Liu Duzhou: experience in learning traditional Chinese medicine (worth collecting and reading over and over again)

26 Mar 2020 08:10

Guide: this article tells about Mr. Liu Duzhou's academic essence of his life, which is completely practical. Both freshmen and doctors who have studied traditional Chinese medicine for decades can get a lot of inspiration from it. The final summary is more concise and inculcate.

In the old society, the method of teaching students varied from person to person, and there were roughly two forms: the first, teachers used shallow reading materials, such as "Tang Tou Song", "Drug Fu", "near Lake vein Science", "Medical three characters Sutra" and other teaching materials, to teach to students, and asked to recite.

It is understood that almost all teachers who use such teaching materials have one thing in common, that is, they pay more attention to imparting their own experience, while not paying enough attention to the teaching of classics such as the Internal Classic and the Treatise on febrile Diseases. Therefore, the students they train tend to focus on clinic, but ignore the theoretical research.

Second, contrary to the above, teachers in the enlightenment teaching stage, starting with four classics. Their ideas echo the spirit of "Qianjin Fang Da Yi". Therefore, the students they trained, generally speaking, the theoretical level is relatively high, and the foundation is also solid, has the potential for development, so it has been supported by doctors in the past dynasties.

Xu Lingtai, a master of medicine in Qing Dynasty, pointed out in his article "Shen Ji Rong Yan": "all Taoist skills must have their origin. There is no purpose not to see the books before the Han and Tang dynasties. They can only remember several kinds of fashion medicine, but can be used as a doctor." When he said the books before the Han and Tang dynasties, he referred to classics such as "inner", "difficult" and so on. It can be seen that Xu also advocates that learning classics first is the foundation of learning medicine.

How did I learn traditional Chinese medicine?

Since I was weak and sick, I often extended medicine, so I was able to get close to traditional Chinese medicine and joined the team of traditional Chinese medicine by reason of fate. My teacher, mainly practicing medicine in Yingkou, took three disciples, and I was the youngest.

At that time, I studied the course of traditional Chinese medicine, now recalled, generally divided into two stages of basic theory of traditional Chinese medicine and clinical treatment, a total of six years. In the stage of theoretical foundation, Zhang and Ma co-authored "Huangdi Neijing", "three Notes of Herbal Medicine", "Annotated Treatise on febrile Diseases" and "Golden Chamber Heart Canon" and so on. As I have read private mats for a few years, the ancient Chinese is a bit basic, so the writing is not very difficult. However, there are great problems in the medical aspects of the teacher.

I remember one time the teacher said "oriental wind, wind and wood, wood, acid, acid, liver, tendons, heart, etc." in the theory of "Yin and Yang should be like the Great idea", "Oriental wind, wind and wood, wood, acid, acid, liver, tendons, hearts." In spite of the teacher's eyebrow dancing, I was like a cloud driving through the fog.

I have studied the theoretical basis of traditional Chinese medicine for three years. Although some problems are still hazy, but some classics have been studied systematically, which has laid a solid foundation for further study of traditional Chinese medicine, and it is also a great gain.

In the fourth year, the teacher taught me the clinical courses in "Medical Zong Jin Jian", such as "the key to miscellaneous illness", "the key to gynecological heart law" and "the key to kindergarten heart method" and so on. Because these contents are written in song format, the teacher asks to learn and memorize them until they are familiar with them. Endorsement is no stranger to me, but it is very stressful, can not come a little false, must get up early and go to bed late every day to pay hard work.

About endorsements.

There has always been a debate about endorsement. My opinion tends to be memorized.

"Medical Zong Jin Jian ·Fan Fang" said: "if the doctor is not familiar with the book, the reason is unknown, the reason is not clear, the temporary travel, there is no definite opinion, the drug certificate is not suitable, it is difficult to work." It points out that "back" is for the sake of familiarity, for the sake of clarity, for the sake of clarity, and for the sake of clinical syndrome differentiation. Thus it can be seen that a large number of songs written in Jin Jian are written for the sake of people's recitation and memory, so don't blame it.

However, the books of traditional Chinese medicine are so vast that no one can read them all. Therefore, there are still places in the region, or because of the differences of teachers, and can not help but have a choice. For example, doctors in the south have many studies of Menghe School of Fei and Ma, while the three provinces of Northeast China have regarded "Medical Zong Jin Jian" as the standard.

The book, originally the unfinished book by the right hospital of Qianlong Tai Hospital in Qing Dynasty, was developed by the government and thought that it could be used as a national medical code. He still instructed Wu Qian and Liu Yudo to seriously revise it on the basis of the original book in line with the purpose of "considering the ancient times to allow for the present," which means to remove the complexity of the abstract. It took about two more years before it was completed in 1742 AD. The book consists of 90 volumes and is divided into 11 subjects. It can be compared with the Tang Dynasty's "New repair Grass" and the Song Dynasty's "Harmony Bureau", which can go hand in hand with each other.

Xu Lingtai commented that this book has the reputation of "source", "spirit" and "plain", and advocates "febrile illness" and "synopsis of the Golden Chamber" for its purpose. After that, it is widely accepted, strict to take, not new, completely unparanoid "reputation, which shows that the achievements of this book are extraordinary. It not only has an impact in the three provinces of the Northeast, but also as far away as the whole country and Southeast Asia.

Under the instructions of the teacher, I bought a "Medical Zong Jin Jian". Through my own study, I found that one of the "revised typhoid theory notes" collected the elders of the various families, referred to their own meaning, explained clearly, and made people interested in reading. Therefore, I eagerly buried myself in the study of "Treatise on febrile Diseases". From this point on, Fang changed from passive learning to active learning, and took a new step towards self-study.

On the problem of self-study

Self-study is the only way for every scientist. Because we can't live with teachers, sooner or later we have to take our own road of struggle. However, self-study must emphasize methods, there must be a practical plan, and if necessary, someone must point out one or two points.

Self-study also needs conditions, the main need to have time to ensure, to compete against the clock, cherish time, to have the necessary reference books and reference books, if there are the conditions to often go to the library, it is ideal.

There are three taboos in self-study:

A taboo floating: refers to the self-study person, the heart is not dedicated, can not go deep into the book, just glancing through the light, of course, there is no result of this kind of learning;

Second taboo chaos: refers to the self-study person, does not have a complete study plan and the step, reads this book one after another, then reads another book, seems to fly the water, this kind of disorder, does not have the system study, also must learn nothing;

Three taboos fear difficulties: refers to the self-study of the person, in the process of self-study, some of the content can not be seen, there have been difficulties. I do not know, where they do not understand, is also a specific reflection of the lack of knowledge. If we do not use the spirit of nails to deal with difficulties in order to solve them, but fear difficulties and abandon themselves, it will inevitably cost a lot of effort and give up halfway.

I remember that the ancients urged people to learn and uttered many proverbs and aphorisms, such as "stone pestle and embroidery needle, work to nature", "as soon as the spirit arrived, iron stone opened", "without a cold bone, how to get plum blossoms smelly", all illustrate a truth, that is, only those who persist in learning and are not afraid of difficulties can win the final victory.

In this spirit, I work hard on myself, cold and summer continue to learn the knowledge of traditional Chinese medicine. I have read a lot of famous medical works, such as the four Jinyuan schools and the Qing Dynasty typhoid commentators and febrile pathologists, as well as other representative works of Ming and Qing dynasties, so that my horizons are wide open and my knowledge continues to improve.

On the relationship between Learning and use

The purpose of learning the theory of traditional Chinese medicine is to guide the clinic to solve the problems of disease prevention and treatment. Therefore, in the study, there is a problem of the unity of theory and practice. Why did Chen Xiuyuan, a Qing, advocate seeing a doctor during the day and reading at night? It is just a combination of emphasis on the application of learning and the combination of learning and using.

I like a paragraph that Kong Ming said to Cheng Deshu, a counselor of Soochow, when he spoke to Cheng Deshu, a counselor of Soochow in the Romance of the three Kingdoms. He said, "if you are a scholar of a small man, you can only make sculptors and specialize in calligraphy; youth gives you Fu, Haofa Sutra; although there are thousands of words in your writing, there is really nothing to do in your chest." Although the day is full of thousands of words, how can you take it? " Kong Ming here ridiculed those who read more than become their economic knowledge, even though they chanted all day long, but had nothing to do with the facts.

The study of traditional Chinese medicine is also the most taboo on the paper light soldiers. It should be noted that no matter any famous work, there are two problems, which need to be tested in practice and developed in practice. If you leave practice, it is likely to lead to blind worship, or grossly negate it. We are firmly opposed to this style of study.

As far as "Treatise on febrile Diseases" is concerned, it is a recognized classic masterpiece and a guide to the clinical practice of traditional Chinese medicine (TCM). However, due to the continuous development of medicine and the summary of clinical data, we find that some of them are too omitted in the aspect of classification.

For example, the "underheart ruffian" of the five Xiexin decoction is mainly painless, but clinically, there are both painful and non-painful cases. It's true. You don't have to make a fuss.

In addition, the heart ruffian, but also can appear under the heart bulging a bag, shaped like chicken eggs too small, press it will disappear, lift hands will rise with it. This bag fluctuates and fluctuates, and there is nothing in it, but the condensation or dissipation of gas. Therefore, it is also called "underheart ruffian", and can not be called other disease names. About this special heart ruffian syndrome, also failed to write in the book.

I think it is a feasible way to verify the theory through clinical practice. To this end, I would like to raise two controversial issues in the Treatise on febrile Diseases for discussion:

One is whether the essence of the six meridians is related to meridians and collaterals, the other is Guizhi to Gui Jia Fuling Atractylodes macrocephala decoction, is to go to Gui or to Paeonia lactiflora.

These two issues have always been at loggerheads and there is no agreement between them. Most of the reasons are discussed theoretically, but few people explain it in clinical practice. Therefore, we should combine theory and practice to discuss in order to solve the problem.

(1) whether acupoint meridians are related to meridians and collaterals

One year, I visited a farmer's home in Beipo at Tianjin Hannian Farm. It happened that a 15-year-old boy had a fever and headache. Try its body temperature 39.6C, cut its pulse floating, tongue coating is thin and white and moist. Is to tell his father: your child is suffering from wind and cold external feeling, take a perspiration medicine will be all right. His father said that there was no medicine in the village and that traditional Chinese medicine had to go to the general field. Only in the afternoon, and the traffic is inconvenient, only tomorrow.

He added, "Why don't you use acupuncture and moxibustion, and why do you need drugs?" He didn't know that I was not good at acupuncture, so he took care of it to comfort his heart. As a result, for acupuncture Dazhui, Fengchi, Fengfu and other points, but did not expect the energy effect, but it is surprising that the child also came from sweat after acupuncture, hot and cold and recovered from illness.

I was not an acupuncture doctor, because when I went to the countryside, there was a set of medical needles in the consultation box, which I thought I needed occasionally. As for my formula, the acupoint selection is carried out in accordance with the spirit of "first piercing wind pool, wind house" and "Dazhui first room" in the Treatise on febrile Diseases. Through the fact of acupuncture and moxibustion sweating table, it tells me how close the relationship between the sun and meridians and collaterals is!

Revisit the foot of the sun bladder meridians under the brain, in the waist ridge and "the sun, three yang also, its pulse Lianfeng Fu, so for the main qi of Zhuyang" is how pertinent it is to say.

The method of selecting acupoints along the meridians, the meridians are in the front and the acupoints are behind, so there must be the existence of meridians and collaterals. The key to the main surface of the sun is that its meridians and collaterals are behind it and connected to the Fengfu, so it is the main qi of the internal organs. According to this inference, the bladder is connected by the government and the bladder is the Shuifu, where the body liquid is hidden and vaporized, so there is a "trijiao bladder, the striae should not be hair", Qi and Jin are all carried out in the surface of the statement.

Thus it can be seen that the "sun" is actually a summary of the bladder and meridians, not an empty name. This is the traditional theory of traditional Chinese medicine. Otherwise, it runs counter to the theory of traditional Chinese medicine, which is not taken by traditional Chinese medicine.

(2) the dispute over Guizhi going to Guizhi and adding Poria Ling Baizhu decoction to Guizhi

In Article 28 of Treatise on febrile Diseases, Guizhi goes to Gui Jia Fuling Atractylodes macrocephala decoction, and "Medical Zong Jin Jian" thinks that going to Gui is the mistake of removing Paeonia lactiflora. Since then, there have been a lot of people in accordance with its commentators, forming the two views of removing cinnamon and peony, and entangled with each other. I would like to confirm that Guizhi plus Fuling Atractylodes macrocephala decoction is correct through the following two cases, so that this issue can be clarified.

1. Chen Xiuyuan was in charge of the illness of Mr. Xie Zhitian, who was in charge of the official Department during the Wuchen period of Qingjia Celebration. The symptoms are strong head pain, physical discomfort, and a full heart. If you ask him to pee, he says it's bad. I have taken antipyretic drugs, but do not sweat, but increase the fever. Cut the number of pulse floods.

Chen suspected that this syndrome is quite similar to the sun and Yangming meridians. However, thinking for a long time, then suddenly realized, before knowing this disease in the sun invisible gas, now in the sun visible water. Cure, but make the visible sun urinate a benefit, make the water evil go and reach the qi, then the foreign syndrome self-solution, and all the syndromes can also be cured. Is to use Guizhi to Gui add Fuling Atractylodes macrocephala decoction, take a dose and cure.

2. Chen Shenwu, the late old traditional Chinese medicine in our school, had treated a patient with low fever before he died, and had been treated by others in many ways, but the final effect was fresh. Cut its pulse string, look at its tongue water, ask its urination is said to be disadvantageous.

Chen Lao distinguishes this syndrome as the syndrome of internal storage of water evil, external depression of yang qi and inability to declare heat, which is basically the same significance as the 28 articles of Treatise on febrile Diseases. Is Shu Guizhi to Gui add Poria Ling Atractylodes macrocephala decoction, three doses of urine smooth benefit, fever will heal with it.

Through these two examples, it can be fully confirmed that the six meridians are related to the meridians and collaterals and viscera, and there is no mistake in Guizhi to Guizhi plus Fuling Baizhu decoction.

A brief talk on how to learn the Theory of febrile Diseases

To study Treatise on febrile Diseases, we should lay a good foundation first, including learning the thought and method of yin and yang syndrome differentiation in Neijing, as well as the physiological and pathological knowledge of Zang-fu meridians and collaterals. At the same time, learn to eat "the key to Jin Jian typhoid heart method" and Chen Xiuyuan's "Changsha side song", and should recite it like a stream and remember not to forget it. This is only the first step.

On this basis, look at the white language (refers to the original text without comments). The original text of Treatise on febrile Diseases is written in the form of articles. According to Zhao Kaimei, there are 398 articles in Song Ben's Treatise on febrile Diseases. Since "Treatise on febrile Diseases" has used articles to express the ideological method of syndrome differentiation, it is necessary to understand the meaning of the relationship between articles and articles as the basic requirement to study "Treatise on febrile Diseases".

It should be noted that Article 398 of the Treatise on febrile Diseases is a complete organism, and between the articles, whether obvious or implicit, or before or after, there is an organic connection between them. In the way of writing, the author has fully dumped the grammar and layout of virtual reality, implicit vomiting, mutual understanding of evidence, false loan between the subject and the guest, so as to express the method of syndrome differentiation and treatment.

Thus it can be seen that in order to learn the Treatise on febrile Diseases, we must first understand the significance of the arrangement and combination of articles and articles, see the spirit of the layout of the articles in each content, realize what is other than the articles from the articles, and resonate with the thoughts of the author; only in this way can we realize the true meaning of the book.

Bai Wen looks at it at least four or five times, and it is useful to memorize the outline of the six scriptures and the indications of 113 parties. At this stage, may feel boring, that does not matter, as long as the firm down is victory, this is the second step.

On the basis of reading the white language, you can read the note. There are no fewer than hundreds of commentators in Treatise on febrile Diseases. Which one is better to see? It's not the same in terms of acquaintance. I thought it would be better to think of it as a "note on febrile fever". Because the advantage of the note is that it is academically impartial, and the theory of classics is the most detailed, and the reasoning is more relevant.

Cheng also wrote "typhoid fever theory" and "Fang Xie" two kinds of books, with the "captive Treatise on febrile Diseases"), indispensable. Therefore, before they are regarded as notes, these two kinds of works should also take a serious look at them in order to have some understanding of the 50 symptoms selected and written by them, in order to strengthen the method and application of syndrome differentiation and treatment.

After reading Cheng's three books, we can take a look at Xu Dazhun's "Treatise on febrile Diseases", Ke Yunbo's "Typhoid to Su Ji" and you Zaijing's "Typhoid Tuanzhu Collection". The above three note families, in the study of febrile fever, the influence is very deep. Their notes, or classified by square, or classified by evidence, or classified by law, different angles, and the same way, can open up ideas, actually have the function of breaking the mystery and solving the confusion.?

The advantages of Ke note, in principle, he pointed out that the "Treatise on febrile Diseases" is not specifically for typhoid fever, and six have been confirmed to be able to control all diseases. His words are insightful and resonate with Zhong Jing's thoughts. His shortcomings, mistakenly understood meridians as meridians, but also the "febrile theory" of the solar bladder meridians as the heart-yang theory, it is far-fetched, there is a loss of the purpose of Zhongjing.

The boldness of the note seems to be inferior to that of Ke, and it is not as bold as Kirschner's pen and ink in terms of writing. However, Mr. you de Ma Yuanyi's true biography, incisive conception, simple and concise, to the Zang-fu meridians and collaterals, qi and blood Rongwei reason and the opportunity of change in good and evil, on the "inside", "difficult", the next hundred schools, but the most obvious kung fu. He is more solid than Kirschner, cherishing the ignorance of people.

In addition, Fang Youzhu's "Treatise on febrile Diseases" and Qian Juan's "traceability of typhoid fever" are all well-known works and can also be covered. After reading the above monographs, we can read a little more comprehensive works, among which we should take the Japanese Dan Bo Yuan Jane's "Treatise on febrile Diseases" as the ideal. This is the third step.

Through the above three steps, and can adhere to the end, it can be said that the classic book "Treatise on febrile Diseases" can be said to have learned more or less.

I have been talking about Treatise on febrile Diseases for more than 20 years, but now I have prepared lessons, there are still things I can learn, and I can find my mistakes in cognition. I can see that the depth and breadth of this book are difficult to measure. For this reason, for those who read this book, they must not dabble in it, nor should they get something, so they will be complacent and stop.

Sum up what I said above: that is, to learn traditional Chinese medicine, first of all, start with the study of classics, do not be afraid of difficulties, to have a little spirit; second, for the original text of traditional Chinese medicine and soup, medicine and singing formula, we should not only understand its meaning, but also memorize its text. There is no time to speak without reciting a little book. Third, to change passive learning into active learning and liberate from passive learning, self-study is not an expedient measure, but a lifelong practice; fourth, it is necessary to establish a good style of study that combines learning with practice and applies to learning; this is even more important to traditional Chinese medicine.

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