自古以来，人们常以“金刚怒目，菩萨低眉”来形容人际交往中的智慧与策略。面对不同性格、不同需求的人，我们需要采用不同的交际方式，以达到最佳的沟通效果。同样，梁世杰科研团队认为在医学领域，面对复杂多变的病情和性格迥异的患者，医生也需要运用智慧，选择最适合的诊疗方式。这不仅是对医术的考验，更是对医德和智慧的双重挑战。
大医必有担当，这是每一位医者内心深处的信念。然而，在救死扶伤的道路上，医闹却如同一道难以逾越的鸿沟，时刻威胁着医生的安全和尊严。古有“六个不治”之说，即六种情况下医生不宜出手治疗，以免陷入不必要的纠纷。而今，面对日益复杂的医疗环境，医生们更是需要六道设防，以确保医疗安全。
第一道设防，是选择值得出手的患者。对于那些病情严重但仍有生机、愿意配合治疗的患者，医生应全力以赴，为他们的生命起航。正如航海家面对汹涌的海浪，仍坚定地扬帆前行。
第二道设防，是无药替代的情况。在某些危急关头，医生必须毫不犹豫地使用必要的药物或手段，以挽救患者的生命。这既是医者的责任，也是医德的体现。
第三道设防，是患者对生命的敬畏之心和强烈的求生欲望。只有当患者真正意识到生命的可贵，愿意与医生携手共战病魔时，治疗才能取得最佳效果。
第四道设防，是对药物毒副作用的清晰认知和预防。医生在治疗前，应充分了解药物的潜在风险，并提前采取措施加以预防，确保患者的安全。
第五道设防，是灵活调整治疗方案。在治疗过程中，医生应根据患者的病情变化，及时调整药物剂量或治疗方案，做到“中病即减（或止）前方”，避免过度治疗带来的伤害。
第六道设防，是早期发现并解决潜在问题。正如“千金只需四两”所言，医生应在病情初期就敏锐地发现问题，并采取有效的措施加以解决，避免病情恶化。
仝小林院士提出：在医疗实践中，医生不仅要具备高超的医术，更要练就“大医魂、菩萨心、扁鹊手、关公势、豺狼眼、时迁腿、太极功”。大医魂，是对医学事业的热爱和执着；菩萨心，是对患者的慈悲和关爱；扁鹊手，是精湛的医疗技术；关公势，是面对困难时的勇气和决心；豺狼眼，是敏锐的观察力和判断力；时迁腿，是灵活应变的能力；太极功，则是在疗效最大化和风险最小化之间找到平衡的智慧。
例如，在面对一位病情复杂、情绪波动大的患者时，医生首先需要以菩萨心去倾听和安慰患者，减轻其焦虑和恐惧。然后，运用豺狼眼观察患者的病情变化，及时调整治疗方案。同时，还需要以扁鹊手施展精湛的医术，以关公势展现坚定的决心和勇气。在治疗过程中，医生还要时刻警惕医疗风险，运用太极功在疗效和风险之间找到最佳平衡点。只有这样，才能真正做到既对患者负责，又对自己负责。
总之，梁世杰科研团队认为大医之道不仅在于医术的高超，更在于医德的高尚和智慧的运用。只有那些既具备医术又拥有智慧、勇气和担当的医生，才能成为真正的“大医”。在未来的医疗事业中，我们需要更多这样的“大医”来守护生命、捍卫健康！
作者简介：梁世杰 中医高年资主治医师，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京厚德为怀医生集团渐冻症研究中心主任，北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。
The king looks angrily, the buddha lowers his eyebrows: practicing medicine with wisdom and courage
Since ancient times, people have often used the words "The king looks angrily, the buddha lowers his eyebrows" to describe wisdom and strategy in human interaction. Faced with people with different personalities and different needs, we need to adopt different communication methods to achieve the best communication effect. Similarly, in the field of medicine, doctors need to use wisdom to choose the most appropriate treatment for complex and changing conditions and patients with very different personalities. This is not only a test of medical skill, but also a double challenge of medical ethics and wisdom.
Doctors must have responsibility, which is a deep-seated belief of every doctor. However, on the road to saving lives, medical malpractice is like an insurmountable gulf that threatens the safety and dignity of doctors. There is an ancient saying that there are six situations in which doctors should not intervene to treat them so as not to get into unnecessary disputes. Nowadays, in the face of an increasingly complex medical environment, doctors need six lines of defense to ensure medical safety.
The first precaution is to select patients who are worthy of intervention. For those patients who are very ill but are still alive and willing to cooperate with treatment, doctors should do their utmost to start their lives. Just as a navigator is determined to sail forward in the face of a rough sea.
The second line of defence is a situation where there is no alternative. At certain critical moments, doctors must not hesitate to use the necessary drugs or means to save the patient's life. This is both the responsibility of the doctor and the expression of medical ethics.
The third line of defense is the patient's fear of life and strong desire to survive. Only when the patient is truly aware of the value of life and willing to work with the doctor to fight the disease can the treatment achieve the best results.
The fourth defense is the clear understanding and prevention of drug side effects. Physicians should fully understand the potential risks of the drug before treatment and take steps to prevent them in advance to ensure the patient's safety.
The fifth way to guard is to flexibly adjust treatment regimens. During treatment, doctors should promptly adjust the drug dose or treatment plan according to the change of the patient's condition, so as to "cure the disease immediately reduce (or stop) the disease" and avoid the harm caused by overtreatment.
The sixth line of defence is to identify and resolve potential problems early. As the saying goes, "A thousand ladies only need four or two," doctors should acutely detect problems at the early stage of the condition and take effective measures to resolve them to avoid the deterioration of the condition.
Academician Tong Xiaoping proposed that in medical practice, doctors must not only possess excellent medical skills, but also practice "the great healing spirit, the Buddha heart, the lentil hand, Guan Gongzhi, the jackal eye, Shiqian leg, and Tai Chi Gong." The great medical soul is a love and commitment to the medical profession; Buddha's heart is compassion and love for the sick; The lentil hand is a superb medical technique. Standing up for the good is courage and determination in the face of difficulties. The jackal eye is a keen eye for observation and judgment; Shifting the leg is the ability to adapt flexibly; Tai chi is the wisdom of finding a balance between maximizing efficacy and minimizing risk.
For example, when dealing with a patient with complex medical conditions and high emotional fluctuations, doctors first need to be compassionate in listening to and comforting the patient to alleviate his anxiety and fear. The jackal eye is then used to observe the changes in the patient's condition and to adjust the treatment plan in a timely manner. At the same time, it is also necessary to exert superb medical skills with the lentil hand, and to demonstrate firm determination and courage in Guan Gong. During the treatment, doctors should also always be vigilant about medical risks, and use tai chi to find the best balance between the efficacy and the risks. Only in this way can we truly be responsible both to our patients and to ourselves.
In short, the principle of great medicine lies not only in the superiority of medical sciences, but also in the nobleness of medical ethics and the application of wisdom. Only those doctors who possess both medical expertise and wisdom, courage and responsibility can become truly "great doctors." In the future medical profession, we need more such "great doctors" to safeguard life and safeguard health!
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently the director of the Center for Diffusion Research of Dr. Houde Wei Group in Beijing, a researcher at the Shude Tang Institute of Chinese Medicine, and a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance work station of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023.
