Zang Fu Pathologies | Yi Shui School

Exploration of Zang Fu Pathologies, Differentiation of Syndromes and Treatments

Initiator: Dr Zhang, Yuan Su

• Song, Jin, Yuan Dynasties
• Wartime
• Lost of many great medical texts on miscellaneous diseases
• War, Famine, Migration
• Great Migration to the South

All Endogenous Diseases relate to Zang Fu dysfunction

• Originates from Neijing, but not in an organized fashion.
• Appeared in Nanjing 难经, Shang Han Za Bing Lun 伤寒杂病论, Zhong Zang Jing 中藏经, Qian Jin Fang 千金方, Xiao Er Yao Zheng Zhi Jue 小儿药证直诀.
• by the time, when Song dynasty rolls around, we are using old formula for new Zang Fu conditions

• Born in Jin Dynasty
• Yi Shui County, He Bei Province
• Elaborated upon the etiology of endogenous diseases are due to dysfunction of Zang Fu
• Focused on Zang Fu theories, differentiation of syndromes, and treatments.
• Able to heal Dr. Liu, Wan Su’s Shang Han disease.
• Li Dong Yuan, Wang Hao Gu are his students 李东垣, 王好古。
• ”Beginning Source of Medicine” (Yi Xue Qi Yuan 医学启源), “Minaudiére of Pearls” (Zhen Zhu Nang 珍珠囊)
• Other publications unfortunately lost.

• Yi Xue Qi Yuan 医学启源
• Most chapters are written by Li Ming 李明, his disciple
• based on Neijing and Zhong Zang Jing
• 3 sections
• First section focused on Zang Fu, channel theories, and treatments of symptoms
• Second section focused on diseases of Wu Yun Liu Qi (five cycles and six qi’s)
• Third section focused on the use of herbs and nature of herbs

• Zang Fu Differentiation of Syndromes
• Herbal Categorization
• New Formulations and classifications

• Liver normal physiology
• Liver abnormal pulses
• Liver symptoms
• Liver disease progression and prognosis
• Liver disease treatment
• Liver Disease
  • Pulse rapid emphasized, irritable speech;
  • slightly rapid, qi congestion in hypochondria;
  • slow emphasized, vomiting and reversals;
  • slightly slow, water retention;
  • large emphasized, Nei Yong 内痈, hematemesis;
  • slightly large, tendon pain;
  • small emphasized, excessive Yin 饮;
  • slightly small, Bi syndrome;
  • slippery emphasized, hernia;
  • slightly slippery, urinary incontinence;
  • sluggish emphasized, Liu Yin 流饮;

• Clarified tastes and directional energies
• Clarified tastes, temperatures and Zang Fu treatments
• Deepened the concept of channel entering
• Clarified herbs according to Zang Fu

• Zang Fu	Five Taste – Bu-Xie		Four Qi – Bu-Xie
  	Taste-Bu	Taste-Xie	Qi-Bu	Qi-Xie
  LV/GB	Pungent	Sour	Warm	Cool
  HT/SI	Salty	Sweet	Hot	Cold
  SP/ST	Sweet	Bitter	Cold/Cool	Warm/Hot
  LU/LI	Sour	Pungent	Cool	Warm
  KD/UB	Bitter	Salty	Cold	Hot

• Create new formulations from old formulas
• Classified herbal formulas according to Wind, Summer Heat, Damp, Dryness, and Cold.

	Tonification	Sedation
LV/GB	pungent	sour
HT/SI	salty	sweet
SP/ST	sweet	bitter
LU/LI	sour	pungent
KD/UB	bitter	salty

The Qi	Main Treatment	Assisting Treatment	Type I	Type II
Wind Control	Pungent Cool	Bitter Pungent	Sweet to slow down	Pungent to Dissipate
Summer Heat Control	Salty Cold	Sweet Bitter	Sour to astringent	Bitter to bring out
Damp Control	Bitter Hot	Salty Bland	Bitter to dry	Bland to diuresis
Dryness Control	Bitter Warm	Sweet Pungent	Pungent to moisten	Bitter to bring down
Cold Control	Sweet Hot	Bitter Pungent	Pungent to dissipate	Bitter to bring down

• Reactionary Disease – exogenous pathogen invades the channel, disease occurs with reaction to this pathogen. (Qi disease)
• Original Disease – endogenous, self created disease due to channel weakness or imbalance and not caused by exogenous pathogens. (Xue disease)

• 李杲 Li Gao, 李明之 Li Ming Zhi, Li Jun 李君
• 1180 – 1251 AD
• He Bei Province, Bao Ding City
• Jin, Yuan Dynasties
• Hunger, famine, wartime, fear, fright, diseases
• Much damage to the spleen and stomach.
• “Stomach Qi is the source of human body”, “who has the grain flourishes, who has not diminishes.”, “Five Zang Six Fu all obtain their Qi from the Stomach”…Neijing
• Established “Internal injury to Spleen-Stomach, hundred diseases arise” concept
• Publications
  • Pi Wei Lun 脾胃论 3 chapters
  • Nei Wai Shang Bian Huo Lun 内外伤辨惑论 3 chapters
  • Lan Shi Mi Zang 兰室秘藏 3 chapters
  • Mai Jue Zi Zhang Bing Shi Tu Shuo 脉诀指掌病式图说 1 chapter
  • Huo Fa Ji Yao 活法机要 1 chapter
  • Yi Xue Fa Ming 医学发明 1 chapter
  • Dong Yuan Shi Xiao Fang 东垣试效方 9 chapters
  • Shang Han Hui Yao 伤寒会要
  • Shang Han Zhi Fa Ju Yao 伤寒治法举要
  • Wan Yu Fang 万愈方

• Expansion on SP-ST physiology
• Spleen and Stomach is the source of Yuan Qi
• Spleen and Stomach is the central switch or regulator of ascend and descend movements throughout the body.
• Expansion on etiopathology of Nei Shang 内伤 (Endogenous “Injuries” Disease)
• Expansion on the differentiation of endogenous and exogenous conditions.
• Expansion on SP-ST physiology
  • Yuan Qi 元气 Source Qi = Zhen Qi 真气 True Qi
  • It is the source energy for the human body to function.
  • Yuan Qi, Gu Qi, Ying Qi, Wei Qi are one of the same denoting Stomach Qi.
  • The strength of Yuan Qi is determined by the strength of the Stomach Qi.
• Ascend and Descend
  • The nature of universal energy is ascending and descending; changing and transforming.
  • The human body has similar activity and movement. This is regulated by the Spleen and Stomach.
• Body Functions
  • Breathing
  • Reception of Food
  • Distribution of Food Essence and Qi
  • Discharge of Food Waste
• Pathology Expansion
  • Relationship of Yuan Qi and Yin Fire
  • Yin Fire is Ministerial Fire
  • Ministerial Fire is caused by
  • Sp/St Qi Xu
  • Irregular food intake
  • Stress and strain
  • Emotional congestion
  • Yin Fire rising creates fever, flushing, asthma, restlessness, pulse large and flooding, headache, and insatiable thirst.

• Tonify Middle Benefit Qi, Raise Yang Lift Prolapsed
• Sp/St Qi Xu: poor appetite, fatigue and tired limbs, quiet with limited speech, pale face, loose stools, pulse deficient large and soft.
• Qi Xu Prolapsed Condition: uterine or other organ prolapses, chronic diarrhea, chronic dysentery, Beng Lou 崩漏, dyspnea, pale tongue and weak pulse
• Qi Xu Fever Condition: fever, spontaneous sweating, thirst with desire for warm drinks, fatigue, dyspnea, pale tongue, pulse forceless

Composition: Huang Qi, Gan Cao, Ren Shen, Dang Gui, Chen Pi, Sheng Ma, Chai Hu, Bai Zhu.

Initiation
focused on endogenous disease through deeper understanding of Zang Fu pathologies via differentiation of syndromes

• Initiator: Zhang, Wan Su
• Main Publication:
• “Beginning Source to Medicine” (Yi Xue Zi Qi 医学自启)
• Minaudiére of Pearls” (Zhen Zhu Nang 珍珠囊
• Supporting Publications Earth School
  
  • Discussion of Spleen and Stomach (Pi Wei Lun 脾胃论) – Li, Dong Yuan
  • Discussion on Differentiation and Clarification of Exogenous and Endogenous Diseases ( Nei Wai Shang Bian Huo Lun – Li, Ga
• Supporting Physicians
  
  • Li, Dong Yuan – Earth School
  • Wang, Hao Gu – Three Yin Syndromes
  • Luo, Yuan Yi – Sanjiao Syndromes
  • Zhang, Bi – Son of Zhang Yuan Su