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Traditional Chinese Medicine Classic Ancient Books Electronic Series

Shanghan Henglun (Constant Commentary on Cold Damage), Upper Volume

Qing Dynasty · Zheng Qin'an (Author)

Interpretation · Tang Buqi

Proofread by Minjian Traditional Chinese Medicine Network

Shanghan Henglun, Upper Volume
Shanghan Henglun, Lower Volume

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Shanghan Henglun
Electronic Edition Preface

Chinese culture is profound and extensive, with a long history. Traditional Chinese Medicine (TCM) is a treasure of the Chinese nation, having safeguarded the health of the Chinese people for thousands of years. Inheriting and promoting TCM is our innate mission. However, due to various reasons, many TCM classics remain hidden away today. Human history in the 21st century has entered the information age. To fully utilize modern electronic technology to promote our country's traditional medicine and excellent culture, netizens of the Minjian Traditional Chinese Medicine Network spontaneously organized themselves to launch the compilation work of the "Traditional Chinese Medicine Classic Ancient Books Electronic Series."

Zheng Qin'an's *Shanghan Henglun* is the third electronic book completed after our previous works, *Yili Zhuan* (True Transmission of Medical Principles) and *Yifa Yuantong* (Comprehensive Understanding of Medical Methods). This book uses the *Shanghan Henglun* contained in *Zheng Qin'an Yishu Chanshi* (Interpretation of Zheng Qin'an's Medical Books), published by Bashu Book Society in January 1996, as its base text. During the proofreading process, we strove to maintain the original appearance of the edition, corrected printing and layout errors of the original book, and redrew the illustrations. Netizens who participated in the proofreading include lihua2006, lizlopez, putaojia, tengel, qiqi, wesleybb, wyjk, yinxing3m, Baishao, Changguan Wwo, Chang Jingjin, Chengkong Assistant, Dahui Lang, Guyue, Nianfo, Yue Liang Xin Shi, Yuan Yi Qiudao, Yuanzhoulv, Hanfu, etc. The entire book was compiled and laid out by Hanfu. During the organization process, we also received support and assistance from Mr. Sanqisheng and Mr. Liu Wencheng, for which we express our gratitude here.

The "Traditional Chinese Medicine Classic Ancient Books Electronic Series" was published on the "Minjian TCM - Theory and Methods" forum. We strive to provide an error-free electronic version, but limited by our capabilities, we acknowledge that errors are inevitable. Therefore, we hope that all friends reading this series of e-books will inform us of any errors found on the forum, and we will update irregularly based on actual situations. Netizens who obtained this book from other places should also check here promptly to obtain the latest version, to prevent erroneous versions from circulating indefinitely. We are still producing electronic versions of other excellent TCM books and hope and welcome more volunteers to join our team.

Volunteer Compilation Group of the Traditional Chinese Medicine Classic Ancient Books Electronic Series, Minjian Traditional Chinese Medicine Network

March 2006 AD

Original Preface by Zheng Qin'an

The book *Shanghan Lun* (Treatise on Cold Damage) has been passed down for over a thousand years, said to be the original text of Zhang Zhongjing. Many distinguished scholars have emerged, and there are numerous commentators, too many to enumerate. Having read the original text, I have gained considerable understanding. Here, I analyze the original text item by item. I dare not compete with former sages, but merely expound upon my humble insights item by item. Although I do not claim superior insight, this is the fundamental intention of saving the world, merely attempting to make up for the shortcomings of famous sages. It is also a great joy. I trust that the learned will understand. This serves as the preface.

1. This book follows Mr. Shu Chi Yuan's division into upper, middle, and lower sections, expounding sequentially. Other books have inconsistent ordering of the original text. In summary, discussing the original text and elucidating the sage's intent means that even if the order is confused, the original text remains. Scholars need only focus on the content without debating shortfalls or merits.

2. In the Taiyang Chapter, there are phrases mentioning "Zhong Feng" (Wind Strike/Stroke). These likely refer to the Taiyang channel being affected by wind, but the character "Zhong" (Strike/Hit) is inappropriate. Why? "Zhong" implies hitting a target like an arrow; how can a person withstand such force? Moreover, the texts distinguish between striking the channels, wind strike, and striking the viscera. The "wind strike" mentioned in these clauses does not resemble the clinical presentation of stroke at all. Scholars should observe this carefully.

Preface by Zheng Shouquan (Zhen'an) of Linqiong, Early Winter of the 20th Year of Guangxu, Qing Dynasty

Original Preface by Zhang Zhongjing (Corrected and Supplemented)

Discussion: Whenever I read about Bian Que's diagnosis in Guo and his observation of the color of the Duke of Qi, I cannot help but sigh at their outstanding talent. I am puzzled by the scholars of today who do not pay attention to medicine and pharmacology, nor meticulously study medical arts. They fail to treat the illnesses of rulers and parents above, save the poor and lowly below, or preserve their own bodies and lives in the middle. Instead, they compete for glory and power, grovel before the wealthy and powerful, diligently pursuing only fame and profit. They adorn the superficial while neglecting the root, beautifying the exterior while exhausting the interior. If the skin does not exist, where will the hair attach? Suddenly encountering pathogenic wind qi, suffering from unusual diseases, when disasters and calamities arrive, they tremble in fear. They lower their ambitions and submit, hoping in vain for shamans and diviners. When all avenues are exhausted, they resign themselves to death, surrendering to defeat. They entrust their hundred-year lifespan and precious body to mediocre physicians, allowing them to act arbitrarily. Alas! Their bodies perish, their spirit vanishes, turning into strange entities; buried deep in the underworld, they become objects of tears. It is painful that the whole world is confused and unaware; they do not cherish their lives, treating them so lightly. What glory or power could possibly justify this? Advancing, they cannot love or understand others; retreating, they cannot love or know themselves. Encountering disaster and calamity, they find themselves in desperate situations, ignorant and dim-witted, foolish as wandering souls. How sorrowful! Those who pursue worldly affairs gallop after vanity and splendor, failing to solidify their roots, forgetting their bodies to serve external things, precarious as ice and valleys, reaching this state.

My clan was originally large, numbering over two hundred. Since the Jian'an era, less than ten years have passed, yet two-thirds of them have perished. Seven out of ten deaths were due to Shanghan (Cold Damage). Grieving the loss of the past and mourning the untimely deaths that could not be saved, I diligently sought ancient teachings, extensively collected prescriptions, utilized the *Suwen* (Basic Questions), *Nanjing* (Classic of Difficult Issues), *Yin Yang Da Lun* (Great Treatise on Yin and Yang), *Tailu Yaolu* (Records of Fetal Development and Pharmacology), along with pulse assessment and syndrome differentiation, compiling them into the *Shanghan Zabing Lun* (Treatise on Cold Damage and Miscellaneous Diseases) in sixteen volumes. Although unable to cure all diseases completely, it allows one to see the disease and know its source. If one can follow what I have compiled, one will have grasped more than half of medical knowledge.

Heaven distributes the Five Elements to operate all categories; humans receive the Five Constants to possess five Zang organs. Meridians, collaterals, fu organs, and shu points connect yin and yang. Profound and subtle, changes are difficult to fathom. Unless one possesses high talent and profound insight, how can one explore its principles and implications? In ancient times, there were Shennong, Huangdi, Qibo, Bogao, Leigong, Shaoyu, Laoshi, and Zhongwen. In the middle ages, there were Changsang and Bianque. In the Han dynasty, there were Gongcheng Yangqing and Cangong. Below these, nothing has been heard of. Observing doctors of today, they do not reflect on seeking the essence of classics to expand their knowledge. Each inherits family skills, adhering strictly to old traditions. When examining illnesses and asking about diseases, they rely solely on eloquence. After a brief conversation, they immediately prescribe decoctions. Checking the cun pulse does not extend to chi; holding the wrist does not reach the foot. Renying and Duyang pulses are not compared among the three positions. Counting breaths during rapid pulses takes less than fifty beats. For short-term prognosis, diagnosis is undecided; the nine pulses show no resemblance. The Mingtang (forehead) and Yueting (nose bridge) are not observed at all. This is merely peeking through a tube. To distinguish between life and death truly is indeed difficult. Confucius said: "Those who know from birth are superior; those who learn are next; those who hear much and know widely are inferior." I have long valued medical arts. Please allow me to act upon these words.

Foreword

The *Shanghan Lun* is the first medical classic authored by Zhang Zhongjing, summarizing medical achievements prior to the Han Dynasty and integrating his clinical experience. It possesses complete theory, methods, formulas, and herbs, thereby forming China's unique theoretical system of "Syndrome Differentiation and Treatment." Since the publication of Cheng Wuji's *Annotated Shanghan Lun* in the Jin Dynasty, hundreds of commentators have emerged over thousands of years (including Japanese Kampo physicians). Due to its archaic language and concise symptom descriptions, most commentaries explain from a textual perspective, rarely discussing how to specifically apply its formulas. Interpretations of its connotations vary, leading to academic diversity and disagreement, yet all highly praise it, honoring it as the "Ancestor of Formula Books."

Famous physician Zhanglingshao particularly pointed out that the *Shanghan Lun* is a comprehensive book for treating all diseases. He said: "Although the book discusses Shanghan, it covers viscera, meridians, Ying and Wei, Qi and Blood, Yin and Yang, Water and Fire, Cold and Heat, Deficiency and Excess without exception. If understood spiritually and clearly, thousands of difficulties are like looking at one's palm. Thus, ancients said: 'One who can treat Shanghan can treat miscellaneous syndromes.' This is certainly not false." Ke Yunbo also emphasized: "Zhongjing's Six Channels establish laws for all diseases. Shanghan and miscellaneous diseases share no different principles; all fall under the regulation of the Six Channels." However, those who can comprehensively apply the theory, methods, formulas, and herbs of the *Shanghan Lun* to treat various conditions are rare.

Zheng Qin'an closely grasped the essence of the *Shanghan Lun*, widely applying its formulas and herbs to treat various conditions clinically with remarkable effectiveness. He wrote three books: *Yili Zhuan*, *Yifa Yuantong*, and *Shanghan Henglun*. These mutually illuminate each other, forming an inseparable whole, all summaries of clinical experience. They are permeated by the academic thought that Yin and Yang are the general outline, all diseases do not exceed the principle of the Six Channels, and none depart from the Primordial Qi.

He particularly emphasized the elaboration of Yang deficiency and Yin excess, reaching the pinnacle. He skillfully used large doses of Ginger, Cinnamon Twig, and Aconite Root to restore Yang and rescue from collapse, saving people from danger. His unique experiences accumulated in diagnosing and treating Yang deficiency truly uncovered what predecessors had not revealed. It is a treasure of national medicine, unique in millennia!

I deeply admire his theories and have found them effective in practice. Regrettably, due to the passage of time, the original books have become scarce. I resolved to punctuate, proofread, and interpret these three books based on my daily learning and clinical experience. The interpretations of *Yili Zhuan* and *Yifa Yuantong* have already been published. After publication, the Japanese Kampo community also sent letters of praise. For instance, Director Yabu Kazumasa of the Institute of Oriental Medical Comprehensive Research included this book in the *Kampo Clinical Series*, and Vice President Ito Ryo of the Oriental Medical Association praised it as "filling the gap in Japanese research on Kampo history regarding the Qing Dynasty Shanghan School," expressing gratitude for its therapeutic efficacy using formulas from the book. The Zhenrentang Rehabilitation Center in Germany invited me to lecture last year. Scholars from Taiwan and Hong Kong also repeatedly requested copies. Domestic acquaintances and strangers alike sent letters or visited. The encouragement from all sides stays constantly in my heart.

Mr. Li Yimang, former head of the State Council's Ancient Books Compilation Leading Group, offered strong encouragement, urging me to complete the interpretation of the three books so that Zheng's three works would form a perfect whole. Due to his advanced age, he also provided the title calligraphy for *Shanghan Henglun*. His earnest expectations I dare not forget. For three years, I have had no rest, repeatedly verifying and modifying. Now it is ready for print, slightly comforting Mr. Li's spirit in heaven.

In his self-preface to *Shanghan Henglun* (published in the 20th Year of Guangxu, i.e., 1894 AD), Zheng stated: "Having read the original text, I gained considerable understanding. Here, I analyze the original text item by item. I dare not compete with former sages, but merely expound upon my humble insights item by item. Although I do not claim superior insight, this is the fundamental intention of saving the world, merely attempting to make up for the shortcomings of famous sages." Reviewing the entire book, it does not follow stale views but expresses independent opinions. It corrects doubtful parts of the original text without suspicion of distortion or arbitrary judgment. Its greatest feature is tightly linking clauses to clinical reality, explaining principles concretely, and closely combining theory with clinical practice to guide syndrome differentiation and treatment. For example, Clause 13 of the Middle Taiyang Chapter states: "Those with dry throat should not undergo sweating therapy." Zheng said: "For anyone with a dry throat, body fluids are already damaged. How can one induce sweating again to further deplete fluids? Some cases result from the decline of True Qi in the Lower Burner Kan center, failing to initiate the ascent of True Water; the method should support Yang. Some result from pathogenic fire scorching body fluids; the method should clear and moisten. Some result from cold water reversing in the middle, obstructing the ascending Qi of the Stomach; the method should move water..." He analyzed various situations and indicated careful observation in clinical practice. He also said, "If these syndromes are present, sweating therapy is unsuitable." Arguing from actual clinical situations provides much enlightenment for treating diseases, which is rare among ancient physicians. Another example is Clause 13 of the Later Shaoyin Chapter: "Shaoyin disease, with cold extremities, where the patient may have cough, palpitations, difficulty urinating, or diarrhea with a sensation of heaviness below, is primarily treated with Sini San (Four Counterflow Powder)."

Zheng believed: "Regarding Shaoyin disease progressing to cold extremities, this indicates weak Yang and flourishing Yin. Cough or palpitations indicate Water Qi interfering upwards. Difficulty urinating indicates Yang failing to transform Yin. Abdominal pain and heaviness below indicate extreme Yin Cold. The method should use large doses to restore Yang. Yet this clause prescribes Sini San, which I greatly do not understand." This shows Zheng was not limited to previous explanations, dared to express independent opinions, dialectically examined doubtful errors in the original text, proposed treatment methods, and supplemented what Zhongjing omitted.

Regrettably, the writing of *Shanghan Henglun* is concise, with many omissions. Flexible application in clinical settings awaits further elucidation; furthermore, it lacks listed formulas and formula explanations, making reference inconvenient. Now, adding punctuation, proofreading, and interpretation, supplementing clear formulas, explaining herb properties and application scopes one by one, and verifying with fifty years of clinical experience aims to use the past for the present, eliminate the old to bring forth the new, and preserve the original book's full appearance for widespread dissemination. For what is unknown, I leave it blank, awaiting future researchers. Given my sparse scholarship, errors are inevitable. I beg experts within and beyond the seas not to withhold corrections.

I have never known the people at Bashu Book Society, but they do not follow vulgar trends, disregard economic losses, look far ahead, and take promoting excellent traditional Chinese culture as their responsibility. They carefully edited and reviewed, publishing my interpreted *Yili Zhuan* and *Yifa Yuantong* in recent years. Now that the interpretation of *Shanghan Henglun* has just been finalized, the responsible editor took over editing to ensure early publication. At an appropriate time, it is planned to bind the three books together into one volume for expanded, fine printing to enjoy broad readership. Such measures deserve admiration not only from the author.

During the compilation of this set, I received earnest advice from Ren Yingqiu, former Vice President of the China Association of Chinese Medicine and Professor at Beijing College of Traditional Chinese Medicine, to organize and promote Zheng's medicine; calligraphy by Liao Moshan, former member of the National Committee of the Chinese People's Political Consultative Conference; biography of Zheng Qin'an written by renowned scholar and old friend Professor Wang Liqi; care and support from Guo Qi, professor and old classmate, former president of Northwest University; Hou Zhanyuan, former vice president and researcher of Chengdu College of Traditional Chinese Medicine; Professors Guo Ziguang and Dai Fuyan of Chengdu College of Traditional Chinese Medicine; old friend Professor Yu Xingda; and Wu Chuanxian, director of the Sichuan West China Institute of Traditional Chinese Medicine. I sincerely express my gratitude.

The interpretation of Zheng's three books took fifteen years, and this book underwent multiple drafts. My wife, Zhang Cijin, who has long engaged in middle school Chinese teaching, discussed and revised every draft with me, providing deep inspiration and benefit. My sons, Gao Long and Gao Xiang, participated in collection and copying, bringing much progress. I shall encourage them to study diligently to inherit the family learning.

Tang Buqi at Huaishu Studio, Chengdu, November 30, 1993

General Rules

1. This book interprets the original text of Zheng Qin'an's *Shanghan Henglun* item by item, adhering to the principles of inheritance and promotion, aiming for practical use by clinicians.

2. Zheng's book arrangement follows Shu Chi Yuan's *Re-revised Shanghan Jizhu* (Shu's chapter titles follow Yu Jiayan's *Shanglun Pian*, thus this book's chapters follow them exactly without change). However, the clauses are disordered and often inconsistent with the original *Shanghan Lun*. Now, based on the *Shanghan Lun Yu Yi* (Verbatim Translation of Shanghan Lun) compiled by the Academy of Traditional Chinese Medicine in 1959, we proofread against this edition. After the word "Original Text" at the end of each clause in Zheng's book, Arabic numerals indicate the sequence number of that clause in the original *Shanghan Lun*, facilitating reader comparison and retrieval.

3. The *Shanghan Lun Yu Yi* edition includes the "Chapter on Differentiating Huoluan Disease Pulse, Syndromes, and Treatment" and other clauses, but neither Shu Chi Yuan's nor Zheng Qin'an's books contain them. As this book is an interpretation of Zheng's work, we do not include them in the main text, but list them sequentially at the end of the book for reference.

4. The original book did not list formulas after the clauses. The author supplements them, providing formula explanations and application scopes, attaching lifelong experience for verification.

5. For unclear meanings in the original text, a specific annotation section is established, providing Chinese pinyin and direct pronunciation for obscure characters. For ease of reading, end-of-page notes are adopted.

6. Collation generally does not produce collation notes. Wrong characters, missing characters, or superfluous characters are marked with "( )". Corrected characters or inserted ones are marked with "[ ]".

7. The original book has some marginal comments inconvenient for horizontal typesetting. These are rewritten after the original text and before the interpretation.

Also, in the cooking and administration instructions for various formulas, the character "You" (Right/Previous) meaning "the aforementioned [number] ingredients" is changed to "Shang" (Up/Above) due to horizontal typesetting.

Shanghan Henglun, Volume One

Taiyang Upper Chapter

All syndromes where Wind injures Wei (Defensive Qi) are listed in this chapter, totaling fifty-three methods (added according to Shu's edition).

1. Taiyang disease presents with floating pulse①, stiffness and pain in the head and neck, and aversion to cold② Original Text 1 (Sequence number refers to the original order of Clause 398 in *Shanghan Lun*, same throughout the book).

① Floating Pulse: The floating image is superficial, obtained with light pressure, indicating pathogenic factors have just entered.

② Head and Neck Stiffness and Pain: Means headache and stiff neck, referring to a feeling of pulling and discomfort in the neck. "Neck" refers to the posterior part of the neck. Aversion to Cold: Fear of cold and chilliness.

Zheng's Commentary: According to Taiyang, its native Qi governs Cold Water. Taiyang controls the skin, hair follicles, Ying and Wei, all vessels, and meridians of the whole body, serving as the guideline for the entire body. Hair follicles are the exit route for the transformation of Taiyang Cold Water Qi㈠. All incoming external pathogens must enter internally starting from the hair follicles. The characters "enter" and "exit" are the mechanism of pathogen and righteous Qi, the standard for all diseases. A floating pulse indicates pathogenic factors have just entered; head and neck stiffness and pain indicate pathogens invading the Taiyang territory meridians; aversion to cold indicates the Taiyang native Qi is diseased. The two characters "aversion to cold" are the outline of Taiyang, the key to identifying syndromes. Knowing these two characters, regardless of the season causing illness, as long as the patient currently exhibits head, neck, waist, back stiffness and pain, aversion to cold, and fever, one should treat according to Taiyang methods. Do not be constrained by seasonal timing, lest one lose the essence of the classics.

㈠ There are two interpretations of "Qi Transformation": That which exits through hair follicles is light and clear dew; that which exits downward is heavy and turbid fluid. Thus, Taiyang transmission via channels or transmission to fu organs are all explored through this Qi transformation (Top Comment).