Transcript

Acupuncture CEU Online Course:

Series: Overview of TCM Classics and Doctrines

Author: Dr. Daoshing Ni, Yo San University of Traditional Chinese Medicine

Class: Jing Fang: Herbal Formulary Doctrine
(Classical or Experiential)

Thank you for joining me today into our next topic. Classical or experiential formulary doctrine commonly known as in Chinese. Jing Fang Xue Pai. This is one of the courses within the program of overview of TCM classics and doctrine.

The earliest documentation and this is all about herbal medicine. The earliest documentation of the herbal formulations was first described in the book of Han. The book of Han is written by Ban Gu. It’s a historical document of the West Han Dynasty from 202 B.C. to about 23 A.D. The Han dynasty consists of two main separate dynasties: the West Han and East Han dynasties. If you combine them together they lasted about 422 years. It was a pretty long dynasty and because of this stability of the 422 years after many many years of war lording during the Spring-Autumn Warring State Era of Zhou Dynasty as well as the brutal unification of the entirety of China in the QinDynasty, which only lasts about 30 some years.

This stability of 422 years really improved the cultural growth in all areas and not the least, also Traditional Chinese medicine. So it improved the documentation and advancement of medicine where though we see the creation of TCM classics such as Shang Han Za Bing Lun, which is a major body of therapies in traditional Chinese medicine, and there are others too, but unfortunately most of other ones are lost.

So when they’re lost it doesn’t necessarily mean that they are no good. They might be classics on their own. Or there may be just something that is not as profound or is not as useful. And then they somehow disappeared. But regardless you need to know that Shang Han Za Bing Lun is not the only classic that appeared in the Han dynasty. So in the book of Han this historical documentation when you talk about Jing Fang This is what it states: it says there are around 11 formulary books spanning 274 chapters at that time.

And the formulary, originates from cold and warmth of herbs, detecting the severity of the disease, borrow the nourishing effect of the herbs, sensing the Qi, differentiate tastes, to cause the alignment of Water and Fire, to relieve bowel and stasis, to bring back to balance.

So in some ways in the early statement of what herbal formulations do, it already says it is about not only to treat diseases but really is to bring back our body into some sort of balance. Now there is a lot lost in these Jing Fang books unfortunately. It states that most of these eleven publications have been lost through time. And the only one with collections of formulas around that time that was able to be passed down was Shang Han Za Bing Lun. And amazingly it is a good one. There is a theory that the herbal formulas in these eleven publications were primitive and not as effective. Hence, the reason for their disappearance. Now I cannot tell you that. But that is a theory that’s floating around. That’s the reason why these so-called 11 classics never really got passed down.

So what is Jing Fang?

So the earliest first definition of Jing Fang is that these are mostly a combination of herbs, mostly two or more herbs in one formula. Obviously a formula can be made of one herb. It’s all there and there are certain formulas that just use one herb but this is more of a minority. And the majority is a plural of herbs. Numerous herbs combined together. There are known combinations that are used to treat diseases somewhat effectively. Therefore Jing Fang is defined as ”experiential formulas.” Formulas that are known through experience to work in in the Book of Han.

Even though this was defined, the Book of Han did not provide the actual formulations themselves. It just provides a historical document to come from that such a formula of book’s existed, and what a formula is used for.

Now, the very first comprehensive herbal formula book has to be Shang Han Za Bing Lun. If you look at Huang Di Nei Jing it’s only got about 13 formulas in there. And that is very little. It’s more of a theoretical foundation book. But when you get to Shang Han Za Bing Lun, this is an amazing book that is not just dealing with herbal formulas but it actually has frameworks on how to evaluate different Qi and diagnose diseases so that you can appropriately classify disease in different stages, or what we call different channels of differentiation so you can give proper herbal formulas for them.

So there are other formula books before Shang Han Za Bing Lun. Again, they are mostly lost. And there is mostly a lack of etio-pathology framework. And mostly primitive and the use is poorly documented.

Shang Han Za Bing Lun is a combination of two books written by Dr. Zhang, Zhong Jing. One is Shang Han Lun and the second is Jin Gui Yao Lue.

Now Shang Han Lun is the discussion of cold injury diseases and it’s a book demonstrating herbal therapy via the six channel differentiation and it has listed around a hundred and twelve formulas. Truth to be told is that this book became later on a whole school of thought about core injury diseases we call Shang Han Xue Pai, and that is something we will discuss in the future future lectures.

Now, the Jin Gui Yao Lue is also part of this book. It’s “essentials” in the name of Jin Gui Yao Lue means “the essentials from the golden cabinet”.

It’s a book that focused on herbal therapies for conditions that are non-infectious or we call it miscellaneous disease. You must understand that at this time, what is the most difficult disease or the diseases that kill people are the infectious diseases. We don’t have good antibiotics. At that time we don’t have all the major herbs that can be used for infection at that time. So people died of infection very easily in the old days. Therefore the main therapy is the treatment of these infectious diseases. That’s why the Shang Han Lun is so popular at that time. And even today

Now Jin Gui Yao Lue is the book that treats the miscellaneous disease or what sometimes what we call the other main diseases caused by injuries. And it has listed about two hundred sixty two formulas. So quite a bit of formula it tells you right off the bat already that infectious diseases are so very important to treat but miscellaneous disease is this whole big category outside of the infectious diseases and this category can be quite huge and Jin Gui Yao Lue attempts to solve some of these non infectious disease problems.

So Shang Han Za Bing Lun is the first comprehensive herbal therapy publication that has been that has clearly defined diagnostic stages.

Therefore they are considered to be Classics. They are the Classics of Formulary Doctrine. Any good students who believe in the importance of studying of herbal formulas must study this book.

This book is considered to be the Bible or the father of all or Herbal Formulary books. Therefore because of what Dr Zhang, Zhong Jing has brought to us, he is therefore revered as the saint or the Father of TCM today.

And both of these books that he has brought to us are now considered to be the Classics of TCM in etiology, in pathology, and herbal therapies. So a good Chinese medicine student must study these two books.

Now interestingly enough, this book was lost for a time. And that’s due to subsequent war time after the Han dynasty. There was a lot of fighting. And with the fighting were famines and wars. These two publications were somewhat lost or it was in private collectors hands but it never appeared in the society again at that time.

Now during the Song Dynasty which is about 960 to about 1279 A.D. there was a rise of feverish, feverish interest in studying Shang Han Lun and Jin Gui Yao Lue due to the re-discovery of these two books.

In fact, Sun Simiao actually published, or republished these books into his Qian Jin Yao Fang publication. So that’s where we can see some. These are former editions of this book. Because of this interest and because of the importance of these two publications. There are now numerous hundreds of different editions and interpretations of Shang Han Lun as well as Jin Gui Yao Lue.

Now the second definition of Jing Fang. Sometimes we call it Jing Lue Fang. The use of these formulas are widespread and generally accepted. These formulations therefore become the new definition of Jing Fang. So it is no longer just “experiential” formulations, but formulas come from these two classics, coming in on these two classics are what we call the classical formulas.

So people who want to stay true to TCM, the first thing they tell you is you’ve got to study these true classical formulas from Shang Han Za Bing Lun.

Therefore the study of these ”Classical” formulations and its variants becomes the focus for Jing Fang or Formulary Doctrine. Or we call it classical formulary doctrines.

Now they are further delineations. For example, formulas from Shang Han Za Bing Lun are Jing Fang (Classical Formulas). Formulas published after Shang Han Za Bing Lun are considered to be Shi Fang (Contemporary Formulas). Or sometimes we call it Contemporary Formulas. So contemporary formulas versus classical formulas.

Now in summary there are really two definitions.

The first definition of Jing Fang.

Sometimes we just call it Jing YanFang. Jing YanFang means “experiential” formulas. OK. This is the study of any published – published or nonpublished herbal formula that has shown efficacy. The second definition is Jing Fang again, some who call it Jing Lun Fang. Jing Lun means “classical discussion”. So Jing Lun Fang, basically means “classical discussion formulas” from these two books. So the study of any formula from Shang Han Za Bing Lun and its variants are considered to be Jing Lun doctrine, Jing Lun Fang doctrine.

Now if we look at publications there are two main types of published herbal formulations.

The very first is Direct Type. Well, Direct Type is the one like: someone who has created formulas that have worked well. And so these doctors have written down some of the experiences that they have had. The experiential formulas they have, for example in Shang Han Za Bing Lun there is a very good case where Zhang, Zhong Jing wrote some the formulas that he’s aware of that he has created, that have worked really well. So that’s a Direct Type.

Then the second type is an Indirect Type. Well, the Indirect Type is more of a compilation, or shall we say a collection. Let’s say in the next village over, there is a doctor who does very good work and he passed on. But his formula has been passed on to us.

So we collect these formulas and then in “village B” we have somebody who does the same thing. We collect that formula from village B, then village C. So eventually you compile. And we call this the Indirect Type – a compilation. of other physicians formulas, which include also governments sanction and private funded publications. For example, Wai Tai Bi Yao – Medical Secrets of An Official 外台秘要 written by Wang, Tao.

And further to give you more definition, there are Three Classifications of Formulations Based on Time.

So Jing Fang – frequently we call that Classical Formulations. So that’s the earliest and most ancient formulas.

The next would be Shi Fang – that is Contemporary Formulations. These are formulas that come after Shang Han Za Bing formula.

And then the third definition – Jin Fang. Jin Fang means Modern Formulation. These are mostly 1900’s formulas to today. OK. We call them Modern Formulations.

Now Shang Han Lun is basically defined or translated as a Discussion of Injury by Cold. Now in this book it describes herbal treatments for exogenous diseases. It is the first book that describes treatments for infectious diseases in the world. actually.

It has a great description of all different formulas and it contains about 112 herbal formulas.

Now Jin Kui Yao Lue. The other book. Sometimes we call it a “Synopsis of Golden Chamber” or “Medical Treasures of the Golden Chamber” or Essential Strategies of the Golden Box”. It describes herbal treatments for internal medicine, gynecology, obstetrics and pediatrics. It is the first book that describes treatments for non-infectious miscellaneous diseases.. Twenty five chapters.

Chapter 1 is on TCM fundamentals. Chapter 2 to 19 are internal medicine, Chapters 20, 21, 22 are women’s health issues, Chapter 23 is miscellaneous diseases, Chapter 24 and 25 are nutritional guidance. Very well thought out, very well laid out book. It contains about 262 herbal formulas.

Now after the publication of Shang Han Za Bing Lun in the Han Dynasty. If we continue forward there are many many more compilations and direct work of formulary books. For example in the sixth dynasty which is about 220 to about 589 A.D. there’s 150 plus publications on formulary alone.

Tang Dynasty (618-907 AD) – also around 150 plus publications.

Song Dynasty (960-1279 AD) – Now you see more because don’t forget the Song Dynasty was the dynasty that the Chinese discovered paper printing. Obviously all of a sudden the amount of publications shoots right up. So in that time there’s about 250 plus different classical publications.

Then the compilation publication where you compile and collect thousands of formulas, this is about 69 plus publications. So we’re going to go through some of it. And they are all from various authors.

Now if we can break it down and say, so what other publications before and during the Tang Dynasty which is about 618-907 AD, so it’s about 80 years. Around that time.

Now there are several of them. For example Wu Shi Er Bing Fang. That is 280 formulas. Huang Di Nei Jing was 12 or 13 formulas as I discussed earlier. Shang Han Za Bing Lun, we talked about 113 to 262. And all together you’re talking about three hundred seventy five formulas. So the Zhou Hou Bei Ji Fang is written by Ge, Hong which we’ll talk about in a moment has a hundred and one formulas.

And then you have the Bei Ji Qian Jin Yao Fang

Bei Ji Qian Jin Yao Fang, Qian Jin Yi Fang that is a total of about fifty three hundred formulas. It’s a profound amount of formulas. By this point it’s becoming more of a reference book but it’s still a very important book to study. And Wai Tai Bi Yao. It’s another giant book and that includes about six thousand formulas. About six thousand formulas.

So let’s talk about Zhou Hou Bei Ji Fang. Zhou Hou Bei Ji Fang means Handbook of Prescriptions for Emergencies. It’s about 101 formulations, mostly singular herbs. I said this earlier that would be a minority, well in this situation, in this particular book mostly singular herbs. Ge, Hong is a thrifty person he doesn’t want people to spend tons of money to treat their own illnesses. So he decided to actually find locally sourced herbs that are easy to get and that’s cheap enough. So he was able to accomplish that. Now this book is written around 341 AD by Ge, Hong. 8 sections 72 chapters and the current edition has been revised by Tao, Yin Ju. Most of the herbal formulations have been used in agriculture community where people are poverty driven.

The herbs are cheap, easy to obtain and quite effective. It also discussed about how these diseases can be contagious. This book also described the pathology of small pox and TB. So it was quite advanced compared to the western medicine counterpart at this point. For example the formula Cong Chi Tang is a combination of Cong Bai and Xiang Chi for the treatment of exogenous common cold for example and is still widely used today.

OK so let’s move forward and talk about Ge Hong for a moment. Ge Hong. His Taoist name is Bao Pu Zi. He was born 283 and he passed away about 343 as far as we can get that documentation. He was a very famous Taoist and physician during the Eastern Jin Dynasty. So he was a chemist, a doctor, he’s a philosopher and a Taoist and he is well respected and one of the earliest scientists documented. He’s married a well-known government. OK so in that situation you know he is wonderfully suited. Oh by the way Bao Gu is also a very famous moxibustionist.

So obviously with both them in this field they kind of helped each other to propel their training and understanding of TCM.

Now this Zhou Hou Bei Ji Fang it’s basically written by him and it’s called Handbook of Prescriptions for Emergencies. There’s three sections. First section is about thirty five chapters on internal condition and diseases. The second section thirty five chapters on the external appearing diseases. And a third section is thirty one chapters on external injuring diseases.

OK so if we look at the book and just go to the section six chapter sixteen: Treating Cold-Heat Malaria. On line two of this documentation it reads that Qinghao 1 bunch, immerse with 2 liters of water, wring out and drink the juice. And it is basically the first attempt to make people aware that Qinghao is used for hepatitis. Qinghao is used for many different conditions. And so nowadays Qinghao has been known as the major herb behind the ingredient Artemisinin for malaria. For malaria. So the Chinese have contributed greatly to the treatment of malaria by identifying the right plant for this kind of condition.

Now. Qing Hao was recommended and Ge Hong was the first in medical history to recommend the herb Qing Hao for the treatment of ‘intermittent fevers”. And his recommendation is to soak the entire plant in water. Not warm water, just cold water so wring it out. Therefore result in immersion of water flavonoids and will make aromatic oils contained in the stem and leaves. This extraction process is likely to yeild artemisinin in a larger quantity than the decoction method, than the cooking method.

Now it was and is directly linked to use in acute episodes of fever especially in malaria both artemisinin is the extract isolated effective ingredient in Qing Hao as well as some flavonoids and they have anti malarial properties as well as synergism. Now Ge Hong’s recommendation is to ingest such a juice wrung out of Qing Hao , rather than a herbal tea or infusion made of hot water poured on a dry plant directly may be critical in obtaining the effectiveness of this herb in the treatment of malaria.

So remember Qing Hao is not cooked that well Qing Hao is basically an immersion. An immersion.

So let’s move on to the next major classic: Bei Ji Qian Jin Yao Fang and Qian Jin Yi Fang. This is a pretty big volume book and it, it translates as Prescriptions Worth a Thousand in Gold for Every Emergency, or shortened to be called Qian Jin Fang (QJF) It was written by Sun, Si Miao another titan in TCM about six hundred fifty two AD. It has a collection of approximately fifty three hundred formulas so some of it is written by him but some of it is probably a collection find some other book. And it is written in sections starting from conditions of OBGYN, Pediatrics, as you can see there minds are very clear that the mother and the child children should be the most important people to take care of before the husband.

So a lot of times , that is what he means there. Now. So it’s it’s a big it’s a big book. It’s a pretty nice sized book and includes a lot of different therapies as well. It’s just it’s not just limited to herbal therapy. Again, the funny thing is that this book Bei Ji Qian Jin Yao Fang was written around six hundred eighty two A.D. by Sun, Si Miao. Which at that time he was 90 years old he wrote this book at 90 years old. Obviously he probably had some student to help him.

Now it is a. And then there he wrote Qian Jin Yi Fang which is what we called a supplement to Qian Jin Yao Fang. So on top of the main book itself there’s also a secondary book and it includes 30 sections . The second there is the second book that included 30 sections. Twenty nine hundred formulas. Topics are Materia Medica, OBGYN, pediatrics, Shang Han Lun, prevention, dietary guidance, tonification, wind stroke, miscellaneous diseases, chemistry, Chuang Yong, pulse diagnosis, acupuncture, and prohibitions.

OK so we’ve discussed a lot of different aspects of TCM.

Now another major publication which is a compilation is called Wai Tai Bi Yao.

The author is Wang, Dao. He’s not a TCM Doctor interesting enough but he is a scholar. He is a government official who worked in the imperial palace library. This book is written in 752 AD. 40 sections and collected over six thousand formulas that existed in the Tang and before the Tang dynasty. It also preserves some of the rare writings before the Tang dynasty

So let’s take a look at the Song dynasty. Well during and before the Song Dynasty which is about 960 to about 1279 A.D., getting closer to us now.

The government actually did interfere then got into the publishing business in the sense of publishing something that’s easy for people to follow and understand But also the collection of the herbal formulas. The volume just increased astronomically for example Tai Ping Sheng Hui Fang: It’s about 16,834 formulas. Tai Ping Hui Min He Ji Ju Fang is about 788 formulas, that’s actually the smallest one. But imagine if your studying them that’s going be a problem that’s going to be hard to study. And then you have Sheng Ji Zong Lu, about twenty thousand formulas that you have. Yu Yao Yuan Fang, that’s about 1089 formulas. OK. so you can see that as time goes on the collection of the formulas increases.

OK. Got to a point where that’s kind of hard to study which we’ll discuss in a moment.

Now Tai Ping Hui Min He Ji Ju Fang is also known as He Ji Ju Fang. The author was Chen, Shi Wen, et.al.

It was written in about ten seventy eight A.D. There’s seven hundred eighty eight formulations which is a compilation. Highly useful and “father” of patent herbal formulations herbal formulas and for example like Er Chen Tang Si Jun Zi Tang, Si Wu Tang, a combination of different herbs combined together. OK.

Let’s take a look at some of the background of this time. During the Song dynasty 960 to 1279 AD. This is a period of many invasions from the Mongols. Many wars, severe corruption, but also the invention of printing press and medical schools and standardized patent herbal medicines.

So at that time this is the beginning of what we call patentized formulas. So you have for example Su He Xiang. That’s very good for opening the blockages, increased consciousness. For example Zi Xue Dan, Zi Xue Dan is used for high fever. For example Zhi Bao Dan. And that’s used in your genital area issues. And herbs tend to be tonics, warm pungent in nature that’s the nature overall in this situation.

Now let’s look at private sector because some of it is public sector and a lot of times we don’t know what the private sector holds. Well a lot of Chinese were generous. They were able to donate them to the local library or donate them to people so they can print it out and read. And so I listed in the chart in the slides basically over 10 different classics. And each one is very effective in their own right. OK.

So you can start with Bo Ji Fang – seven thousand formulas. Su Sheng Liang Fang. You can go to Ji Feng Pu Ji, three thousand formulas. OK. And then you can look at all the different other ones that come afterwards.

There is the Ben Shi Fang Xu Ji 366. There’s the San Yin Ji Yi Bing Zheng Fang Lun that one was about fifteen hundred formulas. There’s Xu Yi Jian 150 formulas. There is the Shi Zhai Bai Yi Xuan Fang and find this about 1000 formulas. There is Ji Sheng Fang there is Ji Sheng Xu Fang there is Dong Yuan Shi Xiao that’s about 240 formulas then there is the Shi Yi De Xiao 3000 formulas, so you can see they are becoming a lot of formulas. They’re in the thousands and when you start to get into thousands it gets kind of hard to learn from them hard to read them. They become more of a reference book.

And this happens, continue onward, if you look at during the Ming and Qin Dynasties, which is about 1368 to 1911 A.D. you’re starting to see formula books that are basically unruly. Too big.

Let’s take a look at Pu Ji Fang. Pu Ji Fang, the book fills this several sections, that book fills my whole entire bookshelf. In this there’s sixty one thousand seven hundred thirty nine different herbal formulas. Think about that for a moment. That’s daunting. That’s hard to even learn all of them. And you try not to know all of them you’re trying to learn what’s effective in your clinical setting.

And the next formula is Qi Xiao Liang Fang, which is about seven thousand formulas. Yi Fang Kao comes to about seven hundred formulas Wan Bing Hui Chun is one hundred and ninety formulas. Zheng Zhi Zhun Sheng Lei Fang is about two thousand nine hundred twenty seven formulas. Twenty five formulas. OK. And then you have Zheng Zhi Zhun Sheng Lei Fang about twenty nine hundred formulas and Zu Ji which is about seventy four formulas. And tGu Jin Ming Yi Fang Lun is 150 formulas.

So you see some small ones and some really really large compilation books. Yi Fang Ji Jies three hundred eighty books. Tang Tou Ge Jue, about two hundred formulas. And on and on so you can see that there are small ones and there’s also large large compilations.

So if we look at nineteen eleven AD onward, then we are starting to see the books that are quite useful. And the very first one is Yi Xue Zhong Zhong Can Xi Lu which is an integrated Chinese and Western medicine book that provides us some of the very useful formulas, about one hundred sixty seven of them.

Now the next ones are for example Zhong Yi Fang Ji Da Ci Dian. This is the dictionary of TCM herbal medicine. The entries are about ninety six thousand five hundred ninety two formulas. When you get to this level these are not the books that you’ll learn about framework. These are book you’ll learn about herbal formulas. These are now reference books. These are now dictionaries.

Onward, you can have Li Dai Ming Yi Liang Fang Zhu Shi: 2000 formulas. You can Zhong Yi Lei Fang Ci Dian: two thousand five hundred forty formulas. You could have Chinese research TCM research modern research formulations: that’s about eight hundred of them. You could have Zhong Guo Xian Dai Ming Yi Yan Fang Hui Hai: that’s about ten thousand formulas, for example.

And outside of China you can see Yi Xin Fang in Japan published in 982 A.D. You can see Yi Fang Lei Ju in Korea published about fourteen forty five AD, and that’s about fifty thousand formulas. You could be looking at Dong Yi Bao Jian in Korea. And then you can also look at Lin Chuang Ying Yong Han Fang Chu Fang Jie Shuo. And that it’s about, published in Japan 1966 A.D. And that has 366 formulas. 366 formulas.

OK. So just to give you a rundown of the enormous, enormous volumes of formulas that you can access. So we are not lacking formulas. Obviously having them translated would be very helpful. But we are not lacking formulas.

Now knowing that we need to take a look at what are the 10 most popular formulas used today. These are Xiao Yao San, Xue Fu Zhu Yu Tang, Wu Ling San, Gui Pi Tang, Xiao Qing Long Tang, Liu Wei Di Huang Wan, Xiao Chai Hu Tang, Da Cheng Qi Tang, Wen Dan Tang, and not the least, Bu Zhong Yi Qi Tang

OK these other ten top formulas and they come from different classics. For example Xiao Yao San comes from Tai Ping Hui Min He Ji Ju Fanhaving. Xue Fu Zhu Yu Tang comes from Yi Lin Gai Cuo written by Qingren Wang. Fabulous fabulous book.

And then Wu Ling San comes from Shang Han Lun written by Zhang Zhongjing, for example. Onward and upward not the least these Bu Zhong Yi Qi Tang is written in the Pi Wei doctrine. It’s a school of thought doctrine and so he’s attending some these, basically some of these formulas are so powerful and so useful today. They are commonly used throughout all the patent formulas. These are very easy to use. These are all in pill form capsule form and you can just buy as over-the-counter and then you can use them for various different diseases.

So again Xiao Yao San, Xue Fu Zhu Yu, Wu Ling San, Gui Pi Tang, Xiao Qing Long. Liu Wei Di Huang Wan, Xiao Chai Hu, Da Cheng Qi, Wen Dan Tang, and Bu Zhong Yi Qi. OK, these are some of the formulas that we should see.

Let’s take a look at Xiao Yao San. We’ll just go through two examples. So there you kind of have an idea of some the patent herbal form in particular. This, Xiao Yao San, is very widely used. Xiao Yao San as we translate it means freedom. Powder Freedom from what? Well freedom from liver stasis.

This is freedom from emotional trauma and congestions. Freedom from pain.

And this was , appeared, first appeared in Tai Ping Hui Min He Ji Ju Fangin. In a formula the herbs ar Chai Hu, Dang Gui, Bai Shao, Bai Zhu, Fu Ling, Gan Cao, Bo He, Sheng Jiang. It is useful in liver Qi stasis faces with blood deficiency, causing hypochondriate pains on both sides. Alternating fever and chill headaches, vertigo, dry mouth and throat, fatigue and poor appetite, irregular menstruation, breast distending pain And when you have wiry pulse but deficient pulse.

So that is Xiao Yao San. It originates, if you look carefully, it really originated from the modification or combination of two formulas: Si Ni San and Dang Gui Shao Yao San. Both are from the Classics.

Si Ni San is from Shang Han Lun. It is made of Gan Cao, Zhi Shi, Chai Hu, Shao Yao. And then you have Dang Gui Shao Yao San which has come from Jin Gui Yao Lue. Dang Gui, Shao Yao, Chuang Xiong, Fu Ling, Ze Xie, as well as Bai Zhu. The combination of these is Gui Shao Yao San.

So a lot of times what people say into the future is that, well you know materia of your formulas are built from Shang Han Za Bing Lun. So therefore the real true student, students of formulary doctrine it is really to study Classics. Study these classical formulations. And that is true to a certain degree. The materia of formula you can find roots there. But they are going to be some formulas that are not from the classical formulas. We call these non classical formulas. And they are equally as experienced effectively. So therefore it’s important to understand that these, the doctrine, doesn’t necessarily just means classical. You must also study non classical formulas

So we know for example Si Ni San was used for Shao Yin Disease while Dang Gui Shao Yao San was for gynaecological problems. When you combine them together it is very nicely used for liver stasis with blood deficiency situation.

Now, for the current use of this formula. I mean if you think this formula was designed so many years ago, what can you use for the current disease. Oh my God. It can be used for so many different things.

If you look at research of Xiao Yao San it’s been known to be effective and helpful in viral hepatitis hepatic cirrhosis, cholecystitis, anxiety, depression, mood disorders, impotence, menopausal symptoms, chronic PID, fibrocystic breast disease, optic neuritis, optic neuropathy, hyperpigmentation, acne, etc.. So there’s a lot of research of the current use of Xiao Yao San. An ancient formula that’s combined. So a classical formula that is so useful today for these different diseases.

The next formula you should know is this. Liu Wei Di Huang Wan. It’s come out of, interesting enough. It was really first designed for children for infants and it has come out of Xiao Er Yao Zheng Zhi Jue. And the formula is Shu Di Huang, Shan Zhu Yu, Shan Yao, Ze Xie, Dan Pi, Fu Ling. OK. These are the what we call the 6, 3, tonification herbs. Three not tonifying plus sedating herbs combined together give us six. This formula is used to Nourish Yin Tonify Kidney. OK so it is useful in kidney essence deficiency. People that may have back pain, heel pain, sluggish urination night sweat, xiao ke, vertigo, ear-ringing, Chi pulse large and deficient.

So this is what you can use it for. But originally it was used for kidney essence deficiency in growth retardation in children.

OK so nowadays you can see it can be useful for a variety of conditions which we’ll talk about in a moment. Now again this formula’s so important it actually originated from the classics again.

It originates from Jin Gui Shen Qi Wang. Jin Gui Shen Qi Wang is a a combination of oDi Huang, Shan Zhu Yu, Shan Yao, Ze Xie, Fu Ling, Dan Pi, Gui Zhi, Fu Zi. So you get rid of Gui Zhi, Fu Zi, and you have the ideal formula. It warms up the kidney’s Tonify Kidney Yang. Again useful back pain lower trunk and extremity coldness, pelvic pain, sluggish urination, restless heat and difficulty with sleep. Now if we look at current use and current research of Liu Wei Di Huang Wan. You will see its used to treat hypertension. It is used to treat premature atrial contractions, congestive bronchiectasis. hepatitis B and cirrhosis. Atrophic gastritis. D.M., diabetes mellitus, renal failures, ITP idiopathic thrombosis thrombocytopenic purpura. Nefritis, urinary stones, male infertility benign prosthetic hypertrophy, and menopausal disorders. So you can see it’s been well thoroughly researched of what it can be applied in. So quite a bit of diseases.

So in the end, as we’re coming to the end. So why do we learn and collect formularies? Well first of all not all formulations are useful all diseases. So having a collection of formulations helps us to widen the possibility of finding a formula that can work for particular difficult case. That’s number one. Number two it also helps for us to build a foundation of understanding of how herbs are put together synergistically in a formula. Number three it improves our clinical outcome by having more ‘arsenals’ at our disposal. So learning formulas is useful and not only that nowadays.

You know some of the formula books are now dictionaries so they become more of a reference book instead of a straight learning book. So merely collecting herbal formulas will not make us a better doctor.

But trying to understand how the formula is constructed and how the herbs are put together synergistically will help us to design and create better formulas in other cases. This is where creativity counts. This is where being creative can be really helpful to be a good herbalist. Now writing down formulas will help us to know better than just thinking about the formula in our head.

So being able to copy formulas, being able to highlight some of the formulas in the book, really helps us to know. That’s number two.

Number three, knowing deeply the framework of how formulas are constructed by a particular master would be much much better than knowing not as deeply but by many many masters. So sometimes, I always say, stay true with the master’s work. OK. If you start with Qian Jin Yao Fang, stay true with that for a while. You know study that for a while. Or if you study with Zhang Zhongjing’s book, you know, continue with that book for while.

Don’t try to jump around too much if it’s possible So that you get a good feel for the train of thought of that particular author, that particular doctor. That would help you to compose your formulas better.

OK. Highlighting and knowing the frequency of a particular herb is, is useful, to help us to know the consensus of many different doctors. That’s also a very useful thing when we do collection of formulas. OK so this ends our talk today.

And thank you so much for being with me today. I will see you next time. Bye bye.

Acupuncture CEU Online Course:

Series: Overview of TCM Classics and Doctrines

Author: Dr. Daoshing Ni, Yo San University of Traditional Chinese Medicine

Class: Jing Fang Xue Pai
(Classical or Experiential) Formulary Doctrine
经方学派

The earliest documentation of herbal formulation – Jing Fang 经方

Herbal Formulary was first described in “The Book of Han 汉书” written by Ban Gu 班固.

It is a historical documentation of West Han Dynasty from 202 BC to 23 AD.

Han Dynasty is consisted of two main separate dynasties of West Han and East Han dynasties lasting 422 years from 202 BC to 220 AD.

Overview of Han Dynasty 汉朝

Stability of 422 years after many years of warlording during Spring-Autumn and Warring States periods of the Zhou Dynasty as well as the brutal unification of the entire China in the Qin Dynasty.

Stability improves the documentation and advancement of medicine where we see the creation of TCM classics such as Shang Han Za Bing Lun, and others, unfortunately lost.

Book of Han Discussion of Jing Fang

It states,

“There are 11 formulary books spanning 274 chapters”,

“Formulary, originates from cold and warmth of herbs, detecting the severity of the disease, borrow the nourishing effect of the herbs, sensing the Qi, differentiate tastes, to cause the alignment of Water and Fire, to relieve bowel and stasis, to bring back to balance.”

The Loss of Jing Fang Books

Unfortunately most of these 11 publications have been lost through time.

The only ones with collections of formulations around that time that has been able to be passed down in Shang Han Za Bing Lun.

There is a theory that the herbal formulations in these 11 publications were primitive and not as effective, hence of the reason for their disappearance.

What is Jing Fang 经方?
The Earliest First Definition

These are mostly combination of herbs, mostly two or more herbs in one formula.

They are known combinations that are used to treat diseases.

Therefore Jing Fang is defined as ”experiential formula” in the Book of Han.

Even though this was defined, the Book of Han did not provide the actual formulations themselves.

The First “Comprehensive” Herbal Formula Book – Shang Han Za Bing Lun 伤寒杂病论

There are other formula books before Shang Han Lun

Mostly lost

Mostly lack of etio-pathology framework

Mostly primitive and the use is poorly documented

Shang Han Za Bing Lun is a combination of two books written by Dr. Zhang, Zhong Jing 张仲景 – Shang Han Lun 伤寒论 and Jin Gui Yao Lue 金匮要略.

Shang Han Lun – The Discussion of Cold-Injury Diseases is a book demonstrating herbal therapy via the Six-Channel Differentiation (SCD). It has listed around 112 formulas.

Jin Gui Yao Lue – Essentials from the Golden Cabinet is a book that focused on herbal therapies for conditions that are “miscellaneous” or other than diseases caused by Cold-Injury. It has listed 262 formulas.

Shang Han Za Bing Lun 伤寒杂病论
It is a Classic!

They are the first comprehensive herbal therapy publications that have clearly defined diagnostic stages.

Therefore they are considered to be Classics. They are the Classics of Formulary Doctrine.

Therefore Dr Zhang, Zhong Jing is revered as the Saint or the Father of TCM today and both of his books are now considered the Classics of TCM in etiology, pathology, and herbal therapies.

Lost for a Time!

Due to subsequent wartime after the Han Dynasty, these two publications were lost.

During the Song Dynasty (960-1279 AD), there was a rise of feverish interests in studying the Shang Han Lun and Jin Gui Yao Lue due to the re-discovery of these two books.

Because of the interests, and the importance of these two publications, there are numerous editions and interpretations.

Second Definition of Jing Fang 经方

The use of these formulations are wide spread and generally accepted. These formulations therefore become the new definition of Jing Fang.

Therefore the study of these ”Classical” formulations and its variants becomes the focus for Jing Fang or Formulary Doctrine.

In further delineation,

Formulas from Shang Han Za Bing Lun are Jing Fang 经方 (Classical Formulas)

Formulas published after Shang Han Za Bing Lun are considered to be Shi Fang 时方 (Contemporary Formulas)

Summary – Jing Fang Doctrine 经方
Two Definitions

First Definition

Jing – Jing Yan 经验 or experience

Fang – Fang Yao 方药 or herbal formulation

Jing Fang – Experiential Formulations

The Study of any published or nonpublished herbal formula that has shown efficacy.

Second Definition

Jing – Jing Lun 经论 or Classical Discussion

Fang – Fang Yao 方药 or herbal formulation

Jing Fang – Classical Formulations

The Study of any formulas from Shang Han Za Bing Lun and its variants

Two Main Types of Published Herbal Formulations

Direct Type – experiential formulation written by the authors of the formulations themselves, i.e. Shang Han Za Bing Lun 伤寒杂病论 written by Zhang, Zhong Jing 张仲景

Indirect Type – compilation of other physician’s formulations which includes government sanctioned and private funded publications, i.e. Wai Tai Bi Yao – Medical Secrets of An Official 外台秘要 written by Wang, Tao 王燾

Three Classifications of Formulations Based on Time

Jing Fang 经方 – Classical Formulations

Shi Fang 时方 – Contemporary Formulations

Jin Fang 今方 – Modern Formulations

Shang Han Lun 伤寒论

Discussion of Injury by Cold

Describe herbal treatments for exogenous diseases. It is the first book that describes treatments for infectious diseases.

Description of Chapters

It contains 112 herbal formulas

Jin Kui Yao Lue 金匮要略

“Synopsis of Golden Chamber” or “Medical Treasures of the Golden Chamber” or Essential Strategies of the Golden Box”

Describes herbal treatments for internal medicine, gynecology, obstetrics and pediatrics. It is the first book that describes treatments for non-infectious miscellaneous diseases.

Sections, 25 chapters. Chapter 1 is on TCM fundamentals. Chapter 2 to 19 are internal medicine, Chapters 20, 21, 22 are women’s health issues, Chapter 23 is miscellaneous diseases, Chapter 24 and 25 are nutritional guidance.

It contains 262 herbal formulas.

Publications After Han Dynasty (Shang Han Za Bing Lun)

Six Dynasty (220-589 AD) – 150+ publications

Tang Dynasty (618-907 AD) – 150+ publications

Song Dynasty (960-1279 AD) – 250+ publications

Compilation publications – 69+ publications.

Various authors

Publications Before and During Tang Dynasties (618-907 AD)

Wu Shi Er Bing Fang 五十二病方 (Time, 280 formulas)

Huang Di Nei Jing 黄帝内经 (Time, 12 formulas)

Shang Han Za Bing Lun 伤寒杂病论 (Time)

Shang Han Lun 伤寒论 (113 formulas)

Jin Kui Yao Lue 金匮要略 (262 formulas)

Zhou Hou Bei Ji Fang 肘后备急方 (Time, 101 formulas)

Bei Ji Qian Jin Yao Fang 备急千金要方，Qian Jin Yi Fang 千金翼方 (Time, 5300 formulas)

Wai Tai Bi Yao 外台秘要 (Time, 6000 formulas)

Zhou Hou Bei Ji Fang
肘后备急方

Handbook of Prescriptions for Emergencies

101 formulations, mostly singular, two and three herbs

Written around 341 AD by Ge, Hong 葛洪

8 sections, 72 chapters. The current edition has been revised by Tao, Yin Ju 陶隐居. Most of the herbal formulations have been used in agriculture community where people are poverty driven. The herbs are cheap, easy to obtain and quite effective. This book also described the pathology of small pox and TB. It also discussed about how these diseases can be contagious.

Example: Cong Chi Tang 葱豉汤 = Cong Bai + Xiang Chi for the treatment of exogenous common cold

Ge Hong 葛洪
Taoist Name: Bao Pu Zi 抱朴子

Ge Hong (283-343）

Was a famous Taoist and physician during the Eastern Jin Dynasty

A chemist, doctor, philosopher, and a Taoist. Well respected and one of the earliest scientist documented.

Married Bao Gu 鲍姑, a well known moxibustionist

Zhou Hou Bei Ji Fang 肘后备急方
Handbook of Prescriptions for Emergencies

3 Sections

First Section: 35 chapters on internal diseases

Second Section: 35 chapters on external appearing diseases

Third Section: 31 chapters on external injuring diseases

Section Three – Chapter 16
Treating Cold-Heat Malaria

Line 2 – Qinghao 1 bunch, immerse with 2 liters of water, wring out and drink the juice

Qing Hao 青蒿

Ge Hong was the first in medical history to recommend the herb Qing Hao for the treatment of ‘intermittent fevers”.

His recommendation is to soak the entire fresh plant in water and to wring it out thereafter resulting in an emulsion of water, flavonoids and aromatic oils contained in the stem and leaves. This extraction method is likely to yield artemisinin in larger quantities than the decoction method.

It was and is directly linked to its use for acute episodes of fever, especially in malaria. Both artemisinin, the extracted isolated effective ingredient in Qing Hao and some flavonoids have antimalarial properties and synergism.

Ge Hong’s recommendation to ingest such a juice wrung out of Qing Hao (rather than a herbal tea or infusion made of hot water poured on to dried plant material) may be crucial in retaining the effectiveness of this herb in the treatment of malaria.

Bei Ji Qian Jin Yao Fang 备急千金要方
Qian Jin Yi Fang 千金翼方

Bei Ji Qian Jin Yao Fang 备急千金要方
Qian Jin Yi Fang 千金翼方

Bei Ji Qian Jin Yao Fang – Prescriptions Worth a Thousand in Gold for Every Emergency, or shortened to be called Qian Jin Fang (QJF), written by Sun, Si Miao, 652 AD, a collection of approximately 5300 formulations.

It is written in sections starting from conditions of OBGYN, Pediatrics, ENT, Shang Han, Liver/GB, Heart, Small Intestines, Spleen, Stomach, Lung, Large Intestines, Kidney, Urinary Bladder, Xiao Ke, Dermatology, Proctology, Poisoning, Nutrition, Prevention, Pulse Diagnosis, and Acupuncture.

Bei Ji Qian Jin Yao Fang 备急千金要方
Qian Jin Yi Fang 千金翼方

Qian Jin Yi Fang was written around 682 AD by Sun, Si Miao when he was 90 years old. It is a supplement to the original Qian Jin Fang. As he gained more clinical experience and collected more formulations, he decided that he needed to publish a supplement to the original book.

It included 30 sections, 2900 formulations. Topics are Materia Medica, OBGYN, pediatrics, Shang Han Lun, prevention, dietary guidance, tonification, wind stroke, miscellaneous diseases, chemistry, Chuang Yong, pulse diagnosis, acupuncture, and prohibitions.

Wai Tai Bi Yao 外台秘要

Author: Wang, Dao 王焘, not a TCM doctor but a scholar/government official, worked in the imperial palace library.

Written in 752 AD, 40 section and collected 6,000 + formulations that existed in Tang and before Tang Dynasty.

It also preserved some of the rare writings before Tang Dynasty.

Before and During Song Dynasty (960-1279 AD): Government Sanctioned Compilations

Tai Ping Sheng Hui Fang 太平圣惠方 16834

Tai Ping Hui Min He Ji Ju Fang 太平惠民和剂局方 788

Sheng Ji Zong Lu 圣济总录 20000

Yu Yao Yuan Fang 御药院方 1089

Tai Ping Hui Min He Ji Ju Fang 太平惠民和剂局方

It is also known as He Ji Ju Fang 和剂局方

Author: Chen, Shi Wen, et al. 陈师文. 1078 AD

788 formulations, a compilation.

Highly useful and “father” of patent herbal formulations

Examples: Er Chen Tang, Si Jun Zi Tang, Si Wu Tang

Background

Song Dynasty 960-1279 AD

A period of many invasions from the Mongols. Many wars, severe corruption, but also the invention of printing press and medical schools and standardized patent herbal medicines

Tai Ping Hui Min He Ji Ju Fang 太平惠民和剂局方 is the foundation that created the patent herbal medicine movement

Su He Xiang Wan 苏合香丸, Zi Xue Dan 紫雪丹, Zhi Bao Dan 至宝丹

Herbs tend to be tonics, warm, pungent in nature

Private Sector
Individual Publications:

Bo Ji Fang 博济方 7000

Su Sheng Liang Fang 苏沈良方

Ji Feng Pu Ji Fang 鸡峰普济方 3000

Pu Ji Ben Shi Fang 普济本事方，Ben Shi Fang Xu Ji 本事方续集 366

San Yin Ji Yi Bing Zheng Fang Lun 三因极一病证方论 1500

Yang Shi Jia Zhang Fang 杨氏家藏方 1109

Yi Jian Fang 易简方，Xu Yi Jian Fang 续易简方 150

Shi Zhai Bai Yi Xuan Fang是斋百一选方 1000

Ji Sheng Fang 济生方，Ji Sheng Xu Fang 济生续方

Ren Zhai Zhi Zhi Fang Lun仁斋直指方论

Xuan Ming Lun Fang 宣明论方

Dong Yuan Shi Xiao Fang 东垣试效方 240

Dan Xi Xin Fa 丹溪心法 100

Shi Yi De Xiao Fang 世医得效方 3000

During Ming and Qin Dynasties 1368 – 1911 AD:

Pu Ji Fang普济方 61739

Qi Xiao Liang Fang 奇效良方 7000

Yi Fang Kao 医方考 700

Wan Bing Hui Chun 万病回春 190

Zheng Zhi Zhun Sheng Lei Fang证治准绳类方 2925

Zu Ji 祖剂 74

Gu Jin Ming Yi Fang Lun 古今名医方论 150

Yi Fang Ji Jie 医方集解 380

Tang Tou Ge Jue 汤头歌诀 200

Jiang Xue Yuan Gu Fang Xuan Zhu 绛雪园古方选注 345

Chuan Ya Nei Wai Bian 串雅内外编

Yan Fang Xin Bian 验方新编，Mei Shi Yan Fang Xin Bian 梅氏验方新编 6000

Others

1911 AD and onward:

Yi Xue Zhong Zhong Can Xi Lu 医学衷中参西录 167

Zhong Yi Fang Ji Da Ci Dian 中医方剂大辞典 96592

Li Dai Ming Yi Liang Fang Zhu Shi 历代名医良方注释2000

Zhong Yi Lei Fang Ci Dian 中医类方辞典 2540

Zhong Yi Fang Ji Xian Dai Yan Jiu 中医方剂现代研究 800

Zhong Guo Xian Dai Ming Yi Yan Fang Hui Hai 中国现代名医验方荟海 10000

Outside of China

Yi Xin Fang 医心方 (Japan 982 AD)

Yi Fang Lei Ju 医方类聚 (Korea 1445 AD) 50000

Dong Yi Bao Jian 东医宝鉴 (Korea)

Lin Chuang Ying Yong Han Fang Chu Fang Jie Shuo 临床应用汉方处方解说 (Japan 1966 AD) 366

10 Most Popular Chinese Herbal Formulas Used Today

Top 10 Formulas

Xiao Yao San 逍遥散

Xue Fu Zhu Yu Tang 血府逐瘀汤

Wu Ling San 五苓散

Gui Pi Tang 归脾汤

Xiao Qing Long Tang 小青龙汤

Liu Wei Di Huang Wan 六味地黄丸

Xiao Chai Hu Tang 小柴胡汤

Da Cheng Qi Tang 大承气汤

Wen Dan Tang 温胆汤

Bu Zhong Yi Qi Tang 补中益气汤

Their Sources

Xiao Yao San 逍遥散

Tai Ping Hui Min He Ji Ju Fang 太平惠民和剂局方

Chai Hu, Dang Gui, Bai Shao, Bai Zhu, Fu Ling, Gan Cao, Bo He, Sheng Jiang

Liver stasis with blood deficiency causing hypochondriac pains, alternating fever and chill, headache, vertigo, dry mouth and throat, fatigue and poor appetite, irregular menstruation, breast distending pain, pulse wiry but deficient.

Xiao Yao San 逍遥散

Originated from a modification of combination of two formulas.

Si Ni San and Dang Gui Shao Yao San

Si Ni San 四逆散 (Shang Han Lun) – Gan Cao, Zhi Shi, Chai Hu, Shao Yao

Dang Gui Shao Yao San 当归芍药散 (Jin Gui Yao Lue) – Dang Gui, Shao Yao, Chuang Xiong, Fu Ling, Ze Xie, Bai Zhu

Xiao Yao San 逍遥散

Si Ni San 四逆散

Shao Yin Disease, cough, palpitation, sluggish urination, abdominal pain, dysentery

Liver stasis with cold extremities.

Dang Gui Shao Yao San 当归芍药散

Gynecologic pelvic pains and pelvic pains during pregnancy.

Xiao Yao San 逍遥散
Current Uses

Viral hepatitis, hepatic cirrhosis, cholecystitis, anxiety, depression, mood disorders, impotence, menopausal symptoms, chronic PID, fibrocystic breast disease, optic neuritis, optic neuropathy, hyperpigmentation, acne

Liu Wei Di Huang Wan 六味地黄丸

Xiao Er Yao Zheng Zhi Jue 小儿药证直诀

Shu Di Huang, Shan Zhu Yu, Shan Yao, Ze Xie, Dan Pi, Fu Ling.

Nourish Yin Tonify Kidney

Kidney Essence Deficiency: lumbago, heel pain, sluggish urination, night sweat, xiao ke, vertigo, tinnitus, Chi pulse large and deficient.

Liu Wei Di Huang Wan 六味地黄丸

Originated from Jin Gui Shen Qi Wang 金匮肾气丸 (Jin Gui Yao Lue)

Di Huang, Shan Zhu Yu, Shan Yao, Ze Xie, Fu Ling, Dan Pi, Gui Zhi, Fu Zi

Warm Tonify Kidney Yang

Lumbago, lower trunk and extremity coldness, pelvic pain, sluggish urination, restless heat, difficulty with sleep.

Liu Wei Di Huang Wan 六味地黄丸
Current Uses

Hypertension, PAC (premature atrial contractions), congestive bronchiectasis, hep B and cirrhosis, atrophic gastritis, diabetes mellitus, renal failure, ITP (idiopathic thrombocytopenic purpura), nephritis, urinary stones, male infertility, benign prostatic hypertrophy, menopausal disorders, etc.)

Why learn and collect formularies?

Not all formulations are for all diseases. Having a collection of formulations help to widen the possibilities of finding a formulation that can work for a particularly difficult case

It helps to build a foundation of understanding of how herbs are synergistically put together in a formula

It improves our clinical outcome by having more “arsenals” in our disposal.

Discussion – Some Personal Thoughts

Merely collecting herbal formulas will not make us a better doctor, but understand how the formula is constructed and how the herbs synergistic work within a formula will help us in design and create better formulations in other cases.

Writing down formulas help us learn better than just thinking about the formula in our head.

Knowing deeply the framework of how formulas are constructed by a particular master would be much better than knowing not as deeply but by many masters.

Highlighting and knowing the frequency of a particular herb is used will help to know the consensus use of many doctors.