用药，必先通过辨证}立方，须灵活调配。所谓调配，就是指某种药物，其功用与病人之症状相符，而药物的性质却与病因相悖时，就必须加用其它药物以调配之。例如麻黄能平喘，其性温，用于寒喘，当然很适当，再配以祛寒药或化痰药，刚效用更明显。如用于热喘，其功用是对症的，但麻黄之温性却与病因不相宜，如加用石膏、甘草以调配之，则麻黄虽属温性而仍可用于热喘。叉如大黄为苦寒通下药，用于热闭，当然很适合，如用于寒阻，就必须配以温热药。调配得当，既发挥了药物的主要作用，叉制约了它与病因不相适宜的性质。先叔父常教导我：「仲景制方之神妙，非同寻常，好多方剂寒热并用，攻补兼施，调配得非常确当，必须认真学习，仔细领会。」诚然，如果不善于调配，治寒证一味寒性药不用，。治热证一味热性药不用，如此严格限制，表面看来，似乎运用辨证施治的原则未尝有错，但在利用某种药物的特长方面不免有不足之处。我记得初临床时，遇一湿温病人，牡热八、九日不退，口渴欲饮，胸中烦懊，脉象孺数，早已用过三仁汤等轻开淡渗之剂而无效，』因湿热俱重，拟重用芩、连、山栀，但鉴于患者舌苔黄腻而偏干燥，湿温中期，邪从热化，用芩、连恐犯古人苦燥伤津之戒。疑虑不决，请教于先兄，指导我用知母，花粉，芦根配合芩、连、山栀等药，可无苦燥伤滓之虑。如法用之，果然热渐退，舌苔黄腻渐化，并未出现滓伤液涸之象。因知用药之调配，关系药物之间的协同作用和相互制约作用，在治疗中有极其重要的意义。
结语
以上叙述，为过去学医中的一部分回忆，我的体会平凡，不值识者一粲。但自感上述问题，当年对启发学习的思路方面，起着一定作用，尤其在从书本开始结合临床这一阶段更为重要。将结业时，先叔父、先兄又相继告诫说：「学习是知识的源泉，将来即使业务繁忙!也决不能长期抛弃阅读。」自出师门，未忘教导。多年来在业务上能免于陨越，追根求源，皆得力于师训。
从师和交友厚积而薄发
中医杂志名誉主编中华全国中医学会常务理事董德懋
[作者简介]董德懋(1912年～)，北京房山人。从事中医工作五十年，毕生致力予中医临床和杂志编辑工作，对于中医内科、儿科和针灸有较高的造诣。主要著作有《中医基础学》、《中药学》、《针灸经穴概要》、《针灸铜人图》、《中医对痢疾的治疗》等。历任中华全国中医学会常务理事、全国针灸学会副理事长、北京中医学会副会长、中华医学会理事、中华儿科学会常务理事、《中医杂志》名誉主编、《中华医学杂志》编委、中医研究院学术委员会委员、中国农工民主党北京市委医药卫生工作委员会副主任等职。
从良师取法乎上
我出生在北京房山县曹章村。一九二六年在良乡县高小毕业后，由于家道贫寒，无力继续学业，由人介绍到一家商店学徒，以维持生计。因胞弟患病，贻误于庸医，不胜悲恸，遂立志从医。我学医的启蒙老师是岳父赵廷元先生，他开始教我习诵《雷公药性赋》、《濒湖脉学》、《医学三字经》、《医宗金鉴》等书。当时年青好强，常发愤攻读，即更衣亦手不释卷。有一次到姑母家，犹不忘背书。姑母深为感动，资助我报考华北国医学院，开始自己真正的医学生涯。
华北国医学院，为北京四大名医之一施今墨先生于一九三一年刨建。学院除设立中医课程外，还设有西医基础和临床课程，学制四年。施老任院长，并亲自授课和带学生临床实习。学院所聘教师有许多名家，如赵炳南、陈宜诚、姚季英、赵锡武、杨叔澄、于道济及西医专家姜泗长等，都曾先后在校执教。学院成立十余载，培养学生五、六百人，毕业后分布全国，而以京、津、冀、鲁、豫等地为多，其中不少人已成为目前中医界的骨干力量。
我在该校第三届学习，毕业后又随施老学习内科。当时先后随师的同学有哈荔田、祝谁予、李介呜等。在这样优越的环境熏陶下，使自己的学业大有长进。从一九三六年我就在施老诊所襄理业务，并从事针灸临床，时达五载余。
在施老亲自教诲下，耳濡目染，心领神会。我当时学习的主要方法；清晨背书，白天随师诊病抄方，晚间整理脉案，阅览医书，我把老师的脉案按病、按证、按方分剐归类，并查阅相应的文献，作笔记，加按语，还常试用治疗，把个人体会也记下来。如此温故知新，反复验证，从中省悟老师的学术经验。
施老治外感热病，擅用清解法。他说；「吾侪治疗外感病，首宜辨明表里、寒热、虚实，则层次分明。表病不可只知发汗，且应注意清里。」他根据表里病情的不同，合理配用解表和清里药物比例。在治疗感染性发热疾病，如流感、白喉、风疹、水痘、猩红热、丹毒、流行性腮腺炎、急性扁桃昧炎等，常用银翘散加减，宣散风热，清热解毒，其加减变化甚妙，如；挟寒加麻，杏，加重荆芥量；挟血热加生地、丹皮、丹参，热毒重加公英、地丁、紫草、甘中黄}挟湿加茯苓、大豆卷，通草、绿豆衣；若肢体痛甚，银花用藤，加桑枝；若发疹，加浮萍、蝉衣等。他对紫雪散应用亦别具一格，常在未见神昏谵语时即用，只要高热、便秘、舌红、苔黄，用之腑行热退，不致热陷营血。
施老对内伤病的治疗，重视气血证治。认为「气血」当列于八纲之内，而成「十纲」。且重视调理脾胃，以疏脾、运脾、醒脾为法，培后天之本。
先生习用药物「对偶」，人称「施氏对药」，往往寒热、明阳、气血、燥润、辛苦之药同用，除沿用古人习惯配伍(如乳香配没药、三棱配莪术)和有效的小方(如左金、枳术、失笑、金铃子散)外，每多创造。众所周知，施老善用山药配黄芪治屎糖高，苍朮配元参治血糖高，为中药现代药理所汪实，并屡验于糖尿病临床治疗中。他对药物应用，常在古人启发下有所发挥，如蒲黄治中风失语舌强，蝉衣治耳鸣，为先生临床经验心得。
先生对孙一奎《赤水玄珠》和张石顽《张氏医通》尤其推崇，认为是中医内科必读之书，每教吾等阅读。《张氏医通》为张石顽师生心血结晶，集前贤书百余种，十六卷，七十万字，述内科证治，兼及妇、儿、外科。我读《张氏医通》，以内难仲景学说为经，后世各家学说为纬，掌握其辨证纲领、方药运用为要。对张氏个人实案、证治发明，亦每留意，如交肠、百合病，历代较少记述验证治例，张氏书中有载，特录出以供以后参考。对每种疾病，尤其着眼于历代各家在诊治上的认识发展，从中自有收益。以后我还参考《古今医案按》等优秀医案，相互参阅，也有不少新意发现。
采百花荟革群芳
我毕生从事中医期刊的编辑创办工作。个人经手主办的杂志，有《中国医药月刊》(1940．6～1943．12)、《中华医学杂志》(1947．10～1958．9)、《北京中医月刊》(1951．5～1954．12)三种。以前者较早，且办刊时间较长，放以为介绍。
该刊创办于一九四0年六月十五日(民国二十九年)，停刊于一九四三年十二月(民国三十二年)，共出四十二期，每期约十至三十页不等，发表文章十五至二十篇，最多时曾达三十余篇。老五号字体直排分栏。杂志还分设各项专栏，如长篇专著连载，言论(相当于「学术探讨」)、方药研究、针灸研究、治验与医话、医案、笔记、小品、文苑、家庭医学和读者园地等。先后参加编辑工作的同人，有田小石、张慧中、周绒章(燕麟)、汪浩权(慎之)、魏萱(桐青)、李祖芳、潘兆鹏、谢诵穆(仲墨)、潘树仁等。其中以上海汪浩权先生尤为得力，汪是近代名医章次公先生的学生。
刊物创办初期，由施今墨老师支持，诸同窗好友襄助，自筹资垒，本人任社长兼总编。我在《创刊宣言》中郑重声明：「今后愿我同道，苟能共同努力，不存门户之见，以学术为前提，不泯灭中医之长，不回护中医之短，利用科学方法，以求治疗之真理……弃其糟粕，存其精华，祛其空谈，趋于实用，使我国固有之实验医术，追列于世界医林，以发扬我东方之文化。」(见《中国医药月刊》第一卷第一期)这就是创刊的主要宗旨。
我自己在杂志上发表文章不多，主要有《针灸讲座》、联实用临床诊断学》等。平时除处理社务，还帮助编辑文稿。在旧社会办刊物常常会赔钱，但我想只要中医事业能得到复兴昌盛，个人损失算不了什么。自己在办刊期问，广泛结交医界名流、海内贤达，对理论和实践进行交流、学习，使学术水平大有提高。作为编辑，必须有多方面的知识，才能提出问题、分析问题、解决问题。因此要求自己多看书，多看病，虚心向人求教。凡中医典籍，诸于百家，乃至民间验方，风俗人情，都须涉猎通晓。组编面要宽，就要做好社会工作，不管是德高望重的名家，还是初出茅庐的青年，都要广泛结交，以便建立刊物的基本作者队伍，为提高杂志质量打好扎实的基础。当时刊物的主要撰稿者，有曹颖甫、陆渊雷、章次公、余无言、时逸人、叶桔泉、聂云台，谭次仲、祝怀萱、樊天徒、汪浩权、朱小南、姜春华、耿鉴庭、沈伸圭、潘澄濂、杨则民、叶劲秋、周介人、焦勉斋、潘树仁、宋大仁等。还有祝谌予、周燕麟、田尔康、张方舆、袁平、夏雨苍、张慧中、魏克逊等同学，也分别为本刊撰稿。为了启迪后学，表彰前贤，我们自第三卷第一期开始，曾先后刊载当代名医施今墨、肖龙友、孔伯华、汪逢春、陆渊雷、章次公、丁仲英、赵树屏、宋大仁、章巨膺、余无言、朱小南、樊天徒、丁福保、缪铭泽、刘星垣等的个人传略和学术成就，同时骈登照片，为近代中医学史的宝贵史料。
杂志要求「杂」，不仅编辑人员要成为「杂家」，在文稿的形式和内容上也要求「杂」。不仅需要高水平的「阳春白雪」，也需要通俗普及的「下里巴人」。这样才能扩大杂志发行量，达到雅俗共赏的目的，同时为发现、培养中医人才，蔚成学术民主的好风气创造条件。我们在全国各地，特别在京、津、沪、冀、鲁等地设分社，并聘请特约撰稿、特约编辑，使本刊在全国各省畅销，成为当时较有影响的中医期刊之一。
此后，我还主办「中华医学杂志》、《北京中医月刊》，后者于一九五五年改名为《中医杂志》，且于一九五九年并入中医研究院，成为现在《中医杂志》的前身。
重积累循序渐进
我在临证实践中，有个重要体会，就是读书、看病，都有个积累的过程，由少到多，由简到繁，由易到难。一点一滴，日积月累，聚涓滴而成江河。试以脾胃学说为例述之
(一)用古方，妙在师心化裁脾胃病证为临床常见，对脾胃虚弱、中气下陷的内伤发热，人皆知用补中益气汤，即「甘温除大热」法。开始我亦套用此方，主治此证每效。后又发现许多病人在治疗发热过程中，其它症状也随之痊愈，引起了自己的重视。嗣而对此留心观察，将之记录，汇集成册。如有同道王某，患内痔便血，自用补中益气汤无效，余诊之为中气下陷、睥不统血，药证相符，又何以东垣方失灵?窃思痔血尚有大肠血热一层，自古用槐花散凉血清热，故参台二方用之竟效。并试用于其它痔血病人亦效，其处方为：黄芪15克，党参12克，白朮、当归各10克，升麻5克，槐米10克，地榆、侧柏叶各12克，陈皮5克，柴胡3克，甘草5克。每用五剂即血止，继服十剂巩固。自此，余习用补中益气汤参以他方，治中气下陷诸疾。如习惯性流产，用原方加阿胶、艾叶、续断、杜仲、桑寄生之补肾固胎』脱肛，用原方加防风、枳壳，即合三奇散，能升提益气；用原方加川芎(2．4克)、防风治脾虚久泻，源于尤怡《金匮冀》，但总不出东垣补中益气升阳。可见用古方，关键在于师其心，用其法，灵活化裁，方可积累自己的经验。
用药，必须先通过辨证来确立治法，处方时必须灵活调配。所谓调配，就是指某种药物的功效与病人的症状相符，但药物的性质却与病因相悖时，就必须加入其他药物来进行调和。例如麻黄能平喘，其性温，用于寒喘，当然很适当，再配以祛寒药或化痰药，疗效更明显。如果用于热喘，其功用是对症的，但麻黄的温性却与病因不相宜，如加用石膏、甘草来进行调和，则麻黄虽属温性而仍可用于热喘。又如大黄为苦寒通下药，用于热闭，当然很适合，如用于寒阻，就必须配以温热药。调配得当，既发挥了药物的主要作用，又制约了它与病因不相适宜的性质。先叔父常教导我：“仲景制方之神妙，非同寻常，好多方剂寒热并用，攻补兼施，调配得非常确当，必须认真学习，仔细领会。”诚然，如果不善于调配，治寒证一味不用寒性药，治热证一味不用热性药，如此严格限制，表面看来，似乎运用辨证施治的原则未尝有错，但在利用某种药物的特长方面不免有不足之处。我记得初临床时，遇一湿温病人，发热八九日不退，口渴欲饮，胸中烦闷懊恼，脉象濡数，早已用过三仁汤等轻开淡渗之剂而无效，因湿热俱重，拟重用黄芩、黄连、山栀，但鉴于患者舌苔黄腻而偏干燥，湿温中期，邪从热化，用黄芩、黄连恐犯古人苦燥伤津之戒。疑虑不决，请教于先兄，指导我用知母、花粉、芦根配合黄芩、黄连、山栀等药，可无苦燥伤津之虑。如法用之，果然热渐退，舌苔黄腻渐化，并未出现津伤液涸之象。因知用药之调配，关系药物之间的协同作用和相互制约作用，在治疗中有极其重要的意义。
结语
以上叙述，为过去学医中的一部分回忆，我的体会平凡，不值识者一笑。但自感上述问题，当年对启发学习的思路方面，起着一定作用，尤其在从书本开始结合临床这一阶段更为重要。将结业时，先叔父、先兄又相继告诫说：“学习是知识的源泉，将来即使业务繁忙，也决不能长期抛弃阅读。”自出师门，未忘教导。多年来在业务上能免于陨越，追根求源，皆得力于师训。
从师和交友厚积而薄发
中医杂志名誉主编 中华全国中医学会常务理事 董德懋
[作者简介] 董德懋(1912年～)，北京房山人。从事中医工作五十年，毕生致力于中医临床和杂志编辑工作，对于中医内科、儿科和针灸有较高的造诣。主要著作有《中医基础学》、《中药学》、《针灸经穴概要》、《针灸铜人图》、《中医对痢疾的治疗》等。历任中华全国中医学会常务理事、全国针灸学会副理事长、北京中医学会副会长、中华医学会理事、中华儿科学会常务理事、《中医杂志》名誉主编、《中华医学杂志》编委、中医研究院学术委员会委员、中国农工民主党北京市委医药卫生工作委员会副主任等职。
从良师取法乎上
我出生在北京房山县曹章村。一九二六年在良乡县高小毕业后，由于家道贫寒，无力继续学业，由人介绍到一家商店学徒，以维持生计。因胞弟患病，贻误于庸医，不胜悲恸，遂立志从医。我学医的启蒙老师是岳父赵廷元先生，他开始教我习诵《雷公药性赋》、《濒湖脉学》、《医学三字经》、《医宗金鉴》等书。当时年青好强，常发愤攻读，即更衣亦手不释卷。有一次到姑母家，犹不忘背书。姑母深为感动，资助我报考华北国医学院，开始自己真正的医学生涯。
华北国医学院，为北京四大名医之一施今墨先生于一九三一年创建。学院除设立中医课程外，还设有西医基础和临床课程，学制四年。施老任院长，并亲自授课和带学生临床实习。学院所聘教师有许多名家，如赵炳南、陈宜诚、姚季英、赵锡武、杨叔澄、于道济及西医专家姜泗长等，都曾先后在校执教。学院成立十余载，培养学生五、六百人，毕业后分布全国，而以京、津、冀、鲁、豫等地为多，其中不少人已成为目前中医界的骨干力量。
我在该校第三届学习，毕业后又随施老学习内科。当时先后随师的同学有哈荔田、祝谌予、李介呜等。在这样优越的环境熏陶下，使自己的学业大有长进。从一九三六年我就在施老诊所襄理业务，并从事针灸临床，时达五载余。
在施老亲自教诲下，耳濡目染，心领神会。我当时学习的主要方法：清晨背书，白天随师诊病抄方，晚间整理脉案，阅览医书，我把老师的脉案按病、按证、按方分别归类，并查阅相应的文献，作笔记，加按语，还常试用治疗，把个人体会也记下来。如此温故知新，反复验证，从中省悟老师的学术经验。
施老治外感热病，擅用清解法。他说：“吾侪治疗外感病，首宜辨明表里、寒热、虚实，则层次分明。表病不可只知发汗，且应注意清里。”他根据表里病情的不同，合理配用解表和清里药物比例。在治疗感染性发热疾病，如流感、白喉、风疹、水痘、猩红热、丹毒、流行性腮腺炎、急性扁桃体炎等，常用银翘散加减，宣散风热，清热解毒，其加减变化甚妙，如：挟寒加麻黄、杏仁，加重荆芥量；挟血热加生地、丹皮、丹参，热毒重加公英、地丁、紫草、甘中黄；挟湿加茯苓、大豆卷，通草、绿豆衣；若肢体痛甚，银花用藤，加桑枝；若发疹，加浮萍、蝉衣等。他对紫雪散应用亦别具一格，常在未见神昏谵语时即用，只要高热、便秘、舌红、苔黄，用之腑行热退，不致热陷营血。
施老对内伤病的治疗，重视气血证治。认为“气血”当列于八纲之内，而成“十纲”。且重视调理脾胃，以疏脾、运脾、醒脾为法，培后天之本。
先生习用药物“对偶”，人称“施氏对药”，往往寒热、阴阳、气血、燥润、辛苦之药同用，除沿用古人习惯配伍(如乳香配没药、三棱配莪术)和有效的小方(如左金、枳术、失笑、金铃子散)外，每多创造。众所周知，施老善用山药配黄芪治糖尿病，苍朮配元参治血糖高，为中药现代药理所证实，并屡验于糖尿病临床治疗中。他对药物应用，常在古人启发下有所发挥，如蒲黄治中风失语舌强，蝉衣治耳鸣，为先生临床经验心得。
先生对孙一奎《赤水玄珠》和张石顽《张氏医通》尤其推崇，认为是中医内科必读之书，每教吾等阅读。《张氏医通》为张石顽师生心血结晶，集前贤书百余种，十六卷，七十万字，述内科证治，兼及妇、儿、外科。我读《张氏医通》，以内难仲景学说为经，后世各家学说为纬，掌握其辨证纲领、方药运用为要。对张氏个人实案、证治发明，亦每留意，如交肠、百合病，历代较少记述验证治例，张氏书中有载，特录出以供以后参考。对每种疾病，尤其着眼于历代各家在诊治上的认识发展，从中自有收益。以后我还参考《古今医案按》等优秀医案，相互参阅，也有不少新意发现。
采百花荟萃群芳
我毕生从事中医期刊的编辑创办工作。个人经手主办的杂志，有《中国医药月刊》(1940．6～1943．12)、《中华医学杂志》(1947．10～1958．9)、《北京中医月刊》(1951．5～1954．12)三种。以前者较早，且办刊时间较长，故以为介绍。
该刊创办于一九四0年六月十五日(民国二十九年)，停刊于一九四三年十二月(民国三十二年)，共出四十二期，每期约十至三十页不等，发表文章十五至二十篇，最多时曾达三十余篇。老五号字体直排分栏。杂志还分设各项专栏，如长篇专著连载，言论(相当于“学术探讨”)、方药研究、针灸研究、治验与医话、医案、笔记、小品、文苑、家庭医学和读者园地等。先后参加编辑工作的同人，有田小石、张慧中、周绒章(燕麟)、汪浩权(慎之)、魏萱(桐青)、李祖芳、潘兆鹏、谢诵穆(仲墨)、潘树仁等。其中以上海汪浩权先生尤为得力，汪是近代名医章次公先生的学生。
刊物创办初期，由施今墨老师支持，诸同窗好友襄助，自筹资垒，本人任社长兼总编。我在《创刊宣言》中郑重声明：“今后愿我同道，苟能共同努力，不存门户之见，以学术为前提，不泯灭中医之长，不回护中医之短，利用科学方法，以求治疗之真理……弃其糟粕，存其精华，祛其空谈，趋于实用，使我国固有之实验医术，追列于世界医林，以发扬我东方之文化。”(见《中国医药月刊》第一卷第一期)这就是创刊的主要宗旨。
我自己在杂志上发表文章不多，主要有《针灸讲座》、《联实用临床诊断学》等。平时除处理社务，还帮助编辑文稿。在旧社会办刊物常常会赔钱，但我想只要中医事业能得到复兴昌盛，个人损失算不了什么。自己在办刊期间，广泛结交医界名流、海内贤达，对理论和实践进行交流、学习，使学术水平大有提高。作为编辑，必须有多方面的知识，才能提出问题、分析问题、解决问题。因此要求自己多看书，多看病，虚心向人求教。凡中医典籍，诸子百家，乃至民间验方，风俗人情，都须涉猎通晓。组编面要宽，就要做好社会工作，不管是德高望重的名家，还是初出茅庐的青年，都要广泛结交，以便建立刊物的基本作者队伍，为提高杂志质量打好扎实的基础。当时刊物的主要撰稿者，有曹颖甫、陆渊雷、章次公、余无言、时逸人、叶桔泉、聂云台，谭次仲、祝怀萱、樊天徒、汪浩权、朱小南、姜春华、耿鉴庭、沈伸圭、潘澄濂、杨则民、叶劲秋、周介人、焦勉斋、潘树仁、宋大仁等。还有祝谌予、周燕麟、田尔康、张方舆、袁平、夏雨苍、张慧中、魏克逊等同学，也分别为本刊撰稿。为了启迪后学，表彰前贤，我们自第三卷第一期开始，曾先后刊载当代名医施今墨、肖龙友、孔伯华、汪逢春、陆渊雷、章次公、丁仲英、赵树屏、宋大仁、章巨膺、余无言、朱小南、樊天徒、丁福保、缪铭泽、刘星垣等的个人传略和学术成就，同时骈登照片，为近代中医学史的宝贵史料。
杂志要求“杂”，不仅编辑人员要成为“杂家”，在文稿的形式和内容上也要求“杂”。不仅需要高水平的“阳春白雪”，也需要通俗普及的“下里巴人”。这样才能扩大杂志发行量，达到雅俗共赏的目的，同时为发现、培养中医人才，蔚成学术民主的好风气创造条件。我们在全国各地，特别在京、津、沪、冀、鲁等地设分社，并聘请特约撰稿、特约编辑，使本刊在全国各省畅销，成为当时较有影响的中医期刊之一。
此后，我还主办《中华医学杂志》、《北京中医月刊》，后者于一九五五年改名为《中医杂志》，且于一九五九年并入中医研究院，成为现在《中医杂志》的前身。
重积累循序渐进
我在临证实践中，有个重要体会，就是读书、看病，都有个积累的过程，由少到多，由简到繁，由易到难。一点一滴，日积月累，聚涓滴而成江河。试以脾胃学说为例述之
(一)用古方，妙在师心化裁脾胃病证为临床常见，对脾胃虚弱、中气下陷的内伤发热，人皆知用补中益气汤，即“甘温除大热”法。开始我亦套用此方，主治此证每效。后又发现许多病人在治疗发热过程中，其它症状也随之痊愈，引起了自己的重视。嗣而对此留心观察，将之记录，汇集成册。如有同道王某，患内痔便血，自用补中益气汤无效，余诊之为中气下陷、脾不统血，药证相符，又何以东垣方失灵?窃思痔血尚有大肠血热一层，自古用槐花散凉血清热，故参合二方用之竟效。并试用于其它痔血病人亦效，其处方为：黄芪15克，党参12克，白朮、当归各10克，升麻5克，槐米10克，地榆、侧柏叶各12克，陈皮5克，柴胡3克，甘草5克。每用五剂即血止，继服十剂巩固。自此，余习用补中益气汤参以他方，治中气下陷诸疾。如习惯性流产，用原方加阿胶、艾叶、续断、杜仲、桑寄生之补肾固胎；脱肛，用原方加防风、枳壳，即合三奇散，能升提益气；用原方加川芎(2.4克)、防风治脾虚久泻，源于尤怡《金匮翼》，但总不出东垣补中益气升阳。可见用古方，关键在于师其心，用其法，灵活化裁，方可积累自己的经验。
Medication must first be guided by syndrome differentiation (Bian Zheng, pattern differentiation) to establish treatment principles; prescriptions require flexible adjustment. "Adjustment" refers to the situation where a drug's efficacy matches the patient's symptoms, but its nature contradicts the etiology. In such cases, other drugs must be added to harmonize it. For example, Mahuang (Ephedrae Herba) can relieve asthma and is warm in nature. It is appropriate for cold-type asthma; when combined with cold-dispelling or phlegm-resolving drugs, its effect is more pronounced. If used for heat-type asthma, while its efficacy targets the symptom, its warm nature is unsuitable for the etiology. However, if adjusted with Shigao (Gypsum Fibrosum) and Gancao (Glycyrrhizae Radix et Rhizoma), Mahuang can still be used for heat-type asthma despite its warm nature. Similarly, Dahuang (Rhei Radix et Rhizoma) is bitter, cold, and purgative, suitable for heat obstruction. If used for cold obstruction, it must be combined with warm-hot drugs. Proper adjustment both maximizes the primary action of the drug and restricts its properties that are incompatible with the etiology. My late uncle often taught me: "The ingenuity of Zhang Zhongjing's prescription formulation is extraordinary. Many formulas combine cold and hot properties, and tonification and purgation simultaneously, with very precise adjustments. One must study this seriously and comprehend it carefully." Indeed, if one is not skilled in adjustment, avoiding all cold-natured drugs for cold syndromes and all hot-natured drugs for heat syndromes, such strict restriction might seem consistent with the principle of syndrome differentiation and treatment on the surface, but it inevitably falls short in utilizing the specific strengths of certain drugs. I recall my early clinical practice when I encountered a patient with damp-warmth disease (Shi Wen). The fever persisted for eight or nine days, accompanied by thirst and desire to drink, vexation and restlessness in the chest, and a soggy and rapid pulse. Light diaphoretic and bland-leaching agents like Sanren Tang (Three Seeds Decoction) had already been used without success. Given the heavy dampness and heat, I intended to heavily use Huangqin (Scutellariae Radix), Lianhua (Loti Stamen), and Shanzhi (Gardeniae Fructus). However, considering the patient's yellow and greasy tongue coating leaning towards dryness, and the mid-stage of damp-warmth where pathogenic factors transform into heat, using Huangqin and Lianlian risked violating the ancient warning against bitter-dryness injuring body fluids. Hesitant, I consulted my late elder brother, who advised using Zimu (Anemarrhenae Rhizoma), Huafen (Trichosanthis Radix), and Lugeng (Phragmitis Rhizoma) in combination with Huangqin, Lianlian, and Shanzhi, thereby avoiding the concern of bitter-dryness injuring fluids. Following this method, the fever gradually subsided, the yellow greasy tongue coating gradually resolved, and no signs of fluid depletion appeared. Thus, I realized that medication adjustment relates to the synergistic and restraining effects among drugs, holding extremely important significance in treatment.
Conclusion
The above narrative is part of my memories from past medical studies. My insights are ordinary and hardly worth a smile from experts. However, I feel that these issues played a certain role in inspiring learning approaches back then, especially during the stage of combining book knowledge with clinical practice. Before graduation, my late uncle and elder brother repeatedly admonished: "Learning is the source of knowledge. Even if business becomes busy in the future, never abandon reading for long periods." Since leaving my master's door, I have not forgotten their teachings. Over the years, avoiding mistakes in my professional work can be traced back to these master's instructions.
Learning from Good Teachers and Making Friends: Accumulate Thickly, Erupt Thinly
Dong Demao, Honorary Editor-in-Chief of Chinese Medicine Journal, Standing Director of China Association of Chinese Medicine
[Author Biography] Dong Demao (1912–), born in Fangshan, Beijing. Engaged in traditional Chinese medicine (TCM) work for fifty years, dedicating his life to TCM clinical practice and journal editing. He has high attainments in TCM internal medicine, pediatrics, and acupuncture. Major works include *Basic Theory of Traditional Chinese Medicine*, *Chinese Materia Medica*, *Summary of Acupuncture Meridian Points*, *Bronze Man Figure of Acupuncture*, *Treatment of Dysentery by Traditional Chinese Medicine*, etc. He served as Standing Director of China Association of Chinese Medicine, Vice Chairman of National Acupuncture Society, Vice President of Beijing Association of Traditional Chinese Medicine, Director of Chinese Medical Association, Standing Director of Chinese Pediatric Society, Honorary Editor-in-Chief of *Chinese Medicine Journal*, Editorial Board Member of *Chinese Medical Journal*, Academic Committee Member of Academy of Traditional Chinese Medicine, and Deputy Director of the Medical and Health Work Committee of Beijing Municipal Committee of the Chinese Peasants' and Workers' Democratic Party.
Taking Standards from Good Teachers
I was born in Caozhang Village, Fangshan County, Beijing. After graduating from Liangxiang County Primary School in 1926, due to family poverty, I could not continue my studies. Introduced by someone, I became an apprentice in a shop to make a living. Because my younger brother fell ill and was misled by quack doctors, causing great grief, I resolved to become a doctor. My启蒙 teacher was my father-in-law, Mr. Zhao Tingyuan. He began teaching me to recite *Leigong Yaoxing Fu* (Lei Gong's Treatise on Drug Properties), *Binhu Moxue* (Pulse Studies from Binhu), *Yixue Sansanzi* (Three-Character Classic of Medicine), and *Yizong Jinjian* (Golden Mirror of Medicine). Being young and competitive, I studied hard, keeping books in hand even when changing clothes. Once at my aunt's house, I did not forget to recite texts. Deeply moved, she sponsored me to take the entrance exam for North China College of Traditional Chinese Medicine, starting my true medical career.
North China College of Traditional Chinese Medicine was founded by Shi Jinmo, one of the Four Famous Doctors of Beijing, in 1931. Besides TCM courses, the college offered Western medicine basics and clinical courses, with a four-year curriculum. Mr. Shi served as president, personally teaching and supervising clinical internships. Many famous teachers were hired, including Zhao Bingnan, Chen Yicheng, Yao Jiying, Zhao Xiwu, Yang Shucheng, Yu Daoji, and Western medicine expert Jiang Siliang, who taught successively. In over ten years, the college trained five or six hundred students, who distributed nationwide, mostly in Beijing, Tianjin, Hebei, Shandong, and Henan. Many have become backbone forces in the current TCM community.
I studied in the third cohort of the school and subsequently studied internal medicine under Mr. Shi. Classmates who followed him included Ha Litian, Zhu Chenyu, and Li Jiewu. Under such excellent environmental influence, my academic progress was significant. From 1936, I assisted in business at Mr. Shi's clinic and engaged in acupuncture clinical practice for over five years.
Under Mr. Shi's personal guidance, I absorbed knowledge through osmosis and understanding. My main study methods were: reciting texts in the morning, accompanying the master for diagnosis and copying prescriptions during the day, organizing pulse records and reading medical books in the evening. I categorized the master's pulse records by disease, syndrome, and formula, consulted corresponding literature, took notes, added comments, and often tried treatments, recording personal experiences. Thus reviewing old knowledge to understand new things and verifying repeatedly, I gained insights into the master's academic experience.
Mr. Shi specialized in the clearing and resolving method for treating exogenous febrile diseases. He said: "In treating exogenous diseases, we must first distinguish exterior/interior, cold/heat, deficiency/excess, so that levels are clear. For exterior diseases, one should not only know sweating but also pay attention to clearing the interior." Based on different exterior-interior conditions, he reasonably matched the proportions of exterior-releasing and interior-clearing drugs. For infectious febrile diseases such as influenza, diphtheria, rubella, chickenpox, scarlet fever, erysipelas, mumps, and acute tonsillitis, he commonly used Yinqiao San (Honeysuckle and Forsythia Powder) with modifications to disperse wind-heat and clear heat-toxin. Its modifications were exquisite: adding Mahuang (Ephedrae Herba) and Xingren (Armeniacae Semen Amarum) and increasing Jingjie (Schizonepetae Spica) for cold involvement; adding Shengdi (Rehmanniae Radix), Danpi (Moutan Cortex), and Danshen (Salviae Miltiorrhizae Radix et Rhizoma) for blood-heat involvement; adding Yinggong (Centipedae), Diding (Violaris Herba), Zicao (Arnebiae Radix seu Rhizoma), and Ganzhonghuang (Calamini Pulvis) for severe heat-toxin; adding Fuling (Poria), Dadoujuan (Sojae Preparata), Tongcao (Tetrapanacis Medulla), and Lvdouyi (Phaseoli Semen Testa) for dampness involvement; using Yinhua Teng (Lonicerae Japonicae Caulis) and Sangzhi (Mori Ramulus) for severe limb pain; adding Fuping (Urticae Herba) and Chanyi (Bombyx Batryticatus) for rashes. His application of Zixue San (Purple Snow Powder) was also unique; he often used it before coma and delirium appeared. As long as there was high fever, constipation, red tongue, and yellow coating, using it would lead to bowel movement, heat retreat, and prevent heat from sinking into the nutritive and blood levels.
For treating endogenous diseases, Mr. Shi emphasized the treatment of Qi and Blood syndromes. He believed "Qi and Blood" should be listed within the Eight Principles, forming the "Ten Principles." He also valued regulating the Spleen and Stomach, using methods to soothe, transport, and awaken the Spleen to nourish the Post-Heaven Root.
The Master frequently used drug "pairs," known as "Shi's Paired Drugs," often combining cold/hot, yin/yang, Qi/blood, dry/moist, acrid/pungent drugs. Besides inheriting ancient habitual combinations (such as Ruxiang (Olibanum) with Moyao (Myrrha), Sanleng (Sparganii Rhizoma) with Ezhu (Curcumae Rhizoma)) and effective small formulas (such as Zuojin Wan, Zhiju Wan, Shixiao San, Jinlingzi San), he created much. It is well known that Mr. Shi skillfully used Shanyao (Dioscoreae Rhizoma) paired with Huangqi (Astragali Radix) to treat diabetes, and Cangzhu (Atractylodis Rhizoma) paired with Yuan Shen (Scrophulariae Radix) to treat high blood sugar, which has been confirmed by modern pharmacology and verified repeatedly in clinical diabetes treatment. His application of drugs often expanded upon ancient inspirations; for instance, using Puhuang (Typhae Pollen) for stroke-induced aphasia and tongue stiffness, and Chanyi (Bombyx Batryticatus) for tinnitus, were insights from his clinical experience.
The Master highly esteemed Sun Yikui's *Chishui Xuanzhu* (Mysterious Pearl of Red Waters) and Zhang Shiwang's *Zhangshi Yitong* (Comprehensive Essentials from Zhang's Family), regarding them as essential readings for TCM internal medicine, often teaching us to read them. *Zhangshi Yitong* is the crystallization of the efforts of Zhang Shiwang and his students, collecting over a hundred books from former sages, in sixteen volumes and seven hundred thousand words, describing internal medicine syndrome treatments, and covering gynecology, pediatrics, and surgery. When reading *Zhangshi Yitong*, I took the theories of Neijing, Nanjing, and Zhang Zhongjing as the warp, and later schools' theories as the weft, focusing on mastering its syndrome differentiation guidelines and formula applications. I also paid attention to Zhang's personal cases and innovations in syndrome treatment, such as Jiaochang (Intestine Exchange) and Baihe Bing (Lily Disease), which had few recorded verification examples in history. Zhang's book contained them, so I specifically recorded them for future reference. For each disease, I focused on the development of understanding in diagnosis and treatment by various schools throughout history, gaining benefits from this. Later, I also referred to excellent case records like *Gujin Yi'an An* (Annotations on Ancient and Modern Medical Cases), cross-referencing them, discovering many new insights.
Gathering Hundred Flowers, Assembling Fragrances
I devoted my life to the editing and founding of TCM journals. The magazines I personally managed were *China Pharmaceutical Monthly* (June 1940 – December 1943), *Chinese Medical Journal* (October 1947 – September 1958), and *Beijing TCM Monthly* (May 1951 – December 1954). The former started earlier and ran longer, so I introduce it here.
This journal was founded on June 15, 1940 (29th Year of the Republic of China), and ceased publication in December 1943 (32nd Year of the Republic of China), publishing forty-two issues in total. Each issue varied from ten to thirty pages, publishing fifteen to twenty articles, sometimes exceeding thirty. It used old No. 5 font, vertical arrangement, and column layout. The magazine also featured various columns, such as serialized monographs, opinions (equivalent to "academic exploration"), materia medica and formula research, acupuncture research, verified treatments and medical anecdotes, medical cases, notes, essays, literary garden, family medicine, and reader's corner. Colleagues participating in editing included Tian Xiaoshi, Zhang Huizhong, Zhou Rongzhang (Yanlin), Wang Haoquan (Shenzhi), Wei Xuan (Tongqing), Li Zufang, Pan Zhaopeng, Xie Songmu (Zhongmo), Pan Shuren, etc. Among them, Mr. Wang Haoquan from Shanghai was particularly capable; he was a student of the modern famous doctor Zhang Cigong.
In the early stages of the journal's founding, supported by Teacher Shi Jinmo and assisted by classmates and friends, I raised funds myself and served as publisher and editor-in-chief. In the "Founding Declaration," I solemnly stated: "In the future, I hope my colleagues, if we can work together, do not harbor sectarian views, take academics as the premise, do not obscure the strengths of TCM, nor cover up its weaknesses, utilize scientific methods to seek the truth of treatment... discard the dross, preserve the essence, remove empty talk, tend towards practicality, so that our country's inherent experimental medicine may rank among world medicine, promoting our Eastern culture." (See *China Pharmaceutical Monthly*, Vol. 1, No. 1) This was the main purpose of founding the journal.
I published few articles in the magazine myself, mainly *Acupuncture Lectures* and *Applied Clinical Diagnostics*. Apart from handling society affairs, I helped edit manuscripts. In the old society, running a journal often resulted in losses, but I thought that as long as the TCM cause could be revived and prospered, personal loss meant nothing. During the period of running the journal, I widely befriended medical celebrities and sages, exchanging and learning theories and practices, greatly improving my academic level. As an editor, one must possess diverse knowledge to propose, analyze, and solve problems. Therefore, I required myself to read more, see more patients, and humbly seek advice from others. All TCM classics, writings of various schools, folk prescriptions, customs, and human sentiments had to be explored and understood. To broaden the scope of compilation, one must do social work well. Whether venerable masters or novices, one must make wide connections to establish a basic author team for the journal, laying a solid foundation for improving magazine quality. The main contributors at that time included Cao Yingfu, Lu Yuanlei, Zhang Cigong, Yu Wuoyan, Shi Yiren, Ye Juquan, Nie Yuntai, Tan Cizhong, Zhu Huaixuan, Fan Tiantu, Wang Haoquan, Zhu Xiaonan, Jiang Chunhua, Geng Jianting, Shen Shengui, Pan Chenglian, Yang Zemin, Ye Jinqiu, Zhou Jieren, Jiao Mianzhai, Pan Shuren, Song Daren, etc. Classmates such as Zhu Chenyu, Zhou Yanlin, Tian Erkang, Zhang Fangyu, Yuan Ping, Xia Yucang, Zhang Huizhong, and Wei Kexun also contributed to the journal. To inspire later learners and commend former sages, starting from Volume 3, Issue 1, we successively published biographies and academic achievements of contemporary famous doctors such as Shi Jinmo, Xiao Longyou, Kong Bohua, Wang Fengchun, Lu Yuanlei, Zhang Cigong, Ding Zhongying, Zhao Shuping, Song Daren, Zhang Juying, Yu Wuoyan, Zhu Xiaonan, Fan Tiantu, Ding Fubao, Miao Mingze, Liu Xingyuan, etc., along with their photos, providing valuable historical materials for the history of modern TCM.
The magazine required "diversity." Not only did editors need to be "generalists," but the form and content of manuscripts also required "diversity." It needed not only high-level "Spring Snow" (refined art) but also popular "Lower Li Ba Ren" (folk songs). This could expand circulation, achieve elegance and vulgarity appreciation, and create conditions for discovering and cultivating TCM talents, fostering a good atmosphere of academic democracy. We established branches nationwide, especially in Beijing, Tianjin, Shanghai, Hebei, and Shandong, and hired special contributors and editors, making the journal best-selling across provinces, becoming one of the influential TCM journals at that time.
Later, I also hosted *Chinese Medical Journal* and *Beijing TCM Monthly*. The latter was renamed *Chinese Medicine Journal* in 1955 and merged into the Academy of Traditional Chinese Medicine in 1959, becoming the predecessor of the current *Chinese Medicine Journal*.
Emphasizing Accumulation and Step-by-Step Progress
In my clinical practice, an important insight is that reading and seeing patients both involve an accumulation process: from less to more, simple to complex, easy to difficult. Drop by drop, accumulating day by day, gathering trickles into rivers. Let me illustrate this with the theory of the Spleen and Stomach.
(1) Using Ancient Formulas: The Wonder Lies in Adapting the Mind. Spleen and Stomach diseases are common in clinical practice. For internal injury fever caused by Spleen and Stomach weakness and sinking of Middle Qi, everyone knows to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), i.e., the "Sweet-Warm to Remove Great Heat" method. Initially, I also applied this formula, and it was effective for this syndrome. Later, I discovered that many patients' other symptoms healed during the treatment of fever, which attracted my attention. Subsequently, I observed this carefully, recorded it, and compiled it into a booklet. For example, a colleague named Wang suffered from internal hemorrhoids with bloody stool. He used Buzhong Yiqi Tang himself without effect. I diagnosed him with sinking of Middle Qi and Spleen failing to control blood. Although the medicine matched the syndrome, why did Dongyuan's formula fail? I pondered that hemorrhoidal bleeding also involves large intestine blood-heat. Since ancient times, Huaihua San (Sophorae Flavescentis Flower Powder) has been used to cool blood and clear heat. So, I combined the two formulas, and it was effective. I also tried it on other hemorrhoidal bleeding patients with similar results. The prescription was: Huangqi (Astragali Radix) 15g, Dangshen (Codonopsis Radix) 12g, Baizhu (Atractylodis Macrocephalae Rhizoma) and Danggui (Angelicae Sinensis Radix) 10g each, Shengma (Cimicifugae Rhizoma) 5g, Huaimi (Sophorae Flavescentis Flos) 10g, Diyü (Sanguisorbae Radix) and Ce Baiye (Platycladi Cacumen) 12g each, Chenpi (Citri Reticulatae Pericarpium) 5g, Chaihu (Bupleuri Radix) 3g, Gancao (Glycyrrhizae Radix et Rhizoma) 5g. Five doses stopped the bleeding, followed by ten doses to consolidate. Since then, I habitually used Buzhong Yiqi Tang combined with other formulas to treat various diseases of sinking Middle Qi. For habitual abortion, I added Ejiao (Asini Corii Colla), Aiyè (Artemisiae Argyi Folium), Xuduan (Dipsaci Radix), Duzhong (Eucommiae Cortex), and Sangjisheng (Taxilli Herba) to tonify Kidney and secure fetus; for rectal prolapse, I added Fangfeng (Saposhnikoviae Radix) and Zhike (Aurantii Fructus Immaturus), combining with Sanqi San (Three Wonders Powder), to lift Qi and augment energy; for chronic diarrhea due to Spleen deficiency, I used the original formula plus Chuanxiong (Ligustici Chuanxiong Rhizoma) (2.4g) and Fangfeng, derived from You Yi's *Jinkui Yi* (Supplement to the Golden Cabinet), but ultimately it did not exceed Dongyuan's lifting Yang with Buzhong Yiqi. Thus, using ancient formulas lies in learning their mindset, applying their methods, and flexibly adapting them, so as to accumulate one's own experience.