Library

[Zhang Zhongjing's *Shanghan Zubiing Lun*] The *New Book of Tang: Bibliography* records ten volumes; extant.
The *Sui Dynasty Bibliography* states: During the Liang Dynasty, there were ten volumes of Zhang Zhongjing's *Bian Shanghan* (Differentiating Cold Damage), which are now lost.
In his preface, Zhang Zhongjing wrote: "It is stated in the discussions: 'Whenever I read about Bian Que diagnosing the Crown Prince of Guo and observing the complexion of Duke Huan of Qi, I cannot help but sigh with admiration for their outstanding talent. It is strange that scholars living in the present world do not pay attention to medicine or carefully study medical techniques. They fail to treat the illnesses of rulers and parents above, rescue the poor and lowly below, and preserve their own bodies for long-term health and nourishment of life. Instead, they compete for glory and power, stretching on tiptoes to admire wealthy nobles, diligently striving only for fame and profit. They embellish the superficial while neglecting the fundamental, appearing splendid outwardly but deteriorating inwardly. If the skin does not exist, where will the hair attach? Suddenly encountering pathogenic wind-qi, one contracts extraordinary diseases. When disaster strikes, one trembles in fear, lowers one's ambition and submits, reverently hoping for witchcraft and prayers. With resources exhausted, one resigns to heaven, hands bound awaiting defeat. A hundred years of lifespan, holding the precious vessel of the body, is entrusted to mediocre physicians, who act arbitrarily. Alas! The body perishes, spirit vanishes, transforming into a foreign entity, buried deep in the underworld, leaving only tears. How painful! The whole world is confused and unaware, unable to awaken, disregarding life itself. If one treats life so lightly, what talk of glory and power is there? One fails to love and understand others when advancing, nor loves and understands oneself when retreating. Encountering disaster and misfortune, one remains in distress, muddled and ignorant, like a wandering soul. How sorrowful! Those who follow the world gallop in competition for vanity, failing to consolidate the root, forgetting the body as a precious object, dangerous as standing in an icy valley, reaching such a state. My clan was originally numerous, with nearly two hundred members. Since the first year of Jian'an, less than ten years have passed, yet two-thirds have died, seven out of ten cases being cold damage. Grieving the loss of the past and mourning the untimely deaths that could not be saved, I diligently sought ancient teachings and widely collected various prescriptions. Utilizing the *Suwen* (Basic Questions), *Jiujuan* (Nine Chapters, i.e., *Lingshu*), *Bayishinan* (Eighty-One Difficulties, i.e., *Nanjing*), *Yinyang Dalun* (Great Treatise on Yin and Yang), *Tailu Yaolu* (Record of Fetal Care and Materia Medica), combined with pulse differentiation and syndrome identification, I compiled the *Shanghan Zabing Lun* (Treatise on Cold Damage and Miscellaneous Diseases) into sixteen volumes. Although it may not cure all diseases completely, it allows one to see the source of the disease through its manifestations. If one explores the collection I have made, half of the understanding can be gained. Heaven distributes the Five Phases to operate all categories of beings; humans receive the Five Constants to possess the Five Zang organs. Meridians, fu-organs, shu-points, and yin-yang connections are harmonious; profound and subtle changes are difficult to exhaust. Without high talent and profound insight, how can one explore its principles? In ancient times, there were Shennong, Huangdi, Qibo, Bo Gao, Leigong, Shaoyu, Shaoshi, and Zhongwen. In the middle era, there were Changsang Jun and Bian Que. In the Han Dynasty, there were Gongcheng Yangqing and Canggong (Chunyu Yi). Since then, nothing has been heard. Observing modern physicians, they do not reflect on seeking the essence of classics to expand their knowledge, instead inheriting family skills and following old traditions. When examining illnesses, they rely on eloquence. Facing patients briefly, they immediately prescribe decoctions. They palpate the cun position but not the chi position, hold the hand but not the foot, and do not compare the Renying, Fuyang, and three positions together. Pulse beats and breaths do not reach fifty. They cannot predict short-term outcomes or grasp the nine-fold pulse examination. They fail to observe the Mingtang and Yueting areas. This is called looking at the sky through a tube. Distinguishing death from life is truly difficult. Confucius said: 'Those who know from birth are superior; those who learn are next; those who hear much and know broadly are inferior.' I have long valued medical arts and request to follow these words. Written by Zhang Ji, courtesy name Zhongjing, Administrator of Changsha during the Han Dynasty."

He Yan's biography states: Zhang Zhongjing of the same commandery visited He Yan in his youth. Yan said, "Your thinking is precise but your demeanor lacks elegance; you will become a good physician later." This came true. Zhang Zhongjing had unique perception, and his words never fell flat. Wang Zhongxuan, at seventeen, met Zhang Zhongjing. Zhang said, "You have an illness; you should take Wushi Tang (Five-Stone Decoction). If untreated, it will develop into 'Shicu' (corpse compression). At thirty, your eyebrows will fall out." Wang, considering himself young and distant, did not seek treatment far away. At thirty, the disease manifested, and his eyebrows indeed fell out. His medical skill was so exquisite. Zhang Zhongjing's prescriptions are still transmitted today (from *Taiping Yulan*).

*Yilin Liezhuan* records: Zhang Ji, courtesy name Zhongjing, was from Nanyang. He studied under Zhang Buzu of the same commandery. He was skilled in treatment, especially proficient in classic prescriptions. Recommended as a Xiaolian (Filial and Incorrupt), he rose to the rank of Administrator of Changsha. Later, he became a famous physician in the capital, ranked first among his contemporaries. Because over two hundred members of his clan died two-thirds since the first year of Jian'an, with seven-tenths suffering from cold damage, he wrote twenty-two chapters of discussion, covering 397 methods and 112 formulas outside the syndromes. His writing is concise, ancient, and elegant. No one in history treating cold damage has exceeded this work. It is the ancestor of all formulas. People of his time believed Bian Que and Canggong could not surpass it, hence he is called the "Medical Sage" in later generations.

*Guqin Shu* records: Zhang Ji, courtesy name Zhongjing, from Nanyang, studied under Zhang Buzu and was proficient in treatment. One day, entering Tongbai Mountain to find herbs, he met a patient seeking diagnosis. Zhang said, "Why is there a beast pulse on your wrist?" The man answered truthfully that he was an old ape from a cave on Mount Yi. Zhang gave him pills from his pouch; one dose cured him. The next day, the man brought a huge piece of wood, saying, "This is a Ten-Thousand-Year Paulownia; let me repay you." Zhang made two zithers from it, named "Ancient Ape" and "Ten Thousand Years". Huangfu Mi recorded: Zhang Zhongjing saw Attendant-in-Waiting Wang Zhongxuan, then over twenty years old, and said, "You have an illness; your eyebrows will fall out at forty, and you will die six months after they fall. Take Wushi Tang to avoid this." Wang disliked the offensive words, accepted the medicine but did not take it. Three days later, Zhang asked, "Have you taken the medicine?" Wang said, "Yes." Zhang said, "Your complexion does not match the signs of having taken the medicine. Why do you disregard your life?" Wang remained silent. Twenty years later, his eyebrows fell out, and he died 187 days later, exactly as predicted (from *Jiayi Jing Preface*).

It also states: Zhang Zhongjing expanded upon Yi Yin's *Tangye* (Decoctions), writing dozens of volumes, which proved effective. Wang Shuhe, Imperial Medical Director in recent times, edited Zhang Zhongjing's selected discussions with great precision, making them applicable (ibid.).

It also states: Hua Tuo preserved unique insights; Zhang Zhongjing demonstrated wonders through fixed formulas (from *Jin Shu Biography and Discouragement of Pleasure*).

Gao Zhan recorded: Wang Shuhe edited Zhang Zhongjing's formula discussions into thirty-six volumes, which became widely popular (from *Taiping Yulan*).

Ge Hong recorded: Zhang Zhongjing opened the chest and administered Chibing (Red Cake) (from *Baopuzi*).

Sun Simiao recorded: Teachers in Jiangnan kept Zhang Zhongjing's essential formulas secret and did not transmit them.

Preface by Sun Qi et al.: "*Shanghan Lun* generally follows the intent of the Great Sage; no other school compares. Thus, Huangfu Mi of Jin said in the preface to *Jiayi Zhenjing*: 'Yi Yin, with original sage talent, used *Shennong Bencao* to write *Tangye*. Han's Zhang Zhongjing discussed and expanded *Tangye* into ten-plus volumes, proving effective. Recent Imperial Medical Director Wang Shuhe edited Zhang Zhongjing's remaining discussions with great precision, all applicable. This shows Zhang Zhongjing originated from Yi Yin's method, and Yi Yin from Shennong's classic. Is this not following the Great Sage's intent?' Zhang Zhongjing has no biography in *Han Shu*, but appears in *Mingyi Lu*. He was from Nanyang, named Ji, with Zhongjing as his courtesy name. Recommended as Xiaolian, he became Administrator of Changsha. He first studied under Zhang Buzu of the same commandery. People said his discernment and application surpassed his teacher. His writings are profound and elegant, methods simple and detailed, beyond the reach of shallow learning. For eight hundred years since Zhang Zhongjing, only Wang Shuhe learned from him. Figures like Ge Hong, Tao Jing, Hu Qian, Xu Zhicai, and Sun Simiao were not without talent but were self-named masters who did not clarify it. During Kai Bao, Jiedushi Gao Jichong submitted an edited version, but the text was erroneous and uncorrected. Though stored in libraries, it lacked collation, causing physicians worldwide to be unaware. The state ordered scholar-officials to collate medical books. Ju Qi was selected, believing no emergency is greater than cold damage. We now collate Zhang Zhongjing's *Shanghan Lun* into ten volumes, totaling twenty-two chapters, 397 methods, removing duplicates to fix 112 formulas, and request promulgation."

Zhu Gong recorded: Hua Tuo referred to Zhang Changsha's *Shanghan Lun* as the *Huoren Shu* (Book of Living People). Later people also named it *Jingui Yuhan*. It was so valued by the world. However, its language is elegant and profound; only those proficient in meridians can understand it.

Zhao Xibian recorded: Zhang Zhongjing's *Shanghan Lun* is ten volumes, narrated by Han's Zhang Zhongjing, edited by Jin's Wang Shuhe. According to *Mingyi Lu*, Zhongjing was from Nanyang, named Ji, with Zhongjing as his courtesy name. Recommended as Xiaolian, he became Administrator of Changsha. With over two hundred clan members, two-thirds died within ten years since Jian'an, seven-tenths from cold damage. He wrote twenty-three chapters, 397 methods, and 113 formulas. Some say *Shanghan Lun* is an immutable classic. However, it covers adult diseases but not infant ailments; it has northern medicines but lacks southern treatments. This is its deficiency. South of Chen and Cai, Chaihu Tang and Baihu Tang are not used for cold damage; this reasoning is very sound.

Chen Zhen-sun recorded: *Shanghan Lun* is ten volumes, written by Zhang Ji, courtesy name Zhongjing, Han Administrator of Changsha from Nanyang. A person of the Jian'an era. His writing is concise, ancient, and elegant. Also known as *Shanghan Zubiing Lun*. It contains 112 formulas. No one in history treating cold damage has exceeded this.

Yan Qizhi recorded: Yi Yin, with original sage talent, wrote *Tangye* to eliminate commoners' diseases and save all living beings. Later Han's Zhang Zhongjing expanded *Tangye* into *Shanghan Zubiing Lun* of ten-plus volumes, greatly perfecting medical formulas. The former and latter sages matched like tally tokens. Jin's Imperial Medical Director Wang Shhek edited Zhang Zhongjing's book into a complete volume. Past people regarded Zhang Zhongjing's formulas as the ancestor of all formulas, continuing the works of former sages. For over a thousand years, it has not fallen into obscurity, thanks to Wang's elucidation. *Shanghan Lun* is ten volumes, with profound language and simple, detailed methods, beyond the reach of shallow learning.

Liu Wusu recorded: In late Han/Wei, Zhang Ji (Zhongjing), Administrator of Nanyang, pitied the people suffering from cold damage and premature death. He examined ancient classics to write *Shanghan Zubiing Fanglun* in sixteen volumes, providing basis for future learners. Although incomplete, it covers key points for various diseases. If one deduces by mind, half the understanding is gained. Many works exist, and many are practiced. From Zhang Zhongjing to now, barely a millennium has passed, yet medical writings exceed ancient ones by eight or nine times. The *Sanfen* books are the teachings of Great Sages, modeling heaven and earth, conforming to nature, based on the Great Dao. Zhang Zhongjing is the Sub-Sage. Although his book does not fully contain the Sage's teaching, it approaches it. The text is profound, making it difficult for modern learners. Thus, people practice modern formulas, studying the tip but not the root. Moreover, Zhang's book was edited by Wang Shuhe and compiled by Gao Jichong in Kai Bao. Although these men used wisdom to expand methods, mixing old theories, some aspects are valuable. However, some lost Zhang's original intent and deviated from ancient classics, making learning harder (from *Yuanbingshi Preface*).

Wu Cheng recorded: In late Han, Zhang Zhongjing wrote *Shanghan Lun*. I once lamented that Eastern Han literary style could not surpass Western Capital style. Only this medical book is profound, elegant, and resembles Three Dynasties literature. I wondered why. Reading Zhang's preface, which seemed humble, I realized the preface was self-written by Zhang, and *Shanghan Lun* is the ancient *Tangye Lun*, likely an ancient遗书 (relic book) compiled by Zhang, not his original creation. Jin's Wang Shhek re-edited it, but transcribers mistakenly mixed Wang's words with Zhang's, failing to distinguish them (from *Huoren Shu Bian Preface*).

Lu Fu recorded: *Shanghan Lun* is ten volumes, written by Han's Zhang Ji (Zhongjing) using *Suwen: Re Lun* to expand Yi Yin's *Tangye*. Jin's Wang Shhek re-edited it based on old theories. Song's Cheng Wuji annotated it. Later, Pang Anchang, Zhu Gong, Xu Shuwai, Han Zhihe, and Wang Shizhi developed it further, but the main outline did not exceed four methods: vomiting, sweating, purging, and warming. Each syndrome matched each herb perfectly, like tally tokens across millennia. Predecessors called it the ancestor of all formulas, rightly so. The regret is that pulse diagnosis mixed Wang Shhek's words, and Yin San chapters are mostly fragments. Zhang's classics and Wang's transmissions often repeat or reverse, with textual errors. Without careful study, one cannot reach its depths. Chen Wuye supplemented Yin San syndrome medicines in *Sanyin Lun*, revealing his intent.

Wang Lü recorded: When reading Zhang Zhongjing's book, one must seek the intent behind his legislation. If found, the book serves as an eternal model, unconquerable by later generations. If not found, doubt and belief mix, leading to contradictions. Alas! Since Zhang Zhongjing, many have expounded his book, yet none have clearly shown the legislative intent. Did they fail to find it? Or did they follow custom without seeking? Or did I miss it? Though dull, I will state my view. Cold injury has immediate onset and delayed onset. Immediate onset occurs at the time of infection; delayed onset occurs in spring and summer. Immediate is called Shanghan; delayed is called Wen and Shu. Although categories differ, the origin is the same. Hence, all are called Shanghan. But treatments must not be mixed due to category differences. Mixing treatment based on name harms later generations, who blame Zhang Zhongjing and discard half his work. Alas! If Zhang's law harmed later generations, *Shanghan Lun* need not exist. If it did not harm, how could it be missing a day? Blaming the legislator rather than one's own limited view is like blaming Boyi for falling in a well or Suiren for fire. Zhang's law is the ancestor; later generations cannot exceed its rules. Can his laws and formulas be discarded? No. Zhang's laws and formulas were specifically for immediate Shanghan, not for delayed Wen/Shu. If later generations knew this, they would regret the loss of methods and inability to counter crude physicians' errors. Discarding half without realizing error stems from not understanding the legislative intent. Using Shanghan methods for Wen/Shu is merely borrowing. Zhang's legislation is the standard for the world. It can be borrowed for other diseases, not just Wen/Shu. All miscellaneous diseases can borrow from it. Modern people think because Shanghan methods apply to Wen/Shu, the law is for both. This confuses the stream with the source. Let me prove it. In Zhang's book, Yin San cold syndromes account for 70-80% of heat syndromes. Delayed Wen/Shu is purely heat; how can it become cold? Examining Yin San cold syndromes confirms my words. Some say Yin San cold syndromes are miscellaneous diseases added by Wang Shhek. Others say cold resulted from mistaken cold-medicine treatment. Both are wrong. Wang Shhek only added *Bian Mai*, *Ping Mai*, and *Ke Han/Bu Ke Han* chapters. The Six Meridian chapters are not Wang's addition. Only some Jueyin diarrhea/vomiting entries were attached by Wang due to Jue Ni similarity. Heat-to-cold transformation from mistaken treatment is mostly Taiyang. Even if Yin San transforms, it shouldn't be so numerous. Because later generations treated Zhang's book as for both Shanghan and Wen/Shu, they doubted warm agents and dared not use them.

Also stated: Wang Shhek's collection of scattered old theories was a great merit. But he mixed his own views with Zhang's and included miscellaneous pulses/diseases at the beginning, confusing jade with stone and host with guest. If he listed Zhang's words first, then his own with clear names, he wouldn't confuse later generations or burden Zhang. Han scholars repaired broken bamboo slips after Qin burning, adding commentaries; critics said merit and fault were equal. Wang Shhek might face similar criticism. I wanted to reorganize the book: *Shanghan Li* first, then Six Meridian diseases, similar diseases, post-recovery diseases, diagnosis/treatment methods, contraindications/errors, resolution/non-resolution, etc. Attach related miscellaneous pulses/diseases; delete unrelated ones. This would ensure pure methodology and clear distinction. But I lacked time, so I record this for the future.

Also stated: I heard since childhood of "397 methods of Shanghan," thinking them exhaustive. Checking Cheng Wuji's commentary, I couldn't find them. Asking physicians, they only recited the phrase. Trying to count articles with formulas, the number didn't match. Counting articles with/without formulas exceeded the number. Excluding *Bian Mai*, *Ping Mai*, *Shanghan Li*, and *Ke/Bu Ke Han/Tu/Xia* chapters, counting Six Meridian articles still didn't match. Including *Shi*, *Huoluan*, and *Yinyang Yi/Cha Hou Lao Fu* chapters exceeded the number. Counting only articles with formulas in these chapters was too few. I couldn't decide. Should I dismiss it as baseless or respect it as possibly originating from Zhang/Wang? Song's Lin Yi et al. collated *Shanghan Lun*, stating: "We collated Zhang Zhongjing's *Shanghan Lun* into ten volumes, twenty-two chapters, 397 methods." I searched these ten volumes. In Six Meridian, *Huoluan*, and *Yinyang Yi/Cha Hou Lao Fu* chapters, regarding articles with prescriptions...