Library

Regarding the syndrome of Shanghan (Cold Damage), it is most severe in those with deficient Yuan Qi (Primordial Qi). If deficiency is not treated with tonification, how can the situation be reversed? Regrettably, modern physicians all claim that there is no tonifying method for Shanghan. This statement has no basis in ancient texts, yet contemporary mediocre practitioners frequently cite it, leading to widespread belief among people of all ages. The harm caused by this misconception is immeasurable. Let us consider a single year as an example: during the Yisi year of the Wanli era (1605 AD), a plague prevailed in the capital. For patients who were elderly or suffered from internal injury and insufficiency, I used formulas combining strong warming and tonifying properties with dispersing agents. Dozens of lives were saved. Had these patients unfortunately fallen into the hands of mediocre doctors, not one would have survived. Considering my own experience within just one year, let alone the long span of years and the vast expanse of the empire, how many must have been killed by the doctrine of "no tonification"? It is incalculable!

I grieved at the unjust deaths and searched extensively through classical texts, finding no precedent for the idea that "Shanghan has no tonifying method." Tracing its origin, only Tao Jie'an stated: "After treating Shanghan with sweating, vomiting, or purging methods, one should not immediately use Ginseng Radix et Rhizoma (Renshen) or other strong tonics, lest the pathogenic factor be strengthened by the tonic, causing the heat to intensify further. This is what is meant by 'no tonifying method for Shanghan.'" This view seems derived from Sun Simiao's advice: after recovery via Chengqi Decoction (Chengqi Tang), one must be cautious about tonification. His intent was that since recovery resulted from purging excess pathogens, using tonics indiscriminately might aid the pathogen; he did not mean that deficiency syndromes should not be treated with tonification. Beyond this, the most vulgar and detrimental influence on future generations came from Li Zijian's "Ten Admonitions on Shanghan," which became the source of this fallacy. Therefore, in previous discussions, I directly refuted his errors and examined Zhang Zhongjing's *Treatise on Cold Damage* (*Shanghan Lun*) and the established methods of other sages to clarify the truth. Moreover, currently, seven or eight out of ten cases of Shanghan involve fatigue-induced internal injury or emotional factors combined with deficiency. Yet, nine out of ten people blindly follow the teaching of "no tonification." How can patients with deficiency endure such rigid adherence to non-tonification? They do not realize that those who die from direct aggressive treatment are precisely those with underlying deficiency. For laypeople, skepticism due to erroneous rumors is understandable. However, for self-proclaimed physicians to assert "Shanghan has no tonifying method" is profoundly ignorant, arrogant, and harmful, deserving of shame and hatred.

Even worse are those without medical skill who bewitch others. Upon encountering seasonal diseases, they invariably declare: "The cold pathogen has not dispersed; how can tonification be used? Tonifying now is like closing the door to drive away thieves." This metaphor appears nowhere in classics and represents dangerous heresy. Another group argues: "Based on pulse and symptoms, the patient is indeed deficient and should be tonified. However, since pathogens remain, we must wait until they are cleared before tonifying." These individuals fail to understand that if Zheng Qi (Upright Qi) cannot recover, pathogens will deepen daily, making clearance impossible. If Yuan Yang (Primordial Yang) is unsupported, death can occur in a breath; delay is fatal. Such people ignore life and death. Others suggest: "This is a deficiency syndrome; why not tonify? Quickly administer 7-8 fen of Ginseng Radix et Rhizoma (Renshen), controlled by Qingpi (Aurantii Fructus Pericarpium Viride) and Chenpi (Aurantii Fructus Pericarpium), so it will be harmless." They fail to see that this nominal tonification lacks substance. Such trivial measures offer no security against danger, and relying on simultaneous dispersal and tonification merely hinders oneself. These are people who do not grasp weight and measure. Even when someone proposes urgent tonification, it is usually only when the condition is critical: "Tonify quickly!" But waiting until the horse reaches the cliff edge is too late. If tonification fails, they will claim: "Those who use Ginseng for Shanghan always die." Thus, the belief in "no tonification" strengthens, confusion deepens, and even eloquent speakers like Yi Qin could not refute it. I have witnessed countless victims of this error and feel profound sorrow; I must argue against it.

Pathogens of Shanghan enter from outside, but severity depends on the strength of the host's Qi. Strong hosts experience mild illness because pathogens cannot penetrate deeply. Weak hosts suffer severe illness because internal deficiency prevents self-defense. This is a struggle between exterior/interior and pathogen/upright Qi. Upright victory leads to survival; pathogen victory leads to death. In cases of pathogen excess and upright deficiency, failing to secure the root guarantees failure. Treating deficiency differs from treating excess. Tonification treats deficiency, not excess; why say it traps cold pathogens? Tonification supports the interior (Middle Jiao), not the exterior; why call it "closing the door to drive away thieves"? Even if invaders enter the hall, a weak host would flee, not close doors. If one can close doors, the host is strong. A strong host repels thieves; catching them is acceptable. Disease management mirrors human affairs: when upright Qi advances, pathogens retreat. This is called "internal support" or "expelling pathogens," not "closing doors." Consider Zhang Zhongjing’s use of Xiaochaihu Decoction (Minor Bupleurum Decoction), combining Ginseng Radix et Rhizoma (Renshen) and Chaihu (Bupleuri Radix); or Li Dongyuan’s use of Buzhong Yiqi Decoction (Decoction for Replenishing the Middle and Augmenting Qi), combining Renshen, Baizhu (Atractylodis Macrocephalae Rhizoma), Shengma (Cimicifugae Rhizoma), and Chaihu. One disperses pathogens, the other secures the root. This integrates expulsion within consolidation and consolidation within expulsion. It is neither trapping nor locking doors. The harm of a single false statement is infinite; no mediocrity exceeds this. Since I cannot spread this orally everywhere, I write this treatise. May anyone who propagates my views and saves a life accumulate merit greater than reciting the Amitabha Sutra countless times.

Xu Donggao said: Zhang Zhongjing of the Han Dynasty wrote *Shanghan Lun*, focusing on external injuries. The secret of protecting Spleen-Stomach Yuan Qi is rarely known by modern physicians. Observing Shaoyang syndromes, Xiaochaihu Decoction uses Renshen to prevent pathogens from entering the Three Yin channels, anticipating slight Spleen-Stomach deficiency allowing pathogen invasion. Renshen and Gancao (Glycyrrhizae Radix et Rhizoma) consolidate the Spleen-Stomach to fill Middle Qi, showing that external injuries often involve internal causes. Formulas like Lizhong Decoction (Regulate the Middle Decoction), Fuzi Decoction (Aconite Decoction), Huanglian Decoction (Coptis Decoction), Zhi Gancao Decoction (Honey-Fried Licorice Decoction), Wuzhuyu Decoction (Evodia Decoction), Fuling Sini Decoction (Poria and Four Reversal Decoction), Guizhi Renshen Decoction (Cinnamon Twig and Ginseng Decoction), Renshen Baidu Decoction (Ginseng and Toxin-Expelling Decoction), Renshen Baitu Decoction (Ginseng and White Tiger Decoction), Yangdu Shengma Decoction (Yang-Toxin Cimicifuga Decoction), and Da Jianzhong Decoction (Great Construct the Middle Decoction) all utilize Renshen and Baizhu for external infections. This reveals Zhang Zhongjing’s prescribing genius. Some claim he excelled in external injuries but ignored internal ones; this misunderstands him completely. Why do current physicians ignore the principle of Yuan Qi? Clinging to Wang Lun’s erroneous warning against Renshen in *Zazhuo* (Miscellaneous Writings), they stubbornly prefer bitter-cold herbs, attacking disease symptoms rather than roots, causing unnecessary deaths. Patients’ families hesitate between belief and doubt, delaying treatment until Yuan Qi exhausts itself, leading to inevitable death. Is this wise? In our time, population density increases while innate constitution weakens. People toil for fame and profit, risking fire and water, indulging in wine and lust, depleting true essence. Denying internal injury to Yuan Qi is unbelievable. Observing miscellaneous diseases, even mild aggressive treatments damage the Spleen-Stomach, sometimes causing death by starvation. This logic applies broadly.