肺痈一病，首先在张仲景《金匮要略方论》中得以确认，对其病因、病理、脉象、疾病的过程及其预后，都进行了系统的总结，奠定了祖国医学对该病形成与辨证论治的基础。分析张仲景的观点，可以了解肺痈的病因为风热入肺，壅遏营血，热伤血脉，久之热盛则肉腐血败而蓄结成脓。即所谓「热之所过，血为之凝滞蓄结，痈涨吐如米粥」。其病理是里证、热证、实证。此外他还指出了在不同情况下的诊断与治则，认为对肺痈的诊断，应突出咳唾脓血腥臭为主要症状，治疗上他把肺痈分为「脓未成而又喘不得卧」的初期与「口中辟辟燥，咳则胸中隐隐痛，咳唾脓血」的肺痈已溃期两个阶段，并提出前者用葶苈大枣泻肺汤以泻肺行水平喘，后者则可用桔梗汤以排脓解毒，但从患者的症状严重程度看来，上述方剂似有病重药轻之嫌。自隋，唐、明、清以后各医家，在仲景泻肺治则的基础上，又有新的发展，如喻嘉言在《医门法律》中提出；「肺痈属在有形之血络，宜骤攻。」余听鸿《外证医案汇编》说：「治肺痈之法，如始萌之时，将一『通』字着力，通则壅去。」两论精凿切当，诚为至理名言。继而出现了千金苇茎汤等效果不错的方剂。我在临床中看到患儿高热起伏，咳吐脓血痰，联想到《金匮要略·肺痿肺痈咳嗽上气病脉证治》所说「热之所过，血为之凝滞，蓄结痈脓」的条文，始悟到此处也正是热盛气滞血瘀之病证。经过反复推敲，一九六六年起，我开始用以活血化瘀为主，佐以清热解毒排脓消肿的方药脓疡散(主要药物为乳香、牙皂、紫草、青黛、天竺黄、寒水石等)治疗儿肺脓肿五十余例，不用抗菌素，结果无一例死亡及转外科手术治疗者。这不但简、便、廉、安全，同时也可避免经胸壁直接穿刺排脓，肺内注射青霉素，气管内注入药物等所引起的副作用。此方在浙江、湖南等地部分医院的应用中也取得了类似的效果。北京市科学技术委员会经组织专家审定后，授于科技成果三等奖，目前已列入卫生部、北京市科委的重点研究项目之一。长期服用脓疡散，临床不仅未见有副作用，相反的在后期，患儿的体重都普遍得到增加。道理是：紫草一药色紫质滑，甘咸气寒，专入血分，功能凉血解毒，在血热毒盛的肺痈早期能疗「恶疮」，在后期有补中益气(见《本草经疏》)的作用。所以，我以为对于药物除了记住各家公认的主要功能外，还要记住某些临床家对该药的不同认识与用法，这样才能在配伍时灵活多变。
上面谈了一些体会，目的是要说明，年青中医无论如何应该首先扎扎实实地把基础理论学好，同时还要把历代医着有选择地联系起来学习，这样才能做到心中有数，到了一定阶段才能在原有的基础上有所创造。
(陈昭定整理)
迂回曲折艰难困苦
中国科学院学部委员南京药学院副院长叶橘泉
【作者简介】叶桶泉(1896～)，浙江吴兴人。幼年从师学医，早年在苏州从事中医中药教学工作，同时开业行医并致力予本草学的研究。解放后历任江苏省卫生厅副厅长、江苏省中医研究所所长、江苏省中医院院长、中国医学科学院江苏分院副院长、中国科学院学部委员、江苏科学技术协会副主席、南京药学院副院长等职。着有《现代实用中药》、《近世内科中医处方集》、《近世妇科中医处方集》、《古方临床运用》、《中医直觉诊断学》、《本革推陈》、《食物中药与处方》等。
严师教诲刻苦学习
我的学历是一穷二白的，学习路子是迂回曲折的。自己出生于农村，仅读了数年乡塾，读的是《三字经》、《百家姓》、《千家诗》，还读了四书五经，只知高呼迭唱，背诵不懈，囫囵吞枣，苦读死记，不求甚解。而且农忙、蚕忙，在家参加劳动，学殖荒芜，根底薄弱。十七岁拜师学中医。业师张克明先生是一位三代祖传名医，学宗仲景，擅长经方，临证处方，药简效宏，往往一、二剂立起沉疴，里人无不称颂。他对于贫苦病人，不计报酬，常常施诊赠药，但对城市富人，远道慕名延诊者，则非重金不就，时人称之为「医而侠」者。老师对我要求甚严，而且十分关怀，谆谆教导说：学业要靠自己的努力，命我多读书多写字。当时乡里缺乏医书，老师把家藏医籍借给我抄写，并说；抄书一遍，胜于读书十遍。还要我把伤寒三百九十七法、一百一十三方熟读背诵。我遵循师教，每日除随师临证录方外，还起早带晚抄录了《伤寒论》、《金匮要略》、《内经》、医方，本草等大批医书。尤其密切注意老师的临证经验。老师临证，目光炯炯，胆大心细，根据望、闻、问、切，熟练地捕捉主证，立即施用其经验处方(大都用的是经方)。我把老师得心应手常用的验方，一一记录下来，这对自己很有裨助。
结合实际加强认识
学然后知不足。我在老师指导下，读了许多中医经典，可是越读越感到自己知识的不足，问题越来越多。因老师诊务很忙，常常我自己翻检图书，或证之于实践，以求得解答。有时向老师请教。老师说：「中医古典医学是非常深奥的，有些问题我也讲不清楚。古人曾说『此事难知』。只能多读多记，还要多用，熟能生巧，一旦豁然贯通。这不仅学中国医学，学中国古时的一般文学大都如此。」我在老师处学了三年满师后，回到自己家乡独立开诊。按照老师的经验，处方用药，治疗效果还不差。后来诊治病人越多，越觉得自己所学的太少了，于是白天看病，晚上查对医书，对照一天看病处方的得失，温书补课，多方面吸取先辈的经验，联系实际。把读过的经书，加以思考，求得认识的深化，灵活地应用于具体的病例。一次出诊，一妇人与人争吵而投河，被救起后嚎哭辩踊，突然僵仆，挺卧如死者半日余。诊之四肢冰冷，牙关紧闭，脉尚未绝，知为尸厥。此时药不能进，为之束手。忽然想到扁鹊医虢太子，有「砺针砭石，八减之汤，五分之熨」之说，因即用汤沐热熨其四肢，适见围观者一妇人手中持有扎鞋底之针，即藉以强刺涌泉穴，患者抽缩其脚，即哭叫而醒。病虽得救，其理何在，仍不得解。事后查阅医书，原来早有记载：「血之与气，并走于上，则为大厥。厥复返则生，不返则死。」恍然予针刺热熨，殆促使其气血复返耳。犹忆老师曾经教我要多读、多记、多用，所谓熟能生巧，这是理论联系实际，在实践中求得解答的一种认醒方法。
钻研中药保证疗效
中药是中医治病的重要武器。工欲善其事，必先利其器。我国地大物博，中药品种繁多，经验极为丰富。但由于同名异物，同物异名，名实混淆，妨碍用药的正确性。例如，《金匮要略·呕吐哕下利病脉证治》紫参汤中紫参这昧药阴错阳差地变成了蚤休、重楼，因而真正的蚤体(七叶一枝花)则不予收购，沦落民间。又如《伤寒论·辨阳明病》麻黄连轺赤小豆汤之连轺，是金丝桃科的小连翘(地耳草、田基黄)。考诸本草学，原有「大翘」、「小翘」，「狭叶、黄花」，「药用茎叶，连花实」等记述。李时珍云；「旱莲乃小翘，今用如椿实者，乃蜀中来。」意思是说今用的木樨科连翘，是后来新发现的，而原来的大翘、小翘因而失传。其实，小连翘(田基黄)对早期肝硬化有效，麻黄连轺赤小豆汤明记用根，是金丝桃科连翘，今叫做红旱莲。还有萝蘑科的杠柳，也是后来发现的，叫做「北五加」，因而原来五加科的五加失传了。真正的五加皮是功似人参的一种珍贵强壮药。本草所载「金玉满车，不如五加」，是记其功用也。诸如此类，无疑影响了中医用药的正确性和疗效。所以，我感到中医需要研究中药本草，这是非常迫切的任务。为了解决这方面的问题，我又重点投入了这方面的工作，写了《江苏中药名实考》、《现代实用中药》和「本草推陈》等书。
破除门户拓宽思路
中医过去有所谓经方派、时方派以及所谓温补派、寒凉派、补阴派，攻下派等等的门户之见。百家争鸣是好事，但囿于门户成见，往往束缚了自己的思路，必须克服。我自幼接受业师传授，开始偏重于经方。平心而论，张仲景《伤寒论》，《金匮要略》的辨证处方，理法严谨，方药组织颇有规律，其备受历代各家所推崇者，不是偶然的。可是医药学术总是不断发展的。后世各家，各有其心得与经验，药物亦在不断地发展。旧社会之宗经方者，强调仲景经方能治万病，而宗时方者则谓古方不能治今病，这些论调都是错误的，应该破除门户之见，学习各家之长，择善而从。例如，温热学家所发展的清热解毒药，养阴学家创造的滋阴降火剂，温补学派所擅长的补中益气汤，泄火攻实学派的防风通圣散等，都是我国医药史上的新发展，应当兼收并蓄，取精用宏，通过自已的再实践，加以总结提高。个人认为中医中药以防病治病为唯一目标，不管经方、时方，哪家、哪派，只要行之有效，而能重复推广的，就是好的，就要学习和效法。
反复实践深化领会
解放前农村极端贫困，农民往往「贫、病相连」。记得有一年我去乡里出诊时，一病家邀我顺便一诊。患者是中年妇女，病由黄疸后变成黑疸，面目青褐色，胸满腹胀，大便顽固秘结，邻人悄悄说：黄病变成臌胀，怕是不治之症了吧!患者呻吟病床已年余，因长期负担医药费用，家中已典卖一空，寡妇孤儿，情殊堪怜，故给予免费诊治，并送了几服药，稍稍好转。乃教给她十多岁的儿子，自挖蒲公英(当地农民叫「奶汁草」)，每天大量(90～120克或更多)煮汤喝，喝了一个多月，不化分文，竟把这迁延了一年零七个月的慢性肝胆病治愈了。这对我触动很大。蒲公英过去我也常用，而这次鲜草大量单独用，未料竟有如此的威力，可见生草药单方对症使用，其力专，其效确。这就增加了我对中药的用法、剂量与疗效关系的新认识。使用单味药，剂量应增加，而复方则不然。根据我的经验，复方成人每日一帖药的总重量，60～90克已足够了。中药的定量问题希望有专人研究讨论之。关于生草药，曾以一味野菊花治愈重症口唇疔。一位三十岁左右的男性，鼻旁生一小疖，一夜之间，肿胀蔓延面颧，口唇坚硬紧张，疼痛高热，神志恍忽，人都知道这是疔疮将走黄。其时，我急命采取野菊花一大把(约半斤)煎汤，一天连喝数大碗，当夜即安静，翌日退热，痛大减，不过一星期而愈。还有一个二十多岁的女性，患慢性肾盂炎、膀胱炎，带浊淋漓，痛苦不堪，半年多来，抗菌素用了不少，时轻时重，已失去了治疗信心。我介绍其自采新鲜车前草十至二十棵煎水，多量饮服，很快见效。连服一个月，后未复发。以上这些生动事例不是偶然的一次两次，而且是可以重复的。如野菊花还可用于湿疹的感染化脓，煎汤作洗剂，往往一扫而光。蒲公英亦可治乳痈，车前草并能治泻痢等等，还有很多，不能多举。这更使我深深感到：中国医药学这一伟大宝库中，对人民有利的东西太多了。作为一个医生来说，不管经方、时方、单方、复方，内服、外用，只要效果可靠，就应该兼收并蓄，为人民保健服务。
知己知彼取长补短
我在三十岁以后，从乡下迁到双林镇开业，兼双林救济院医生，每周两次为贫苦病人施诊。此时，常和双林教会医院的一位西医接触，并交了朋友。他喜欢中草药和单方、验方，要我给介绍。而我则感到实验室检查对恶性疟疾和伤寒等诊断的帮助很大，经常请他帮助化验标本，并向他学习。当时，中西医之间不但鸡犬之声相闻，老死不相往来，而且往往互相攻讦。我们在坦白交流中，认为各有其长处：西医的优点在于分析，中医的优点在于综合。事实上，理论的研究需要分析，而整体性的内科治疗，则需要综合，何况中医中药治疗的方法很多。在日本有一句名言，叫做「理论之完备，莫如西医；疗法之周到，莫若中医」。这也说明这一点。我对于中医的发展，那时即已有了一些考虑；是否采用中医中药的整体性治病，以西医分析的科学方法说理。因而粗率地先后写了《近世内科国药处方集》和《近世妇科中药处方集》等。当时只是一个尝试，现在看来存在许多缺点，就是疏忽了方剂的辨证。后来看到日本汉方医家大壕敬节、矢数道明、清水藤太郎、木村长久四人合着的《漠方诊瘵0突降》(中译本为《中医诊疗要览》，一九五三年北京人民卫生出版社出版，又一九六三年朝鲜译本名为《实际汉方诊疗》)，此书在日本，已几经修订增补，现改称为《漠方诊瘵医典》，其体例也以现代医学分类，如传染病，呼吸器病，循环器病，消化器病等，病名和病理说，而附以汉方处方。不过他们的处方，说明了该方之适应症，这是值得我学习的。我深深感到应做到老，学到老，改到老。我早就想把〈近世内科国药处方集》加以修订，可是琐事繁剧，而年老体衰，力不从心，这条道路是否走得通，有待今后青年一辈的努力探索。
(马永华整理)
弥甘蔗境忆从前
上海中医研究所顾问，教授刘树农
【作者简介】刘树农(1895～)，江苏省淮安县人，从事中医事业六十余年。历任上海中医学院《金匮》、内科、各家学说教研组和中医文献资料研究窒主任等职，现任上海中医研究所顾问。
肺痈这一疾病，最早在张仲景的《金匮要略方论》中得到确认。书中对其病因、病理、脉象、疾病的发展过程及其预后都进行了系统总结，奠定了祖国医学对该病形成与辨证论治的基础。分析张仲景的观点，可以了解到肺痈的病因是风热侵入肺部，壅滞营血，热邪损伤血脉，久而久之热势炽盛导致肌肉腐烂、血液败坏而蓄积结成脓液。即所谓“热邪所过之处，血液凝滞蓄结，痈肿溃破后吐出如米粥状的脓液”。其病理性质属于里证、热证、实证。此外，他还指出了不同情况下的诊断与治则，认为对肺痈的诊断，应突出咳吐脓血腥臭为主要症状；在治疗上，他把肺痈分为“脓未成且气喘不能平卧”的初期，与“口中干燥，咳嗽时胸中隐隐作痛，咳吐脓血”的肺痈已溃期两个阶段，并提出前者用葶苈大枣泻肺汤以泻肺行水、平喘，后者则可用桔梗汤以排脓解毒。但从患者的症状严重程度来看，上述方剂似乎存在病重药轻的嫌疑。自隋、唐、明、清以来，各医家在张仲景泻肺治则的基础上又有新的发展，例如喻嘉言在《医门法律》中提出：“肺痈属于有形之血络病变，宜用猛烈攻下之法。”余听鸿在《外证医案汇编》中说：“治疗肺痈的方法，如在初起之时，应将一个‘通’字着力，通则壅滞去除。”这两段论述精辟恰当，诚为至理名言。继而出现了千金苇茎汤等效果不错的方剂。我在临床中看到患儿高热起伏，咳吐脓血痰，联想到《金匮要略·肺痿肺痈咳嗽上气病脉证治》中所说“热邪所过，血液凝滞，蓄结而成痈脓”的条文，才领悟到此处也正是热盛、气滞、血瘀的病证。经过反复推敲，从一九六六年起，我开始使用以活血化瘀为主，佐以清热解毒、排脓消肿的方药“脓疡散”（主要药物为乳香、牙皂、紫草、青黛、天竺黄、寒水石等）治疗小儿肺脓肿五十余例，不使用抗菌素，结果无一例死亡及转外科手术治疗者。这不但简便、廉价、安全，同时也可避免经胸壁直接穿刺排脓、肺内注射青霉素、气管内注入药物等所引起的副作用。此方在浙江、湖南等地部分医院的应用中也取得了类似的效果。北京市科学技术委员会经组织专家审定后，授予科技成果三等奖，目前已列入卫生部、北京市科委的重点研究项目之一。长期服用脓疡散，临床不仅未见有副作用，相反的在后期，患儿的体重都普遍得到增加。道理是：紫草一味药色紫质滑，味甘咸、气寒，专入血分，功能凉血解毒，在血热毒盛的肺痈早期能疗治“恶疮”，在后期有补中益气的作用（见《本草经疏》）。所以，我以为对于药物除了记住各家公认的主要功能外，还要记住某些临床家对该药的不同认识与用法，这样才能在配伍时灵活多变。
上面谈了一些体会，目的是要说明，年轻中医无论如何应该首先扎扎实实地把基础理论学好，同时还要把历代医著有选择地联系起来学习，这样才能做到心中有数，到了一定阶段才能在原有的基础上有所创造。
(陈昭定整理)
迂回曲折艰难困苦
中国科学院学部委员南京药学院副院长叶橘泉
【作者简介】叶橘泉(1896～)，浙江吴兴人。幼年从师学医，早年在苏州从事中医中药教学工作，同时开业行医并致力于本草学的研究。解放后历任江苏省卫生厅副厅长、江苏省中医研究所所长、江苏省中医院院长、中国医学科学院江苏分院副院长、中国科学院学部委员、江苏科学技术协会副主席、南京药学院副院长等职。着有《现代实用中药》、《近世内科中医处方集》、《近世妇科中医处方集》、《古方临床运用》、《中医直觉诊断学》、《本草推陈》、《食物中药与处方》等。
严师教诲刻苦学习
我的学历是一穷二白的，学习路子是迂回曲折的。自己出生于农村，仅读了数年乡塾，读的是《三字经》、《百家姓》、《千家诗》，还读了四书五经，只知高呼迭唱，背诵不懈，囫囵吞枣，苦读死记，不求甚解。而且农忙、蚕忙，在家参加劳动，学殖荒芜，根底薄弱。十七岁拜师学中医。业师张克明先生是一位三代祖传名医，学宗仲景，擅长经方，临证处方，药简效宏，往往一、二剂立起沉疴，里人无不称颂。他对于贫苦病人，不计报酬，常常施诊赠药，但对城市富人，远道慕名延诊者，则非重金不就，时人称之为“医而侠”者。老师对我要求甚严，而且十分关怀，谆谆教导说：学业要靠自己的努力，命我多读书多写字。当时乡里缺乏医书，老师把家藏医籍借给我抄写，并说：抄书一遍，胜于读书十遍。还要我把伤寒三百九十七法、一百一十三方熟读背诵。我遵循师教，每日除随师临证录方外，还起早带晚抄录了《伤寒论》、《金匮要略》、《内经》、医方、本草等大批医书。尤其密切注意老师的临证经验。老师临证，目光炯炯，胆大心细，根据望、闻、问、切，熟练地捕捉主证，立即施用其经验处方（大都用的是经方）。我把老师得心应手常用的验方，一一记录下来，这对自己很有裨助。
结合实际加强认识
学然后知不足。我在老师指导下，读了许多中医经典，可是越读越感到自己知识的不足，问题越来越多。因老师诊务很忙，常常我自己翻检图书，或证之于实践，以求得解答。有时向老师请教。老师说：“中医古典医学是非常深奥的，有些问题我也讲不清楚。古人曾说‘此事难知’。只能多读多记，还要多用，熟能生巧，一旦豁然贯通。这不仅学中国医学，学中国古时的一般文学大都如此。”我在老师处学了三年满师后，回到自己家乡独立开诊。按照老师的经验，处方用药，治疗效果还不差。后来诊治病人越多，越觉得自己所学的太少了，于是白天看病，晚上查对医书，对照一天看病处方的得失，温书补课，多方面吸取先辈的经验，联系实际。把读过的经书，加以思考，求得认识的深化，灵活地应用于具体的病例。一次出诊，一妇人与人争吵而投河，被救起后嚎哭辩踊，突然僵仆，挺卧如死者半日余。诊之四肢冰冷，牙关紧闭，脉尚未绝，知为尸厥。此时药不能进，为之束手。忽然想到扁鹊医虢太子，有“砺针砭石，八减之汤，五分之熨”之说，因即用汤沐热熨其四肢，适见围观者一妇人手中持有扎鞋底之针，即藉以强刺涌泉穴，患者抽缩其脚，即哭叫而醒。病虽得救，其理何在，仍不得解。事后查阅医书，原来早有记载：“血之与气，并走于上，则为大厥。厥复返则生，不返则死。”恍然予针刺热熨，殆促使其气血复返耳。犹忆老师曾经教我要多读、多记、多用，所谓熟能生巧，这是理论联系实际，在实践中求得解答的一种认知方法。
钻研中药保证疗效
中药是中医治病的重要武器。工欲善其事，必先利其器。我国地大物博，中药品种繁多，经验极为丰富。但由于同名异物，同物异名，名实混淆，妨碍用药的正确性。例如，《金匮要略·呕吐哕下利病脉证治》紫参汤中紫参这味药阴错阳差地变成了蚤休、重楼，因而真正的蚤体（七叶一枝花）则不予收购，沦落民间。又如《伤寒论·辨阳明病》麻黄连轺赤小豆汤之连轺，是金丝桃科的小连翘（地耳草、田基黄）。考诸本草学，原有“大翘”、“小翘”，“狭叶、黄花”，“药用茎叶，连花实”等记述。李时珍云：“旱莲乃小翘，今用如椿实者，乃蜀中来。”意思是说今用的木樨科连翘，是后来新发现的，而原来的大翘、小翘因而失传。其实，小连翘（田基黄）对早期肝硬化有效，麻黄连轺赤小豆汤明记用根，是金丝桃科连翘，今叫做红旱莲。还有萝蘑科的杠柳，也是后来发现的，叫做“北五加”，因而原来五加科的五加失传了。真正的五加皮是功似人参的一种珍贵强壮药。本草所载“金玉满车，不如五加”，是记其功用也。诸如此类，无疑影响了中医用药的正确性和疗效。所以，我感到中医需要研究中药本草，这是非常迫切的任务。为了解决这方面的问题，我又重点投入了这方面的工作，写了《江苏中药名实考》、《现代实用中药》和“本草推陈”等书。
破除门户拓宽思路
中医过去有所谓经方派、时方派以及所谓温补派、寒凉派、补阴派，攻下派等等的门户之见。百家争鸣是好事，但囿于门户成见，往往束缚了自己的思路，必须克服。我自幼接受业师传授，开始偏重于经方。平心而论，张仲景《伤寒论》，《金匮要略》的辨证处方，理法严谨，方药组织颇有规律，其备受历代各家所推崇者，不是偶然的。可是医药学术总是不断发展的。后世各家，各有其心得与经验，药物亦在不断地发展。旧社会之宗经方者，强调仲景经方能治万病，而宗时方者则谓古方不能治今病，这些论调都是错误的，应该破除门户之见，学习各家之长，择善而从。例如，温热学家所发展的清热解毒药，养阴学家创造的滋阴降火剂，温补学派所擅长的补中益气汤，泄火攻实学派的防风通圣散等，都是我国医药史上的新发展，应当兼收并蓄，取精用宏，通过自已的再实践，加以总结提高。个人认为中医中药以防病治病为唯一目标，不管经方、时方，哪家、哪派，只要行之有效，而能重复推广的，就是好的，就要学习和效法。
反复实践深化领会
解放前农村极端贫困，农民往往“贫、病相连”。记得有一年我去乡里出诊时，一病家邀我顺便一诊。患者是中年妇女，病由黄疸后变成黑疸，面目青褐色，胸满腹胀，大便顽固秘结，邻人悄悄说：黄病变成臌胀，怕是不治之症了吧！患者呻吟病床已年余，因长期负担医药费用，家中已典卖一空，寡妇孤儿，情殊堪怜，故给予免费诊治，并送了几服药，稍稍好转。乃教给她十多岁的儿子，自挖蒲公英（当地农民叫“奶汁草”），每天大量（90～120克或更多）煮汤喝，喝了一个多月，不化分文，竟把这迁延了一年零七个月的慢性肝胆病治愈了。这对我触动很大。蒲公英过去我也常用，而这次鲜草大量单独用，未料竟有如此的威力，可见生草药单方对症使用，其力专，其效确。这就增加了我对中药的用法、剂量与疗效关系的新认识。使用单味药，剂量应增加，而复方则不然。根据我的经验，复方成人每日一帖药的总重量，60～90克已足够了。中药的定量问题希望有专人研究讨论之。关于生草药，曾以一味野菊花治愈重症口唇疔。一位三十岁左右的男性，鼻旁生一小疖，一夜之间，肿胀蔓延面颧，口唇坚硬紧张，疼痛高热，神志恍忽，人都知道这是疔疮将走黄。其时，我急命采取野菊花一大把（约半斤）煎汤，一天连喝数大碗，当夜即安静，翌日退热，痛大减，不过一星期而愈。还有一个二十多岁的女性，患慢性肾盂炎、膀胱炎，带浊淋漓，痛苦不堪，半年多来，抗菌素用了不少，时轻时重，已失去了治疗信心。我介绍其自采新鲜车前草十至二十棵煎水，多量饮服，很快见效。连服一个月，后未复发。以上这些生动事例不是偶然的一次两次，而且是可以重复的。如野菊花还可用于湿疹的感染化脓，煎汤作洗剂，往往一扫而光。蒲公英亦可治乳痈，车前草并能治泻痢等等，还有很多，不能多举。这更使我深深感到：中国医药学这一伟大宝库中，对人民有利的东西太多了。作为一个医生来说，不管经方、时方、单方、复方，内服、外用，只要效果可靠，就应该兼收并蓄，为人民保健服务。
知己知彼取长补短
我在三十岁以后，从乡下迁到双林镇开业，兼双林救济院医生，每周两次为贫苦病人施诊。此时，常和双林教会医院的一位西医接触，并交了朋友。他喜欢中草药和单方、验方，要我给介绍。而我则感到实验室检查对恶性疟疾和伤寒等诊断的帮助很大，经常请他帮助化验标本，并向他学习。当时，中西医之间不但鸡犬之声相闻，老死不相往来，而且往往互相攻讦。我们在坦白交流中，认为各有其长处：西医的优点在于分析，中医的优点在于综合。事实上，理论的研究需要分析，而整体性的内科治疗，则需要综合，何况中医中药治疗的方法很多。在日本有一句名言，叫做“理论之完备，莫如西医；疗法之周到，莫若中医”。这也说明这一点。我对于中医的发展，那时即已有了一些考虑：是否采用中医中药的整体性治病，以西医分析的科学方法说理。因而粗率地先后写了《近世内科国药处方集》和《近世妇科中药处方集》等。当时只是一个尝试，现在看来存在许多缺点，就是疏忽了方剂的辨证。后来看到日本汉方医家大壕敬节、矢数道明、清水藤太郎、木村长久四人合着的《漠方诊瘵0突降》（中译本为《中医诊疗要览》，一九五三年北京人民卫生出版社出版，又一九六三年朝鲜译本名为《实际汉方诊疗》），此书在日本，已几经修订增补，现改称为《漠方诊瘵医典》，其体例也以现代医学分类，如传染病，呼吸器病，循环器病，消化器病等，病名和病理说，而附以汉方处方。不过他们的处方，说明了该方之适应症，这是值得我学习的。我深深感到应做到老，学到老，改到老。我早就想把〈近世内科国药处方集》加以修订，可是琐事繁剧，而年老体衰，力不从心，这条道路是否走得通，有待今后青年一辈的努力探索。
(马永华整理)
弥甘蔗境忆从前
上海中医研究所顾问，教授刘树农
【作者简介】刘树农(1895～)，江苏省淮安县人，从事中医事业六十余年。历任上海中医学院《金匮》、内科、各家学说教研组和中医文献资料研究窒主任等职，现任上海中医研究所顾问。
**Lung Abscess (Fei Yong)**
The disease of Lung Abscess (Fei Yong, a condition characterized by pus formation in the lungs) was first identified in Zhang Zhongjing's *Jingui Yaolue Fanglun* (Essential Prescriptions from the Golden Cabinet). This text systematically summarized its etiology, pathology, pulse manifestations, disease progression, and prognosis, laying the foundation for Traditional Chinese Medicine (TCM) regarding the formation and syndrome differentiation treatment of this disease. Analyzing Zhang Zhongjing's views reveals that the etiology of Lung Abscess involves wind-heat invading the lungs, obstructing the Ying (Nutritive) and Xue (Blood), damaging blood vessels with heat. Over time, excessive heat causes tissue decay and blood degeneration, leading to the accumulation and formation of pus. As stated, "Where heat passes, blood becomes stagnant and accumulates; when the abscess ruptures, one expectorates pus resembling congee." Its pathological nature belongs to Interior Syndrome (Li Zheng), Heat Syndrome (Re Zheng), and Excess Syndrome (Shi Zheng). Furthermore, he pointed out diagnostic and therapeutic principles for different situations. He believed that diagnosis should highlight coughing up purulent, bloody, and foul-smelling sputum as the main symptom. Therapeutically, he divided Lung Abscess into two stages: the initial stage ("pus not yet formed, accompanied by wheezing and inability to lie flat") and the ruptured stage ("dryness in the mouth, dull pain in the chest upon coughing, expectoration of pus and blood"). For the former, he proposed using Tingli Dazao Xiefei Tang (Descurainia Seed and Jujube Decoction to Drain the Lungs) to drain lung water and relieve wheezing; for the latter, Jiegeng Tang (Platycodon Decoction) could be used to expel pus and resolve toxicity. However, judging by the severity of symptoms, these formulas might appear insufficient for the heavy disease burden. Since the Sui, Tang, Ming, and Qing dynasties, various physicians developed new approaches based on Zhang Zhongjing's principle of draining the lungs. For instance, Yu Jiayan proposed in *Yimen Falv* (Medical Laws of the Medical Gate): "Lung Abscess involves tangible blood collaterals and should be treated with aggressive purgation." Yu Tinghong stated in *Waizheng Yi'an Huibian* (Compilation of External Disease Medical Cases): "The method for treating Lung Abscess, especially in its early萌芽 stage, should focus on the character 'Tong' (Unblocking); unblocking removes obstruction." These theories are precise and appropriate, truly words of wisdom. Subsequently, effective formulas such as Qianjin Weijing Tang (Thousand-Gold Reed Rhizome Decoction) emerged. In clinical practice, I observed children with fluctuating high fever and expectoration of purulent, bloody sputum. Recalling the clause in *Jingui Yaolue·Fei Wei Fei Yong Sou Ke Shang Qi Bing Mai Zheng Zhi* (Pulmonary Withering, Lung Abscess, Cough, and Asthma Disease Pulse and Syndrome Treatment): "Where heat passes, blood becomes stagnant and accumulates to form abscesses," I realized this was also a syndrome of excessive heat, Qi stagnation, and Blood stasis. After repeated deliberation, starting from 1966, I began using the formula Nongsang San (Abscess Powder), which primarily focuses on invigorating blood and resolving stasis, supplemented by clearing heat, detoxifying, expelling pus, and reducing swelling (main ingredients include Ru Xiang (Frankincense), Ya Zao (Gleditsia Sinensis Fruit), Zi Cao (Arnebiae Radix seu Cortex), Qing Dai (Indigo Naturalis), Tian Zhu Huang (Bambusae Concretio Silicea), and Han Shui Shi (Halloysit Rubrum)), to treat pediatric lung abscess in over fifty cases without antibiotics. The result was no deaths or referrals for surgical treatment. This approach is simple, convenient, inexpensive, and safe, while avoiding side effects associated with direct thoracic puncture for pus drainage, intrapulmonary penicillin injection, or intratracheal drug administration. Similar effects were achieved in some hospitals in Zhejiang and Hunan provinces. After expert review, the Beijing Municipal Science and Technology Commission awarded it a Third Prize for Scientific and Technological Achievements. It has now been included as one of the key research projects of the Ministry of Health and the Beijing Municipal Science and Technology Commission. Long-term use of Nongsang San showed no side effects clinically; conversely, in the later stages, the children's weight generally increased. The reason is: Zi Cao (Arnebiae Radix seu Cortex) is purple in color and smooth in texture, sweet and salty in taste, cold in nature, and specifically enters the Blood level. It functions to cool the blood and resolve toxicity. In the early stage of Lung Abscess with severe blood-heat and toxin, it treats "malignant sores"; in the later stage, it tonifies the Middle and benefits Qi (as seen in *Bencao Jing Shu*). Therefore, I believe that besides memorizing the main functions recognized by various schools, one must also remember the different understandings and usage methods of certain drugs by specific clinicians. This allows for flexibility in prescription composition.
The above reflections aim to illustrate that young TCM practitioners must first solidly master basic theory and selectively connect their study with historical medical texts. Only then can they have a clear mind and achieve innovation at a certain stage based on existing foundations.
(Compiled by Chen Zhaoding)
**A Tortuous and Arduous Path**
Ye Juquan, Member of the Academic Division of the Chinese Academy of Sciences, Vice President of Nanjing College of Pharmacy
**Author Profile:** Ye Juquan (1896–), from Wuxing, Zhejiang. He studied medicine under a master in his childhood. In his early years, he engaged in TCM teaching in Suzhou, practiced medicine, and devoted himself to the study of Materia Medica. After liberation, he served as Deputy Director of the Jiangsu Provincial Health Department, Director of the Jiangsu Institute of Traditional Chinese Medicine, President of Jiangsu Province Hospital of TCM, Vice President of the Jiangsu Branch of the Chinese Academy of Medical Sciences, Member of the Academic Division of the Chinese Academy of Sciences, Vice Chairman of the Jiangsu Association for Science and Technology, and Vice President of Nanjing College of Pharmacy. His works include *Modern Practical Chinese Materia Medica*, *Collection of Internal Medicine Prescriptions in Recent Times*, *Collection of Gynecological Prescriptions in Recent Times*, *Clinical Application of Ancient Formulas*, *Intuitive Diagnostic Methods in TCM*, *Pushing the Boundaries of Materia Medica*, and *Food, Chinese Herbs, and Prescriptions*.
**Strict Teacher's Teachings and Diligent Study**
My educational background was poor, and my learning path was tortuous. Born in a rural area, I attended a village school for a few years, studying *Three Character Classic*, *Hundred Family Surnames*, *Poems of a Thousand Families*, as well as the Four Books and Five Classics. I only knew how to chant loudly and recite tirelessly, swallowing dates whole, studying hard by rote memory, without seeking deep understanding. Moreover, during busy farming and silkworm seasons, I participated in labor at home, leaving my studies neglected and my foundation weak. At seventeen, I apprenticed to learn TCM. My master, Mr. Zhang Keming, was a famous doctor from a three-generation lineage, following the teachings of Zhang Zhongjing and specializing in Classical Formulas (Jing Fang). In clinical practice, his prescriptions were simple yet highly effective, often curing serious illnesses in one or two doses, earning him praise from locals. For poor patients, he did not care about remuneration, often providing free consultations and medicines. However, for wealthy city dwellers who traveled far to seek his services, he demanded high fees. People at the time called him a "physician-chivalrous hero." The teacher had strict requirements for me but was also very caring, earnestly instructing me: "Academic achievement relies on your own efforts. I order you to read more and write more." At that time, medical books were scarce in the countryside. The teacher lent me his family's collection for copying, saying, "Copying a book once is better than reading it ten times." He also ordered me to memorize the 397 methods and 113 formulas of *Shanghan Lun* (Treatise on Cold Damage). Following his teachings, every day, besides recording prescriptions during clinical follow-ups, I copied large amounts of medical books, including *Shanghan Lun*, *Jingui Yaolue*, *Neijing* (Inner Canon), medical formulas, and Materia Medica, from early morning to late night. I paid particular attention to the teacher's clinical experience. During consultations, his eyes were bright, he was bold yet meticulous, skillfully capturing the main syndromes through Observation, Auscultation/Olfaction, Inquiry, and Palpation, and immediately applying his experienced prescriptions (mostly Classical Formulas). I recorded all the effective formulas he used proficiently, which greatly benefited me.
**Strengthening Understanding by Combining Theory with Practice**
Learning reveals one's deficiencies. Under my teacher's guidance, I read many TCM classics, yet the more I read, the more I felt my knowledge was lacking, and problems multiplied. Due to the teacher's busy schedule, I often consulted books myself or verified them through practice to find answers. Sometimes I asked the teacher. He said, "Classical TCM medicine is extremely profound. Some questions I cannot explain clearly either. The ancients said, 'This matter is difficult to know.' One can only read and memorize more, and apply more. Proficiency brings skill, and suddenly everything will become clear. This applies not only to learning Chinese medicine but also to general ancient Chinese literature." After three years of apprenticeship, I returned to my hometown to open a clinic independently. Following the teacher's experience, my prescriptions and medication yielded good results. However, the more patients I treated, the less I felt I had learned. Thus, I saw patients by day and checked medical books by night, comparing the merits and demerits of daily prescriptions, reviewing lessons, making up for deficiencies, absorbing predecessors' experiences from multiple aspects, and connecting theory with practice. I reflected on the classics I had read, deepening my understanding and applying them flexibly to specific cases. Once, during a house call, a woman, after an argument, attempted suicide by drowning. After being rescued, she cried hysterically, then suddenly collapsed, lying stiffly as if dead for over half a day. Examination revealed cold limbs, clenched jaw, and a pulse that had not yet ceased. I diagnosed it as Corpse-like Syncope (Shi Jue). At this point, medication could not be administered, leaving me helpless. Suddenly, I recalled Bian Que treating the Crown Prince of Guo, mentioning "sharpened needles and stone lancets, Ba Jian Decoction, and five-part moxibustion/warming." I therefore used hot compresses on her limbs. Seeing a bystander holding a needle for sewing shoes, I used it to strongly stimulate Yongquan (KI-1, Bubbling Spring) Acupoint. The patient jerked her foot, cried out, and woke up. Although saved, the rationale remained unclear. Later, consulting medical books, I found the record: "When blood and Qi rush upward together, it is called Great Syncope. If the syncope reverses, life returns; if not, death ensues." I suddenly understood that acupuncture and hot compressions likely promoted the return of Qi and Blood. I remembered my teacher teaching me to read, memorize, and apply more, stating that proficiency brings skill. This is a cognitive method of integrating theory with practice and seeking answers in practice.
**Studying Chinese Herbal Medicine to Ensure Efficacy**
Chinese herbal medicine is an important weapon for TCM in treating diseases. To do a good job, one must first sharpen one's tools. China is vast and rich in resources, with numerous varieties of Chinese herbs and rich experience. However, due to same-name-different-substance, different-name-same-substance, and confusion between names and realities, the correctness of medication is hindered. For example, in *Zi Shen Tang* (Purple参 Decoction) in *Jingui Yaolue·Ou Tu Yue Xia Li Bing Mai Zheng Zhi* (Vomiting, Hiccups, Diarrhea Disease Pulse and Syndrome Treatment), the herb Zi Shen (Zi Shen) was mistakenly identified as Zhe Bei Mu/Chong Lou (Paris Polyphylla), causing the true Paris Polyphylla (Seven-Leaf-One-Flower) to be rejected and relegated to folk use. Again, in *Ma Huang Lian Qiao Chi Xiao Dou Tang* (Ephedra, Forsythia, and Red Bean Decoction) in *Shanghan Lun·Bian Yang Ming Bing* (Differentiating Yangming Disease), Lian Qiao refers to Hypericum japonicum (Di Er Cao, Tian Ji Huang). According to Materia Medica studies, there were originally "Da Qiao" (Large Forsythia) and "Xiao Qiao" (Small Forsythia), described as having narrow leaves, yellow flowers, and medicinal stems, leaves, flowers, and fruits. Li Shizhen stated: "Han Lian is Xiao Qiao; what is currently used like Chun Shi comes from Shu." This means that the current Forsythia (Forsythiae Fructus, Oleaceae family) is a later discovery, while the original Da Qiao and Xiao Qiao were lost. Actually, Xiao Lian Qiao (Tian Ji Huang) is effective for early-stage liver cirrhosis. *Ma Huang Lian Qiao Chi Xiao Dou Tang* explicitly states using the root, referring to the Hypericum species, now called Hong Han Lian. Additionally, Periploca sepium (Metaplexidis Japonici Radix, Asclepiadaceae family), discovered later, is called "Bei Wu Jia" (Northern Acanthopanax), causing the original Acanthopanax gracilistylus (Wu Jia Pi, Araliaceae family) to be lost. The true Wu Jia Pi is a precious tonic similar to Ginseng. The Materia Medica records, "Gold and jade filling carts are not as good as Wu Jia," describing its efficacy. Such issues undoubtedly affect the correctness and efficacy of TCM medication. Therefore, I feel that researching Chinese herbal Materia Medica is an urgent task for TCM. To address this, I focused on this work, writing *Jiangsu Chinese Herb Name and Reality Examination*, *Modern Practical Chinese Materia Medica*, and *Pushing the Boundaries of Materia Medica*.
**Breaking Sectarianism to Broaden Perspectives**
In the past, TCM had sectarian views such as Classical Formula School, Contemporary Formula School, Warm-Tonic School, Cold-Cooling School, Yin-Nourishing School, and Purgative School. While the Hundred Schools of Thought contending is good, being confined by sectarian prejudices often restricts one's thinking and must be overcome. I received instruction from my master since childhood and initially leaned towards Classical Formulas. Fairly speaking, the syndrome differentiation and prescription logic in Zhang Zhongjing's *Shanghan Lun* and *Jingui Yaolue* is rigorous, and the organization of formulas and herbs follows patterns. Their high regard by generations is not accidental. However, medical science is constantly developing. Later generations each have their insights and experiences, and drugs continue to evolve. In the old society, those adhering to Classical Formulas emphasized that Zhang Zhongjing's formulas could cure all diseases, while those adhering to Contemporary Formulas claimed ancient formulas cannot treat modern diseases. These arguments are wrong. One should break sectarian prejudices, learn the strengths of various schools, and choose the best. For example, heat-clearing and detoxifying herbs developed by Warm-Heat scholars, Yin-nourishing and fire-reducing agents created by Yin-Nourishing scholars, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) favored by the Warm-Tonic school, and Fang Feng Tong Sheng San (Saposhnikovia Releasing the Exterior Powder) used by the Fire-Purging and Excess-Attacking school are all new developments in Chinese medical history. They should be absorbed comprehensively, extracting the essence, and summarized/improved through personal practice. Personally, I believe the sole goal of TCM is disease prevention and treatment. Regardless of Classical or Contemporary Formulas, any school or sect, as long as it is effective and reproducible, is good and should be learned and emulated.
**Repeated Practice to Deepen Comprehension**
Before liberation, rural areas were extremely poor, and farmers were often linked by poverty and illness. I recall one year when I went to the township for a consultation, a patient invited me to examine another. The patient was a middle-aged woman whose jaundice had turned into black jaundice, with a bluish-brown complexion, chest fullness, abdominal distension, and stubborn constipation. Neighbors whispered, "Jaundice turning into ascites; perhaps it's an incurable disease!" The patient had been bedridden for over a year. Due to long-term medical expenses, her family had pawned and sold everything. She was a widow with young orphans, evoking great pity. I provided free treatment and sent a few doses of medicine, resulting in slight improvement. I then taught her ten-year-old son to dig wild dandelion (locally called "Milk Juice Grass"), boil it in large quantities (90–120 grams or more) daily, and drink the soup. After drinking for over a month, without spending a penny, this chronic hepatobiliary disease lasting one year and seven months was cured. This touched me deeply. I had often used dandelion before, but using fresh grass in large quantities alone unexpectedly had such power. It shows that using single raw herb formulas for specific syndromes has concentrated strength and definite efficacy. This enhanced my new understanding of the relationship between herb usage, dosage, and efficacy. When using single herbs, the dosage should be increased, whereas for compound formulas, it is not necessary. Based on my experience, the total weight of one dose of compound formula for adults per day, 60–90 grams, is sufficient. I hope specialists will study and discuss the quantitative issue of Chinese herbs. Regarding raw herbs, I once cured a severe lip carbuncle with a single herb, wild chrysanthemum. A male around thirty years old had a small boil near his nose. Overnight, swelling spread to his cheeks, lips became hard and tense, accompanied by painful high fever and delirium. Everyone knew this was a carbuncle about to spread systemically (Zou Huang). I urgently ordered taking a large bunch of wild chrysanthemum (about half a jin/250g), decocting it in water, and drinking several large bowls throughout the day. That night, he calmed down; the next day, fever subsided, and pain decreased significantly. He recovered within a week. Another female in her twenties suffered from chronic pyelonephritis and cystitis, with continuous turbid discharge and unbearable suffering. For over half a year, she used many antibiotics, with symptoms fluctuating, losing confidence in treatment. I introduced her to collect 10–20 fresh plantains, decoct in water, and drink in large amounts. Effect was rapid. After one month of continuous use, it did not recur. These vivid examples are not accidental occurrences but are repeatable. For instance, wild chrysanthemum can also be used for infected eczema suppuration; decocted as a wash, it often clears it completely. Dandelion can also treat breast abscess (Ru Yong), and plantain can treat dysentery, among many others. This makes me deeply feel that in the great treasure trove of Chinese medicine, there are too many things beneficial to the people. As a doctor, regardless of Classical or Contemporary Formulas, single or compound, internal or external use, as long as the effect is reliable, one should absorb comprehensively and serve public health.
**Knowing Oneself and Others to Complement Strengths**
After turning thirty, I moved from the countryside to Shuanglin Town to practice, serving as a doctor at the Shuanglin Relief Institute, providing free consultations for poor patients twice a week. At this time, I frequently interacted with and befriended a Western doctor at the Shuanglin Missionary Hospital. He liked Chinese herbs, single formulas, and empirical formulas, asking me to introduce them. I felt that laboratory tests greatly assisted in diagnosing malignant malaria and typhoid fever, so I often asked him to help test specimens and learned from him. At that time, not only did TCM and Western medicine exist side by side without interacting, but they often attacked each other. Through frank exchange, we recognized each other's strengths: the advantage of Western medicine lies in analysis, while the advantage of TCM lies in synthesis. In fact, theoretical research requires analysis, while holistic internal medicine treatment requires synthesis. Moreover, TCM offers many treatment methods. There is a Japanese proverb: "No theory is as complete as Western medicine; no therapy is as thorough as TCM." This illustrates this point. I already had some considerations regarding the development of TCM at that time: whether to adopt the holistic treatment of TCM while using Western analytical scientific methods for explanation. Thus, I roughly wrote *Collection of Internal Medicine National Drug Prescriptions in Recent Times* and *Collection of Gynecological Chinese Herb Prescriptions in Recent Times*. At the time, it was just an attempt. Looking back now, it has many shortcomings, particularly neglecting syndrome differentiation of formulas. Later, I saw the book *Kampo Shinryou Yoran* (Overview of Kampo Diagnosis and Treatment) co-authored by four Japanese Kampo physicians: Otsuka Keisetsu, Yazu Michiaki, Shimizu Shotaro, and Kimura Chokyu (Chinese translation published by People's Medical Publishing House, Beijing, 1953; Korean translation titled *Practical Kampo Diagnosis and Treatment*, 1963). This book has been revised and supplemented several times in Japan and is now called *Kampo Shinryou Iden*. Its structure uses modern medical classifications, such as infectious diseases, respiratory diseases, circulatory diseases, digestive diseases, etc., listing disease names and pathology, followed by Kampo prescriptions. However, their prescriptions specify indications, which is worth learning. I deeply feel that one should keep learning and improving until old age. I had long wanted to revise *Collection of Internal Medicine National Drug Prescriptions in Recent Times*, but due to trivial matters and declining health, I lacked the strength. Whether this path is viable awaits the exploration of the younger generation.
(Compiled by Ma Yonghua)
**Recalling the Past in a Sweet State**
Liu Shunong, Advisor and Professor, Shanghai Institute of Traditional Chinese Medicine
**Author Profile:** Liu Shunong (1895–), from Huai'an County, Jiangsu Province. He has engaged in TCM for over sixty years. He served as Director of the Teaching and Research Section for *Jingui*, Internal Medicine, and Various Schools of Thought, and Director of the TCM Literature and Data Research Room at Shanghai College of Traditional Chinese Medicine. He is currently an advisor at the Shanghai Institute of Traditional Chinese Medicine.