Medical door mallet

Author: Zhang Nan
Publisher:
Publishing Date: 1999-03-01
Features: Preface The Medical Rod of Warning (Yimen Banghe) is a seminal work by the Qing Dynasty physician Zhang Nan. Zhang Nan, styled Xugu, was from Huji, Zhejiang (now Shaoxing). Based on his self-description and the dating of his writings, he was likely born in the mid-to-late Qianlong era, slightly later than Wu Jutong. Afflicted with illness in his childhood, he turned to medicine, traveling through Guangdong, Hebei, Jiangsu, and other regions, learning from various masters and studying the works of many, yet for ten years remained uncertain of the essence of medicine. After reading Ye Tianshi's medical case studies, he gained enlightenment, claiming to have finally glimpsed the profound principles of medicine and discerned the intentions of various schools. Thereafter, he devoted himself to even harder study, spending about thirty years immersed in learning, achieving a deep understanding of the Neijing (Yellow Emperor's Inner Canon) and the Shanghan Lun (Treatise on Cold Damage), and able to synthesize and integrate the arguments of various schools while making selective judgments. He believed that Liu Hejian, Zhang Jiugu, Li Dongyuan, and Zhu Danxi, each with their own experiences and insights, had elucidated certain aspects of the classics, whether discussing external pathogens or internal injuries, emphasizing qi tonification or yin nourishment, but only revealing a part of the classic's meaning, not the whole. As for Zhang Jingyue, whose arguments centered on supporting yang, this too was one-sided. Scholars should trace the flow to its source, understanding where the principles lead, and if they cling to the partial, they may find contradictions. Thus, he wrote The Medical Rod of Warning, combining controversial yet important issues in medical theory with his own insights, aiming to awaken the times. The first draft was completed in the fifth year of Daoguang's reign (1825), and after revising the manuscript during his second trip to Guangdong in the eighth year (1828), he had it commented on by his hometown compatriot Tian Jinyuan (Xuefan). It was published in the ninth year (1829) by Yiniuquan and Ji Shuofu from Haijing, Guangdong, marking the first collection of The Medical Rod of Warning. The second collection (also known as The Essence of the Shanghan Lun or The New Book for Saving Lives) was completed in the fifteenth year (1835) and published by Chen Zuwang and Qian Chang from Shanyin, Zhejiang. Its content primarily explains the Shanghan Lun and develops the theory of warm disease. The first collection of The Medical Rod of Warning is a miscellaneous medical treatise, modeled after Xu Dachun's On the Sources and Development of Medicine, containing twenty-seven essays, thirteen appendices, and ten preliminary rules. The main points of this book are as follows:
1. While it is correct that the Six Qi all transform into fire according to the theory of Hejian, this only applies to the pathogens of the Six Qi. The manifestation of disease varies based on an individual's constitution and cannot be universally treated with cold herbs. To reject Hejian's theory because of the harm caused by excessive use of cold herbs is another error.
2. Danxi's assertion that "yang is always in excess, yin is always deficient," citing the Neijing's "one water cannot withstand two fires" as justification, is actually discussing the imbalance of yin and yang in disease, not the theory of yin and yang itself. The sovereign fire and ministerial fire are indeed the embodiment and application of fire. Jingyue opposed this, saying "yang is always deficient, yin is always in excess," and both schools had their biases. Ultimately, the Six Qi all transform from yin and yang, and one cannot judge the root based on superficial differences.
3. Jingyue lacked understanding of the changes in the Six Qi and the source of human endowment. His treatment of external pathogens leaned too heavily on tonification, while his treatment of internal injuries focused too much on supporting yang, misapplying the phrase "support yang and restrain yin" from the Great Changes of the I Ching. The I Ching discusses the principles of treatment, not medical theory. If discussing medical theory, then yin and yang must not be slightly imbalanced; when yin is balanced and yang is sealed, the spirit is treated.
4. Dongyuan discussed the harm of ministerial fire and qi essence, while Jingyue discussed their foundation. Dongyuan focused on their transformation, while Jingyue on their constancy. Both views have their merits and cannot be dismissed.
5. In the Shanghan Lun by Zhongjing, some treatments for warm and heat diseases were mixed into the "Examples of Cold Damage," and even after Zhang Luyu pointed this out, later scholars still confused them. For example, You's Juzhu Collection included treatments for warm and heat diseases like Huangqin and Baihu in the main treatments for cold damage, which was a oversight.
6. Because Wu Youke's Treatise on Pestilence indiscriminately referred to all warm diseases as pestilence and failed to distinguish the theory of latent pathogen disease, Zhang Nan clearly distinguished warm diseases into five types—spring warmth, wind warmth, summer warmth, damp warmth, and pestilence—and listed their symptoms and treatments.
7. The theory of the Six Qi's circulation differs from their pathogenicity. When one yin is born at the summer solstice, its warmth is already active, making it the time when ministerial fire dominates the seasonal qi. However, when it causes disease, it is the combination of fire and dampness that forms summer heat. The fire-dominant aspect is yang, while the dampness-dominant aspect is yin. Strong constitutions tend to form yang syndromes, while weak constitutions form yin syndromes.
8. Wu Jutong grouped wind warmth and pestilence together without distinguishing their severity or depth. He also failed to analyze the "latent pathogen disease" of cold in winter and warmth in spring. He interpreted "injury by dampness in autumn leads to cough in winter" as internal cold and fluid retention, even arguing that Yu Jiayan's change of "warm" to "damp" was incorrect, which deviated from the principles.
9. Ye Tianshi's twenty treatments for wind warmth, analyzing the transmission of ying, wei, qi, and blood, were highly appropriate. Xue Shengbai's Treatise on Damp-Heat with its thirty-five treatments was very detailed. Wu Jutong's discussion of the properties and functions of medicinal substances was particularly refined, and his critique of the flaws of Xie Bai San at the end of the volume was especially accurate.
10. When treating deficiency syndromes, one must first distinguish between yin and yang, then divide into upper and lower. Yin deficiency should avoid qi stagnation, while yang deficiency should avoid cold and cooling herbs. For upper deficiency, clearing the metal (lung) is primary, while for lower deficiency, consolidating the kidneys is fundamental. Additionally, treating deficiency syndromes requires equal attention to the spleen and stomach and the kidney essence, and nurturing the root must involve promoting the mechanism. These are all practical and experienced insights.
11. Ancient discussions on smallpox and measles lacked thorough understanding of the principles. The Correct Principles of Smallpox Treatment described smallpox as toxic fire, with only excess and no deficiency, leading shallow scholars to confuse the and indiscriminately use purgatives. Treatment for measles must first use Sheng and Ge herbs, mixing it with the methods for treating rashes. Therefore, treating smallpox must distinguish the source and flow, organizing the five zang organs as the framework and listing symptoms as the objectives. Treatment for measles must examine whether it is caused by external pathogens or congenital toxicity, and then induce it at the right time, allowing the condition to resolve. From this, we can see that Zhang Nan was indeed a clinician and theorist with broad knowledge and profound expertise. His purpose in writing was "to see the root and correct errors," revealing in every word a scholar's sincerity and compassion for the people. His thoughts were meticulous and detailed, his writing unrestrained and thorough, his arguments clear and direct, repeatedly explaining until the principles were fully understood. This loyalty to medicine and relentless pursuit of knowledge is worth learning from. During our collation, we used the Qing Tongzhi edition (1867) from the Polytext Hall as the base text, with the Xuantong edition (1909) from Licheng Sanyou Yizhai as the collation text, and also referenced Qiu Jisheng's supplement in 1919. The lithographed edition originally bore the inscription "Commented by Wang Mengying of Haijing," but upon verification, it was nearly identical to Tian Jinyuan's comments in the Polytext Hall edition, likely a forgery in the market. The marginal notes were mostly praise, with occasional discussions of medical theory, all of which were deleted due to formatting constraints. Qiu Jisheng's edition recorded Wu Jutong's comments on this book, marking the beginning of a good precedent in medical history for scholars to exchange views and critique each other. This part of the valuable material is preserved in notes. Due to our limitations, errors may still exist, and we welcome readers' corrections.
China Ancient Books Publishing House, December 1986