My love for Chinese medicine may well be encoded in my DNA. Even as a young child, I was fascinated by all manner of folk superstitions, and I have been terrified of needles since forever — if I could take medicine by mouth, there was absolutely no way you were putting me on an IV drip. As everyone knows, the 1990s saw the emergence of all sorts of “masters,” and books on fortune-telling, bazi (eight-character birth charts), and “life codes” appeared in our home. Information about martial arts and qigong filled the streets and alleyways, leaving an indelible impression on my young mind.
Let me state for the record: as far as our family history goes, I am the only one who has ever practiced medicine. This is not a family tradition — not a family tradition, not a family tradition, not a family tradition.
My real study of Chinese medicine began after middle school graduation, during the summer before entering high school. With nothing better to do, I frequented the Xinhua Bookstore, and one day a copy of the Golden Mirror of the Medical Tradition (Yi Zong Jin Jian) caught my eye. I still remember opening it to this passage:
“Spirit arises from the wondrous union of Essence and Qi.
Soul, the active Yang spirit, moves with it to and fro.
Po, the receptive Yin spirit, enters and exits with Essence.
Intent is the stirring of the Heart-mind, not yet given form.
What Intent focuses upon is called Will.
The movement and transformation of Will is named Thought.
Using Thought to plan afar is called Reflection.
Applying Reflection to handle things — Wisdom is thereby born.”— From the Yi Zong Jin Jian (Golden Mirror of the Medical Tradition), a Qing-dynasty imperial medical compendium. This passage describes the relationships between the five mental faculties (Spirit, Soul, Po, Intent, Will, Thought, Reflection, Wisdom) in traditional Chinese physiology.
With my meager knowledge of classical Chinese, I was instantly captivated, marveling at the inexhaustible subtlety of the ancients’ prose. I paid what felt like a fortune and bought all three volumes, took them home, and read them over and over until I was utterly entranced. Those three books are still lying in my camphor-wood chest — truly the work that awakened me to this path.
Gradually I became obsessed with various health manuals and miraculous prescriptions and clinical case records. Any high school classmate who knew me well knew about my big notebook, filled with remedies from every conceivable school. I would put on airs and take the pulse of many classmates, even writing out prescriptions for them. There were quite a few cases of fù bēi jí yù — “recovering before the cup is set down” — and for a time I earned the honorary title of “Master.” I once tried to pass on a thing or two to certain people, only to be firmly rejected as if I were the plague itself. But one Chinese literature teacher was enormously supportive and even squeezed out an entire class period for me to lecture on Yin-Yang and the Five Elements. During those three years of high school, besides extensively studying Yin-Yang, the Five Elements, and all manner of empirical prescriptions, I also acquired several classic Western medicine textbooks through classmates’ help. I never sensed any wall between Chinese and Western medicine, so to this day I don’t understand what’s so hard to accept about studying Chinese medicine in the morning and Western medicine in the afternoon.
After the college entrance exam, while playing basketball in the square, I ran into a student from Shandong University of Traditional Chinese Medicine who seemed to sneer at everything I had learned. He asked me what formula I would use for a common cold. I said Mahuang Tang (Ephedra Decoction) or Guizhi Tang (Cinnamon Twig Decoction). The moment those words left my mouth, the kid scoffed, lifted his haughty nose, and said, “Go study some more,” then turned on his heel and walked away, leaving me standing there dumbfounded. Looking back now, in 2008 the classical formula (jingfang) movement was just getting started, and nobody used Mahuang Tang to treat colds. If I had mentioned Jingfang Dabiao Tang or Yinqiao San, I probably wouldn’t have been so thoroughly humiliated.
When filling out college applications, I insisted on leaving Shandong Province. My family didn’t support studying Chinese medicine — in that era, traditional medicine universities were decidedly unglamorous. As the saying goes, “Up above there is heaven; down below there are Suzhou and Hangzhou.” Getting into Suzhou University was a long shot, but Zhejiang Chinese Medical University seemed within reach — so I was admitted to the Computer Science and Technology program instead. That year, the university did not offer a Chinese medicine major in Shandong. Once at college, I spread my wings across departments, joined several clubs, firmly established myself in my major through ACM programming competitions, worked on a few small research projects, studied some Japanese with Professor Jiang, dabbled in robotics for a while, and then infiltrated the Chinese medicine circle. I didn’t just audit a few classes — I mainly participated in their extracurricular activities, earnestly studied Huang Huang’s Classical Formulas and the Four Sages’ Source (Si Sheng Xin Yuan), memorized the Treatise on Cold Damage (Shanghan Lun) every day — even while queuing at the World Expo — made a whole group of friends, set up a “barefoot doctor” clinic, accumulated a pile of Chinese herbs, and needled every single one of my roommates.
Truth be told, during those first two years I had no intention of making Chinese medicine my lifelong career. Once, in an “ideological cultivation” class, the teacher asked us to write down our ambitions, and I wrote: “First be a programmer for 40 years, then become an old Chinese medicine doctor after retirement.” Naturally, this drew yet another round of incredulous commentary. It wasn’t until I noticed, during a few final exams, that these medical students were blatantly cheating — and privately heard them say they didn’t even believe in Chinese medicine — combined with the lamentations of veteran doctors at the time crying about having no successors — that I resolved to use my own strength to revive Chinese medicine. The first step was the graduate entrance exam.
I began preparing after my junior year. The college thoughtfully set up a dedicated study room, and when school started in September, I threw myself into it body and soul. Our major had no classes in senior year, so I luxuriated in four solid months of study. English and politics need no elaboration. For the Chinese medicine specialty exam, there was only one subject — I went through the Comprehensive Chinese Medicine syllabus point by point, memorizing everything and doing practice problems repeatedly, and I passed. In those days there was no distinction between professional and academic degrees; everyone was in the same boat — it simply came down to choosing which advisor to work with.
Now comes the crucial question: how exactly did I study Chinese medicine? In one word: memorize.
There is nothing that memorization cannot solve. Let me offer this advice to students just beginning their medical studies: do not expect to understand everything at first, do not imagine that simply reading a textbook will produce some magical revelation. Mere reading only skims the surface — it is completely useless. All of Chinese medicine’s knowledge is simply a set of rules; it is not truth in the absolute sense, and it will not allow you to analyze everything with airtight precision. Respecting the rules of the game is what matters. Many veteran Chinese medicine doctors, on their deathbeds, said they had only just begun to scratch the surface. This gave me great insight — they were not being modest. Traditional medicine is vast and profound. What we pursue is the accumulation of more experiential knowledge, not the deconstruction of the underlying generative rules — otherwise, you will be trapped in a chicken-and-egg cycle of suffering.
After the graduate exam, I interviewed with several companies and was about to start an internship at Zhejiang University’s Supcon, when an opportunity arose to intern at Hangzhou Red Cross Hospital. They were building an information system and needed someone to maintain it. I immediately proposed that I be given two half-days per week to shadow senior Chinese medicine doctors and copy their prescriptions. Once they agreed, I went with great enthusiasm, forged deep bonds with my senior colleagues, and probably became one of the rare few who got paid to do a hospital internship.
Shadowing senior doctors and copying their prescriptions is the critical stage for rapidly improving one’s clinical competence. I wrote about my experiences with three senior doctors at Red Cross Hospital a few years ago. Now let me summarize what it truly means to “copy prescriptions”:
1. You must know your Chinese medicine knowledge inside out. Upon receiving any piece of clinical information, you must be able to immediately recall the relevant textbook knowledge. This is the necessary and sufficient condition for genuinely effective prescription-copying. Many students have weak foundations — ask them anything and they draw a blank. When a patient arrives and they can’t even understand the chief complaint, it’s game over: they can’t identify the disease pattern, let alone the syndrome differentiation. They become mere spectators. I would usually give such students a hint; if they still looked completely lost after the hint, then it was truly hopeless — they might as well go home and lie flat.
2. You must get your hands dirty. Observation, listening, questioning, and pulse-taking — none can be omitted, or you’re just an armchair strategist. This places enormous demands on the teacher, who must understand the student’s current stage and the knowledge and skills they need. If students aren’t given hands-on opportunities, there is no room for growth. The transition from theory to practice requires this back-and-forth guidance. Why does society always say you should seek out veteran doctors? Because they have gone through this back-and-forth countless times — their information is comprehensive, their diagnoses accurate. Ancient doctors, lacking standardized early training and systematic knowledge transmission, developed slowly. Modern academic education can absolutely compress this process, allowing students in a few semesters of clinical apprenticeship to cover ground that would have taken ancient doctors a decade.
3. You must reflect after each session. You must mentally review every patient from that day: how did the teacher differentiate the syndrome? How did they compose the prescription? If I had treated this patient myself, what would the outcome have been? Where is the gap between me and my teacher, and why? Without this process, impressions won’t be deep, learning won’t be promoted, and the purpose of copying prescriptions will not be achieved.
Six months of prescription-copying flew by. I was very satisfied and felt I had made rapid progress. The most direct result was the courage to actually treat patients and the ability to write many prescriptions. At the time I felt there was no disease I couldn’t handle — after all, Chinese medicine theory is self-consistent. I think many beginners in Chinese medicine share this feeling: there is no disease that can’t be cured, only syndromes that haven’t been correctly identified. This is a deeply mistaken view. We must respect objective reality — many diseases are simply beyond what any doctor can resolve. I held another view at the time that, in retrospect, remains correct: one should not enter clinical practice too early. Clever people who encounter clinical work prematurely easily become slick, falling into a set of diagnostic patterns that work reasonably well for them, thereby losing the motivation for further exploration — or becoming constrained by their existing knowledge, which hinders further progress. Many students of lesser aptitude who study under brilliant doctors can master that doctor’s clinical experience but lack the ability to summarize and improve on their own, so they always feel they can’t grasp the essence of their teacher’s art. This is perfectly normal. Chinese medicine is easy to enter but hard to go deep — which is also why so many veteran doctors have no successors: the students lack solid foundations and sufficient aptitude, merely mimicking the teacher’s experience without real understanding, making improvement extremely difficult. The loss of lineage is inevitable.
Getting admitted to the China Academy of Chinese Medical Sciences meant I had formally crossed the threshold into Chinese medicine. My advisor was of senior academic standing — a well-known physician and scholar in the country — and helped me enormously in many ways. Most crucially, I came to understand the formation of clinical thinking and the importance of drug combination (peiwu). I imagine that anyone who has studied Chinese materia medica and formulaology is familiar with the concept of drug combination, but familiarity and true understanding are different things. Most of what people know remains armchair theorizing. To put it into real practice requires extraordinary intuitive insight. We see many clinical case records mentioning the critical role of certain drugs within a formula — these are all arrived at through the physician’s personal perception. I have often had this feeling myself: certain drugs in a formula play a special role, but sometimes I cannot articulate exactly why. That is intuitive insight.
The caliber of the faculty at the Academy made me feel as if I had ascended to heaven. The names you read in textbooks were everywhere. I even got my hair cut at the same barbershop as Professor Tu Youyou before she won the Nobel Prize — looking back, it seems almost surreal. Here I learned the Five Movements and Six Qi (wuyun liuqi), figured out the Seven Damages and Eight Benefits (qi sun ba yi), came to appreciate the multi-source and complex nature of the Inner Canon’s theories, studied the classic theory of the Three-Part Six-Disease (sanbu liubing) system, mastered research methodology, and witnessed many remarkable clinical cases. In short, I felt my horizons and my path suddenly widen. Those graduate school years were a golden age for reading — I had energy, some life experience, academic credentials, and the classmates and teachers around me were all outstanding. I improved without even realizing it.
Another stage of enlightenment was my understanding and practice of the dose-response relationship. Every Chinese medicine practitioner knows the saying: “The untransmitted secret lies in the dosage.” I had never fully grasped this question, and arriving in Beijing didn’t make it much clearer. During that period, two doctors were particularly prominent: the Shanxi veteran physician Li Ke, and Tong Xiaolin of Guang’anmen Hospital. Their hallmark was using certain drugs in very large doses — naturally, for the sake of therapeutic efficacy. But what theoretical framework actually supported this approach?
I decided to search classical texts for answers and quickly found many insights. The ancients indeed had highly distinctive approaches to prescribing. Some loved using ginseng, some favored rhubarb, some preferred rehmannia — each with their own rationale, all using very large doses, treating a very wide range of diseases, and all achieving remarkably good results. This only deepened my confusion: a single disease could be understood and treated in so many different ways, and everyone was both effective and theoretically justified — how was a later generation supposed to choose? In actual clinical practice, few teachers particularly emphasize the dosage of any single drug. Many use nearly identical doses, generally around ten grams, and still achieve results. So was this dose-response relationship nothing more than a castle in the air?
There was nothing for it but to practice myself. Later, I discovered that the dosage of the principal drug in a formula is indeed critical, closely related to the patient’s immediate disease mechanism. Chinese medicine is about dynamic balance, and the principal drug (or principal formula) is the key weight that adjusts this balance. When it is emphasized, results are often better; when it is not, the formula still usually won’t be ineffective. This ability to calibrate dosage reflects a physician’s clinical level — it is the direct expression of intuitive insight and capability, something that truly can only be sensed, not easily articulated in words. So later I stopped worrying too much about technical-level manipulation. How many grams of each drug to use in a formula became mainly a matter of grasping the overall picture from the perspective of xiang (the observable pattern or manifestation), followed by technical adjustments (such as modifying based on the patient’s response after taking the medicine). Perhaps this is a new way of interpreting the dose-response relationship.
Reading the classics is the wellspring and catalyst of enlightenment. The classics are fundamentally different from modern Chinese medicine textbooks. Reading the classics feels like conversing with the ancients — the person on the other end is vividly alive, pouring out their heart to tell you everything they thought and did in their lifetime. The ancients had their own subtle tricks; at first I couldn’t detect them and was constantly being fooled. But after spending enough time with these crafty old characters, all that remains is a knowing smile. If you don’t read the original texts and rely only on Baidu and databases, your improvement will be very limited.
For me, there was another experience in this period that cannot be overlooked: battling the anti-Chinese-medicine trolls. I have always enjoyed intellectual debate — the spirit of the Jixia Academy (the ancient philosophical debate hall of the Warring States period) has always wandered in my heart. At first I wrote quite a few short essays on Chinese medicine; practically no one inside or outside the circle read them — but the trolls loved them, and their comments were infuriating. Later I actively sought out topics on Weibo, DXY (Dingxiangyuan), and other platforms to engage them. Their condescending attitude was deeply offensive. They would not engage in reasoned debate — their purpose was singularly simple: to smear Chinese medicine by every means possible, promote their own value system, and achieve ideological conversion. In recent years these trolls have rarely made such brazen pronouncements on public platforms, but the damage they caused over decades is appalling — they have given an entire generation a distorted view of Chinese medicine, which is truly infuriating. In almost every country in the world, traditional medicine exists. The most popular complementary and alternative therapy in the United States is meditation, with very high public acceptance. Having traveled to various countries in recent years, I have found that Western publics generally hold positive or neutral views toward Chinese medicine. In fact, through these battles with the trolls, I developed a more systematic understanding of Western developmental history, values, and medical concepts, which provided a completely different angle for re-evaluating Chinese medicine. My takeaway from nearly a decade of this struggle: whenever you encounter someone who doesn’t believe in Chinese medicine, do not waste your breath trying to reason with them — that’s beneath you. Just crush them completely.
After graduate school, I caught the tail end of a policy window and passed the medical licensing exam, beginning legal practice in 2016, followed by multi-site licensure. I learned a great deal during this period. On one hand, the range of diseases was staggering — some I genuinely didn’t know about or wasn’t clear on. While Chinese medicine had no problem accounting for them theoretically, I still wanted to give patients a more comprehensive explanation, so I studied a lot of Western medicine. On the other hand, one of my practice sites was short-staffed, and I often helped dispense medicines. This intimate contact with Chinese herbal drugs gave me new insights into the theory of drug properties. The world of Chinese herbs is unfathomably deep. To master Chinese medicine, you must understand drugs. I strongly recommend visiting herbal factories, examining herbs, dispensing them, decocting them, and drinking them — without hands-on practice, you can never grasp the true essence. Nowadays many doctors prescribe enormous doses, calling it “original formula, original dosage.” I’ve seen a doctor prescribe 30 grams of Dengxin Cao (Juncus medullae) in a single prescription. I really wanted to ask them to search the literature: which classical formula records taking two taels of dried Juncus in a single dose? It neither improves efficacy nor creates unnecessary difficulty for the patient — and worse, it wastes precious medicinal materials. This is absolutely unacceptable.
When I first entered clinical practice, I was quite eager about therapeutic outcomes and desperately wanted to hear good news — but most of the time I didn’t hear any, mainly because the patients simply didn’t come back. Once I finally “caught” one — a patient who had seen me but never returned for a follow-up. I had assumed the treatment was ineffective, but to my surprise, he reappeared a few weeks later. He said my medicine had worked well, but after finishing it he came back to the hospital and saw another doctor, and the condition relapsed. I happened to be in the clinic that day, so he came to find me again. At that moment, my inner monologue was unprintable. Later I realized this type of patient was extremely common: some didn’t know they should come back for follow-up; some didn’t know who to follow up with; but most simply felt better and didn’t want to keep taking medicine. It all came down to communication. The ancients taught us not to solicit patients, so at first I didn’t fully explain to patients that they should return after finishing their course. This was a grave mistake. You must clearly explain approximately how many treatments are needed, what the cycle looks like, and how adjustments will be made — only then can you achieve stable therapeutic outcomes.
Since I was essentially moonlighting at outpatient clinics and looked young, it was not easy to establish myself in Beijing. Many people in society would rather be treated to death by a veteran doctor than be cured by someone like us — a deeply frustrating social phenomenon that doctors within the system can never truly appreciate. This is why institutional Chinese medicine doctors often have an inflated sense of self-satisfaction. When I was shadowing doctors in Beijing, one of my mentors once half-jokingly said that if you took someone who knew absolutely nothing and put them in a 100-yuan “special consultation” slot at Guang’anmen Hospital, patients would still flock to them. So I hope that when you all enter the system — especially prestigious hospitals — you will not lose yourselves.
I once felt quite confident that I had grasped the principles by which Chinese medicine understands the human body, and I even devised numerous explanations. Later I realized this wasn’t quite right — it perfectly illustrated the line from Sun Simiao’s Da Yi Jing Cheng (On the Absolute Sincerity of Great Physicians): “After practicing medicine for three years, one realizes there is no formula under heaven that can be used.” Even now, I still feel as if I am wandering in clouds and mist. This is very similar to the stages of photography: at first, “a mountain is a mountain”; then, “a mountain is not a mountain”; finally, “a mountain is still a mountain.” When I began, I thought Chinese medicine was simple — wasn’t it just formula-pattern correspondence? Wasn’t it just Eight-Principle differentiation? Wasn’t it just that one mass of qi? Wasn’t it just reading modern pharmacological research? Later I realized something was off. Why, when the diagnosis clearly matched, did it sometimes work and sometimes not? What was more maddening was that many times I cured a disease without knowing exactly how I had done it. Where exactly are the boundaries of Chinese medicine theory? To be honest, I am on the verge of giving up on this question. The only key problem I want to solve now is the seemingly unbridgeable chasm between Chinese medicine theory and clinical practice.
“The road ahead is long and has no ending; yet high and low I will search with my will unbending.”
— Li Sao (The Lament) by Qu Yuan (c. 340–278 BCE), from the Chu Ci (Songs of Chu). Original: 路漫漫其修远兮，吾将上下而求索。
中文原文 / Chinese Original
我对中医的热爱可能源于DNA，早在幼年时期就十分热衷各种封建迷信，而且从小就怕打针，能喝药就绝对不可能输液。众所周知90年代各路大师横空出世，家中亦有诸多八字排盘生命密码之类书籍出现，武术气功的信息充斥大街小巷，在我的心里留下了无法磨灭的印象。
这里郑重声明一下，从有历史记载起家族中只有我一人行医，不是祖传中医，不是祖传中医，不是祖传中医。
真正开始学习中医始于初中毕业后，考上高中的那个暑假百无聊赖，没事就去新华书店，终于有一天一本医宗金鉴进入了我的视线，到现在都还记得，翻开后就是这一段：
神从精气妙合有，随神往来魂阳灵，并精出入阴灵魄，意是心机动未形，意之所专谓之志，志之动变乃思名，以思谋远是为虑，用虑处物智因生。
凭借仅有的一点文言文知识，当时就被吸引了，暗自感慨古人文字之奥妙无穷，掏出了巨款直接买下了三本，回家就反反复复读了个如痴如醉，这三本书还在我的樟木箱子里躺着，真乃启蒙之佳作。
后来就逐步迷恋各种养生宝典和神方验案，跟我熟悉的高中同学都知道，我有一个大本本，上面记载了各路神方，装模做样地给很多同学号过脉，还开过方，出现过不少覆杯即愈的案例，一时间获得过大师荣誉称号。曾经我还想给某些人传授一二，奈何像避瘟神一般被坚定地拒绝了，但有一位语文老师非常支持我，还挤出了一节课专门让我讲阴阳五行。在高中这三年里，除了广泛学习阴阳五行和各路验方，我还在同学的帮助下得到了数本西医经典教科书，似乎没感觉到中西医的隔阂和壁垒，所以我到现在也不明白上午学中医，下午学西医到底有什么难以接受的地方。
高考结束后，在广场打球时碰到了一个山东中医药大学的学生，似乎对我的所学所感嗤之以鼻。他问我感冒用什么方，我说用麻黄汤或者桂枝汤，当这句话说出口后，那小子瞬间哼了几声，抬起了高傲的鼻子，说你再学学吧，随即拂袖转身而去，留我在原地不知所措。现在回想起来，2008年经方刚刚准备要火，没人会用麻黄汤去治感冒，我那时候要是能说个个荆防达表汤或者银翘散什么的，估计就不会碰一鼻子灰了。
高考填报志愿，我执意要离开山东省，家里并不支持学中医，在那个年代中医药大学一点都不吃香。俗话说的好，上有天堂，下有苏杭，能考上苏州大学的希望不大，考个浙江中医药大学还是有可能的，于是我就被计算机科学与技术专业录取了。那一年，她在山东省并不招收中医学专业。来到大学后，我同时在本学院和其他学院展开手脚，加入了若干个社团，依靠ACM竞赛先在本专业彻底站稳了脚跟，做了几个小课题，跟江老师学了学日语，研究了一段时间机器人，然后去混迹中医药圈。我并没有去蹭几节课，主要是参加他们的课外活动，认真学习了黄煌经方和四圣心源，每天拿着伤寒论背，在世博会排队的时候也背，认识了一票小伙伴，开了一个赤脚医生诊所，倒腾了一堆中药，把寝室同学挨个扎了一遍。
其实头两年我并没有想把中医作为终身职业，有一次思修课上老师让写下自己的理想，我写的是先做40年程序员，等退休了当老中医，当然最终结果是又被不可思议地评论了一番。直到有几次期末考试的时候我发现这帮学医的玩意居然一直作弊，私下里经常听他们说自己并不信中医，又受到当时一众老中医哀鸿遍野自叹后继乏人的影响，我决定要用自己的力量去振兴中医，首先第一步就是考研。
准备考研是大三结束之后，学院非常贴心地准备了考研教室，9月份一开学我就全身心投入这项活动中，我们专业大四是没有课的，很任性的在那里学了4个月，英语和政治就没啥可说的，中医的专业课就一门，按照中医综合的大纲一个知识点一个知识点的背，反复做题，就考上了。那个时候还没有分专业学位和科学学位，大家都一样，无非就是选择考哪个导师的问题。
关键问题就来了，我到底如何学习中医呢，一个字，背。
没有什么是背诵不能解决的，奉劝各位刚刚学医的同学，不要奢求理解，不要觉得看教科书能看出花来，单纯的看只是浮在表面，一点用没有，所有中医的知识都只是一套规则而已，并不是真理，并不能让你剖析得严丝合缝，尊重游戏规则非常重要。诸多老中医在临死前都说自己才刚刚入了个门，这给我很大的启发，他们并不是谦虚，传统医学博大精深，我们追求的是获得更多的经验知识，而不是试图去解构这背后的产生式规则，否则就将陷入鸡生蛋的痛苦循环中。
考研结束后，我面试了诸多公司，正准备去浙大中控实习，这时得到了一个去杭州红会医院实习的机会，他们正在构建一套信息系统需要人员维护，我随即提出每周要给两个半天时间跟老中医抄方，同意后欣然前往，歃血为盟认识了诸位大哥，恐怕成为了去医院实习还有工资拿的少数分子。
跟诊抄方是快速提高医学素养的关键阶段，我在红会医院跟三位老中医的故事几年前已经写过了，现在总结一下如何才是真正的抄方：
1.必须对所学的中医知识了如指掌，收到一个信息就能立刻联想出书上的知识，这是能否真正开展抄方行为的充要条件。许多同学基础并不好，问啥啥不知道，病人来了听不明白主诉是什么，这就完蛋，这样就辨不了病，更辨不了证，成了外行看热闹。我一般会给同学一点提示，如果提示完了还是一脸懵，那就彻底完蛋，可以回去躺平了。
2.抄方必须要上手，望闻问切一个都不能少，否则就沦为纸上谈兵。这时候对老师的要求就非常高了，带教老师必须明白学生所在的阶段和所需要的知识技能，如果不给学生上手的机会，那就没有进步的空间，从理论到实践必须要有这样一个来来回回指导的过程。为什么社会上总流传要看老中医，那是因为他们经历了无数次这种来来回回，信息掌握的就全面，看的就准。古代的医生由于缺乏早期的标准化训练，同时缺乏系统的知识传授，所以成长的慢，现代学院派教育完全可以把这个过程压缩，让学生在几个学期的抄方过程中完成古代医生十年要走的路。
3.抄方结束后必须要思考，必须要把当天所有的病人过一遍，思考老师是如何辨证的，如何处方的，换位思考如果自己接诊这个病人会是怎样的结果，跟老师的差距在哪里，以及为什么，缺少这个过程印象就不会深刻，就不能促进学习，无法达到抄方的目的。
半年的抄方很快就结束了，我非常满意，感觉进步很快，最直接的感受就是敢看病，能开很多方了，那时候觉得好像没有什么看不了的病，中医理论毕竟是可以自圆其说的嘛。我想许多中医初学者都会有这种感受，就是没有看不好的病，只有辨不对的证，这个观念很错误，我们一定要遵循客观规律，很多病不是医生能解决的。我当时还有一个观点，现在想想仍然很正确，那就是不能过早临床，聪明人过早接触临床很容易变油，陷入自己一套比较行之有效的诊疗规律中，从而缺乏进一步探索的动力，或者被现有知识羁绊，阻碍了继续前进。许多资质不足的同学在跟比较高明的医生学习后能够掌握这个医生的诊疗经验，但缺乏自我总结提高的能力，所以总感觉学不到老师的精髓，这很正常，中医入门很简单，想深入很难，这也是为什么许多老中医后继无人的原因：学生并没有很好的中医基础，资质也不高，只是照猫画虎学了学老师的经验，很难提高，失传不可避免。
考上中国中医科学院之后就算正式踏入中医这扇门了，我的导师辈分比较高，是国内有名的医生和学者，导师在很多地方对我都有极大的帮助，最关键的就是认识到了临床思维的形成和药物配伍的重要性。我想，学过中药和方剂的同学对配伍都不会陌生，但仍然不熟悉，多是纸上谈兵的功夫，真正落到实处必须有高超的悟性才可以。我们看到许多医案中都提到某些药物在方剂中的重要作用，这都是医生个人感觉出来的，我时常也有这种感觉：一个方子中某些药起到了特殊的作用，但有时又说不出为什么，这就是悟性。
中研院的师资水平让我有种升天的感觉，那些书上的名字这里随处可见，我还跟获奖之前的屠呦呦老师一块理过发，回想起来简直不可思议。在这里我学会了五运六气，搞明白了七损八益，认识到了内经理论的多源性与复杂性，学习了三部六病的经典理论，掌握了科研方法，见证了许多奇特病例，总之感觉视野和路子一下子拓宽了。读研那几年是读书的黄金时期，既有精力，也有了些阅历，还有点学历，而且周围的同学和老师都非常优秀，不知不觉中就提高了。
顿悟的另一个阶段是对量效关系的理解与实践。中医人都知道，不传之秘在于量，这个问题我之前一直也没想明白，到北京之后也不是特别明白，那段时间有两个人很火，一个是山西老中医李可，一个是广安门医院的仝小林，他们的特点就是某些药用量特别大，目的当然是为了疗效，那么究竟有哪些理论支撑了这个用法呢？
我决定先从古籍中找找答案，很快就有了许多收获，古人用方确实很有特色，有人爱用人参，有人爱用大黄，有人爱用地黄，总之各有各的说法，用的量都特别大，治的病都特别多，效果都特别好，这就更让人疑惑了，一个病有这么多种理解和治疗的方法，你们都有效还都有理，这可让后人如何选择？在实际临床过程中，很少有老师会特别突出某一种药的用量，许多老师的用量几乎一致，基本上都是十克为主，但也有效，那这量效关系究竟是不是空中楼阁呢？没有办法，只能自己实践，在后面我发现方中主药的用量确实非常关键，这与患者的即时病机有密切关系，中医讲究的是动态平衡，而方中的主药或主方是调节这个平衡的关键砝码，一旦突出，往往效果更好，不讲究大部分情况下也不会无效，这种量效调配的能力是医生临床水平的体现，是悟性和能力的直接表达，确实只可意会难以言传，所以到后面我就不是很关心技术层面的操作了，一个方子中的药究竟用多少克主要是从象的角度对整体把握定夺，然后再做技术调整（比如服用后的反应），这可能是对量效关系的一种新诠释吧。
读经典，是顿悟的源泉和激发点，经典与现代中医书截然不同，读经典的感觉就是与古人对话，这个人往往很鲜活，他在拼尽全力地告诉你这辈子自己都想了什么做了什么。古人也有许多小心思，刚开始发现不了，总被人骗，后来跟这帮狡猾的家伙相处久了，只留下会心一笑。不读原文，只靠百度和数据库，提高非常有限。
对我而言，这个阶段还有一个不能忽略的经历，那就是与中医黑斗智斗勇。我喜欢争鸣，稷下学宫的精神始终在我心中游荡，起初我写了不少中医小短文，圈内基本没人看，圈外基本也没人看，但是中医黑爱看，他们的评论令人气愤。后来我广泛在微博、丁香园等阵地找话题跟他们聊，他们那种高高在上的态度令人十分厌恶，道理是不会讲道理的，他们的目的非常单纯，就是要用各种方法诋毁中医，进行价值观的输送，实现和平演变。这几年中医黑已经很少在公共平台大放厥词了，但他们这几十年的影响非常恶劣，已经让一代人对中医药有了不正确的看法，令人愤慨。在这个世界上几乎每一个国家都有传统医学的存在，美国最吃香的补充与替代疗法是冥想，人群接受率非常高，这几年游走各国，西方世界民众对中医的看法普遍是积极与中立的。其实在与中医黑们的斗争中，我对西方世界的发展史、价值观及医学观念都有了更加系统的认识，对重新看待中医提供了一个完全不同的角度。在近十年的斗争中，我总结出来的经验就是，但凡遇到不相信中医的，千万不要给他们讲道理，那太掉价了，赶尽杀绝即可。
研究生毕业后赶上了政策的末班车，通过了执业医师考试，16年开始合法执业，然后又开始了多点执业。这段时间学习了很多，一方面病种实在太多了，有些病确实不知道或者不清楚，虽然说从中医角度看没有问题，但是我还是希望给患者一个比较全面的解释，又学了很多西医知识。另一方面，我的一个执业地点人手短缺，很多情况下我都会去帮忙司药，与中药的亲密接触又让我对药性理论有了新的认识，中药的水真的是太深了，想学好中医必须懂药，十分建议各位多去药厂参观，多看药，多抓药，多煎药，多喝药，不亲身实践永远不能体悟真谛。现在很多医生开的药量贼大，美其名曰”原方原量”，我见过有的医生一张处方开30克灯心草，我真想请他去文献里找一找，哪家的方子记载干灯心草一次喝二两，既提高不了疗效，还给患者增加困难，更可恶的是浪费了宝贵的药材，万万不可取。
刚上临床的时候我也对疗效比较期待，特别希望听到好消息，可是很多时候都听不到好消息，主要原因是病人不来了。有一次终于被我”逮到了”一个，他在我这看完之后没有复诊，我曾经以为是不是没效果，没想到过了几周他又来了，他说吃我的药挺好，吃完之后来医院又找别的医生看了，结果又犯了，今天正好我在所以又来找我，这时我的心里是MMP。后来我发现这种病人特别多，有的是不知道要复诊，有的是不知道要找谁复诊，更多的是觉得好点了自己不想再吃了，总结起来就是沟通的问题。古人教育我们，不要自己主动上门，所以刚开始我不会给病人完整地说吃完药回来再找我看，这样非常不好，一定要讲清楚大概治几次，怎么个周期，如何调整，这样才能有比较稳固的疗效。
由于我都是在门诊走穴，人看起来又年轻，其实在北京是不太好混的，社会上很多人宁愿在老中医那吃死，也不愿意来我们这治好，这是一个非常无奈的社会现象，在体制内的医生完全体会不到这一点，所以体制内的中医往往自我感觉异常良好。我在北京跟诊时老师曾经半开玩笑地说过，找一个什么都不懂的人去广安门医院出一百元挂号费的特需，患者肯定趋之若鹜。所以希望各位同学进入体制内后，特别是进入知名医院后，千万不要迷失自我。
曾经我很自信地觉得已经把中医对人体的认识规律掌握清楚了，甚至还琢磨了不少说法，后来发现不太对，正应了大医精诚中的那句”治病三年乃知天下无方可用”，直到现在，我仍然感觉云山雾绕。这跟摄影的境界十分相似，从看山是山，到看山不是山，再到看山还是山。刚开始我觉得中医很简单，不就是方证相应么，不就是八纲辨证么，不就是那一团气么，不就是看看现代研究药理机制么；后来我发现不太对，为什么明明对的上，有的时候管用，有的时候他就不管用，更可气的是，很多时候把病治好了，我都不知道究竟是怎么治好的。中医理论的边界究竟在哪里，说实话我已经快要放弃探索这个问题了，现在唯一想解决的关键问题就是中医理论与实践之间的那条难以逾越的鸿沟。
路漫漫其修远兮，吾将上下而求索。
先生的话许多话都很让人思考，很感谢分享