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Contemporary with Yun Tieqiao, who also fiercely criticized the Ye Tianshi school, was Zhang Shanlei (1873–1934). Zhang, whose given name was Shouyi, was from Jiading, Jiangsu. He was enthusiastic about Traditional Chinese Medicine (TCM) education. While teaching at the Zhejiang Lanxi TCM Specialized School, he compiled his own textbooks, emphasizing practicality, and produced numerous works, approximately twenty in total. Among them, *Zhongfeng Jiaozhun* (Corrected Explanation of Wind Stroke) and *Yangke Gangyao* (Outline of Surgery) had a certain influence in the medical community. His book *Shiwenbing Gjin Yian Pingyi* (Commentary on Ancient and Modern Medical Cases of Damp-Warmth Disease) was primarily written because he felt that Wu Jutong’s *Wenbing Tiaobian* (Systematic Classification of Warm Diseases), regarding damp-warmth, although appearing "clearly organized and logically sound," was always "speculative and illusory." He feared that "adhering to rigid rules to treat living patients would be like forcing a square peg into a round hole, causing significant harm through misdiagnosis." Therefore, he selected medical cases, traced their origins, and wrote this book to establish a standard for clinical experimentation for students. Criticisms of the Ye school are visible throughout the text. For instance, in commenting on Li Gong’s treatment of Patient Zeng, he stated: "Delirium and coma essentially belong to heat scorching the brain marrow and disturbing the nerves." "If physicians of the Ye school encountered this, they would certainly say it is retrograde transmission to the Pericardium (Xinbao, 心包 - the protective membrane surrounding the heart), and would readily prescribe formulas such as Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), Xuanshen Zhimu Maidong Tang (Scrophularia, Anemarrhena, and Ophiopogon Decoction), or Niuhuang Zhibao Dan (Calculus Bovis and Precious Treasure Pill). This would lead to the situation described by Su Tan: 'preventing spasms and convulsions, preventing external closure and internal collapse,' yet inevitably resulting in spasms, convulsions, closure, and collapse, responding instantly to calls. Eight or nine out of ten famous physicians of that time were like this." Furthermore, after commenting on the case of Tian Zhixiang, he said: "...The mental state has already become confused, and the brain nerves have been scorched. Li Quan’s statement that 'heat enters the Ying (Nutritive) level and collaterals, invading the Palace City of the Heart Master' is still the deceptive talk of the Ye school. Today, we know this is just empty jargon; there is no need to waste ink on it." In another case, the initial diagnosis by Physician Jia on September 15, Bingyin year, in the commentary following Physician Bing’s eighth diagnosis, he believed: "The current manifestations are clear evidence of heat pathogens filling the Sanjiao (Triple Burner, 三焦 - the system of fluid metabolism and energy distribution) and deeply scorching Yin fluids. To come up with the concept of 'nourishing Yin' at this stage is another brilliant but deadly trick of the Ye school." He stated that these prescriptions "have nothing to recommend them, but I will preserve them and discuss their errors in detail to warn beginners, so they may be alert. This is also a method." From these commentaries, it can be seen that his theoretical stance aligns with Lu Jiuzhi. This corroborates the view that "Since Ye’s *Wenre Lun* (Treatise on Warm Heat) proposed the eight-character outline of 'first attacking the Lung, then retrograde transmission to the Pericardium,' people came to believe that warm diseases either affect the Lung or the Heart, never both simultaneously. They neglected the most common and important syndromes of the Yangming channel. Upon seeing coma, they invariably treated from the perspective of the Pericardium, making it customary to indiscriminately administer complex drugs such as Zhibao Dan (Precious Treasure Pill), Xihuang Wan (Rhino-Horn and Musk Pill), Shengdi (Rehmannia Root), and Xuanshen (Scrophularia Root), aiding tyranny until the condition became incurable."

Thus, the faction criticizing and rejecting the Ye-Wu (Ye Tianshi and Wu Jutong) school, represented by Lu Jiuzhi, Yun Tieqiao, and Zhang Shanlei, had basically formed. Through academic debates with the Ye school, this faction consolidated, deepened, and expanded its influence, leaving a lasting legacy.

Analysis of Trends

III. The Period of Novel Refutation of the Ye School

After Yun Tieqiao, academic debates became entangled with sectarian attacks, becoming an evil habit in the TCM community that has not yet been fully eradicated. However, academic questioning and refutation continued to develop in depth.

It was not until Zhu Weiju from Shanyin emerged that new perspectives appeared in the criticism of the Ye school. For example, he refuted the theory that warm pathogens cause warm diseases, integrating Chinese and Western medicine, and voicing opinions previously unexpressed, thereby touching upon the very foundation of the Ye school’s theories. Zhu practiced medicine early in Chengdu, where he was a famous physician in Sichuan, and later moved to Shanghai, establishing a unique style. He formed the Zhu School, characterized by warming and tonifying methods, and was publicly recognized by the TCM community as a capable successor to the lineage of Zhang Zhongjing.

Zhu first arrived in Shanghai in 1927. According to his own account: At that time, most physicians in Shanghai belonged to the Ye school. Because his medical style differed, he initially dared not practice recklessly. "So, with humility, I waited for consultations under the guidance of a famous physician surnamed Zhu for three months. I deeply admired his unpredictable ingenuity and divine ability to predict changes. However, patients often progressed from mild to severe conditions and died. Physicians predicted the changes step-by-step but could not save them. Treatments ranged from acrid-cool methods to release the exterior, sweet-bland methods to drain dampness, to penetrating heat and transforming Qi, clearing the Ying level and dispersing blood stasis; from ventilating and transforming damp turbidity, nourishing Yin and clearing heat, to washing away phlegm and opening the orifices, and calming liver wind. Physicians achieved each step but could never stop the progression or save lives. Thus, feeling lost, I silently realized that the reason famous physicians gain fame lies in predicting disease and recognizing changes, not in desperately trying to save lives against inevitable decline." Consequently, Zhu was greatly dissatisfied with Ye school physicians. He fiercely criticized this malpractice: "Physicians of that time prescribed medicines valuing lightness and subtlety as popular, and cold/cool properties as safe. They exaggerated pathological changes to shift blame, feigned modesty, and displayed excessive caution. Medications were kept light, techniques refined. They showed sympathy, asking about cold and warmth. If successful, they claimed credit; if failed, they blamed fate. This could deceive women and children and astonish the vulgar, but how could it bear the responsibility of healing?" He further said: "Vulgar physicians of that era habitually used light and clear herbs. By luck, they succeeded, merely prolonging life. Often, diseases that could heal without medication were dragged out session by session, until both pathogen and healthy Qi were exhausted. They stole heaven’s merit for themselves; they are all sinners." Criticizing Ye school physicians with such wording truly reflected the legacy of the Yun school. However, Zhu’s attacks stemmed from indignation, as members of the Ye school at that time excluded dissenters inappropriately. For example, in 1929, the younger brother of Patient Xu suffered from a severe infectious syndrome. Initially treated by a Ye school physician who diagnosed "heat entering the Pericardium" and primarily used Qinggong Tang (Clear the Palace Decoction), the treatment was ineffective. The family then invited Zhu. Zhu prescribed Ephedrae Herba (Mahuang, 麻黄), Cinnamomi Ramulus (Guizhi, 桂枝), Zingiberis Rhizoma (Ganjiang, 干姜), and Aconiti Lateralis Radix Praeparata (Fuzi, 附子). After one dose, there was no improvement. Anxious, the family invited a famous Ye school physician, who claimed Zhu had caused fatal mismanagement and refused to treat the patient. In grief, the family begged Zhu to return. Expressing resentment towards Zhu, Zhu, after understanding the situation and relying on his rich experience and courage, took full responsibility. He did not change the prescription a single character. After taking six doses, the patient recovered (this incident is detailed in *Shanghan Zhinan*). From this example, it can be seen that members of the Ye school, due to blind faith in their own theories, could rashly slander other doctors. Zhu’s indignant words in his writings in response to such attacks are understandable. However, times have changed. If physicians continue to attack each other due to differing academic views, it will only deepen sectarian prejudices and foster clique mentality, harming the revitalization of TCM. This is a point worthy of our attention today.

According to *Wenbing Mingli*, during Yun Tieqiao’s time, many contemporary physicians "worshipped Tianshi [Ye Tianshi] as the Medical Sage, believing that Jutong’s [Wu Jutong’s] *Wenbing Tiaobian* could stand shoulder-to-shoulder with Zhongjing’s *Shanghan Lun* (Treatise on Cold Damage)." This shows that not only was Zhang Zhongjing worshipped as an idol, but Ye Tianshi was also revered as such. Therefore, Jiang Chunhua senior said, "We should not worship Ye as an idol, nor regard his experience in treating warm diseases as the pinnacle." This is undoubtedly correct. On this issue, Zhu’s attitude of not blindly following authority is commendable. Zhu’s use of five stages instead of the Six Channels demonstrates that he esteemed Zhongjing’s theories without being bound by them. Regarding Ye Gui, he said: "Tianshi was also a human. Humans all possess wisdom. How do we know that modern people are inferior to ancients?" Of course, this sounds arrogant to those who worship Ye as the Medical Sage. But Zhu believed: "Theories evolve continuously. What was correct yesterday may be wrong today. The younger generation is to be feared; how do we know future generations will not surpass the past?" He also said: "If one can integrate Chinese and Western medicine and explore truth, once understood, it becomes clear as day, like standing atop Mount Tai watching the sunrise, with myriad vistas. The scholars of the Jin and Yuan dynasties are merely floating clouds beneath one's feet." Such insights are unimaginable to those clinging to preconceptions, rejecting new knowledge, worshipping Zhang Zhongjing or Ye Tianshi as sages, bowing before ancients, and letting existing knowledge bind their minds, unable to accept different opinions.

Among Zhu’s medical writings, *Shanghan Zhinan* (Difficult Questions on Cold Damage) has high academic value and contains many novel insights. The chapter "Differentiation between Taiyang Cold Damage and Warm Diseases" is specifically dedicated to refuting and criticizing Ye’s theories. Generally, Zhu believed that the Ye school’s theories should not be followed blindly. *Wenre Lun* has many flaws, and Wu Jutong, Wang Mengying, and others fueled the fire, claiming that Ye’s warm diseases could rival Zhongjing’s cold damage. In reality, there are countless contradictions and errors.

*Shanghan Zhinan* was dictated by Zhu and recorded by his disciple Chen Susheng. It was written in 1944 and published in 1950. It is a monograph discussing exogenous febrile diseases in the form of teacher-student dialogues. The writing is fluent, the reasoning profound, and it incorporates Western concepts, offering many creative views. Unfortunately, only 2,000 copies were printed, and it is rarely circulated today. (A copy is held in the library of the Shanghai Association of Traditional Chinese Medicine.)

Chen Susheng was originally a practitioner of contemporary formulas. He engaged in heated debates with Zhu, eventually submitting after several rounds of argumentation, becoming a disciple, and ultimately inheriting Zhu’s core teachings. He became a representative of the Zhu school and authored *Wenre Guankui* (Peering into Warm Heat, internally printed), which is also an outstanding work. Mr. Chen is still alive today.

Another famous pediatrician in Shanghai, Xu Xiaopu, was originally a practitioner of contemporary formulas. Later, when his son Boyuan fell critically ill, renowned Ye school physicians and Western doctors in Shanghai were at a loss. After Zhu took charge and cured him, Xu was influenced and changed his medical style, becoming a prominent figure in the Zhu school. His sons, Boyuan and Zhongcai, studied under Zhu. Professor Xu Zhongcai currently teaches at the Shanghai University of Traditional Chinese Medicine. There are still many living disciples of the Zhu school among famous physicians in Shanghai, such as Jiang Keming, Wang Shaoji, and Wang Jiufeng.

Contemporary with Zhu, who also vigorously criticized the Ye school, was Kong Qinglai (?–1816? - Note: Dates likely reversed or typo in source, usually late Qing/Republic era figures lived later, but sticking to text: 1816-?). Kong, whose courtesy name was Airu, was from Xiaoshan, Zhejiang. He passed the Xiucai examination in 1902, went to Japan to study at Keio University, obtained a Ph.D. in Chemistry, and returned to China. He was first employed by Commercial Press to edit *Chemistry*. He was a poet and a member of the Nanshe society. Due to poor health, he later devoted himself to medicine. Modern famous physician Chen Daolong was his student. In 1929, while teaching at the Zhejiang TCM Specialized School, he published medical essays such as *Zhongfeng Zhenleibian* (True Classification of Wind Stroke) and *Jindai Yipai Lun* (Discussion on Modern Medical Schools) in the *Alumni Annual*. He highly respected Xu Lingtai but severely criticized Wu Tang. In *Jindai Yipai Lun*, he said: "Xu possessed innate talent, lofty morality, intelligence, integrity, and outstanding character, talent, and learning, surpassing ages past. He inherited the orthodox tradition and inspired future generations, embodying the spirit of the nation. He is truly the number one person in centuries." He heavily disparaged the Ye school, saying: "The fool Wu Jutong was absurdly ridiculous, shameless, stealing others' saliva to write *Wenbing Tiaobian*. He gained fame locally, but his learning was inconsistent—sometimes clear, sometimes obscure, sometimes connected, sometimes disconnected. He was unworthy, and his theories were unworthy of record. During the end-times disaster, his book became popular. Ignorant people, finding it simple and easy to learn, blindly worshipped it, treating it as a secret imperial library text, claiming that the ultimate truths of Qibo and Huangdi were contained therein. Patients rushed to it, and foolish physicians became increasingly arrogant and haughty, viewing patients as nothing." Kong even said: "The disasters of war last only ten years, but the calamity of Jutong will last a hundred years and not cease." Thus, he cursed Jutong as a "scum of the medical gate" and believed the spread of his learning was a curse on the people. To denounce his theories, he specially wrote *Jutong Fahui* (Elucidation of Jutong). Additionally, he attacked Wang Mengying, saying: "At the same time, there was Wang Mengying, who wielded pen and ink, appearing plausible but actually incorrect. Compared to Jutong, he seemed slightly better, but it was merely the difference between fifty paces and a hundred steps." Dissatisfied with Mengying’s frequent references to Yin deficiency and cold/cool medications, he wrote *Mengying Wendi* (Questions and Answers on Mengying) to refute him, believing that his plausible-but-wrong arguments misled people deeply, though he was unaware of his own errors. Kong also believed that although Lu Jiuzhi’s criticism of the Ye-Wu schools stood out like a crane among chickens, the force was insufficient, and the effect was minimal. Due to the highbrow nature of the critique and few followers, he lamented, "Sighing that the remaining wind has vanished, pained that there is no successor." Hence, he wrote the aforementioned two books. However, since they were not printed and only circulated in manuscript form, their influence was limited. Additionally, Kong authored *Zhenyu Tongyan* (Painful Words from Diagnosis Rest), the content of which is unknown.

In the magazine *Yijie Chunqiu*, Senior Xiong Liaosheng, in a letter to Yu Wu Yan, stated based on his treatment experience that using Ye school herbal methods to treat damp-warmth yields poor results. Senior Xiong is also a veteran figure in the modern medical field.

The famous modern thinker Zhang Taiyan also held a critical attitude toward the Ye school theories. While lecturing at the Hangzhou TCM Specialized School, he criticized the Ye school, saying: "The stream of the modern Ye school, before even explaining the symptoms, first expands on Five Elements discourse, which is simply slick and slippery talk!" Actually, Ye’s case records were relatively plain. Although he mentioned the Five Elements frequently, he rarely indulged in elaborate discussions. Later practitioners of Ye’s school failed to grasp the essence, focusing merely on the literal meaning and embellishing with Five Elements talk, akin to the fable of the man from Handan who went to learn walking and forgot his original way. This was indeed a reason for Zhang’s criticism. However, Zhang held a critical attitude toward the Five Elements theory itself, hence his remarks. Actually, Zhang’s complete denial of the Five Elements was incorrect. But Zhang’s discussion on damp-warmth offered a novel criticism of Ye and Wu, pointing out the discrepancy between name and reality ("hanging a cow's head but selling horse meat"). He spoke what predecessors had not, with profound language. He pointed out: "The term damp-warmth first appeared in *Nanjing* (Classic of Difficult Issues), but its symptoms were not recorded. It was supplemented in *Maicheng* (Pulse Classic). Subsequently, *Huo Ren Shu* and *Benshi Fang* used it as a basis. However, later generations forcibly applied the name 'damp-warmth' to diseases with completely different pulse and symptom presentations. Ye Gui initiated this, and Wu Tang followed. Public opinion became uniform and unbreakable. While treatments for diseases may differ between ancient and modern times, if disease names are determined by symptoms, one cannot violate antiquity and arbitrarily change them. The damp-warmth defined by Ye and Wu can be called 'hanging a cow's head but selling horse meat.'" This argument provided great inspiration for later criticisms of the Ye school. In the criticism of Ye school theories, such novel arguments were rare after Lu Jiuzhi and Yun Tieqiao. Because Zhu Weiju, Zhang Taiyan, and others refuted the Ye school without adhering to the old arguments discussed by Lu and Yun, I call this the period of novel refutation of the Ye school.

IV. The Period of Foundational Consolidation of Criticism of the Ye School

Lu Jiuzhi’s criticism of the Ye school was relatively intense in wording. Yun Tieqiao’s major debate with the Abolitionist Faction involved mutual insults, with the Cold-Warm controversy mixed in, stirring up a trend of mutual attacks. Even in the period of refuting the Ye school, bad habits persisted. However, subsequently, exclusion and attacks gradually shifted towards emphasizing reasoning, and the atmosphere of academic debate became somewhat more normal.

For example, Shi Yiren’s (1896–1966) discussion on Cold and Warm, although criticizing Wu Jutong and others, used balanced wording, focused on reasoning, and adopted a dialectical approach. There was no atmosphere of venting anger through defamation between the lines. Discussing academics in this manner is worthy of our emulation.