一九三二年九月至一九三三年七月，我第三次到上海中国医学院任教职。该院系上海国医学会设立，实际上由上海名医朱鹤皋出资兴办，教务长为蒋文芳。教材全用讲义，有的参以西医学说，有的纯是古义。学生大都勤奋好学，成绩斐然，如著名中医师肖熙即是该院高材生。此为三个医学院校的概况。
那时中医界出版的医学刊物可分为三个类型：一为中医学术团体主办的，如《神州国医学报》、《中医杂志》等，一是以研究学术，交流经验为宗旨的，如张赞匿主编的《医界春秋》，陆渊雷主编的《中医薪生命》等；一为宣传中医常识，唤起民众注意卫生的，如陈存仁创办的《康健报》，吴克潜创办的《医药新闻》，朱振声创办的《幸福报》等。但总的来说，当时研究学术未成风尚，刊物稿源常虑不足，因此更促进了我对写稿的兴趣。
另外，那时要在十里洋场以医业立足，颇不容易，大都先做善堂医生，取得民众信仰，然后自立门户。如陆渊雷是善堂医生，章次公是红十字会医院医生，徐衡之家境宽裕，自设诊所。由于反动政府崇西抑中，设备完善的西医院专为官僚富商服务，贫困的劳动人民只能到善堂求医。即如《神州国医学报》编辑吴去疾终因业务萧条，抑郁而死。又我老友张汝伟，虽自设诊所，却无病人上门，赖其女资助，生活艰难。那时上海虽有声望卓著的中医，但为数不多，太多数中医同道门庭冷落，为柴米油盐操心，那有心情研求学术。回忆往事，令人感叹不止。
在半封建半殖民地的旧中国，反动政府千方百计排斥和摧残祖国医学。一九二九年，国民党反动政府第一次中央卫生委员会议通过了余云岫等提出的「废止旧医」案，并提出了消灭中医的六项办法，立即引起了全国中医界的极大愤怒和强烈反对。全国各地中医团体代表聚集上海，召开全国医药团体代表大会，向反动政府请愿，强烈要求取消提案。当时裘吉生、汤士彦和我等，作为杭州代表出席会议，强烈呼吁，一致反对，迫使国民党反动政府不得不取消了这个提案。
抗日战争爆发后，我只身逃难入蜀，到达重庆，任北碚中医院院长等职。
解放后，我在四川重庆中医进修学校任教，那时副校长胡光慈，教务主任任应秋，均为西南中医优秀之士。我在那里讲授方剂、温病，编了两种讲义，讲义稿后在上海、南京出版。
一九五五年底中医研究院在首都建院，应钱信忠部长的邀请，我与蒲辅周、李重人等大夫从四川词京，参加中医研究院工作迄今，韶华荏苒，忽忽二十五年过去了。
以上谈了我学医的经过。下面再谈谈我的治学体会，约有下列几项：熟滨精思不断总结
古人读书，有「三到」之说，即口到、眼到、心到。口到是指朗诵，眼到是指阅看，心到是指领会和思考。后人又加上手到，即要求勤记笔记。这四到，概括了读书的基本方法。
我青年时代，因文化程度不高，感觉古典医籍深奥难馑，故采取了从流溯源的学习方法，即先从浅显的门径书学起，逐渐上溯到《伤寒》、《金匮》、《内经》、《难经》等经典著作。和当时一般中医学徒一样，首先读《汤头歌诀》、《药性赋》、《医学三字经》、《濒湖脉学》等书，做到能熟练地背诵，即使到了现在也大半能记得。根据我的经验，年青时要读熟几本书做底子。因年轻记忆力强，一经背诵，便不易忘记，可以终身受益，同时为以后进一步学习打下基础。『
我酷爱读书的习惯，即在那时养成。我平生所读之书，以明清著作为多。清末民初，浙江桐乡大麻金子久先生曾对门人说；「《内》、《难》、《伤寒》、《金匮》为医学之基础，然在应用时即感不足，如《金匮要略》为杂病书之是早者，然以之治内妇科等病，不如后世医书之详备。所以唐宋诸贤补汉魏之不足，金元四家又补唐宋之不足，迨至明清诸名家，于温病尤多发挥。」金氏这段话，与我治学之路正复相同。我细心阅读的书有汪昂的《素灵类纂约注》、徐大椿的《难经经释》、《医学源流论》，治《伤寒》、《金匮》，宗《医宗金鉴》，温病宗《温热经纬》。明·王肯堂《证治准绳》，清·国家编纂的《医宗金鉴》，以及沈金鳌的《沈氏尊生书》，均是煌煌巨著，内、外各利具备，也是我案头必备的参考书。其它如本草、方书、医案、笔记等，平居亦常浏览，以扩见闻，这些书仅是所谓眼到而已，不要求背诵。从前读书，强调背诵，对初学来说，确是一个值得重视的好方法。清·章学诚说：「学问之始，非能记诵。博涉既深，将超记诵。故记诵者，学问之舟车也。」(《文史通义》)涉山济海，少不了舟车，做学问也是如此。只要不是停留在背诵阶段，而是作为以后发展的基础和出发点，那么，这样的背诵便不得以「读死书」诮之。
熟读了，还要精思，把读的东西消化吸收，领会其精神实质，同时要善于思考，养成一定的鉴另q能力，既不要轻于疑古，也不要一味迷信古人，这就是心列。
所谓手到，就是要记笔记。笔记可分两种；一种是原文精粹的地方节录下来，作为诵读学习的材料；一种是读书心得，这是已经经过消化吸收，初步整理，并用自己的文字作了一定程度的加工的东西，比起前一种笔记来，是又进了一步。在学习过程中，这两种笔记都很重要，前一种是收集资料的工作，后一种是总结心得的工作。待到一定时候，笔记积累多了，便可分类归纳，这便是文章的雏形了。
这四到，不仅互相关联，而且互相促进。一九二八年至一九三三年，我在上海中医院校任教时，由于教学须编讲义，写稿须找数据，只好多读多看，勤记勤想，周此在中医理论方面提高较快。
持益多师不耻下问
韩愈说：「古之学者必有师，师者所以传道、授业、解惑也。」又说；「巫医乐师百工之人，不耻相师。」求师问业，原是中医的良好传统。我早年幸遇名师王香岩先生，经他传道、授业、解惑，为我以后的学业奠定了基础。王师擅长治疗温热病，我学习的基本上是叶派学说。迨至壮年入蜀，接触到不同的学术流派，不同的环境、民情风俗、用药习惯等等，对我理论和临床的提高起了一定的作用。如江浙医生用乌、附，大率几分至钱许，而川蜀医用乌、附，常用三、四钱，甚至有用两许大剂者。解放后到了北京，北京是政治、经济、文化的中心，名医云集，因此得与四方名医时相过从，各出所学，互相切磋，获益良多。
古人为学，提倡「读万卷书，行万里路」，这话很有道理。司马迁能写成「究天人之际，通古今之变，成一家之言」的《史记》，一来由于「天人遗文古事，靡不毕集太史公」，掌握了大量文献资料，同时他「二十而南游江淮，上会稽，探禹穴，窥九疑，浮沅湘，北涉汶泗……西征巴蜀以南，略邛、笮、昆明」，历览天下名山犬川，积累了丰富的生活经验和创作经验，这也是一个重要的原因。我国版图辽阔，地理环境，自然条件，风俗习惯，发病特点等，各地有所不同，在长期的发展中，逐渐形成了具有地方特色的用药习惯、医学流派等，这是由来已久了。如《素问·异法方宜论》即曾评论五方的发病，治疗的差别，提出「杂合以治，各得其所宜」的主张。因此，多向各地医药同行学习，吸收他们的长处，不但不耻相师，还要转益多师，不周于门户之见，也是克服局限性，取得不断进步的一个重要方法。我自己曾从「行万里路」中学到了不少东西，故有深切的体验。
老前辈读书多，经验丰富，并有某种专长，向他们请教，得益甚多。同辈亦可互相研讨，交流经验。
例如裘吉生老中医自订疏肝和胃散，治肝胃气痛疗效可靠，方用沉香曲、香附、甘松、延胡、降香、九香虫、刺猬皮、瓦楞子，左金丸、甘蔗汁、生姜汁。我向裘老索方，他即告我，以后我用此方治神经性胃痛、胃溃疡胃痛，均有疏肝和胃，行气止痛之功，但不宜于虚证。解放后，我长期与蒲辅周老中医一起工作，蒲老临床经验丰富，治病颇有把握，我向他学习了不少东西。
各地中、青年中医，与我联系者颇多，对于中青年医生，我总是满腔热忱地希望他们能继承发扬祖国医学，对他们的请教尽量做到有问必答，有信必复，同时也虚心学习他们的长处，认真听取他们的意见。例如，我在一九七九年曾写了《银翘散的研讨》一文，寄给北京中医学院研究生连建伟同学，请他毫不客气地提出修改意见，结果他果然提出了自己的一些看法，我根据他的意见，对文章中的某些不足之处作了修改。有时遇到疑难病症，我也常常主动邀请连建伟同学一起研究治疗方案，做到集思广益。
努力实践逐步提高
从前有人说，学习中医要有「十年读书，十年临证」的工夫，读书是掌握理论知识，临证是运用理论与实践。如不掌握一定的基本理论作为实践的根本，比如初学皮毛，辄尔悬壶，以人命为尝试，难免「学医人费」之讥；反之，如有了一定的理论基础，而没有实践经验，纸上谈兵，又易误事，而且理论水平也难于真正提高。青藤书屋有一副对联，写道：「读不如行，使废读将何以行；蹶方长智，然屡蹶讵云能智。」这说出了读书和临床两者之间的辩证关系。
理论、实践是一个反复循环、不断提高的过程，要不断总结临床经验，包括失败的经验。我从前曾写过一篇《肺病失治记》，总结了自己的失败经验。善于总结失败的经验，可以取得教训，使失败成为成功之母，避免「屡蹶」。正反两个方面的经验积累多了，业务水平也就提高了，对理论知识的感受也深刻了。医学理论必须时时和临床相印证，体会才能深刻，自愧数十年来疑难大病治愈不多。但每当运用理论于临床，取得预期的疗效时，便感到由衷的高兴，如我曾治疗粒细胞白血病，有二例得到缓解，肝硬化腹水有一例根本治愈，高血压消化性溃疡病治愈较多等等，反过来，对我的理论水平也有不同程度的提高。我院曾与首都医院协作，临床研究门脉性肝硬化腹水(即臌胀)之治疗规律，经过临床实践，我深深感到用泄水峻剂，如大戟、芜花、甘遂之类，虽能水去腹小，但不久叉复膨脖，反复施用，元气大伤，终至不救。由此体验，益信朱丹溪《格致余论》的一段话，为至当不易之论。丹溪说：「医不察病起于虚，急于取效，病者苦于胀急，喜行利药以求一时之快，不知宽得一日半日，其肿益甚。病邪甚矣，真气伤矣!」故治此症必须「和肝补脾，殊为切当」。
近年我曾用赞化血余丹治愈阳痿一例。患者李某，广西梧州某厂工人，患阳痿已数年，伴有腰酸腿软，心悸失眠等症，来信要求处方。我分析病情，认为系心肾两亏，拟赞化血余丹加减，并改为汤剂。他照方服用月余，诸症消失，一九八0年四月间来信道谢。
赞化血余丹，方用血余、熟地各24克，首乌(牛乳拌蒸)、核桃肉、苁蓉、茯苓、小茴香、巴戟、杜仲、菟丝子、鹿角胶(炒球)、当归、枸杞各12克，人参6克。照方十倍量，炼蜜为丸，每丸9～15克，饭前服。功能补气血，乌须发，壮形体。按此方补而不峻，滋而不腻，有补气血、益肝肾之效。因历用有效，放附记于此。
长期以来，我还结合临床，努力学习西医知识，以为他山之助。在《新编经验方》等书中，尝试结合西医学理，说明中医方剂的使用，虽然做得不够好，但我一直认为中西医应互相学习，取长补短，共同为人民服务。
自从一九二四年杭州三三医社出版了我先师遗着《医学体用》后，至今我已先后编写了中医书籍十多本。已出版的有《养生琐言》、《诊断与治疗》、《仲圭医论汇选》、《食物疗病常识》、《肺肾胃病研讨集》、《中医经验处方集》、《中国小儿传染病学》、《中医温病概要》、《临床实用中医方剂学》、《医学碎金录》、《新编经验方》共十二本。近年来，我又编写了《论医选集》、《中医内科临证方汇》二本，共三十余万言，其它论文、医案三十余篇。我年虽老迈，但在有生之年，愿为祖国的四化事业，为祖国医学的发扬光大，不断努力，不断前进。
学到老学不了
上海市华东医院中医科主任沈六吉
【作者筒分】沈六吉(1901～)，上海嘉定县人。现任上海市华东医院中医科主任，上海市政协委员。从事中医临床近六十年，解放前即有声于时。一九五六年起供职于华东医院以来，治慢性肝炎，重症肝内妲管炎、胆结石、尿路结石、血栓闭塞性脉管炎、危重血小板减少性紫癜、流行性出血热及严重褥疮等疑难一九七七年十二月被评为上海市先进科技工作音。
1932年9月至1933年7月，我第三次到上海中国医学院担任教职。该学院由上海国医学会设立，实际上由上海名医朱鹤皋出资创办，教务长是蒋文芳。教材全部使用讲义，有的参考了西医理论，有的则完全是古代医理。学生大多勤奋好学，成绩显著，如著名中医师肖熙就是该院的高材生。这是当时三个医学院校的概况。
那时中医界出版的医学刊物大致可分为三类：一类是由中医学术团体主办的，如《神州国医学报》、《中医杂志》等；一类是以研究学术、交流经验为宗旨的，如张赞匿主编的《医界春秋》，陆渊雷主编的《中医薪生命》等；还有一类是宣传中医常识、唤起民众注意卫生的，如陈存仁创办的《康健报》，吴克潜创办的《医药新闻》，朱振声创办的《幸福报》等。但总的来说，当时研究学术尚未形成风尚，刊物稿源常常担心不足，因此更促进了我写稿的兴趣。
另外，那时要在十里洋场（指上海）以医术立足，颇为不易，大多先做善堂医生，取得民众的信任，然后自立门户。如陆渊雷曾是善堂医生，章次公是红十字会医院医生，徐衡之家境宽裕，自设诊所。由于反动政府崇洋抑中，设备完善的西医院专为官僚富商服务，贫困的劳动人民只能到善堂求医。就像《神州国医学报》编辑吴去疾最终因业务萧条，抑郁而死。又比如我的老友张汝伟，虽然自设诊所，却无病人上门，依靠女儿资助，生活艰难。那时上海虽有声望卓著的中医师，但为数不多，大多数中医同道门庭冷落，为柴米油盐操心，哪有心思钻研学术。回忆往事，令人感叹不已。
在半封建半殖民地的旧中国，反动政府千方百计排斥和摧残祖国医学。1929年，国民党反动政府第一次中央卫生委员会议通过了余云岫等人提出的“废止旧医”案，并提出了消灭中医的六项办法，立即引起了全国中医界的极大愤怒和强烈反对。全国各地中医团体代表聚集上海，召开全国医药团体代表大会，向反动政府请愿，强烈要求取消提案。当时裘吉生、汤士彦和我等作为杭州代表出席会议，强烈呼吁，一致反对，迫使国民党反动政府不得不取消了这一提案。
抗日战争爆发后，我只身逃难入蜀，到达重庆，担任北碚中医院院长等职。
解放后，我在四川重庆中医进修学校任教，那时副校长是胡光慈，教务主任是任应秋，均为西南地区的中医优秀之士。我在那里讲授方剂学、温病学，编写了两种讲义，讲义稿后来在上海、南京出版。
1955年底，中医研究院在首都建院，应钱信忠部长的邀请，我与蒲辅周、李重人等大夫从四川进京，参加中医研究院工作至今，时光荏苒，忽忽二十五年过去了。
以上谈了我学医的经过。下面再谈谈我的治学体会，约有以下几项：熟读精思，不断总结。
古人读书，有“三到”之说，即口到、眼到、心到。口到是指朗诵，眼到是指阅看，心到是指领会和思考。后人又加上手到，即要求勤记笔记。这四到，概括了读书的基本方法。
我青年时代，因文化程度不高，感觉古典医籍深奥难懂，故采取了从流溯源的学习方法，即先从浅显的门径书学起，逐渐上溯到《伤寒论》、《金匮要略》、《黄帝内经》、《难经》等经典著作。和当时一般中医学徒一样，首先读《汤头歌诀》、《药性赋》、《医学三字经》、《濒湖脉学》等书，做到能熟练地背诵，即使到了现在也大半能记得。根据我的经验，年轻时要把几本书读熟作为底子。因为年轻记忆力强，一经背诵，便不易忘记，可以终身受益，同时为以后进一步学习打下基础。
我酷爱读书的习惯，即在那时养成。我平生所读之书，以明清时期的著作为多。清末民初，浙江桐乡大麻金子久先生曾对门人说：“《内经》、《难经》、《伤寒论》、《金匮要略》为医学之基础，然在应用时即感不足，如《金匮要略》为杂病书之始祖者，然以之治内妇科等病，不如后世医书之详备。所以唐宋诸贤补汉魏之不足，金元四家又补唐宋之不足，迨至明清诸名家，于温病学说尤多发挥。”金氏这段话，与我治学之路正复相同。我细心阅读的书有汪昂的《素灵类纂约注》、徐大椿的《难经经释》、《医学源流论》，治《伤寒论》、《金匮要略》，宗法《医宗金鉴》，温病学宗法《温热经纬》。明代王肯堂的《证治准绳》，清代国家编纂的《医宗金鉴》，以及沈金鳌的《沈氏尊生书》，均是煌煌巨著，内科、外科各类兼备，也是我案头必备的参考书。其它如本草、方书、医案、笔记等，平时亦常浏览，以扩见闻，这些书仅是所谓“眼到”而已，不要求背诵。从前读书，强调背诵，对初学来说，确是一个值得重视的好方法。清代章学诚说：“学问之始，非能记诵。博涉既深，将超记诵。故记诵者，学问之舟车也。”（《文史通义》）涉山济海，少不了舟车，做学问也是如此。只要不是停留在背诵阶段，而是作为以后发展的基础和出发点，那么，这样的背诵便不得以“读死书”讥之。
熟读了，还要精思，把读的东西消化吸收，领会其精神实质，同时要善于思考，养成一定的鉴别能力，既不要轻于疑古，也不要一味迷信古人，这就是“心到”。
所谓“手到”，就是要记笔记。笔记可分两种：一种是原文精粹的地方节录下来，作为诵读学习的材料；一种是读书心得，这是已经经过消化吸收，初步整理，并用自己的文字作了一定程度的加工的东西，比起前一种笔记来，是又进了一步。在学习过程中，这两种笔记都很重要，前一种是收集资料的工作，后一种是总结心得的工作。待到一定时候，笔记积累多了，便可分类归纳，这便是文章的雏形了。
这四到，不仅互相关联，而且互相促进。1928年至1933年，我在上海中医院校任教时，由于教学须编讲义，写稿须找数据，只好多读多看，勤记勤想，因此在中医理论方面提高较快。
择益多师，不耻下问。
韩愈说：“古之学者必有师，师者所以传道、授业、解惑也。”又说：“巫医乐师百工之人，不耻相师。”求师问业，原是中医的良好传统。我早年幸遇名师王香岩先生，经他传道、授业、解惑，为我以后的学业奠定了基础。王师擅长治疗温热病，我学习的基本上是叶天士学派学说。及至壮年入蜀，接触到不同的学术流派，不同的环境、民情风俗、用药习惯等等，对我理论和临床的提高起了一定的作用。如江浙医生用乌头、附子，大率几分至钱许，而川蜀医用乌头、附子，常用三、四钱，甚至有用一两许大剂者。解放后到了北京，北京是政治、经济、文化的中心，名医云集，因此得与四方名医时相过从，各出所学，互相切磋，获益良多。
古人为学，提倡“读万卷书，行万里路”，这话很有道理。司马迁能写成“究天人之际，通古今之变，成一家之言”的《史记》，一来由于“天人遗文古事，靡不毕集太史公”，掌握了大量文献资料，同时他“二十而南游江淮，上会稽，探禹穴，窥九疑，浮沅湘，北涉汶泗……西征巴蜀以南，略邛、笮、昆明”，历览天下名山大川，积累了丰富的生活经验和创作经验，这也是一个重要的原因。我国版图辽阔，地理环境，自然条件，风俗习惯，发病特点等，各地有所不同，在长期的发展中，逐渐形成了具有地方特色的用药习惯、医学流派等，这是由来已久了。如《素问·异法方宜论》即曾评论五方的发病，治疗的差别，提出“杂合以治，各得其所宜”的主张。因此，多向各地医药同行学习，吸收他们的长处，不但不耻相师，还要转益多师，不拘于门户之见，也是克服局限性，取得不断进步的一个重要方法。我自己曾从“行万里路”中学到了不少东西，故有深切的体验。
老前辈读书多，经验丰富，并有某种专长，向他们请教，得益甚多。同辈亦可互相研讨，交流经验。
例如裘吉生老中医自订疏肝和胃散，治肝胃气痛疗效可靠，方用沉香曲、香附、甘松、延胡索、降香、九香虫、刺猬皮、瓦楞子，左金丸、甘蔗汁、生姜汁。我向裘老索方，他即告我，以后我用此方治神经性胃痛、胃溃疡胃痛，均有疏肝和胃，行气止痛之功，但不宜于虚证。解放后，我长期与蒲辅周老中医一起工作，蒲老临床经验丰富，治病颇有把握，我向他学习了不少东西。
各地中、青年中医，与我联系者颇多，对于中青年医生，我总是满腔热忱地希望他们能继承发扬祖国医学，对他们的请教尽量做到有问必答，有信必复，同时也虚心学习他们的长处，认真听取他们的意见。例如，我在一九七九年曾写了《银翘散的研讨》一文，寄给北京中医学院研究生连建伟同学，请他毫不客气地提出修改意见，结果他果然提出了自己的一些看法，我根据他的意见，对文章中的某些不足之处作了修改。有时遇到疑难病症，我也常常主动邀请连建伟同学一起研究治疗方案，做到集思广益。
努力实践，逐步提高。
从前有人说，学习中医要有“十年读书，十年临证”的工夫，读书是掌握理论知识，临证是运用理论与实践。如不掌握一定的基本理论作为实践的根本，比如初学皮毛，辄尔悬壶，以人命为尝试，难免“学医人费”之讥；反之，如有了一定的理论基础，而没有实践经验，纸上谈兵，又易误事，而且理论水平也难于真正提高。青藤书屋有一副对联，写道：“读不如行，使废读将何以行；蹶方长智，然屡蹶讵云能智。”这说出了读书和临床两者之间的辩证关系。
理论、实践是一个反复循环、不断提高的过程，要不断总结临床经验，包括失败的经验。我从前曾写过一篇《肺病失治记》，总结了自己的失败经验。善于总结失败的经验，可以取得教训，使失败成为成功之母，避免“屡蹶”。正反两个方面的经验积累多了，业务水平也就提高了，对理论知识的感受也深刻了。医学理论必须时时和临床相印证，体会才能深刻，自愧数十年来疑难大病治愈不多。但每当运用理论于临床，取得预期的疗效时，便感到由衷的高兴，如我曾治疗粒细胞白血病，有二例得到缓解，肝硬化腹水有一例根本治愈，高血压消化性溃疡病治愈较多等等，反过来，对我的理论水平也有不同程度的提高。我院曾与首都医院协作，临床研究门脉性肝硬化腹水（即臌胀）之治疗规律，经过临床实践，我深深感到用泄水峻剂，如大戟、芫花、甘遂之类，虽能水去腹小，但不久又复膨隆，反复施用，元气大伤，终至不救。由此体验，益信朱丹溪《格致余论》的一段话，为至当不易之论。丹溪说：“医不察病起于虚，急于取效，病者苦于胀急，喜行利药以求一时之快，不知宽得一日半日，其肿益甚。病邪甚矣，真气伤矣！”故治此症必须“和肝补脾，殊为切当”。
近年我曾用赞化血余丹治愈阳痿一例。患者李某，广西梧州某厂工人，患阳痿已数年，伴有腰酸腿软，心悸失眠等症，来信要求处方。我分析病情，认为系心肾两亏，拟赞化血余丹加减，并改为汤剂。他照方服用月余，诸症消失，一九八0年四月间来信道谢。
赞化血余丹，方用血余炭、熟地黄各24克，首乌（牛乳拌蒸）、核桃肉、肉苁蓉、茯苓、小茴香、巴戟天、杜仲、菟丝子、鹿角胶（炒珠）、当归、枸杞子各12克，人参6克。照方十倍量，炼蜜为丸，每丸9～15克，饭前服。功能补气血，乌须发，壮形体。按此方补而不峻，滋而不腻，有补气血、益肝肾之效。因历用有效，故附记于此。
长期以来，我还结合临床，努力学习西医知识，以为他山之助。在《新编经验方》等书中，尝试结合西医学理，说明中医方剂的使用，虽然做得不够好，但我一直认为中西医应互相学习，取长补短，共同为人民服务。
自从一九二四年杭州三三医社出版了我先师遗着《医学体用》后，至今我已先后编写了中医书籍十多本。已出版的有《养生琐言》、《诊断与治疗》、《仲圭医论汇选》、《食物疗病常识》、《肺肾胃病研讨集》、《中医经验处方集》、《中国小儿传染病学》、《中医温病概要》、《临床实用中医方剂学》、《医学碎金录》、《新编经验方》共十二本。近年来，我又编写了《论医选集》、《中医内科临证方汇》二本，共三十余万言，其它论文、医案三十余篇。我年虽老迈，但在有生之年，愿为祖国的四化事业，为祖国医学的发扬光大，不断努力，不断前进。
学到老，学不了。
上海市华东医院中医科主任沈六吉
【作者简介】沈六吉（1901～），上海嘉定县人。现任上海市华东医院中医科主任，上海市政协委员。从事中医临床近六十年，解放前即有声于时。一九五六年起供职于华东医院以来，治慢性肝炎，重症肝内胆管炎、胆结石、尿路结石、血栓闭塞性脉管炎、危重血小板减少性紫癜、流行性出血热及严重褥疮等疑难……一九七七年十二月被评为上海市先进科技工作者。
From September 1932 to July 1933, I served as a faculty member at the China Medical College in Shanghai for the third time. The college was established by the Shanghai Association of Chinese Medicine and actually funded by Zhu Hegao, a renowned traditional Chinese medicine (TCM) practitioner in Shanghai, with Jiang Wenfang serving as the Dean of Academic Affairs. All teaching materials were lecture notes; some incorporated Western medical theories, while others adhered strictly to ancient TCM principles. Most students were diligent and eager to learn, achieving outstanding results; for instance, Xiao Xi, a famous TCM physician, was an outstanding graduate of this institution. This provides a general overview of the three medical colleges at that time.
The medical journals published by the TCM community then could be divided into three categories: one type was sponsored by TCM academic groups, such as *Shenzhou Guoyi Bao* and *Zhongyi Zazhi*; another type aimed at academic research and experience exchange, such as *Yijie Chunqiu* edited by Zhang Zanni and *Zhongyi Xin Shengming* edited by Lu Yuanlei; the third type focused on promoting common knowledge of TCM and raising public awareness of hygiene, such as *Kangjian Bao* founded by Chen Cunren, *Yiyao Xinwen* founded by Wu Keqian, and *Xingfu Bao* founded by Zhu Zhensheng. However, generally speaking, academic research had not yet become a trend, and there was often concern about insufficient manuscript sources for journals, which further stimulated my interest in writing.
Furthermore, it was quite difficult to establish oneself as a physician in the bustling commercial hub of Shanghai ("Ten-Mile Foreign Settlement") at that time. Most physicians first worked as doctors in charitable clinics to gain public trust before setting up their own practices. For example, Lu Yuanlei was a doctor in a charitable clinic, Zhang Cigong worked at the Red Cross Hospital, and Xu Hengzhi, coming from a wealthy family, opened his own clinic. Due to the reactionary government's preference for Western medicine over TCM, well-equipped Western hospitals served only bureaucrats and wealthy merchants, while impoverished working people could only seek medical treatment in charitable clinics. Take Wu Quji, editor of *Shenzhou Guoyi Bao*, for instance; he ultimately died of depression due to the decline in his practice. Similarly, my old friend Zhang Ruwei, although he ran his own clinic, had no patients visiting him and relied on financial support from his daughter, leading to a difficult life. Although there were some highly respected TCM practitioners in Shanghai at that time, they were few in number. Most of my TCM colleagues faced empty waiting rooms, worrying about daily necessities like firewood, rice, and oil, leaving them no mood to study academics. Recalling those past events evokes endless sighs.
In the semi-feudal, semi-colonial Old China, the reactionary government employed every means to exclude and suppress national medicine. In 1929, the First Central Health Committee Meeting of the Kuomintang reactionary government passed the "Abolition of Traditional Medicine" proposal put forward by Yu Yunxiu and others, along with six measures to eliminate TCM. This immediately sparked great anger and strong opposition throughout the national TCM community. Representatives from TCM organizations across the country gathered in Shanghai to convene the National Pharmaceutical Organizations Representative Conference, petitioning the reactionary government and strongly demanding the withdrawal of the proposal. At that time, Qiu Jisheng, Tang Shiyan, and I attended the conference as representatives from Hangzhou, strongly advocating and unanimously opposing the proposal, forcing the Kuomintang reactionary government to cancel it.
After the outbreak of the Anti-Japanese War, I fled alone to Sichuan, arriving in Chongqing, where I served as the Director of the Beibei Traditional Chinese Medicine Hospital and held other positions.
After liberation, I taught at the Sichuan Chongqing Advanced Training School for TCM. At that time, Vice Principal Hu Guangci and Director of Academic Affairs Ren Yingqiu were both outstanding TCM scholars in Southwest China. There, I lectured on Formulas (Fangji) and Warm Diseases (Wenbing), compiling two sets of lecture notes, which were later published in Shanghai and Nanjing.
At the end of 1955, the Academy of Traditional Chinese Medicine was established in the capital. Invited by Minister Qian Xinzong, I traveled from Sichuan to Beijing with Dr. Pu Fuzhou, Li Chongren, and others to join the work of the Academy. Time flies; twenty-five years have passed in a flash.
Above, I have discussed my journey of learning medicine. Below, I will share my insights on academic study, which can be summarized as follows: Read thoroughly, think deeply, and constantly summarize.
Ancient scholars spoke of the "Three Arrivals" in reading: mouth arrival, eye arrival, and heart arrival. "Mouth arrival" refers to recitation aloud; "eye arrival" refers to visual reading; "heart arrival" refers to comprehension and reflection. Later generations added "hand arrival," meaning diligently taking notes. These four arrivals summarize the basic methods of reading.
In my youth, due to my limited educational background, I found classical medical texts profound and difficult to understand. Therefore, I adopted a learning method of tracing the source from the stream: starting with accessible introductory books and gradually moving up to classic works such as *Shanghan Lun* (Treatise on Cold Damage Disorders), *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), *Huangdi Neijing* (Yellow Emperor's Inner Canon), and *Nanjing* (Classic of Difficult Issues). Like most TCM apprentices of that era, I first studied books such as *Tangtou Gejue* (Song Formulas for Decoctions), *Yaoxing Fu* (Ode to Drug Properties), *Yixue Sansan Jing* (Three-Character Classic of Medicine), and *Binhu Maixue* (Pulse Studies of Binhu), mastering them through fluent recitation. Even now, I can still recall most of them. Based on my experience, it is essential to memorize several books thoroughly during youth. Because young people have strong memories, once memorized, they are hard to forget and can benefit one for a lifetime, while also laying a foundation for further study.
My passion for reading was formed during that period. Among the books I have read in my life, those from the Ming and Qing dynasties are the most numerous. During the late Qing and early Republic of China periods, Mr. Jin Zijiu from Dama, Tongxiang, Zhejiang, once told his disciples: "*Neijing*, *Nanjing*, *Shanghan Lun*, and *Jingui Yaolue* form the foundation of medicine. However, when applied clinically, they feel insufficient. For example, *Jingui Yaolue* is the earliest book on miscellaneous diseases, but treating internal and gynecological diseases with it is less detailed than later medical books. Thus, the sages of the Tang and Song dynasties supplemented the deficiencies of the Han and Wei dynasties; the Four Masters of Jin and Yuan supplemented the deficiencies of the Tang and Song dynasties; and finally, the masters of the Ming and Qing dynasties made significant contributions, especially in the field of Warm Diseases." Mr. Jin's words align perfectly with my path of academic study. Books I read carefully include Wang Ang's *Suling Leizuan Yuezhù*, Xu Dachun's *Nanjing Jingshi* and *Yixue Yuanliu Lun*. For studying *Shanghan Lun* and *Jingui Yaolue*, I followed the *Yizong Jinjian* (Golden Mirror of Medicine); for Warm Diseases, I followed *Wenre Jingwei*. Wang Kentang's *Zhengzhi Zhunsheng* from the Ming Dynasty, the state-compiled *Yizong Jinjian* from the Qing Dynasty, and Shen Jin'ao's *Shenshi Zunsheng Shu* are all monumental works covering various internal and external specialties, serving as indispensable reference books on my desk. Other books, such as materia medica, formula collections, medical cases, and notes, are also frequently browsed to broaden my horizons. These books correspond merely to "eye arrival" and do not require memorization. In the past, emphasizing recitation was indeed a good method worth valuing for beginners. Zhang Xuecheng of the Qing Dynasty said: "At the beginning of learning, one cannot rely solely on memorization. After extensive reading, one will transcend mere memorization. Thus, memorization is the boat and cart of learning." (*Wenshi Tongyi*). Just as traveling over mountains and seas requires boats and carts, so does scholarly pursuit. As long as one does not stop at the stage of memorization but uses it as a foundation and starting point for future development, such memorization should not be criticized as "reading dead books."
After reading thoroughly, one must think deeply, digesting and absorbing what has been read to grasp its spiritual essence. One must also cultivate the ability to discriminate critically, neither being too quick to doubt ancient authorities nor blindly worshipping them. This is "heart arrival."
"Hand arrival" means taking notes. Notes can be divided into two types: one involves excerpting the essence of the original text as material for recitation and study; the other consists of personal reflections after digestion and absorption, preliminary organization, and processing in one's own words. Compared to the former, the latter represents a further step. Both types of notes are important in the learning process: the former is for collecting data, and the latter is for summarizing insights. When enough notes accumulate over time, they can be classified and organized, forming the prototype of an article.
These four arrivals are not only interconnected but also mutually reinforcing. From 1928 to 1933, while teaching at TCM institutions in Shanghai, I had to compile lecture notes for teaching and find data for writing articles. Consequently, I had to read and observe more, take notes diligently, and think actively, which led to rapid improvement in my understanding of TCM theory.
Choose beneficial teachers and do not hesitate to ask questions of those below you.
Han Yu said: "Ancient scholars necessarily had teachers; teachers are those who transmit the Way, impart professional skills, and resolve doubts." He also said: "Physicians, musicians, and artisans do not disdain learning from each other." Seeking teachers and asking about one's profession has always been a fine tradition in TCM. Fortunately, in my early years, I met the renowned teacher Mr. Wang Xiangyan, who transmitted the Way, imparted skills, and resolved doubts for me, laying the foundation for my subsequent studies. Master Wang specialized in treating Warm-Heat diseases, and my basic learning was based on the Ye Tianshi school of thought. Later, when I entered Sichuan in my prime, I encountered different academic schools, environments, folk customs, and medication habits, which played a certain role in improving my theory and clinical practice. For instance, doctors in Jiangsu and Zhejiang used Aconite root (Wutou) and Prepared Aconite lateral root (Fuzi) in doses of only a few fen to a qian, whereas doctors in Sichuan commonly used three or four qian, and sometimes even large doses of nearly one liang. After liberation, when I arrived in Beijing, the center of politics, economy, and culture, where many famous doctors gathered, I had the opportunity to interact with renowned physicians from all directions, exchanging our respective expertise and benefiting greatly from mutual discussion.
Ancient scholars advocated "reading ten thousand books and traveling ten thousand miles," which makes much sense. Sima Qian was able to write the *Records of the Grand Historian* ("Investigating the relationship between heaven and humanity, understanding changes from ancient to modern times, and forming a school of thought himself") partly because "all remnants of heaven and earth and ancient events were collected by the Grand Historian," allowing him to master a vast amount of documentary materials. At the same time, "at age twenty, he traveled south to the Jianghuai region, climbed Mount Kuaiji, explored the Yu Cave, peered into the Jiuyi Mountains, floated down the Yuan and Xiang rivers, crossed north the Wen and Si rivers... and marched west to Bashu and beyond, surveying Qiong, Za, and Kunming." By touring famous mountains and great rivers across the land, he accumulated rich life and creative experience, which was also an important reason. Our country has a vast territory, and geographical environments, natural conditions, customs, and disease characteristics vary by region. Over long-term development, local medication habits and medical schools with regional characteristics have gradually formed, a phenomenon with a long history. For example, *Suwen: Yifa Fangyi Lun* (Different Methods Suitable for Different Regions in the Basic Questions) commented on the differences in diseases and treatments among the five regions, proposing the principle of "combining various methods to treat, each obtaining what is suitable." Therefore, learning from medical peers in various regions, absorbing their strengths, not only avoiding disdain for learning from others but also seeking multiple teachers without being confined to sectarian views, is an important method to overcome limitations and achieve continuous progress. I myself learned a great deal from "traveling ten thousand miles" and thus have deep personal experience.
Senior elders who have read widely, possess rich experience, and have specific specializations can provide great benefits when consulted. Peers can also discuss and exchange experiences with each other.
For example, the senior TCM physician Qiu Jisheng formulated the Liver-Soothing and Stomach-Harmonizing Powder (Shugan Hewei San), which has reliable efficacy for liver-stomach Qi pain. The formula contains Agarwood Curd (Chenxiang Qu), Cyperus Rhizome (Xiangfu), Nardostachys Root (Gansong), Corydalis Rhizome (Yanhusuo), Aquilaria Wood (Jiangxiang), Coridius Fruit (Jiu Xiangchong), Hedgehog Skin (Ciwupi), Arca Shell (Walengzi), Zuojin Pill, Sugarcane Juice, and Ginger Juice. I requested the formula from Elder Qiu, and he provided it. Subsequently, I used this formula to treat neurotic gastric pain and gastric ulcer pain, achieving effects of soothing the liver, harmonizing the stomach, moving Qi, and relieving pain, though it is not suitable for deficiency syndromes. After liberation, I worked closely with the senior TCM physician Pu Fuzhou for a long time. With rich clinical experience and confidence in treating diseases, I learned much from him.
Many middle-aged and young TCM practitioners from various regions have contacted me. Regarding young doctors, I am always full of enthusiasm, hoping they can inherit and promote national medicine. I strive to answer all their inquiries and reply to all their letters. At the same time, I humbly learn from their strengths and seriously listen to their opinions. For example, in 1979, I wrote an article titled "Discussion on Yin Qiao San" and sent it to Lian Jianwei, a graduate student at the Beijing College of Traditional Chinese Medicine, asking him to propose revision suggestions without hesitation. Indeed, he offered his own views, and I modified certain shortcomings in the article based on his advice. Sometimes, when encountering difficult cases, I often proactively invite Student Lian to jointly study treatment plans, pooling wisdom.
Strive in practice and improve gradually.
It was once said that learning TCM requires "ten years of reading and ten years of clinical practice." Reading is mastering theoretical knowledge, while clinical practice is applying theory and practice. If one does not master basic theories as the foundation for practice—for example, if one opens a clinic with superficial knowledge and treats human lives as experiments—one risks ridicule for "wasting money on learning medicine." Conversely, if one has a certain theoretical foundation but lacks practical experience, engaging in armchair strategy may lead to errors, and theoretical levels are difficult to truly improve. There is a couplet in the Green Vine Study Room: "Reading is inferior to action; if reading is abandoned, how can one act? Falling leads to wisdom; but frequent falls do not constitute wisdom." This expresses the dialectical relationship between reading and clinical practice.
Theory and practice form a repeated cycle of continuous improvement. One must constantly summarize clinical experience, including failures. I once wrote an article titled "Record of Mismanagement of Lung Disease," summarizing my own failures. Being good at summarizing failure experiences allows one to learn lessons, making failure the mother of success and avoiding "frequent falls." Accumulating sufficient positive and negative experiences improves professional competence and deepens understanding of theoretical knowledge. Medical theory must be constantly verified against clinical practice for profound realization. I regret that in decades of practice, I have cured few critical and difficult diseases. However, whenever I apply theory to clinical practice and achieve expected curative effects, I feel sincere joy. For instance, I treated granulocytic leukemia, with two cases achieving remission; hepatic cirrhosis with ascites was fundamentally cured in one case; and hypertension and peptic ulcer disease were cured in many cases. Conversely, these successes have improved my theoretical level to varying degrees. Our hospital collaborated with the Capital Hospital to conduct clinical research on the treatment patterns of portal cirrhosis with ascites (i.e., Drum Distension). Through clinical practice, I deeply felt that using harsh purgatives such as Kansui Root (Daji), Genkwa Flower (Yuanhua), and Kansui Root (Gansui) might reduce abdominal distension temporarily, but the abdomen would swell again shortly thereafter. Repeated use severely damages vital energy, ultimately leading to death. From this experience, I firmly believe that a passage from Zhu Danxi's *Gezhi Yulun* is an unchangeable truth. Danxi stated: "Physicians fail to realize that diseases originate from deficiency. Impatient for quick results, and seeing patients suffer from bloating and urgency, they favor diuretics to seek temporary relief, unaware that although relief lasts for a day or half a day, the swelling worsens subsequently. The pathogenic factor becomes severe, and the true qi is damaged!" Therefore, treating this condition must involve "harmonizing the liver and tonifying the spleen," which is extremely appropriate.
Recently, I used the Zanhua Xuyu Pill to cure a case of impotence. The patient, Mr. Li, a worker from a factory in Wuzhou, Guangxi, had suffered from impotence for several years, accompanied by symptoms such as soreness and weakness of the waist and legs, palpitations, and insomnia. He wrote to request a prescription. Analyzing his condition, I determined it was due to dual deficiency of the Heart and Kidney. I prescribed a modified Zanhua Xuyu Pill, changing it to a decoction. After taking the prescription for over a month, all symptoms disappeared. He wrote to thank me in April 1980.
Zanhua Xuyu Pill consists of Human Hair Charcoal (Xuyu Tan) and Prepared Rehmannia Root (Shudi), each 24 grams; Polygonum Multiflorum (Shouwu steamed with cow's milk), Walnut Meat, Cistanche Stem (Rongrong), Poria (Fuling), Small Fennel Seed (Xiaohuixiang), Morinda Root (Baji), Eucommia Bark (Duzhong), Dodder Seed (Tusizi), Deer Antler Glue (Lu Jiao Jiao fried into beads), Angelica Sinensis (Danggui), and Goji Berry (Gouqi), each 12 grams; and Ginseng (Renshen) 6 grams. Using ten times the dosage, refine honey to make pills, each weighing 9–15 grams, taken before meals. Its functions are to tonify Qi and Blood, darken beard and hair, and strengthen the body. According to this formula, it tonifies without being harsh and nourishes without being cloying, having the effects of tonifying Qi and Blood and benefiting the Liver and Kidneys. Since it has proven effective in repeated use, I record it here.
For a long time, I have combined clinical practice with earnest study of Western medical knowledge, utilizing it as assistance from other hills. In books such as *Newly Compiled Empirical Prescriptions*, I attempted to explain the use of TCM formulas by integrating Western medical principles. Although I did not do this well enough, I have always believed that TCM and Western medicine should learn from each other, complement each other's strengths, and serve the people together.
Since the publication of my late teacher's posthumous work *Yixue Ti Yong* by the Hangzhou Sanyin Medical Society in 1924, I have compiled more than ten TCM books. Published works include *Essays on Health Preservation*, *Diagnosis and Treatment*, *Selected Essays of Zhonggui*, *Common Knowledge of Food Therapy*, *Studies on Lung, Kidney, and Stomach Diseases*, *Collection of TCM Empirical Prescriptions*, *Chinese Pediatric Infectious Diseases*, *Outline of TCM Warm Diseases*, *Clinical Practical TCM Pharmacology*, *Records of Medical Fragments*, and *Newly Compiled Empirical Prescriptions*, totaling twelve volumes. In recent years, I have compiled *Selected Essays on Medicine* and *Compilation of Internal Medicine Clinical Formulas*, totaling over 300,000 words, along with more than thirty other papers and medical cases. Although I am advanced in years, during my remaining life, I wish to continue striving and advancing for the modernization of our motherland and the promotion of national medicine.
Learn until old age, and learning never ends.
Shen Liuji, Director of the Department of Traditional Chinese Medicine, East China Hospital, Shanghai
[Author Profile] Shen Liuji (1901–), born in Jiading County, Shanghai. Currently serves as the Director of the Department of Traditional Chinese Medicine at East China Hospital, Shanghai, and as a member of the Shanghai Municipal Political Consultative Conference. Engaged in TCM clinical practice for nearly sixty years, he gained fame before liberation. Since joining East China Hospital in 1956, he has treated chronic hepatitis, severe intrahepatic cholangitis, gallstones, urinary stones, thromboangiitis obliterans, severe thrombocytopenic purpura, epidemic hemorrhagic fever, and severe bedsores, among other difficult cases. In December 1977, he was awarded the title of Shanghai Advanced Science and Technology Worker.