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Traditional Chinese medicine is "the precious wealth left to us by our ancestors", "the treasure of the Chinese nation", and "the key to open the treasure house of Chinese civilization". In order to promote the inheritance, innovation and development of traditional Chinese medicine, Nanjing Hospital of Traditional Chinese Medicine hosted the "National Treasure: Oral History Project of Famous Masters of Jinling Medical School" on the occasion of the 90th anniversary of its founding.
From now on, the series of "National Treasures: Oral History of Famous Masters of Jinling Medical School" will be launched one after another, recalling the family inheritance of Jinling Medical School, feeling the benevolence of famous doctors, and passing on the spiritual genealogy of Jinling Medical School from the perspective of those who have experienced history, seen and heard firsthand.
【Column Name】National Treasures: One of the Selected Oral History Achievements of Jinling School of Medicine
Liu Yongnian's oral history –
From learning Fu Zonghan for decades, the road is good
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【Profile】
Liu Yongnian, male, born in 1934, is a native of Nanjing, Jiangsu Province. He graduated from Nanjing College of Traditional Chinese Medicine in 1963. Under the tutelage of Zhang Jianzhai and the former president of Nanjing Hospital of Traditional Chinese Medicine, Mr. Fu Zonghan, he studied the diagnosis and treatment of difficult and miscellaneous diseases in internal medicine, and was one of the main members of his academic team. He has been practicing medicine for more than 50 years, and has rich knowledge and experience. In 1991, he served as the chief physician of Nanjing Hospital of Traditional Chinese Medicine, the adjunct professor of Nanjing University of Traditional Chinese Medicine, the doctoral supervisor of internal medicine of traditional Chinese medicine, the second, third, fourth and fifth batches of national old Chinese medicine inheritance tutors, and the second batch of academic guidance of the national famous old Chinese medicine inheritance studio, and enjoyed the special allowance of the State Council. In 1984, he was rated as "Outstanding Scientific and Technological Worker during the Sixth Five-Year Plan Period of Nanjing". In 1993, he was elected as a member of the 7th CPPCC of Jiangsu Province. He used to be a director of the Famous Medical Research Association of the China Association of Traditional Chinese Medicine, and was employed as a member of the Jiangsu Provincial Health Technology Senior Title Evaluation Committee, and a member of the Nanjing Health Technology Senior Title Evaluation Committee, and the leader of the TCM Internal Medicine Department. He has won 12 scientific and technological progress awards at all levels of the State Administration of Traditional Chinese Medicine, provincial and municipal levels.
At the beginning of studying medicine, I met a famous doctor
To study medicine, you must dabble in a wide range of topics
[Dictation content]
Three generations of my family are from Nanjing, but none of the three generations have studied medicine, which started from my generation. At that time, I didn't have any special motivation, it was because I was in poor health when I was a child, I was often sick, and when I stayed at home, I would flip through medical books, which was considered to be related to medicine.
I started my formal medical studies in 1958. At that time, it was the Great Leap Forward, and hospitals were also running schools. The Jiangsu Provincial Department of Health, the Jiangsu Provincial Department of Higher Education and the Nanjing Hospital of Traditional Chinese Medicine jointly established a TCM college. Fu Zonghan served as the executive vice president of this Nanjing College of Traditional Chinese Medicine, which belongs to the municipal higher medical colleges, and taught courses such as "History of Medicine in the Motherland" and "Gynecology of Traditional Chinese Medicine". This school is a five-year program, so this is where I started my medical studies.
Liu Yongnian when he was a student
During my time at school, Fu Zonghan once gave us a lecture. He talked about the history of Chinese medicine, and I was very interested. It was only at that time that I began to know that TCM has such a rich content, which further increased my interest in TCM. I got good grades and often came first in my school in exams. I studied in a professional school of traditional Chinese medicine for five years, but before I graduated, the school broke up. What about students? No package allocation. At that time, the "Three-Self Policy" was proposed, and internships were carried out at their own expense, food stamps were brought by themselves, and they were able to find their own way out. So at that time, it was quite difficult for a while, and I had to find a job on my own. Where to look, I often go to the Municipal Health Bureau, and many people in the Municipal Health Bureau know me. Later, I thought that Fu Zonghan was my teacher, and he knew me. At that time, he was the vice president of Nanjing Hospital of Traditional Chinese Medicine, so I went to him, he wanted me, but he didn't have the right to decide. Mr. Fu liked me very much, and when my work was not officially confirmed, he first asked me to follow him to copy prescriptions and learn from him clinically. I told him that whatever the teacher needs and what the students need to do, leave it to me. So our relationship, very special, has never been broken for decades.
At that time, the Municipal Hospital of Traditional Chinese Medicine was still in the Confucius Temple, a simple two-story building, which was an outpatient department. Most of the people came to see the doctor, but there were also high-level cadres, which were called high-level outpatient clinics or special outpatient clinics at that time. What impressed me deeply about Dean Fu was that he treated both the common people and senior cadres equally. As far as he is concerned, there are no special patients, whether it is ordinary people or high-ranking cadres who come to see a doctor, he is quite serious, and I am still very impressed. As a doctor, a doctor who heals the sick and saves people, this quality should be preserved forever.
Group photo of Liu Yongnian and his wife
Traditional Chinese medicine has a saying that "medical treatment is expensive and difficult diseases are cured", and when I was studying clinically with my teachers, I privately hoped that there would be some diseases that teachers could not see well. With this medicine today, it doesn't look good. The next week, the patient came, but it didn't work, so the teacher changed the prescription again. At the time, it was a naïve idea, but I still wanted to learn more from the teacher. As a joke, if the teacher keeps changing the formula, we can keep learning, just like a child has to dig into an adult's pocket. As for the teacher, he must hope that the medicine will have an effect, the patient will be happy, and everyone will be happy.
We have a characteristic of Chinese medicine, which is to talk about schools. In the past, when we talked about genres, we actually had the meaning of a gateway view. At this point, it frames people to death. I think that our Chinese medicine needs to be improved and needs to be widely involved. I often say to my students, you learn from me, I am good at using Poria cocos, but Mr. Wang uses Baizhu, so you can't say learn from me, so you don't go to learn from Mr. Wang, this is too narrow, you have to learn extensively, you have to learn comprehensively. There are many schools of traditional Chinese medicine, and the styles are different, southern Jiangsu has the style of southern Jiangsu, and northern Jiangsu has the characteristics of northern Jiangsu. Even within the same genre, each teacher is different. Whether it's Dr. Zhang or Dr. Li, you all have your own characteristics, so this is completely different, my opinion, that is, you learn from the teacher, you have to understand, you have to master, but you don't deliberately imitate, you should have your own opinions.
Our Nanjing is the intersection of the north and the south, famous far and near, there are many people from the south to the north, there are many exchanges, and the more things are brought. So you have to master it comprehensively, you have to master it broadly, so that you can absorb a lot of things. As a doctor, especially a medical student, be broad and don't limit yourself to a certain boundary.
Liu Yongnian took a group photo with his family
【Historical Scene】
In 1956, Nanjing Hospital of Traditional Chinese Medicine was established at No. 1 Jinling Road. Fu Zonghan and a number of famous Chinese medicine experts such as Zhang Zhongliang, Pu Qingyu, and Ding Zemin became the veterans of the hospital. The 39-year-old Fu Zonghan was appointed vice president of administration. During Fu Zonghan's outpatient clinic, there are often some young doctors and students who gather around to "learn".
Liu Yongnian recalled: Dean Fu's memory is also very good, and when he sees patients, most of us students sit on his right hand side to observe and learn how he understands the patient's medical history, including Dean Fu's oral case. He was able to report the case in one go, and then he could see the second patient. For the first patient, the rest of the work is left to us students. Therefore, I was very nervous when I went to the clinic with him, my brain had to memorize, my hands had to write, and my eyes had to pay attention everywhere.
He is good at treating difficult diseases in internal medicine
Innovate and develop research and treatment of Sjogren's syndrome in traditional Chinese medicine
[Dictation content]
When I first practiced medicine independently, I saw a difficult case. The presentation of this patient is abdominal cramps. It's stomach pain, back pain. In fact, this disease is neuralgia, but specifically in this patient, it is a stone, there are stones in the urinary tract, there are various shapes, and some of them are invisible with the conventional imaging methods at that time, and they are invisible. Then during the treatment, you can't just stare at the X-ray, just look at how big that stone is. You have to teach the patient all kinds of ways to cooperate with the treatment, and you have to find ways to make him move, even if the patient is in pain like that, you still have to ask him to move. The more he moves, the more parallel the stone is to the urinary tract, and the stone is easier to come out. So encourage the patient to move.
I have always been more concerned about incurable diseases in internal medicine, and I have done a little work in this area. For example, atrophic gastritis, neurological disease, thrombocytopenia, etc., as well as some autoimmune diseases, such as Sjögren's syndrome, rheumatoid arthritis, systemic lupus erythematosus, etc.
Liu Yongnian and his classmate Xie Yingbiao took a group photo on the side of the Feihong Bridge in the Ming Dynasty
As far as we are Chinese medicine, we should have novel ideas, flexible treatment methods, and form our own unique diagnosis and treatment style. For example, in the treatment of chronic gastric diseases, it is necessary to pay attention to the combination of syndrome differentiation and disease differentiation, the combination of macro and micro, emphasizing the "harmony of the stomach when it descends", balance the rise and fall, apply both general supplements, use bitter cold with caution, and pay attention to the protective film. My self-proposed "Jiawei Qingpu Drink" is used to treat all kinds of gastritis, especially the heat depression and qi stagnation syndrome caused by reflux gastritis, and the effect is stable. The treatment of depression syndrome requires us to be able to distinguish between the two different conditions of "depression caused by illness" and "illness caused by depression", to be able to accurately distinguish the clinical characteristics and pathogenesis characteristics of depression syndrome, and pay attention to grasping several relationships in the treatment of the disease, such as treating the liver and treating other organs, suppressing and Yang, deficiency and reality, clearing and warming and replenishing, invigorating blood and regulating qi, medicinal stone treatment and psychological counseling, etc. To treat intractable insomnia, I am based on the theory of "Five Divine Treasures", which believes that insomnia is mainly closely related to the liver and soul.
In the treatment of sweat syndrome, we should not be confined to the theory of yin deficiency and night sweats and yang deficiency and self-sweating, but should take the deficiency and reality as the key link, and the focus should be on distinguishing the cause and pathogenesis, and then determine the treatment method. There is also a special situation, that is, severe autonomic nerve dysfunction caused by frequent sweating caused by stubborn hyperhidrosis, with other treatment methods are ineffective, I will treat from the loss of yin and yang, the liver with instability, with the fairy spleen, Morinda officinalis Tianwu cork, Coptis chinensis and other Xie to manage yin and yang, with sedum notoginseng to soothe the liver to achieve depression and blood activation, the purpose is to make the fluid compress balanced. In addition, according to the theory of the homology of sweat and urine, Tongli Prefecture has opened the canal to benefit water, dampness and sweat reduction, and the opening and closing of Xuanfu has restored its normality, and the effect of reconciling and guarding sweat and dehumidification provides a new way for the diagnosis and treatment of such patients. For idiopathic thrombocytopenic purpura, we should learn from the theory of warm disease in the early days, pay attention to cool blood and disperse blood, especially pay attention to scattered blood. The so-called scattering of blood has three meanings in it: one is to dispel stasis and calm the meridians, the second is to dissipate the heat of the camp, and the third is to nourish yin and increase fluid, so as to smooth the pulse. In the later stage, it is necessary to emphasize the tonic kidney Peiyuan, and for those who have qi deficiency syndrome with blood consumption, they should be given products to replenish qi and solidify the intake along with the syndrome, and in addition, it is necessary to participate in pharmacological studies on the basis of syndrome differentiation to confirm that it has a platelet-raising effect of single Chinese medicine.
I have studied immunorheumatism for 30 years, and in clinical practice, I have found that "toxicity, stasis, and deficiency" are the etiological and pathogenesis characteristics of this type of disease. Through a large number of clinical cases, I have summarized and established a special prescription of "dry poison qing" (decoction), which has achieved remarkable results in controlling symptoms, reducing recurrence, slowing down internal organ damage, and improving prognosis.
Liu Yongnian was with his disciples and colleagues
For the diagnosis and treatment of systemic lupus erythematosus, I mainly use the combination of staged treatment and special prescriptions, and use the methods of nourishing yin, cooling blood, invigorating blood, and detoxifying, and self-proposed "lupus drink" (decoction) for the virus is hot and hot, and the kidney yin is depleted, and I have accumulated new experience in withdrawing hormones and reducing the side effects of hormones, which has significantly improved the quality of life and prognosis of patients with this disease. Judging from the reaction after clinical application, hormones have the nature of yang heat, which is a bit similar to our traditional Chinese medicine Daxin Da Fever medicine, the so-called "strong fire and food qi", long-term use will hurt yin and consume qi, and then lead to the dissipation of yang qi, which is related to the long-term or large use of oral hormones, resulting in the inhibition of hypothalamic-pituitary-adrenocortex-thymus axis function, resulting in a decrease in pituitary and adrenal cortex reserve capacity. Therefore, in the active stage of the disease, the initial treatment or impact stage of hormones, the clinical manifestations are mostly yin deficiency and internal heat symptoms, and the treatment should pay attention to clearing heat and purging fire to nourish yin, so as to reduce the dissipation of yang energy, commonly used large green leaves, cork, gardenia, danpi, white flower snake tongue grass, artemisia annua, turtle shell, turtle plate, raw land, ligustrum, etc., as the disease enters a stable period, the dosage of hormones should be gradually reduced until it is stopped. In order to avoid recurrence of the disease due to hormone reduction, before the hormone is withdrawn, you can participate in the formula to benefit the temperature and yang, commonly used drugs are Astragalus, Codonopsis, Atractylodes, Polygonatum Essence, Morinda officinalis, Xianling Spleen, Psoralen, Eucommia, Cinnamon Branch, Cuscuta Seed, etc., it is always advisable to be warm and peaceful, "slightly less fire, to generate vitality", replenish yang without robbing yin, which is conducive to hormone withdrawal. In my opinion, hormone withdrawal must be cautious, not too hasty, and the withdrawal process should be slow, step by step, and watch while decreasing. Before withdrawing hormones, it is necessary to make a detailed observation and comprehensive evaluation of the patient's condition, not only to pay attention to the side effects of hormones, but also to pay attention to the pathogenesis characteristics of systemic lupus erythematosus and whether the current condition is stable. In addition, the effect of traditional Chinese medicine is mild and slow, and it takes a period of time to show the efficacy, so for patients who have been on hormone therapy for a long time, it is not advisable to withdraw hormones immediately when they are just receiving traditional Chinese medicine treatment, let alone stop hormones immediately, otherwise the disease is prone to recurrence.
Liu Yongnian studied the textbooks of traditional Chinese medicine that year
【Historical Scene】
"Sjögren's syndrome diagnosis and treatment and research" is Liu Yongnian's clinical diagnosis and treatment of Sjögren's syndrome for many years of practical experience and theoretical research results of the summary, is the first Chinese medicine research on Sjögren's syndrome monograph, the book fully demonstrates the modern Chinese medicine on the diagnosis and treatment of Sjögren's syndrome level and characteristic advantages, for the name of the disease, etiology and pathogenesis, syndrome differentiation and treatment, prescription medicine for the dry syndrome has carried out in-depth discussion and research, in the country to put forward a more systematic theory of traditional Chinese medicine, put forward the "dryness of the disease" As the name of this disease in traditional Chinese medicine, he founded and developed the "theory of blood stasis causing dryness" and "the theory of (yang) qi deficiency causing dryness", breaking through the traditional treatment method of simply nourishing yin and generating jin. The disease is divided into five syndrome types: dry and poisonous type, yin deficiency type, qi (yang) deficiency type, astringent stagnation type, and double deficiency type (qi and light deficiency).
As advocated by Dean Fu Zonghan
Efforts should be made to improve the theoretical level of traditional Chinese medicine
[Dictation content]
When Fu Zonghan was the president of the Municipal Hospital of Traditional Chinese Medicine, he had a very good working method, he asked the doctors of our Hospital of Traditional Chinese Medicine to write articles and papers, and then our Hospital of Traditional Chinese Medicine set up a journal of its own, which was very helpful to improve the theoretical level of the doctors of our Hospital of Traditional Chinese Medicine, and persisted for many years.
I am very interested in the history and theory of traditional Chinese medicine, and I have also served as the head of the science and education department of the Municipal Hospital of Traditional Chinese Medicine, and have presided over the scientific research and teaching work of the hospital for more than ten years. At that time, in view of the phenomenon that the Chinese medicine community, especially our traditional Chinese medicine hospitals, did not pay enough attention to scientific research, I wrote a special article called "The Tendency and Countermeasures of the Dilution of Scientific Research Awareness of Chinese Medicine Clinical Personnel", which was published in the journal "Chinese Medicine Research", and later reprinted by "China Journal of Traditional Chinese Medicine". Over the years, I have published a lot of papers, which can be regarded as doing some useful work for the enrichment and development of TCM intractable diseases.
Hao's head is poor, and Liu Yongnian still insists on teaching medical skills on the front line
In my opinion, talent is a major event related to the rise and fall of traditional Chinese medicine, and I have always told my students to calm down, study diligently, study hard, learn from the classics, learn from various works, learn from journals and literature, learn from colleagues, learn from clinical practice, and most importantly, learn from patients. Accumulate knowledge and skills bit by bit, so that you can use them handy. "Life is endless, practice is endless", this is my academic motto, and I also ask my disciples to practice it. As a student of traditional Chinese medicine, I must learn to comprehend by myself, the so-called "master leads the door, practice in the individual", my teaching philosophy is "teach people to fish", in the daily clinical certificate, I often ask questions, make key comments are just to the point, inspire students to figure out and comprehend by themselves, and promote students to deeply experience. In addition, I highly respect the famous saying of the master of Chinese painting Qi Baishi, "Those who learn from me live, and those who resemble me die", so when I teach my students academic experience, I never ask them to deliberately imitate me, I ask them to combine their own professional foundation, boldly expound their own academic opinions, in terms of theoretical understanding, dialectical legislation, prescription selection, etc., I encourage them to boldly explore, put forward different opinions, and follow their own path.
I have been practicing medicine for decades, and I have a little knowledge and understanding, which must be passed on to those who come after me, so as not to leave regrets in the future. Because of this, I continue to continue to teach first-line clinical and apprenticeship even after retirement. The hospital is the cradle of my academic growth, and it should be a solid foundation for me to serve patients, and I can still serve patients, relieve their pain, and get their trust and praise, which is the greatest happiness in my life, what more could I ask for?
Liu Yongnian has been the editor of the Journal of Nanjing Hospital of Traditional Chinese Medicine for a long time
【Historical Scene】
On the bookshelf in Liu Yongnian's room, there are more than ten copies of the "Compilation of Medical Materials". Liu Yongnian said that Dean Fu once asked me to be the editor in charge of the "Medical Data Collection".
In 1978, Fu Zonghan served as the president of Nanjing Hospital of Traditional Chinese Medicine. In order to create an academic atmosphere in the hospital and improve the academic level of the hospital, he vigorously organized the editing and publication of the journal "Collection of Medical Materials", requiring each of the backbone of traditional Chinese and Western medicine in the hospital to write high-quality academic papers, and he insisted that papers were published in the journal of the hospital every issue. Many young doctors take pride in having their results published in the journal. According to Liu Yongnian's recollection, the publication of the journal continued until the mid-to-late 90s of the 20th century, leaving a large number of precious scientific research materials.
[Collection time] the morning of May 16, 2024
【Location】Nanjing Hongtu Garden
【Collection and arrangement】Nanjing Hospital of Traditional Chinese Medicine