Experience of TCM (1) As we all know, TCM is the only medicine in China for thousands of years, and the people of China have relied on TCM to prevent and treat diseases for thousands of years. For thousands of years, Chinese medicine has played a very important role in the prosperity and health care of the Chinese nation.
Chinese medicine and western medicine have their own advantages and characteristics in professional technology. The advantages of western medicine lie in the precision of testing instruments, superb surgery, complicated organ transplantation and advanced rescue methods. The advantage of traditional Chinese medicine is precisely the weakness of western medicine. The dialectical treatment of traditional Chinese medicine is accurate, flexible and mysterious, which has its unique characteristics in the diagnosis and treatment of many diseases. Such as the diagnosis and treatment of functional diseases, degenerative diseases, viral diseases, phlegm and blood stasis and difficult diseases. People have a deep understanding of Chinese medicine, and quite a few people like Chinese medicine. With the rapid development and evolution of society, people's requirements for health and longevity are constantly improving, and the demand for the treatment basis and nourishing function of traditional Chinese medicine is more urgent.
The traditional understanding of China people is that the older Chinese medicine is, the more popular it becomes. An old Chinese doctor, despite his mediocre skills, can be called an old Chinese doctor, or even a little exaggerated as a "famous old Chinese doctor", which illustrates a very important problem. Chinese medicine is a lifelong profession. So, how can we learn Chinese medicine well? "Biography of Bian Que Cang Gong" said: "People suffer from many diseases, and doctors and patients suffer from fewer diseases", which shows that Chinese medicine is difficult to learn. Wu Jutong, a famous febrile disease scientist, said, "If you are not good at studying medicine, you must study medicine." .
It is difficult to learn Chinese medicine, and it is even more difficult to learn essence. However, if you want to study medicine, you must learn essence. At least, you must establish the goal of "learning essence" in order to become an excellent Chinese medicine practitioner. How can we achieve this goal? According to my personal experience in studying medicine, there are two main points: First, study hard. It is not enough to use "sweating like a pig" to describe the books of Chinese medicine. Reading books of traditional Chinese medicine, we should not only know and understand, but also familiarize ourselves with reading and memory, and even remember many important contents. For example, TCM diagnostics, TCM prescriptions, TCM internal medicine, TCM gynecology, TCM pediatrics, treatise on febrile diseases, synopsis of the golden chamber and so on. If we want to have a deep theoretical foundation, we must also learn Neijing well. Reading Chinese medicine books, we should be good at mastery. The theories of TCM are all derived from Huangdi Neijing, and the clinical courses of TCM are all derived from the experience accumulation and practice summary of doctors in past dynasties.
For example, the study of Treatise on Febrile Diseases should not only be integrated with Synopsis of the Golden Chamber, but also be linked with Neijing first, and then with Treatise on Febrile Diseases. In addition, it should be linked with internal medicine, prescription, pharmacology and diagnostics. For example, shaoyang syndrome in Treatise on Febrile Diseases comes from Su Wenre's theory in Neijing. The shaoyang syndrome in Neijing is limited to the symptoms of chest pain and deafness in shaoyang meridian, while the shaoyang syndrome in Treatise on Febrile Diseases is a syndrome of half exterior and half interior, with symptoms of "bitter mouth, dry throat, dizziness, cold and fever, chest pain, silent appetite, upset and vomiting". Xiaochaihu decoction is the main indication. In Treatise on Febrile Diseases, there is also a syndrome of pathogenic stagnation and shaoyang, which is characterized by mixed cold and heat, upset and thirsty, abdominal distension, yellow and greasy tongue coating, mainly with Haoqin Qingdan decoction, and it is a syndrome of damp-heat stagnation and shaoyang. This kind of contact is more natural.
Experience of TCM (2) I found in the process of learning that I combined profound medical principles with life practice into simple common sense of life. The basic theory of traditional Chinese medicine is more important than speculation, abstraction and practicality, but weaker than intuition, concreteness and poor operability. Therefore, in learning, paying attention to understanding with your previous cultural knowledge and common sense of life often gets twice the result with half the effort.
For example, take the shape of moss on the surface of stones or other objects soaked in river water for a long time in summer as an example to understand the nature of greasy, explain the relationship between greasy tongue coating and water wetness, and thus understand the pathogenic characteristics of wet sticky greasy. Combined with previous clinical practice, abstract theory is integrated into common diseases. For example, after human skin catches cold, it may appear chills, anhidrosis, nasal congestion and runny nose, chest tightness and cough, etc. After taking traditional Chinese medicine to disperse lung and relieve exterior syndrome, the cold is cured. This explains the medical principles of lung anchor powder, resuscitation and nasal congestion, and skin closure in vivo.
It is also found that this subject is closely related to China's ancient philosophy and China's ancient traditional culture. In the process of its development, it also constantly absorbs foreign cultures. Li Shizhen's Compendium of Materia Medica records that most Chinese herbal medicines are not from China, which is enough to prove this point. However, to improve the quality of Chinese medicine, practitioners of Chinese medicine must have excellent basic skills. To lay a good foundation, there are three steps:
The clinical work of traditional Chinese medicine is divided into five links: disease differentiation, disease differentiation, legislation, prescription and medication, which must be implemented in all places in the end. If there is no accurate prescription, there will never be a good curative effect. Therefore, Chinese medicine has always regarded soup head, pulse prescription and medicinal properties as the "three treasures" of enlightenment. "Tangtou" means "Brother Fang". Traditional Chinese medicine is based on Wang Ang's Tang Touge Ji in Qing Dynasty, supplemented by the Collection of Medical Prescriptions. It is required that "soup head" must be memorized to the point where it can be used freely in clinic. "Pulse prescription" refers to the melody of pulse science. At present, the most popular is Li Shizhen's Linghu Vein, but Li Zhongzi's Jia Zhen Yan Zheng seems to be more practical, so the cloud vein will be Er Li. Of course, it is better to have the energy to read more books. Such as: four diagnostic insights, a summary of pulse diagnosis tactics, and seeking truth from pulse science. Yaofu is an introductory book that has been circulated among the people for many years and has great influence. Easy to understand and catchy, it really has a preliminary outline for beginners to use drugs. Although some contents are out of date, they are still loved by the majority of Chinese medicine practitioners. In addition to the "three treasures" mentioned above, "acupuncture songs" can not be ignored. As we all know, acupuncture is the quintessence of China, and it is also a "sharp weapon" for Chinese medicine to go global. To learn acupuncture well, reciting songs and rhymes is a necessary basic skill. Such as: Fourteen Classics, Major Diseases, Songs of Acupoint Detection, Deep and Quiet Fu, Golden Needle Fu, Huitong Acupoint Fu, Liuzhu Micro Fu, Yusheng Song, Yulong Song, Twelve Classics Tonifying and Reducing, and Liuzhu Eight Methods to Recite. As the saying goes, "The song never leaves the mouth, and the fist never leaves the hand". The first step above is the "reciting skills" of Chinese medicine.
The second step after reciting is to strengthen the study of China's ancient literature and medical history. The ancients said, "If a worker wants to do a good job, he must sharpen his tools first." . The Chinese nation has experienced a long history and left a splendid Chinese medicine culture to future generations, which deserves to be a great treasure house for future generations to explore. These documents are all written in ancient Chinese. If you don't work hard on ancient Chinese, it will be difficult to understand. For example, the composition of words, the evolution of vocabulary, the differences of grammar, the common sense of ancient literature and ancient astronomy and so on. , all need to have a certain understanding, otherwise it is very difficult to learn ancient medical literature.
Learning classical Chinese well is like responding to the ancients, and cross-era communication is also a great pleasure in life. Moreover, learning classical Chinese well is the key to open the door to the treasure house of traditional Chinese medicine. Therefore, the second step of Kung Fu is to "learn ancient Chinese well" first.
Everything, any knowledge has a development process. Therefore, no matter what you study, you must understand the development history of this door. To engage in politics, we should learn political history, and to engage in literature, we should learn literary history. Of course, Chinese medicine is no exception, and we must learn medical history well. Only by learning the history of medicine well can we understand the famous doctors and masterpieces of various dynasties and their academic viewpoints, that is to say, we must understand the historical background and objective conditions of their formation. At the same time, we should also know the anecdotes of famous doctors in their past lives. For example, Zhu Danxi studied medicine at the age of 30 and became a doctor at the age of 35. Ye studied medicine at the age of fourteen and studied under seventeen people. This has certain inspiration for the study and growth of a Chinese medicine practitioner. However, people today regard the history of learning as superfluous, which seems to have nothing to do with clinical practice. This is a big fallacy.
Learning ancient prose has the ability to read ancient books, and learning medical history has made clear the choice of reading ancient books. In the process of choosing books to read, you will naturally not go astray. At the same time, we should also read the medical theories, books and medical records of doctors in past dynasties, and have a framework understanding of the achievements of doctors in past dynasties, so as to lay a good foundation for the framework of academic theories. So the second step is "basic work".
If you want to learn Chinese medicine well, you must read some classic medical books intensively, such as Neijing, Difficult Classics, Treatise on Febrile Diseases, Synopsis of the Golden Chamber, Treatise on Febrile Diseases, Warming Classics and Jingwei, Shennong Materia Medica, Medical Heart and so on.
Neijing and Difficult Classics are the basis of Chinese medicine. Yin and yang, five elements, viscera such as meridians, principles of diagnosis and treatment, five movements and six qi all need to be explored from two classics: Neijing and Difficult Classics. However, there are 8 1 Lingshu and Suwen in Neijing, 8 1 Difficult Classic, and more than 240 * * *, which are difficult to read quickly. Therefore, beginners can choose Li Zhongzi's "Ming Nei Jing" or Qin Bowei's "Nei Jing" as readers, and some chapters and sentences must be memorized.
Treatise on febrile diseases is a model of syndrome differentiation of six meridians; Differentiation of zang-fu organs and meridians in synopsis of the golden chamber is the basis of differentiation and treatment of miscellaneous diseases. Compared with Treatise on Febrile Diseases, Treatise on Febrile Diseases systematically discusses the syndrome differentiation of triple energizer, which makes it impossible to diagnose all diseases in this vertical and horizontal direction. (Treatise on Febrile Diseases, Examples). Wen Wen Jingwei takes Neijing and Zhongjing as classics, and leaves, blood, aging and depression as latitudes. Among them, the dialectical system mainly discussed in Exogenous Warmth of Leaves should also be memorized. Shennong's Classic of Materia Medica is the originator of prescription and pharmacy, and it is also a must-read book. Chen Xiuyuan's Materia Medica of Shennong in Qing Dynasty can be regarded as a good reader for beginners. Medical Interpretation is generally regarded as an introductory book, which is a systematic exposition of "eight principles and eight methods", and contains many prescriptions with high curative effect and wide practicability, such as Qige San, Kaiyun Fan, Banxia Baizhu Tianma Decoction, etc., all of which are commonly used in clinic. Intensive reading of these medical books can frame the theoretical framework of TCM. So the third step is "framing work".
As mentioned above, studying for merit, basic skills and building merit are the three steps that "true Chinese medicine" must have. On the basis of these three steps, we should read widely, learn from the experience of modern people and actively introduce modern science and technology. The ancients said, "There are many clinical evidences, so it is better to read Wang Shuhe". Early and multi-clinical, so as to cultivate and bring up a new generation of hard-core "true Chinese medicine."
Long Huang Qi Road, I will look up and down.
Experience in traditional Chinese medicine (3) I lacked confidence in my medical skills before. Mr. Yue Meizhong, a famous Chinese medicine practitioner, once said: "You can forget yourself and lose people everywhere." I once asked myself, "Can I see a doctor like a teacher?" Maybe this is fate. When I was in doubt, I went to xx in 20xx to attend a five-week pure Chinese medicine clinic. Under the leadership of my brothers, plus the Chinese herbal pieces we brought from China, I witnessed the lives saved by pure Chinese medicine again and again, and I also saw many patients get health from this great treasure house of Chinese medicine, which also made me deeply understand the goals and responsibilities that a young Chinese medicine practitioner should have. This experience encouraged me to read and study blogs and further explore the charm of classics.
I think, as a student, the real follow-up is that you have a thinking process of syndrome differentiation and treatment.
First of all, after collecting the information of patients' four diagnoses, the first pathogenesis will appear in your mind, and then think about whether this pathogenesis is consistent with the information of four diagnoses you collected. If not, it may be another pathogenesis. We have to match the pathogenesis with the information of the four diagnoses again, and repeat this process several times before we can roughly find the real pathogenesis of the patient.
Second, think again. What can explain this pathogenesis? Are there any corresponding prescriptions in Treatise on Febrile Diseases, Synopsis of the Golden Chamber and Pharmacology? Instead of looking at the prescription used by the teacher, the point is that you should have this kind of thinking process. Don't go to see the teacher's prescription at this stage, because it may affect your thinking. Because it is possible that the teacher sees a doctor too quickly, and his thinking process of syndrome differentiation and treatment is too familiar, so you can't catch up.
This kind of thinking process can be trained better than copying or reciting a common prescription that a Chinese medicine teacher specializes in treating a disease. Because Chinese medicine has not been classified into different disciplines since ancient times, it can be divided into bone injuries and traumatic miscellaneous diseases at most. The so-called trauma is exogenous diseases, and the so-called miscellaneous diseases are internal diseases, exogenous diseases and women and children. These are consistent and depend on the thinking of syndrome differentiation and treatment of traditional Chinese medicine. If the dialectical step is not taken well, how to treat it? We should study and improve ourselves in a targeted way.
First of all, it is best to read the original text when learning the classics of traditional Chinese medicine. As for the version, I think that for a person who doesn't even understand syndrome differentiation and treatment, he should not understand it first and take the wrong road less.
Secondly, when reading the article, imagine that you are seeing a doctor. This article shows the situation of a patient. Imagine yourself as a doctor. Learn how to analyze the article while reading it. When reading, you may see one or two clinical symptoms at first, and you may wonder if it is some kind of pathogenesis, but it is exterior and interior. Is it cold or hot? If there are a few more clinical symptoms, will you think about the pathogenesis you just thought about? Is there a contradiction? Repeat this idea many times, and finally get a pathogenesis, which is the central pathogenesis to be expressed in this paper. At this time, in fact, we have done a treatment based on syndrome differentiation. Therefore, Zhang Zhongjing's book is regarded as a model of syndrome differentiation and treatment by later generations because of its rich connotation, emphasizing learning and understanding dialectical thinking of Chinese medicine, seeking the mechanism of syndrome differentiation and treatment and investigating the cause.
Chinese medicine education aims at cultivating Chinese medicine practitioners with dialectical thinking. When communicating with many TCM students, I found that everyone has a "atavism" TCM thinking. The so-called "atavism" phenomenon is to ignore syndrome differentiation and pay attention to a thinking method similar to that of western medicine. What cold and heat, exterior and interior, excess and deficiency, etc. , are just a summary of symptoms, and then euphemistically called what disease is caused, not even mentioning the pathogenesis, abandoning the process of syndrome differentiation and treatment.
From the study of classic Chinese medicine works such as Treatise on Febrile Diseases and Synopsis of the Golden Chamber, it is not difficult for us to find a way to see a doctor, which can also be said to be the "housekeeping skill" of Chinese medicine. It is to find out the essential problems and contradictions of the disease in a pile of clinical symptoms and summarize the pathogenesis by combining the reference after four diagnoses. The fourth diagnosis, you may have several pathogenesis in your mind. Think repeatedly about whether those symptoms correspond to this pathogenesis. Maybe this pathogenesis should have another symptom, and then ask the patient. So this is actually consistent with reading and analyzing the provisions of Treatise on Febrile Diseases and Synopsis of the Golden Chamber. Therefore, we can't just focus on reciting articles, and we can't ignore the analysis of articles, because the lack of analysis seems to be divorced from clinic and the thinking method of TCM syndrome differentiation and treatment.