat than deficiency patterns.
Physicians Must Value Medical Ethics and Conduct
My father was not only diligent and proficient in medicine throughout his life but also highly valued medical ethics. He was humble, cautious, strict with himself, and lenient with others. He was extremely responsible towards colleagues and patients, did not show favoritism or flatter, did not shirk responsibility when things went wrong, and did not steal credit when things succeeded. Many of his words and deeds serve as models.
In his early years practicing in Chengdu, a Mr. Huang from Zitong fell seriously ill, and his family invited him back late at night for treatment. At that time, the famous doctor Mr. Guo Daixing had already been consulted. Mr. Guo diagnosed Yangming Fu-organ Excess and recommended urgent purgation, but the wealthy family feared minerals and rhubarb like tigers and wolves and dared not take the medicine. After diagnosis, my father requested Mr. Guo's prescription, scrutinized it carefully, and believed the herbs matched the syndrome. He said: If the prescription matches the syndrome, why hesitate? If the medicine had been taken yesterday, the illness would have resolved by more than half today. Such fuss is a waste of manpower. After his explanation, the family boiled half a cup of Mr. Guo's prescription. After taking it, the patient had a bowel movement in half a day, and after finishing the dose, improved by eighty to ninety percent. Years later, my father still mentioned this incident, emphasizing the need to avoid obscuring others' merits or stealing their credit. When he sent me *Yu Family Father and Son Experience Collection*, he explicitly stated in the letter: Master Fengxian deeply understands medical principles and fully considers human emotions; he is indeed a wise and outstanding person. The praise for Mr. Ling Yangwu is certainly not excessive. "Bamboo with humility has leaves that bow low; plum blossoms with proud bones do not face upward." "Diligent learning is close to wisdom; earnest practice is close to benevolence; knowing shame is close to courage." How different are these words from those of the sages? He is truly a model for the medical community. Writing books without bowing to the powerful or seeking the brushwork of officials to gain fame is indeed a pillar of strength in a declining world! The sections on hidden ailments of patients and fulfilling nature are particularly valuable. If clinicians do not pay attention to these aspects, they often labor in vain.
When I first started practicing medicine, he warned me not to crave fame or profit, and to live frugally. He used his ancestors as an example: Your grandfather, even at sixty years old, did not distinguish between cold and summer, wore straw sandals, went in and out of mountains and fields, and worked tirelessly to treat patients. Sometimes, when families had no money, he helped them pay for medicine. I practiced in Chengdu for nearly fifty years and never wore a piece of cloth clothing. If doctors dress too luxuriously, poor people often turn away. You should inherit these family traditions well. Old TCM practitioner Master Chen Xin San said: When I bowed to Master Pu, he repeatedly admonished that regardless of whether a patient has money or not, one should treat them wholeheartedly. Decades have passed, and I have never violated his teachings; this is also a virtue a doctor should possess. My father advocated responsible treatment of patients and detested the unhealthy medical trend of blindly flattering patients. He often criticized those who prescribed expensive or overly tonifying medicines to shock the world. He especially despised doctors who included nutritional items in prescriptions to cater to certain patients. He once said: Some people prescribe pork ribs on prescriptions, and patients take them for reimbursement. What kind of atmosphere is this! You must be careful in the future and not resort to any means to cater to certain patients!
My father once said: Reading ancient books requires strictness, while dealing with contemporary scholars requires tolerance. He highly praised Zhang Shanlei's book *Zhongfeng Zhenquan* (Clarification of Wind Stroke), annotating in many places: Extremely precise and appropriate, explaining profound truths... Alas, he looks down upon everyone, speaks rudely, and exaggerates, which are flaws in his perfection. He also said: Not a single national medicine practitioner of Mr. Zhang has realized this principle. Without divine insight and special understanding, one could never thoroughly comprehend this truth. Saying "one dog barks at a shape, a hundred dogs bark at the sound" is perhaps too arrogant. Physicians should cherish their verbal virtue. Moreover, in every ten-house village, there are loyal and trustworthy people; one should be as open-minded as a valley.
My father established a culture of consultation and discussion in Zitong early on. The TCM community in Zitong was dominated by the Shanghan School, with few involving Wenbing (Warm Diseases). Only the Hao and Xue families had significant insights into Wenbing, and my father frequently discussed with them. He believed that *Shanghan Lun* (Treatise on Cold Damage) discusses generalized Shanghan, which already includes Wenbing. Many formulas and herbs from *Shanghan Lun* can also treat Wenbing, and the Wenbing theories of the Ming and Qing dynasties are developments based on the treatment methods of *Shanghan Lun*. Thus, he broke down the antagonistic attitude of the two schools establishing separate sects and being as incompatible as water and fire. Old TCM practitioner Master Chen Xin San said: Master Pu pioneered the culture of consultation in Zitong early on, making unremitting efforts to integrate the Shanghan and Wenbing schools, setting an example for us in eliminating sectarian prejudices.
In letters to me and daily conversations, my father often discussed his views on sectarian prejudices. He said: Due to historical reasons, sectarian prejudices in TCM are deeply rooted. Times have changed now; the younger generation should get along harmoniously, learn from each other's strengths, and improve together. These teachings remain vivid in my ears to this day.
He worked in Beijing for nearly twenty years, and his medical ethics and demeanor are still praised by colleagues. Even when his reputation filled the nation, he said: If doctors are divided into three grades, I can only count as average. I often read medical journals like *Journal of Traditional Chinese Medicine* and found that TCM practitioners in some commune hospitals have quite good professional skills; there is great talent at the grassroots level! Regarding colleagues such as Zhang Cigong, Ran Xuefeng, Qin Bowei, Yue Meizhong, Ren Yingqiu, Li Hanqing, and others, he believed they each had their strengths. Gathering in one hall, discussing and refining each other's skills, learning from each other—what joy there is in that! Senior Yue Meizhong once handwritten a poem for my father. I loved its beautiful language and brought it back to Zitong, but unfortunately, it was destroyed. I can only remember a few lines: "Cherishing true friends who are also teachers, following them fulfills my private wish. Often wielding the axe to scrape off my blemishes, lacking skill in the green bag, I bear deep expectations..." This shows the depth of friendship. I remember my brother Zhizhong and I both asked to study under him. He said: Exchanging children for teaching is best. Zhizhong follow Old Li (Sichi), and you follow Chen Xin San; both are good. Old Li is a famous hand in Sichuan, and Chen Xin San has years of clinical experience. Studying with them is the same as studying with me. He never favored his own children.
My father treated all patients equally, regardless of their position. He once criticized the practice of immediately prescribing Renshen (Ginseng) and Lurong (Deer Antler) when high-ranking cadres came for consultation, believing this not only wasted state funds but also harmed patients and oneself. He said: Cadres and civilians are both humans; diseases of cadres are no different from those of ordinary people. Once, he treated Premier Zhou Enlai, and the medicine cost only a few cents, yet the efficacy was excellent. Premier Zhou greatly appreciated such inexpensive and effective prescriptions.
In April 1975, before passing away, my father said to me: I practiced medicine very cautiously throughout my life, truly as if standing on the edge of an abyss or walking on thin ice. To study medicine, one must first read books seriously, and after reading, practice seriously; both are indispensable. Merely reading without practice leads to knowing only theory but lacking clinical understanding; blind clinical practice without proper reading is disregarding human life. You must remember this firmly! My life was spent in reading and practice.
My father has been deceased for over five years. Looking back, his voice and appearance seem present. I write this article in memory. Recalling Teacher Wu Zhaoxian
Tang Yushu
[Biography of Wu Zhaoxian] Wu Zhaoxian (1892-1976), named Xianzong, was from Baxian County, Sichuan Province. He received family training in childhood, studying the Four Books and Five Classics and simultaneously learning medicine. During his youth, he attended Chongqing Baxian Medical Hall, Chongqing Official Medical School, Chongqing Medical Research Association Public Medical School, and Chongqing Cunren Medical School. He studied medical classics intensively and was highly regarded by Wang Gongfu, a famous doctor from Neijiang. Later, he studied under the acupuncture master Xu Zhinai, obtaining secret transmissions of Zi Wu Liu Zhu (Midnight-Noon Ebb-Flow) and Ling Gui (Spirit Turtle) acupuncture methods. For the survival and development of TCM academia, he lived frugally and donated funds to establish Chongqing National Medicine Hall, National Medicine Training Institute, Chongqing Traditional Chinese Medicine Hospital, Baxian National Medicine School, Susong National Hospital, and Chongqing Chinese Medicine Science Lecture Institute, earning widespread praise from the medical community. After the founding of the People's Republic of China, he taught at Chongqing TCM Advanced Studies School, served as director of the First and Second TCM Hospitals in Chongqing, and as head of the Medical Classics Teaching and Research Group and Acupuncture Teaching and Research Group at Chengdu TCM College. He was elected as a member of the Second Committee of the Sichuan Provincial CPPCC and the Third Session of the Sichuan Provincial People's Congress. He was rigorous in scholarship, advocated practice, had rich experience, profound medical theory, frequently used classical formulas, practiced for over sixty years, repeatedly cured severe illnesses, and became a well-known classical formula expert of the contemporary era. He authored *Zi Wu Liu Zhu Shuo Nan* (Difficulties in Zi Wu Liu Zhu Theory), *Yijing Shenglixue* (Medical Physiology), *Yijing Binglixue* (Medical Pathology), *Lingshu Jing Qianzhu* (Light Commentary on the Spiritual Pivot), etc. In winter 1955, during the National CPPCC meeting, he presented *Zi Wu Liu Zhu Huanzhou Tu* (Diagram of Zi Wu Liu Zhu Cycle) to Chairman Mao Zedong, receiving his commendation. Besides mastering medicine, he was skilled in calligraphy, phonetics, and poetry, authoring *Tingqiusheng Guan* (Listening to Autumn Sounds Pavilion), *Xingling Ji* (Collection of Spirituality), and *Yangshi Zhai Shigao* (Manuscripts of Yangshi Studio Poetry).
Teacher Wu Zhaoxian was born into a farming and scholarly family in Baxian County, Sichuan Province. His father, named Junsheng, had extensive research in classics. Dissatisfied with the imperial examination system and disheartened by official careers, he abandoned Confucianism in middle age to study medicine with his fellow townsman, Mr. Li Tongqing. After completing his studies, he began practicing medicine in Longtan Market, Fuzhou (now Fuling District). In his spare time, he taught his sons the Four Books and Five Classics and also instructed them in medicine, using Chen Xiuyuan's *Sixteen Types of Supplementary Works* as textbooks, ordering my teacher to recite them. For two years, my teacher could recite both the main text and annotations of *Shanghan Lun Qianzhu* (Light Commentary on Treatise on Cold Damage), laying the foundation for his future medical career.
In 1905, Emperor Guangxu, pressured by the times, abolished the imperial examinations and promoted schools, striving for vigorous governance. The government converted the Baxian County Zishui Academy into Baxian Medical Hall, notifying students from various prefectures and counties to apply, with five spots allocated per county. At that time, it was hot, and the Yangtze River flooded, stopping ferries. By the time the water receded, the exam had ended. Due to special circumstances, the school allowed my teacher to take a makeup exam. The topic was: Discuss the rationale of studying medicine for livelihood versus saving the world. My teacher wrote immediately: Studying medicine is to save the world first, and then seek livelihood. He quoted from the *Preface of Shanghan Lun*: "To treat the illnesses of rulers and parents above, to rescue the poverty and distress of the poor below, and to preserve growth and completeness in the middle, thereby nourishing life," elaborating in detail. The chief examiner, Mr. Chen Weiran, appreciated it and provisionally accepted him. During the re-examination, Inspector Tang Defu randomly tested Article 6 of *Shanghan Lun*. My teacher not only recited the main text of Article 6 but also recited all the annotations, ranking at the top and gaining priority admission. After entering the school, my teacher buried himself in hard study, cherishing every minute, avoiding entertainment. Although Chongqing had beautiful scenery and a bustling market, my teacher never ventured there; even on holidays, he stayed in the school library, browsing fifty-four medical series published over two centuries of the Qing Dynasty. In the 1908 exams, all students achieved excellent grades and graduated in the first batch. After the prefectural official reviewed the papers in detail, he commended the school and added four liang of silver per land deed to fund the school, renaming it Chongqing Official Medical School to train teachers. My teacher then advanced to the normal class. Courses included Internal Medicine, Surgery, *Neijing*, *Shanghan*, *Jingui*, Diagnosis, and Materia Medica, as well as *New Neijing* (equivalent to modern physiology and anatomy). Teachers were local scholars or Confucians who were also renowned physicians. The school respected teachers and valued the Way; classroom lectures were orderly. My teacher had several differing views on the teaching of *Neijing*, wrote them up as questioning papers, and discussed and analyzed them with friends like Peng Dusheng until he deeply understood them. The school had an attached clinic where, under teachers' guidance, every student interned. Applying principles, methods, formulas, and herbs, they practiced syndrome differentiation and treatment. Those who performed correctly received certificates; those who did not continued to follow teachers in clinical practice. My teacher often said: This apprenticeship method is best. Theory connects with practice, preventing the situation where one studies medicine for three years claiming no disease is untreatable, and then practices for three years claiming no medicine works.