中医体系介绍(TCM newsletter)1

 

中医体系介绍

Different systems in Traditional Chinese Medicine

 

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Millwoods Acupuncture Center
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Edmonton AB,   Canada

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TCM newsletter (1). 中医体系介绍

Different systems in Traditional Chinese Medicine

 

本系列文章主要是为那些不懂汉语,所以没有机会进一步通过自学提高中医草药治疗水平的中医针灸医生所编写。如果您懂汉语,也没有兴趣,或觉得没有必要通过我们这里的中医资料提高自己的中医水平的话,可以就此打住,点击下面的 unsubscribe” 键取消我后续的文章。如果本文打扰您,就请原谅。

This is a series of articles introducing Traditional Chinese Medicine (TCM), especially its herbal therapy. It is designed for those acupuncturists, who have no access to the TCM books since they do not speak Chinese, but who have desire to increase their skill level of Chinese herbal therapy. If you speak Chinese, and if you have no interests to read more articles about TCM herbal therapy since you believe that you already know all the knowledge about TCM from your TCM text book, you can stop now and click the “unsubscribe” button below. We will no longer bother you in future.

这一系列文章将以讲解《伤寒论》起步,之后介绍常用经方以及时方方剂的临床应用经验。这是作者学习《伤寒论》本文,学习诸多中医前辈应用经方的经验(出版的书籍和网上的经验文章)之后的总结。对于年近退休的作者,觉得实在有必要将自己学习和应用经方的心得和体会和有志提高中医诊疗水平的人们分享。

The series of articles will start from the introduction of our TCM bible Shanghan Lun. Later we will introduce the use of the herbal formula in this book, which we call it Jing Fang (it means the principle of herbal formula), as well as some commonly used conventional herbal formula. The information here is the summary of the experience of the author during his own study of the book, and also the experience of other famous TCM doctor in the use of the Jing Fang. The author feels worthwhile to share his experiences with those who want to learn more about Chinese medicine. The author would feel pity that his experience is lost after his soon retirement.

许多经方,比如大青龙汤,如果我们单就《伤寒论》原文来学习,或者仅仅结合中医教科书来学习怎么应用,大青龙汤在临床上应用机会会很少。许多中医医生恐怕一辈子也用不上几次。然而,大青龙汤在我们这里 (指的是加拿大西北部,埃德蒙顿市)应用的机会非常多。这是因为大青龙汤的主要适应症为‘寒包火’,即外寒里热之证。我们这里的气候寒冷而干燥,体质和疾病本质为“寒包火” 的病人其实很多。许多在一般中医医生那里看来是风热外感,常需要用银翘散,或桑菊饮的病人,用上大青龙汤后疗效比用这些时方的疗效好很多。当然,需要用于‘寒包火’的方子很多,比如说小青龙汤加石膏,麻杏石甘汤,等等,如何区别这些方剂是之后一系列文章要讨论的。

Many Jing Fang, such as Da Qinglong Tang, would have no much chance to be used in clinic, if we only learn how to use them from the book Shanghan Lun or from TCM text book. Many TCM doctors may use such formula only several times through his whole life in clinic work. However, it has been used very common in our clinic. We are in Edmonton, the northwest of Canada. The main indication for using this herbal formula is the “Cold folds Fire”. It means that the body is cold syndrome in the outside layer of the body, but hot inside. People live in the north of the Canada (even in China, or on the whole earth), tend to be such body constitution.People live in the south of the earth tend to be “Fire folds Cold”, e.g. outside of the body is hot but inside is cold. Many times, for a patient who suffers from a syndrome which is typically diagnosed as Wind-hotness syndrome and needs the herbal formula - Yin Qiao San for the treatment. However, we use Da Qinglong Tang. It works much faster. The illness consistently gets better.

我们相信不同地区,由于气候条件不同,就会有不同的疾病类型,故而常用的方剂也就会有所不同。比如说温哥华气候温和潮湿风大,用于湿热性疾病的寒凉性中药方剂就多一些。而我们这里需要用的药物和他们那里就很不同,我们温热方剂用的非常多,比如桂枝汤,麻黄加术汤,桂枝附子汤,附子汤,等等。我们就是希望能和同行交流这样的经验,共同提高中医疗效。中医现在连继承,复制老祖先的疗效都达不到,还奢谈什么中医的发展!

We believe that there are different disease patterns in different parts of the earth, for the different weathers, different life styles, etc.; therefore there should have different patterns of herbal therapies, e.g. some herbal formulae would be used more frequently than others. For example, the weather in Vancouver is humid, warm, and windy. There is more Dample-hotness syndrome, so the doctors need to use more Cold and wet-removing herbs for the treatment. In our city - Edmonton, the weather is cold and dry. We use more warm herbs, such as formula Guizhi Tang, Mahuang jia Zhu Tang, Guizhi Fuzi Tang, Fuzi Tang, etc. Our aim here is to share such experiences, thus increase the healing level of TCM doctors.  

中医其实是有不同学派,或称之为风格的。它们之间的区别不仅仅是将治疗从脾胃着手还是从肾着手那样的区别,而是从区分疾病类型,对药物的理解等方面都不同。作为系列文章的第一篇,我们先讨论中医有那些不同的学派。

There are several major styles of Traditional Chinese medicine. The TCM here mostly means the Chinese herbal therapy of the TCM system. For example, we have Jing Fang style, conventional style, and college style, etc. As a professional TCM doctor or an acupuncturist, you should know that what you learn from TCM school is not the whole TCM. What you learnt in school is only an information mixture of TCM from various TCM sources.

现在我们来看中医有那些主要的学派

Here let’s see how many major styles the TCM has:  

 

(1). 经方派

(1). The Jing Fang style.

经方派指的是《伤寒论》书中的方剂。因为本书被公认是中医的经典,所以书中的方剂也就被称为经方。表明上看,本书谈的是对于外感风寒所致疾病的诊断和治疗,也就是我们所说的伤寒病,但是它也指出了对于温病的鉴别诊断和治疗框架。一般来说,伤寒病不传染,而温病属于传染性疾病。如果一个医生主要用经方来治疗疾病,我们就说他属于经方派。

This is the TCM style that based on the TCM book Shang Han Lun. This book is regarded as our TCM holy bible. This book focuses on the treatment of diseases that are caused by the Wind- and Cold-attack, which we call Shanghan disease, though it actually also introduced the principles for the diagnosis and treatment for the diseases caused by the Wind- and Hotness-attack, which we call it Wen disease.

If a doctor mostly uses the herbal formula from the book Shang Han Lun, we call his style is the Jing Fang style. Jing here means the principle, the bible. Fang means herbal formula.

伤寒论将疾病分为六个阶段,也称之为六种病。它们分别是太阳病,阳明病,少阳病,太阴病,少阴病和厥阴病。这样,许多伤寒类型的急性病和许多杂病都可以被简化为这六种病,或这六种疾病的合病。

In the Shanghan Lun system, the diseases are separated into six stages. The disease develops from an early stage into further deeper stages. These stages are named Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin and Jueyin stage. Master Zhang Zhongjing called these stages also diseases, such as Taiyang disease, Yangming disease…. and Jueyin disease. In this way, most of clinic problems can be summarized into these six kinds of diseases. It makes the clinic situation much simple and easy to handle.

比如说,如果病人脉浮,头项强痛而恶寒,我们就可以说他患了伤寒病中的太阳病,也就是说他的病现在是太阳病阶段。这时候,不管他是否有咽干咽痛,是否有咳嗽咯痰等都可以作出这样的诊断。

For example, if a patient feels chilly, has pain on the head and neck, and if his pulse is floating, we will say that the patient suffers from Taiyang disease, or we will say that his disease is in the Taiyang stage of the Shanghan disease. If a patient has bitter taste in mouth, dry in throat, and feels dizziness, we will say that the patient has Shaoyang disease, or we will say that his disease in the Shaoyang stage of a Shanghan disease.

对于治疗,不同的疾病阶段都有相应的主方。比如说治疗太阳病有麻黄汤和桂枝汤;治疗阳明病有白虎汤,葛根汤,栀子豉汤,承气汤;少阳病有小柴胡汤;太阴病有理中汤;少阴病有四逆汤,当归四逆汤,黄连阿胶汤;厥阴病有乌梅丸。一般来说,经方中药味多在四到六味。许多药味是普通中医医生所不敢用的,比如麻黄,石膏,附子及大黄等。他们不敢用这些中药,是害怕副作用。但就我们自己的经验,这样药并不是想象的那么有毒性,或副作用并不是那么可怕。

For the treatment, each disease has a main formula for the treatment. In most cases, the main formula contains only 4 to 6 herbal ingredients. Many herbal ingredients used in the formula, such as Ma Huang, Da Huang, Shi Gao, Fu Zi, etc., are rarely used by TCM doctors in College style (see below).  They are afraid to use them, fear of possible side effects. However, in our clinic practice, the side effects from those herbs are not as severe as they think.

经方派对于中药作用的理解似乎并不遵从现在中医教材使用的李时珍的《本草纲目》,而是符合于《神农本草经》。

In this Jing Fang style, its understanding of herbal function appears based on the book Shen Nun Ben Cao Jing, not on the book Ben Cao Gang Mu that is used by College style of TCM.

如果诊断正确和准确,经方的疗效极佳,而且疗效肯定,确实,可重复。如果我们说对于一个具体的病,经方的疗效为 80%以上,那么用时方或学院派思路治疗的有效率大概就只有50%60%

The healing effects from these herbal formulas are excellent indeed, if the diagnosis is correct. If we say that the success rate with the use of these formula are more than 80%, then with the use of herbal formula in other herbal therapy styles might be only 50% to 60%, according to our comparison in clinic practice.

学习经方的困难在于初学难。因为《伤寒论》并不讲疾病为什么这么诊断和那么治疗。不讲每种药物的作用。不讲为什么加一味和减少一味的原因。所以不同的读者会有不同的理解和体会。加之仲景先生似乎将诊断和鉴别诊断的段落安排在同一个疾病章节,不太容易判断那些段落属于本章节,那些当为鉴别诊断之目的而列为同一个疾病章节中。这样,难以判定那些著者的看法是仲景本意,而那些不是。但是,如果我们一旦掌握了它,会觉得经方真管用。

The real problem with the Jing Fang style is that it is hard to learn in the beginning. However, once we really understand it, it works very well. In my experience, it should not be studied only from the book itself. We should learn from other doctors’ clinic experiences in the use of this Jiang Fang style. Therefore, once we really understand the way to use such formula for the treatment, it would be easier to feel success in clinic practice.

 

(2). 温病学派

(2). The Wen Being style.

温病学派起源与伤寒论,这是无疑的。可以说温病学派是对于伤寒论对于温病的诊断和治疗手段的补充和发展。

This system is a development, not a completely new, from the Shanghan Lun system above.

温病学派由叶天士先生和吴菊通先生创立。它是伤寒论经方派对于温病诊断和治疗手段的发展和补充。

It was introduced by Master Ye Tianshi and Wu Jutong (Qing dynasty). It is the supplementary of the Shanghan Lun in the treatment of epidemic diseases characterized by fever. Wen means hot or fever. Being here means a disease. So, the Wen Being means epidemic diseases that characterized as fever.

温病学派将疾病分为卫气营血几个主要的阶段。不同的阶段用不同的药物。如同对于温病的理解为温病之本为邪气导致机体处于火热状态,故而需要用寒凉药物治疗。但是由于对于这种寒凉疗法的夸大,造成许多许多医生滥用寒凉,使得许多需要用温热药物,如麻黄,附子等,治疗的疾病不能得到适当治疗。目前卫气营血辩证主要用于发热性传染病的诊断和治疗过程中。

The Wen Being system bases on Wei Qi Ying Xue and Three Jiao diagnosis system. As mentioned above, it is mostly used with epidemic disease. It is not a commonly used diagnosis system in daily clinic work.

(3). 四圣心源学派

(3). The Si Shen Xing Yuan style.  

四圣心源学派由黄元御老先生创立,彭子益先生进一步将其通俗化。

It is introduced by Master Huang Yuanyu and further completed and explained by Dr. Peng Ziyi. Si means number four; Shen means sages, and the Xing Yuan means the secret experience in heart.

本学派注重人身元气在体内的周流畅通,认为元气升降沉浮的动力不足或通道上的堵塞是导致疾病的原因。元气是从人体的左侧上升(从左手诸脉判断),而从人体的右侧下降(从右手脉搏判断)。进一步讲,脾气升而胃气降,肝气升而胆气降,等等。补足元气和疏通通道是治疗疾病的目标。

This system focuses more on the Qi movement in the body: its rising and falling and its round circle in the body. The aim of the diagnosis is to find if the problem is due to the block on the way of the Qi rising, or on the way of the Qi falling, or both. It believes that fixing the block and improving the Qi in circle in the body would solve the disease.

在诊断上,本学派特别注重脉诊。本学派对于草药作用的理解也多从草药对于元气的升降沉浮作用上来理解和解释。

During the diagnosis, this system pays much more on the pulse. Doctor in this TCM style needs to have very fine feeling on the pulse. In this style, its understanding of the herbal function is somehow different from other TCM styles.

 

(4). 小方疗法

(4). Xiao Fang Liao Fa style.

小方疗法由郭志辰先生创立。小方疗法用药很少,一个方剂里面多少情况下仅仅用四位药物,而且每味药物的用量也多在七克左右。所以称为小方疗法。

Xiao means small; Fang means formula; Liao Fa means therapy. This system treats disease with very little herb ingredients and less amount of ingredients in formula.

小方疗法也称空间医学。因为它将人体看作为有四个空间。除了中医常说的三焦,即上焦,中焦和下焦外,还有第四焦,即脊柱腔。它认为人体能量的运动是从下焦上升到中焦,再到上焦,从上焦越过肩部到达后焦,从后焦经会阴部返回下焦完成一个循环。如果元气上升过程中的路途受堵或元气推动力不足就会出现疾病。

This style of TCM is developed by Master Guo Zhicheng. Xiao Fang means small formula - using only several herbs and using small doses for each herb. It works to improve body energy movement smoothly in the four cavities of the body (e.g. the chest, the upper belly, the lower belly, and the spine cavity.) It believes that the energy of the body, the Qi, moves in circle from the spine cavity to the lower belly cavity, up to the upper belly cavity, to the chest, and then turns down to the spine cavity again. If there is any blocks in the way of the Qi circle, the person will get sick. To remove the block and to improve the Qi circle in such a way in the body, the disease can be cured.

In the treatment, it used only very limited total amount of herbs, say about 20 to 30 kinds of herbs in total. For each formula, it uses only 4, or only 6 herbs, for the treatment.

诊断上,本学派特别注重舌诊基本上不用脉诊。对于舌头形状,血色,舌苔的薄厚湿润程度等的理解和解释都和中医教材有很大不同。同样,对于所用草药的作用的理解和解释也多从其对于元气运动的作用上来着手。

Upon diagnosis, it focuses much more on the tongue. Its understanding on the shape and size of the tongue, as well as the color and the thickness of the tongue covering, is much different from the TCM text book. Its understanding of the herb function is also much more different than any other TCM styles.

(5). 象数疗法

(5). Xiang Shu Liao Fa

象数疗法是让病人默念某种特定的数字组合来治病的中医体系。这些数字的组合是根据脏腑和数字的对应关系,以脏腑辩证-气血阴阳虚实辩证为依据的。比如说数字 4 代表 肝;3 代表 心;8 为脾;2 为肺;6为肾;5 为胆;7为胃;3 为小肠;1 为大肠;6为膀胱;3为三焦等。

The Xiang Shu Liao Fa style uses number (1, 2, 3, 4, …) for the treatment. Xiang means a phase, a stage, a status, or a direction. For instance, the spring, the summer, the autumn, and the winter, are different phase, different stage, different status, or a different direction. Shu means number, one, two, three, four… up to ten. Liao Fa means a therapy.

The theory behind this style is the five element theory in TCM, in which liver is associated with, connected to, affected by, the figure 4; heart, by figure 3; spleen, 8; lung, 2; kidney, 6; gall bladder, 5; stomach, 7; small intestine, 3; large intestine 1; urinary bladder, 6; and the three Jiao, 3.  

数字的选择根据病变的部位和性质。比如说肺气虚,选择数字820. 其中8为脾,2为肺,脾生肺。0用来加强疗效。所以用脾土来生肺金。让病人默念820多遍也就可以达到治疗目的。

In the treatment, the patient is asked to patter in heart the numbers. The chose of the number is decided by the nature of the disease and the relationship between the organs that was involved in the diseases. For example, if the disease is diagnose as lung Qi deficiency, the patient is asked to patter 820. The 8 represents the function of Spleen; the 2 represents that of Lung. To patter zero here is to enhance the healing effect. To patter number 8 will improve the function of Spleen, and patter 2 will improve that of Lung. By this way, the function of the lung is improved directly by pattering 2 and indirectly by pattering 8. Therefore, pattering 820 can solve Lung Qi deficiency condition. This is one of the principles in the chose of numbers for the treatment.

显然,象数疗法完全不用草药。它是中医体系中一个完全不同于我们熟悉的分支,然而,它仍然遵从五行学说及脏腑辩证学说。

Apparently, the Xiang Shu Liao Fa does not use any herb at all. It is a completely different therapy in the TCM scope while it still applies the basic concept in the TCM for the diagnosis and treatment.

 

(6). 时方派

(6). Shi Fang style

这一学派的中医多有自己对中医独特的理解和贡献。比如说提出脾胃论》的李东垣,提出滋阴学说的朱丹溪。王清任的活血化瘀理论和和实践;陈少东先生的外伤治疗体系;傅青主先生治疗男科女科;张锡纯先生治疗晚期病;郑钦安先生的阴阳辩证治疗法,祝味菊等先生的火神派疗法。

The Shi Fang style of TCM means the conventional TCM style. Doctors in this style follows various TCM systems developed by other doctors in the history, but also have their own contributions to the development of the TCM. Their contributions complete and make supplementary to the whole TCM. For example, Dr. Li Dongyuan developed the Spleen-stomach theory; Dr. Zhu Danxi developed Yin-nourishing theory.

Dr. Wang Qingren developed the way to solve blood stasis condition. Dr. Chen Shaodong contributed to the treatment of external damage (trauma). Dr. Fu Qingzhu contributed to the treatment of disorders in the male and female system. Dr. Zhang Xichun contributed to the treatment of later stage diseases, in which the patient’s condition is very complex and the treatment becomes very difficult. Dr. Zheng Qing contributed to the use of herb Fuzi in the treatment of various diseases.

这些中医流派的发生和发展多少都带有经方派的痕迹,但仍然有自己的特点。它们的出现的继承丰富和完善了中医的整个体系。中医历史上这样的名医大师很多,比如当今的李可老先生,刘绍武先生,等等。

There are many famous TCM doctors in Chinese history. For the treatment of some diseases, their herbal formulas work better than the Shanghan Lun style, so that their formulae are still popularly used in current days.

 

(7). 学院派中医

(7). The College system.

学院派中医指的是现代中医院校教材所用体系. 其为整合历史上各中医流派而重新编排的体系, 并无实质上的诊断和治疗上的创新. 我们也可称之为课本中医吧。如果一个中医医生觉得中医课本是中医知识的精华,是将浩瀚的中医知识,理论,学说,临床经验等经过去伪存真,去粗取精后的归纳总结,那么这个“课本中医”在他那里就当是个褒义词吧。

This style is developed from the TCM text book that is still used in China and out of China currently.

The TCM text book is a mixture of the TCM literatures and styles from various sources. It is not developed by a single doctor or a group of doctors in the history, but edited by a group of western medicine doctors in about 1950s’, who wanted to learn TCM and wanted to make the TCM easier to learn. It is pretty much as a mixture of Chinese food, Indian food, Italian food, and French food, all in one dish.

本学派注重脏腑辩证-气血阴阳虚实寒热辩证. 注重舌诊和脉诊. 治疗上讲究平和安全,不敢用作用猛烈之方,如经方。讲究治病目标的面面俱到,故用药味多, 量大, 随意加减。

This style follows the Organ diagnosis and Qi, Blood, Yin, Yang, Phlegm…diagnosis system. It pays more on the tongue diagnosis and pulse diagnosis. It focuses to use “safe” herbs for the treatment, so that it dares not to use “stronger” herb, those of which are used commonly in Jing Fang style.

其对于中药药理理解以李时珍《本草纲目》为主. 注重引经药物的使用。

For the understanding of herbal function, this style follows the book from Dr. Li Shizheng Ben Cao Gang Mu.  It also pays more attention to the use of meridian-guiding herbs in a herb formula (the guiding herbs brings the rest of herbs working in a specific part of the body).

实际工作中, 医生多用经方派所用的治疗八法 (汗吐下和, 温清消补) 中的和法, 温法, 清法, 消法和补法. 较少使用汗法, 吐法, 下法. 用药较少用麻黄, 石膏, 大黄, 附子等作用竣烈, 毒副作用较大的药物. 一个方剂中药物的种类用的多,多在十多味以上,每味药物的用量也越来越大,达二十,三十克或更多。这是由于医生多期望用一个方剂解决病人所有的病痛而尽可能出现少的药物副作用。

In practice, doctors in this style usually use only the harmonizing therapy, warming therapy, cleaning therapy and supplying therapy, but less the sweat therapy, vomiting therapy, or colon-cleansing therapy. They tend to use less strong herbs for the treatment, such as Mahuang, Shigao, Dahuang or Fuzi, etc.

The herbal formulas prescribed by the TCM doctors of College style tend to use more than ten, even twenty or thirty herb ingredients in a single formula. Each amount of the ingredient is also usually very high. It can reach 20 grams, 30 grams, or even more. They tend to solve all the problems of a patient at the same time, while to make the patient feels as less discomfort (side effect) as possible from the herbal therapy.

其疗效因病种和因医生而差异极大. 医生自己心里的把握不甚大,所以常需要病人吃一周或更长的时间才才复诊。一旦诊断或治疗受阻, 章法自乱.

In clinic, the healing effect from the College style of TCM is low and largely variable among doctors (compared with the Jing Fang style). The doctors usually tell patients to take the herbal tea for one week, or ten days, then come back to check the effect of the herbal therapy. Once the herbal formula does not work, the doctor usually has no clear ideas what to do next.  

课本中医初学容易, 之后临床应用难. 这是由于教材的编写之故:比如说有个病人咳嗽,医生首先诊断为咳嗽,然后判断是那种证,是风寒袭肺,风热犯肺,风燥伤肺,还是痰湿蕴肺,痰热郁肺,肝火犯肺,肺阴亏耗。教科书上讲,如果是风寒袭肺,用三拗汤,或止嗽散加减;如果是风热犯肺,用桑菊饮加减;如果是风燥伤肺,用桑杏汤加减;痰湿蕴肺者用二陈汤;痰热郁肺者用清金化痰汤加减;肝火犯肺者用加减泻白散合黛蛤散;肺阴亏耗者则用沙参麦冬汤加减。

The textbook TCM is easy to learn from beginning, but difficult to feel success in later clinic work. This is because of the weakness of the current TCM textbook. For example, if there is a patient suffering from cough, the TCM textbook teaches the student to diagnose if the cough is due to Wind-cold cough, Wind-fire cough, Wind-dryness cough, or Phlegm-accumulating in lung, Phlegm-fire in lung, Liver-fire attacking the lung, or due to the Lung Yin deficiency condition. The textbook lists only one or two herbal formula for the treatment of each of these different cough conditions.

如此,在校学习时并不难。好像咳嗽的病人不是外感就是内伤导致的咳嗽。外感者,无非是是风寒袭肺,风热犯肺,风燥伤肺这些类型;内伤者,也不过还是痰湿蕴肺,痰热郁肺,肝火犯肺,肺阴亏耗几种类型。每种类型之间的区别十分分明,所以,如果不是这种证型,就会是另外一种类型。用排除法也可以得出诊断。用上相应的方剂也自然和必然有疗效,或多少都有疗效的 中医没有治疗不了的病。

Therefore, it is easy for student to remember how to diagnose and how to treat the cough condition. It seems that, a cough condition, either caused by external Xieqi attack, or inner reasons. If it does not belong to Wind-Cold cough, Wind-dryness cough, it should belong to the Wind-fire cough. The symptoms among each kind of the cough conditions are so clear for the diagnosis. This makes students feel that no disease that TCM cannot solve, because the diagnosis is so clear and the herbal formula should work – they usually think so.

可现实情况是,许多病人只有咳嗽而没有别的不舒服,看舌象和查脉象都未必能提供更多的诊断参考资料。这种感冒后仅有咳嗽,而咳嗽迁延数周,数月的病人临床上很常见。这种情况下,诊断不易,而用书本上的方剂,一方面选方不易,而治疗更难奏效。治疗如果没有效果,下一步该怎么办?教材上没有讲。

However, in practice, many patients have no others symptoms, except cough. We may not get more evidences from the tongue or pulse to support diagnosis. Such cough occurs spontaneously but can last for several weeks or months. In this case, the diagnosis is not so easy at all – I believe so. We tried all of the herbal formulas that are listed in the textbook, none worked. If there is no healing effect, or the cough was not improved at all, what should be next step? What should we do? The textbook did not teach us.  

另外,如果病人有咳嗽,还有头晕,关节痛,尿频等等,诸症皆很严重,该如何选择主要的治疗目标?还是眉毛胡子一把抓,什么都治?教科书上讲不了这么多。

Furthermore, if the patient has, cough, dizziness, pain in joints, frequent urination, etc all together. All the symptoms are equally severe. How should we decide the main symptom for the treatment? Should we treat all of them the same time, or one after another? The textbook did not give us more education.

还有,如果用了某些方剂,这些方剂有那些可能的副作用,这些副作用意味着身体的那些情况,又该如何应对?教科书上没有涉及这些临床知识。

In addition, if there some side effects from a herbal formula that is recommended in the textbook, what does that side effect means (what the side effect implies to us)? How to prevent such side effects? The textbook did not include such clinic experience.

显然,教科书只起到了最基本的中医基本知识的介绍作用。距离教授临床工作所需要的实用技术的要求还很远。如果认识不到这一点,以为教科书已经包罗万象,已经将中医浩瀚的知识作了去伪存真,去粗取精的作用,而不愿意继续看书学习,不愿采纳其它中医体系的知识,就很容易在临床上有挫折感,从而感慨中医什么病也治不了,进而在工作中就加用或改用西药治疗了,就此还美名其曰中西医结合。这还不是现实吗?

Apparently, the textbook only give us a very basic knowledge about Traditional Chinese medicine. It introduces too less knowledge for TCM doctor to work in clinic. If we do not recognize this, and if we believe that we have already learnt everything about TCM, and refuse and have no desire to continue update our knowledge after graduation, it would be easy for us to feel failure in TCM practice. If such failure happens again and again, we cannot prevent from claiming that TCM cannot solve any disease! We would be ready to adapt the western medicine in our clinic thereafter or even completely quit form the TCM. Wouldn’t you think this is the fact?

以上介绍的绝不是中医的所有体系。这些体系为中医的发展起到或多或少的作用。就算是学院派中医,也能起到基础性的中医入门教育的作用。作为一个中医医生绝不可以忽略对经方的学习,可惜伤寒论之经方在目前的中医学院多被列为选修课而非必修课。很难想象一个中医医生不懂得如何应用麻黄,石膏,附子,大黄等作用竣烈的草药而可以成为中医大家的。

The introduction above is only some of the TCM styles. They contributed to the development of TCM more or less. Even for the textbook style of TCM, it helps to introduce the basic knowledge to student. In clinic, none of the styles are the perfect, but as a TCM practitioner, we must first understand how to practice the Jing Fang style. Without such basis, no one can be a TCM expert. In TCM history, almost all the famous TCM doctors are at least the expert in the Jing Fang style.

 


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 Millwoods Acupuncture Center is located in Edmonton, Alberta, Canada and serves Edmonton and its surrounding area, including: St. Albert, Big Lake, Spruce Grove, Stony Plain, Devon, Beaumont, Sherwood Park, Calgary, Red Deer and Whitecourt, Barrhead, Westlock, Wetaskiwin, Camrose, Fort Saskatchewan, Grande Prairie. Our clients also come from Vancouver and Saskatoon.