Library

(All from the works of Xu Lingtai. Xu Lingtai, whose given name was Dachun, was a native of Wujiang, Jiangsu.)

On the Combination and Separation of Formulas and Herbs

Formulas (Fangji) and herbs (Yaowu) appear combined but are essentially distinct. Herbs absorb the Qi of Heaven and Earth, forming their unique natures, each possessing specific functions capable of altering the flow of Blood and Qi in the body to eliminate disease. This is the power of herbs. However, the nature of herbs differs from the human constitution. Upon entering the stomach and intestines, how can they act according to one's will to achieve efficacy? The Sages formulated formulas to regulate them. Some formulas are used for targeted attack, some for concurrent treatment of multiple conditions, some with herbs that assist each other, some that constrain each other, some that utilize each other, and some that suppress each other. Therefore, when prescribing based on the condition, even if the herbs are appropriate, if one or two herbs in the formula are irrelevant to the pathology, it is called "having a formula without proper herbs." This is like calligraphy: even if the brushwork is skilled, if the structure is inverted, or if the character forms are complete but the strokes are malformed, it cannot be called proficient writing. Thus, a skilled physician, viewing individual herbs, ensures none deviate from the pathology; viewing the whole formula, ensures no formula departs from ancient methods. Only then can they be applied; otherwise, it amounts to killing people. As for the methods regarding the size and odd/even combinations of formulas, these are detailed in the *Huangdi Neijing* (Yellow Emperor's Inner Canon), so there is no need to repeat them here.

On the Addition and Subtraction of Ancient Formulas

The intent behind the ancients' formulation of prescriptions was subtle, profound, and inconceivable. They carefully examined the pathology, differentiated the meridians, referenced herb properties, and weighed the dosages. Their accuracy regarding the treated diseases was impeccable. Thus, they did not need rare items or exotic techniques, yet stubborn and dangerous diseases often responded miraculously to these treatments. These were the formulas before the Han Dynasty. However, the diseases of the people are infinite. If a separate formula were created for every disease, when would it end? Therefore, the ancients employed the method of addition and subtraction. If the general nature of the disease is the same but the manifested symptoms differ, there is no need to establish a new formula. Instead, within the existing formula, adjustments are made based on the differing symptoms. For example, in the *Shanghan Lun* (Treatise on Cold Damage), Guizhi Tang (Cinnamon Twig Decoction) is used for Taiyang disease. If neck and back stiffness appears, Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Pueraria Decoction) is used. If wheezing occurs, Guizhi Jia Houpo Xingren Tang (Cinnamon Twig Decoction plus Magnolia Bark and Apricot Kernel Decoction) is used. After purgative therapy, if rapid pulse and chest fullness appear, Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction minus Peony Root Decoction) is used. If aversion to cold worsens, Shaoyao is removed and Fuzi Tang (Aconite Decoction) is added. This is still adding or subtracting single herbs. If Guizhi Mahuang Ban Ge Tang (Half-and-Half Cinnamon Twig and Ephedra Decoction) is used, it involves combining two formulas. If treating Ben Tun (Running Piglet syndrome), using Guizhi Tang with increased dosage of Guizhi (Cinnamon Twig) represents adjustment by weight. However, adding or subtracting one or two herbs usually retains the original formula's name but must explicitly state the added or subtracted herbs. If Shaoyao (Peony Root) is doubled in Guizhi Tang and Yi Tang (Maltose) is added, it is no longer called Guizhi Jia Yitang Tang but Jianzhong Tang (Middle-Building Decoction). Although the herbs are similar, the meaning has changed, so the name differs. The rigor of ancient methods was such. Later physicians, failing to understand this principle yet wishing to borrow the prestige of ancient formulas, would take one or two herbs from an ancient formula and label it as that formula. For instance, using Chaihu (Bupleurum Root) and calling it Xiao Chaihu Tang (Minor Bupleurum Decoction), unaware that the efficacy of Xiao Chaihu Tang lies entirely in Renshen (Ginseng Root); using Zhuling (Polyporus) and Zexie (Alisma Rhizome) and calling it Wuling San (Five-Ingredient Powder with Poria), unaware that the subtlety of Wuling San lies entirely in Guizhi (Cinnamon Twig). Removing key herbs, mixing in others, yet still labeling it as a specific formula, results in inefficacy. Not blaming themselves, they blame the disease or the herbs, claiming ancient formulas cannot treat modern diseases. Alas! Even if the disease is correctly identified, using fragmented and disjointed ancient formulas cannot yield efficacy. Consequently, people warn that ancient formulas are difficult to use, completely missing the essence of ancient formulas, thus being not only useless but harmful. So, what should be done? One should say: If the pathology matches an ancient formula, use it entirely. If there are additional symptoms, apply additions and subtractions according to ancient methods. If it does not fully match, follow the principles of ancient formulas: remove inappropriate herbs from the ancient formula, retain beneficial ones, and discard harmful ones, ensuring every herb corresponds to the symptoms. Naturally, this will not violate ancient methods, and the prescription will yield miraculous effects.

On Ancient and Modern Formulas

Modern formulas number in the hundreds of millions, yet few deserve the title of true formulas. In antiquity, the Sages formulated prescriptions by exploring the origins of pharmacology, recognizing specific herb properties, investigating the compliance or opposition of flavors and aromas, assessing the preferences and aversions of Zang-Fu organs, coordinating the relationships between Sovereign, Minister, Assistant, and Envoy herbs, exploring disease sources, and tracing meridians. Their thinking was far-reaching, and their meanings profound. With merely three or four ingredients, their applications were infinite. The wisdom of the Sages was truly on par with Heaven and Earth, beyond the reach of ordinary human thought. From antiquity to the present, passed down through thousands of sages, never lost or abandoned. It was Mr. Zhang Zhongjing who clarified usage, posed questions and difficulties, and noted indicated symptoms. His *Shanghan Lun* (Treatise on Cold Damage) and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) gathered the achievements of thousands of sages to inherit the past and initiate the future. Ten thousand generations could not exceed its scope. These are called ancient formulas, immortal alongside the *Neijing*. Famous experts before and after him, such as Cang Gong, Bian Que, Hua Tuo, and Sun Simiao, each had their own lineages, slightly different from Zhongjing's, yet still forming their own schools. However, they could not claim direct lineage from the *Lingshu*, *Suwen*, and *Shennong Bencao Jing* as the orthodox branch. Gradually, habits persisted; every book written involved creating hundreds of new formulas. In the Tang Dynasty, although doctors used a wide variety of herbs, they lacked spiritual transformation. By the Song Dynasty, doctors barely understood herbs; their formulas were rigid, solid, and superficial. The Yuan Dynasty boasted great prosperity, with various sects displaying personal views. The Ming Dynasty merely followed Yuan remnants. Today's physicians constantly speak of ancient formulas, not realizing that "ancient formula" refers to different things. If referring to pre-Qin formulas, few exist outside those transmitted by Zhang Zhongjing. If referring to Song and Yuan formulas, very few are worthy of emulation, while many are irregular and absurd; how can they be regarded as canonical? If referring to all formulas before the Ming Dynasty, there are millions. With only hundreds of commonly used herbs, millions of formulas have been created by randomly picking a few ingredients. Why insist on naming them specific formulas? Alas! How rigorous were ancient formulas, and how casual are modern ones. Among them, there are ingenious methods and subtle herb uses that may supplement the ancients' omissions and serve as references. However, their fundamental laws cannot compare to the ancients. Moreover, some formulas violate classics and laws, causing harm. Where are the learned scholars to select and preserve the best, compile the greatest collection, delete the inappropriate, and accomplish this great task for millennia? I have the ambition but lack the time.

On the Size of Ancient and Modern Formulas

Those discussing ancient formulas today suspect that ancient dosages were too heavy, arguing that ancients had robust constitutions and thus required heavier medication. This is baseless talk born of ignoring historical evidence. Measures of volume and weight varied across dynasties. From the Three Dynasties to the Han Dynasty, compared to today, they were only about one-tenth to one-fifth the size. (I have personally seen a Han Dynasty bronze measure of six Sheng, which holds the equivalent of today's 1.2 Sheng.) For example, Guizhi Tang is a large dose for Shanghan. It contains Guizhi (Cinnamon Twig) 3 Liang, Shaoyao (Peony Root) 3 Liang, and Gancao (Licorice Root) 2 Liang, totaling 8 Liang. Eight times eight equals sixty-four, converting to 1.6 Qian as one dose, divided into three servings. Thus, one serving is only about 0.53 Qian in modern terms. Other formulas with more ingredients might double the weight, but rarely exceed this significantly. Modern doctors use over ten herbs, each 1-2 Qian or 3-4 Qian, totaling over 3 Liang per dose. Ignorant fools use 4-5 Liang per dose. Recent practitioners even use 8 Liang of Shudi (Rehmannia Root Preparata) per dose, which is utterly improper. The same applies to pills and powders. For instance, ancient Wumei Wan (Mume Pill) prescribed twenty pills the size of paulownia seeds per dose, whereas today's equivalent is only 4-5 Fen. Modern pill doses range from 3-4 Qian to 7-8 Qian. Powder doses using a square-inch scoop (Fangcunbi) were only 6-7 Fen today, but now people take 3-4 Qian. Ancient dosages were never heavier than today's. (According to *Zhouli*, the food allowance for the people was four Fu per person per month. A Fu is 6.4 Dou. Four Fu total 2.5 Dou 6 Sheng, meaning daily intake was over 8 Sheng.) Yet rumors spread that dosages have increased over time. This absurdity alone suffices; imagine the depth of the error. Lacking the ability to think historically and without master teachers, it is no wonder discussions are so frivolous.

On the Method of Decocting Herbs

The method of decocting herbs deserves deep study. Efficacy depends entirely on this. Improper cooking of poultry, fish, or meat can harm humans, let alone medicinal herbs... [Text gap inferred] ...then add remaining herbs to decoct together. This is the method where sovereign herbs are decocted first. However, Guizhi Tang does not require pre-decocting Guizhi; drinking hot porridge after administration to boost efficacy is another method. For Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction), Ganlan Shui (Agitated Water) is used to pre-decoct Fuling. For Wuling San, it is taken with rice water, followed by drinking warm water. Xiaojianzhong Tang requires decocting five herbs first, straining, then adding Yitang (Maltose). Dahuang Chaihu Tang is decocted until reduced by half, strained, and then re-decocted. Chaihu Jia Longgu Muli Tang is boiled for twenty boils. There are countless decoction methods, each with specific meanings. Generally, dispersing and aromatic herbs should not be decocted long to preserve their raw, dispersing qualities. Tonifying and cloying herbs should be decocted longer to achieve cooked, accumulating properties. This is the general rule. Thus, even if the formula is correct, improper decoction makes the medicine ineffective in curing the disease. Modern physicians often do not know this, let alone patients.

On the Method of Taking Medicine

Whether a disease is cured depends not only on the formula matching the pathology but also on the method of administration. Even if the formula is correct, improper administration yields no benefit and may cause harm. This must be known. For dispersing agents intended to expel wind-cold externally, they must be taken hot and covered warmly to allow the medicinal Qi to circulate in Ying and Wei, spreading heat to induce sweating and expel wind-cold. If taken lukewarm, sitting in drafts, or lying quietly, the medicine remains in the stomach and intestines, failing to induce sweat. Wind-cold will not dissipate secretly, and Ying Qi will be damaged by the wind-dispersing herbs. For purgative agents intended to resolve stagnation and guide it downward, they must be taken on an empty stomach in one dose to stimulate the medicinal action and push turbidity out via stool. If taken with food, old and new contents mix, medicinal Qi conflicts with food, Qi becomes unfocused, and food stagnation worsens. Therefore, texts like *Shanghan Lun* specify various administration methods: hot, warm, cool, cold, slow, fast, large amount, small amount, early, late, full stomach, empty stomach. Some suit decoctions better than powders, powders better than pills, pastes better than pills. Regarding light/heavy, large/small, upper/lower, exterior/interior, each treatment has its appropriate method. These are fixed truths. Deep contemplation of their meaning will yield understanding.