About 2000 words of Chinese medicine teachers' experience

Up to now, the theoretical system of traditional Chinese medicine has mostly been developed on the basis of summing up the experience of predecessors. What is lacking in today's study is clinical experience and the guidance and answering questions of the previous generation, which makes the study completely theoretical and too abstract, and cannot make the theoretical knowledge more solid with practice. During my one-year study as a teacher, I got careful guidance from Mr. Chen Ming in learning Chinese medicine. I still clearly remember the first day with my teacher. Mr. Chen Ming kindly asked me about the difficulties in my study and what I wanted to know more. Because Mr. Chen Ming is in the Chinese medicine class, he recommended us to recite the three-character medical classics and teach us to recite them more. Memory is the basis and the most important thing in the learning process of TCM. Even if you can't fully understand the essence of the contents in the book, you must rely on rote learning, so that you can fully understand the will in the book in clinical practice. After making the study plan, the teacher took me around the whole hospital and patiently told us some hospital stories. In the process of following the teacher, you can learn a lot of knowledge that you can't learn in class. In the conversation with the teacher, I can learn what good methods she has in reading classics. I can also get a deeper understanding from a shallow understanding and correct my biased understanding. When learning any subject, the most precious thing is to get the guidance and instruction of predecessors. While strengthening learning objectives, we can also deepen our understanding and expand our knowledge. Most of the great men in the world have succeeded on the shoulders of others. Only with the experience of previous failures can we start to study from more other aspects. It is precisely because of the successful experience of predecessors that more people can have the confidence to strengthen their goals and achieve more and better success. It is precisely because of the experience of our predecessors that we can succeed faster and better, and we can continue to learn at a higher and deeper level on the basis of success. Only in this way can society progress. In the course of my life, following the teacher is a great gain, which makes me have a deeper understanding of Chinese medicine learning, and also makes me understand the distance between theory and practice and the importance of combining theory with practice. In the process of learning Chinese medicine, we often feel the abstraction of theoretical knowledge, so that we can't really understand its meaning, have no solid theoretical foundation, and can't fully understand its theoretical meaning in actual clinic. Therefore, in the process of learning from teachers, we must lay a solid theoretical foundation and memorize more theoretical knowledge, which is for better combination with clinic, better integration into clinic and better use of what we have learned. This month, we can attend the surgeon seminar again. Everyone is divided into groups. In each group, besides studying together, we can also discuss the problems encountered in clinic and exchange different opinions on dealing with diseases. In our communication, we can learn more people's ideas and learn to understand the same problem from different aspects.

It also exercises our expressive ability. Therefore, I hope this system can continue and let us learn more knowledge. As the old saying goes, "One day as a teacher, one life as a father". In the process of learning, we should get along with teachers, respect each other and advocate some traditional good behaviors. When we meet the truth over time, teachers will definitely give their knowledge to each other.

Learn from the teacher (2)

Clinical research of traditional Chinese medicine is a process of combining theory with practice. How to integrate what you have learned?

It is every student who enters the clinical stage who applies knowledge to clinical practice and grasps it well.

Expect to come true. However, after students enter the clinic, they find that there is a great difference between clinical learning and theoretical learning.

The difference is hard to grasp at the moment, and there is always a feeling of being anxious to see a doctor every day but getting little. After studying with the teacher for so many days, let's talk about how to be clinical with the teacher according to my learning experience.

First, we should pay attention to cultivating practical ability. The practical ability of traditional Chinese medicine is the exercise of observing, smelling, asking and palpating. The four diagnoses of traditional Chinese medicine are definitely not a simple photo and an examination.

Replace "advanced technology". We must combine past knowledge with present symptoms; It can only be obtained through instant random communication with patients. At the same time, the "clear knowledge" that can be accurately expressed and recorded in books is only a small part. More knowledge of human beings is something that can only be understood but difficult to express. As the saying goes, "A word is true and thousands of books is false." Only by learning from teachers and setting an example can we master the essence of traditional Chinese medicine. Clinical practice has proved that in the development of diseases, the changes of tongue are rapid and vivid, and it is like a mirror of internal organs. The deficiency of viscera, the rise and fall of qi and blood, the profit and loss of body fluid, the depth of disease and the prognosis can all be objectively reflected from the tongue picture, which becomes an important basis for doctors to diagnose diseases. If you see a pale white tongue, it is mostly due to deficiency of both qi and blood or yang deficiency.

; If you see red tongue, it is mostly heat syndrome. If you see a purple tongue, it means that the blood flow is not smooth. Clinical observation is needed to obtain accurate information. Another example is "To treat exogenous fever in children, it is necessary to look at the tongue and examine the throat."

The throat is a "shady place", which is of great significance to distinguish cold and heat from excess. For example, the throat is red and swollen, which is true fire; Red dryness is yin deficiency; Not red or swollen, it is yang deficiency; A sore throat that is not red or swollen is really hot in winter vacation, and a sore throat that is red and swollen but shows cold syndrome all over the body is really hot and fake cold. When you ask questions, you should pay attention to skills. When you learn from the teacher, you should also learn the methods and skills of asking questions from the teacher.

This is a long-term training process. When I first went to the clinic, I often tried to be perfect and detailed according to the method of western medicine asking about medical history, but after asking, my mind was at a loss and I didn't understand until I imitated the teacher's consultation. The consultation of traditional Chinese medicine depends on the theoretical level and clinical skills of doctors. The main purpose of consultation is to confirm a disease or a syndrome or to exclude a disease or a syndrome. As for pulse diagnosis, we must first master the characteristics of pulse condition. If the pulse condition of floating pulse is characterized by shallow pulse position, you can take it gently and put it down, and then press it slightly but not empty, such as floating wood like water. Reflect the location of the disease in the table. The pulse condition of deep pulse is characterized by deep pulse position, which should not be taken lightly, but should be weighed as heavy as a stone sinking into the water. Reflect that the disease is located in the hospital. After mastering the characteristics of pulse conditions, it is best to start with several common and simple pulse conditions, such as floating, sinking, late, counting, string, thin and red, under the guidance of a teacher with rich experience in pulse feeling, and make a careful clinical experience. Second, experience it often. Learning to feel the pulse is like playing a ball, which emphasizes the "feel" and must be persevered and often trained consciously. Over time, you will learn something. When I followed my teacher to the clinic for the first time, the teacher pointed to an old man with high blood pressure and asked me to take my pulse and see what it was. I can blurt out the pulse characteristics of more than 20 pathological pulse conditions in books. I also read the book Hu Ling Pulse Sutra very well, but once I went to the clinic, I was "hard to understand" and said timidly, "The pulse condition is so hard, like a tight rope". The teacher smiled and said, "Yes. I suddenly realized, isn't the string pulse "straight and long, like pressing a string" Since then, I am no stranger to string pulse, and I realize that seeing the string pulse of middle-aged and elderly people, especially the left hand pulse, is strong and powerful, which is mostly a precursor to the hyperactivity of liver yang and even the movement of liver wind. It is necessary to take large doses of products that calm the liver and suppress yang, calm the liver and calm the wind, and prevent problems before they happen.

Second, we should make medical records.

When you go out with your teacher every day, you should make a good medical record. The principle of recording should be detailed, including your tongue pulse for future reference. Some common diseases can be recorded simply, while difficult and rare diseases should be recorded in detail, including the teacher's medication.

Carefully recording medical records is the best way to collect original data. Whenever I encounter intractable diseases in clinic, I always review my previous medical records several times and often find some good solutions.

Third, be diligent in thinking.

Follow the teacher's clinic to ask about the medical history, take the pulse, record and think about the teacher's prescription. After four consultations, I thought about what syndrome type this disease is, what main prescription to use, and how to add and subtract. Then see if it is consistent with the dialectical thinking of the teacher and whether the prescription and medication are the same. If they are the same, you will know that your dialectical thinking is basically consistent with the teacher's. If it's not the same, you should consider where your gap is, and even ask the teacher to point out the maze. What's wrong with my thinking, what's wrong with my medicine, what's right with it, and why the teacher uses it like this. Sometimes teachers must carefully consider special prescriptions or special doses.

Fourth, learn to get along with patients.

Treat patients like relatives, be considerate of patients, let patients cooperate with you better, let you have an examination and answer your questions. Finally, we should "study hard, see a doctor hard, sum up hard, and be a man hard". These experiences in reading, clinic and being a man are hard for us to learn in class and books.

Learn from the teacher (3)

Through a year's study with the teacher, we learned that Chen Ming, deputy chief physician, quietly paved the way for me to know Chinese medicine. I didn't understand at that time, but I was trying to learn Chinese medicine.

study There are many patients who study with teachers. They often go to see a doctor during the day and study by themselves at night. It was past nine when they got home by bus. Looking at the flashing night lights all over the street, watching the endless traffic, watching the passers-by in a hurry, thinking about my lover who is anxiously waiting for dinner at home, I can't help but sigh. But when I think about this day, I understand the truth of Chinese medicine and see a new self.

The illness deepened shallow views and corrected the wrong understanding in the past. The joy in my heart and my heartfelt thanks to my teacher are beyond words. Now the three-year study with the teacher is over. From beginning to end, I think that learning with the teacher does not lie in the word-for-word teaching of the teacher, but in the subtle way, let the disciples feel the spark of the teacher's thinking and wisdom. After much thought, he still couldn't figure it out. I discussed it with other colleagues, but there was still no answer. I found a suitable opportunity to ask the teacher. At this time, the teacher's words are the truth, and what I have learned from the teacher countless times is the patient's problem. The teacher's answer made me stunned. Below I will write down the experience of studying medicine with teachers accumulated in the past three years for the reference of my peers. First, before learning from teachers, we must first have a comprehensive understanding of teachers and achieve "two essentials", which is a necessary condition for success in learning from teachers. First, it is necessary to know the development status of the hospital and discipline where the teacher works, who he studied with, whether it is a family heirloom or a teacher's inheritance, what medical theories he has studied intensively, what are his medical characteristics and what theories he is concerned about. By mastering these conditions, we can understand his academic origins and thoughts, and what theories and viewpoints he inherited and developed. In this way, when summing up its experience, there is a basis; The second is to understand the academic expertise and experience characteristics of teachers. And around this problem, we should collect information extensively, accumulate and master detailed and reliable first-hand information, which is the basic material and foundation of our future academic experience. To achieve the above-mentioned "two essentials", we must achieve "six more" in our daily study with teachers: ask more questions: ask more teachers about some key problems encountered in our study, ask questions in depth and make them clear as far as possible. For example, how many kinds of drugs does an experienced party have? What are the compatibility features? How does the dose change? What are the requirements for the decoction method? How to add, subtract, multiply and divide? For what reason? What doesn't apply? What are the taboos? What is the basis of prescription, etc. Never take it for granted. In the process of learning, asking more questions is an important way to make the questions deeper. Although the teacher has many years of experience, he doesn't always explain the problems thoroughly. Some problems are shared by teachers themselves, but others may not know the mystery. Therefore, we should get to the bottom of it. In this process, learners often ask themselves: What experience have they learned from teachers? Will it be used clinically? Always ask the patient: Has the patient's symptoms improved, has there been any change, and has there been any uncomfortable reaction after taking the medicine, so as to realize the subtlety of the teacher's treatment experience in detail. Listen more: when following the teacher's clinical practice or listening to his stories, listen to the teacher's views and thoughts on each problem. It is one of the important parts of first-hand information to master his thinking method, academic thought and academic viewpoint and find out the law of dialectical medication. Read more: read more teachers' clinical diagnosis, prescriptions, papers and writings, and repeatedly understand the clinical application of their academic thoughts. At the same time, according to its academic origin, read the medical theories and works of sages who have great influence on it, so as to trace back to the source and master the theoretical basis; Read modern medical books related to this subject,

Proficient in the theory of Chinese and western medicine, comprehensive knowledge; Read all kinds of literature related to your major to understand the origin of medicine. Multi-recording: recording what you hear and see at any time is an important means to collect information. One is instant recording, that is, listening, watching and recording; The other is memory, that is, what you hear and see is recorded through memory. On this basis, it can be classified. In the past three years, my teacher and I have taken notes in this book. Multi-purpose: diligent in clinic, dare to prescribe medicine every time I encounter similar medical records, and even copy the teacher's methods and ask for advice in time when I find problems. This medical skill will improve quickly. Think more: classify the above questions, listen, watch, remember and use them, analyze and summarize them in an orderly and systematic way in your mind, and find out their regularity. This is the essence of teachers' experience, and it takes some time to sublimate and improve on the basis of the original materials. "The Analects of Confucius for Politics" said: "Learning without thinking is useless, thinking without learning is dangerous". Sorting out the experience of old Chinese medicine practitioners is both work and study. If you want to inherit the teacher's experience, you must work hard on "learning" and "thinking". More communication: communication and communication are the extension of asking more questions. In the process of following the teacher, more communication with the teacher and more clinical questions can improve the teacher-student relationship. I also have academic exchanges with doctors around me and share successful examples. Finally, as a modern Chinese medicine practitioner, we should use a variety of information exchange methods, such as Weibo and email. Communicate with medical colleagues to share some learning experience, teacher's experience and confusion. The above is a summary of my experience, and I hope it will be beneficial to everyone.