除此以外，对富于创觅，独具一格的医家著作，更是择善而从之。在这一点上，我常想：本来我这北方民间医生，只会开大柴胡、大青龙之类的方子，对于温热病就需向南方医生学习。底本就是《张聿青医案》和费伯雄的《医醇媵义》。丸方膏方偏学前者，处理急性热病多学后者。张聿青少承家学，毕生勤于临床辨证察色，尤长脉诊，极注意节令等对病人的影响。曾着《如梦录》一篇，自述一生为人行事，其经历越艰苦，其成就越大，钻研越深，所得越多。费伯雄先生习举子业，后学医，清咸丰，』可治年问，以医名远近，请诊者踵相接，乃居遂成繁盛之区。费氏治学，宗于东垣、丹溪，不偏不倚，善于通变化哉古人有效之剂。
学医就要有善于撷众长的学风，既向书本学习，又要向师友请教。至今我仍常常热望参加各种学术会议，从中汲取营养。利用余暇翻阅近代医学杂志期刊，凡遇有效之一方一药，凡有新颖独特学术见解，都笔记于册，推敲揣摩，深入研究，或验之于】摇床，重复推广。例如曾向《中医杂志》学习过一个治疗白，塞氏病的方法，用犀角地黄汤、兰黄解毒汤、当归连翘赤小豆汤加升麻、土茯苓，临床用之辄效。又如曾亲自走访老中医张仲元先生，学习他治精神病的宝贵经验，并进行整理、归纳、总结、分析，写成医话。
熟读经典苦学本草
经典著作是中医理论的源泉，有了熟读乃至重点篇章能够背诵的硬功，博览各家各派，才能抓住重点。老一辈所以能引经据典，脱日而出，如数家诊，就是困年轻时下过一番苦功。经典读熟了，以后才有豁然贯通之妙。尤其在青少年时，奠基更为重要。我四岁时，随祖父课徒的学生念些歌赋，虽不理解，念得多了，也就记住了。背，不单纯是记忆的问题，还有加深理懈的作用。学习方歇、药物更是如此，不背不成。熟背才能得心应手，口到笔到，熟能生巧。临术时初有方，后无方，最后又有方。这种意境都是背诵、记忆、实践、提高的过程。背诵开始要少，由少而多，积腋成裘，积沙成塔。到一段落，可以暂放，再另起第二段落，记熟了再开始第三段。《金匮要略》我就是这样分条分段背诵的，一共四百条都能朗朗上口，永志不忘，并可由此及彼，互相联想，互相印证。这种背诵的「童子功」，对学中医的人是必备的。
回顾早年学医的历程大致分为四个阶段：
启蒙(或称入门)阶段。开始时，背学《医学三字经努、《四百味》、《四诊心法》、《药性赋》。不懂的字词在老师的指导下查字典，疑难问题请老师讲解。
第二阶段，学《神农本草三家注》、《内经知要》、《伤寒论浅注》、《金匮要略浅注》、《温病条辨》，同时参考《本草备要》、《灵素类纂约注》、《长沙方歌括》等。重点章句，熟读乃至背诵，并做些读书笔记。
第三阶段，背《汤头歌诀》、读《医方集解》，参考《成方切用拜、《成方便读》等，打一点方剂学的基础。
第四阶段，读内科方面的书籍。初起可学《医学刍言》、《医学心悟》、《医宗必读》、《笔花医镜》。边学边写心得笔记。最后，再看李用粹《证治汇补》、林佩琴《类证治裁》、沈金鳌《杂病源流犀烛》。还兼看一些各家的书，妇科如陈修园的《女科要旨》、明武之望《济阴纲目》，儿科可由《保婴要旨》到《万密斋儿科》、《幼幼集成》等。
这样大约需三年时间，其间一半时间临床，一半读书。临床忙时挤时间学，利用「三余」时间(冬者岁之余，夜者日之余，阴雨者时之余)。抓紧零散时间，且要有毅力。读书是艰苦的，但可读出趣味来。
我常以自身浮浅的体会告诉随学的学生说：「作为中医，熟读经典著作，触类而旁通．这是贯彻始终的学问，舍此是无径可循的。
多年来，我一直注重本草学的研究。我认为成认方药是治疗疾病的前提，没有方药，临床恰似无米之炊，巧妇也难为之。后来，从事教学工作，进一步提高了中药理论水平。解放初，协助陈慎吾先生创办北京汇通学校，主讲《神农本草经》。一九五六年北京中医学院成立后，在中药教研组任讲师。因具有英、日两门外语基础，得以不断学习中外各种研究成果，扩展了中药研究的深度、广度，为深入探讨提供了条件。由于酷爱本草，重视实地考查。在三十年代后期，曾追随赵爝黄先生多次到河北祁州(安国)药材市场，辽宁营口人参市场，也参观过四大怀药产区，到抗州笕桥了解生地的栽培，到四川绵阳考察大面积栽培麦冬，到灌县考察种植川芎。每次都眼到，口到、笔到，均能总结经验，写成考察文章。此外，还参观过重庆佟君阁曲厂，杭州{胡炭余堂，苏州雷允卜，卜海蔡同德堂、姜衍泽，北京同仁堂老式药厂等。教学期问，随学生采集中草药，炮制、配制丸散膏丹等，教学相长，提高了实际操作技能。
为了使脏腑辨证及药物应用熔为一体，有益于临床工作，我对张元素《脏腑标本药式》进行了初步探讨。该书原本虽已亡佚，但在明·李时珍《本草纲目》中记录下来了。张元素的弟子李东垣、王好古，罗天益等人师其法，于他们著作中亦可见一斑。其后，张山雷纂辑了《脏腑药式补正》，按脏腑分类用药，作了系统的理论概括，言简意赅，切于实用。我注意将古人用药经验证之于临床，察之于古，验之于今，努力取得直接的体验。
我觉得研究本草，不能忽视药物的组方及炮制工作。中医方剂是一个单元，正于一味中药是一个单元一样。组方配伍，要与辨证有机结合，法随证立，方依法出。张景岳说；「夫方之善者，得其宜也，可以法也；方之不善者，失其宜也，失其宜者，可为鉴也。」所谓得其宜者，得法之宜也。徐洄溪也指出：「若夫按病用药，药虽切中，而立方无法，谓之有药无方；或写一方以治病，方虽云善，而其药有一，二味与病不相关者，谓之有方无药。」由此可见，古人制方用药，务求方中有法，法中有方。量方用药，有规矩准绳。制方要通权达变，取前人经验，不落前人窠臼。古人谓方之为做也，傲病而有力者也。正如喻嘉言所云：「凡用药太过、不及皆非适宜，而不及尚可加，太过则病去药存，为害最烈。」我体会，在组方配伍中，除注意君压佐使等组方原则外，还应根据治法要求，处理好五个辨证关系：．
一日散与收。散指发散、宣散，多指祛除外邪，宣通气机，收指收微固脱，固摄气血之谓。二者相互为用，互相制约。如虚人外感，既要祛除外邢，甩荆防之辛散，叉要助其正气以芪术之甘温固表，所谓黄芪防风相畏而相使，实际上是反应了扶正祛邪两种治法的作用。
二日攻与补。攻为祛邪，补为扶正。应根据邪正斗争情况，将攻补灵活配合，两者之中，关键在于扶正。《伤寒论》保胃气、存津液，温病之「存得一分津液，便有一分生机」，皆在于顾护正气。正如十枣汤之用大枣，白虎汤之粳米、甘草，小柴胡汤之党参…．．我每用清热解毒、活血化瘀及攻伐之剂，必适当佐以顾护正气之品，正本此意。至于具体方药之多少，或平补平泻，均应据证灵括掌握，惟以祛邪而不伤正，扶正而不留邪为目的。，
三曰温与清。温指「寒者热之」，清指「热者寒之」，治寒以热，治热以寒，「治寒不远热，治热不远寒」，是治则之大法。但因病情复杂多变，组方配伍并非纯用寒热，而是寒热并施，温清并用。寒热错杂之证，自不待言。真假寒热之证，因纯用寒热易致格拒不受，亦需反佐一、=味药性相反之品，谓之反治。根据方剂配伍及治疗的需要，常宜灵活伍用寒热之剂，如左金之萸连，交泰之连桂，取其相互制约、相反相成之功，或为监制他药以防其偏。这些药物虽数少而量轻，但其效用颇大，往往有出奇制胜之妙。
四日升与降。升指提升，言其向上，降指通降，谓其向下。升降本为人体血气之正常运动，所谓「升降出入，无器不有」。若升降失常，则生化无权。故治病当调气机之升降，配伍应注意药物的升陬使气升降相宜，调配得当，升者不可升而无制，降者不可降之太过。女眩晕一证，无论病因若何，其病机无非清者不升，浊者不降所致，应升清降浊并用。虚者，升其清阳为主，升麻、荷叶之属皆可加入，实者，降其浊气为主，重镇潜降之品皆可选用。
五日静与动。静者言其阴柔呆滞也，属阴，动者言其行走通达也，属阳。补益之剂，尤其滋阴养血之品，易于壅塞气机，故其性多静而宣通之剂，如行气活血通阳气之品，则多属动。组方配伍时，应注意动静结合，动中有静，静中有动。如补法最易引起脘腹痞胀，纳食欠佳等气机不畅、胃气不和之证，或郁而化火变生它疾，常宜台宣通和胃之法，佐以动药，以行其滞，宣其痞，散其壅，故补气常佐以行气，补血常佐以活血养阴注意助阳化气，温阳注意阴阳互根，才能补而不滞，滋而不腻，阳生阴长，能生能化。我临证尤其喜用羌活一昧，其具宣通气机促进生化之力，用补益之法时，均可佐入，甚得其益。亦应注意动中有静，通中有补，防止用过，伤其正气。
这五个关系相互渗透、互相联系，其间含有丰富的辩证法思想，可补君臣佐使之不足。组方配伍时若能处理妥当，对提高辨证论治水平必有帮助。
此外，临证选药务使精当，推敲玩味，始能切中病情，制方在于常法之中，选药要有独到之处。我应用活血化瘀法时，常将伤科常用之刘寄奴、鬼箭羽、苏木、泽兰等用于内科，效果颇佳。在应用扶正固本法时，常用胡桃肉、黑芝麻、补骨脂、龙眼肉等平和温润之品补肾益脑而收功。在辨证论治指导下，还将现代药理研究成果为我所用。如血小板减少症常合用一些有升血小板作用的药物，。如连翘、首乌等，粒细胞减少症，应用较大剂量鸡血藤等}真性红细胞增多症，应用桔梗、远志、紫菀等。这些药物的应用一般并不违背中医理论。
着重临床法中求法
我从事本草研究多年，但始终不愿放弃临床，并力求做到临床、教学，科研三位一体。因为我觉得既有丰富的药物学知识，又有临床l侔会，医药并茂，方为上工。本人虽非上工，但毕生是向这方面努力的。
下面就中医治法方面的一些问题谈一点体会。
对疾病进行辨证之后，确立治法用药，是诊治疾病的基本过程。确立治法为理法方药中承先启后的重要一环。固然，无正确的辨证，就无有效的治疗}但若无正确的论治，虽则辨证无误，亦属徒劳无功。总之是立法一错，方药全误。早在《黄帝内经》中就已奠定了中医治疗学的理论基础，对基本治法进行了初步总结。随着医疗实践的发展，遂有八法的形成。但我认为，八法只是一个总的原则，临证中具体治法应用很有深入探讨的必要。本人体会，人体生理、病理应以邪正斗争为中心，应着眼于扶正祛邪，恢复人体正常之生理状态，救病有寒热虚实，治有温清补泻；脏腑有生克制化，治有补母泻予病有六淫七情，治也各有不同，应随其病因病机而转变。人以正气为本。尤其要重视脾胃脏腑活动中作为先、后天之本的重要地位。肾为先天水火之脏，元阴元阳之所居，命门所系，元气之根，是一身气化之源，其为「封藏之本，精之处也」，能藏精生髓主骨充脑，扳为「作强之官」，主水液代谢，司生殖发育，为人体生命活动之动力，抗御外邪之源泉。肾的功能关系到全身脏腑，肾病必影响其它脏腑，而其它脏腑病变，后期也必影响到肾，所谓「久病及肾」，动摇根本。但先天之本肾，又必赖后天之本脾的营养。人生之后，先天之源已断，赖后天水谷精微之气补充。故《内经》指出「胃者，水谷之海，六腑之大源也。五味入口藏于胃，以养五脏气」，「五脏者皆禀气于胃，胃者五脏之本也」。李东垣进一步指出：「真气又名元气，乃先身生之精气也，非胃气不能滋之。」说明了后天脾胃对先天元气的作用。不仅在生长发育中赖后天水谷之精荣养，而且在病理情况下，亦赖脾胃健运方能祛除外邪，扶助胃气，恢复脏腑功能。况且，不仅水谷由脾胃受纳运化，而药物亦赖其吸收输布。临证时尤应注意胃气的存亡。「有胃则生，无胃则死」。治疗上宜顾护胃气，如「浆粥入胃，泄注止，则虚者活」，乃其胃气来复。
除此之外，对于富有创见、独具一格的医家著作，更是择优而学习。在这一点上，我常想：我本是一个北方民间医生，只会开具大柴胡汤、大青龙汤之类的方子，对于温热病就需要向南方医生学习。主要的参考底本就是《张聿青医案》和费伯雄的《医醇媵义》。丸剂膏方偏向前者学习，处理急性热病多向后者学习。张聿青年少时继承家学，一生勤于临床辨证察色，尤其擅长脉诊，极注意节气时令等对病人的影响。曾写有《如梦录》一篇，自述一生为人行事，其经历越艰苦，其成就越大，钻研越深，所得越多。费伯雄先生早年习举子业（科举考试），后改学医，在清咸丰、同治年间，以医术闻名远近，求诊者络绎不绝，使得居住地成为繁盛之区。费氏治学，宗法于李东垣、朱丹溪，不偏不倚，善于通变化裁古人的有效方剂。
学医就要有善于汲取众人长处的学风，既向书本学习，又要向师友请教。至今我仍常常热望参加各种学术会议，从中汲取营养。利用余暇翻阅近代医学杂志期刊，凡遇到有效的一方一药，凡有新颖独特的学术见解，都笔记在册，推敲揣摩，深入研究，或在临床上验证推广。例如曾向《中医杂志》学习过一个治疗白塞氏病的方法，用犀角地黄汤、黄连解毒汤、当归连翘赤小豆汤加升麻、土茯苓，临床使用往往见效。又如曾亲自走访老中医张仲元先生，学习他治疗精神病的宝贵经验，并进行整理、归纳、总结、分析，写成医话。
熟读经典苦学本草
经典著作是中医理论的源泉，有了熟读乃至重点篇章能够背诵的硬功夫，博览各家各派，才能抓住重点。老一辈之所以能引经据典，脱口而出，如数家珍，就是因为年轻时下过一番苦功。经典读熟了，以后才有豁然贯通的妙处。尤其在青少年时期，奠基更为重要。我四岁时，随祖父课徒的学生念些歌赋，虽不理解，念得多了，也就记住了。背诵，不单纯是记忆的问题，还有加深理解的作用。学习方剂、药物更是如此，不背不成。熟背才能得心应手，口到笔到，熟能生巧。临证时初有方，后无方，最后又有方。这种意境都是背诵、记忆、实践、提高的过程。背诵开始要少，由少而多，积腋成裘，积沙成塔。到一个段落，可以暂放，再另起第二段落，记熟了再开始第三段。《金匮要略》我就是这样分条分段背诵的，一共四百条都能朗朗上口，永志不忘，并可由此及彼，互相联想，互相印证。这种背诵的“童子功”，对学中医的人是必备的。
回顾早年学医的历程大致分为四个阶段：
启蒙（或称入门）阶段。开始时，背诵《医学三字经》、《四百味》、《四诊心法》、《药性赋》。不懂的字词在老师的指导下查字典，疑难问题请老师讲解。
第二阶段，学《神农本草三家注》、《内经知要》、《伤寒论浅注》、《金匮要略浅注》、《温病条辨》，同时参考《本草备要》、《灵素类纂约注》、《长沙方歌括》等。重点章句，熟读乃至背诵，并做些读书笔记。
第三阶段，背《汤头歌诀》、读《医方集解》，参考《成方切用》、《成方便读》等，打一点方剂学的基础。
第四阶段，读内科方面的书籍。初起可学《医学刍言》、《医学心悟》、《医宗必读》、《笔花医镜》。边学边写心得笔记。最后，再看李用粹《证治汇补》、林佩琴《类证治裁》、沈金鳌《杂病源流犀烛》。还兼看一些各家的书，妇科如陈修园的《女科要旨》、明武之望《济阴纲目》，儿科可由《保婴要旨》到《万密斋儿科》、《幼幼集成》等。
这样大约需三年时间，其间一半时间临床，一半读书。临床忙时挤时间学，利用“三余”时间（冬者岁之余，夜者日之余，阴雨者时之余）。抓紧零散时间，且要有毅力。读书是艰苦的，但可读出趣味来。
我常以自身浮浅的体会告诉随学的学生说：“作为中医，熟读经典著作，触类旁通，这是贯彻始终的学问，舍此是无径可循的。”
多年来，我一直注重本草学的研究。我认为承认方药是治疗疾病的前提，没有方药，临床恰似无米之炊，巧妇也难为之。后来，从事教学工作，进一步提高了中药理论水平。解放初，协助陈慎吾先生创办北京汇通学校，主讲《神农本草经》。一九五六年北京中医学院成立后，在中药教研组任讲师。因具有英、日两门外语基础，得以不断学习中外各种研究成果，扩展了中药研究的深度、广度，为深入探讨提供了条件。由于酷爱本草，重视实地考查。在三十年代后期，曾追随赵燏黄先生多次到河北祁州（安国）药材市场，辽宁营口人参市场，也参观过四大怀药产区，到杭州笕桥了解生地的栽培，到四川绵阳考察大面积栽培麦冬，到灌县考察种植川芎。每次都眼到，口到、笔到，均能总结经验，写成考察文章。此外，还参观过重庆佟君阁曲厂，杭州胡庆余堂，苏州雷允上，上海蔡同德堂、姜衍泽，北京同仁堂老式药厂等。教学期间，随学生采集中草药，炮制、配制丸散膏丹等，教学相长，提高了实际操作技能。
为了使脏腑辨证及药物应用熔为一体，有益于临床工作，我对张元素《脏腑标本药式》进行了初步探讨。该书原本虽已亡佚，但在明·李时珍《本草纲目》中记录下来了。张元素的弟子李东垣、王好古，罗天益等人师其法，于他们著作中亦可见一斑。其后，张山雷纂辑了《脏腑药式补正》，按脏腑分类用药，作了系统的理论概括，言简意赅，切于实用。我注意将古人用药经验证之于临床，察之于古，验之于今，努力取得直接的体验。
我觉得研究本草，不能忽视药物的组方及炮制工作。中医方剂是一个单元，正如一味中药是一个单元一样。组方配伍，要与辨证有机结合，法随证立，方依法出。张景岳说：“夫方之善者，得其宜也，可以法也；方之不善者，失其宜也，失其宜者，可为鉴也。”所谓得其宜者，得法之宜也。徐洄溪也指出：“若夫按病用药，药虽切中，而立方无法，谓之有药无方；或写一方以治病，方虽云善，而其药有一、二味与病不相关者，谓之有方无药。”由此可见，古人制方用药，务求方中有法，法中有方。量方用药，有规矩准绳。制方要通权达变，取前人经验，不落前人窠臼。古人谓方之为做也，傲病而有力者也。正如喻嘉言所云：“凡用药太过、不及皆非适宜，而不及尚可加，太过则病去药存，为害最烈。”我体会，在组方配伍中，除注意君臣佐使等组方原则外，还应根据治法要求，处理好五个辨证关系：
一曰散与收。散指发散、宣散，多指祛除外邪，宣通气机，收指收敛固脱，固摄气血之谓。二者相互为用，互相制约。如虚人外感，既要祛除外邪，用荆防之辛散，又要助其正气以芪术之甘温固表，所谓黄芪防风相畏而相使，实际上是反应了扶正祛邪两种治法的作用。
二曰攻与补。攻为祛邪，补为扶正。应根据邪正斗争情况，将攻补灵活配合，两者之中，关键在于扶正。《伤寒论》保胃气、存津液，温病之“存得一分津液，便有一分生机”，皆在于顾护正气。正如十枣汤之用大枣，白虎汤之粳米、甘草，小柴胡汤之党参……我每用清热解毒、活血化瘀及攻伐之剂，必适当佐以顾护正气之品，正本此意。至于具体方药之多少，或平补平泻，均应据证灵活掌握，惟以祛邪而不伤正，扶正而不留邪为目的。
三曰温与清。温指“寒者热之”，清指“热者寒之”，治寒以热，治热以寒，“治寒不远热，治热不远寒”，是治则之大法。但因病情复杂多变，组方配伍并非纯用寒热，而是寒热并施，温清并用。寒热错杂之证，自不待言。真假寒热之证，因纯用寒热易致格拒不受，亦需反佐一、二味药性相反之品，谓之反治。根据方剂配伍及治疗的需要，常宜灵活伍用寒热之剂，如左金丸之萸连，交泰丸之连桂，取其相互制约、相反相成之功，或为监制他药以防其偏。这些药物虽数少而量轻，但其效用颇大，往往有出奇制胜之妙。
四曰升与降。升指提升，言其向上，降指通降，谓其向下。升降本为人体气血之正常运动，所谓“升降出入，无器不有”。若升降失常，则生化无权。故治病当调气机之升降，配伍应注意药物的升降使气升降相宜，调配得当，升者不可升而无制，降者不可降之太过。如眩晕一证，无论病因若何，其病机无非清者不升，浊者不降所致，应升清降浊并用。虚者，升其清阳为主，升麻、荷叶之属皆可加入，实者，降其浊气为主，重镇潜降之品皆可选用。
五曰静与动。静者言其阴柔呆滞也，属阴，动者言其行走通达也，属阳。补益之剂，尤其滋阴养血之品，易于壅塞气机，故其性多静；而宣通之剂，如行气活血通阳气之品，则多属动。组方配伍时，应注意动静结合，动中有静，静中有动。如补法最易引起脘腹痞胀，纳食欠佳等气机不畅、胃气不和之证，或郁而化火变生它疾，常宜合宣通和胃之法，佐以动药，以行其滞，宣其痞，散其壅，故补气常佐以行气，补血常佐以活血养阴注意助阳化气，温阳注意阴阳互根，才能补而不滞，滋而不腻，阳生阴长，能生能化。我临证尤其喜用羌活一味，其具宣通气机促进生化之力，用补益之法时，均可佐入，甚得其益。亦应注意动中有静，通中有补，防止用过，伤其正气。
这五个关系相互渗透、互相联系，其间含有丰富的辩证法思想，可补君臣佐使之不足。组方配伍时若能处理妥当，对提高辨证论治水平必有帮助。
此外，临证选药务使精当，推敲玩味，始能切中病情，制方在于常法之中，选药要有独到之处。我应用活血化瘀法时，常将伤科常用之刘寄奴、鬼箭羽、苏木、泽兰等用于内科，效果颇佳。在应用扶正固本法时，常用胡桃肉、黑芝麻、补骨脂、龙眼肉等平和温润之品补肾益脑而收功。在辨证论治指导下，还将现代药理研究成果为我所用。如血小板减少症常合用一些有升血小板作用的药物，如连翘、首乌等，粒细胞减少症，应用较大剂量鸡血藤等；真性红细胞增多症，应用桔梗、远志、紫菀等。这些药物的应用一般并不违背中医理论。
着重临床法中求法
我从事本草研究多年，但始终不愿放弃临床，并力求做到临床、教学、科研三位一体。因为我觉得既有丰富的药物学知识，又有临床经验，医药并茂，方为上工。本人虽非上工，但毕生是向这方面努力的。
下面就中医治法方面的一些问题谈一点体会。
对疾病进行辨证之后，确立治法用药，是诊治疾病的基本过程。确立治法为理法方药中承先启后的重要一环。固然，无正确的辨证，就无有效的治疗；但若无正确的论治，虽则辨证无误，亦属徒劳无功。总之是立法一错，方药全误。早在《黄帝内经》中就已奠定了中医治疗学的理论基础，对基本治法进行了初步总结。随着医疗实践的发展，遂有八法的形成。但我认为，八法只是一个总的原则，临证中具体治法应用很有深入探讨的必要。本人体会，人体生理、病理应以邪正斗争为中心，应着眼于扶正祛邪，恢复人体正常之生理状态，救病有寒热虚实，治有温清补泻；脏腑有生克制化，治有补母泻子；病有六淫七情，治也各有不同，应随其病因病机而转变。人以正气为本。尤其要重视脾胃脏腑活动中作为先、后天之本的重要地位。肾为先天水火之脏，元阴元阳之所居，命门所系，元气之根，是一身气化之源，其为“封藏之本，精之处也”，能藏精生髓主骨充脑，称为“作强之官”，主水液代谢，司生殖发育，为人体生命活动之动力，抗御外邪之源泉。肾的功能关系到全身脏腑，肾病必影响其它脏腑，而其它脏腑病变，后期也必影响到肾，所谓“久病及肾”，动摇根本。但先天之本肾，又必赖后天之本脾的营养。人生之后，先天之源已断，赖后天水谷精微之气补充。故《内经》指出“胃者，水谷之海，六腑之大源也。五味入口藏于胃，以养五脏气”，“五脏者皆禀气于胃，胃者五脏之本也”。李东垣进一步指出：“真气又名元气，乃先身生之精气也，非胃气不能滋之。”说明了后天脾胃对先天元气的作用。不仅在生长发育中赖后天水谷之精荣养，而且在病理情况下，亦赖脾胃健运方能祛除外邪，扶助胃气，恢复脏腑功能。况且，不仅水谷由脾胃受纳运化，而药物亦赖其吸收输布。临证时尤应注意胃气的存亡。“有胃则生，无胃则死”。治疗上宜顾护胃气，如“浆粥入胃，泄注止，则虚者活”，乃其胃气来复。
In addition, for the works of physicians who are rich in creativity and have a unique style, I select the best to follow. On this point, I often think: originally, I was a folk doctor in the North, only knowing how to prescribe formulas such as **Dachaihu Tang** (Major Bupleurum Decoction) and **Daqinglong Tang** (Major Blue-green Dragon Decoction); for warm-heat diseases, I needed to learn from doctors in the South. The main reference texts were *Zhang Yuqing's Medical Cases* and Fe Boxiong's *Yi Chun Teng Yi*. For pill and paste formulas, I leaned towards the former; for handling acute febrile diseases, I mostly learned from the latter. Zhang Yuqing inherited family learning in his youth and was diligent in clinical differentiation and observation throughout his life, especially skilled in pulse diagnosis, paying great attention to the influence of solar terms on patients. He wrote an article titled "Dream Record," describing his life and conduct; the more arduous his experience, the greater his achievements, the deeper his research, and the more he gained. Mr. Fe Boxiong studied for the imperial examinations early on but later switched to medicine. During the Xianfeng and Tongzhi reigns of the Qing Dynasty, he became famous for his medical skills, with seekers of consultation arriving continuously, making his residence a prosperous area. Fe's scholarship followed Li Dongyuan and Zhu Danxi, neither biased nor extreme, and was good at adapting and transforming effective ancient prescriptions.
To study medicine requires a spirit of learning from others' strengths, studying both from books and consulting teachers and friends. To this day, I still eagerly wish to participate in various academic conferences to absorb nutrients. In my spare time, I read modern medical journals; whenever I encounter an effective prescription or herb, or novel and unique academic insights, I take notes, ponder, study deeply, and verify them clinically or promote their use. For example, I once learned a method for treating **Behcet's Disease** (a systemic vasculitis characterized by oral ulcers, genital ulcers, and uveitis) from the *Chinese Journal of Traditional Chinese Medicine*, using **Xijiao Dihuang Tang** (Rhino Horn and Rehmannia Decoction), **Huanglian Jiedu Tang** (Coptis Detoxification Decoction), **Danggui Lianqiao Chixiaodou Tang** (Angelica, Forsythia, and Adzuki Bean Decoction) plus **Shengma** (Cimicifugae Rhizoma) and **Tufuling** (Smilax Glabrae Rhizoma), which proved effective in clinical practice. Another example is visiting the old TCM practitioner Mr. Zhang Zhongyuan personally to learn his valuable experience in treating mental disorders, organizing, summarizing, analyzing it, and writing medical anecdotes.
Familiarize Yourself with Classics and Study Materia Medica Hard
Classic works are the source of TCM theory. Only with the hard skill of reading familiarly and memorizing key chapters can one grasp the focus after exploring various schools. The older generation could quote classics fluently and recount details like counting family treasures because they worked hard when young. Once classics are mastered, there comes the wonder of sudden enlightenment. This foundation is particularly important during adolescence. At four years old, I recited poems with my grandfather's students; although I didn't understand, repetition helped me remember. Recitation is not just about memory but also deepens understanding. This is especially true for learning formulas and herbs; without memorization, mastery is impossible. Only through rote memorization can one become proficient, speaking and writing effortlessly, where practice makes perfect. In clinical practice, one starts with formulas, then acts intuitively without conscious recall of formulas, and finally returns to having formulas internally. This realm is a process of recitation, memory, practice, and improvement. Recitation should start small, growing larger over time, accumulating layer by layer like fur from armpit hair, or sand into a tower. After finishing a section, one can pause and start another; once memorized, proceed to the third. I memorized *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) in this segmented manner, reciting all 400 articles fluently and never forgetting them, allowing for associative thinking and mutual verification. This "childhood skill" of recitation is essential for TCM students.
Looking back at my early medical studies, it can be roughly divided into four stages:
The Enlightenment (or Entry) Stage. Initially, I memorized *Yixue Sansanjing* (Three Character Classic of Medicine), *Sibaiwei* (Four Hundred Herbs), *Sizhen Xinfa* (Heart Method of Four Diagnostic Methods), and *Yaoxing Fu* (Ode to Herb Properties). I looked up unfamiliar words in dictionaries under my teacher's guidance and asked for explanations on difficult issues.
The Second Stage. I studied *Shennong Bencao Sanjiazhu* (Three Commentaries on Shennong's Materia Medica), *Neijing Yao Yao* (Essentials of the Inner Canon), *Shanghan Lun Qianzhu* (Light Commentary on Treatise on Cold Damage), *Jingui Yaolue Qianzhu* (Light Commentary on Essential Prescriptions of the Golden Cabinet), and *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases), while referencing *Bencao Bei Yao* (Prepared Matters of Materia Medica), *Lingsu Leizuan Yuezhu* (Selected Annotations on Ling Shu and Su Wen), and *Changsha Fang Ge Kuo* (Song Verses of Changsha Formulas). Key sentences were read repeatedly and memorized, accompanied by note-taking.
The Third Stage. I memorized *Tangtou Gejue* (Song Verses of Formula Heads) and read *Yifang Jijie* (Collected Explanations of Formulas), referencing *Chengfang Qieyong* (Practical Use of Established Formulas) and *Chengfang Bian Du* (Easy Reading of Established Formulas) to build a foundation in formulaology.
The Fourth Stage. I read internal medicine books. Initially, I studied *Yixue Chu Yan* (Beginner's Words on Medicine), *Yixue Xinwu* (New Insights into Medicine), *Yizong Bidu* (Must-Reads for Medical Masters), and *Bihua Yijing* (Medical Mirror of Brush Flowers). I took notes alongside my studies. Finally, I read Li Yongcui's *Zhengzhi Huibu* (Compilation of Syndrome Treatment), Lin Peiqin's *Leizheng Zaicai* (Classification and Selection for Syndrome Treatment), and Shen Jin'ao's *Zabing Yuanliu Xizhu* (Sharp Candle of Sources and Flows of Miscellaneous Diseases). I also read various other books: in gynecology, Chen Xiuyuan's *Nüke Yaozhi* (Essentials of Gynecology) and Ming Wuzhiewang's *Jiyin Gangmu* (Outline and Details of Nourishing Yin); in pediatrics, from *Baoying Yaozhi* (Essentials of Infant Care) to *Wan Mizhai Erke* (Pediatrics of Wan Mizhai) and *Youyou Ji Cheng* (Complete Collection for Infants and Children).
This process took about three years, with half the time spent in clinical practice and half in reading. I squeezed study time during busy clinical periods, utilizing "three surplus" times (winter as the year's surplus, night as the day's surplus, rainy days as seasonal surpluses). I seized fragmented time and required perseverance. Reading is arduous but can yield interest.
I often tell my students with my shallow experience: "For a TCM practitioner, familiarizing oneself with classic works and drawing inferences across categories is a lifelong endeavor; without this, there is no path."
For many years, I have focused on researching Materia Medica. I believe that recognizing formulas and herbs is the prerequisite for treating diseases; without them, clinical practice is like cooking without rice, impossible even for a capable housewife. Later, engaging in teaching further improved my theoretical level of Chinese materia medica. In the early days of liberation, I assisted Mr. Chen Shenwu in founding the Beijing Huitong School, lecturing on *Shennong Bencao Jing* (Divine Farmer's Materia Medica). After the establishment of the Beijing College of Traditional Chinese Medicine in 1956, I served as a lecturer in the Chinese Materia Medica Teaching and Research Section. With a foundation in English and Japanese, I continuously absorbed domestic and foreign research results, expanding the depth and breadth of Chinese materia medica research, providing conditions for in-depth exploration. Due to my love for Materia Medica, I valued field investigations. In the late 1930s, I followed Mr. Zhao Yuhuang multiple times to the medicinal material markets in Qizhou (Anguo), Hebei, and Yingkou, Liaoning (ginseng market). I also visited the production areas of the Four Huai Medicinals, learned about the cultivation of **Shengdi Huang** (Rehmanniae Radix Preparata) in Jianqiao, Hangzhou, investigated large-scale **Maidong** (Ophiopogonis Radix) cultivation in Mianyang, Sichuan, and examined **Chuanxiong** (Ligusticum Chuanxiong Rhizoma) planting in Guan County. Each time, I observed, spoke, and wrote, summarizing experiences and writing investigation reports. Additionally, I visited factories such as Chongqing Tongjungge Qu Factory, Hangzhou Huqingyu Tang, Suzhou Lei Yunshang, Shanghai Caitongde Tang, Jiang Yanze, and the old-style Beijing Tongrentang factory. During teaching, I collected Chinese herbal medicines with students, processed them, and prepared pills, powders, pastes, and elixirs. Teaching and learning promoted each other, improving practical operational skills.
To integrate organ differentiation with drug application for clinical benefit, I conducted preliminary research on Zhang Yuansu's *Zangfu Biaoben Yaoshi* (Formula Style for Zang-Fu Excess and Deficiency). Although the original book was lost, it was recorded in Li Shizhen's *Bencao Gangmu* (Compendium of Materia Medica) from the Ming Dynasty. Zhang Yuansu's disciples, including Li Dongyuan, Wang Haogu, and Luo Tianyi, adopted his methods, visible in their works. Later, Zhang Shanlei compiled *Zangfu Yaoshi Bu Zheng* (Supplementary Corrections to the Formula Style for Zang-Fu), classifying drugs by organs and providing systematic theoretical generalizations, concise and practical. I paid attention to verifying ancient drug experiences clinically, observing ancient practices, and testing them today, striving for direct experience.
I feel that researching Materia Medica cannot ignore drug formulation and processing. A TCM formula is a unit, just as a single herb is a unit. Formulation and compatibility must be organically integrated with syndrome differentiation; treatment principles are established according to syndromes, and formulas are derived from treatment principles. Zhang Jingyue said: "Good formulas obtain appropriateness and can serve as models; bad formulas lose appropriateness and serve as warnings." Obtaining appropriateness means obtaining the appropriateness of the method. Xu Huixi also pointed out: "If one prescribes drugs according to disease but lacks methodological structure, it is called 'having drugs but no formula'; or if one writes a formula to treat a disease, and one or two ingredients are irrelevant to the disease, it is called 'having a formula but no drugs.'" Thus, ancients sought to have methods within formulas and formulas within methods. There are rules and standards for measuring and prescribing. Formulation requires flexibility, taking previous experience without falling into old ruts. Ancients said a formula is made to be powerful against disease. As Yu Jiayan stated: "Excessive or insufficient medication is inappropriate; insufficiency can be increased, but excess leaves the disease gone while the drug remains, causing severe harm." My understanding is that in formulation, besides noting principles like Sovereign, Minister, Assistant, and Courier, one must handle five dialectical relationships based on treatment requirements:
First, Dispersing and Astringing. Dispersing refers to dispersing and ventilating, mostly expelling external pathogens and ventilating Qi mechanism; astringing refers to consolidating collapse and securing Qi and Blood. They complement and constrain each other. For example, in deficient individuals with external contraction, one must expel pathogens using the acrid dispersion of **Jingjie** (Schizonepetae Herba) and **Fangfeng** (Saposhnikoviae Radix), while supporting righteous Qi with the sweet-warm exterior-consolidating effect of **Huangqi** (Astragali Radix) and **Baizhu** (Atractylodis Macrocephalae Rhizoma). The interaction between Huangqi and Fangfeng reflects the combined action of supporting righteousness and expelling pathogens.
Second, Attacking and Tonifying. Attacking removes pathogens; tonifying supports righteousness. One should flexibly combine attack and tonification based on the struggle between pathogenic factors and righteous Qi, with the key being supporting righteousness. *Shanghan Lun* emphasizes protecting Stomach Qi and preserving Body Fluids; warm-heat diseases emphasize "preserving one part of fluid preserves one part of vitality," all aiming to protect righteous Qi. Just as **Dazao** (Jujubae Fructus) is used in **Shizao Tang** (Ten Date Decoction), **Jingmi** (Oryza Sativa Germen) and **Gancao** (Glycyrrhizae Radix et Rhizoma) in **Baihu Tang** (White Tiger Decoction), and **Dangshen** (Codonopsis Radix) in **Xiaochaihu Tang** (Minor Bupleurum Decoction)... Whenever I use heat-clearing, detoxifying, blood-invigorating, and stasis-resolving, or attacking agents, I appropriately add substances to protect righteous Qi, originating from this intent. The quantity of specific drugs or the balance of tonification and purging should be flexibly grasped according to the syndrome, aiming to expel pathogens without damaging righteousness and support righteousness without retaining pathogens.
Third, Warming and Clearing. Warming refers to "treating cold with heat"; clearing refers to "treating heat with cold." Treating cold with hot and heat with cold, "not staying far from heat when treating cold, not staying far from cold when treating heat," are major principles. However, due to complex and changing conditions, formulations are not purely hot or cold but combine warming and clearing. In mixed cold-heat syndromes, this is obvious. In false cold-heat syndromes, pure hot/cold may cause rejection, requiring counter-agents (drugs with opposite properties) to prevent rejection, known as counter-treatment. According to formulation and treatment needs, it is often appropriate to flexibly combine hot and cold agents, such as **Yuhuang** (Evodiae Fructus) and **Lianzi** (Coptidis Rhizoma) in **Zuojin Wan**, or **Lianzi** and **Guizhi** (Cinnamomi Ramulus) in **Jiaotai Wan**, leveraging their mutual constraint and complementary effects, or to monitor other drugs to prevent bias. Though few in number and light in dosage, these drugs have significant effects, often achieving surprising victories.
Fourth, Ascending and Descending. Ascending refers to lifting upwards; descending refers to flowing downwards. Ascending and descending are normal movements of human Qi and Blood, as stated, "Ascending, descending, exiting, and entering exist in every vessel." If ascending and descending are abnormal, transformation and production lack power. Therefore, treating disease involves regulating the ascending and descending of Qi mechanism. In formulation, attention should be paid to the ascending and descending properties of drugs to ensure proper coordination. Ascending drugs should not ascend without restraint, and descending drugs should not descend excessively. For dizziness, regardless of etiology, the pathology is usually clear Yang failing to ascend and turbid Yin failing to descend, requiring simultaneous clearing of turbidity and raising of clarity. In deficiency, primarily raise clear Yang, adding items like **Shengma** (Cimicifugae Rhizoma) and **Heye** (Nelumbinis Folium); in excess, primarily descend turbid Qi, selecting heavy-settling and subduing agents.
Fifth, Stillness and Movement. Stillness refers to Yin softness and stagnation, belonging to Yin; movement refers to circulation and penetration, belonging to Yang. Tonifying agents, especially those nourishing Yin and Blood, tend to obstruct Qi mechanism, so their nature is mostly still; whereas ventilating agents, such as those moving Qi, invigorating Blood, and unblocking Yang, are mostly moving. In formulation, one should pay attention to combining stillness and movement, with stillness in movement and movement in stillness. Tonification easily causes abdominal distension, poor appetite, Qi stagnation, and Disharmony of Stomach Qi, or transforms into fire causing other diseases. It is often necessary to combine ventilating and harmonizing Stomach methods, adding moving drugs to move stagnation, ventilate fullness, and dissipate obstruction. Thus, tonifying Qi often adds moving Qi drugs; tonifying Blood often adds invigorating Blood drugs. When nourishing Yin, pay attention to assisting Yang to transform Qi; when warming Yang, pay attention to the mutual root of Yin and Yang, ensuring tonification does not stagnate and nourishment does not cloy, allowing Yang to generate Yin and vice versa. In clinical practice, I particularly like using **Qianghuo** (Notopterygii Rhizoma et Radix) for its ability to ventilate Qi mechanism and promote transformation; it can be added as an assistant when using tonification methods, yielding great benefits. One should also pay attention to stillness in movement and tonification in unblocking, preventing overuse from damaging righteous Qi.
These five relationships permeate and connect each other, containing rich dialectical thought, supplementing the Sovereign-Minister-Assistant-Courier principle. Properly handling them in formulation will certainly help improve the level of syndrome differentiation and treatment.
Furthermore, selecting drugs in clinical practice must be precise and carefully considered to hit the mark. Formulation lies within standard methods, but drug selection requires uniqueness. When applying blood-invigorating and stasis-resolving methods, I often use orthopedic-common herbs like **Liujinu** (Artemisiae Annuae Herba), **Guijianyu** (Eucommiae Cortex), **Sumu** (Pterocarpus Santalinus Lignum), and **Zelan** (Lycopus Lucidus Herba) in internal medicine, achieving excellent results. When applying righteousness-supporting and consolidation methods, I often use mild and warm-tonic herbs like **Hutaorou** (Juglandis Semen), **Heizhima** (Sesami Fructus Niger), **Buguzhi** (Psoraleae Fructus), and **Longyanrou** (Longan Arillus) to tonify Kidney and benefit the brain. Guided by syndrome differentiation, I also utilize modern pharmacological research results. For thrombocytopenia, I often combine drugs that increase platelets, such as **Lianqiao** (Forsythiae Fructus) and **Shouwu** (Polygoni Multiflori Radix); for granulocytopenia, I apply larger doses of **Jixueteng** (Spatholobi Caulis); for polycythemia vera, I use **Jiegeng** (Platycodonis Radix), **Yuanzhi** (Polygalae Radix), and **Ziwan** (Adenophorae Radix). The application of these drugs generally does not violate TCM theory.
Focus on Clinical Practice: Seeking Methods Within Methods
Although I have engaged in Materia Medica research for many years, I have never been willing to abandon clinical practice and strive for the integration of clinical practice, teaching, and scientific research. Because I believe that possessing rich pharmacological knowledge along with clinical experience, excelling in both medicine and pharmacy, constitutes a superior physician. Although I am not a superior physician, I have devoted my life to this goal.
Below are some reflections on TCM treatment methods.
After differentiating syndromes for a disease, establishing treatment methods and prescribing medications is the basic process of diagnosis and treatment. Establishing treatment methods is a crucial link connecting the past and future in the sequence of Principle, Method, Formula, and Drug. Undoubtedly, without correct differentiation, there is no effective treatment; but without correct treatment planning, even if differentiation is error-free, it is futile. In short, if the method is wrong, the formula and drugs are all wrong. As early as *Huangdi Neijing* (Yellow Emperor's Inner Canon), the theoretical basis of TCM therapeutics was established, and basic treatment methods were preliminarily summarized. With the development of medical practice, the Eight Methods formed. However, I believe the Eight Methods are merely general principles; the application of specific treatment methods in clinical practice warrants in-depth discussion. My understanding is that human physiology and pathology center on the struggle between pathogenic factors and righteous Qi, focusing on supporting righteousness and expelling pathogens to restore normal physiological states. Diseases have cold, heat, deficiency, and excess; treatments include warming, clearing, tonifying, and purging. Zang-Fu organs have generating and controlling cycles; treatments involve tonifying the mother and draining the child. Diseases arise from Six Evils and Seven Emotions; treatments vary accordingly, changing with etiology and pathogenesis. Humans rely on Righteous Qi as the root. One must especially value the important status of Spleen and Stomach as the foundations of Pre-heaven and Post-heaven activities in Zang-Fu functions. The Kidney is the organ of Pre-heaven Water and Fire, dwelling place of Primal Yin and Primal Yang, connected to the Gate of Life, root of Primordial Qi, and source of Qi transformation for the whole body. It is the "storehouse of essence and repository of Jing," storing essence, generating marrow, governing bones, and filling the brain, termed the "official of strength," governing water metabolism, overseeing reproduction and development, serving as the motive force of life activities and the source of resisting external pathogens. Kidney function relates to all Zang-Fu organs; Kidney disease inevitably affects other organs, and late-stage lesions of other organs inevitably affect the Kidney, known as "chronic illness affecting the Kidney," shaking the foundation. However, the Pre-heaven root (Kidney) relies on the Post-heaven root (Spleen) for nutrition. After birth, the Pre-heaven source is cut off, relying on Post-heaven Qi from food and drink for supplementation. Thus, *Neijing* states: "The Stomach is the sea of water and grain, the great source of the Six Fu organs. Five flavors enter and store in the Stomach to nourish the Qi of the Five Zang organs," and "All Zang organs receive Qi from the Stomach; the Stomach is the foundation of the Five Zang organs." Li Dongyuan further pointed out: "True Qi, also known as Primordial Qi, is the refined essence generated before birth; without Stomach Qi, it cannot be nourished." This illustrates the role of Post-heaven Spleen and Stomach in Pre-heaven Primordial Qi. Not only in growth and development but also in pathological conditions, one relies on the robust transportation of Spleen and Stomach to expel pathogens, assist Stomach Qi, and restore Zang-Fu function. Moreover, not only food and drink are received and transported by Spleen and Stomach, but drugs also rely on their absorption and distribution. In clinical practice, one must pay special attention to the presence or absence of Stomach Qi. "With Stomach Qi, there is life; without Stomach Qi, there is death." In treatment, one should protect Stomach Qi. For example, "If porridge enters the Stomach and diarrhea stops, the deficient patient survives," indicating the return of Stomach Qi.