又如患者郑××系一偏僻山区农妇。一月前发现腹满胀痛,上腹有一肿物如手掌大,纳呆食减,身体日瘦。凑集钱物来并治疗。经某院检查确诊为肝癌。要求其住院治疗,然因其无力支付任何费用,不得不转请余开具中药处方试治。二年七个月后,其夫又携其来门诊治疗。云:“服药两年,药进300余剂,症状全失,乃停药观察近7个月,近又感腹满纳呆,恐为反复,请再开方。”余问:“两年之内可曾服用其他任何药物?”答曰:“因家贫无力诊病,非但未用任何西药,即如中药亦未连续应用耳。”再询其与其同来的几个肝癌患者尚在否?答曰:“他们几个的家庭条件均较好,在你开具中药后均住人某院,且都于三个月左右故去了。”余思之:“条件好的死了,条件差的活着,为什么呢?”再察门诊久治的几个膀胱癌、肺癌、前列腺癌、皮肤癌患者,大都经济条件较差,且紧紧抱着中药不放,而其他条件优越者,均已早离人世。其故何也?中、西药合用不对乎?条件优越即早逝乎?恐非也。于是我在临床中进行了更大面积的观察。
在与一些医者、药者,甚至是政策的决定者的交谈中,经常遇见一些人谈起如何才能科技兴国和如何才能利用我们自己的优势发展的问题。有人认为中医中药是我们的国宝,应该利用,应该发展。也有人认为中医中药虽是我国医药卫生界存在的客观现象,但它却没有什么优势可言,譬如中医、中药的科研成果和新药发展虽然很多,但很少有站得住脚的,很少有推广开的。还有人说我省自成立药品评审委员会以来,通过的准字号、健字号新药不下数十种,可是真正站住了脚,并取得巨大社会经济效益的却仅有几个品种,而你发明的几个品种都稳稳地站住了脚跟,并且日益扩大,这又是为什么呢?我说:“这个问题很复杂,很难用几句话说清楚,但有一点我认为是很重要的。即当前我们中医的几乎所有科研成果,新药研制的临床基础几乎是一样的。也就是说都是在既用大量西药,又用大量中药的基础上完成的。而且西药、中药的种类常常不够固定。及至研究成功以后,又不说明附加条件,所以推广应用寸,一旦患者、医者单独应用此法、此药,或配合其他药物治疗疾病时常常无效或获得不到研究者所取得的效果。至于我所发明的新药宝宝一贴灵、肾康灵胶囊为什么能取得较大的社会经济效益,这里面的一个重要问题是绝对地遵守了科学研究的规则,绝对地遵守了中医理论的严肃性。我记得在50年前家父与家兄的一次谈话中,家父谈到他通过20多年研究发现应用贴脐法治疗小儿秋委腹泻的问题,家父认为这种方法对秋季腹泻有卓越的疗效,家兄认为效果不好,当时我根本不明白这是为什么?其后数天家兄突然告诉家父说你说得完全对。事后我问家兄这到底是怎么回事。他说:“以前我说不效的病例都用着别的药,今天我说有效的病例是仅用着这一种贴脐膏。”这事虽小,但却对我的临床、科研的作风产生了极其重要的影响。例如:我在临床处方上绝对不随便加减一味药,绝对不随便增减每味药的一点用量,绝对不随便改变服药的时间与节律,绝对不随便嘱咐病人改变一点生活习惯,绝对不随便让患者应用任何治疗性或非治疗性的西药与中药成药,即使人们认为的具有较好疗效的药物。如果加用必须进行严格的、认真的观察,找出它们之间终究是有协同,还是拮抗作用。至于肾康灵胶囊为什么会研制成功,其重要问题是我注意了这一点。
《神农本草经》说:“药有君臣佐使,以相宣摄……药有阴阳配合,子女兄弟。”又说:“有单行者,有相须者,有相使者,有相畏者,有相恶者,有相反者,有相杀者。凡此七情,合和视之。当用相须相使者良,勿用相恶相反者。若有毒宜制,可用相畏相杀者;不尔,勿合用也。”中药与中药之间配伍应用尚有七情合和之利与害,中、西药之间合和岂能无有,今之临床研究成果与新药发明之所以不能推广者,恐亦在斯耳。
中医研究中的思路与方法
最近一些年来,一些中医界的同道问我:“你是通过什么办法提出自己的独特观点,写出著作,并连续创造出能够经受住临床检验的新药的?”经过考虑,其经验大致有以下几点。恰妥与否,请大家研究。
我们是中医药研究院,也就是名符其实的中医研究机构。中医研究机构,顾名思义,一是搞中医的,二是搞研究的。所谓研究,《联绵字典》称为“研臃穷究也。”《辞源》称之为穷究事理。”《辞海》称之为“用严密的方法,探求事理,冀获得一正确结果者,谓之研究。”我对这一句话的理解有两种涵义。其一是探求,追求。其二是发现新的正确的事理和结果。我们搞研究的,就得随时随地考虑我们的任务是研究,是穷究事理者,是用严密的方法探求事理并获得正确结果者,而绝不是应声虫,人云亦云者。我们是搞中医研究的,我们就应随时随地考虑我们的任务是中医研究,是穷究中医事理的,是用严密的方法探求并获得中医的正确结果的,而绝不是已知理沦的简单的应声虫,人云亦云者。
宇宙是无限的、连续的,我们的认识是有限的、破碎的,因此才需要我们不断地有所发现,有所发明,有所创造,有所前进。我们是搞研究工作的,是搞有所发现,有所发明,有所创造的,因此我们必须不是守旧的。
有人说过去的就是落后的,就是不科学的,现在的就是先进的,科学的。这句话看起来很有道理,实际并不如此。因为:①它单纯依靠的是时间标准,而不是以实践作为检验真理的唯一标准。②它单纯依靠的是时间标准,而否定了科学发展道路上的螺旋式上升的事实。③它单纯依靠的是时间标准,而否定了世界地区科学发展不平衡和多源性的事实。
中国医药学是博大精深,蕴含丰富的一门科学。中国医药学是在吸收古代哲学、古代天文学、古代数学、古代植物学的成果的基础上建立起来,并在不断地吸收东方文化的最新成就的基础上发展起来的,因此它处处时时包括着东方文化的成就。近百年来,随着西方科学、西方医学的传人,西方文化的思路和方法经常不断地与东方文化的思路和方法发生着碰撞,并同时与由东方文化为基础发展起来的中国医药学发生着矛盾,甚至提出如何对待中医,研究中医的问题。在这方面最具代表性的人物是民国年间的余云岫氏,他主张完全按照西医的模式研究中医,认为凡是不符合当时西医水平的中医理论,中医方法,都是谬误的,应当废除。可是他们忘记了西医在一定的时间内的发展是有限的,是不完全的,不是完美无缺的这一客观事实,近些年来,一些科学工作者鉴于应用西医的模式研究中医的不断碰壁,纷纷提出了应用多学科研究中医的问题,认为中医的那些理论与现代科学中的控制论、系统论相同,甚至有的提出中医早就有了控制论、系统沦。这种研究方法固然可以解释中医理论中的与现代科学相同的问题,但是由于现代科学中某些理论的局限性,又常常使我们否定实质是科学的中医内容,甚至将中医引入歧途。部分医家鉴于以上两种研究方法的缺点,纷纷提出按照传统的方法研究中医的意见,认为按照中医理论和临床相结合的方法是最好的研究方法。这种方法虽有很多优点,但在中医如何走向世界上有很多不合拍的地方。因此我认为还是采用更加切实可行的办法为好。那么到底以什么方法为好呢?我认为:
必须树立实践是检验真理的唯一标准的观点,采用理论—>实践—>理论—>实践的循环往复方法,提出新的理论与方法才是最好的方法。
数千年的科学发展史证明:任何新的理论,新的方法的提出都是从无到有的。无就是原来没有,没有怎么相同于有呢?所以我认为我们的研究工作最好不要在中医理论与临床实践和什么什么相同上下功夫,当然我们在具体研究上并不排斥借鉴;科学的任何方法和思路,正如我们中医学的发展中不断地借助于任何科学的成就,马克思借助于费尔巴哈与黑格尔一样,但是我们绝不可囿于任何理论而不能自拔。
那么我们应该采用哪些具体方法去研究呢?我认为:
1.首先的方法是我们对我们的每一个具体实践都归于有目的实践。在这方面我们一定要严格地要求自己,绝不可随心所欲地开一个方,一个药,一个用量,一个比例关系,一个用药剂型,一个用药方法,遇有复诊时,我们绝不可改变一个法,一个方,或加一个药,或减一个药,或加一个药的用量,或减一个药的用量。有人说,遇有危重病不用西药能行?不用西药保驾能行?我认为这句话不值一驳。因为西药、西医的办法既已达到了顶峰,那再研究有什么用呢?如果承认西医方法没有达到顶峰,不是绝对地有把握,那怎么谈得上保驾呢?我们是搞研究的,是创造较好的新方法、新理论的,同时我们是搞中医的,是创造中医新方法,新理论的,所以我们必须考虑我们每处理一个问题时,必须考虑我们想尽了方法没有,然后再考虑我们研究了没有。
2.必须随时随地地注意发现一切可注意的苗头。在这里尤其要善于抓住与常法不同的理论、方法,而又在事实上证明有效的理论与方法不放。在注意抓苗头的时候,切忌要避免成见,避免凡是不符合某些名家观点的意见都是错误的任何想法,切忌随便扣迷信的、非科学的帽子,一切都要以实践是检验真理的唯一标准去衡量。
3.要随时随地注意对苗头的追根究底。苗头是不是苗头,苗头能不能成为枝繁叶茂的参天大树,这是只看到苗头所不够的,历史上的很多科学家、发明家的例子说明,很多发现苗头的人并没有成为科学家,发明家,而承认这是苗头,并追根究底的人才成为了科学家,发明家。所以我们研究中医的就是善于追根究底,找出苗头问题的机制,并使其形成成果。
4.要随时随地慎重对待追根究底过程中的每一个失败。俗语说:失败是成功之母。我认为这句话是对成功者而言的,不是对失败者而言的。因为成功者通过锲而不舍的努力在一定阶段,一定时间内,虽然失败了,但他会通过对失败的不断地总结、归纳,找出每个环节、每个阶段所以成功和失败的原因,把他作为前进的动力,并成为成功的催化剂。而失败者则不然,他们往往把苗头看得很大,甚至把苗头看成胜利的成果,当遇到实际困难时,或者立刻产生急躁情绪,或者垂头丧气,一蹶不振,这种情绪是我们研究者的大敌,尤其应该克月艮。
5.善于吸收各种学科合理的内核创造新的理论,发明新的有效方法。我们的先人吸收了古代科学合理的内核创造并发展了中国医学系统的,完整的中医药理论和方法,马克思吸收了黑格尔,费尔巴哈哲学的合理内核,创造了马克思主义学说,列宁吸收了马克思主义合理的内核,创造了列宁主义学说,毛主席吸收了马克思、列宁主义的合理内核创造了毛泽东思想,邓小平吸收了毛泽东思想的合理内核创造了邓小平理论。在创造新的理论的时候,我们一定要善于吸收古今中外一切成就的合理内核,善于吸收群众一切合乎实践是检验真理的成绩,并要随时随地注意将各科理论,各种实践引发出的灵感给予记载、归纳,并上升为理论,只有这样才能创造出新的理论,发明出新的方法来。
药物应用中的时间与节律
又如患者郑某某,是一位偏远山区的农妇。一个月前发现腹部胀满疼痛,上腹部有一个如手掌大小的肿块,食欲不振,身体日渐消瘦。她凑集钱物前来求医。经某医院检查确诊为肝癌。医生建议住院治疗,但因她无力支付任何费用,不得不转请我开具中药处方尝试治疗。两年七个月后,她的丈夫又带她来门诊复诊。她说:“服药两年,共服用300多剂药,症状完全消失,于是停药观察近7个月,最近又感到腹胀、食欲不振,担心病情反复,请再开方。”我问:“这两年内是否服用过其他任何药物?”她回答:“因为家里贫穷无力看病,不仅没用过任何西药,就连中药也没有连续使用。”我又询问与她同来的几位肝癌患者是否还在?她回答:“他们几个家庭条件较好,在我开具中药后都住进了某医院,且都在三个月左右去世了。”我心想:“条件好的死了,条件差的活着,为什么呢?”再观察门诊中久治不愈的几个膀胱癌、肺癌、前列腺癌、皮肤癌患者,大多经济条件较差,且紧紧抱着中药不放,而其他条件优越者,均已早逝。这是什么原因呢?中西药合用不对吗?条件优越就早逝吗?恐怕不是这样。于是我在临床中进行了更大范围的观察。
在与一些医者、药师,甚至是政策制定者的交谈中,经常听到一些人谈论如何才能科技兴国以及如何利用我们的优势发展的问题。有人认为中医中药是我们的国宝,应该利用,应该发展。也有人认为中医中药虽然是我国医药卫生界存在的客观现象,但它却没有什么优势可言,譬如中医、中药的科研成果和新药发展虽然很多,但很少有站得住脚的,很少有推广开的。还有人说我省自成立药品评审委员会以来,通过的准字号、健字号新药不下数十种,可是真正站住了脚,并取得巨大社会经济效益的却仅有几个品种,而你发明的几个品种都稳稳地站住了脚跟,并且日益扩大,这又是为什么呢?我说:“这个问题很复杂,很难用几句话说清楚,但有一点我认为是很重要的。即当前我们中医的几乎所有科研成果,新药研制的临床基础几乎是一样的。也就是说都是在既用大量西药,又用大量中药的基础上完成的。而且西药、中药的种类常常不够固定。及至研究成功以后,又不说明附加条件,所以推广应用时,一旦患者、医者单独应用此法、此药,或配合其他药物治疗疾病时常常无效或获得不到研究者所取得的效果。至于我所发明的新药宝宝一贴灵、肾康灵胶囊为什么能取得较大的社会经济效益,这里面的一个重要问题是绝对地遵守了科学研究的规则,绝对地遵守了中医理论的严肃性。我记得在50年前家父与家兄的一次谈话中,家父谈到他通过20多年研究发现应用贴脐法治疗小儿秋季腹泻的问题,家父认为这种方法对秋季腹泻有卓越的疗效,家兄认为效果不好,当时我根本不明白这是为什么?其后数天家兄突然告诉家父说你说得完全对。事后我问家兄这到底是怎么回事。他说:‘以前我说不效的病例都用着别的药,今天我说有效的病例是仅用着这一种贴脐膏。’这事虽小,但却对我的临床、科研的作风产生了极其重要的影响。例如:我在临床处方上绝对不随便加减一味药,绝对不随便增减每味药的一点用量,绝对不随便改变服药的时间与节律,绝对不随便嘱咐病人改变一点生活习惯,绝对不随便让患者应用任何治疗性或非治疗性的西药与中药成药,即使人们认为的具有较好疗效的药物。如果加用必须进行严格的、认真的观察,找出它们之间终究是有协同,还是拮抗作用。至于肾康灵胶囊为什么会研制成功,其重要问题是我注意了这一点。
《神农本草经》说:‘药有君臣佐使,以相宣摄……药有阴阳配合,子女兄弟。’又说:‘有单行者,有相须者,有相使者,有相畏者,有相恶者,有相反者,有相杀者。凡此七情,合和视之。当用相须相使者良,勿用相恶相反者。若有毒宜制,可用相畏相杀者;不尔,勿合用也。’中药与中药之间配伍应用尚有七情合和之利与害,中西药之间合和岂能无有,今之临床研究成果与新药发明之所以不能推广者,恐亦在斯耳。
中医研究中的思路与方法
最近一些年来,一些中医界的同道问我:‘你是通过什么办法提出自己的独特观点,写出著作,并连续创造出能够经受住临床检验的新药的?’经过考虑,其经验大致有以下几点。恰妥与否,请大家研究。
我们是中医药研究院,也就是名副其实的中医研究机构。中医研究机构,顾名思义,一是搞中医的,二是搞研究的。所谓研究,《联绵字典》称为‘研臃穷究也。’《辞源》称之为穷究事理。’《辞海》称之为‘用严密的方法,探求事理,冀获得一正确结果者,谓之研究。’我对这一句话的理解有两种涵义。其一是探求,追求。其二是发现新的正确的事理和结果。我们搞研究的,就得随时随地考虑我们的任务是研究,是穷究事理者,是用严密的方法探求事理并获得正确结果者,而绝不是应声虫,人云亦云者。我们是搞中医研究的,我们就应随时随地考虑我们的任务是中医研究,是穷究中医事理的,是用严密的方法探求并获得中医的正确结果的,而绝不是已知理论的简单的应声虫,人云亦云者。
宇宙是无限的、连续的,我们的认识是有限的、破碎的,因此才需要我们不断地有所发现,有所发明,有所创造,有所前进。我们是搞研究工作的,是搞有所发现,有所发明,有所创造的,因此我们必须不是守旧的。
有人说过去的就是落后的,就是不科学的,现在的就是先进的,科学的。这句话看起来很有道理,实际并不如此。因为:①它单纯依靠的是时间标准,而不是以实践作为检验真理的唯一标准。②它单纯依靠的是时间标准,而否定了科学发展道路上的螺旋式上升的事实。③它单纯依靠的是时间标准,而否定了世界地区科学发展不平衡和多源性的事实。
中国医药学是博大精深,蕴含丰富的一门科学。中国医药学是在吸收古代哲学、古代天文学、古代数学、古代植物学的成果的基础上建立起来,并在不断地吸收东方文化的最新成就的基础上发展起来的,因此它处处时时包括着东方文化的成就。近百年来,随着西方科学、西方医学的传入,西方文化的思路和方法经常不断地与东方文化的思路和方法发生着碰撞,并同时与由东方文化为基础发展起来的中国医药学发生着矛盾,甚至提出如何对待中医,研究中医的问题。在这方面最具代表性的人物是民国年间的余云岫氏,他主张完全按照西医的模式研究中医,认为凡是不符合当时西医水平的中医理论,中医方法,都是谬误的,应当废除。可是他们忘记了西医在一定的时间内的发展是有限的,是不完全的,不是完美无缺的这一客观事实,近些年来,一些科学工作者鉴于应用西医的模式研究中医的不断碰壁,纷纷提出了应用多学科研究中医的问题,认为中医的那些理论与现代科学中的控制论、系统论相同,甚至有的提出中医早就有了控制论、系统论。这种研究方法固然可以解释中医理论中的与现代科学相同的问题,但是由于现代科学中某些理论的局限性,又常常使我们否定实质是科学的中医内容,甚至将中医引入歧途。部分医家鉴于以上两种研究方法的缺点,纷纷提出按照传统的方法研究中医的意见,认为按照中医理论和临床相结合的方法是最好的研究方法。这种方法虽有很多优点,但在中医如何走向世界上有很多不合拍的地方。因此我认为还是采用更加切实可行的办法为好。那么到底以什么方法为好呢?我认为:
必须树立实践是检验真理的唯一标准的观点,采用理论—>实践—>理论—>实践的循环往复方法,提出新的理论与方法才是最好的方法。
数千年的科学发展史证明:任何新的理论,新的方法的提出都是从无到有的。无就是原来没有,没有怎么相同于有呢?所以我认为我们的研究工作最好不要在中医理论与临床实践和什么什么相同上下功夫,当然我们在具体研究上并不排斥借鉴;科学的任何方法和思路,正如我们中医学的发展中不断地借助于任何科学的成就,马克思借助于费尔巴哈与黑格尔一样,但是我们绝不可囿于任何理论而不能自拔。
那么我们应该采用哪些具体方法去研究呢?我认为:
1.首先的方法是我们对我们的每一个具体实践都归于有目的实践。在这方面我们一定要严格地要求自己,绝不可随心所欲地开一个方,一个药,一个用量,一个比例关系,一个用药剂型,一个用药方法,遇有复诊时,我们绝不可改变一个法,一个方,或加一个药,或减一个药,或加一个药的用量,或减一个药的用量。有人说,遇有危重病不用西药能行?不用西药保驾能行?我认为这句话不值一驳。因为西药、西医的办法既已达到了顶峰,那再研究有什么用呢?如果承认西医方法没有达到顶峰,不是绝对地有把握,那怎么谈得上保驾呢?我们是搞研究的,是创造较好的新方法、新理论的,同时我们是搞中医的,是创造中医新方法,新理论的,所以我们必须考虑我们每处理一个问题时,必须考虑我们想尽了方法没有,然后再考虑我们研究了没有。
2.必须随时随地地注意发现一切可注意的苗头。在这里尤其要善于抓住与常法不同的理论、方法,而又在事实上证明有效的理论与方法不放。在注意抓苗头的时候,切忌要避免成见,避免凡是不符合某些名家观点的意见都是错误的任何想法,切忌随便扣迷信的、非科学的帽子,一切都要以实践是检验真理的唯一标准去衡量。
3.要随时随地注意对苗头的追根究底。苗头是不是苗头,苗头能不能成为枝繁叶茂的参天大树,这是只看到苗头所不够的,历史上的很多科学家、发明家的例子说明,很多发现苗头的人并没有成为科学家,发明家,而承认这是苗头,并追根究底的人才成为了科学家,发明家。所以我们研究中医的就是善于追根究底,找出苗头问题的机制,并使其形成成果。
4.要随时随地慎重对待追根究底过程中的每一个失败。俗语说:失败是成功之母。我认为这句话是对成功者而言的,不是对失败者而言的。因为成功者通过锲而不舍的努力在一定阶段,一定时间内,虽然失败了,但他会通过对失败的不断地总结、归纳,找出每个环节、每个阶段所以成功和失败的原因,把他作为前进的动力,并成为成功的催化剂。而失败者则不然,他们往往把苗头看得很大,甚至把苗头看成胜利的成果,当遇到实际困难时,或者立刻产生急躁情绪,或者垂头丧气,一蹶不振,这种情绪是我们研究者的大敌,尤其应该克服。
5.善于吸收各种学科合理的内核创造新的理论,发明新的有效方法。我们的先人吸收了古代科学合理的内核创造并发展了中国医学系统的,完整的中医药理论和方法,马克思吸收了黑格尔,费尔巴哈哲学的合理内核,创造了马克思主义学说,列宁吸收了马克思主义合理的内核,创造了列宁主义学说,毛主席吸收了马克思、列宁主义的合理内核创造了毛泽东思想,邓小平吸收了毛泽东思想的合理内核创造了邓小平理论。在创造新的理论的时候,我们一定要善于吸收古今中外一切成就的合理内核,善于吸收群众一切合乎实践是检验真理的成绩,并要随时随地注意将各科理论,各种实践引发出的灵感给予记载、归纳,并上升为理论,只有这样才能创造出新的理论,发明出新的方法来。
药物应用中的时间与节律
For example, the patient Zheng XX was a peasant woman from a remote mountainous area. One month prior, she discovered abdominal distension and pain, with a mass in the upper abdomen the size of a palm, poor appetite, reduced food intake, and progressive emaciation. She gathered funds and goods to seek treatment. Examination at a certain hospital confirmed a diagnosis of liver cancer (hepatic carcinoma). Hospitalization was recommended, but due to her inability to pay any fees, she was referred to me for an attempt at treatment with a traditional Chinese medicine (TCM) prescription. Two years and seven months later, her husband brought her back to the outpatient clinic. She stated: “I took medicine for two years, consuming over 300 doses. All symptoms disappeared completely, so I stopped medication and observed for nearly seven months. Recently, I have felt abdominal fullness and poor appetite again, fearing a relapse. Please prescribe again.” I asked: “Have you taken any other medications within these two years?” She replied: “Due to poverty, I could not afford medical care. Not only did I not use any Western medicines, but I also did not use TCM continuously.” I further inquired about several other liver cancer patients who came with her: “Are they still here?” She answered: “Their families had better economic conditions. After receiving my TCM prescription, they were admitted to a certain hospital, and all passed away within about three months.” I pondered: “Why did those with better conditions die, while the one with poorer conditions survived?” Observing several other patients in the outpatient clinic with long-term bladder cancer (bladder carcinoma), lung cancer (pulmonary carcinoma), prostate cancer (prostatic carcinoma), and skin cancer (cutaneous carcinoma), most had poor economic conditions and adhered strictly to TCM, whereas those with superior conditions had passed away early. What is the reason? Is it incorrect to combine TCM and Western medicine? Does having superior conditions lead to early death? Probably not. Thus, I conducted broader observations in clinical practice.
In conversations with some physicians, pharmacists, and even policy makers, I often encountered discussions on how to revitalize the nation through science and technology and how to leverage our own advantages for development. Some believe that TCM and Chinese materia medica are national treasures that should be utilized and developed. Others argue that although TCM and Chinese materia medica exist as objective phenomena in China’s medical and health sector, they lack significant advantages; for instance, although there are many research achievements and new drug developments in TCM, few are robust or widely promoted. Still others noted that since the establishment of the provincial Drug Review Committee, dozens of new drugs with approval numbers or health food numbers have been approved, yet only a few have truly established themselves and achieved significant social and economic benefits. However, the few varieties you invented have firmly established themselves and are expanding daily. Why is this? I said: “This issue is complex and difficult to explain briefly, but one point I consider crucial is that the clinical basis for almost all current TCM research achievements and new drug development is nearly identical. That is, they are completed on the foundation of using both large amounts of Western medicine and TCM. Moreover, the types of Western and TCM medicines are often not fixed. Upon successful research, additional conditions are not specified. Therefore, during promotion and application, when patients or physicians apply this method or drug alone, or in combination with other drugs for disease treatment, it is often ineffective or fails to achieve the results obtained by researchers. As for why the new drugs I invented, Baobao Yitie Ling (Baby Patch Spirit) and Shenkangling Capsules (Kidney Health Capsule), achieved significant social and economic benefits, an important factor here is the absolute adherence to scientific research rules and the strict observance of the seriousness of TCM theory. I remember a conversation between my father and my elder brother 50 years ago. My father mentioned that after over 20 years of research, he found that applying the umbilical patch method (navel sticking therapy) to treat infant autumn diarrhea (autumnal diarrhea in children) was effective. My father believed this method had excellent efficacy for autumn diarrhea, while my brother thought the effect was poor. At that time, I did not understand why. Several days later, my brother suddenly told my father that he was completely right. Later, I asked my brother what happened. He said: ‘Previously, the cases where I said it was ineffective involved patients using other medications. Today, the cases where I said it was effective involved patients using only this specific umbilical patch.’ Although this matter is small, it had a profound impact on my clinical and research style. For example: In my clinical prescriptions, I absolutely do not arbitrarily add or subtract a single herb, do not arbitrarily adjust the dosage of any herb, do not arbitrarily change the timing and rhythm of medication administration, do not arbitrarily advise patients to alter their lifestyle habits, and do not allow patients to use any therapeutic or non-therapeutic Western medicines or proprietary Chinese patent medicines, even those considered to have good efficacy by others. If additions are made, strict and careful observation is required to determine whether there is synergy or antagonism between them. The reason Shenkangling Capsules were successfully developed lies largely in my attention to this point.
The *Shennong Bencao Jing* (Divine Farmer's Materia Medica) states: “Medicines have sovereign, minister, assistant, and courier roles to mutually regulate... Medicines have yin-yang combinations, resembling father-son and brother relationships.” It further states: “There are single agents, there are mutual enhancement (xiangxu), there are mutual assistance (xiangshi), there are mutual fear (xiangwei), there are mutual aversion (xiangwu), there are mutual opposition (xiangfan), and there are mutual elimination (xiangsha). These seven interactions (seven emotions) must be viewed in combination. When using, prefer mutual enhancement and mutual assistance; avoid mutual aversion and mutual opposition. If toxicity needs to be controlled, mutual fear and mutual elimination can be used; otherwise, do not combine them.” There are advantages and disadvantages to the compatibility of the seven interactions among Chinese materia medica; how much more so would there be interactions between TCM and Western medicine? The reason why current clinical research achievements and new drug inventions cannot be widely promoted may well lie in this.
Ideas and Methods in TCM Research
In recent years, colleagues in the TCM field have asked me: “What methods do you use to propose your unique viewpoints, write books, and continuously create new drugs that withstand clinical verification?” After consideration, my experience can be summarized in the following points. Whether appropriate or not, please study them.
We are the Academy of Chinese Medical Sciences, a genuine TCM research institution. As the name implies, a TCM research institution does two things: it practices TCM and conducts research. Regarding research, the *Lianmian Zidian* defines it as “studying and exhausting the truth.” The *Ciyuan* defines it as “thoroughly investigating principles.” The *Cihai* defines it as “using rigorous methods to explore principles, hoping to obtain a correct result, which is called research.” I understand this definition to have two implications. First, exploration and pursuit. Second, discovering new, correct principles and results. Those engaged in research must constantly consider that our task is to research, to thoroughly investigate principles, to use rigorous methods to explore principles and obtain correct results, and certainly not to be mere echoers who parrot others. Since we conduct TCM research, we must constantly consider that our task is TCM research, to thoroughly investigate TCM principles, to use rigorous methods to explore and obtain correct TCM results, and certainly not to be simple echoers of known theories who parrot others.
The universe is infinite and continuous, while our understanding is limited and fragmented; therefore, we need to continuously discover, invent, create, and advance. We are engaged in research, in discovery, invention, and creation; thus, we must not be conservative.
Some say that the past is backward and unscientific, while the present is advanced and scientific. This statement seems reasonable but is actually not so. Because: ① It relies solely on time standards rather than using practice as the sole criterion for testing truth. ② It relies solely on time standards, denying the fact of spiral ascent in the path of scientific development. ③ It relies solely on time standards, denying the facts of uneven and multi-sourced scientific development across different regions of the world.
Chinese medicine is a profound and rich science. It was established on the basis of absorbing ancient philosophy, astronomy, mathematics, and botany, and has developed by continuously absorbing the latest achievements of Eastern culture; thus, it encompasses the achievements of Eastern culture everywhere and at all times. Over the past century, with the introduction of Western science and Western medicine, Western cultural ideas and methods have frequently collided with Eastern cultural ideas and methods, and simultaneously conflicted with Chinese medicine, which developed based on Eastern culture, raising questions about how to treat and research TCM. The most representative figure in this regard was Yu Yunxiu during the Republic of China era. He advocated researching TCM entirely according to the Western medicine model, believing that any TCM theory or method not conforming to the Western medicine standards of that time was erroneous and should be abolished. However, they forgot the objective fact that the development of Western medicine is limited, incomplete, and imperfect within certain timeframes. In recent years, some scientists, facing repeated failures in applying the Western medicine model to research TCM, have proposed applying multidisciplinary approaches to research TCM, arguing that TCM theories are similar to cybernetics and systems theory in modern science, with some even claiming that TCM possessed cybernetics and systems theory long ago. While this research method can indeed explain aspects of TCM theory that align with modern science, due to the limitations of certain modern scientific theories, it often leads us to deny TCM content that is essentially scientific, or even mislead TCM into error. Given the shortcomings of the above two research methods, some physicians have proposed researching TCM according to traditional methods, believing that combining TCM theory with clinical practice is the best research method. Although this method has many advantages, it has many mismatches regarding how TCM goes global. Therefore, I believe adopting a more practical approach is better. So, what is the best method? I believe:
We must establish the view that practice is the sole criterion for testing truth, adopt the cyclical method of Theory → Practice → Theory → Practice, and proposing new theories and methods is the best approach.
Thousands of years of scientific development history prove: Any new theory or method arises from nothingness. Nothingness means originally there was none; how can nothing equal something? Therefore, I believe our research work should best not focus on proving that TCM theory and clinical practice are identical to this or that. Of course, we do not exclude borrowing in specific research; scientific methods and ideas, just as the development of TCM constantly borrows from any scientific achievements, Marx borrowed from Feuerbach and Hegel, but we must never be confined by any theory without extricating ourselves.
So, what specific methods should we use for research? I believe:
1. The primary method is to attribute every specific practice to purposeful practice. In this regard, we must strictly demand of ourselves. We must never casually prescribe a formula, a herb, a dosage, a ratio, a dosage form, or a method of administration. When encountering follow-up visits, we must absolutely not change a method, a formula, add a herb, subtract a herb, increase a herb’s dosage, or decrease a herb’s dosage. Some ask: “Is it acceptable to not use Western medicine for critical illnesses? Is it acceptable to not use Western medicine for protection/support?” I believe this statement is not worth refuting. Because if Western medicine and Western medical methods have already reached their peak, what is the use of further research? If we admit that Western medical methods have not reached their peak and are not absolutely assured, how can we talk about protection/support? We are engaged in research, creating better new methods and new theories; simultaneously, we are engaged in TCM, creating new TCM methods and new theories. Therefore, we must consider whether we have exhausted all methods before handling each problem, and then consider whether we have researched it.
2. We must constantly pay attention to discovering all noteworthy signs/clues. Here, it is especially important to grasp theoretical and methodological approaches that differ from conventional methods but are proven effective in practice, and not let them go. When paying attention to grasping clues, one must avoid prejudices, avoid the idea that any opinion not conforming to certain famous experts’ views is wrong, and avoid casually labeling things as superstitious or unscientific. Everything must be measured by the criterion that practice is the sole test of truth.
3. We must constantly pursue the root causes of clues. Whether a clue is truly a clue, and whether a clue can grow into a towering tree with lush branches and leaves, seeing only the clue is insufficient. Examples from many historical scientists and inventors show that many people who discovered clues did not become scientists or inventors, whereas those who acknowledged them as clues and pursued their root causes became scientists and inventors. Therefore, those researching TCM must be good at pursuing root causes, finding the mechanisms of clue-related problems, and transforming them into achievements.
4. We must carefully treat every failure in the process of pursuing root causes. The proverb says: Failure is the mother of success. I believe this statement applies to successful people, not to failed ones. Because successful people, through persevering effort, although failing at certain stages or times, will constantly summarize and induce from failures, find the reasons for success and failure in each link and stage, use them as driving forces for progress, and become catalysts for success. Failed people are different; they often exaggerate the importance of clues, even viewing clues as victorious achievements. When encountering actual difficulties, they either immediately become impatient or become dejected and unable to recover. This emotion is the great enemy of researchers and must be overcome.
5. Be good at absorbing the rational core of various disciplines to create new theories and invent new effective methods. Our ancestors absorbed the rational core of ancient science to create and develop the systematic and complete TCM theory and method system. Marx absorbed the rational core of Hegel and Feuerbach’s philosophy to create Marxist theory. Lenin absorbed the rational core of Marxism to create Leninism. Chairman Mao absorbed the rational core of Marxism-Leninism to create Mao Zedong Thought. Deng Xiaoping absorbed the rational core of Mao Zedong Thought to create Deng Xiaoping Theory. When creating new theories, we must be good at absorbing the rational core of all achievements from past and present, domestic and foreign, and be good at absorbing all mass achievements that conform to the criterion that practice is the sole test of truth. We must constantly note, record, induce, and elevate inspirations triggered by theories from various subjects and various practices into theory. Only in this way can we create new theories and invent new methods.
Time and Rhythm in the Application of Medicines