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How much do you know about TCM?

This is a very serious problem, I have thought about it for a long time, my mood is difficult to calm, and it is very painful.
     First of all, how exactly should traditional Chinese medicine be learned, and how far can it be learned. From ancient times to now, there have been many discussions. Sun Siying did give a very clear answer in the Great Physician Jingcheng, and I would like to excerpt:

If you want to be a doctor, you must understand the “Suqian”, “A and B”, “Huangdi Acupuncture Classic”, “Mingtang Flowing Injection”, “Twelve Meridians”, “Three Divisions”, “Five Organs and Six Organs”, “Surface Hole”, “Herbal Medicine Pair”, “Zhang Zhongjing”, “Wang Uncle”, “Ruan Henan”, “Fan Dongyang”, “Zhang Miao”, “Jin Shao” and other classical prescriptions. In addition, it is necessary to subtly dissolve the Yin-Yang life, all family phasms, and the burning turtle five trillion, “Zhou Yi” six ren, and it must be proficient, so it is a great doctor. If he is not well, he will move and cause turbulence if he swims at night without eyes. Secondly, it is necessary to read this method thoroughly, seek thoughtful reasoning, pay attention to research, and only then can it be with those who speak medical dao. And you have to dabble in books, which one? If you do not read the Five Classics, you do not know the way of benevolence; if you do not read the three histories, you do not know the things of ancient and modern times; if you do not read the sons, you cannot see the things silently; if you do not read the Classics, you do not know the virtues of compassion and mercy; if you do not read “Zhuang” and “Lao”, you cannot let the true physical exercise, you will be lucky and cynical, and you will be born. As for the Five Elements Xiuwang and Qi Yao astronomy, they must be explored. If they can learn from it, they will have no hindrance to the medical path and be perfect.

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    这是个非常严肃的问题,我思考了很久,心情难以平复,也非常痛苦。

     首先,中医到底该怎么学,学到什么程度就可以了,从古至今讨论很多,孙思邈在大医精诚中确实给出了一个非常明确的答案,我想摘录一下:

凡欲为大医,必须谙《素问》《甲乙》《黄帝针经》、明堂流注、十二经脉、三部九候、五脏六腑、表里孔穴、本草药对、张仲景、王叔和、阮河南、范东阳、张苗、靳邵等诸部经方。又须妙解阴阳禄命,诸家相法,及灼龟五兆,《周易》六壬,并须精熟,如此乃得为大医。若不尔者,如无目夜游,动致颠殒。次须熟读此方,寻思妙理,留意钻研,始可与言于医道者矣。又须涉猎群书,何者?若不读五经,不知有仁义之道;不读三史,不知有古今之事;不读诸子,睹事则不能默而识之;不读《内典》,则不知有慈悲喜舍之德;不读《庄》《老》,不能任真体运,则吉凶拘忌,触涂而生。至于五行休王、七耀天文,并须探赜,若能具而学之,则于医道无所滞碍,尽善尽美矣。

    显然,这个要求是很高的,按照孙真人的标准,想做一名好中医,必须上知天文、下至地理、中知人事,诸家之法无所不通,否则难以做到尽善尽美,这个标准在古代能不能达到很难说,至少在现代这几乎是不太可能的。这里面很多东西都已经被归为是封建迷信,新中国建立后培养的绝大多数中医和现在活跃的许多民间中医,他们的古文水平和对传统文化的认知程度可以说基本没有入门,而且绝大部分都已经被现代科学洗脑,对于古人那一套思维理解偏差很大,所以我觉得,孙思邈的标准是一个参考,但也只是个参考,参考价值一般。

    我们再研究一下全国老中医药专家学术经验继承指导老师的遴选标准,圈内的人都知道,凡是能被这个项目遴选上的,就是国家级名老中医。国家的标准比较宽松,首先必须是正高级职称,然后要求必须具有30年以上临床经验,再加上有一定的学术成果就可以申报,报上去之后怎么选那就是政府的事了。

    值得注意的是,无论是评选国家级名老中医,还是评选国医大师,申请时都要求提交门诊量,但不对门诊量做硬性要求,这里面有很大的问题。许多老中医其实并不热衷临床工作,可能在临床上的水平很一般,但是他们大多数由于资格老,名声在外,而且在体制内的大医院工作,他们并不缺患者,在中国这种特殊的医疗体制下,门诊量很不能说明问题,也很能说明问题,许多临床造诣并不高的老专家们一但作为一个标杆被树立起来,后患无穷,影响深远,更会搅乱局势。

    由此可看,如果把职称、资历作为中医水平的高低,显然是不合适的。也就是说,你不能讲老专家的水平就是高的,国医大师的水平就是很高的,不能这么讲,他们可能确实比较高明,懂的比较多,但是,参照物在哪里呢?跟圣人比,能比么?跟小啰啰比,能比么?相互攀比?不可想象!

    我们常常能听到一些老专家们说,自己都六七十了,感觉中医才入了个门,才稍微懂一点。我能理解他们,因为我现在也觉得,我学中医终于感觉算是入了门,终于懂了点,终于能明白点古人的意思,能猜想他们写书时的心境,感同身受。能不能把这种入门的感觉叫做懂呢?这种懂的感觉实在是主观了点,能不能客观一些呢?

    这一切仍然需要研究。

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