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Regarding the relationship between Shanghan and Jinkui, the correspondence of formulas and syndromes, and how to view the Inner Canon (Neijing), it’s like a sharp wake-up call.
Original Link
https://mp.weixin.qq.com/s/8hsOscvtpIaEWSdwwWtLsA
Main Text
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Because I previously posted several articles related to gongfa (practice methods) (see in detail: 《Talking about the Gongfa I Practiced》 and 《Only for TCM Practitioners Series (1): Further Discussion on Gongfa》), the WeChat backend has been filled with inquiries about which gongfa is good, how to practice, and how to correct deviations.
Emmm in my earliest articles I mentioned that if you want to learn gongfa, try not to ask online (including asking me), it’s really hard to guarantee quality. Whenever possible, you should meet and learn offline. Online communication is only feasible in one situation: when you know the person on the other side of your phone screen is extremely talented and has very high quality.
But here we have a paradox: those extremely talented and respectable people usually won’t teach you online, and generally ask you to find a way to learn offline. So in summary, online communication is only for sharing experiences; if you want to learn, you should learn offline.
Alright, let’s not get off topic. Although I wrote several articles on gongfa, basically they were written at the invitation of readers from the WeChat backend. In my knowledge base, gongfa-related content ranks perhaps only T3 level. I mainly work on Da Fangmai, especially on external contraction and internal injury. Academically, it’s mainly about some Han and Tang dynasty works, mainly Shanghan Zabing Lun (Treatise on Cold Damage and Miscellaneous Diseases); personally, I also delve a bit into Yishui School, thermal tonification school, and some of later generations’ works. Clinically, I mainly research systemic metabolic diseases, reproductive system diseases, urinary system diseases, etc., alongside some Western medicine clinical knowledge. Therefore, gongfa combined with moxibustion and the like, can only be placed in the third tier (T3).
Recently, several scattered readers asked some relatively “trendy” questions related to Shanghan Zabing Lun. I would like to share my thoughts on these questions.
First of all, I probably won’t talk much about this topic on this public account in the future, and even if I write, it won’t be too detailed because this is my current focus area. The main reason for not writing much is fear of misleading others; more so, I dare not write anything wrong that would bring disgrace to my master: “How did Teacher X teach such a student?”
The articles I wrote previously on moxibustion and gongfa are from my T3 knowledge. Even if others criticize me, I say: Anyway, this is not my research area, argue as you wish. But Shanghan Jinkui is really my own research, so I am very cautious about it.
Huang Kan once said: Do not publish books before fifty (though he only lived to 49). Fei Xiaotong also said: I wrote only two articles throughout my life. They are my idols. My attitude toward the subjects I research deeply is vastly different from that of the average TCM practitioner.
Therefore, in today’s era of publish or perish, someone like me—an “idiot”—finds it very difficult to survive. I also ask readers to be more tolerant when encountering people like me.
Daily Routine Reminder:
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If something is clearly stated in textbooks or is already generally accepted in the academic community, I will definitely not talk about it anymore. What I write will definitely involve academic controversies. If you disagree, feel free to reply in the public account backend for discussion. Don’t just criticize at first glance; we are all adults and should be more civil.
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Some statements might offend people, so I try my best to change them to “XXX”. If you want to know exactly what they are, we can discuss.
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Academics and clinical practice are different!!!
Readers who have studied clinically or already engage in TCM clinical practice should understand this. Undergraduate students in the early years might not realize this much. I won’t elaborate here; those who understand will understand.
One
How to View the Theory of Formula and Syndrome Correspondence?
This is definitely an unavoidable problem in learning Shanghan Zabing Lun in this era, and an extremely awkward issue with a kind of “political correctness” that makes it hard to confront directly. Here I will share my own viewpoint.
I don’t want to make this public account too academic because it would be exhausting to read. But before clarifying the issue, we should first set a scope to facilitate discussion. The main content of the theory of formula and syndrome is formula-syndrome correspondence (this is the main idea; I know there are also formula-syndrome relevance and association). I define formula-syndrome correspondence as follows:
Let the set of syndromes be A, and the set of formulas be B. There exists some correspondence rule f, such that for any element a (a syndrome) in set A, there exists a corresponding element b (a formula) in set B, namely f(a) → b.
Firstly, it’s necessary to admit that formula-syndrome theoretically can exist, because the formula set B is finite, as the total number of Chinese herbs is finite, so the possible combinations of herbs are also finite (although the number is very large). Therefore, for a certain syndrome a, there must be an optimal solution b, which is the theoretical optimal formula-syndrome match, and this is theoretically possible.
However, clinical reality is real (readers who have read my last article 《【Yulu】Teacher’s Day Special》will have a deep impression). There are many practical factors obstructing the function f in the equation. Here’s an example to explain:
Efficacy judgment is the only criterion to judge f. Simply put, if formula b is ineffective for syndrome a, this is obviously not “formula-syndrome correspondence.” But if a certain formula b is effective for syndrome a, does that mean this is formula-syndrome correspondence? Clearly not. The range of “effective” is too broad, not to mention we have other efficacy criteria like cure, remarkable effect, effectiveness, improved quality of life, and so on. So how should we identify which formula b is indeed the optimal solution for syndrome a?
Besides, there are many factors such as the number of available herbs and the number of available formulas, which for diseases is actually relatively scarce (common Chinese herbs are limited, limiting formula variety). That is why many people at Peking University still work on expanding the number of Chinese herbs, such as researching marine medicines.
Even teachers who most advocate formula-syndrome correspondence find it very difficult in clinical practice not to modify or combine formulas. This further proves that the ideal of formula-syndrome correspondence, the idea that “using a certain formula just right to cure the body in an abnormal state,” is almost impossible to achieve.
But that’s okay; the Chinese have always been very smart. If we cannot achieve it, we can infinitely approximate it. Hence we have a more compromised version called “formula-syndrome correspondence,” which is the most common “grasping primary syndrome” / “grasping primary symptoms” version nowadays. This is a subjective matter for each person, and different teachers express it differently. I will share some of my own views based on readers’ questions in the backend.
- Does the theory of formula-syndrome correspondence have practical value?
Answer: Yes, very much. Partly as I wrote above, it is theoretically valid. Moreover, this theory is very suitable for beginners to learn and easy to grasp. The decline of TCM is partially caused by the difficulty in getting started. The formula-syndrome theory partially solves this problem.
Of course, it is a double-edged sword. Too simple and popular (“cheap therapy” in my summary) can easily mislead many TCM students to think that just this method can cure diseases. Actually, it is not true; curing a patient completely is difficult, and truly mastering jingfang (classical formulas) is also difficult.
The downside of “cheap therapy” is that it limits people’s thinking. And TCM itself is a continuous process of breaking through its fixed ways of thinking. I won’t expand on this now, will write new articles when I have time.
- Can jingfang be modified?
Most of the “formula-syndrome” promotions nowadays mainly revolve around jingfang. One common point they raise is that only the original classical formula must be used without modification. So can jingfang be modified? Here I give three points.
① Who exactly is using original classical formulas to treat diseases?
I limit the discussion here to Chinese people. I know Japanese practitioners like to use original classical formulas to treat diseases.
Let me share an interesting story:
In a certain TCM discussion group (now disbanded), many argued for a long time about using original classical formulas for treatment. Someone cited a book “Original Formula XXX” by Teacher X in TCM, arguing this proves original jingfang use for treatment.
Immediately, someone replied: Don’t joke, I have a friend who studies under Teacher X. In clinical practice, 90% of cases involve modifications. This book just compiles a few clinical cases that happened to use original formulas. To put it bluntly, it’s just cutting the leeks (scamming money).
No other meaning, just for readers’ laughter. So here I ask again: Who in China is purely treating diseases using original jingfang formulas?
② Zhang Zhongjing’s formulas are also modifications of other formulas
Researchers who study pre-Tang and Han dynasty formulas and books know that many of Zhang Zhongjing’s formulas are “borrowed from others,” such as Yue Bi Tang; Ma Huang Tang, Huán Hún Tang, and San Ao Tang, etc.
In other words, even if you use original jingfang, I can still say you are modifying.
I don’t know how those teachers who say jingfang can’t be modified view this problem.
③ Zhang Zhongjing himself also modified formulas
First, many of Zhang Zhongjing’s formulas have post-formula notes indicating modifications.
Second, some formulas are modifications of his own other formulas, e.g., Guizhi Tang type formulas.
Third, Zhang Zhongjing explicitly instructed on how to modify formulas, such as the modification method of Guiling Wuwei Gancao Tang in “Treatise on Phlegm and Drink Disease,” from Jin Kui Yao Lue (Essential Prescriptions from the Golden Cabinet).
Zhang Zhongjing painstakingly teaches you to modify, yet some people deny his good intentions and still claim to be disciples of Zhongjing. I really don’t understand how those who say jingfang cannot be modified think about this issue.
PS:
The modern teacher X who proposed the theory of “formula-syndrome” indeed has his level, but only his two books “Lectures on Shanghan and Jinkui” are worth reading; other books and those written by his self-proclaimed students are unreadable. This has been repeatedly confirmed by me and many people around me.
Moreover, we believe those so-called students neither have the academic nor the writing ability to match teacher X’s level; frankly, they are bringing shame upon their teacher. Although they are all senior directors in large tertiary hospitals, they keep writing books under their teacher’s name, clearly their own reputation is not valuable, so they hang a label to attract attention and profit.
Every time these students publish new books, my friends and I laugh: “Here they go again, embarrassing their teacher and still putting his name on the book.”
Two
Can Six Meridians Treat Miscellaneous Diseases?
Many teachers claim nowadays that the Six Meridians can govern the differentiation and treatment of miscellaneous diseases. Let me share my viewpoint.
First, Shanghan Lun and Jin Kui Yao Lue indeed form the two parts of one book. But this does not mean that the book was written continuously.
In other words, Zhang Zhongjing might have written Shanghan Lun and Jin Kui at widely different times. Why say that? Because these two books are very unlike each other. For example, several points:
① Shanghan Lun contains only three mentions of the “lung” character, while Jin Kui Yao Lue is replete with “lung,” even having special chapters like “lung wilting” and “lung carbuncle.”
② Shanghan Lun mainly follows the Six Meridians differential diagnosis system, while Jin Kui Yao Lue includes Zang-fu organ differentiation, qi, blood, and body fluid differentiation, and other systems.
There are many other points. If there were no other evidence proving that both books were written by Zhang Zhongjing, one would surely think different people wrote them.
So under what circumstances would an author write two disconnected books?
What does this represent? It means that Zhongjing himself lacked the ability to reconcile the contradictions between Six Meridians and Zang-fu, qi, blood, and body fluid differentiation, and lacked the ability to integrate the treatment methods of broad Shanghan disease and miscellaneous diseases. If he could, Jin Kui Yao Lue would be written as Six Meridians differentiation.
Therefore, when someone asks me whether the Six Meridians can govern miscellaneous disease differentiation and treatment, my answer is: “You can, but Zhongjing cannot” or “Your Six Meridians can, but Zhongjing’s Six Meridians cannot.”
This often makes me think when exactly Zhang Zhongjing encountered the Huangdi Neijing. Did he see the version we now have? There are countless questions that may need archaeology to answer.
Here I want to say one more thing. Many like to quote the Huangdi Neijing, but this is actually dangerous for two reasons:
① The Huangdi Neijing is itself the source of many later theories (this is based on historical materialism). Using theories derived later to verify Huangdi Neijing is like using many deductions based on axioms in mathematics to prove that “the axioms are correct.” This is logically foolish. But in the field of TCM, very few understand this; people always argue about how great Huangdi Neijing is by using knowledge learned later, which in essence is putting the cart before the horse.
I would rather read articles proving that the Huangdi Neijing is wrong based on later theories. Who needs to prove that Neijing is right? You need to justify that!
② The Huangdi Neijing is a collection of essays, not written by one person, and contains many contradictions. So when quoting lines from Neijing, you must ensure no other part contradicts your quote.
Many people’s actions can be simply summarized as “quoting ‘Don’t take out of context’ by taking things out of context.” You are not quoting Neijing to prove yourself; you are using yourself to prove yourself.
In Conclusion
I’ll stop at these two questions for now. I have been busy with academics and proposal writing recently.
Also, my offline clinic is busy, and I have started offering psychological health clinics, using gongfa and guiding methods, which truly can be taxing on body and mind. Sometimes after finishing the clinic, I need time to recover.
However, I will strive to respond to everyone’s messages in the public account backend and ensure the quality of each article, such as this one. I will later write about how Zhang Zhongjing treated serious diseases and so on.
If any reader thinks the quality of my articles is not high, please be sure to criticize me in the backend.
If you have any questions about Shanghan Zabing Lun, you can also leave messages in the backend.
End of article. If you have read this far and like it, please leave a like and “Watching”~