典藏书目

(I) Carbuncles and Ulcers. For all cases of carbuncles, sores, and ulcers involving tissue damage that belong to Yang syndromes, heat-clearing and detoxifying methods are used. The main formulas include Xianfang Huoming Yin (Immortal Life Elixir), Wuwei Xiaodu Yin (Five-Ingredient Toxin-Expelling Decoction), and Huanglian Jiedu Tang (Coptis Decoction for Detoxification). For internal carbuncles, blood-invigorating and stasis-resolving methods combined with pus-draining techniques are employed. For example, in lung abscess (Fei Yong), Qianjin Weijing Tang (Thousand-Gold Reed-Stem Decoction) is combined with Jiegeng Tang (Platycodon Decoction), plus Chishao (Radix Paeoniae Rubra), Yuxingcao (Houttuyniae Herba), and Yiyiren (Semen Coicis). In chronic episodes, Danggui Shaoyao San (Angelica-Salvia Powder) is often added with modifications.

(II) Heat-Toxicity Damaging Zang-Fu Organs and Qi-Blood. The location should be differentiated, and treatments such as clearing Qi-level heat and cooling Blood, or clearing heat-toxicity from specific Zang-Fu organs, should be adopted respectively. If heat-toxicity is in the Blood level, blood-cooling and detoxifying methods are used, while differentiating deficiency and excess to regulate Zang-Fu Yin-Yang. Generally, I use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) with modifications. Since rhino horn is expensive and rare, it is often replaced by Dai Mao (Megalosauri Carapax et Plastrum) or Guang Jiao (Saiga Antelope Cornu), termed "Dai Mao Dihuang Li" (Megalosaurus and Rehmannia Infusion), which is also effective. If heat-toxicity damages Zang-Fu organs and meridians, the affected meridians must be identified, and treatment principles and herbs selected based on physiological and pathological characteristics.

(III) Cancer. The term "cancer" has existed since ancient times, first appearing in the Song Dynasty text *Weiji Baoshu*. Its causes are generally considered to be external pathogenic toxins, emotional stagnation, or irregular diet and lifestyle leading to disharmony of Zang-Fu Qi-Blood or accumulation of phlegm-dampness, blood stasis, and toxicity. In treating cancer, I emphasize heat-clearing and detoxifying methods. Guided by a holistic perspective, these are combined with methods to support healthy Qi and nourish the root (Fuzheng Peiben), invigorate blood and resolve stasis, etc., for comprehensive treatment. For leukemia, during the initial stage or relapse, when healthy Qi is still adequate but pathogenic toxicity is severe, manifesting as extreme proliferation of immature cells and obvious systemic heat-toxic symptoms, heat-clearing and detoxifying is primary, while supporting healthy Qi is secondary. In the remission phase, supporting healthy Qi is primary, heat-clearing and detoxifying is secondary, and blood-invigorating and stasis-resolving methods are used opportunistically. Common heat-clearing and detoxifying herbs include Qingdai (Indigo Naturalis), Longkui (Solanum nigrum L.), Xionghuang (Realgar), Mutouhui (Ardisiae Japonicae Rhizoma), Lvhui (Aloe), Xiuxiu (Paris polyphylla), Baihua She She Cao (Hedyotis diffusa), and Huangyaozi (Dioscorea bulbifera).

When applying heat-clearing and detoxifying methods, note: ① The severity of heat-toxicity; ② Protect the Spleen and Stomach. Since heat-clearing and detoxifying herbs are mostly bitter and cold, they easily damage Stomach Qi. Herbs that strengthen the Spleen and harmonize the Stomach can be added as assistants, especially for those with weak Spleen-Stomach function. ③ Correctly understand "inflammation." Although "inflammation" is mostly a heat syndrome, not all heat syndromes are inflammation, nor is all inflammation a heat syndrome. One must not automatically apply heat-clearing and detoxifying methods upon seeing inflammation. Conversely, while some heat-clearing and detoxifying methods have anti-inflammatory and antibacterial effects, heat-clearing and detoxifying is not merely anti-inflammatory or antibacterial, and these herbs should not be used simply as antibiotics. Anti-inflammatory/antibacterial treatment and heat-clearing/detoxifying are two different concepts from Western and Traditional Chinese Medicine, respectively, and should not be conflated.

The three methods listed above illustrate the principle of inferring other cases from one instance, seeking methods within methods, demonstrating that only by valuing practice can one deeply explore academic issues.

In clinical practice, one must be flexible and adaptive, as disease patterns change infinitely, making treatment methods equally limitless. Rigidly adhering to these three methods is like cutting off feet to fit shoes or gluing the tuning pegs of a zither. Cheng Zhongling said: "Within one method, eight methods are prepared; within eight methods, a hundred methods are prepared." Only by combining various methods can one achieve success in every attempt. Different diseases naturally require different treatments, and even the same disease cannot always be treated with a single method. Treatment principles should be established based on pattern differentiation and syndrome identification, addressing different pathomechanisms. On the other hand, while flexibility in treatment is prized, once the symptoms are identified and the treatment method determined, one must hold firm convictions and not vacillate or change methods arbitrarily. Flexibility and firm conviction seem opposite but actually complement each other. Without flexibility, one cannot respond to the myriad changes of diseases; without firm conviction, one cannot achieve therapeutic efficacy. Both flexibility and firm conviction presuppose accurate pattern differentiation.

(Organized by Lou Baiceng)

Plum Blossoms Fragrance Comes from Bitter Cold

Lou Baiceng, Researcher at Zhejiang Provincial Institute of Traditional Chinese Medicine, Director of Acupuncture Research Office

[Author Profile] Lou Baiceng (1913–), from Zhuji, Zhejiang. Graduated from Zhejiang TCM Special School in 1935. Devoted over forty years to acupuncture research, also involved in internal medicine, particularly pioneering needle tonification and sedation techniques. His acupuncture experiences were input into electronic calculators for clinical application. Author of *Acupuncture Techniques*, among others.

I have engaged in acupuncture research for nearly half a century, experiencing much hardship. I deeply feel that, like other disciplines, there is no smooth path to climbing the peak. Only by laying a solid foundation, working tirelessly, and persistently applying dialectical materialist viewpoints can one enter the hall and reach the inner chamber.

Striving for Strength

I was born in a middle-peasant family in Zhuji County, Zhejiang Province. My father scrimped and saved, determined to train me into a respected doctor. As a farmer's son, witnessing the lack of medical care and drugs in rural areas, I also aspired to relieve suffering and help people. Thus, in autumn 1930, at the age of eighteen (by traditional counting), I entered the five-year "Zhejiang TCM Special School."

The school offered courses in physiology, anatomy, medical history, hygiene, pathology, diagnosis, materia medica, formulas, Shanghan Lun, internal medicine, gynecology, pediatrics, surgery, acupuncture, tuina, general medical theory, illustration, and calligraphy. The first two years were preparatory, focusing on basic theories, and the next three years were professional, studying clinical subjects. Due to the reactionary government's discrimination and suppression of TCM, disparaging it as "unscientific," and because theories like "Taiji generates Two Modes, Two Modes generate Four Images, Four Images generate Eight Trigrams" in physiology and "Yin-Yang and Five Elements" in pathology often made beginners feel they were ethereal and obscure, difficult to grasp, classes had sixty to seventy new students initially. However, after the first two semesters, more than half would voluntarily drop out. Following my strict instructions and coming from a rural background where I knew education was hard-won, I studied diligently regardless of whether I fully understood the content, relying on rote memorization. Besides evening self-study, I studied hard under dim streetlights at dawn. After lunch and dinner, I practiced calligraphy using *Xingshu Beiyao* (Essentials of Running Script). Due to diligence, I ranked first in the final exams of the two-year preparatory period (four semesters) focused on basic theory. According to school regulations, this exempted me from tuition fees, a great encouragement for a poor student from a modest family.

Entering the third year, the focus shifted to clinical courses. Morning lectures were followed by afternoon internships at the "Medical Service Bureau." Third-year students mainly copied prescriptions, while fourth- and fifth-year students diagnosed patients and teachers revised prescriptions. These teachers were local famous doctors rotating through the role of "internship teachers." Due to busy medical work, most did not lecture, offering at most a few "prescription internship classes." Students recorded patient cases in "Prescription Internship Books," noting gender, age, onset, symptoms, pulse, and tongue coating, then explained the rationale, method, formula, and herbs for teacher review. Since I had a solid grasp of basic courses, my performance in clinical courses remained top-notch.

During the three years of professional study, Dean Xu Jiuren greatly benefited and inspired me. Also from a rural area, he understood the lack of medical resources in villages and often encouraged me to treat patients boldly during holidays to improve skills through practice. He insisted on one rule: regardless of familiarity with the disease, one must consult books afterward. This ensures easy retention, prevents accidents, and accelerates improvement. Thus, during the winter break of my third year, I began treating people. I recall using *Shi Bing Lun* (Treatise on Seasonal Diseases) as my main reference, achieving good results. Teacher Xu's teachings remain unforgettable, and frequent book consultation became my consistent scholarly style.

Obsessed with Acupuncture

During the internship at the Medical Service Bureau, I witnessed the significant therapeutic effects of acupuncture. It not only produced immediate results for sprains and pain but also amazed me with its efficacy for many chronic miscellaneous diseases. This aroused my admiration. Reading the ancient maxim "Herbal medicines attack internally, needles and stones attack externally, thus diseases have nowhere to escape" further stimulated my enthusiasm for learning acupuncture. In the last semester of my fifth year, I shifted my study focus to acupuncture. At that time, there was only one acupuncture teacher, Zeng Guangyi, from Shaanxi, whose ancestors were imperial physicians. He used few acupoints per session, paid great attention to needle manipulation techniques, and could actively control the radiation and conduction of needle sensation, reminiscent of Hua Tuo: "If needling is required, it is usually only one or two points. After inserting the needle, guide the Qi to a certain extent; if you tell the patient and they say the sensation has arrived, withdraw the needle immediately, and the disease will subside." However, this teacher was reluctant to teach his techniques freely, only asking me to practice finger strength by twisting needles in cotton balls. Understanding this was to build a foundation, I practiced on cotton balls and also used spare time walking or talking to twist matches or toothpicks between my fingers. Over time, my finger dexterity improved significantly. Coincidentally, Mr. Cheng Dan'an's *Chinese Acupuncture Therapy* was published in its first edition, containing photos of acupoint locations. I treasured it like a treasure, reading the songs describing acupoint dimensions until memorized, then comparing the chosen acupoints on patients with the photos book by book. I recorded patient symptoms, needled acupoints, depth, radiation pathways of needle sensation, and condition changes. After a period, I roughly mastered his selection rules, but Teacher Zeng still did not allow me to needle patients. I recall once when a patient with retained needles at Quchi (LI11) reported the loss of sensation, while Teacher Zeng was treating another patient. I imitated his manipulation technique and twisted the needle slightly; the patient immediately said, "It's there, it's there!" I felt indescribable joy. After this trial, I proactively manipulated needles for all patients with retained needles. Additionally, I frequently tested needling on myself and classmates; the more I needled, the more flexible my manipulation became. Although Teacher Zeng in the service bureau did not fully let go, whenever teachers or classmates at school had pain or other ailments, they actively sought my needling. I also treated fellow villagers outside the school, with referrals providing daily opportunities for practice. Near the end of the semester, Teacher Zeng suddenly became very warm towards me, giving me a packet of needles, saying, "This is a gift for you, keep it as a souvenir. Your skills are almost learned. I agree to let you hang the sign 'Taught by Master Zeng Guangyi' to practice medicine. You can contact me if you need anything." This surprised me greatly, boosting my confidence in learning acupuncture and making me feel the need for diligent study even more.

Integrating Diverse Approaches

After graduating from Zhejiang TCM Special School in spring 1935, I practiced medicine in my hometown, Zhuji. At that time, the medical community looked down upon acupuncture doctors, mocking them as quacks. Coupled with the collapse of the rural economy, few patients with chronic conditions sought treatment, and most contacts were seasonal infections. Under these circumstances, I focused primarily on internal medicine. I重点 studied *Wenre Jingwei* (Classic of Warmth and Heat), *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases), *Guang Wenbing Lun* (Extended Treatise on Warm Diseases), *Ye Tianshi Yi An* (Case Records of Ye Tianshi), and *Shanghan Zhizhang* (Guiding Principles of Shanghan Lun). Among these, Wu Kun'an's *Shanghan Zhizhang* was particularly insightful and practical. For instance, the included "Method of Observing Tongue and Differentiating Symptoms" was a profound contribution, guiding syndrome differentiation and herb selection. Regarding the plain text of *Shanghan Lun*, although I could recite it upon graduation, the varying interpretations of Six-Meridian transmission by commentators throughout history left me confused and unable to apply it clinically. Later, encountering a child patient with "asthma, sweating, and slight fever," I recalled the clause in *Shanghan Lun*: "For sweating and asthma without high fever, Maxing Shigan Tang may be given." I prescribed one dose, and the condition improved the next day. This helped me truly understand the meaning of "Reading a thousand times, the meaning reveals itself." Consequently, my application of Shanghan formulas leaped forward: I no longer rigidly adhered to terms like "day one, day two, day seven" or "meridian-to-meridian transmission, skipping meridian transmission" in the text. Instead, starting from the actual disease pattern and following the spirit of the original text, I flexibly applied corresponding formulas. For example, if the main symptom was "vexation and oppression in the heart" (heat-toxins congesting the chest causing blockage), I generally used Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) with modifications. If presenting the four major symptoms of "high fever, profuse sweating, intense thirst, and surging pulse," I used Baihu Tang (White Tiger Decoction), keeping in mind the contraindication for cases without sweat. Whenever encountering "knotted and intermittent pulse (irregular rhythm with pauses) and palpitations," I used Zhigancao Tang (Prepared Licorice Decoction), and so on. Furthermore, regarding the application of Banxia Xiexin Tang, Shengjiang Xiexin Tang, and Gancao Xiexin Tang, since the three formulas essentially share the same ingredients but differ in emphasis, I grasped three key points in clinical use: for significant dry belching with food odor, use Shengjiang Xiexin Tang; for severe diarrhea with undigested food, use Gancao Xiexin Tang; for all other cases, use Banxia Xiexin Tang. Thus, returning to simplicity from complexity, mastering the simple to manage the complex, allowed me to achieve good results repeatedly in clinical practice.

At that time, although I focused on internal medicine, I did not forget acupuncture. This was influenced by clauses in *Shanghan Lun* related to acupuncture, such as "In Taiyang disease, headache lasting more than seven days may heal spontaneously because the meridian cycle is complete. If it is about to transmit to another meridian, needle Foot-Yangming to prevent transmission and cure," and "In Taiyang disease, if after taking Guizhi Tang, vexation worsens and does not resolve, first puncture Fengchi (GB20) and Fengfu (DU16), then give Guizhi Tang to cure." *Zhenjiu Dacheng* (Great Compendium of Acupuncture and Moxibustion) was a key text I studied, paying special attention to memorizing various schools' songs and odes, such as "Baizheng Fu" (Ode to Hundred Symptoms), "Biaoyou Fu" (Ode to Subtle Secrets), and "Jinzhen Fu" (Ode to Golden Needles), ensuring evidence-based acupoint selection in practice. During self-study, I deeply felt "Learning alone without friends leads to narrow-mindedness and limited knowledge." However, in the rural area where I lived, there were no acupuncture peers. Therefore, whenever I encountered markets selling acupuncture and plasters, I would gather around to observe their operations closely. I recall once witnessing the needling of Jingming (BL1), with a depth exceeding one cun, which shocked me. Ancient texts recorded only one or two fen depth, and Teacher Zeng at school also used only this depth. I had never seen depths exceeding one cun. Thus, I actively befriended them. Over time, I gained much practical and useful knowledge from them that could not be found in literature. For example, although historical texts listed certain acupoints as "contraindicated for needling/moxibustion," these records contradicted each other, confusing beginners. But folk practitioners viewed it simply: believing "the back is thin as paper," they advised that back acupoints must be needled obliquely along the skin, not perpendicularly. They also stated "avoid tendons and vessels, and you find the acupoint," where tendons and vessels refer to muscle tendons and blood vessels. Although these views seem trivial today, they greatly inspired me at the time. To this day, I still maintain this depth for needling Jingming.

Courageous Exploration

In summer 1947, I left my hometown Zhuji and moved to Hangzhou to open a clinic. For the first two years, since I was known for internal medicine in my hometown and Hangzhou was not far from Zhuji with many fellow townsmen, most patients still sought internal medicine treatment. By 1949, after the liberation of Hangzhou, the People's Government attached great importance to and promoted acupuncture therapy. This eliminated my concern that specializing in acupuncture would label me a quack. Simultaneously, more patients came seeking acupuncture, so I devoted all my energy to the acupuncture discipline I had long been passionate about. My clinic was located opposite the most prestigious "Guangji Hospital" (now Second Affiliated Hospital of Zhejiang Medical University), akin to "setting up a porridge stall in front of a restaurant." Patients who failed to benefit from hospital treatment or refused surgery often came to me with a glimmer of hope to try acupuncture. That was a period of gradually increasing business and my effort to explore and enhance knowledge by linking theory with practice. Through repeated tempering in acupuncture medical practice, some thyroid adenoma patients originally recommended for surgical removal recovered with reduced adenomas after needle treatment. Some low-back and leg sprain patients, for whom hospitals struggled to provide rapid relief, often achieved the effect of "carried in, walked out" after acupuncture. Consequently, the number of patients surged daily, wearing out the door threshold, and the range of diseases expanded.

With the development of acupuncture services, provincial and municipal health bureaus and hospitals successively hired me as a special (acupuncture) physician at institutions such as "Provincial Hangzhou Sanatorium," "Central Outpatient Department," "Zhejiang Hospital," and "Provincial Hangzhou Hospital," and frequently invited me for consultations. Thus, I encountered even more disease types, and the scope of acupuncture treatment expanded to diseases in all systems of internal medicine. In the decades of groping, although I took many detours and experienced failures, I also gained considerable harvest. Here, I select the key points of my experience to narrate, hoping to benefit future scholars.