When reading medical books, we usually pay attention to the order. By analyzing the reading experience of doctors in The Road to Famous Old Chinese Medicine, we can know that there are two main ways to learn Chinese medicine, one is from shallow to deep, and the other is from deep to shallow. Next, come with me to learn about the reading experience of famous old Chinese medicine practitioners!

Reading experience of famous old Chinese medicine practitioners 1

Pay attention to the World Expo.

During the three years I studied with my teacher, Mr. Wang Yongyu taught very hard and supervised very carefully. The first choice is Neijing and Difficult Classic, both of which are selected, explained, specified or recited, and all of which are recited, while Materia Medica, Pulse Formula and Tangtouqu Formula are all recited. I have a good memory when I was a child, and I can recite it after reading it many times. I can still blurt out today that clinical prescriptions are always available, which should be attributed to my efforts when I was young. Therefore, there is no trick to reading, as long as you read and recite it repeatedly after understanding the content, you can benefit for life. The theories of traditional Chinese medicine are interrelated, and internal factors, external factors, women and children, big and small, prescription and pulse complement each other. Although my teacher specializes in acupuncture, she is also proficient in women and children at home and abroad. He often tells me that to relieve patients' pain, not only acupuncture and cupping, but also prescription, decoction, fumigation and massage are needed. The more comprehensive the medical skill, the more effective it will be in an instant. He said that Bian Que and Hua Tuo, ancient famous doctors, were all models of versatility and superb medical skills. They can use decoction, acupuncture, moxibustion, * * and Wuqinxi to treat diseases. Therefore, in my medical experience, besides intensive reading of Acupuncture A-B Classic and Acupuncture Taicheng, I also studied Treatise on Febrile Diseases and Synopsis of the Golden Chamber. My teacher especially praised Zhang Jiebin's classic works, not only assigned to recite selected works, but also asked to browse them one by one. The teacher's teaching has made me keep reading Zhang's "Zhang" for decades, and I deeply feel that to become an acupuncturist, I must read through volumes 19 to 22. The first four volumes summarize the opinions of ancient doctors on acupuncture, and only after reading them can we understand the academic ideological origin of later acupuncture monographs. Take the seventh issue of Volume 19 "reinforcing and reducing the deficiency and deficiency with needles" as the discovery, and talk about some experiences in my study. "Lingshu Nine Needles and Twelve Skirts" Tian: "Anyone who uses needles is also virtual and real. When it's full, it leaks. If it is exhausted, it will be eliminated. Evil wins, and then it is empty. This paper reveals the law of acupuncture treatment, which still guides the clinical practice of acupuncture.

Jing Lei combines the original texts of Su Wen Pian and Ling Xie Zhen as its own annotation, which is very helpful to understand the author's original intention. What does "emptiness is truth" mean? "Small Needle Solution" Tian: "The so-called empty reality, empty talk to make up." "Needle solution" item; . For those with deficiency of needling, the needle is full of heat, and the gas is full of heat. Several original articles about reality and reality are concentrated in one place, which can make up for each other and are easy to understand. Deficiency means correcting qi deficiency. There is a virtual image of the pulse at the mouth of the inch, and acupuncture is warmed with needles. At present, the commonly used methods of heating up or burning mountain fires are all developed on the basis of the laws of Neijing. "When it is full, it will leak." "Small Needle Solution" Day: "Those who are full will vent, and those who are full will vent. The day of acupuncture: "Those who are full and discharge, acupuncture cold, qi deficiency cold. "Full means full of pathogens. Mouth pulse, that is, inch mouth pulse, is full of evil spirits, so acupuncture should be used to eliminate evil spirits. Zhang Jiebin Note: People who feel cold due to acupuncture will feel cold due to their own fever.

Cold is the elimination of pathogenic factors, but it is actually empty, so it is diarrhea. The commonly used cooling and purging method, or tongtian cooling method, is the evolution of this treatment method. "Everything is removed, even blood." "Needle Solution" Day: "Evil blood. The meaning is more clear; If there is a disease of blood stasis, it can be eliminated by acupuncture to achieve the effect of promoting blood circulation and removing blood stasis. I used seven-star needle shallow needling and cupping to pull out the coagulated evil blood, which played a role in removing blood stasis and promoting new life, and had a certain effect on treating all kinds of pain and blood stasis. " "Evil prevails over deficiency" means that "if the meridians are unobstructed, evil will be eliminated". The so-called "don't press the needle as soon as it comes out" is to purify its evil spirits. The original text of this section has played an important role in the development and application of reinforcing and reducing techniques in later generations. "Small needle solution" day; Xu's illness is real, and Xu's illness is also said. Illness and Xu are empty, and illness and Xu are out. This is the origin of Ji Xu's modern reinforcing and reducing method. In this section, there are also records of opening, closing and reinforcing diarrhea: "Those who are chronically ill must be solid, and those who are chronically ill must press;" If you are sick and weak, take the needle and press it. Therefore, reading Zhang's classic works is very helpful to understand the ins and outs of acupuncture theory.

Reading widely and using it for me is another experience of my medical course. Studying medicine with a teacher is of course the first step to get started, but studying medicine with a teacher is only a short period of your life. After you are a full-time teacher, you will teach yourself. I often get inspiration from reading medical books when I encounter complicated syndromes in clinic. For example, Li Dongyuan's internal injury theory and spleen-stomach theory are of great help to my treatment. Li believes that the formation of internal injuries is the result of the lack of "Qi" in the human body, and the fundamental reason for the lack of "Qi" is the damage to the spleen and stomach. In the theory of spleen and stomach, deficiency and cold of spleen and stomach lead to discomfort of nine orifices. He said, "The true qi, also known as primordial qi, is the essence of previous life, and it can't be nourished without stomach qi." Acupuncture treatment, focusing on regulating qi, can often strengthen the body resistance and eliminate evil by strengthening the spleen and regulating the stomach. In my clinical practice, when the liver and stomach are not in harmony, chest tightness and pain, acupuncture at Yangwei point and cupping after pulling out the needle can not only expand the chest and relieve bloating, but also regulate qi and stomach. It is also effective for dizziness caused by yang deficiency disorder. In addition, in my 60 years of clinical practice, my understanding of stroke has gradually deepened in fl sentences. In the follow-up class, the previous teachers insisted on the stroke theory in Neijing and Jingui and attached importance to the common cold as a disease. Of course, this cold refers to the external wind and internal wind, and emphasizes the principle of eliminating evil in treatment. At that time, he admired Sun Simiao's comprehensive therapy. Sun Simiao said in Acupuncture: "The way to be a good doctor is to feel the pulse first and then acupuncture. With the help of internal and external factors, the disease will be cured. What is this? Decoction attacks the interior and acupuncture attacks the exterior. You can't do this. Although there is a lot of phlegm, this is an accidental difference, not a medical difference. Therefore, teachers often use acupuncture and traditional Chinese medicine simultaneously in clinical practice. Early treatment of stroke is mainly at Baihui, Fengchi, Li Anquan, Tiantu, Waiguan, Hegu, Zusanli, Taixi and Taichong. Acupuncture manipulation supplements the healthy side and causes diarrhea on the affected side. It is believed that the affected side is attacked by the common cold, and the pathogenic factors are stranded in the meridians, so the mattress method is used to eliminate the pathogenic factors. Bujianfang is to promote the execution of qi and blood with the help of the health of Jianfang, which contains the meaning of governing the left with right and the right with left. Two weeks after the stroke, acupuncture treatment only selected acupoints of the affected limb, such as Shoubang, Quchi, Hegu and Waiguan on the upper limb, Ikezawa and Qu Ze on the contracture of the arm, Tiaoli, Shi Feng, Yangling, Zusanli, Fenglong, Yangfei, Kunlun and Taichong on the lower limb, so as to promote the circulation of qi and dredge the meridians. Drugs for expelling wind and dredging collaterals, calming the liver, calming the wind, resolving phlegm and calming the nerves are also used in the prescription, such as gastrodia, Uncaria tender, fried Saposhnikovia divaricata, Vitex negundo, tender mulberry twig, Trachelospermum, bamboo Pinellia tuber, pilose antler, turmeric, mother-of-pearl, concha Haliotidis, earthworm, arborvitae seed, fried polygala root, etc. I combine acupuncture with traditional Chinese medicine, which can get good results in the early treatment of stroke. However, some elderly stroke patients with weak constitution often show signs of eliminating evil, and the withered limbs recover relatively slowly. What should I do with oral decoction? After reading a lot of medical books, I gradually realized something. Ye said: "Generally speaking, meridians govern qi, collaterals govern blood, and blood stasis is caused by long-term illness. "Wang Qingren's" Yilin Gaicuo "also used Buyanghuanwu Decoction to treat stroke and neglect of hands and feet, and increased the dosage of raw astragalus to strengthen the efficacy of invigorating qi and promoting blood circulation. In recent ten years, in the treatment of hemiplegia caused by apoplexy sequelae, the principle of Buyanghuanwu decoction has been imitated and quite satisfactory results have been achieved. It makes me feel that all strange diseases and chronic diseases encountered today can play a role by imitating the purpose of ancient prescriptions and ancient laws. Therefore, extensive reading can prevent a family's prejudice and constantly revise and supplement their own arguments.

Pay attention to pulse-taking and tongue diagnosis.

The human body is an organic whole and local lesion, which can affect the lesions of the whole body and internal organs, and can also be reflected from the five senses and limbs. As "Danxi Heart Method" said: "If you want to know the inside, you should observe the outside, diagnose the outside and know the inside. Cover the inside, plastic it outside. I have realized the importance of four diagnoses in clinic. Patients taking medicine or injections need to feel the pulse and look at the tongue in order to make correct syndrome differentiation.

In the aspect of pulse diagnosis, besides being familiar with and mastering the different pathogenesis symptoms and different pulse shapes of 28 pulses reflected by the method of nine-waiting and three-diagnosis, this is the basic skill of a Chinese medicine worker and the necessary knowledge to distinguish floating, heavy, late, counting, deficiency and excess pulses to control other pulse conditions. It is particularly important to recognize the pulse as "whether there is a god or not, powerful and powerless" and know that the existence of God can distinguish between life and death; Only by recognizing the existence of strength can we distinguish the deficiency from the reality of disease. Only then can the treatment rules be drawn up, either reinforcing or purging, or reinforcing first and then purging, or reinforcing first and then purging, or reinforcing mother's diarrhea, and so on. However, sometimes the zang-fu organs are deficient and the qi and blood are mixed, and the pulse shapes cross. Then it is necessary to distinguish the relationship between viscera, meridians, yin and yang, deficiency and excess, and five elements, and use the method of regulating meridians and points. For example, slow down to the original pulse of the spleen. For example, there is a deep vein in the right pass, which is water against the soil and wins the slight evil. We must use the method of purging wood to supplement gold in treatment. Aquatic wood, water is the mother of wood, and wood is the son of water. Shedding wood takes away the mother gas, making water unable to resist soil; Soil produces gold, soil is the mother of gold, and gold is the son of soil. Supplementing gold makes the child not eat the mother's anger, and gives the soil a chance to recuperate. It is also a method of invigorating the spleen and benefiting water. In pulse diagnosis and treatment, we must carefully study the principle of five elements to produce grams, combined with clinical experience, in order to keep improving and avoid mistakes.

Pay attention not only to pulse diagnosis, but also to tongue diagnosis. "Clinical Syndrome Tongue Diagnosis Method" says: "The tongue is the seedling of the heart, and the five internal organs are the main ones. The qi passes here and the orifices open here." According to the viscera map, the spleen, lung, liver and kidney are all rooted in the heart, the meridians are the core, and the yin and yang of the hands and feet are tested, and there is no pulse resistance in the tongue. As we know, the diseases of meridians and viscera are not only related to typhoid fever, but also related to internal and external miscellaneous syndromes. These diseases have their shapes and colors on the tongue ... According to the tongue, excess and deficiency can be divided into yin and yang, and yin and yang are not absurd. According to the tongue, the viscera is the main prescription, and there is nothing wrong with the main prescription. This shows the importance of tongue diagnosis. Clinically, it is indeed possible to distinguish the nature of lesions, the depth of pathogenic factors and the deficiency and excess of diseases according to tongue coating, tongue quality and tongue shape. Therefore, there is a saying that "the quality of the tongue can distinguish the deficiency and excess of the five internal organs, and the coating of the tongue can be observed by six internal and external evils". In addition, I think observing the shape of the tongue and carefully identifying the degree of tongue tip tremor can help us understand the patient's psychology and illness. For example, in clinic, patients with similar neurasthenia often have a normal diet and are conscious of their faces, with numerous complaints and endless complaints. Because of the occasional shock or accident in life, they will feel depressed and unhappy, have doubts and doubts, sleep badly, have palpitations and chest pain, feel uneasy, have a weak pulse and have disharmony between liver and stomach. When diagnosing this kind of patients, we must pay attention to observe whether there is tongue tremor. According to the degree of tremor, there are three diagnostic possibilities: first, if the tongue coating is normal and the tip of the tongue trembles, you can know that the patient is as timid as a mouse; Second, the tongue coating is thin, purple or crimson, and the fat on the tip of the tongue vibrates, which can be diagnosed as cardiac pathology; Third, if there is a slight tremor in the middle of the tongue and the coating is thin, yellow or white, it is neurasthenia. According to this, the patients diagnosed as neurasthenia can adopt the method of "taking medicine with the heart", do ideological work patiently and carefully, and treat them on the principle of nourishing the heart and regulating the spleen and stomach, so that there is no doubt that there is no joy in the heart, and the disease wisdom will be lost. According to Dong Yuan's "far desire", patients can smile through tears, and the curative effect is remarkable. This is my understanding of the diagnosis and treatment of neurasthenia in the past 60 years.

Of course, besides feeling the pulse and looking at the tongue, we also need to look at the face, listen to the words, watch the movements, smell the smell, ask questions and ask about the medical history in detail in order to fully understand the illness. Only after comprehensive analysis can the correct diagnosis be made, the treatment be thorough and the expected effect be obtained.

Pay attention to meridian differentiation

Meridian theory is closely related to acupuncture. Acupuncture points are the places where the qi of meridians is injected and exported, so we can't do without the guidance of meridian theory in syndrome differentiation and treatment, prescription selection and other aspects. For example, acupuncture should first distinguish the zang-fu organs, meridians and collaterals of diseases, and then according to the relationship between the zang-fu organs, meridians and acupoints, take the methods of selecting points along meridians, selecting points in regions or adjacent points to make prescriptions. As "Soul Pivot, Acupoint and True Evil" said: "Those who use needles must first examine the deficiency of their meridians, cut them, press them, and then take them according to their reactions." As far as my experience is concerned, it is wrong not to speak according to the meridians. Now acupuncture and moxibustion meridians are often called together, which shows that acupuncture and moxibustion cannot be separated from meridians.

Meridian is the channel that connects zang-fu organs with external collaterals and executes qi and blood, and acupoints are the parts of human body where qi and blood infuse the body surface. Therefore, visceral diseases often respond to body surface acupoints through meridians as tenderness.

Clinically, I often check the tenderness of acupoints on the body surface to analyze the pathological changes of internal organs. Generally, acute tenderness is more obvious, and the range of chronic tenderness is smaller. Although the five zang-organs are in the chest and abdomen, the pulse and qi all originate from the bladder meridian of the foot-sun, so the five zang-organs and Shu are all behind. For example, Shu Fei's cough and choking cough, and Danshu's cholecystitis all have pain, which can be used as an auxiliary diagnosis.

Acupuncture treatment should be induced to some extent, which is called getting angry. I think the degree of radiation induced by acupuncture is determined by meridian route and acupoint efficacy. If the hand is three yin, walk from the chest. Neiguan and Shaohai clear away heat and soothe the nerves, and the needle feels downward; Zhongfu and Legqog withered lung and benefited qi, all of which dissipated downward. The third Yang's hand, walk from it. Hegu can rise and fall, the technique is correct, the needle feeling can reach the shoulder, even the head and neck, and the curved pool can not be kept. Sanyang's feet, coming from the beginning. Zusanli and stomach meridian relieve pain and tonify qi, and the needle feels down to the second toe; Clearing away heat, promoting diuresis and relieving pain, inducing obedience: to the heel, Yanglingquan relieves shock and relieves pain, and the needle feels downward. Foot has three yin, from foot to chest and abdomen. Interrow and Tessie spread upward; Especially Sanyinjiao, can spread to the groin. Obtaining these radiation sensations has a great relationship with the direction of meridians. Yang meridian has the conduction route of Yang meridian, and Yin meridian has the induction direction of Yin meridian. However, this is not absolute. When acupuncture, the divergent route can be changed by changing the direction of the needle tip. For example, Neiguan point, which belongs to the meridian of hand Jue Yin, generally feels that it radiates downward to the middle finger, but you can also use the method of urging qi to spread the feeling of acid swelling upward to the upper part of elbow joint, so that qi can reach the lesion and stop chest pain such as angina pectoris. Therefore, in clinic, in addition to being familiar with meridian circulation, we must master the operation method to improve the curative effect.

Acupoint selection along meridians is a commonly used method in acupuncture clinic. According to the theory of "where the meridians pass, the indications are located", I think that sometimes the treatment along the meridians is better than the regional acupoint selection. If the throat is dry, take Shuangtaixi and use yin acupuncture, which has obvious effect; The hypochondriac pain, nausea and diarrhea at Neiguan and Taichong points, acute tonsillitis pricking the valley and less injury, and taking Yanglingquan have good curative effects. This all belongs to the method of following the meridian. Another example is the hand Yangming large intestine meridian crossing from one person to another on the face, so the mouth and eyes are skewed to take Hegu, the right needle is left, and the left needle is right.

The twelve tendons in the meridians are distributed along the the twelve meridians and follow the body surface without entering the five zang-fu organs. On the aiming platform, I often use the method of "focusing on pain" to treat diseases of meridians and tendons. For example, tennis elbow is a common disease. When examining the patient's elbow, you can find limited tenderness and refuse to press it. At this time, we can use strong acupuncture or Hegu point to vent its evil spirits, and then cooperate with moxibustion and warm acupuncture, which can often relieve tension and achieve better results.

It can be seen that the importance of meridian theory was recorded as early as Lingzhi Jing. "Therefore, the meridians can live and die, can be in all diseases, can adjust the actual situation, and are indispensable. All subjects of traditional Chinese medicine need the guidance of meridian theory, especially acupuncture.

Pay attention to acupuncture manipulation

Acupuncture treatment, in addition to pulse-taking, tongue examination, syndrome examination and cause finding, also has a great relationship with manipulation. I advocate gentle needling. First, tighten the acupoints with the fingernail of the left thumb to disperse qi and blood, and then hold the needle with the thumb and forefinger of the right hand. The speed of needle insertion should be slow, and the rotation angle should be small and slow, which can not only alleviate the pain when skin is broken, but also do not damage blood vessels. This will make the newly diagnosed patients who are afraid of acupuncture willing to accept acupuncture treatment. However, children's needle insertion methods vary from person to person. Because children are small and thin, it is not easy to get cooperation, so it is not appropriate to use the method of strong needling for a long time, nor to use the method of slow needling and twisting. Specially selected half-needle method, no needle left, easy for children to accept, clinical use, good effect.

For adults, it is necessary to strengthen twisting and proper insertion when acupuncture reaches the dermis and enters between bones and muscles. When there is a heavy feeling under the needle, the patient also feels bloated and bitter, which is getting angry; If the patient only has a tingling sensation after the needle is inserted, and the doctor feels like stabbing a knife in tofu, there is no tension. This is not good for qi, so we must use the method of waiting for qi to get the curative effect. As "The Nine Needles and Twelve Origins of Lingshu" said: "The key to pricking is qi, and qi is effective." This is very reasonable. I have been practicing medicine for 60 years and have compiled ten prescriptions: "Acupuncture therapy focuses on getting angry." Methods of getting angry, lifting, inserting and twisting. Lifting and inserting combination, twisting and turning combination. Fingers have changed, much the same.

After purity, the spirit is one. Of course, everyone or every acupoint is not exactly the same. Most acupoints may have a feeling of soreness and swelling, while some acupoints have a feeling of heaviness or numbness. After acupuncture, according to the results of syndrome differentiation, selecting acupoints and using appropriate techniques will certainly achieve good results.

As for the method of supplementing thirst, it is mostly composed of lifting, inserting and twisting, plus the combination of fast and slow diseases, yin and yang, and 96 numbers. Used properly is effective. Deficiency syndrome is supplemented by purgation, excess syndrome by purgation, heat before cold by purgation, and heat after cold by purgation. When the pain is severe, I often use Long Hudou's method, which is a comprehensive method of reinforcing and reducing, with twisting as the main method, combined with turning left nine times and turning right six times, and repeated implementation can dredge channels and activate collaterals to achieve the effect of pain relief.

Pay attention to regulating spleen and stomach

Chinese medicine believes that after birth, people mainly rely on the improvement of spleen and stomach function to ensure the needs of growth and development. "Stomach governs reception" and "spleen governs transport and transformation", which cooperate with each other to digest Shui Gu and absorb subtleties, thus nourishing the whole body tissues and organs. Therefore, the spleen and stomach are often compared to "the source of biochemistry" and "the foundation of the day after tomorrow". Based on this, Li Dongyuan thought that "vitality is sufficient, and it can nourish vitality if it is not harmed by the qi of the spleen and stomach. Stomach qi is weak, diet is doubled, spleen and stomach qi is damaged, but vitality is not full, and all diseases are caused by it. Deficiency of stomach leads to deficiency of qi in the five zang-organs and six fu-organs and limbs of the twelve meridians's fifteen collaterals, and all diseases arise. As for the evil spirits of heaven and earth, they are sentimental about the internal organs and lack of qi, which is caused by external evils. Don't be trapped in virtual evil, thief evil can't harm others alone. Please get sick from the spleen and stomach, very clear. He expounded and developed the pathogenesis of "Qi deficiency due to the combination of pathogenic factors" and "Excess of vital qi leads to the impossibility of pathogenic factors". Thus, it puts forward the arguments that "people take stomach qi as the foundation", "spleen and stomach are injured, and five diseases coexist" and "diseases start from spleen and stomach, and health preservation should be true vitality", and establishes the "spleen and stomach theory" Advocate the method of warming spleen and stomach as the treatment. Strengthening yang and benefiting qi is enough to resist external forces, strengthen the soil and consolidate the foundation, make the vitality self-sufficient and relieve all diseases. All changes of deficiency and excess should be based on the treatment of spleen and stomach. It embodies the essence of "treating diseases from the root" and is the central idea of Li Dongyuan's spleen and stomach theory.

I agree with Li Dongyuan's theory of spleen and stomach. Clinically, it belongs to the disorder of gastrointestinal digestive system, and it is important to regulate the spleen and stomach. If it is other diseases, whether it is emotional depression, eating fatigue or symptoms of wind, cold and dampness, it is treated according to the spleen and stomach theory. The treatment method should be based on regulating the spleen and stomach, combined with symptomatic treatment.

Reading experience of famous old Chinese medicine practitioners on the road II

I have seen the road of famous old Chinese medicine practitioners more than once, and I have gained something from watching the road of famous old Chinese medicine practitioners Reading it before the first class at night shift is just like reading a novel. A cursory tour will soon be finished. When I closed the book, I didn't feel much except the spirit that it was not easy to study medicine and the unremitting pursuit of the old gentlemen. Intermediate stage, read it again. After opening the book, every word reads much more kindly. I like the medical records mentioned in the book, and I am deeply moved by the old gentleman's way of learning medicine and practicing medicine.

Now, reading it again has a different feeling. This time, I read every word carefully. I like reading medical records best, but what benefits me most is the research methods introduced by the old gentlemen, and what moves me most is their steadfast, persistent and persistent spirit of seeking and studying!

With regard to learning methods, all the old gentlemen, without exception, stressed the need to study hard, be good at thinking and face clinical changes. At first glance, this seems to be a cliche. But why is everyone emphasizing this? There is only one reason: because it is really the only effective way. After studying in the first ten classes, I think the method summarized by Mr. Ren Yingqiu is more suitable for the present study. Teacher Ren used a lot of space to carefully introduce the eight-character motto of "intensive reading, diligent writing, thoughtful thinking and good memory".