Library

Wang Haicang stated: "Currently, there are established principles for treating *Shanghan* (Cold Damage) and ready-made prescriptions for treating *Zabing* (Miscellaneous Diseases). While this is correct, it is incomplete. I argue that treating *Zabing* also requires principles, and treating *Shanghan* also utilizes prescriptions. A prescription is a principle; a principle is a prescription. Is there any difference? The key lies in fully comprehending the domains of meridians, exterior-interior relationships, and zang-fu organs. How could there be two distinct systems? It is merely because the intellectual capacity of later generations fell short of the ancients that *Shanghan* and *Zabing* were divided into two categories. Consequently, some excel in one but lack in the other, while others excel in the latter but lack in the former. When the state selected officials by dividing them into seven departments, scholarship became increasingly superficial with specialization, and technique became increasingly crude with narrow focus.

Let us discuss these two departments. *Shanghan*, entering from the exterior to the interior, should be treated by addressing the exterior first and the interior subsequently. *Zabing*, originating from the interior and manifesting externally, should be treated by addressing the internal cause first and the external manifestation subsequently. If the interior and exterior conditions are unrelated, only the primary disease should be treated. The method remains essentially the same; why must they be divided into two? Generally, the pathology of *Zabing* does not depart from the Exterior (*Biao*), while the pathology of *Shanghan* does not depart from the Interior (*Li*). For conditions at the Exterior, sweating methods are used; for conditions at the Interior, purgative methods are used; for conditions in the Middle, harmonizing methods are used. This is an unchangeable principle. The cold, heat, warm, and cool properties of medicines are contained within these methods.

As for departments such as Wind diseases, Obstetrics, Sores and Ulcers, Swellings, and Pediatrics, each has become a specialized field, which explains why their medical skills appear shallow and crude. Those who know symptoms but not pulse diagnosis, or know herbs but not the source of disease, do not possess true knowledge or comprehensive understanding. Familiarity through hearing and seeing leads to habitual adherence to flawed classics, resulting in long-term errors. When treatment coincides with the condition, the illness resolves; when it does not coincide, the illness worsens. One may have a slight understanding of what has been seen and heard, but knows nothing of what has not. This approach of inheriting without innovating falls far short of the ancient sages. Alas! Is human intellectual endowment limited by Heaven? Truly pitiable! Mediocre practitioners, driven by livelihood and verbal disputes, view study as an enemy, regard jealousy as capability, ruin lives without remorse, act cruelly ignoring moral retribution, and neglect heavenly principles. Is this due to educational failure, the influence of the times, or the misfortune of patients themselves?

According to records: Zhang Zhongjing of the Han Dynasty expanded upon the *Neijing* (Inner Canon) regarding *Shanghan* pulse and syndrome theories, establishing laws. Although based on syndrome transmission, it remained rooted in immediate-onset *Shanghan*. In the Song Dynasty, Li Donggan argued that times had changed and established new prescriptions using formulas like *Shensu Yin* (Ginseng and Ephedra Decoction) and *Huoxiang Zhengqi San* (Agastache Powder for Regulating Qi), thereby neglecting immediate-onset *Shanghan*. This caused common people to often misunderstand Zhang Zhongjing’s intent. Furthermore, dividing *Shanghan* and *Zabing* into two categories means that those specializing in *Shanghan* cannot fully grasp its variations, and those specializing in *Zabing* cannot broadly recognize its patterns. This leads to erroneous teaching and patient misfortune, causing regret.

Alas! Zhang Zhongjing’s expansion of the *Neijing*’s great methods was an infinite benefit, yet people failed to understand its examples. Three hundred methods were prepared to cover the transmission of immediate-onset *Shanghan*. The Song physicians discussed 'Seasonal Qi' variations, which were not true *Shanghan*; thus, their prescriptions were few. Diseases entering from the exterior involve Wind, Cold, Summerheat, and Dampness; among these, transmitted cases are generally mild *Shanghan*. Diseases originating from the interior involve Seven Emotions; among these, deteriorated cases are not severe *Shanghan*. Hence, distinctions in severity led to division.

Generally, students must distinguish between external invasion and internal injury during diagnosis, assess the severity of Exterior-Interior in *Shanghan*, and identify differences in pulses and syndromes between *Shanghan* and *Zabing*. The treatment principles for *Shanghan* and *Zabing* are not different. They are 'not different' because *Zabing* stays at the Exterior and *Shanghan* stays at the Interior. They differ in that *Shanghan* moves from Exterior to Interior, while *Zabing* moves from Interior to Exterior. Treat external invasions following Zhang Zhongjing’s methods; treat internal injuries following Li Dongyuan’s methods. Expand Six Qi theory into prescriptions; integrate *Zabing* through various schools. Ten thousand methods return to one mind; one mind penetrates ten thousand methods. Avoid gaining one aspect while losing another, preventing criticism from the world for splitting disciplines and lacking broad insight.