World Integrated Medicine Master Shen Baofan

INTRODUCTION OF SHEN BAOFAN

Prof. Shen Baofan (Han nationality) was born in Shanghai. He graduated from Shanghai First Medical College (now known as Shanghai Medical College of Fudan University). In 1960,he participated in the national traditional Chinese medicine (TCM) courses held by the Ministry of Health for doctors of western medicine. He is currently the chief expert, professor of internal medicine and chief physician of Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region, academic consultant of Encephalopathy Branch of China Association of Chinese Medicine,and the consultant of Integrative Medicine Committee of the Project of Prevention and Treatment of Stroke of National Health Commission, member of Academic Committee of Key Laboratory of TCM Syndrome and Treatment of Encephalopathy of Beijing University of Chinese Medicine and State Administration of Traditional Chinese Medicine, member of TCM Expert Committee of National Public Health Emergencies, member of Panel of Experts of National Alliance for Study of Coronary Heart Disease, member of Panel of Experts of Clinical Treatment Platform of Integrated Chinese and western Medicine for New and Sudden Emergence of Infectious Diseases under the National Science and Technology Major Project of the Twelfth Five-Year Plan, expert consultant of China National Committtee for Terms in Traditional Chinese Medicine, and consultant of Specialty Committee of Clinical Research for Ancient Classical Formulation of World Federation of Chinese Medicine Societies.

Since 1997, he was approved as one of the national famous TCM experts whose academic experiences should be inherited.In 2013, he was certified as a postdoctoral tutor for the inheritance of TCM in China. He was awarded the Special Contribution Award of Traditional Chinese Medicine by the China Association of Chinese Medicine and the excellent instructor by the State Administration of Traditional Chinese Medicine twice continuously. He was appraised as an excellent expert with outstanding contributions by Xinjiang Uygur Autonomous Region for three consecutive times and enjoys Special Government Allowances of the State Council. In 2017, he was certified as the third batch of National TCM Master. Longhua Hospital of Shanghai University of Traditional Chinese Medicine, Guangdong Hospital of Traditional Chinese Medicine, Sanya Traditional Chinese Medicine Hospital and other hospitals in Jiangsu and Zhuhai have established workshops for him. The Information Center of China Health Care Association has logged his medical expertise into the World Famous Doctors and Medical Data Book of the Internet.

Left picture

National TCM Master,Prof. Shen Baofan

Right picture

Prof. Shen Baofan,National TCM Master(left) and the Interviewer,Prof. Zou Jianhua (right)

Prof. Zou: Hello! Professor Shen, thank you very much for accepting the interview of World Journal of Integrated traditional and western Medicine (English version). At present, under the guidance of Xi Jinping's Thought of Socialism with Chinese Characteristics for a New Era, the development of traditional Chinese medicine (TCM) has also entered a new era. In October 2018, during his visit to TCM Science and Technology Industrial Park of Cooperation between Guangdong and Macao, President Xi pointed out that TCM is a treasure of Chinese culture and it is necessary to deeply explore the essence of TCM, to promote the integration of production,study and research, to promote the industrialization and modernization of TCM, and to provide a global stage for TCM, which indicates that the CPC Central Committee and the State Council have put Chinese medicine on the strategic height in the overall reform and development of the Party, and the revitalization and development of TCM is ushering in the great opportunity with favorable conditions.

As an outstanding representative of western medicine, we hope that you can introduce some development in the field of integrated traditional Chinese and western medicine to our colleagues in the world. First of all, would you like to talk about your understanding of the integration of traditional Chinese and western medicine or what do you think is the integration of traditional Chinese and western medicine?

Prof. Shen: There has been divergent opinions about the true connotation of the integration of trational Chinese and western medicine for a long time. To sum up, there are two main types. In a limited sense, it is a new kind of medicine resulting from the combination and unification of TCM and western medicine. And there is a broad understanding that the clinical efficacy is improved with the academic and pratical cooperation of the practitioners of the two medicine. In my opinion, the true connotation is to integrate TCM and western medicine into the unity of medical science and through the process of contradictory movement of thinking, what is that false is discarded and what is genuine is kept and the 2 kinds of medicine get a new level of integration and complement each other through mutual penetration, dependence,connection and combination.

Prof. Zou: What do you think are the key points of the integration of traditional Chinese and western medicine, and what are the differences and what should we pay attention to in clinical practices?

Prof. Shen: The core is to grasp the relationship between inheritance and innovation.

As for the method, first of all, disease differentiation and syndrome differentiation should be combined,systmetical syndrome differentiation and local syndrome differentiation should be combined, treatment based on syndrome differentiation and special prescription for a particular disease should be combined, through which not only the deficiency of TCM on microscopic understanding of some diseases, but also the excessive emphasis on disease qualitative positioning of western medicine which leads to the neglect of to overall reaction and the dynamic changes of the body during the development of the diseases are neutralized. Disease differentiation is essential in both TCM and western medicine. And the simple determination of diseases in western medicine and the syndrome differentiation in TCM are inappropriate. Disease differentiation is also of significance in TCM. Although there are same syndromes between different diseases, there are still distinguishing symptoms, and the cause, nature, degree of seriousness,location, pathogenesis, development, sequelae and prognosis are also different. Let's take the symptom of cough for an example. There are some aspects that need to be taken into consideration, such as syndrome differentiation of cold and heat, deficiency and excess,and the cause of lung consumption and lung distention.While disease differentiation puts emphasis on the pathological development based on the similarities of the diseases, syndrome differentiation attaches importance to the function and the environment of every patient which is based on individual differences. Besides, western medicine also emphasizes individual differences, such as pneumonia. It is necessary to determine whether it is caused by viral infection, bacterial infection, or mycoplasma infection, etc., according to which the choice of anti-infective drugs including antiviral, antibacterial,and anti-mycoplasma drugs. Therefore, the integration of diseases and syndromes should be based on both differentiation of both diseases and syndromes of TCM and differential diagnosis of western medicine.

Then, we should comprehensively analyze data gained by four diagnostic methods and attach importance to the results of auxiliary examination. The special methods of western medicine shoud also be combined to find more objective information, and the application of new technology can also contribute to more comprehensive understanding of the occurrence and development of diseases from the aspects of cytochemistry, neurotransmitters, hormones, immunity and even genes, thus facilitating the better planning of treatment and prevention. For example, X-ray,ultrasound, gastroscopy and other imaging examination and ECG, pulmonary function test, laboratory tests and other methods are the extension of TCM observation.C14breath test and some physical examination of western medicine such as auscultation of heart and lung can be used as an extension of TCM diagnosis through auscultation and olfaction. Palpation and percussion in western medicine are also extensions of pulse-feeling and palpation of TCM. And all of these can promote early diagnosis. For example, the onset of precordial pain in middle-aged and elderly patients is corresponding to chest painful impediment of TCM. When the attack is frequent and severe, with the help of ECG and cardiac enzyme markers and other examinations, acute myocardial infarction can be detected as early as possible, and revascularization therapy can be adopted as early as possible to open up the patient's blood vessels, which plays a pivotal role in reducing the mortality and improving the cure rate.Brain CT and MRI examination can help to determine whether it is hemorrhagic stroke or ischemic stroke;ECG, echocardiography and other modern scientific examination methods can help to distinguish between cardiac neurosis and organic heart disease for those with palpitation with sensitive heart throbbing and irregularly and regularly intermittent pulse.

In addition, if TCM workers take syndrome differentiation and treatment as the main means, with the help of detection methods of modern science and clear diagnosis of western medicine, the form and content of syndrome differentiation and treatment can be changed,so that clinical efficacy is improved. For example,gastroscopy can be used as a reference for the treatment of gastritis. According to the results, herbs that can drain dampness and promote blood circulation are added if there is mucosal congestion and edema; herbs that can warm and activate yang and reinforce qi are added if the gastric mucosa is pale and edematous with a pale tongue and slippery coating; if there is gland atrophy, gastric mucosal thinning, and decreased secretion of gastric juice with a reddened tongue and little coating, which are syndromes of yin deficiency, Yiguan Decoction and Yiwei Decoction that are yin-replenishing can be used.

Clear diagnosis is the premise and basis of treatment for both TCM and western medicine. At present, due to various standards of TCM syndrome differentiation,clinical efficacy, scientific research, new drug research and development, and academic exchange of integrated traditional Chinese and western medicine are limited,which sometimes exposes itself to detriment in some medical disputes. Quantitative and standardized diagnostic criteria of TCM which is also accurate,practicable, advanced and stable should be established as common standards of clinical, scientific and education development of the integrated traditional Chinese and western medicine to promote the academic, scientific and clinical development of TCM. At present, diagnosis of western medicine is relatively clear and standardized.Therefore, during the clinical diagnosis, I ask the patients about the current medical history, past medical history, family history, marriage and childbearing history, etc., and the physical examination should also be comprehensive and meticulous to determine the location and nature of the disease. Meanwhile, standard diagnosis of TCM should also be made according to the four diagnostic methods. Only in this way can it provide scientific basis for the application of drugs of TCM and western medicine.

Finally, the treatment of integrated traditional Chinese and western medicine is an organic integration which fully brings into play the advantages of the two kinds of medicine and develops better curative effects instead of the non-focus, non-principle combination of drugs. For example, I once treated Gao Dana, a Yugoslav foreign woman whose husband is the director of the Maize Research Institute, who has many cooperative projects with China and is also the recipient of the Chinese Friendship Award. At that time, she suffered from rheumatism, diabetes, coronary heart disease, swelling and pain in the joints of the whole body especially of the fingers and knees, and she was treated with adrenocorticosteroids and antipyretic and analgesic drugs for a long time before hospitalization in our hospital. In my opinion, long-term use of hormones is unfavorable for blood glucose control, and long-term use of antipyretic and analgesic drugs would cause the symptoms of epigastric pain, loose stools and spleen and stomach discomfort. Therefore, I used TCM of invigorating the spleen and harmonizing the stomach in combination with acupuncture, physiotherapy and other treatments after syndrome differentiation. After two months of treatment,not only the hormones were stopped, but also the joint pain was well controlled, and she had better spirits and appetite, and other diseases such as coronary heart disease were also improved before discharged from the hospital.This shows that in the treatment of some refractory diseases, the integration of traditional Chinese and western medicine can greatly reduce adverse reactions and ensure the completion of the previous treatment.In addition to reducing the adverse effects of western medicine, TCM itself has a certain therapeutic effects.

With the development of the times, new pathogenic factors are constantly emerging, and with new treatment methods existing some new problems, such as the prevention and treatment of restenosis after intracoronary stent implantation. The emergence of new diseases requires us to take advantage of the advantages of TCM and western medicine to constantly explore effective treatment and prescriptions, which is also certified by the significant therapeutic effects of SARS with TCM involvement.

Prof. Zou: Prof. Shen, I am wondering what stimulate you to study medicine and learn both TCM and western medicine. Could you share something about your experiences?

Prof. Shen: During the time of wars, the Japanese army invaded and launched the "8 • 13" Incident. The old house of mine was destroyed in the war, thus my family had to move to the outskirts of Shanghai. I was about two years old at that time. Since then, my family's fortune declined. In my memory, we were living a very hard life.

My mother bored 10 children, and I'm the third.Unfortunately, my sixth, seventh and eighth younger brothers died out of illness when they were young. My mother was weak, and the pain of losing her sons made her sick for a long time, which gave me the idea of studying medicine as a teenager.

When I was a child, I received the new type of education and was not interested in TCM. It was from a disease when I was going to graduate from junior high school and go to senior high school that I started to pay attention to TCM. At first, I was weak and had a poor appetite, and then I had a low fever for two or three months. My parents took me all around for medical treatment. I took X-ray films for five or six times in hospitals, but no one knew the cause of the disease, not to mention curing it. Seeing me getting more and more emaciated, a colleague of my fathers recommended a doctor of TCM. Since western medicine did not work with the disease, I had no choice but to try TCM.

I still clearly remember what the senior TCM doctor looked--thin body, gray hair, and his outstanding behavior was like that of immortals. The old man inquired about my illness in detail. I was relieved by his gentle tone and self-confidence. After two weeks of taking the medicine, the fever completely subsided. After another week of treatment, I recovered and returned to the campus brimming with energy. It was then I started to be interested in TCM and long to be practice medicine and serve the people.

At the time when I graduated from high school,there was no university of TCM in China. I had no alternative but to choose to learn western medicine. I remembered I filled my application form, from the first column to the seventh column, with the major of clinical medicine. I planned to learn western medicine at first, and then conducted a further study of TCM.

I was then successfully admitted to Shanghai First Medical College, which was the most famous medical college in Shanghai at that time. According to the regulations, every exam had an oral test, and the students answered the questions they got on the spot, which could effectively examine whether they had acquired the basic knowledge or not. Many years later when I was the director of Clinical Teaching Department of Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region, I used this method for reference in the graduation examination of interns. At that time, the only thing that made me feel pitiful was that there were few places where I could learn TCM, for there was only one course involving TCM - Introduction to Traditional Chinese Medicine.

Prof. Zou: Professor Shen, you have a great accomplishment in clinical work of TCM. How did you learn TCM systematically? And how to engage in the work of integrated traditional Chinese and western medicine?

Prof. Shen: On the instructions of Chairman Mao, China Academy of Chinese Medical Science was established in Beijing and the first TCM courses for doctors of western medicine was conducted. When I graduated from college in 1960, the wave of western medicine doctors learning TCM was spreading throughout the country. I was selected to study in the second TCM course for doctors of western medicine. This class mainly recruited excellent graduates from universities who would be engaged in the research of integrated traditional Chinese and western medicine and create the Oriental school in the future. I'm glad that I can learn TCM finally.

According to the plan, the course lasted for two years. The first year was for theoretical study and the second year was for clinical practice. Just one month before the end of the theory-learning period, I was informed that because of the tough condition, I was allocated to Xinjiang as a group of trainees organized to support construction in remote and poor areas. However,I was worried about my mother that time. I wrote a letter to my younger brother and said, "Don't tell our mother this news at first. I'm afraid she won't accept it at this time… The situation in Xinjiang is still unknown… In the absence of mine, mother and sister will depend on you..." Then I went to the Hospital of Traditional Chinese Medicine in Xinjiang Autonomous Region.

Despite the poor conditions of the hospital in Xinjiang Autonomous Region at that time, there were a lot of talents. Dr. Chen Susheng, Dr. Zhu Boxin and other well-known TCM experts came here for political reasons. I was assigned to work with Dr. Chen Susheng.I have a solid mastery of TCM theories, but lacked of clinical experiences, so I learned from Dr. Chen Susheng and consulted every experienced TCM doctors. During the decades in Xinjiang, I was learning constantly and communicating with local patients in Uygur. Sometimes I even forgot how to speak Shanghai dialect.

There is another thing that a patient with thromboangiitis came to see a doctor. Because of the necrosis of his toe tissue, his fifth toe had been removed,but then the fourth toe had the same condition. Such disease is called "gangrene" in TCM. At that time, Dr.Li Yukun, the head surgeon, suggested to use Simiao Yong'an Decoction for the treatment, which was the right way to treat the disease. However, the Radix Angelicae Sinensis, which was very important in the prescription, was scarce in Xinjiang at that time. Under such circumstances, Director Li boldly replaced 2 Liang of Radix Angelicae Sinensis with 4 Liang of Caulis Spatholobi, and achieved good clinical efficacy. Two or three months later, the patient recovered. This event left great impression on me. I also realized that this method has great promotional value at the time of shortage of material and medicine. Therefore, I looked up the literature and cases from all over the country over and over to summarize the case experience of Dr. Li Yukun.I published a paper in Shanghai Journal of Traditional Chinese Medicine. Later, many TCM doctors replaced Radix Angelicae Sinensis with Caulis Spatholobi, and a new Simiao Yong'an Decoction with remarkable curative effects appeared.

I think, first of all, it is the environment that creates me and strengthens me. I am well aware of that. The local people were very simple and enthusiastic. In such an environment, I gradually learned how to behave and how to treat people.

Although Xinjiang is very good, I also needed to get advanced studies in big cities. The most impressive and influential one was the time when I was studying in Beijing, Tianjin and Shanghai with the help of Mr.Lin Shixiao, my old superior. When Mr. Lin Shixiao was sent to Xinjiang, he suffered from back pain. And I was in charge of treating him. After discharging from the hospital, I was asked to send him back to Beijing,when he suddenly said to me in the carriage, "Do you know why I asked you to go to Beijing with me?" I was stunned, "Escorting you back to Beijing?" He smiled:"Because I think you are a talent and I want to take you to Beijing to study further." I was very excited, because in the Great Cultural Revolution, it was very difficult for me to have a further study. And I have always been grateful to him.

After I arrived in Beijing, under the arrangement of Mr. Lin Shixiao, I attended the ward rounds and consultations with Professor Chen Zaijia and Professor Liu Lisheng in Fuwai Hospital during the day, and copied prescriptions with 2 famous TCM doctors, Dr. Zhao Xiwu from China Academy of Chinese Medical Sciences and Dr. Wei Longxiang from Beijing Hospital in the evening.Three months later, I was arranged to study in Tianjin and Shanghai. In Shanghai, I met Dr. Su Wanfang, an senior TCM doctor, and learned a lot. It can be said that the further education in this period has developed a solid foundation for my future development.

I met many people who helped me in my life. My medical advancement benefited from the cultivation of Dr. Lin Shixiao, and the later academic development could hardly do without the help of Academician Wang Yongyan. In the 1980s, Academician Wang Yongyan,the president of Beijing College of Traditional Chinese Medicine at that time, drew up a criterion for the diagnosis and evaluation of the efficacy of stroke. He invited experts from various health departments to discuss the criteria. And I left him some deep impression as I put forward some pertinent amendments. Later, when President Wang originated the national stroke research collaboration group, he strongly invited me to join. Since then, the two of us have formed a deep friendship. And he invited me to participate in many major academic activities in the field of TCM. I have always been deeply grateful for this.

Prof. Zou: Your theory of the simultaneous treatment of phlegm and blood stasis is very famous.Would you like to share with us about the theory and how it was formed?

Prof. Shen: On the basis of the local natural environment, climate characteristics, and lifestyle habits in Xinjiang, I adjust ancient prescriptions according to the pathological characteristics of people nowadays to form the theory, and diagnosis and treatment of simultaneous treatment of phlegm and blood stasis.

As a matter of fact, Mr. Zhu Danxi is my teacher.He used Siwu Decoction combined with Semen Persicae,Fructus Chebulae, Pericarpium Citri Reticulatae Viride, fresh bamboo sap, and ginger juice to treat lung distension, and used Kongxian Special Pills combined with Taorenni Pills to treat general aching and hypochondrial pain, and used Xuekuai Pills to remove blood stasis with drastic medicaments to disintegrate abdominal mass, from which I got enlightenment about diseases caused by phlegm and blood stasis. Phlegm originated from body fluid that shares a common source with blood which will form blood stasis, as a result of which the process of blood stasis formation is often accompanied by metabolic disorders of fluid which leads to the formation of phlegm and disharmony between qi and blood, in turn leading to blood stasis. And qi stagnation can lead to both blood stasis and existence of dampness that will transform into phlegm. Therefore,phlegm and blood stasis share a common source.

Due to the pathogenic factors of the yin nature that tends to stagnate, there is still no radical cure for patients with intermingled phlegm and blood stasis if only one factor was revoed. Therefore, I think that phlegm and blood stasis should be removed simultaneously. Blood stasis should be removed to resolve phlegm, and it will easier to resolve phlegm when blood stasis is removed and vice versa. However, the simultaneous treatement of phlegm and blood stasis is not simple combination of herbs that can promote blood circulation to remove obstruction from meridians and that can resolve phlegm. Treatment varies from each other according to different degree, duration, depth, size, zang-fu organs and meridians, and should also be based on syndrome differentiation of hot and cold, deficiency and excess, and on the order of the emergence of phlegm and blood stasis.Meanwhile, herbs that can regulate the flow of qi should also be combined to facilitate the removal of blood stasis and phlegm.

Let's take angina pectoris caused by coronary heart disease for an example. The formation of coronary atherosclerotic plaque leads to weakened elasticity of coronary artery, and lumen stenosis affecting the coronary blood supply, so that myocardial ischemia and hypoxia produced angina, palpitations, shortness of breath and so on, which is known as angina pectoris of coronary heart disease. According to the clinical features, it is corresponding to chest painful impediment, heart pain,and pectoral pain with cold limbs.

I think the main pathogenesis of chest painful impediment is phlegm and blood stasis blocking in the heart and chest,which blocks yang qi and collaterals.Clinically, chest distress and dragging pain are common,accompanied by chest tightness and fullness, nausea and anorexia, fatigue and other symptoms. The tongue is dark red, blue-purple, or crimson, and is fat with teeth marks on the edge, and the coating is white greasy or yellow greasy. There can be slow, deep, rough, wiry, or irregularly and regularly intermittent pulse, indicating that blood stasis and phlegm stagnation are intermingled.The causes are related to the unique geographical,environmental, ethnic customs and habits of Xinjiang.Firstly, Xinjiang is located in the western border of the motherland with a cold and dry climate, making it easier for the pathogenic factor of cold to affect those with chest painful impediment and heartache because they already suffer from yang deficiency and dejected yang in the chest which will be aggravated and accompanied by qi stagnation and cold congealing that will block blood flow,thus triggering chest pain. Secondly, the residents in this area like to eat greasy, sweet, fried and roasted foods,which will gradually harm the spleen and stomach, cause disorders of transportation and transformation, and induce the formation of phlegm which will invade the chest and heart, causing dejected yang and qi stagnation, and further developing to obstruction of the Heart Meridian.It may also be caused by qi deficiency and dysfunction of the spleen in transportation, which will induce phlegm and blood stasis that blocks the meridians. And the disharmony of qi and blood will retain the phlegm which intermingles with blood stasis, thus triggering the disease.In addition, the disease mostly occurs in the middleaged. Those who are over fifty years old will experience the decline of kidney-qi and kidney-yang deficiency which will fail to activate the yang of five-zang organs,resulting in insufficiency of heart-qi or deficiency of heart-yang, as a result of which the blood vessles are blocked due to the loss of warmth; it is also possible that the dysfunction of the spleen in transportation due to the old age will fail to disffuse the fluid, which will gather and form phlegm that is intermingled with blood stasis and lead to difficulty in circulation of qi and blood; and if there is deficiency of kidney-yin, the yin of five-zang organs will not be fully nourished, which will lead to the consumption of heart-yin, as a result of which there will be heart fire that condense fluids to phlegm, and the Heart Meridian will be blocked with symptoms of chest painful impediment. Chest painful impediment is deficiency in nature and excess in superficiality that presents as phlegm and blood stasis. While phlegm and blood stasis interact as both cause and effect, the blockage of phlegm will cause the stasis of blood and the stasis of blood will block the circulation of fluid and form phlegm. Therefore,emphasis should be placed on activating meridians and collaterals in the treatment of chest painful impediment.The simultaneous treatment of phlegm and blood stasis should be applied under the guidance of that "all diseases are accompanied by phlegm or blood stasis", and that"phlegm and blood stasis share a common source".

Both TCM and western medicine believe that"stagnation may bring about pain" which is the cause of angina pectoris of coronary heart disease. Based on this principle, I make a prescription--Xintongning Decoction,which can diffuse blockage and activate blood circulation,eliminate phlegm and remove obstruction in collaterals,as well as promote the flow of qi and blood, thus relieving chest painful impediment.

The prescription includes Radix Angelicae Sinensis, Radix Salviae Miltiorrhizae, Flos Carthami,Rhizoma Ligustici Chuanxiong, Fructus Trichosanthis,Bulbus Allii Macrostemonis, Rhizoma Corydalis, Cortex Magnoliae Off i cinalis, and Radix Platycodonis, among which Radix Angelicae Sinensis with flavor of acrid and sweet and property of warm can enrich blood activate meridians and collaterals; Radix Salviae Miltiorrhizae with flavor of bitter and property of slightly cold can activate blood circulation to remove blood stasis and activate meridians; Flos Carthami and Rhizoma Ligustici Chuanxiong with flavor of acrid and property of warm can promote blood and qi circulation to relieve pain. Rhizoma Corydalis with flavor of acrid and flavor of warm can regulate the flow of qi and activate meridians to relieve pain; Fructus Trichosanthis with flavor of sweet and property of cold can promote the flow of qi and resolve phlegm, relieve chest stuffiniess and remove stagnation; Bulbus Allii Macrostemonis with the flavor of acrid for dispersing stagnation and sweet for removing phlegm and property of warm for activating heart-yang; Cortex Magnoliae Officinalis with flavor of bitter and acrid property of warm can promote circulation of qi to remove blood stasis, and relieve chest stuffiniess and remove stagnation; Radix Platycodonis with flaor of bitter and moderate property can resolve phlegm and bring the effects of the drug upward to the chest. With the cooperation of those medicine, blood stasis and phlegm can be removed, meridians can be activated and pain is relieved.

And the theory system of simultaneous treatment of phlegm and blood stasis is improving through years of clinical research and application.

Prof. Zou: Prof. Shen, would you like to talk about how the theory is applied in clinical practices?

Prof. Shen: Phlegm and blood stasis can cause extensive pathological changes of the body from the surface to the inside, from the top to the bottom, as well as viscera and meridians, limbs, qi, blood, yin and yang, among which cardiovascular and cerebrovascular diseases are the most closely related with them. The theory of simultaneous treatment of phlegm and blood stasis can play a significant role in the treatment of diseases of circulatory system including hypertension,pulmonary heart disease, sick sinus syndrome, chronic heart failure, restenosis after coronary intervention,chronic hypotension, etc.; diseases of nervous system including stroke, senile dementia, epilepsy, facial neuritis,neurasthenia, Parkinson's disease, trigeminal neuralgia,etc.; as well as others including diabetes, hyperlipidemia,cold, senile back pain, postpartum pain, paralysis, etc.

Let's take stroke as another example. In the 1980s,I set up the "Clinical and Scientific Research Group on Stroke" in Xinjiang to conduct clinical and experimental studies on stroke. Through a series of experiments I found that stroke is a disease caused by intermingled phlegm and blood stasis with deficiency in nature that presents as deficiency of qi and blood, and zang-fu organs and excess in super ficiality that presents as excess wind, fire,as well as phlegm and blood stasis. According to the theories that "all diseases are accompanied by phlegm or blood stasis" and that "all strokes are caused by phlegm",we concluded two main kinds of stroke, consisting of apoplexy with zang-fu organs involved that is divided into three types, including inner phlegm-heat and windfire agitating the heart, intermingled phlegm-dampness and blood stasis blocking heart and spirit, severe loss of original qi leading to deranged mental activity, and apoplexy with the meridians and collaterals involved that is divided into four types including wind-phlegm and blood stasis blocking meridians, wind from excess liver yang and phlegm-heat intermingled with blood stasis,blood stasis due to qi deficiency blocking meridians with phlegm, blood stasis and phlegm due to yin deficiency causing wind. All those types of apoplexy are treated with different herbs that can promote blood circulation, like those can warm the meridians, cool the blood, reinforce and enrich qi, and remove blood stais, combined with those herbs that can induce resuscitation by clearing phlegm or clear heat, those can warm and resolve coldphlegm, those can moisten and resolve phlegm, and those can invigorate the spleen to resolve phlegm according to different syndromes except the type of severe loss of original qi leading to deranged mental activity.

I also got a lot of enlightenment on the development of prescriptions from the theory of simultaneous treatment of phlegm and blood stasis. In 1994, under the guidance of the theory, I developed Xihonghua Kangfu Decoction which was spreaded in American Medical Exhibition.

In order to improve the curative effect in the recovery period of stroke and facilitate the treatment,those prescriptions including Pinggan Maitong Tablets,Huatan Maitong Tablets and Buqi Maitong Tablets have been widely used in clinical treatment by more than 10,000 patients with significant curative effects after development.

Prof. Zou: What's your opinion on the development of new drugs of TCM?

Prof. Shen: In today's society, on the one hand,there is increasing need of "returning to nature", which attracts more attention to TCM; on the other hand, there are different forms of prepared drugs of TCM including pills, powder, ointment, pellet, dew, wine, yeast, ingot,gum, tea and other categories, among which decoction and pills are commonly seen. Although there is a saying that decoction has a quick and strong effect on expelling pathogenic facors, it is inconvenient in the emergence treatment of clinical critical illness, and it is still not as fast as injections of western medicine. If patients need to go out during treatment, it is also inconvenient to carry decoction. So I advocate the reform of forms of TCM drugs to meet the needs of patients in many aspects. I also have some principles for this:

Firstly, the development of new drugs of TCM should be based on more compound prescriptions, which is more in line with the theory of TCM. Secondly, we must pay attention to the clinical efficacy and safety,which is the premise. Then, the development of new drugs should be guided by TCM theory of syndrome differentiation and treatment. A series of preparations rather than a single one should be developed according to different syndrome types of a disease, which will be more effective. Finally, only with the cooperation of other disciplines, such as chemistry and pharmacy, can we develop effective, quick-acting, and long-lasting drugs that is convenient to keep, carry, and take with little dosage, toxicity, and adverse reactions.

Prof. Zou: I heard that you have treated some important persons. Would you like to tell about your experiences and feelings?

Prof. Shen: Yes, I have some patients from Central Asian countries, such as Shujaat--former Prime Minister of Pakistan and Ahlibek-- architectural designer of Kazakhstan. People all over the world are in need of TCM. We must fully realize the potential of TCM and make great efforts to inherit and develop the cause of TCM so as to serve the people of China and the world.

Prof. Zou: Now you have achieved a lot in all aspects. Have you ever considered leaving Xinjiang and returning to Shanghai to live a peaceful life in old age?

Prof. Shen: My family and friends all want me to go back to Shanghai. With tears in her eyes, my aunt said to me, "You have devoted your whole life to Xinjiang.Now it's time to come back." My old friend, Doctor Zhang Yunpeng, a famous TCM doctor in Shanghai, also told me, "You'd better come back. If you do not want to rest, I will help you contact major hospitals in Shanghai if you like." However, I refused.

I also want to enjoy the happiness of family reunion.I talk to my wife in Shanghai on the phone and hear the babyish voice of my grandson babbling. I couldn't help laughing but sometimes I cried. I wanted to go back to Shanghai for many times. But when I think about the old patients who come to see me every week, and the disciples who need to learn and practice, I quickly abandon the idea.

Prof. Zou: Doctors have always been one of the most sacred professions in the world. They all have their own beliefs and ideals, and also have lofty moral character. Would you like to tell us your beliefs of practicing medicine? And what qualities do you think a good doctor should have?

Prof. Shen: In my years of practicing medicine,I have always taken Sun Simiao's words in Eseence of Great Doctors as my guideline: every great doctor should be calm, determined and without desire during the treatment.

I think that the greatest happiness is to treat patients as your family members and relieve their pain.

A good doctor should not only be proficient in medicine, but also have a noble medical virtue which is more important than skills, and only those with good virtue can have exquisite skill. I will examine the patients'sputum and stool personally. Sometimes I go to the ward and ask my students about the color of the patient's stool.I will be dissatis fied if they don't know.

I will take special care of those nonlocal patients.It's not easy for them to come to Urumqi. They have extra expenses for accomodations. And I have limited number of appointment every day. So I made special rules for them. With their ID cards, they can made the appointment as soon as possible and go home on the same day. I don't want ticket scalpers to awail themselves of loopholes. The head nurse proposed that nonlocal patietns could make extra appointment with their tickets on the same day. In this way, nonlocal patients are guaranteed to make the appointment as long as they come to the hospital before I am off duty.

I also have always been opposed to the prescriptions including expensive drugs. And I also try to ensure the efficacy through reasonable synergy. For example, if the patient's economic situation is not so good, Fructus Citri that can regulate the qi flow can be used as an alternative for Fructus Citri Sarcodactylis whose price is expensive.And I also require my students to know the prices of the drugs and try ro save money for patients when prescribe.

In fact, I don't think that money is very important.Many pharmaceutical companies have advised me to sell patents of three kinds of Maitong Tablets, which is entirely reasonable and legal. Although the patent fees for the three kinds tablets can add up to several million yuan, I still refused, because the price would rise that would add to patient's burden once I sell the patent. In the 1990s when I went to the United States to attend the world academic symposium on integrated Chinese and western medicine, an American pharmaceutical group came to my hotel for three consecutive nights,promising hundreds of thousands of dollars a year and"green card", hoping that I would work in the United States. I responded: "I am a Chinese, and all my career is in Xinjiang, China."

Like other doctors, it's my responsibility to serve the people, and I'm not going to be special in terms of medical fees. Besides, consultation fees are not charged.

Prof. Zou: What's your opinions on cultivating your successors?

Prof. Shen: No matter how skilled a person is in medicine and how capable he is, the number of patients he can treat is extremely limited. He can only treat hundreds of patients every year, and at most thousands of patients.What about tens of thousands of patients in the world?I can train students to treat more patients. However, in the current education of TCM, the style of study and the education system are unsatisfactory. Emphasis should be placed on clinical practices when learning TCM,but many masters and doctoral students have dedicated themselves to books for many years without enough clinical practices, about which I am worried. So I used to explain to students every week when I visited the ward,organize them to listen to the lectures, and review and modify their notes.

I have taught students from Han, Uygur, Kazakhstan and Mongolian nationalities, and I feel proud of them.I feel most gratified that my academic life is constantly growing through them.

Now I am old, but I think I still have the energy to train my academic successors and help them develop.

I feel very happy. The greatest happiness and value of a doctor's life is to save the dead and help the wounded.Human life and energy are limited. Therefore, how can I serve the society better with my knowledge? I should do well in teaching and scientific research while doing well in clinical work. My students will continue to inherit my medical skills after my retirement. And my scientific research achievement will become the immortal wealth of mankind. Nothing is happier than this.

Prof. Zou: Thank you very much for your time and we appreciate your experience and contribution on treating the cardiovascular diseases with integrated Chinese and western medicine. We have learnt a lot from your love and kindness to the patients and the achievement in the course of integrated medicine. Thank you again and wish you a heathy and happy life.