Original: Wang Qingqi Official Number of China Traditional Chinese Medicine Newspaper
Today's TCM clinical practice is facing three new situations: modern disease is not ancient disease, modern people are not ancient, and modern medicine is not ancient medicine. From the perspective of clinical practice, we face more patients with difficult and complicated diseases, and the disease mechanism is more complex, often virtual, cold and hot, yin and yang, so the treatment can not be conformed to the rules. "Generous restoration" is not a mixed method, in which there is ingenuity and strict compatibility, there are many masters without chaos, and there are few teachers without control.
The author of this article has followed the Chinese medicine master Qiu Peiran to study Chinese medicine for 20 years, and has benefited a lot, let's take a look at what the author has gained.
From 1990 to 2010, the author had the privilege of studying Traditional Chinese medicine with the master of traditional Chinese medicine, Qiu Peiran, and benefited a lot in the past 20 years.
Legislation: Medicine has a common way, and there is no law for treatment
In his long-term medical career, Qiu Peiran has seen various complex medical evidence, so as to realize that "medicine has a common way and cures impermanence". He has treated various types of asthma, and has been cured and alleviated by the conventional therapy of quenching the lungs, warming the lungs, and dissipating the cold, and has also had a certain understanding of the "Golden Essentials" "Sick phlegm drinkers, when warm medicine and it".
In 1990, Qiu Peiran treated a phlegm drinking patient, witnessed a severe cough, day and night, breathlessness, phlegm gushing, the course of the disease has been more than a year. The patient is obese, the tongue is white and greasy, and the pulse is deep. After repeated treatment with Chinese and Western medicine was ineffective, he sought treatment from Qiu Peiran. Qiu Peiran successively used the methods of warming, dissolving, propagating, descending, and purifying, eliminating, and attacking and expelling, but he did not lose any doubt. In the case of the patient's insistence on continuing treatment, he had to switch to skullcap, raw land, gentian three flavors, large doses, 2 doses. After the patient took it, the cough decreased by nine out of ten, and the sputum gushing image was also removed, and several doses were taken continuously and the disease was cured. The sick man rejoiced, and he was also shocked.
Illness is a cold drink, but it is a bitter cold to get it, which is really an "extra-legal method". After experiencing similar lessons, he put forward the theory that "medical theory is difficult to understand, and the usage is variable", believing that only by understanding the "law is impermanent" and "the common law is illegal" can we truly grasp the true essence of the methods of Chinese medicine to treat diseases.
Qiu Peiran taught the students: "Whenever the disease is treated, legislation is enacted, and the law is the key to guiding the prescription to dispense medicines." We usually say that the circular machine living method and the law change with the evidence, which means that the law should be flexible and should not be muddled, that is, the lesion method also changes, otherwise it is difficult to do the work. The ancients had the story of curing fever and changing three times a day. As a doctor, the method should be more, not to glue to a certain law, the more the merrier, for clinical choice, in order to help improve the level of clinical diagnosis and treatment, more methods, can change, less law, want to change can not. ”
Prescription: Eclectic prescription
Chinese medicine prescription has a monarch and a ruler, but Qiu Peiran advocates "eclectic prescription". Xi Yu Jiayan has the famous saying of "discussing the disease first, discussing the medicine later", believing that the prescription medicine is designed for the disease, and the disease is ever-changing, how can the prescription medicine be chiseled and unchanged? When medical students are young, they read prescriptions and memorize medicines, which is only used as a basic basis for entry, and must be learned to change clinically.
Generous restoration, false "both" to surprise
The "Su Qing Zhi Zhi Zhi Da" says: "If the odd does not go, it is even, and it is said to be heavy." "Heavy square" means to integrate the odd square and the even square in one furnace, also known as the generous. Zhu Danxi was critical of "generous" treatment of diseases, saying: "Wide network of wilderness, hope to get a rabbit." Ye Tianshi also said: "Falsehood is used to be fortunate, and peace is used to hide clumsiness."
Qiu Peiran disagreed with the above view, he believed that the changes of human illness are infinite, how can we respond to infinite changes in one law? The cubic medicine is not limited to the number of medicinal tastes, mainly in line with the disease mechanism. "Generous restoration" is not a mixed method, in which there is ingenuity and strict compatibility, there are many masters without chaos, and there are few teachers without control. Qiu Peiran called it "cluttered and orderly.". That is, Zhang Jiebin's so-called "seeking yang in the yin, seeking the yin in the yang", is the law in the law, without a certain degree of medical attainment and clinical accumulation, it is difficult to do.
It is magical in the plain, and it is hidden in "peace"
Qiu Peiran sometimes only uses a bland formula to work. Fei Boxiong, a famous doctor of Ximenghe, famously said: "There is no magic party in the world, only the plain party, and the plain is extremely magical."
Qiu Peiran once treated a 7-year-old boy with swelling for more than 3 months, with proteinuria, and was diagnosed with nephrotic syndrome. Although it has been treated with hormones, cyclophosphamide, spironolactone, pioneer mycin, etc. for more than 2 months, the edema is getting worse and worse, and the proteinuria (+++) is only more than 100 ml per day. When the child came to the clinic, the child's face was unpretentious, shortness of breath, eyelid puffiness, chest and abdomen were swollen like a drum, scrotum was swollen like a ball, the lower limbs were puffy, according to it, the urine was not smooth, the mouth was not thirsty, and the sodium was poor. The tongue is light and fat, the tongue is thin and white, and the veins are deep. This three-burn gasification loss, water wet flooding, treatment should be replenished gasification wet diarrhea. Prescription: Raw astragalus 40 g, oysters 40 g, zephyllum 15 g, black soybean 30 g, jujube 7 pieces. 14 doses. Second diagnosis: after the injection, the child can enter the examination room by himself, the chest, abdomen and face edema are significantly improved, the scrotal edema is all subsided, the lower limbs are slightly swollen, the stomach has increased, the spirit has improved, and the urine protein (++) has been improved. It should still be the original law, and it should be continued to be governed. After half a year of the following service, the patient's condition completely recovered, and the proteinuria disappeared.
Dare to make a strong dose, and be well-matched
Qiu Peiran's medication dosage dares to break through the constant, such as 9 to 15 grams of fine spices, 15 to 30 grams of guizhi, 12 to 30 grams of dried ginger, 9 to 20 grams of appendages, 15 to 30 grams of gentian, 15 to 30 grams of licorice, etc. Qiu Peiran said that compared with the dose of the Zhongjing era prescription, our current dose is much smaller, and the real cure is the Zhongjing fang. Qiu Peiran once used 15 grams of Korean ginseng, 30 grams of dried ginger, 15 grams of cannon appendages, 12 grams of huanglian, 30 grams of fried white art, etc., and 2 doses to cure a patient with diarrhea due to flora disorders caused by excessive antibiotic use.
Use reverse thinking to be surprisingly effective
There are often people who criticize Zhang Jiebin's understanding of the skill of a thick stomach and intestines, Qiu Peiran thinks that this is not the case, he does not avoid the tongue with cooked land, does not avoid the stomach, and the patient often turns incense after taking the medicine. He often treats bronchial infections with Jinshui Liujun decoction, does not avoid coughing and phlegm, and uses cooked ground and angelica. For patients with hypertension, ordinary people avoid appendages, but Qiu Peiran dialectically uses appendages to reduce blood pressure. He warned the students that in the use of medicine, they should dare to question the laws of their predecessors, and that their knowledge should be tested by practice before they can become true knowledge.
Dispatch: Counter-radical and rebellious, chaotic and orderly
Qiu Peiran has been practicing medicine for more than 70 years and has accumulated rich clinical experience, and in 1987, he creatively summarized and published the "Research on Traditional Chinese Medicine and Treatment methods for Difficult Diseases". The "counter-radical rebellion" method proposed in the article highlights the characteristics of Qiu Peiran's prescription. The so-called "counter-radical conformity" is to use drugs with sexual taste, efficacy or effect opposite, thereby stimulating new therapeutic effects.
Qiu Peiran said that today's TCM clinical facing three new situations: the current disease is not an ancient disease (the disease spectrum has changed), the modern person is not ancient (patients often see Western medicine first, take antibiotics, hormones and other Western medicines, changing the patient's physique and adherence to drugs), modern medicine is not ancient medicine (ancient Chinese medicine is more wild, modern Chinese medicine is more cultivated, and there is no ancient authenticity).
From the perspective of clinical practice, we face more patients with difficult and complicated diseases, and the disease mechanism is more complex, often virtual, cold and hot, yin and yang, so the treatment can not be conformed to the rules. Qiu Peiran often uses methods such as cold and heat, diarrhea and mutual accommodation, dispersion and casting, moisturizing and drying, lifting and lowering, and combining dynamic and static, etc., flexible and flexible, and cures many difficult and complicated diseases.
In February 1990, Qiu Peiran treated a 9-year-old boy with cough and shortness of breath for 3 days. Patients have frequent cough and shortness of breath every autumn and winter, and it has been 7 years so far. The day before yesterday, due to the cold from the rain, coughing and wheezing, the phlegm in the throat was screaming, the phlegm was white and viscous, the breath was open and the shoulders were raised, the head was sweating, the thirst was thirsty, and the stool was dry. The tongue is thin and yellowish and slightly greasy, and the pulse is slippery. Auscultation: Both lungs are filled with wheezing sounds. The dialectic is caused by the cold and evil on the outside, the drinking of evil and the heat of drinking evil, the obstruction of the airway, and the sputum and qi fighting each other, resulting in asthma. It is advisable to spread cold in the lungs, clear the heat, and calm the phlegm and asthma. Prescription: Tender dried, net ephedra, light dried ginger, half summer, northern fine spices, schisandra, gentian, mussel, mulberry white peel, ginkgo biloba, hamassaki meat, 7 doses. Taking only 2 doses of medicine, the patient coughs, wheezing is flat, and after exhausting the dose, the phlegm has been reduced, and the stool is also smooth. After a month, the weather changed, the cold became cold again, coughed and wheezed, and auscultation: the breath sounds in both lungs were rough, and dry rales were heard at the bottom of the right lung. Then add aster and white before the top, still take 7 doses, after the medicine, wheezing and cough is flat.
The upper lung is used together with the lung, the evacuation and the lung are combined, and the bitter cold and the heat are applied at the same time, and the effect is rapid.
Qiu Peiran said that the "anti-radical and rebellious obedience" method has meticulous ingenuity and matching skills. Zhang Zhongjing is the first to open the opposite of drug compatibility, and the scientific truth in it is worth in-depth study.
In the clinical practice after leaving the teacher, the author used the teacher's method to cure many difficult and complicated diseases. I have experienced the advantages of this method: the opposite of the medicinal properties, stimulating new therapeutic effects; mutual supervision between drugs to slow down toxic reactions; expanding the scope of treatment and opening up new ways of treatment.
Reading: Must be accompanied by testimony
Qiu Peiran said: "To learn from the teacher, you must practice both proof and reading, only reading without proof, and always feel shallow on paper; only proof without reading, the clinical level will not improve." According to Qiu Peiran's experience, reading should be "boiled on a fierce fire and slowly warmed." The so-called "fierce boiling", that is, when you start to study a certain discipline, or a certain book, you should make deep efforts and read it well. But perhaps can not really seek "very understanding", after repeated reading, thinking, understanding, and gradually understand the true meaning, this is a "slow temperature" process. Su Dongpo has a cloud: "Therefore, the book is not tired of reading a hundred times, and it is familiar with deep thinking and self-knowledge." "Read the book a hundred times, its righteousness is self-evident", it is not enough to do learning with "fierce fire", but also to go through a certain period of "slow fire", the latter is indispensable, and more important. For example, if you boil a large tonic, you must first cook it over a fierce fire, and then slowly warm it before you can fry the true taste. For example, reading the book of Zhongjing, Qiu Peiran advocated "seeking the dharma degree from the pen and ink, and taking the true meaning between the words."
Qiu Peiran believes that those who really have to read the three ambiguities are expensive in a "hua" word. "Transformation" has two meanings, one is digestion; the other is reduction. Whether it can be "transformed" reflects the ability of the reader to unite knowledge and action. For example, licorice soup is a famous remedy for "palpitations and pulse knots" in the "Treatise on Typhoid Fever", also known as "compound pulse soup". Qiu Peiran does not agree with the view that "the ancient formula cannot cure the present disease", and often uses this formula to treat arrhythmia, myocarditis and various heart diseases, and when used, it is not more blind, the whole party is hired, or the addition and subtraction of the chemical cut, and the good effect is not uncommon. There are three main herbs in licorice soup: burning licorice, raw land, and cinnamon sticks. Licorice nourishes the heart, restores the heart pulse, is born in the yin and blood and can activate the blood stasis, and the laurel branch helps the heart yang and through the veins. This side of the qi and blood yin and yang, the combination of dynamic and static, rigid and soft, and mutual control, for the model of the cube. The dose of three flavors can be aggravated, commonly used licorice 30 to 60 grams, raw land 30 to 60 grams, cinnamon 15 to 30 grams. However, if there is puffiness, stool, abdominal distension and diarrhea, the dose of raw land and licorice should be reduced; tachycardia is heavy with bitter ginseng and mulberry parasitism; bradycardia can be added; qi deficiency is even worse, dang ginseng is easy to produce sun ginseng or American ginseng; chest tightness plus danshen 30 grams; palpitations jialong mu, magnet; sleep restlessness plus yuanzhi, bai zi ren, sour jujube kernel; irregular heart rhythm plus bitter ginseng, huang lian, etc. Qiu Peiran often taught: "Zhongjing is wonderful in the fixed direction", it is necessary to study deeply, if you can understand the true interest, you will be able to play with ease, left and right, Yu firmly believes.
Qiu Peiran reads a lot of books, is good at touching the bypass, and has a profound experience of reading. He said, "People say that there is pleasure in reading, and I say that there is suffering and there is pleasure, and happiness comes from suffering, and small suffering gets small happiness, and great suffering gets great happiness." He who does not enjoy himself is unwilling to suffer, and he who enjoys it is happy but does not know his suffering." Qiu Peiran's interpretation of the bitterness of reading can be described as a full range of mysteries, and it is impossible to have such a profound insight without personal experience and experience.
For the doctor: cultivate virtue first, cultivate oneself to reassure people
Qiu Peiran attaches great importance to "education" for teacher education. For the doctor, we should first learn to be a person, and the key to being a person is to have medical ethics.
"Medicine is anthropology", the healer serves people, and no one is virtuous. Qiu Peiran put forward three principles for people: benevolence as the foundation, etiquette as the festival, and righteousness as the balance. Regarding benevolence, "benevolence is also the way of the people", benevolence is the nature of man. "Benevolent, loving others", the meaning of benevolence is "to stand up for oneself, to reach one's own desires" and "not to do to others what one does not want", which is the basis of one's existence. Medicine is a benevolent art, only a virtuous person can "others have diseases, if they have themselves", regard patients as relatives, and be sincere, save lives from water and fire, and turn the tide of the tide. Etiquette not only refers to the etiquette system, the legal system, etc., but is actually the norm of human behavior, which is a specific measure for practicing "benevolence". With "etiquette", people can get rid of barbarism and integrate civilization. The righteous, the righteous, refer to the handling of things to the point of being difficult. Mencius said, "Righteousness is the right way of man," and whether or not etiquette is in harmony with benevolence must be measured by righteousness. That is, ju ren does righteousness, and righteousness is served. A person who lacks medical ethics, the higher the medical skills, the greater the harm to the cause. He believes that Confucianism is the source of nourishment for our dealings with the world, and the so-called "self-cultivation and self-reliance" of Confucianism is first of all self-cultivation, "self-cultivation must first be the right mind", and then "peace of mind", for this reason, during the period of following the teacher, I was asked to study the "Notes on the Four Books".
Qiu Peiran stressed: "Medicine is a trail, culture is a road, a road is a road, and a trail is easy to pass." TCM is both medicine and culture. TCM interprets life and establishes a complete set of cognitive systems to interpret and expand traditional Chinese culture. If you study Chinese medicine without traditional culture, you cannot truly understand its true meaning, nor can you clarify the root and source of its academic development, let alone go deep into the mysteries of Chinese medicine.
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New Media Editor | Luo Naiying