炒川连18克，茯苓12克，橘红4．5克，制南星、郁金、石菖蒲各9克，磁石30克(先煎)，当归、勾藤各12克，白金丸4．5克(吞)，淮小麦30克，礞石滚痰丸9克(包煎)。
二诊：神倦嗜睡之象略见好转，便艰亦顺，然手足依然逆冷，而色晦暗，脉舌如前。筹思推敲，审证求因。恐由肾阳不振，阴箍弥漫，痰热内阻，瘀凝气结所致。治当标奉兼顾，故投温振肾阳，清化捩热、理气化瘀之剂
熟附子、桂枝各9克，炒茅术，茯苓各12克，制南星0克，制半夏12克，石莴蒲15克，陈皮6克，当归、桃仁各12克，川芎6克，全鹿丸9克(吞)，礞石滚痰丸12克(包煎)。
三诊：投温肾通阳化痰祛瘀之剂后，颇见应手，服药两天即自行起床，无烦躁狂乱诸症，且感神情爽朗，四肢转温，苔白腻减而转澜，舌暗转淡红，边紫，脉沉弦小。肾阳不振有恢复之机，痰热血瘀虽化末净。前方既效，毋庸更张，壮肾阳以治本，化痰瘀以治标，故前方去茅术、桃仁、川芎，加红花9克。
服药后症状消失，体力日见好转，前方略为出入，续服三十余剂，得以痊愈。
患者罹病多年，迭经各地中西医诊治，诊断尚不明确，有日「阀随病变」，有日「突发性睡眠症」等等。治疗或用养心安神镇潜之品，或予镇静药、兴奋药交替使用，皆不效，症情日益加剧。我于是症，则抓住嗜睡一症加以辨证，投温补、清化、祛瘀之剂，标本兼顾，攻补寒热同用，使肾阳得温补而浙振，痰热得泄化而渐清，多年痼疾终告痊愈。足见，对待疑难杂症，正如严苍山先生所云，方药不避其「杂乱」，但须杂中有法，乱中有序，这也是我得力于《千金》之处。
学无止境学无快捷方式
山东中医学院教授，中医基础敏研室主任张珍玉
【作者筒介】张珍玉(1920～)，山东平度人。幼承家学。青年时期悬壶于青岛。一九五六年调山东中医进修学校任教，一九五八年任教于山东中医学院。医理精深，长于内科杂病的治疗，对一些中医理论和临床问题常有独到的见解。编着和主编出版的主要著作有《病机十九条》、《谈脏腑辨证》、《内经摘要》、《中医基础学》等
先诵后解由浅入深
家父业医，悬壶青岛，诊务繁忙，活人无算。我幼承家训，耳濡目染，潜移默化，对中医略有了解，也逐渐爱好起来。父亲也希望我承袭家技，攻读歧黄，将来置身杏林。我十六岁时，父亲便让我一面上学，一面在业余时问和哥哥一起学习中医。首先学习浅显的内容，背诵《医学三字经》、《药性赋》、《濒潮脉学》、《(汤头歌诀》替。《索问·着至教论》提出知医应做到「诵」、「解」、「别」、「明」、「彰」，父亲也要求我们从背诵入手，先装进肚子里，再慢慢消化、吸收。起初父亲不给讲解，又没有通俗版本，全凭死记硬背，非常吃力。父亲家教甚严，过一阶段就考我们，提出其中的一句，我们必须熟练地往下背诵。我和哥哥互相督促，互相问答，睡觉前背，走路时背，上厕所也背。学识渐进，背诵也渐容易了。二，年间把《医学三字经》、《药性赋》濒湖脉学》、《汤头歌诀》都背过了。阻后开始攻读王冰次注「内经》、陈修园的《金匮要略浅注》、《伤寒论浅注》，也是先背诵。虽然都有注释，也不准看。说实在的，当时看了注释也不崔，又怕耽误时间。父亲经常教导我们学习没有快捷方式，必须扎扎实实地学，打好基础，多记多背，。熟能生巧，临证时才能得心应手，举一反三。我们背过《内经》的主要内容及《金匮》、《伤寒》的全部条文以后，父亲开始给我们讲解。星期天跟父亲看病时，他常结合病情，让我们背诵有关的经文。我们看到学过的理论知识在临床实践中得到了验证，有说不出的高兴，更加激发了学习的热情，坚定了信心。
以后我们开始涉猎历代医家的名著，由于有了一定的基础，记忆和理解都快多了，背诵了不少的佳句与名篇。
博采众长开阔眼界
经过一段学习以后，钻研深进去了，遇到不少疑难问题。例如，《内经》为什么还有「阴阳剐论」、「脏腑别论」、「经脉别说」呢?别说」指什么而言的呢?父亲诊务繁忙，除了晚上以外，抽不出更多的时间给我们讲解，强烈的求知欲望驱使我走出家门，拜访名医求教。我出访了当地的一些名医，提出问题，请他们解答，倾听他们的观点，吸取他们的长处。记得当时青岛云南路有位老中医叫谢文良，北京人，颇有盛名，就诊者盈门。我问他，经云「春夏养阳，秋冬养阴」应当怎样理解。他说：春夏温暖，阳气旺盛，阳生阴长，生机蓬勃，万物争荣，此时应当顺应自然之势，保护生发的阳气，秋冬寒凉，阳杀阴藏，阴气当令，万物收藏，此时应保护主令之阴气。
治病要考虑节令气候，勿伐天和。这对我启发很大。
一九五二年，青岛中医进修学校成立，给我们上课的是山东大学医学院的老师。课程安排得很紧，一年的时间，从西医基础课到诊断学、传染病学等均学了一遍。当时，旧社会歧视中医的影响还很深，学习结束时，不少人想改业西医，弃旧图新。有人劝我，你现在这么年青，为什么不改行千西医呢?我说，中医还没学好吶,中西医虽理论体系不同，但殊途同归，研究的对象是共同的，都是人。二者各有所长，亦各有所短，双方应互相学习而不能互相取代。随着医学科学的发展，中医工作者若不了解西医知识，自然会碰到不少困难。通过西医学习，使我掌握了不少现代的医疗知识，对临床和教学帮助很大，为研究中医提供了知识和借鉴，也更加坚定了我从事中医事业的信心。
由虚务实加深理解
背诵原著，学习理论是重要的，是基础。但理论必须与临床实践相结合，才能加深对理论的理解，也才能变成有用的活的理论。如《伤寒论》中「胃家实」一语，开始父亲引经据典，反复讲解，但理解还是不深。以后随父见习，见一位病人头痛，家父却投以大承气汤，遂问其理。父云：「病人便秘拒按，苔黄脉洪，是阳明实证。阳明之热邪上冲，干扰清窍，所以头痛。阳明经行于前，故病人头痛部位在前。用大承气汤以泻其实邪，邪去正复，头痛自然可愈。」至此才真正悟出「胃家实」之意。，更加认识到理论与实践相结合的重要性。
见习一段以后，就转入实习，在门诊看病。开始我诊过病人以后，向家父汇报病情，再说明理法方药，说对了，就让开方，否则不能开，父亲再给讲解。一次我诊断一个胃痫病人，开了柴胡疏肝汤。父亲问为什么开这个方，我说，病人饭前痛，喜按，暖气，乃胃虚肝气乘之，肝胃不和，治应疏肝和胃。父亲听后，点头称是。在处方中又加了几昧健胃的药。白天临床碰列疑难问题，晚上查书寻求理论解决，主要是看《景岳全书》，带着问题学，针对性强，理解深，记得也牢。正所谓：感觉的东西不一定理解它，只有理解了的东西，才能更好地感觉它。
父亲开了个小诊所，我在那里一方面诊病，另一方面还要兑药，亲手加工炮制药物。通过实践，我不仅能够较熟练地辨别常用药物，而且还学会了常用药物的加工炮制，会制常用的膏丹丸散。也更加深了对药物功效的认识。例如防风和前胡，是比较难区别的，通过实践也能准确而熟练地分辨了。
经过一段见习和实习，：当着老人的面诊病问题不大了。然从父亲「把关」，过渡到自己独立看病，也还是很不容易的。我第一次独立出诊，是一个冬天。在路上我就有些打怯。病人是位经理，八十多岁，看我年轻，有几分瞧不起。我当时一紧张，乱了阵脚，未问一句病情，即忙于切脉，好久也试不出什么脉，不知所措，虽值隆冬，已作汗颜。切完脉，我才问病人哪里不好，有什么感觉。我一问，病人不仅不答，反倒问我一句：「你摸了一阵子脉，不知道什么病吗?」弄得我张口结舌。病人看我实在难堪，就说一「我给你说说病情，回去问问你父亲，看看开个什么方。」他说主要症状是：咳嗽、吐痰、胸闷、喘息，遇冷就犯病，已有几十年了。我又切了脉，脉弦滑，属痰喘咳嗽，处方二陈汤加味。回家向父亲作了汇报。父亲说，是外邪诱发痰喘咳嗽，应有解表的药物，当该用小青龙汤加减。以后在实践中不断磨炼，临证就逐渐心中有数，遇事不慌了。
有一些病只有在经过临床实践以后，对经文才有深刻的认识。《金匿要略·百合狐惑阴阳毒病脉证并治》云：「病者脉数，无热微烦，默默但欲卧，汗出。初得之三、四日，目赤如鸠眼……」当时，我既没见过这样的病人，又没见到过鸠眼，怎么也想象不出什么样子。以后看到斑鸠，临床上又碰到病人，才体会到仲景将病人发红的眼睛喻为鸠跟，是非常生动形象的。
对方剂也是如此，初次运用往往是以成方按圈索骥，去套病人的症状。临床时间长了，也就能灵活化裁，运用自如了。如四物汤是补血的首方、要方，。其配合是非常巧妙的。大自然有春夏秋冬，万物有生长收藏，春夏为阳，主生长，秋冬为阴，司闭藏，阴静阳动，无动则无以静，无静亦无以动，动中有静，静中有动。四物汤中，川芎为春，当归为夏，二者主动，自芍属秋，熟地系冬，=者主静。动静配合，所养之血，是有生机的活血。明白这个道理，临床应用就胸中有数了。
分析对比抓住实质
不管是中药方剂，还是基础理论和临床各科，有一些内容很类似，容易记串，造成混淆，学习非常困难，我就采取分析对比的手法，抓住实质，通过鉴别、比较，从相同中找出不同，从不同中找出相同，掌握和运用就容易得多了。
学习中药，植物药的药用部分不同。功用也不同。近乎天者走于上。花叶向上生长，近乎天，质轻扬，属阳，功用主表主升；近乎地者行于下，根近乎地，质重，属阴，向下，主降主泻。这就是一般规律。但普遍中又有特殊，如诸花皆升，而旋复花独降。
就是同一味药，由于配伍不同，在不同的方剂中，作用也有所不同。如小柴胡汤、理中汤、自虎加人参汤都用人参，而其义不同：小柴胡汤中，人参扶正，使邪气不得复转入里，理中汤中人参补气健脾，振奋脾胃功能，白虎加人参汤中，人参补气生津，治津气两伤。我们现在用人参与古代又有不同，现在多用于气虚气弱的病证，而少用于气津两伤。
方剂中，仲景积术汤与东垣枫术丸，虽然都是由枳实、白朮构成，但功用不同。枳术汤治水饮停滞于胃，心下坚，大如盘，按之外坚而内虚。而枳术丸治睥胃运化无力，戗食停滞，腹胀痞满。乌梅丸的寒热并用与西心汤的寒热并用也是不同的。
呕吐是常见的症状，病机是胃失和降，气逆于上所致，内伤与外感邪气均可引起。外感中寒气、火热、湿浊等病邪都可引起本病。所以同是岖吐，其病因、治疗是不相同的。《伤寒论》中谈及呕吐者六十多条。举例说，小柴胡汤的「心烦喜呕」，是由于胆热犯胃，胃气上逆所致桂枝汤的「鼻鸣干呕」，是由于感受了风邪以后，致肺气不利，胃气上逆所致，大柴胡汤的「郁郁微烦，呕不止」，为邪在半表半里兼里气壅实；柴胡桂枝汤的「微呕」，即少阳主证喜呕之轻者}调胃承气汤的「心下温温欲吐，但欲呕」，是由于胃热郁结，黄连汤的「欲呕吐者」，是由于膈热，小青龙汤的「干呕」，是由于心下有水气，十枣汤的「千呕短气」，是由于水饮内蓄胸膈，吴莱萸汤的「食谷欲呕」，则是由于寒浊上攻。就小柴胡汤之呕来说，细分起来，又有不同类型。通过这样分析对比，对《伤寒论》所及的呕吐就比较清楚了。
在治疗方面，有时同一疾病，由于病人体质不同，或疾病的发展阶段不同，出现的症状亦不同，因而治疗也就不同，称为「同病异治」。另外，不同的疾病，由于病机相同，治疗可以采用同一法则，即「异病同治」。我们应当通过分析对比，从同中求异，从异中求同，找出规律，抓住实质，有的放矢地进行治疗。
脱发病是一种比较常见的病症。一般认为发为血之余，为肾之外荣。血虚不能滋养，血瘀不能运行，或肾精亏虚不能生发，皆可造成脱发。治疗多活血养血或滋肾填精，往往收效。但有时碰到脱发的病人用以上两法治疗无效。经过分析对比发现，这样的病人并不出现血虚血瘀或肾虚的症状，而出现神疲少气、声音低怯、自汗怕冷、面色眺白、舌质淡、脉虚弱等肺气虚的症状。《灵枢·经脉》说：「人始生，先成精，精成而脑髓生……皮肤坚而毛发长。」肺主皮毛，肺气不足，自然也可引起脱发。所以，大补肺气，可收到很好的疗效。
我曾治疗一无汗症，病人自出生后就未出过汗，年幼时尚无特殊感觉，长大后，每当劳动或活动剧烈时就面赤发热、心慌、烦躁。某医院诊断为无汗症。一般很容易认为，肺主皮毛，应该治肺，使其发汗。但仔细分析，病人并无肺病的症状，而面赤、身热、心慌、烦躁为心阴虚的表现。汗为心之液。我从滋补心阴为治，获得满意效果。
初诊：炒黄连18克，茯苓12克，橘红4.5克，制南星、郁金、石菖蒲各9克，磁石30克（先煎），当归、钩藤各12克，白金丸4.5克（吞服），淮小麦30克，礞石滚痰丸9克（包煎）。
二诊：神疲嗜睡的症状略有好转，大便困难也顺畅了，但手足依然逆冷，面色晦暗，脉象和舌象与之前相同。仔细思考推敲，审查证候以探求病因。恐怕是由于肾阳不振，阴寒之气弥漫，痰热内阻，瘀血凝滞、气机结聚所致。治疗应当标本兼顾，所以投用温振肾阳、清化痰热、理气化瘀的方剂。
熟附子、桂枝各9克，炒苍术、茯苓各12克，制南星9克，制半夏12克，石菖蒲15克，陈皮6克，当归、桃仁各12克，川芎6克，全鹿丸9克（吞服），礞石滚痰丸12克（包煎）。
三诊：服用温肾通阳、化痰祛瘀的方剂后，疗效显著，服药两天即自行起床，没有烦躁狂乱等症状，且感到神情爽朗，四肢转温，白腻苔减少而变得滑润，舌色由暗转为淡红，边缘有紫气，脉象沉弦小。肾阳不振有恢复的迹象，痰热血瘀虽然尚未完全清除。前方既然有效，无需更改，旨在壮补肾阳以治本，化痰祛瘀以治标，因此在前方的基础上去掉苍术、桃仁、川芎，加入红花9克。
服药后症状消失，体力日渐好转，前方略作加减，继续服用三十余剂，得以痊愈。
患者患病多年，经过各地中西医诊治，诊断尚不明确，有的说是“间歇性病变”，有的说是“突发性睡眠症”等。治疗或用养心安神镇潜的药物，或予镇静药、兴奋药交替使用，均无效，病情日益加重。我针对此症，抓住嗜睡这一主要症状进行辨证，投用温补、清化、祛瘀的方剂，标本兼顾，攻补寒热同用，使肾阳得到温补而逐渐振奋，痰热得到泄化而逐渐清除，多年的顽疾最终宣告痊愈。由此可见，对待疑难杂症，正如严苍山先生所说，方药不避其“杂乱”，但须杂中有法，乱中有序，这也是我得力于《千金方》之处。
学无止境，学习没有快捷方式
山东中医学院教授，中医基础教研室主任 张珍玉
【作者简介】张珍玉（1920～），山东平度人。幼年继承家学。青年时期在青岛行医。一九五六年调至山东中医进修学校任教，一九五八年任教于山东中医学院。医理精深，擅长内科杂病的治疗，对一些中医理论和临床问题常有独到的见解。编著和主编出版的主要著作有《病机十九条》、《谈脏腑辨证》、《内经摘要》、《中医基础学》等。
先诵后解，由浅入深
家父从事医学工作，在青岛行医，诊务繁忙，救治的人无数。我幼年接受家训，耳濡目染，潜移默化，对中医略有了解，也逐渐产生爱好。父亲也希望我继承家技，攻读岐黄之术，将来置身杏林（指医学界）。我十六岁时，父亲便让我一面上学，一面在业余时间和我哥哥一起学习中医。首先学习浅显的内容，背诵《医学三字经》、《药性赋》、《濒湖脉学》、《汤头歌诀》等。《素问·著至教论》提出知医应做到“诵”、“解”、“别”、“明”、“彰”，父亲也要求我们从背诵入手，先把知识装进肚子里，再慢慢消化、吸收。起初父亲不给讲解，又没有通俗版本，全凭死记硬背，非常吃力。父亲家教甚严，过一阶段就考我们，提出其中的一句，我们必须熟练地往下背诵。我和哥哥互相督促，互相问答，睡觉前背，走路时背，上厕所也背。学识渐进，背诵也渐容易了。两年间把《医学三字经》、《药性赋》、《濒湖脉学》、《汤头歌诀》都背过了。随后开始攻读王冰次注《内经》、陈修园的《金匮要略浅注》、《伤寒论浅注》，也是先背诵。虽然都有注释，也不准看。说实在的，当时看了注释也无益，又怕耽误时间。父亲经常教导我们学习没有快捷方式，必须扎扎实实地学，打好基础，多记多背，熟能生巧，临证时才能得心应手，举一反三。我们背过《内经》的主要内容及《金匮》、《伤寒》的全部条文以后，父亲开始给我们讲解。星期天跟父亲看病时，他常结合病情，让我们背诵有关的经文。我们看到学过的理论知识在临床实践中得到了验证，有说不出的高兴，更加激发了学习的热情，坚定了信心。
以后我们开始涉猎历代医家的名著，由于有了一定的基础，记忆和理解都快多了，背诵了不少的佳句与名篇。
博采众长，开阔眼界
经过一段学习以后，钻研深入进去了，遇到不少疑难问题。例如，《内经》为什么还有“阴阳别论”、“脏腑别论”、“经脉别说”呢？“别说”指什么而言的呢？父亲诊务繁忙，除了晚上以外，抽不出更多的时间给我们讲解，强烈的求知欲望驱使我走出家门，拜访名医求教。我出访了当地的一些名医，提出问题，请他们解答，倾听他们的观点，吸取他们的长处。记得当时青岛云南路有位老中医叫谢文良，北京人，颇有盛名，就诊者盈门。我问他，经云“春夏养阳，秋冬养阴”应当怎样理解。他说：春夏温暖，阳气旺盛，阳生阴长，生机蓬勃，万物争荣，此时应当顺应自然之势，保护生发的阳气；秋冬寒凉，阳杀阴藏，阴气当令，万物收藏，此时应保护主令之阴气。治病要考虑节令气候，勿伐天和。这对我启发很大。
一九五二年，青岛中医进修学校成立，给我们上课的是山东大学医学院的老师。课程安排得很紧，一年的时间，从西医基础课到诊断学、传染病学等均学了一遍。当时，旧社会歧视中医的影响还很深，学习结束时，不少人想改业西医，弃旧图新。有人劝我，你现在这么年轻，为什么不改行干西医呢？我说，中医还没学好呢。中西医虽理论体系不同，但殊途同归，研究的对象是共同的，都是人。二者各有所长，亦各有所短，双方应互相学习而不能互相取代。随着医学科学的发展，中医工作者若不了解西医知识，自然会碰到不少困难。通过西医学习，使我掌握了不少现代的医疗知识，对临床和教学帮助很大，为研究中医提供了知识和借鉴，也更加坚定了我从事中医事业的信心。
由虚务实，加深理解
背诵原著，学习理论是重要的，是基础。但理论必须与临床实践相结合，才能加深对理论的理解，也才能变成有用的活的理论。如《伤寒论》中“胃家实”一语，开始父亲引经据典，反复讲解，但理解还是不深。以后随父见习，见一位病人头痛，家父却投以大承气汤，遂问其理。父云：“病人便秘拒按，苔黄脉洪，是阳明实证。阳明之热邪上冲，干扰清窍，所以头痛。阳明经行于前，故病人头痛部位在前。用大承气汤以泻其实邪，邪去正复，头痛自然可愈。”至此才真正悟出“胃家实”之意，更加认识到理论与实践相结合的重要性。
见习一段以后，就转入实习，在门诊看病。开始我诊过病人以后，向家父汇报病情，再说明理法方药，说对了，就让开方，否则不能开，父亲再给讲解。一次我诊断一个胃痛病人，开了柴胡疏肝汤。父亲问为什么开这个方，我说，病人饭前痛，喜按，嗳气，乃胃虚肝气乘之，肝胃不和，治应疏肝和胃。父亲听后，点头称是。在处方中又加了几味健胃的药。白天临床碰到疑难问题，晚上查书寻求理论解决，主要是看《景岳全书》，带着问题学，针对性强，理解深，记得也牢。正所谓：感觉的东西不一定理解它，只有理解了的东西，才能更好地感觉它。
父亲开了个小诊所，我在那里一方面诊病，另一方面还要兑药，亲手加工炮制药物。通过实践，我不仅能够较熟练地辨别常用药物，而且还学会了常用药物的加工炮制，会制常用的膏丹丸散。也更加深了对药物功效的认识。例如防风和前胡，是比较难区别的，通过实践也能准确而熟练地分辨了。
经过一段见习和实习，当着老人的面诊病问题不大了。然而从父亲“把关”，过渡到自己独立看病，也还是很不容易的。我第一次独立出诊，是一个冬天。在路上我就有些打怯。病人是位经理，八十多岁，看我年轻，有几分瞧不起。我当时一紧张，乱了阵脚，未问一句病情，即忙于切脉，好久也试不出什么脉，不知所措，虽值隆冬，已作汗颜。切完脉，我才问病人哪里不好，有什么感觉。我一问，病人不仅不答，反倒问我一句：“你摸了一阵子脉，不知道什么病吗？”弄得我张口结舌。病人看我实在难堪，就说：“我给你说说病情，回去问问你父亲，看看开个什么方。”他说主要症状是：咳嗽、吐痰、胸闷、喘息，遇冷就犯病，已有几十年了。我又切了脉，脉弦滑，属痰喘咳嗽，处方二陈汤加味。回家向父亲作了汇报。父亲说，是外邪诱发痰喘咳嗽，应有解表的药物，当该用小青龙汤加减。以后在实践中不断磨炼，临证就逐渐心中有数，遇事不慌了。
有一些病只有在经过临床实践以后，对经文才有深刻的认识。《金匮要略·百合狐惑阴阳毒病脉证并治》云：“病者脉数，无热微烦，默默但欲卧，汗出。初得之三、四日，目赤如鸠眼……”当时，我既没见过这样的病人，又没见到过鸠眼，怎么也想象不出什么样子。以后看到斑鸠，临床上又碰到病人，才体会到仲景将病人发红的眼睛喻为鸠眼，是非常生动形象的。
对方剂也是如此，初次运用往往是以成方按图索骥，去套病人的症状。临床时间长了，也就能灵活化裁，运用自如了。如四物汤是补血的首方、要方，其配合是非常巧妙的。大自然有春夏秋冬，万物有生长收藏，春夏为阳，主生长，秋冬为阴，司闭藏，阴静阳动，无动则无以静，无静亦无以动，动中有静，静中有动。四物汤中，川芎为春，当归为夏，二者主动，白芍属秋，熟地系冬，二者主静。动静配合，所养之血，是有生机的活血。明白这个道理，临床应用就胸中有数了。
分析对比，抓住实质
不管是中药方剂，还是基础理论和临床各科，有一些内容很类似，容易记串，造成混淆，学习非常困难，我就采取分析对比的手法，抓住实质，通过鉴别、比较，从相同中找出不同，从不同中找出相同，掌握和运用就容易得多了。
学习中药，植物药的药用部分不同，功用也不同。近乎天者走于上。花叶向上生长，近乎天，质轻扬，属阳，功用主表主升；近乎地者行于下，根近乎地，质重，属阴，向下，主降主泻。这就是一般规律。但普遍中又有特殊，如诸花皆升，而旋覆花独降。
就是同一味药，由于配伍不同，在不同的方剂中，作用也有所不同。如小柴胡汤、理中汤、白虎加人参汤都用人参，而其义不同：小柴胡汤中，人参扶正，使邪气不得复转入里；理中汤中人参补气健脾，振奋脾胃功能；白虎加人参汤中，人参补气生津，治津气两伤。我们现在用人参与古代又有不同，现在多用于气虚气弱的病证，而少用于气津两伤。
方剂中，仲景枳术汤与东垣枳术丸，虽然都是由枳实、白术构成，但功用不同。枳术汤治水饮停滞于胃，心下坚，大如盘，按之外坚而内虚。而枳术丸治脾胃运化无力，食滞停滞，腹胀痞满。乌梅丸的寒热并用与泻心汤的寒热并用也是不同的。
呕吐是常见的症状，病机是胃失和降，气逆于上所致，内伤与外感邪气均可引起。外感中寒气、火热、湿浊等病邪都可引起本病。所以同是呕吐，其病因、治疗是不相同的。《伤寒论》中谈及呕吐者六十多条。举例说，小柴胡汤的“心烦喜呕”，是由于胆热犯胃，胃气上逆所致；桂枝汤的“鼻鸣干呕”，是由于感受了风邪以后，致肺气不利，胃气上逆所致；大柴胡汤的“郁郁微烦，呕不止”，为邪在半表半里兼里气壅实；柴胡桂枝汤的“微呕”，即少阳主证喜呕之轻者；调胃承气汤的“心下温温欲吐，但欲呕”，是由于胃热郁结；黄连汤的“欲呕吐者”，是由于膈热；小青龙汤的“干呕”，是由于心下有水气；十枣汤的“干呕短气”，是由于水饮内蓄胸膈；吴茱萸汤的“食谷欲呕”，则是由于寒浊上攻。就小柴胡汤之呕来说，细分起来，又有不同类型。通过这样分析对比，对《伤寒论》所及的呕吐就比较清楚了。
在治疗方面，有时同一疾病，由于病人体质不同，或疾病的发展阶段不同，出现的症状亦不同，因而治疗也就不同，称为“同病异治”。另外，不同的疾病，由于病机相同，治疗可以采用同一法则，即“异病同治”。我们应当通过分析对比，从同中求异，从异中求同，找出规律，抓住实质，有的放矢地进行治疗。
脱发病是一种比较常见的病症。一般认为发为血之余，为肾之外荣。血虚不能滋养，血瘀不能运行，或肾精亏虚不能生发，皆可造成脱发。治疗多活血养血或滋肾填精，往往收效。但有时碰到脱发的病人用以上两法治疗无效。经过分析对比发现，这样的病人并不出现血虚血瘀或肾虚的症状，而出现神疲少气、声音低怯、自汗怕冷、面色㿠白、舌质淡、脉虚弱等肺气虚的症状。《灵枢·经脉》说：“人始生，先成精，精成而脑髓生……皮肤坚而毛发长。”肺主皮毛，肺气不足，自然也可引起脱发。所以，大补肺气，可收到很好的疗效。
我曾治疗一无汗症，病人自出生后就未出过汗，年幼时尚无特殊感觉，长大后，每当劳动或活动剧烈时就面赤发热、心慌、烦躁。某医院诊断为无汗症。一般很容易认为，肺主皮毛，应该治肺，使其发汗。但仔细分析，病人并无肺病的症状，而面赤、身热、心慌、烦躁为心阴虚的表现。汗为心之液。我从滋补心阴为治，获得满意效果。
Initial Visit: Chao Huanglian (Fried Coptidis Rhizoma, *Coptidis Rhizoma*) 18g, Fuling (Poria, *Poria*), 12g, Juhong (Exocarpium Citri Reticulatae Viride, *Exocarpium Citri Reticulatae Viride*), 4.5g, Zhi Nanting (Prepared Arisaematis Cum Bile, *Arisaematis Cum Bile*), Yujin (Curcumae Radix, *Curcumae Radix*), Shichangpu (Acori Tatarinowii Rhizoma, *Acori Tatarinowii Rhizoma*) each 9g, Cishi (Magnetitum, *Magnetitum*) 30g (decocted first), Danggui (Angelicae Sinensis Radix, *Angelicae Sinensis Radix*), Gouteng (Uncariae Ramulus cum Uncis, *Uncariae Ramulus cum Uncis*) each 12g, Baijin Wan (Platinum Pill, *Baijin Wan*) 4.5g (swallowed), Huaixiaomai (Tritici Fructus, *Tritici Fructus*) 30g, Mengshi Guntan Wan (Magnesiae Sulfas Phlegm-Expelling Pill, *Mengshi Guntan Wan*) 9g (wrapped and decocted).
Second Visit: The symptoms of mental fatigue and excessive sleepiness have slightly improved, and bowel difficulty has also become smooth. However, the hands and feet remain cold, the complexion is dull, and the pulse and tongue presentation are as before. After careful consideration and analysis, examining the syndrome to seek the cause, it is feared that this is due to the failure of Kidney Yang to rise, the diffusion of Yin-cold, internal obstruction by Phlegm-Heat, and coagulation of Blood Stasis with Qi stagnation. Treatment should address both the branch (symptoms) and the root (cause); therefore, a formula warming and revitalizing Kidney Yang, clearing and transforming Phlegm-Heat, and regulating Qi while resolving Blood Stasis was administered.
Shu Fuzi (Prepared Aconiti Lateralis Radix, *Aconiti Lateralis Radix Praeparata*), Guizhi (Cinnamomi Ramulus, *Cinnamomi Ramulus*) each 9g, Chao Maoyu (Fried Atractylodis Rhizoma, *Atractylodis Rhizoma*), Fuling (Poria, *Poria*) each 12g, Zhi Nanting (Prepared Arisaematis Cum Bile, *Arisaematis Cum Bile*) 9g, Zhi Banxia (Prepared Pinelliae Rhizoma, *Pinelliae Rhizoma Praeparatum*) 12g, Shichangpu (Acori Tatarinowii Rhizoma, *Acori Tatarinowii Rhizoma*) 15g, Chenpi (Pericarpium Citri Reticulatae, *Pericarpium Citri Reticulatae*) 6g, Danggui (Angelicae Sinensis Radix, *Angelicae Sinensis Radix*), Taoren (Persicae Semen, *Persicae Semen*) each 12g, Chuanxiong (Ligustici Chuanxiong Rhizoma, *Ligustici Chuanxiong Rhizoma*) 6g, Quanlu Wan (Whole Deer Pill, *Quanlu Wan*) 9g (swallowed), Mengshi Guntan Wan (Magnesiae Sulfas Phlegm-Expelling Pill, *Mengshi Guntan Wan*) 12g (wrapped and decocted).
Third Visit: After administering the formula for warming the Kidney, unblocking Yang, resolving Phlegm, and dispelling Stasis, the response was quite effective. The patient got out of bed on their own after two days of medication, without symptoms such as irritability or madness, and felt mentally clear and refreshed. The limbs became warm, the white greasy tongue coating decreased and became slippery, the tongue color turned from dark to pale red with purple edges, and the pulse became deep, wiry, and small. There were signs of recovery in the failure of Kidney Yang, although Phlegm-Heat and Blood Stasis had not yet been completely cleared. Since the previous formula was effective, no changes were made to the core strategy; instead, the aim was to strengthen Kidney Yang to treat the root and resolve Phlegm-Stasis to treat the branch. Therefore, Maoyu (Atractylodis Rhizoma, *Atractylodis Rhizoma*), Taoren (Persicae Semen, *Persicae Semen*), and Chuanxiong (Ligustici Chuanxiong Rhizoma, *Ligustici Chuanxiong Rhizoma*) were removed from the previous formula, and Honghua (Carthami Flos, *Carthami Flos*) 9g was added.
After taking the medicine, the symptoms disappeared, and physical strength gradually improved. With slight modifications to the previous formula, continued administration for over thirty doses led to a complete cure.
The patient had suffered from the illness for many years and had undergone diagnosis and treatment by various Chinese and Western medicine practitioners, but the diagnosis remained unclear. Some called it "intermittent pathology," others "sudden onset sleep disorder," etc. Treatments included herbs for nourishing the Heart and calming the Spirit with sedative properties, or alternating use of sedatives and stimulants, all of which were ineffective, and the condition worsened daily. For this case, I focused on the symptom of hypersomnia for pattern differentiation, administering formulas for warming tonification, clearing transformation, and blood stasis removal, addressing both root and branch, combining attack and tonification, and cold and heat. This allowed the Kidney Yang to be warmed and gradually revitalized, and the Phlegm-Heat to be drained and transformed, eventually curing the chronic ailment. This demonstrates that in treating difficult and complicated diseases, as Mr. Yan Cangshan stated, one need not avoid "disorderly" prescriptions, provided there is method within the disorder and order within the chaos. This is where I derive benefit from the *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold).
(Compiled by Yan Shi Yun and Zhang Ju Sheng)
Learning has no limits; there are no shortcuts to learning.
Zhang Zhen Yu, Professor at Shandong College of Traditional Chinese Medicine, Director of the Department of Basic Theory of TCM.
[Author Introduction] Zhang Zhen Yu (1920–), from Pingdu, Shandong. Inherited family medical knowledge in childhood. Practiced medicine in Qingdao during his youth. Transferred to teach at Shandong TCM Advanced Training School in 1956, and taught at Shandong College of Traditional Chinese Medicine starting in 1958. Profound in medical theory, skilled in treating internal medicine miscellaneous diseases, often having unique insights into certain TCM theories and clinical issues. Main works compiled or edited include *Ji Bing Ji Shi Jiu Tiao* (Nineteen Pathogenesis Mechanisms), *Tan Zang Fu Bian Zheng* (On Zang-Fu Pattern Differentiation), *Nei Jing Jian Yi* (Summary of the Inner Canon), and *Zhong Yi Ji Chu Xue* (Basic Theory of TCM).
Recite first, then explain; proceed from shallow to deep.
My father practiced medicine, running a busy clinic in Qingdao, saving countless lives. I inherited family teachings in childhood, influenced by what I heard and saw, gradually developing an understanding and interest in TCM. Father hoped I would inherit our family skills, study the Yellow Emperor's Inner Canon and Classic of Difficult Issues, and enter the medical profession. At sixteen, he allowed me to attend school while studying TCM with my brother in my spare time. We started with simple content, memorizing *Yi Xue San Zi Jing* (Three Character Classic of Medicine), *Yao Xing Fu* (Ode to Properties of Medicinals), *Bin Hu Mai Xue* (Binhu’s Studies on Pulse Diagnosis), and *Tang Tou Ge Jue* (Song Formulas). *Su Wen: Zhuo Zhi Jiao Lun* (Plain Questions: Discussion on Zhuo Zhi Jiao) states that a physician should achieve "recitation," "understanding," "distinction," "clarity," and "manifestation." Father required us to start with recitation, filling our minds first, then digesting slowly. Initially, father did not explain, and there were no popular versions, so we relied on rote memorization, which was very arduous. Father’s discipline was strict; he tested us periodically, giving us a line to recite fluently. My brother and I supervised each other, quizzing each other, reciting before sleep, while walking, and even while using the toilet. As knowledge accumulated, recitation became easier. Within two years, we memorized *Yi Xue San Zi Jing*, *Yao Xing Fu*, *Bin Hu Mai Xue*, and *Tang Tou Ge Jue*. Subsequently, we began studying Wang Bing’s annotated *Nei Jing* (Inner Canon), Chen Xiuyuan’s *Jin Gui Yao Lue Qian Zhu* (Light Annotation on Essential Prescriptions of the Golden Cabinet), and *Shang Han Lun Qian Zhu* (Light Annotation on Treatise on Cold Damage), also starting with recitation. Although annotations existed, we were forbidden to look at them. Honestly, looking at annotations then was useless and feared to delay time. Father often taught us that learning has no shortcuts; one must study solidly, build a good foundation, memorize and recite much, and through proficiency, handle clinical situations adeptly and apply knowledge flexibly. After memorizing the main content of *Nei Jing* and all clauses of *Jin Gui* and *Shang Han*, father began explaining. On Sundays accompanying father to see patients, he often combined clinical conditions with relevant classics for us to recite. Seeing theoretical knowledge verified in clinical practice brought indescribable joy, further stimulating our enthusiasm and firming our confidence.
Later, we began exploring famous works of past physicians. With a certain foundation, memory and comprehension accelerated, and we memorized many excellent verses and masterpieces.
Gather strengths from diverse sources to broaden horizons.
After a period of study, as research deepened, many difficult problems arose. For example, why does *Nei Jing* still contain "Bie Lun on Yin and Yang," "Bie Lun on Zang and Fu," and "Bie Shuo on Meridians"? What does "Bie" refer to? Father was busy with clinic duties and could not find more time to explain except at night. Driven by a strong desire for knowledge, I left home to visit famous doctors for guidance. I visited local renowned physicians, posed questions, sought answers, listened to their views, and absorbed their strengths. I recall an old TCM doctor named Xie Wenliang on Yunnan Road in Qingdao, originally from Beijing, who was quite famous with a full waiting room. I asked him how to understand the classic saying "Nourish Yang in Spring and Summer, Nourish Yin in Autumn and Winter." He said: Spring and summer are warm, Yang Qi is abundant, Yang generates and Yin grows, vitality is vigorous, and all things flourish. At this time, one should conform to the trend of nature and protect the generating Yang Qi. Autumn and winter are cold, Yang kills and Yin stores, Yin Qi dominates, and all things store. At this time, one should protect the dominating Yin Qi. Treating disease must consider seasonal climate and not violate Heavenly Harmony. This inspired me greatly.
In 1952, Qingdao TCM Advanced Training School was established, and teachers from Shandong University Medical College gave lectures. The curriculum was tight; within one year, we covered Western medicine basic courses, diagnostics, infectious diseases, etc. At that time, the influence of discrimination against TCM in the old society was still deep. Upon completion of studies, many wanted to switch to Western medicine, abandoning the old for the new. Someone advised me, "You are so young, why not switch to Western medicine?" I replied, "I haven't learned TCM well yet." Although TCM and Western medicine have different theoretical systems, they arrive at the same goal through different paths; their research object is common—human beings. Each has its strengths and weaknesses; both should learn from each other rather than replace each other. With the development of medical science, if TCM workers do not understand Western medical knowledge, they will naturally encounter difficulties. Learning Western medicine enabled me to master modern medical knowledge, greatly helping clinical and teaching work, providing knowledge and reference for TCM research, and further firming my confidence in pursuing a career in TCM.
From emptiness to substance to deepen understanding.
Memorizing original texts and studying theory is important and foundational. But theory must be combined with clinical practice to deepen understanding of theory and turn it into useful, living theory. For instance, the phrase "Wei Jia Shi" (Stomach House Excess) in *Shang Han Lun* (Treatise on Cold Damage): initially, father cited classics and explained repeatedly, but my understanding remained shallow. Later, during clinical observation with my father, I saw a patient with headache, yet father prescribed Da Cheng Qi Tang (Major Order the Qi Decoction). I asked for the rationale. Father said: "The patient has constipation and refuses pressure, yellow tongue coating, and surging pulse, indicating Yangming Excess Syndrome. Heat pathogen of Yangming rushes upward, disturbing the clear orifices, causing headache. The Yangming meridian runs anteriorly, hence the headache is located anteriorly. Using Da Cheng Qi Tang to purge the excess pathogen, once the pathogen is gone, righteousness returns, and the headache naturally heals." Only then did I truly comprehend the meaning of "Wei Jia Shi," further realizing the importance of combining theory with practice.
After a period of observation, I moved to internship, seeing patients in the outpatient clinic. Initially, after diagnosing a patient, I reported the condition to my father, then explained the rationale, principles, formula, and herbs. If correct, I was allowed to prescribe; otherwise, I could not, and father would explain. Once, I diagnosed a patient with stomach pain and prescribed Chai Hu Shu Gan Tang (Bupleurum Powder to Soothe the Liver). Father asked why I chose this formula. I said, "The patient has preprandial pain, prefers pressure, and belching, indicating Stomach deficiency with Liver Qi invading, Liver-Stomach disharmony. Treatment should soothe the Liver and harmonize the Stomach." Father nodded in agreement and added a few stomach-strengthening herbs to the prescription. When encountering difficult problems clinically during the day, I consulted books at night for theoretical solutions, mainly reading *Jing Yue Quan Shu* (Complete Works of Jingyue), learning with specific questions, leading to strong relevance, deep understanding, and firm memory. As the saying goes: Sensory perception does not necessarily imply understanding; only understood things can be better perceived.
Father opened a small clinic, where I一方面 treated patients and另一方面 prepared medicines, personally processing and preparing drugs. Through practice, I not only became proficient in identifying common herbs but also learned their processing and preparation, mastering the making of common pastes, pills, powders, and electuaries. This deepened my understanding of drug efficacy. For example, Fangfeng (Saposhnikoviae Radix, *Saposhnikoviae Radix*) and Qianhu (Peucedani Radix, *Peucedani Radix*) are difficult to distinguish, but through practice, I could accurately and skillfully differentiate them.
After a period of observation and internship, diagnosing patients in front of elders was no longer a major issue. However, transitioning from father "checking" to independent practice was still not easy. My first independent consultation was in winter. On the way, I felt somewhat timid. The patient was a manager, over eighty years old, who looked down on me due to my youth. Nervous, I lost my composure, failed to ask about the condition, and busied myself with pulse taking, unable to discern the pulse for a long time, feeling ashamed despite the cold weather. After taking the pulse, I finally asked where the patient felt unwell. Upon my question, the patient not only didn't answer but retorted, "You've felt the pulse for a while, don't you know what disease it is?" Leaving me speechless. Seeing my embarrassment, the patient said, "Let me tell you the condition; go back and ask your father what prescription to open." He described the main symptoms: cough, expectoration, chest tightness, wheezing, triggered by cold, lasting for decades. I took the pulse again; it was wiry and slippery, indicating Phlegm-Wheezing Cough. I prescribed Er Chen Tang (Two-Cured Decoction) with modifications. Upon returning, I reported to my father. Father said, "This is Phlegm-Wheezing Cough induced by external pathogens; there should be exterior-resolving herbs. Xiao Qing Long Tang (Minor Green Dragon Decoction) with modifications should be used." Through continuous tempering in practice, I gradually gained confidence in clinical situations and remained calm when facing emergencies.
Some diseases only allow for profound understanding of classics after clinical practice. *Jin Gui Yao Lue: Bai He Huo Yin Yang Du Bing Mai Zheng Bing Zhi* (Golden Cabinet: Pulse, Symptoms, and Treatment of Lily Disease, Huo Disease, and Yin-Yang Toxic Disease) states: "The patient has a rapid pulse, no fever but slight irritability, silence but desire to lie down, sweating. In the first three or four days, eyes red like dove eyes..." At that time, I had neither seen such a patient nor a dove eye, so I couldn't imagine what it looked like. Later, seeing a turtledove and encountering such a patient clinically, I realized Zhongjing's metaphor of the patient's red eyes as "dove eyes" was very vivid and形象 (figurative).
The same applies to formulas. Initial application often involves mechanically applying fixed formulas to match patient symptoms. With long-term clinical experience, one can flexibly modify and apply them freely. For example, Si Wu Tang (Four Substance Decoction) is the primary and essential formula for tonifying Blood, and its combination is ingenious. Nature has spring, summer, autumn, and winter; all things have growth, flourishing, harvesting, and storing. Spring and summer are Yang, governing growth; autumn and winter are Yin, governing storage. Yin is static, Yang is dynamic; without movement, there is no stillness; without stillness, there is no movement. Movement contains stillness; stillness contains movement. In Si Wu Tang, Chuanxiong (Ligustici Chuanxiong Rhizoma, *Ligustici Chuanxiong Rhizoma*) corresponds to Spring, Danggui (Angelicae Sinensis Radix, *Angelicae Sinensis Radix*) to Summer; both are active. Baishao (Paeoniae Radix Alba, *Paeoniae Radix Alba*) corresponds to Autumn, Shudi (Rehmanniae Radix Preparata, *Rehmanniae Radix Preparata*) to Winter; both are static. Dynamic and static cooperation results in nourished Blood that is vital and moving. Understanding this principle makes clinical application confident.
Analyze and compare to grasp the essence.
Whether regarding herbal formulas, basic theory, or clinical specialties, some content is similar, easily confused, making learning difficult. I adopted the method of analysis and comparison, grasping the essence, distinguishing and comparing, finding differences in similarities and similarities in differences, making mastery and application much easier.
In learning herbs, different medicinal parts of plants have different functions. Those close to heaven act upwards. Flowers and leaves grow upward, close to heaven, light and ascending, belonging to Yang, primarily acting on the exterior and ascending; those close to earth act downwards. Roots are close to earth, heavy, belonging to Yin, descending, primarily acting downward and purging. This is the general rule. But within universality lies特殊性 (particularity); for example, most flowers ascend, but Xuanfu Hua (Inulae Flos, *Inulae Flos*) alone descends.
Even the same herb, due to different compatibilities, acts differently in different formulas. For instance, Ren Shen (Ginseng Radix, *Ginseng Radix*) is used in Xiao Chai Hu Tang (Minor Bupleurum Decoction), Li Zhong Tang (Regulate the Middle Decoction), and Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction), but with different meanings: In Xiao Chai Hu Tang, Ren Shen supports righteousness, preventing pathogen from re-entering the interior; in Li Zhong Tang, Ren Shen tonifies Qi and strengthens the Spleen, invigorating Spleen-Stomach function; in Bai Hu Jia Ren Shen Tang, Ren Shen tonifies Qi and generates fluids, treating injury to Qi and fluids. Our current use of Ren Shen differs from ancient times; now it is mostly used for Qi deficiency and weakness, less for Qi and fluid injury.
In formulas, Zhongjing's Zhi Zhu Tang (Immature Bitter Orange and Atractylodes Decoction) and Dongyuan's Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Pill), although composed of Zhishi (Immature Bitter Orange Fructus, *Aurantii Immaturus Fructus*) and Baizhu (Atractylodis Macrocephalae Rhizoma, *Atractylodis Macrocephalae Rhizoma*), have different functions. Zhi Zhu Tang treats water-fluid retention in the Stomach, hardness below the heart, large as a plate, hard externally and empty internally. Zhi Zhu Wan treats weak Spleen-Stomach transportation, food stagnation, abdominal distension and fullness. The simultaneous use of cold and heat in Wu Mei Wan (Mume Pill) differs from that in Xie Xin Tang (Drain the Epigastrium Decoction).
Vomiting is a common symptom, caused by Stomach failing to descend and Qi rebelling upward, resulting from internal injury or external pathogens. External pathogens such as cold, heat, dampness, and turbidity can all cause this. Thus, although both are vomiting, their etiology and treatment differ. *Shang Han Lun* mentions vomiting in over sixty clauses. For example, "irritability and frequent vomiting" in Xiao Chai Hu Tang is caused by Gallbladder heat invading the Stomach and Stomach Qi rebelling; "nasal whistling and dry vomiting" in Gui Zhi Tang (Cinnamon Twig Decoction, *Cinnamomi Ramulus*) is caused by wind pathogen affecting Lung Qi, leading to Stomach Qi rebellion; "oppressive slight irritability and incessant vomiting" in Da Chai Hu Tang (Major Bupleurum Decoction) indicates pathogen in half-exterior/half-interior combined with interior Qi congestion; "slight vomiting" in Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction) is a mild form of the Shaoyang main symptom of frequent vomiting; "warm sensation in the epigastrium desiring to vomit, but only wanting to vomit" in Tiao Wei Cheng Qi Tang (Regulate the Weight Order the Qi Decoction) is due to Stomach heat constraint; "desire to vomit" in Huang Lian Tang (Coptis Decoction) is due to Diaphragm heat; "dry vomiting" in Xiao Qing Long Tang (Minor Green Dragon Decoction) is due to water-Qi in the epigastrium; "dry vomiting and shortness of breath" in Shi Zao Tang (Ten Date Palm Decoction) is due to water-fluid accumulation in the chest and diaphragm; "vomiting upon eating" in Wu Zhu Yu Tang (Evodia Decoction) is due to cold-turbidity attacking upward. Regarding vomiting in Xiao Chai Hu Tang, subdividing reveals different types. Through such analysis and comparison, the vomiting mentioned in *Shang Han Lun* becomes clearer.
In treatment, sometimes the same disease presents different symptoms due to different patient constitutions or stages of disease development, requiring different treatments, called "treating the same disease differently." Conversely, different diseases with the same pathogenesis can be treated with the same principle, called "treating different diseases similarly." We should analyze and compare, seeking difference in similarity and similarity in difference, finding laws, grasping the essence, and treating with precision.
Alopecia is a relatively common condition. Generally, hair is considered the surplus of Blood and the external glory of the Kidney. Blood deficiency failing to nourish, Blood stasis failing to circulate, or Kidney Essence deficiency failing to generate hair can all cause alopecia. Treatment often involves activating and nourishing Blood or tonifying Kidney and filling Essence, usually effective. But sometimes, patients with alopecia do not respond to these two methods. Analysis and comparison revealed that such patients do not show symptoms of Blood deficiency/stasis or Kidney deficiency, but rather symptoms of Lung Qi deficiency such as mental fatigue, shortness of breath, low voice, spontaneous sweating, aversion to cold, pale complexion, pale tongue, and weak pulse. *Ling Shu: Jing Mai* (Spiritual Pivot: Meridians) states: "Human life begins, first forming Essence; Essence forms, then Brain and Marrow generate... Skin becomes firm and hair grows." Lung governs skin and hair; insufficient Lung Qi can naturally cause alopecia. Therefore, greatly tonifying Lung Qi can yield good results.
I once treated a patient with Anhidrosis (lack of sweating). The patient had never sweated since birth. In childhood, there were no special sensations; in adulthood, whenever laboring or exercising vigorously, the face would flush, body heat would rise, palpitations occur, and irritability would arise. A certain hospital diagnosed Anhidrosis. It is generally easy to assume that since Lung governs skin and hair, one should treat the Lung to induce sweating. But careful analysis showed the patient had no Lung disease symptoms; flushing, body heat, palpitations, and irritability were manifestations of Heart Yin deficiency. Sweat is the fluid of the Heart. I treated by nourishing Heart Yin and achieved satisfactory results.