Academic Characteristics and Main Contributions of Li Shizhen Medicine
3.1Academic Characteristics of Li Shizhen Medicine
3.1.1Equal Emphasis on Medical Science and Medicinal Drugs
In Ben Cao Gang Mu, there are abundant medical dialectical thoughts. For instance, Eight Trigram are used to describe drugs and pulses. Li Shizhen’s medical thoughts also run through this book, such as the view of yin and yang, holism, constant change, image-number, and mingmen (life gate) theory, etc.
(1)The view of yin and yang in differentiating drugs and pulses
In Ben Cao Gang Mu and Bin Hu Mai Xue (Binhu’s Sphygmology), Li Shizhen makes elaborate explanations on the theory of yin and yang and a brilliant argument on differentiating yin and yang drugs before using them. He argues that some drugs belong to yang, but also contain yin, and vice versa. Besides listing ideas of Wang Haogu, Zhang Yuansu, and Li Gao, he also added his own views. For example, in Category of Waters, Ben Cao Gang Mu, he says: “Kan, the indicator of water... Its substance is pure yin, and its function is pure yang.” From the view of Zhou Yi (The Book of Changes), the sun is yang, the moon is yin, fire is yang and water is yin, so he thinks that water is pure yin in its substance. Still according to Zhou Yi (The Book of Changes), kan is yang in Eight Trigram. Therefore, its function is pure yang. Danshen/radix salviae miltiorrhizae/danshen root is red, bitter, its flavor is flat, so it’s a drug of yang within yin with the tendency of descending. Qianhu/radix peucedani/hogfennel root tastes sweet and pungent, its flavor is slightly flat. It’s a drug of yin within yang with the tendency of descending. Xixin/herba asari/herb of manchurian wild ginger has a thick flavor which produces heat. It’s yang within yang. Dijiang/mudderwater is produced in earth. It is yin within yin and can purge yang within yang. Dansha/cinnabaris/cinnabar is discovered in the hot south, formed in the li fire. Its property is yang and its function is yin. Therefore, it is red in color exteriorly but contains mercury inside. Its flavor is not hot but cold, indicating yin contained in the li fire. Its taste is not bitter but sweet, indicating earth contained in fire.
Li Shizhen cites the theory of yin and yang in Nei Jing (Internal Classic) to expound the relationship between yin and yang and body, property and flavor, and zang-fu organs. Its simple dialectical method is embodied more in the corresponding unified view of drug recognition.
Li Shizhen believes that drugs have seven emotions, which oppose and complement each other. He says: “Drugs have seven emotions... There are many mutual inhibition and opposition in ancient prescriptions. The emperor way is to use the drugs that reinforce and assist each other. The king way is to use the ones that are incompatible and counteract each other. The overlord way is to use the ones that inhibit and suppress each other. Using normal and abnormal methods to deal with problems is a strategy needing cautious thoughts.” The mutual promotion between drugs will exert a synergistic effect, but the opposition of drugs will counteract each other’s effect. Some diseases just need be antagonistic to be effective, that is, the incompatibility to a certain extent results in unexpected complement. He illustrates the idea in Zexie/rhizoma alismatis/rhizome of oriental waterplantain: “In Zhongjing Dihuang Pills, Fuling/poria/Indian bread and Zexie/rhizoma alismatis/rhizome of oriental waterplantain are used to purge the pathogenic qi of urinary bladder. The ancient doctors always used tonics together with the drugs that can purge pathogenic factors. When pathogenic factors go away, the tonics would function in a better way. It’s quite mysterious.” To use the tonics and drugs of purgation at the same time will remove the pathogen and make the tonics more effective. The relationship between opposites and complements is briefly explained.
In treatment, there is also the view that yin and yang are opposite and complementary. For example, he treats a febrile syncope and thinks that “... As yang qi cannot be spread outside, yin qi is not held in the inside; that is to say, there is a syncope. Then, with Dachengqi Decoction, the patient was cured when one dose was given.” (Author’s Notes, Volume 1, Ben Cao Gang Mu) Another treatment of the escape syndrome, “this syndrome is reflection of yin deficiency and yang exhaustion. Decoction of Renshen/radix ginseng/ginseng was stewed urgently. The patient took it immediately. At the same time, he was given moxibustion on the Qihai (CV6) with eighteen moxa rolls. Then his right hand could move. After another three moxa rolls, his lips and mouth could move slightly. Then he took a cup of Extract of Renshen/radix ginseng/ginseng. At midnight he took three more cups, and his eyes could move. After taking three jin1 of Renshen/radix ginseng/ginseng, he could talk and ask for porridge. When five jin was consumed, the dysentery stopped. After having ten jin, the patient was cured. If this syndrome had been taken as the syndrome of pathogenic wind and treated, it would have resulted in malpractice.” (Herbs, Volume 12, Ben Cao Gang Mu) These are numerous cases of syndrome differentiation based on yin and yang.
Li Shizhen also uses yin and yang theory to differentiate pulses in sphygmology. In his Bin Hu Mai Xue (Binhu’s Sphygmology), the pulses are labeled as yang and yin. Besides, according to the theory of “yang within yin” and “yin within yang”, pulses also fall into more detailed categories. The so-called “yang” pulses are floating, rapid, smooth, excessive, long, surging, tense, tremulous, running, knotted, and intermittent etc. The pulses labelled “yin” are deep, slow, cold, deficient, short, faint, moderate, soggy, weak, scattered, thready, hidden and so on. The pulses labelled “yin within yang” are smooth, hollow and wiry. “Yang within yin” is firm pulse. In addition, he uses yin and yang to explain the principal diseases of pulses. For example, the floating pulse indicates an exterior yang disease; the deep pulse indicates “an interior yin disease”; the slow pulse means “yang is invincible over yin, a qi-blood cold syndrome”; and the rapid pulse means “yin insufficiency and yang preponderance, which leads to agitation”. Others, such as “slippery pulse indicates the decline of yang original qi”, “full pulse indicates the excessiveness of yang fire” and so on. Almost for the 27 pulses, all related diseases can be analyzed on the basis of yin and yang concept.
(2)The holistic view of syndrome differentiation of drug use
The holistic view of medicine differentiation is related to the zang-fu organs and meridians of the whole human body, they cannot be separated. Therefore, sickness cannot be treated one-sidedly and whole conditions should be investigated. In addition to close relationship with the internal aspects, human body is also closely related to the external aspect-nature. The three aspects — heaven, earth and human — should be thought of as a whole. Li Shizhen’s thinking in this respect can be reflected in two points:
a)The unity of human and universe. Li Shizhen inherits the medical thoughts of “the correspondence between human and the universe” proposed in Nei Jing (Internal Classic). He says: “Human beings are produced on earth, so their qualities and characteristics are related to the qi of the mountains and rivers. One’s appearance and life span are all involved. Metals, stones, herbs and woods are influenced by the earth and water, not to mention human beings. If people rely on earth and water for their health, shouldn’t they be cautious about their choices?” The relationship between man and nature is emphasized. In terms of menstrual physiology, he took the tide and the moon as an example. He says: “Women are related to yin. Blood is a quite essential thing for a woman. Their blood echoes tai yin (the moon) and the tide. The moon waxes and wanes, the tide ebbs and flows, while women’s menstruation comes and goes monthly. Therefore, it is called yuexin (monthly letter), yueshui (monthly water), and yuejing (monthly experience). If women’s menstruation comes and goes monthly, it is regular. If it comes earlier or later, too much or too little, it is regarded as diseases.”
He also attaches great importance to the illness of seven emotions, emphasizing that “the external cause is in heaven, and the internal cause is in man. The climate changes can be yin, yang, windy, rainy, dark and bright; people have seven emotions: joy, anger, worry, anxiety, sadness, fear and fright.” Bin Hu Mai Xue (Binhu’s Sphygmology). He also puts emphasis on the combination of external contraction and internal injury while treating diseases. Like cholera, he points out that “damp-heat, cold-damp, internal injury caused by seven emotions, and external contraction caused by six qi,” thus internal causes and external factors are related.
In the medication aspect, Li Shizhen advocates that people should follow the pattern of qi in order to conform to the nature. He says: “In spring months, pungent and warm medicine should be added like Bohe/herba menthae/peppermint, Jingjie/herba schizonepetae/fineleaf schizonepeta herb and so on, in order to follow the ascending spring qi; in summer months, pungent and hot medicine should be added like Xiangru/herba elsholtziae/elsholtzia herb, Shengjiang/rhizoma zingberis recens/fresh ginger and so on, in order to follow the floating summer qi; in late summer, sweet-bitter, pungent and warm medicine should be added like Renshen/radix ginseng/ginseng, Baizhu/rhizoma atractylodis macrocephalae/rhizome of largehead atractylodes, Cangzhu/rhizome atractylodis/atractylodes rhizome, Huangbo/cortex phellodendri/bark of Chinese corktree and so on, in order to go with the evolving and consolidating qi; in autumn months, sour warm medicine should be added like Shaoyao/paeonia/poeny, Wumei/fructus mume/smoked plum and so on, in order to follow the descending qi; in winter months, bitter cold medicine should be added like Huangqin/radix scutellariae/baical skullcap root, Zhimu/rhizoma anemarrhenae/common anemarrhena rhizome and so on, in order to follow the sinking qi. This principle is called following the qi of seasons to maintain the natural harmony.”
For the pulse, he says: “The sky is less in the northwest, yang is south and yin is north, so the man’s cun (It is the pulse-taking sections, which is on the distal side where the tip of the physician’s index finger rests.) is strong and the chi (It is the pulse-taking sections, which is on the proximal side where the tip of the physician’s ring finger is placed) is weak, which is similar to the sky; the earth is less in the southeast, yang is north and yin is south, so the woman’s chi is strong and the cun is weak, which is similar to the earth.” This is also based on the view that human beings are closely related to the world.
b)Syndrome differentiation and treatment. Li Shizhen thinks that when treating a disease, a doctor needs to “know the symptoms and give the right prescription”, which means a doctor should give comprehensive analysis by the four examination methods, differentiate the syndromes wholly, and then confirm the treatment and give the prescription for the disease. For instance, “diarrhea” diseases contain kidney diarrhea, watery diarrhea and cold diarrhea, etc. For kidney diarrhea, broken bone, pig kidney can be used to tonify kidney to stop diarrhea; for watery diarrhea, Xiaoxuming Decoction can be used to raise yang to stop diarrhea; for cold diarrhea, Lagui Badou Pill can be used to expel cold to stop diarrhea. The treatment of amnesia is based on the deficiency of heart, while treating this, the doctor should differentiate phlegm and fire.
For drug use, it can be applied from a comprehensive perspective, but also has its characteristics. For example, deficiency, amnesia of old and middle-aged people caused by yang deficiency can be treated by Yinyang huo/herba epimedii/ epimedium herb; amnesia related to impaired spleen caused by anxiety can be treated by Longyan/alillus longan/longan pulp; to tonify kidney and treat forgetfulness, Xuanshen/radix scrophularae/figwort wood can be used; to nourish blood and tranquilize mind, Danshen/radix salviae miltiorrhizae/danshen root, Danggui/radix angelicae sinensis/Chinese angelica can be used. As for the treatment of excess, Huanglian/rhizoma coptidis/golden thread can “purge the heart fire and treat forgetfulness”; Niuhuang/calculus bovis/cow-bezoar is “to remove phlegm and heat accumulation and treats forgetfulness”; Maidongmen/radix ophiopogonis/dwarf lilyturf root, Mudanpi/cortex moutan/tree peony bark, Chaihu/radix bupleuri/Chinese thorowax root, Mutong/caulis aristolochiae manshuriensis/manshurian dutchmanspipe stem are used to “remove the stasis of cold and hot qi stuck in all meridians and collaterals, making people not forget.”
For amenorrhea, syndrome differentiation is applied according to different causes, and ten prescriptions are offered, which are significant for later treatment of amenorrhea. For miscarriage prevention, different drugs are used according to different symptoms to treat bleeding, abdominal pain, to guide and promote the circulation of qi, and so on. Among them, Huangqin/radix scutellariae/baical skullcap root, Baizhu/rhizoma atractylodis macrocephalae/rhizome of large-head atractylodes, Xuduan/radix dipsaci/himalayan teasel root, Sharen/fructus amomi/spiny amomum fruit, Ejiao/colla corii asini/ass-hide glue, Shudi/radix rehmanniae praeparata/prepared rehmannia root and other Chinese medicines are the common drugs used in the treatment of prefetal diseases in gynecology. In the treatment of oral disorder, he not only attaches importance to the relationship between the zang-fu organs and the oral cavity in pathology, but also pays attention to the direct damage to the oral cavity caused by the six evil factors, diet, and medicine and so on.
In a word, Li Shizhen shows the holistic view in the treatment of many kinds of diseases. Especially, from the angle of syndrome differentiation and treatment, he explains the related prescriptions and formulas based on the pathological mechanism of zang-fu organs in accordance with clinical practice, thus enriching the content of zang-fu syndrome differentiation.
(3)Concept of constant change based on regularity
Li Shizhen believes that everything in the world is constantly moving and changing and must not be viewed in isolation and stillness. He takes water as an example: “There are twenty-four solar terms in a year. One term marks half a month. The property of water varies with the change of term, responding to the change of climate. And it is not limited by territory.”
He also believes that the nature of the drug is changing with the passage of time and geographical change in nature. He appreciates Li Dongyuan’s principle of “applying the drugs according to the syndrome,” saying that when the doctor is diagnosing and treating diseases, “the correct compatibility of drugs that should correspond to the disease.” He admires Zhang Yuansu’s view that “the ancient times is different from the modern times, so the old prescriptions cannot necessarily cure the new diseases.” He praises that “Zhang Yuansu had profound interpretation of Chinese medicine, and deep understanding of the heaven and people. And he considered that the old prescriptions could not necessarily cure the new diseases, thus forming his own methods.”
Li Shizhen, when describing the ascending and descending properties of drugs, says: “Sour and salty drugs do not ascend, sweet and pungent do not descend, cold drugs do not float, hot drugs do not sink. That’s the nature of drugs.” This is about the regular property of drugs. “Use salty and coldness to lead the ascending drug, it’ll sink directly to the bottom of lower energize, while use wine to lead the sinking drug, it’ll float to the top.” This is about the changing property of drugs. For example, with different preparation of Xiangfuzi/rhizoma cyperi/nutgrass galingale rhizome, it has several applications. “If the crude drug is used, it functions on the chest and diaphragm and reaches the skin. If it is prepared, it functions on the liver and kidney and descends to the waist and feet. If it is stir-fried to turn black, it can stop bleeding. When soaked in children’s urine and stir-fried, it functions on blood system and tonifies the deficiency. Soaked in salt water and stir-fried, it functions on blood system and moistens the dryness. Stir-fried with salt, it tonifies the kidney qi. Soaked in wine and stir-fried, it functions on meridians and collaterals. Soaked in vinegar and stir-fried, it disperses accumulation. Stir-fried with ginger juice, it disperses phlegm and fluid retention.” He states: “Whether the drug is ascending or descending depends on the drug itself as well as the doctor,” which is enlightening to the following generations.
Li Shizhen always prescribes medicine according to the physiques and conditions of the patients. Due to different regions and patients’ physiques and the differences between ancient and modern, the same medicine should be applied differently. He says: “Both Wutou/radix aconiti kusnezoffii/root of kusnezoff monkshood and Fuzi/radix aconiti laterails preparata/prepared daughter root of common monkshood are toxic and should not be used unless the disease is urgent. But a small amount can be added into tonics to enhance their efficacy. Some patients just take only one qian-bi of these drugs and feel quite restless. But ancient people frequently use them in tonics. Is it because the physiological condition of ancient people was different from that of the present people?” Huanglian/rhizoma coptidis/golden thread was another example, he says: “In the late Han period, the yellow and fat Huanglian/rhizoma coptidis/golden thread produced in Sichuan was regarded as the best. In the Tang Dynasty, the one produced in Fengzhou was the best. Now, it is produced in Wu area and Sichuan, but the best was produced in Yazhou and Meizhou. It can be seen that the same drug can be regarded differently at different times.” For example, Rendong/caulis lonicerae/honeysuckle stem, “in ancient times, it was used as a principal drug to disperse the pathogenic wind, eliminate distention, and stop dysentery. But the following generations didn’t know the usage. People used it to eliminate swelling and detoxify skin sores. But ancient people didn’t mention such usage. From this, we can learn that theory changes from time to time and shouldn’t be taken as the same all the time.” As far back as the Ming Dynasty, it was not easy for Li Shizhen to treat the relationship of drugs and human body, time and space in such a flexible manner.
The treating methods of Li Shizhen are also flexible. Besides internal treatment, there is also external treatment. And the preparation and formula of drugs is rich and colorful, which reflects his concept of constant change based on regularity again.
(4)Postnatal view of paying attention to spleen and stomach
Li Shizhen lays great stress on the postnatal effect of spleen and stomach on human body. He agrees with Li Dongyuan’s theory of spleen and stomach. Attaching importance to reinforcing earth, he emphasizes spleen and stomach as the root of essential qi and points out their important role in ascending and descending the cardinals. Li Shizhen thus makes a great contribution to the development of spleen and stomach theory.
(5)The image and number concept when analyzing drug pulses
The thinking methods of observing objects and drawing analogous images are widely used in the theory of zang-fu organs in traditional Chinese medicine and in all aspects of therapeutic prescriptions. “Observing objects and drawing analogous images” are the important principles of understanding property of drugs and deciding prescriptions.
Drug classifications in Ben Cao Gang Mu take waters as the first category and rain water as the first one of the 1,897 kinds of medicine, the head of the drugs, which embodies the theoretical viewpoint of “nature produces water firstly.” In the categories of Waters, Fires and Earth, Li Shizhen used Eight Trigram images to describe the importance and function of water, fire and earth. For example, “Kan, the indicator of water... Its substance is pure yin, and its function is pure yang” in the Category of Waters. In the Category of Fires, Li Shizhen says, “the fire indicates the south, and the image of inflammation.” In the Category of Earth, Li Shizhen says: “Earth is the master of the five elements, the body of kun.”
In the Category of Stones, Li Shizhen states that Danshen/radix salvia miltiorrhizae/danshen root “is discovered in the red field, formed in the fire. Its substance is yang and its function is yin. Therefore, the external is red in color but contains true mercury. Its qi is not hot but cold, yin contained in the fire.” In the Category of Herbs, he says: “Gancao/radix glycyrrhizae/licorice root is red outside and yellow inside, which is the color of yin and yang. It’s thick in taste and thin in quality. It’s nourished by the virtue of earth. It harmonizes all the drugs in a prescription, that’s why it is regarded as ‘senior statesman’.” In these descriptions, quotations about Eight Trigram are used directly.
In Bing Hu Mai Xue (Binhu’s Sphygmology), Li Shizhen explains several main pulse images based on Eight Trigram. For instance, “floating pulse obeys the law of the sky, with the sign of floating upward. In Eight Trigram, it is gan; in season, it is autumn; in human body, it is lung.” “Deep pulse obeys the law of the Earth, with the sign of sinking downward. In Eight Trigram, it is kan; in season, it is winter; in human body, it is kidney.” “Surging pulse, in Eight Trigram, is li; in season, it is summer; in human body, it is heart.” “Moderate pulse, in Eight Trigram, is kun; in season, it is all four seasons; in human body, it is spleen.” “Wiry pulse, in Eight Trigram, is zhen; in season, it is spring; in human body, it is liver.”
(6)Neutralization theory and mingmen (life gate) theory
Li Shizhen believes that medication should be controlled, and dosage should be appropriate, neither excessive nor insufficient. This is about the standard of drug use.
In the aspect of drug use, different components and proportions of drugs should be strictly controlled. In addition to changing proportion with the season, deciding light or heavy formula in accordance with illness and patient’s physique, doctors should also pay attention to the principle of “things always reverse themselves after reaching an extreme and transform into each other”. For example, in Tingli/semen lepidii seu descurainiae/pepperweed seed, Li Shizhen says: “When the lung is overwhelmed by distended water retention, this drug is needed. But no more is used once water is removed. When it is not overdosed, how could it kill the patient? In Huai Nan Zi, Jingdaji/radix euphorbiae pekinensis/peking euphorbia root can remove water retention, and Tingli/semen lepidii seu descurainiae/pepperweed seed treats distention. If both drugs are not used appropriately, they may cause diseases. So, drugs should be used in a well-controlled way.” According to this, if Tingli/semen lepidii seu descurainiae/pepperweed seed is not overdosed, it won’t kill patients. The point lies in well-measured use of it. Zexie/rhizoma alismatis/rhizome of oriental waterplantain can brighten or affect the eye. He says: “Zexie/rhizoma alismatis/rhizome of oriental waterplantaincan drain humidity, and heat also disappears. Thus, the earth qi is enhanced, and the lucid qi ascends. Therefore, Zexie/rhizoma alismatis/rhizome of oriental waterplantain has the function of nourishing five zang organs, enhancing qi, relieving vertigo, sharpening hearing and brightening the eye. But if it is taken for too long, the descending tendency is too much stressed, the ascending of lucid qi will be hampered, the pure yin is consumed, which will definitely give rise the eye diseases.” As for affecting fertility and infertility, he says: “When Zexie/rhizoma alismatis/rhizome of oriental waterplantain is used with tonics, it can disperse the pathogenic humidity, heat and dirt of lower energizer. Once pathogenic qi is dispersed, yin reinforced and sea of blood cleared, it will facilitate fertility. But if it is taken for too long, it will purge kidney qi, the sea of blood will be cold, and it will harm fertility. So, when reading books, one should realize the different conditions.” This is also about well-measured use of drugs.
Li Shizhen holds that the medicine decocting should also meet certain standards. Decocting drugs properly is an important link to better curative effect. He says: “If too much medicine but insufficient water is decocted, the qualities of the medicine will not be melted into the decoction. If too much water but insufficient medicine is decocted, the efficacy of the medicine will be reduced. When decocting drugs, bronze ware and ironware are not allowed to use. Silverware and pottery are preferred. Clean and cover the utensils, then carefully watch the decocting process. Pay attention to the degree of heating, the decoction is neither underdone nor overdone... For diaphoretics, use tight fire to decoct it, and take the decoction hot. For purgative drugs, use tight fire to decoct it and then add Mangxiao/natrii sulfas/sodium sulfate or Dahuang/radix et rhizome rhei/rhubarb before it’s done, take the decoction warm. Tonic drugs should be decocted with slow fire and to be taken warm. Drugs for acute yin-cold disease should be decocted rapidly with tight fire and the patient should take the decoction immediately. Drugs for yin-cold agitation and insidious yin in summer months, sink them in the water and take the decoction cool.” Drugs of different functions should be decocted in different ways in order to give full play to the best effect, but still the decocting process should meet certain standards.
Taiji model is the basis of the doctrine of mingmen (life gate) in traditional Chinese medicine. Although mingmen (life gate) had been mentioned in Nei Jing (Internal Classic) and Nan Jing (Classic of Medical Problems), since Song Ming’s Neo-Confucianism advocated Taiji theory, doctors also looked for the yin and yang in human body. Famous doctors in the Ming Dynasty also advocated new theories, and the mingmen (life gate) theory was interpreted in a new way. Some doctors did not explicitly refer to the mingmen (life gate) as the Taiji of human, but what they said was also in harmony with the Taiji model of Zhou Yi (The Book of Changes).
Li Shizhen discussed mingmen (life gate) theory before Zhang Jiebin and Zhao Xianke, probably he was influenced by Taiji theory. In Ben Cao Gang Mu, he puts forward the idea that mingmen (life gate) is visible. He says: “triple energizers is the representative of original qi. Mingmen (life gate) is the essence of triple energizers. The former is the name indicating the location, the latter indicating the function. Its body is non-fat and non-flesh, wrapped by white membrane, beside the seventh thoracic vertebrae, between the two kidneys. It is attached to the vertebrae with two veins. It is leading to two kidneys downward, and leading to heart and lung upward, controlled by the brain. It is the source of life, master of fire and house of essential qi” (Volume 30, Ben Cao Gang Mu). His theory, though originated from Nei Jing (Internal Classic) and Nan Jing (Classic of Medical Problems), clearly points out that the mingmen (life gate) is the visible body, the origin of life formation, house of essential qi, and that both people and animals have their own mingmen (life gate). Earlier than Zhao Xianke, he has shown that mingmen (life gate) and kidney are different; there are close physiological relationships between the mingmen (life gate) and the kidney, the brain, the uterus, the heart, the lung and so on. He also emphasizes the physiological function of “fire in the kidney” in Ben Cao Gang Mu and Qi Jing Ba Mai Kao (Textual Research into Eight Extra Meridians). He takes the “fire in the kidney” as the center of the treatment of the mingmen (life gate) syndrome and opens the way for the later generations to study the essence of the mingmen (life gate) and the method of replenishing the mingmen (life gate).
3.1.2Rigorous and Realistic Spirit
The compilation of Ben Cao Gang Mu is characterized by “seeking origin of drugs, seeking truth and being practical.” With quotation from a total of 759 classical works of herbal drugs, and medicine and history, it contains 1,899 kinds of drugs and lists 8,169 prescriptions. Following Yan emperor and Huang emperor’s theory, this book establishes the scientific theory system of medicine syndrome differentiation and treatment.
Li Shizhen never does his research precipitously. In and before the Ming Dynasty, there were many mistakes in books of materia medica. For example, Tao Hongjing mistook Huangjing/rhizoma polygonati/solomonseal rhizome for Gouwen/herbalgelsemimi elegantis/herb of graceful jessamine. Suanjiang/calyx seu fructus physalis/franchet groundcherry fruit and Kudan are the same drug, but they were analyzed as individuals by Zhang Yuxi. Kou Zongshi took Lanhua/orchid as Lancao/herba eupatorii/fortune eupatorium herb, Juandan/bulbus lilii dahurici/lily bulb as Baihe/bulbus lilii/lily bulb, Wubeizi/galla chinesis/Chinese nut-gall as fruit from a tree, etc. There were a lot of such mistakes. In order to correct mistakes and avoid errors, he paid special attention to field investigation, collection of specimens and direct observation of the origin, morphology and characteristics of drugs. Sometimes he even tasted the drugs in person to make sure of its property. For example, pangolins love to eat ants, so he went to the deep mountains to study the animal. “He once cut open a pangolin stomach and found a sheng of ants.” Baihuashe/bungarus parvus/little silver-banded krait is one of the most valuable specialty products in Qizhou area. It is also the main raw material of Baihuashe Liquor and an important drug for treating diseases such as “stroke, damp arthralgia, loss of sensation, ringworm, scabies and pruritus and so on.” In order to understand its living habits, Li Shizhen went to the place where it grew up and carefully observed it. “Most of the snakes inhabit on the vines of Shinan/photinia serrulata Lindl./photinia, eat its flowers and leaves, so people could find the snakes there.” Li Shizhen also collects methods of snake-catching and processing. He trekked over mountains and rivers to investigate various kinds of drugs. He heard that on Taihe Mountain (today’s Wudang Mountain) there was a kind of “fairy fruit” that could prolong people’s life, so he decided to explore it. People dissuaded him: “The royal court listed it as a tribute. Anyone who tries to pick it would be arrested by the government.” However, in order to understand it, he took the risk of picking a few fruits at midnight. Then he found that it was merely the fruit of elm transformed by grafting, Langmei which could “quench thirst” and “dilute alcohol”. He walked thousands of miles and collected thousands of drugs. His “quest for truth spirit” is deeply touching. He spent a long time finding Mantuoluohua/flos daturae/flower of stramonium. Later, from the mountain farmers, he knew that it was commonly called the mountain eggplant which was observed on Wudang Mountains. He, at about fifty years old then, climbed up the steep cliffs, and in the grass bush finally found the drug. He tried it in person and drew the conclusion that the flower could “be used as anesthetics”. In practice, he realized that the two drugs Weirui/rhizoma polygonati odorati/rhizome of fragrant solomoseal and Nvwei were different. But in the past, the medical books often confused them. Tiannanxing/rhizoma arisaewmatis/jack-in-the-pulpit tuber and Hugao/tiger fat are the names of the same drug, but they were described as two different drugs in Zheng Lei Ben Cao (Classified Materia Medica). He points out that many of the predecessors had been unable to correct their mistakes for a long time; the main reason is that “they make guesses only on paper.”
Li Shizhen attaches great importance to folk medicine. Among the new drugs supplemented by Ben Cao Gang Mu, there are many drugs with good effects, such as Tufuling/rhizoma smilacis glabrae/glabrous greenbrier rhizome, Danzhuye/herba lophatheri/lophatherum herb, Banbianlian/herba scutellariae barbatae/barbated skullcap herb, Zihuadiding/herba violae/tokyo violet herb, Fanmubie/semen strychni/nux vomica, Sanqi/radix notoginseng/sanchi and so on. Some drugs have special curative effects on certain diseases. Yunnan Baiyao, a famous drug for treating blood and injury, which is mainly made up of Sanqi/radix notoginseng/sanchi. Sanqi/radix notoginseng/sanchi has now become a common medicine for cardiovascular diseases. It’s increasing in medicinal and economic value.
In order to compile Ben Cao Gang Mu, in addition to reference to rich literature and in-depth field investigation of the drugs, Li Shizhen also actively travelled across China, visited famous doctors, searched for all kinds of single and proved simple and proved prescriptions, collected firsthand materials. He asked for advice with an open mind, obtained medicinal knowledge of cereals and vegetables from the country’s old peasants, knew about the species of fish and shellfish from river fishermen, learned about the living habits of animals and birds from hunting families in mountainous areas, and found out the varieties of Fuling/poria/Indian bread, Zhuling/polyporus/chuling and other drugs from the deep-mountain woodmen.
Li Shizhen is knowledgeable and also proposes original ideas. He follows the classics and ancient ideas but is not confined to them.
(1)Medication according to syndromes and pathogenesis
“If you want to cure a disease, check its source first and observe the pathogenesis,” that is to say, the most important thing in the treatment of diseases is to make sure what the disease is. The diagnosis of the disease, first of all, is to examine the origin of the disease, whether it is caused by the invasion of six excesses or the injury of seven emotions. In the course of disease development, the cause of disease is called “evil qi”, also known as “pathogenic factors”. Pathogenic factors invade the zang-fu organs of the human body, damage yin and yang meridians, qi and blood, affect their germination, growth, transformation, collection, storage, and the normal operation of ascending, descending, floating and sinking. Five circuit phases and six qi has changed, the balance and coordination between heaven and man has been destroyed, and the corresponding pathogenesis is formed. For example, the pathogenesis like “evil gather together, then qi must be deficient,” “the pathogenic domination is considered as excessiveness, the normal loss is considered as insufficiency,” “yang excess leads to heat, yin excess leads to cold,” the statements show the different forms of excess and deficiency as well as cold and heat, reflecting different syndromes. Syndrome medication is to observe the pathogenesis of different syndromes, select the appropriate drugs for treatment. For deficiency syndrome, tonifying formula should be used. Xu Zhicai’s Ben Cao Shi Yi (A Supplement to the Herbal) says “replenishing is a treatment for debility. Renshen/radix ginseng/ginseng and Yangrou/caro caprae seu ovis/mutton are good drugs”. Li Shizhen says “in Nei Jing (Internal Classic), it is pointed out that deficiency was treated by reinforcement. It also says that when the viscus is insufficient, its mother viscus should be tonified. The pungency of Shengjiang/rhizoma zingberis recens/fresh ginger can tonify liver, the saltiness of salt can tonify heart, the sweetness of Gancao/radix glycyrrhizae/licorice root can tonify spleen, the sourness of Wuweizi/fructus schisandrae/Chinese magnoliavine fruit can tonify lung, the bitterness of Huangbo/cortex phellodendri/Chinese corktree bark can tonify the kidney. Fushen/poria cum radice pino/fu-shen can tonify heart qi, Shengdi/radix rehmanniae/rehmanniae root can tonify heart blood, Renshen/radix ginseng/ginseng can tonify spleen qi, Baishao/radix paeoniae alba/white peony root can tonify spleen blood, Huangqi/radix astragali/milkvetch root can tonify lung qi, Ejiao/colla corii asini/ass-hide glue can tonify lung blood, Duzhong/cortex eucommiae/eucommia bark can tonify spleen qi, Shudi/radix rehmanniae praeparata/prepared rehmannia root can tonify spleen blood, Chuanxiong/rhizome chuanxiong/szechwan lovage rhizome can tonify liver qi, Danggui/radix angelicae sinensis/Chinese angelica root can tonify liver blood. These are all tonifying formula. Renshen/radix ginseng/ginseng and Yangrou/caro caprae seu ovis/mutton are not the only tonics.” Xu Zhicai also mentions purgative formula that could treat stagnation, like Tingli/semen lepidii seu descurainiae/pepperweed seed and Dahuang/radix et rhizoma rhei/rhubarb. Li Shizhen said: “Instead of stagnation, it should be excess. Excess is treated by purgation. Tingli/semen lepidii seu descurainiae/pepperweed seed and Dahuang/radix et rhizoma rhei/rhubarb are not the only choices. Use the sourness of Shaoyao/paeonia/poeny to purge the excess of liver. Use the sweetness of Gancao/radix glycyrrhizae/licorice root to purge the excess of heart. Use the bitterness of Huanglian/rhizoma coptidis/golden thread to purge the excess of spleen. Use the pungency of Shigao/gypsum fibrosum/gypsum to purge the excess of lung. Use the saltiness of Zexie/rhizoma alismatis/rhizome of oriental waterplantain to purge the excess of kidney.” This is one of the leading thoughts of syndrome differentiation and treatment according to the deficiency and excess of zang-fu organs, the incidental and the fundamental of diseases.
(2)Adapting to the seasonal change to avoid attack on the harmony of man and nature
Li Gao says: “Drugs act towards different directions: Ascending, descending, floating, sinking and germinating, growing, transforming, harvesting, storing and maintaining, which follow the pattern of four seasons. In spring, drugs tend to ascend; in summer, they tend to float; in autumn, they perform an astringent function as if harvesting, in winter they tend to restrain as if storing. And the earth stays in the middle, tending to transform.” In Nei Jing (Internal Classic), there are similar ideas. “One must know in advance the condition of the year’s qi to avoid attack on the harmony of man and nature,” and “treat ascending, descending, floating, sinking cases with drugs similar in nature, while treat cold, hot, warm and cool cases with drugs opposite in nature.” Based on these view, Li Shizhen says: “In spring months, pungent and warm medicine should be added like Bohe/herba menthae/peppermint, Jingjie/herba schizonepetae/fineleaf schizonepeta herb and so on, in order to follow the ascending spring qi; in summer months, pungent and hot medicine should be added like Xiangru/herba elsholtziae/elsholtzia herb, Shengjiang/rhizoma zingberis recens/fresh ginger and so on, in order to follow the floating summer qi; in late summer, sweet-bitter, pungent and warm medicine should be added like Renshen/radix ginseng/ginseng, Baizhu/rhizoma atractylodis macrocephalae/rhizome of largehead atractylodes, Cangzhu/rhizome atractylodis/atractylodes rhizome, Huangbo/cortex phellpdendri/Chinese corktree bark and so on, in order to go with the evolving and consolidating qi; in autumn months, sour warm medicine should be added like Shaoyao/paeonia/poeny, Wumei/fructus mume/smoked plum and so on, in order to follow the descending qi; in winter months, bitter cold medicine should be added like Huangqin/radix scutellariae/baical skullcap root, Zhimu/rhizoma anemarrhenae/common anemarrhena rhizome and so on, in order to follow the sinking qi. This principle is called following the qi of seasons to maintain the natural harmony.” According to Nei Jing (Internal Classic), ignorant people prefer the incidental to the fundamental: In spring, pungent or cool drugs are used to suppress wood (liver); in summer, salty or cold drugs are used to suppress fire; in autumn, bitter or warm drugs are used to purge metal (lung); in winter, pungent hot drugs are used to dry water (kidney). The drugs are used wrongly, deviating from the principle of Su Wen (Plain Questions). It is a practice aiming to suppress yin in summer and yang in winter. There are four seasons in a year and diseases correspond to the four seasons; autumn diseases may occur in spring, winter diseases may occur in summer; therefore, when treating the diseases, one should be flexible and shouldn’t be rigid. Human beings obey five normal phrases and grow with wind qi. The qi of the five zang organs of the human body correspond to the interior and exterior environment of four seasons and five elements, including spring warmth, summer heat, autumn cool, and winter coldness. Therefore, the diseases can be treated with the five flavors, and follow the operation of “qi of zang organs obeying of seasons” to cure diseases and prolong life.
(3)Drugs for treating a hundred diseases, adopting different methods suitable to different conditions
Because diseases wax and wane, syndromes can be internal and external, the treatment has its priority. Common drugs are selected as the principal drugs. For the treatment of malaria, Qinghao/herba ar temisiae annuae/sweet wormwood herb and Changshan/radix dichroae/antifeverile dichroa root can be effective in the eradication of malaria. Since there are various malarias, like cold-wind malaria, summer-heat malaria, damp malaria, miasmic malaria, malaria of five zang organs and six fu organs, debilitating malaria and malarial mass and so on. It is still necessary to follow the principle of “adopting different methods suitable to local conditions.” The malaria identifications are as follows. For malaria caused by summer-heat, deficiency malaria with chills and fevers, Qinghao/herba artemisiae annuae/sweet wormwood herb can be pounded to get the juice or simmered in wine with Guixin/shaved cinnamon bark. Chaihu/radix bupleuri/Chinese thorowax root is a principal drug functioning on shao yang meridian, which can be used to treat all kinds of malaria. With the conditions of pathogenic cold and heat, deficiency and excess, assisting and guiding drugs can be added to the prescription to the affected meridian or site. Biejia/carapax et plastrum testudinis/tortoise shell can treat chronic malaria with pathogenic conditions in blood system. For debilitating malaria and prolonged malaria, stir-fry it with vinegar and make it into powder. For malaria caused by cold-dampness, use Fuzi/radix aconiti laterails preparata/prepared daughter root of common monkshood to treat qi deficiency in five zang organs; malaria caused by accumulation of phlegm-fluid retention, decoct Fuzi/radix aconiti laterails preparata/prepared daughter root of common monkshood with Dazao/fructus jujubae/Chinese date, Cong/herba allii fistolos/green onionsi and Shengjiang/rhizoma zingberis recens/fresh ginger, take it when the decoction becomes cold. Doukou/fructus amomi rotundus/round cardamom fruit treats asthenia malaria and spontaneous sweating, taking it along with Pingwei Powder (Powder for regulating the function of stomach). For malaria caused by phlegm, Changshan/radix dichroae/antifeverile dichroa root can be used to induce phlegm water. To treat miasmatic malaria, decoct Zhimu/rhizoma anemarrhenae/common anemarrhena rhizome, Qinghao/herba artemisiae annuae/sweet wormwood herb and Taoren/semen persicae/peach seed. The cough identifications are as follows. To treat wind-cold cough, the drug that can disperse wind-cold and the accumulation of pathogenic fire in the lung is used as the major drug. To treat phlegm-damp cough, make Banxia/rhizoma pinelliae/pinellia, Tiannanxing/rhizoma arisaewmatis/jack-in-the-pulpit tuber and Baizhu/rhizoma atractylodis macrocephalae/rhizome of largehead atractylodes into pills ant take them; To treat qi-deficiency cough, fry Laifuzi/semen raphani/radish seed and take it with sugar. To treat phlegm-fire cough, use Huangqin/radix scutellariae/baical skullcap root, Jiegeng/radix platycodi/platycodon root, Qianhu/radix peucedani/hogfennel root, Baihe/bulbus lilii/lily bulb, Tiandong/radix asparagi/asparagus root, Madouling/fructus aristolochiae/dutchmanpipe fruit for clearing away the lung heat and subsiding phlegmatic cough. To clear lung phlegm and stop cough, use Beimu/bulbus ftitillaria thunbergii/bulb of thungerg. To relieve phlegm and moisten lung, nourish yin and reduce fire, use Zhimu/rhizoma anemarrhenae/common anemarrhena rhizome. Cough caused by deficiency heat, take Tianhuafen/radix trichosanthis/snake-gourd root with Powder of Renshen. Cough caused by consumptive disease, take Huangqi/radix astragali/milkvetch root to tonify lung and purge fire, stop phlegmatic cough, spontaneous sweating and purulent blood cough. To check purulent blood cough and clear phlegm and replenish lung, take Ziwan/radix asteris/tatarian aster root. To cure hemoptysis caused by pulmonary tuberculosis, take Fangji/radix stephaniae tetrandrae/fourstamen stephania root and Tingli Powder and glutinous rice soup. To cure inability to eat caused by bone steaming and pulmonary tuberculosis, decoct Lugen/rhizome phragmitis/reed rhizome, Maidongmen/radix ophiopogonis/dwarf lilyturf root, Digupi/cortex lycii radicis/root-bark of Chinese wolfberry, Fuling/poria/Indian bread, Jupi/pericarpium citri reticulatae/orange peel, Shengjiang/rhizoma zingberis recens/fresh ginger and take the medicine. To cure lung abscess, coughing fullness, scaly skin on the chest and epigastrium, decoct Weijing/phragmitis/reed stem, Taoren/semen persicae/peach seed, Dongguaren/semen benincasae/Chinese waxgourd seed, Yiren/semen coicis/job’s-tears seed and take the medicine. Jiegeng/radix platycodi/platycodon root can cure lung abscess, drain pus, nourish blood and tonify fistula. As it can be seen, to select the principal drugs to treat a hundred diseases is to identify certain syndrome and prescribe the medicine. It is “integrate the drugs to cure the disease, with each one in proper use, so the treatments are different while the diseases can all be cured,” which is also the feature of syndrome and drug differentiation.
3.1.3Practical and Innovative Spirit
The compilation of Ben Cao Gang Mu can be described as “connecting the past with the future, pioneering and innovating.” Li Shizhen has made bold innovations in drug classification. Besides the fixed pattern of drugs, which are Explanation of Names, Correction, Previous Explanations, Indication, Quality and Taste, Explication and Prescriptions, he analyzes some contents in detail, like “Five drugs with the same name,” “Four drugs with the same name,” “Three drugs with the same name,” “Similar type with names hidden.” For example, in “Four drugs with the same name”, Chixiaodou/semen phaseoli/rice bean, Hongdoukou/fructus alpiniae galangae/fruit of galangal galangal, Xiangsizi/semen abri precatorii/seed of redbean vine, and Haihongdou/semen adenantherae pavoninae/seed of sandal beadtree couldn’t be regarded as Hongdou. In “Three drugs with the same name”, Shuizhuye/murdannia triguetra (wall.) brucken/herb of triquetrous murdannia, Suiguzi/rhizome of common lophantherum, Yazhicao/herba commelinae/common dayflower herb couldn’t be regarded as Danzhuye/herba lophatheri/lophatherum herb. Li Shizhen’s dividing principle is from organic to inorganic, from the least developed to the most advanced. Following the method of “analyzing family, distinguishing class, dividing category, classifying subcategory,” drugs are classified into 16 gang (categories) and 60 mu (subcategories). Its categories include those of Waters, Fires, Earth, Metals and Stones, Herbs, Cereals, Vegetables, Fruits, Woods, Fabrics and Utensils, Insects, Animals with Scales, Shells, Fowls, Animals and Humans. These classification methods are logical and in accordance with the objective conditions of the time and the law of the development of natural things. Volume 1 and 2 may be called the outline of the whole book, Volume 3 to 4 may be regarded as the general list of diseases, and the rest are subcategories. It forms the norm of system, partial system and subsystem, making the classification of the book systematic, scientific and integral.
Ben Cao Gang Mu integrates the precious and essential medical theories and essential views before the Ming Dynasty, and forms its own thoughts. Based on the theory of zang-fu organs, meridians, correspondence between human and the universe, yin-yang images, five circuit phases, six qi, combined with clinical treatment, the book emphasizes the detection on the causes of disease, observation of disease mechanism, differentiation syndrome and adaptation of treatment and choice of appropriate drugs, and blends them together. The scientific connotation of syndrome differentiation and treatment has been expounded systematically, and a new system has been established.
The property and flavor of drugs is the focus of Li Shizhen’s textual research. He collects and retains the literature of the past dynasties and puts forward his own opinion after textual research. For instance, Baijiangcao/herba patriniae/patrinia was recorded “bitter, flat and non-toxic” in Shen Nong Ben Cao Jing (Shen Nong’s Herbal) but in some books recorded as “slightly bitter and often sweet.” He not only retains the relevant contents of the previous literature, but also puts forward his own views. He accumulates a wealth of information for future generations to study the property and flavor of drugs. Secondly, he corrects and complements the property and flavor of some drugs, such as Shanzha/fructus crataegi/hawthorn fruit. It was recorded as “acid and cold”, but Li Shizhen researched it, he corrected it as “acid, sweet and warm”, which is consistent with the modern research, providing the basis for further research. He makes certain exertion and proposes some original opinions on classification of drugs according to the meridian tropism, the efficacy and the main treatment effects. He carefully studies and seriously analyzes in practice and draws on collective wisdom and absorbs all useful ideas. The drugs in ancient prescriptions were examined and verified one by one. He is praised to “have read lots of books and collected ideas of hundreds of doctors”. He looked up more than 80 ancient books and cited as many as 757 pieces of literature, which makes this masterpiece rigorous, structured, focused, detailed and influential in the medical field. It promotes the inheritance and unearthing of China’s medical heritage and provides a reliable basis for the research of modern medicine and pharmacy.
In Ben Cao Gang Mu, drugs are classified into 16 gang (categories) and 60 mu (subcategories). Its categories include those of Waters, Fires, Earth, Metals and Stones, Herbs, Cereals, Vegetables, Fruits, Woods, Fabrics and Utensils, Insects, Animals with Scales, Shells, Fowls, Animals and Humans. Its dividing principle is “from minor to major, from the least developed to the most advanced.” It is said that its reference books are as many as 800, so it can be described as a masterpiece “connecting hundreds of doctors”.
For each kind of drug, its name is listed as Gang, the explanation of name is recorded as Mu, that’s why the book is named Ben Cao Gang Mu. The contents of each drug contain in detail Previous Explanations, Analysis of Dubious Points, Correction, Preparation, Quality and Taste, Indications, Explication and Prescriptions. etc. The clear classification and description method of Ben Cao Gang Mu is a creative development on the basis of predecessors. In fact, this method obtained the scientific nature of modern biological evolution thoughts.
Ben Cao Gang Mu has also made remarkable contributions to the development of pharmacology. Li Shizhen not only confirms 1,518 kinds of drugs, but also adds 374 kinds of new drugs to the treasure house of Chinese medicine by his own practice, investigation, search and inspection, which is a huge number for a scholar.
In drug identification, Ben Cao Gang Mu corrects many errors and unscientific contents of materia medica works before the Ming Dynasty. As for the adaptation of organisms to the living environment, it also proposes some original views.
Based on Shen Nong Ben Cao Jing (Shen Nong’s Herbal) and Huang Di Nei Jing (Huangdi’s Internal Classic), Li Shizhen praises Zhang Yuansu’s thinking method of “taking drugs according to syndromes” in Jie Gu Zhen Zhu Nang (Materia Medica Annotated By Zhang Jiegu) and states Zhang Yuansu’s achievement as “having profound interpretation of Chinese medicine, and deep understanding of subtle relationship between heaven and man. He considered that the old prescriptions might not necessarily cure the modern diseases, thus forming his own theories, including property and flavor of drugs, yin and yang, thickness and thinness, the movements of drugs (ascending, descending, floating and sinking), the functions of drugs (tonifying and purgative), six qi, twelve meridians and the principles of making prescriptions... Medical theories are comprehensively discussed. He is the one who ranks after Ling Shu (Spiritual Pivot) and Su Wen (Plain Questions).” He makes comments on Li Dongyuan. “He inherited and continued Zhang Jiegu’s theory. Based on Jie Gu Zhen Zhu Nang (Materia Medica Annotated By Zhang Jiegu), Li Dongyuan added introductory notes, guides to the meridians and flexible principles of drug use to his book Yong Yao Fa Xiang (Rules for the Use of Drugs), which can be used as a reference for clinical medicine differentiation and treatment.”
Li Shizhen studies the physiology and pathology of zang-fu organs and attaches great importance to the acquired effect of spleen and stomach in human body. He thinks that “The earth is the mother of everything”. Nourished by their mother, the internal organs will be in harmony, with the balance of water and fire and interaction of woods and metal. Therefore, the pathogen will be prevented, and a person will be free from all diseases. (In “Huangjing/rhizoma polygonati/solomonseal rhizome”). “After water and cereal have entered the stomach, they are fumigated and steamed by humidity and heat of middle energizer, evolve into red substance and spread in zang-fu organs, meridians and collaterals, which is nutrient-blood. The evolvement shows the subtle creation of nature.” (In Hongqu/semen oryzea cum mnasci/medicated red rice.) He emphasizes the close relationship between spleen and original qi and says: “Spleen is the mother of original qi”, “when mother is in harmonious condition, jinye (body fluid) is produced and mental spirit is germinated” (in Lian’ou/nelumbo nucifera gaertn/lotus). It shows that the original qi of human body depends on the breeding of the spleen and stomach. If the physiological function of the spleen and stomach is normal, the original qi of human body is nourished and enriched. Li Shizhen attaches importance to nourishing earth. He emphasizes that spleen and stomach are the root of original qi and points out the important role of spleen and stomach as ascending and descending cardinal. His idea is an enrichment to the development of spleen and stomach theory.
3.2Main Contributions of Li Shizhen Medicine
Li Shizhen is a prolific writer in his life and makes an indelible contribution to the development and perfection of China’s medical theory. Only three books are extant now: Ben Cao Gang Mu, Bin Hu Mai Xue (Binhu’s Sphygmology) and Qi Jing Ba Mai Kao (Textual Research into Eight Extra Meridians). Among them, Ben Cao Gang Mu is world-famous, for which he has struggled for 30 years in spite of hardships.
When he was working at the Imperial Academy of Medicine, after a long period of preparation, Li Shizhen began writing Ben Cao Gang Mu. In the process of writing, along with his students and his son Li Jianyuan, he wore straw shoes, carried medicine baskets, climbed mountains and mountains, visited doctors and collected medicines. They traveled over several areas, such as Henan, Hebei, Jiangsu, Anhui, Jiangxi, Hubei provinces and others, as well as several mountains, like Mount Niu Shou, Mount She, Mount Mao, Mount Taihe and others. They travelled thousands of miles, listened to the opinions of millions of people, read more than 800 kinds of books. After 27 years, he finally finished the book when he was 61 years old (in 1578). Ben Cao Gang Mu comprises 16 categories, 52 volumes, and has 1.9 million Chinese characters. It records 1,518 drugs mentioned in previous materia medica books, adds 374 drugs, all together 1,892 drugs, among which 1,195 are plants. It records 11,096 prescriptions, along with more than 1,100 illustrations. This great work absorbs the essence of the works of the past dynasties, corrects the previous mistakes as far as possible, supplements the deficiencies, and makes many important discoveries and breakthroughs. It has been one of the most systematic, integral and scientific medical works in our country until the 16th century.
When faced with the vast treasure house of herbs, how to control and manipulate it becomes the most critical issue for doctors. This is one of Li Shizhen’s greatest contributions. He not only solves the problems such as the way and retrieval of medicine, but also embodies his new understanding of plant taxonomy and valuable of biological evolution thoughts. He has changed three grades of drugs (high-grade, medium-grade and low-grade) proposed in Shen Nong Ben Cao Jing (Shen Nong’s Herbal), which had been passed down for more than a thousand years. In his book, drugs are classified into 16 gang (categories) and 60 mu (subcategories). Its categories include those of Water, Fire, Earth, Metals and Stones, Herbs, Cereals, Vegetables, Fruits, Woods, Fabrics and Utensils, Insects, Animals with Scales, Shells, Fowls, Animals and Humans. Each drug is categorized as gang, with subcategories as mu. The book also systematically describes the knowledge of various drugs, including Corrections, Explanation of Names, Previous Explanations, Preparation, Quality and Flavor, Indications, Explication, Appendix and Prescriptions. From the history and form of drugs to function and prescription, the account is very detailed. In particular, the “Explication” is mainly his new discoveries and experiences in drug observation, research and practical application, which enriches the knowledge of materia medica. He is the first one who proposes the name of “savage”. The classification method created by Li Shizhen in botany is a scientific method which classifies plants according to their application and morphology and assorts them into different levels. He not only points out kinship of plants, but also unifies nomenclature of plants. He divides more than 1,000 species of plants into five categories (i.e. herbs, woods, vegetables, fruits and cereals) according to their economic use and body, habits and contents, and then divides them into 30 subcategories (such as 9 kinds of herbs, 6 kinds of woods, 7 kinds of vegetables, 7 kinds of fruits, and 5 kinds of cereals), and then subdivides into several types.
In a word, Li Shizhen adopts the method of systematic categories to reanalyze and sort out materia medica works of the dynasties following Shen Nong Ben Cao Jing (Shen Nong’s Herbal). Therefore, this Chinese herbal masterpiece of nearly 2 million words is rigorous, structured and detailed, with key points standing out. In other words, this book is “comprehensive but not complex, detailed but also with key points.”
Ben Cao Gang Mu corrects many mistakes made by predecessors, such as Tiannanxing/rhizoma arisaewmatis/jack-in-the-pulpit tuber and Huzhang/tiger fat, which are the same medicine, but in the past they were mistaken for two different drugs. Weirui/rhizoma polygonati odorati/rhizome of fragrant solomoseal and Nvwei/stem of October clematis were thought to be the same drug, but after identification, Li Shizhen separates them into two different ones. Su Song divided Tianhua/radix trichosanthis/snake-gourd root and Gualou/fructus trichosanthis/snakegourd fruit into two kinds into Tu Jing Ben Cao (Illustrated Materia Medica), but they are actually different parts of the same herb. The predecessors viewed that “the horse sperm can change into Suoyang/herba cynomorii/songaria cynomorium herb” and “a grass seed can change into a fish”. Li Shizhen corrects them one by one. And many new drugs have been added to the book. The efficacy of certain drugs is further described by Li Shizhen through his own experience. The book also contains a wealth of valuable medical data, in addition to a large number of additional prescriptions, medical examinations, medical records, and some other useful medical data.
Ben Cao Gang Mu is a book of pharmacology as well as natural history, which covers a wide range of topics and contributes to biology, chemistry, astronomy, geography, geology, mining and even history. The information collected in the book is extensive, “from the ancient classics to the legends, whatever is relevant has been collected.” Therefore, some of the contents in the book are inconsistent with modern knowledge, and some may even be a bit superstitious. This is unavoidable. For example, Qianfen/lead powder is cold and non-toxic, but modern view holds it is highly poisonous. There are other examples in the category of Humans. Things related to human are used as medicines, like the filial son’s clothing and hat, the dust of the widow’s bed, the grass shoes. Some other examples like “The male pubic hair can be used for snake bite, and the female’s pubic hair for the treatment of stranguria of five types and the yin-yang transmission Syndrome (coital transmission of febrile disease). Renpo (the soul human who has just hanged himself or herself) to calm shock, human meat therapy (cut the flesh of thine to treat one’s relative), human feces to treat hematemesis, dust of the house beam to treat fainting”. For this part, Li Shizhen mostly cites the words from Chuo Geng Lu (South Village Dropout) and Ben Cao Shi Yi (A Supplement to the Herbal) and adopts the attitude of “the medicines that had been used before can’t be left behind”. However, Li Shizhen refutes Chen Cangqi’s view, believing that it is wrong to eat human flesh in order to cure the disease. But it is just because of the detailed collection that some lost ancient medical books and books of materia medica are preserved.
Ben Cao Gang Mu not only makes great contributions to the development of pharmacology in China, but also has a profound impact on the development of medicine, botany, zoology, mineralogy and chemistry in the world. After its publication, it is soon introduced to Japan and later spread to Europe and the United States. It has been translated into Japanese, French, German, English, Latin, Russian, Korean and other languages and spread across five continents. As early as 1951, at the World Peace Council in Vienna, Li Shizhen was listed as an ancient world celebrity; his marble statue stood on the promenade of Moscow University. It has also played a huge role in promoting the development of natural science in the world, thus known as “Colossal Work of Oriental Medicine”. The famous British biologist Darwin also benefited from it, he referred to it as “the encyclopedia of medicine in ancient China”. Joseph Needham, a British expert in the history of Chinese science and technology, wrote in his Science and Civilization in China: “In the 16th century, there were two major works on natural pharmacology in China. The first is Ben Cao Pin Hui Jing Yao (A Compilation of Essential Items of the Materia Medica) at the beginning of the century (1505), and Ben Cao Gang Mu at the end of the century (1595), both of which are very great.”
3.2.1Medical Theory
Although Ben Cao Gang Mu is a pharmacological monograph, it also records many contents closely related to clinical practice. Volume 3 and 4 are “Principal Drugs to Treat a Hundred Diseases”, recording principal drugs treating 113 diseases. In Volume 3 “Drugs to Treat Diseases Caused by Exogenous Factors and Internal Injury”, drugs to treat febrile diseases caused by cold, coughing, asthma and dyspnea are included. Volume 4 mainly consists of five organs, surgical, gynecological and pediatric diseases. The drugs that can be used to cure the plague are: Shengma/rhizoma cimicifugae/largetrifoliolious bugbane rhizome, Aiye/folium artemisiae argyi/arigyi leaf/argyi wormwood leaf, Laxue/snow-water, Dansha/cinnabaris/cinnabar, Yangqishi/actinophorum, Huoyao/gunpowder, Daqing/folium isatidis/dyers woad leaf, Mahuang/herba ephedrae/ephedra, Weilingxian/radix clematidis/Chinese clematis root, Lvcao/herba humulis scandentis/climbing hop herb, Dama/cannabis sativa L./hemp, Dandouchi/semen sojae preparatum/fermented soybean, Hu/allium sativum L./garlic, Zhusun/bamboo shoot, Li/fructus pyri/pear, Song/pinus massoniana lamb./pine, Zhuling/polyporus/chuling, Zhu/lophatherum gracile brongn/bamboo, Shiyan/fossilia spiriferis/fossil shell of spirifer, Xi/rhinoceros and Taoduchong/peach moth.
In addition, Ben Cao Gang Mu contains 11,096 prescriptions of various kinds, involving various clinical departments, including internal medicine, surgery, gynecology, pediatrics, pentaphysics, etc. Among the prescriptions, more than 2,900 are collected from previous books, and the rest are collected at his own time. The scope of the treatment covers the common diseases and frequently occurring diseases. The forms of drugs include pill, powder, extract and pallet. Many prescriptions have both scientific and practical features. For example, the prescriptions for the treatment of coughing appear in a variety of formulas as follows:
Asthma and dyspnoea caused by disorder of lung qi: two liang2 of Madouling/fructus aristolochiae/dutchmanpipe fruit (shell and membrane removed), half liang of butter (stir up in the bowl and stir-bake to dry with slow fire), one liang of Gancao/radix glycyrrhizae/liquorice root (prepared), make into powder. Stew one qian3 with a cup of water until six fen4 is left. Take it warm and little by little.
Phlegmatic cough caused by asthma: Yazhang San (powder of duck web), five Yinxing/ginkgo/ginkgo biloba L., two and half qian of Mahuang/herba ephedrae/ephedra, two qian of Gancao/radix glycyrrhizae/liquorice root (prepared), stew in one and half cups of water till eight fen are left. Take it before sleep. There was a pharmacy selling Baiguo Dingchuan Decoction (Decoction of Baiguo to treat asthma) in Jinling (now called Nanjing). The drug was so effective that the owner of this pharmacy made huge fortune. Prescription: Twenty-one Baiguo/semen ginkgo/ginkgo seed (stir-fry until they turn yellow), three qian of Mahuang/herba ephedrae/ephedra, two qian of Suzi/fructus perrillae/perilla fruit, two qian of Kuandonghua/flos farfarae/common coltsfoot flower, Fabanxia/prepared pinellia tuber/rhizome pinelliae preparata, two qian of Sangbaipi/white mulberry root-bark/cortex mori, prepared with honey. One and a half qian of Xingren/bitter apricot seed/semen armeniacae (without peel and tip), one and a half qian of Huangqin/radix scutellariae/baical skullcap root (slightly fried), one qian of Gancao/radix glycyrrhizae/liquorice root. Stew in three cups of water until two cups are left. Take the decoction in two times at scheduled time. Shengjiang/rhizoma zingberis recens/fresh ginger shouldn’t be used.
Phlegmatic cough caused by lung heat with stuffy chest: One liang of Gualou/fructus trichosanthis/snakegourd fruit, and one liang of Banxia/rhizoma pinelliae/pinellia (soak it in hot water for seven times, bake it dry and grind it). Blend the powder with ginger juice and wheat flour and then make pills (the size of a parasol seed). Take 50 pills every time with ginger decoction after meal.
Therefore, Ben Cao Gang Mu has a high reference value in clinical treatment. It is also a great achievement in the field of therapeutics. In the application of syndrome differentiation and treatment, clinical prepared medicine, it provides some new explanations.
(1)Synthetical application of eight principles, zang-fu organs, aggregation of qi, blood and phlegm and other syndrome differentiation methods
Synthetical application of eight principles, zang-fu organs, stagnation of qi, blood and phlegm and other syndrome differentiation methods have been employed to treat diseases, as reflected by the classification of diseases in “Principal Drugs to Treat a Hundred Diseases”. He takes the disease names as the categories and uses the syndrome differentiation as the subcategory. It is not simply listed according to the disease names, but highlights the principle of syndrome differentiation and treatment. According to the specific differentiation of symptoms and signs, drugs with corresponding main therapeutic effect are provided.
For instance, diarrhea disease includes damp-heat, cold-damp, wind-heat, aggregation-accumulation, fright phlegm and deficiency penetration. Low back pain include consumption, damp-heat, wind-cold, blood stasis and external causes. Dyspnea with reverse flow of qi include wind-cold, phlegm, fire stagnancy, deficiency and asthma. Some of the above classifications are similar to that in the present textbooks of Internal Medicine, such as the classification of low back pain. Some of them are different. But it’s obvious that synthetical application of eight principles, zang-fu organs, aggregation of qi, blood and phlegm and other syndrome differentiation methods are employed. Like the classification of dyspnea with reverse flow of qi different from the current medical textbooks, but it analyzes diseases from the aspect of cold, phlegm, fire and deficiency which is similar to the current ideas.
Since Zhu Danxi had treated miscellaneous diseases with aggregation of qi, blood and phlegm, his theory was accepted by most doctors, and there was the saying that “using Danxi’s way to treat miscellaneous diseases.” Although eight principles was first put forward by Cheng Zhongling of the Qing Dynasty, however, people had treated diseases with it for long. Li Shizhen inherits the outstanding dialectical method of predecessors. In the aspect of syndrome differentiation of zang-fu organs, with the proposal of meridian tropism, a simple bridge was built between the differentiation of syndromes and prescriptions, so the method of syndrome differentiation of zang-fu organs became simple and practical. Li Shizhen applies and expands this method. He not only uses this method to differentiate and treat diseases, but also explains the principles of medicine used in the prescriptions of the classics. He applies the theory to explain the difference between Guizhi Decoction (Cassia-twig Decoction) and Mahuang Decoction (Ephedra Decotion). The ancestors mostly interpreted the pathogenesis as weak defense with strong nutrient and strong defense with weak nutrient, or exterior deficiency and exterior excess, but Li Shizhen elaborates from the aspect of drug composition and the principal treatment pertaining to the zang-fu organs. He says: “Mahuang/herba ephedrae/ephedra is a drug that works exclusively on the Lung Channel, so it is often used in treating Lung diseases.” Zhang Zhongjing treated febrile disease caused by cold with Mahuang/herba ephedrae/ephedra if there was no perspiration. Guizhi/ramulus cinnamomi/cassia twig was used if there was perspiration. Famous doctors in different dynasties explained Zhang’s idea only according to the original text, but there hasn’t been a satisfactory explanation yet. Exterior excess syndrome is a jue syndrome, actually the lung is invaded by pathogenic heat, giving rise to the excess of lung qi. Thus, Mahuang Decoction (Ephedra Decotion) is to be used, “although Mahuang Decoction (Ephedra Decotion) is a strong diaphoretic suitable to the jue yang syndrome, it is actually a prescription in dispersing the accumulation of pathogenic fire in the Lung”. Exterior deficiency syndrome is the leakage of jinye and deficiency of the Lung qi, thus Guizhi Decoction (Cassia-twig Decotion) is used to regulate the spleen and rescue the lung, “although Guizhi Decoction (Cassia-twig Decoction) is generally a light prescription suitable to disperse the pathogenic factors from the muscles in the jue yang syndrome, it is actually one in regulating the spleen and rescuing the lung.” And the above analysis hasn’t been found in previous times. In short, in the course of practice, Li Shizhen inherits and develops the methods of syndrome differentiation and treatment of predecessors, and comprehensively applies various methods of syndrome differentiation to treat diseases. Besides, it also reflects that after thousands of years of development, disease differentiation and classification had become fairly mature until the Ming Dynasty.
(2)Correct compatibility of drugs corresponding to the disease
“Doctors tend to take Xiangyan Decoction as the first choice in treating heatstroke”, in response to this practice, Li Shizhen suggests that treatment should be based on differentiation of syndromes and signs. If the syndrome is caused by exposure to cold and the eating of cold food in summer, yang qi is pent up by pathogenic yin, Xiangyan Decoction can be used to open up the pent-up yang qi, disperse water and harmonize the spleen. If the syndrome is caused by improper intake of food, overwork and too much melancholy, it is a syndrome of overwork with interior damage, so Qingshu Yiqi Decoction (Decoction of Eliminating Summer-heat and Replenishing qi) of Li Dongyuan, Rensheng Baihu Decoction of Zhang Zhongjing should be used to purge the pathogenic fire and reinforce the original qi. As to “no matter what the condition is, Xiangyan is drunk as tea to disperse summer heat”. He criticizes the idea and considers it nonsense.
People tend to take Zhushen/pig’s kidneys as tonics. He comments that “Zhushen/pig’s kidneys is cool in quality. For people who suffer from excessive heat of deficient type in the kidney, they can take it. But for those whose kidney is cold and deficient, they shouldn’t take it”. By this, he emphasizes differentiating the deficiency and excess of diseases.
In the diagnosis and treatment of diseases, Li Shizhen also pays attention to syndrome differentiation and treatment instead of being confused by the appearance of diseases. He used Badou/semen crotonis/croton seed to cure an old woman who had suffered from watery diarrhea for five years. When she ate meat, oily or cold food, she would suffer from pain. She tried drugs with ascending tendency and astringent function to regulate the spleen, but the condition became worse. Li Shizhen examined the patient and found her pulse deep and slippery, he concluded that “the disease was caused by prolonged damage to the spleen and stomach due to cold accumulation and abdominal mass. According to Wang Taipu (Taipu, an official title in feudal times), if the great cold accumulated in the body for a long time, it could cause watery diarrhea. Even it was cured once, it would recur and kept on for several years. The treatment should use heat to relieve cold, then the cold would be removed and diarrhea would stop.” So he used 50 pills of Lagui Badou Pill. In two days, the patient had no discharge of stool, then her watery diarrhea was cured. Li Shizhen thought that watery diarrhea was caused by accumulation of cold at the interior, so he dared to try Badou/semen crotonis/croton seed to stop the diarrhea. He was proud of his accurate syndrome differentiation. He stated: “The subtlety lies in the correct compatibility of drugs that should correspond to the disease.” Almost one hundred patients were successfully treated when he used this way to treat those suffering from such diseases.
(3)Different medications corresponding to different physical conditions
Li Shizhen emphasizes the importance of prescribing different medications according to physical conditions of patients. In Fuzi/radix aconiti lateralis preparata/prepared daughter root of common monkshood, he says, “Both Wutou/radix aconite kusnezoffii/root of kusnezoff monkshood and Fuzi/radix aconiti lateralis preparata/prepared daughter root of common monkshood are toxic and should not be used unless the disease is urgent. But a small amount can be added into tonics to enhance their efficacy. Some patients just take only one qian-bi of these drugs and feel quite restless. But ancient people frequently use them in tonics. Is it because the physiological condition of ancient people was different from that of the present people? King Duchang of Jing state was thin and often felt cold, not suffering from other diseases. He had Fuzi Decoction every day and chewed some Liuhuang/sulfur/sulfur. He kept on doing this for several years. Mr. Zhang, a rich man in Qinzhouwei, got used to take Lurong/cornu cervi pantotrichum/hairy deer-horn and Fuzi/radix aconiti laterails preparata/prepared daughter root of common monkshood all his life. He was healthy until eighty years old. In the book Yi Shuo (Zhang Gao’s Medical Theory) of the Song Dynasty, it was recorded that Mr. Zhao, a governor, indulged himself in sex and wine. He took the Decoction of dried ginger and Fuzi/radix aconiti laterails preparata/prepared daughter root of common monkshood with 100 pills of Liuhuang Jinye Pill (Pills of Sulfur) every day. In this way he maintained a good appetite. If he didn’t take the drugs, he would feel exhausted. But he lived up to ninety years. The drugs would be harmful for others even when they tried one pill. The above examples are just extremes for some people who had extraordinary physiological and pathological conditions in terms of zang-fu organs. The drugs are beneficial rather than harmful for them, but other people should not follow it since it is not conventional.” Li Shizhen also points out that certain drugs are essential for certain special physical conditions. As said in Shengma/rhizoma cimicifugae/largetrifolious bugbane rhizome, “Shengma/rhizoma cimicifugae/largetrifolious bugbane rhizome can lead the lucid qi of tai yang to ascend. Chaihu can lead lucid qi of shao yang to ascend. They are the principal drugs of the spleen and stomach. They can be used to treat the following condition: general debility and deficient original qi caused by overstrain, improper intake of cold food”. From the above, we can see that if a person’s physical condition is not average, then medication should be different from that of ordinary people. Just as he mentions in Dansha/cinnabaris/cinnabar, “Human beings are different from one another. The experienced doctors should differentiate yin and yang, the symptoms and signs. They shouldn’t rely too much on first impressions. Only those who know the delicacy of medicine can handle the cases.”
(4)Drug processing closely combining with clinical syndromes
Concerning drug processing, Li Shizhen adopts different methods of processing according to the different qualities of the syndromes. For example, Banxia/rhizoma pinelliae/pinellia is the guiding drug for drying dampness, dissolving phlegm, bringing down adverse qi and stopping vomiting. When producing Banxiaqu (Banxia leaven), he chooses different ways according to specific phlegm, “to treat damp-phlegm, blend Banxia/rhizoma pinelliae/pinellia with juice of ginger and Banxia Decoction; to treat wind-phlegm, blend the drug with juice of ginger and Zaojiao Decoction; to treat fire-phlegm, blend the drug with juice of ginger and Zhuli/succus bambusae/juice in a bamboo stem, or with Jingli/succus schizonepetae/juice of fineleaf schizonepeta; to treat cold-phlegm, blend the drug with juice of ginger, Baifan/alumen/alum and powder of Baijiezi/semen Sinapis albae/white mustard seed. All these are good ways of processing.” For the usage of Huanglian/rhizome coptidis/gold thread, “to purge the excessive fire of the liver and gall bladder, soak it in pig bile and then stirfry it. To treat deficient fire of the liver and gall bladder, soak it in vinegar and then stir-fry it. To eliminate fire in upper energizer, stir-fry it with wine; fire in middle energizer, with ginger juice; fire in lower energizer, with salt water; fire due to indigestion, soak it with loess in water, and then stir-fry it. The above ways enhance the functions of the drugs. The reason why it is processed in this way is that pungent and hot drugs can hold back the bitter taste of Huanglian/rhizome coptidis/gold thread and cold quality, salty and cold drugs can hold back the dry quality of Huanglian/rhizome coptidis/gold thread. When it is used, all these things should be considered.” It can be seen from the above that Li Shizhen is guided by the principle of processing of drugs serve for clinical practices. The processed drugs are closely connected with clinical syndromes. Li Shizhen divides phlegm into different syndromes such as damp-phlegm, wind phlegm, fire phlegm, cold phlegm and so on. Therefore, when making Banxiaqu (Banxia leaven), different auxiliary materials are added. One more example is the liver-gallbladder fire. It is divided into excess fire and deficiency fire, so the meridian tropism, meridian direction, drug qualities, direction of the action of drugs (ascending, descending, floating and sinking) are all altered according to the clinical needs.
In a word, Ben Cao Gang Mu records a large number of clinical applications of different processed drugs, which provides valuable data for modern clinical research.
(5)Paying attention to the simple prescription and proved prescription, simple and various kinds of treating methods
Since Li Shizhen has been practicing medicine for a long time, he knows very well the difficulties of folk life, especially the difficulty of consulting doctors about medical advice. He is also familiar with the magic effect of single prescription and proved prescription. So he attaches great importance to the collection and application of such prescriptions. For example, in Niuxi/radix achyranthis bidentatae/twoteethed achyranthes root. A relative of Mr. Ye (an official whose title was Chaoyi) suffered from bloody stranguria, who consulted several doctors in vain. A village doctor treated him with Niuxi/radix achyranthis bidentatae/twoteethed achyranthes root, which was simmered into a dense decoction. The patient took it five times in a day. Although he didn’t recover immediately, the color of the urine became paler and turned normal after a long time. After ten years, the disease recurred. The same prescription was applied and the patient became well again. ... Therefore, I recorded it here to praise its miraculous effect.” The prescriptions collected are mostly simple prescriptions and minor prescriptions.
Bin Hu Ji Jian Fang (Bin Hu Collection of Simple Formulas) which was lost was said to be a collection of simple prescriptions and proved prescriptions. Ben Cao Gang Mu collected some prescriptions from this book. There are various treating methods, including internal administration, external application, gargling treatment, anus suppository, threadligating therapy, vagina suppository external coating therapy, baking therapy, needling therapy, shock therapy, suction, fumigation throat blowing therapy, washing, etc. For example, to treat pruritus vulvae, use one liang of Shechuangzi/frutus cnidii/common cnidium fruit and two qian of Baifan/alumen/alum to make a decoction. Wash the affected part with it frequently. The treating methods are diverse and easy to use.
To sum up, Li Shizhen has comprehensively used the eight principles, zang-fu organs, aggregation of qi, blood and phlegm and other dialectical methods to treat diseases, and has put forward some new views. In treatment, he insists on dialectical treatment, differentiation of physical condition, pays attention to simple prescription and proved prescription. Especially, he emphasizes that the drug processing should be closely combined with the clinical syndromes, which promotes the development of clinical drug processing.
Moreover, Ben Cao Gang Mu has also made a great contribution to the development of the theory of drug meridian tropism.
(1)Using meridian tropism to explain efficacy and indication of drugs
When discussing the qualities of drugs, Li Shizhen records the drug meridian tropism. For instance, Mahuang/herba ephedrae/ephedra is a drug that works exclusively on the lung meridian, so it is often used in treating lung diseases. Huluba/semen trigonellae/common fenugreek seed is a drug that functions on the right kidney. For the patients who suffer from insufficiency of original yang and hidden cold qi that prevents the returning of original yang, this drug is effective (Compendium of Materia Medica, Volume 15, Mahuang). The quality and efficacy of drugs are interpreted by meridian tropism. Detailed pharmacological action can be applied in clinical practice effectively.
(2)Proving meridian tropism with clinical effects
Li Shizhen applies the theory of “five flavors and five colors function on the five zang-organs” proposed in Nei Jing (Huangdi’s Internal Classic) in clinical practice, and gives full play to it, thus improving the practical value of meridian tropism theory. “Tianma/rhizoma gastrodiae/gastrodia tuber is a drug functioning on the qi system of liver meridian. Su Wen (Plain Questions) says, “vertigo caused by pathogenic wind is related to liver. Tianma/rhizoma gastrodiae/gastrodia tuber acts on the meridians of tai yin and can treat the above diseases.” (Compendium of Materia Medica, Volume 12, Tianma)
(3)Explaining meridian tropism according to the main treatment of zang-fu organs disease, meridian diseases and orifices disease
When discussing meridian tropism, Li Shizhen always combined the functions of zang-fu organs, meridians and orifices together. Wuzeigu/os sepiellae seu sepiae/cuttlefish bone is a drug acting on the blood system of the tai yin, since it’s salty and functions in blood. Therefore, original diseases of the tai yin, like blood depletion, bloody masses, amenorrhea, metrorrhagia and leakorrhea, dysentery and infantile malnutrition; the diseases related to the tai yin meridian, like malaria with chills and fever, deafness, goiter, lower abdominal pain, and diseases of genitals; the diseases of orifices of the tai yin, like nebulous eye screen and abnormal shedding of tears, Wuzeigu/os sepiellae seu sepiae/cuttlefish bone is good for all the mentioned diseases. Because the tai yin is related to liver, and liver controls blood, it is an effective drug to treat all kinds of blood diseases.
(4)Paying attention to drug processing, never confined to the ancient’s meridian tropism theory
In Li Shizhen’s view, the processing of drug can change its meridian tropism. Like Both Changshan/radix dichroae/antifeverile dichroa root and Shuqi/caulis et folium dichroae febrifugae/stem leaf of antifebrile dichroa can disperse phlegm accumulation and stop malaria... When used with Wumei/fructus mume/smoked plum and Linglijia/squama manitis/pangolin scales, they function on the liver. When used with Xiaomai/semen tritici/wheat, they function on the heart. When used with Shumi/husked sorghum and Mahuang/herba ephedrae/ephedra, they function on the lung. When used with Longgu/os draconis/dragon’s bone and Fuzi/radix aconiti lateralis preparata/prepared daughter root of common monkshood, they function on the kidney. When used with Caoguo/fructus tsaoko/caoguo and Binlang/semen arecae/areca seed, they function on the spleen. For Zhimu/rhizoma anemarrhenae/common anemarrhena rhizome, if the drug is intended to function on the upper part, it should be soaked in wine and then baked dry. If it is intended to function on the lower part, it should be soaked in salt water and then baked dry. These are the criteria for clinical doctors to make up prescriptions.
(5)Paying attention to the use of guiding drugs
Guiding drugs refer to some drugs that can lead other drugs to the site of the disease to play a curative effect. In addition to selecting as many drugs as possible in accordance with the pathological changes of the zang-fu organs in prescriptions, better results can be obtained by paying attention to the use of the guiding drugs directing to the meridians. Some guiding drugs are listed in Ben Cao Gang Mu. Huanglian/rhizome coptidis/gold thread and Xixin/herba asari /manchurian wild ginger are for heart meridian of hand shaoyin. Gaoben/rhizoma ligustici/Chinese lovage and Huangbo/cortex phellodendri/bark of Chinese corktree are for small intestine meridian of hand taiyang. Duhuo/radix angelicae pubescentis/doubleteeth pubescent angelica root, Guizhi/ramulus cinnamomi/cassia twig, Zhimu/rhizoma anemarrhenae/common anemarrhena rhizome and Xixin/herba asari/manchurian wild ginger are for kidney meridian of foot shaoyin. Qianghuo/rhizoma seu radix notopterygii/notopterygium rhizome or root is for bladder meridian of foot taiyang. Jiegeng/radix platycodi/platycodon root, Shengma/rhizoma cimicifugae/largetrifoliolious bugbane rhizome, Congbai/bulbus allii fistulosi/fistular onion stalk, Baizhi/radix angelicae dahuricae/dahurian angelica root are for lung meridian of hand taiyin. Baizhi/radix angelicae/dahurian angelica root, Shengma/rhizoma cimicifugae/largetrifoliolious bugbane rhizome, Shigao/gypsum fibrosum/gypsum are for large intestine meridian of hand yangming. Shengma/rhizoma Cimicifugae/largetrifoliolious bugbane rhizome, Cangzhu/rhizome atractylodis/atractylodes rhizome, Gegen/radix peurariae/root of lobed kudzuvine and Baishao/radix paeoniae alba/white peony root are for spleen meridian of foot taiyin. Baizhi/radix angelicae dahuricae/dahurian angelica root, Shengma/rhizoma cimicifugae/largetrifoliolious bugbane rhizome, Shigao/gypsum fibrosum/gypsum and Gegen/radix peurariae/root of lobed kudzuvine are for stomach meridian of foot yangming. Chaihu/radix bupleuri/Chinese thorowax root and Mudanpi/cortex mountan/tree peony bark are for pericardium meridian of hand jueyin. Lianqiao/fructus forsythiae/weeping forsythia fruit, Chaihu/radix bupleuri/Chinese thorowax root, Digupi/cortex lycii/Chinese wolfberry bark, Qingpi/pericarpium citri reticulatae viride/green tangerine peel and Fuzi/radix aconiti laterails preparata/prepared daughter root of common monkshood are for triple energizer meridian of hand shaoyang. Qingpi/pericarpium citri reticulatae viride/green tangerine peel, Wuzhuyu/fructus evodiae/evodia fruit, Chuanxiong/rhizome chuanxiong/szechwan lovage rhizome and Chaihu/radix bupleuri/Chinese thorowax root are for liver meridian of foot jueyin. Chaihu/radix bupleuri/Chinese thorowax root and Qingpi/pericarpium citri reticulatae viride/green tangerine peel are for gallbladder meridian of foot shaoyang. Guiding drugs refer to the drugs that can direct other drugs to work on the affected meridian or site.
Li Shizhen combines the theory of drug meridian tropism with clinical practice, which makes the theory become more and more mature, and promotes the application and popularization of meridian tropism. So far, as an important component of traditional Chinese medicine, the theory of meridian tropism has been completely independent, indicating that traditional Chinese medicine has formed a systematic understanding of drug’s selective action on the zang-fu organs and meridians.
3.2.2Herbalism
Ben Cao Gang Mu is the most influential pharmacological works of all ages. The contents of the book are rich and detailed with important points standing out. The style of writing is innovative, with the categories clearly analyzed. The rich contents of the cursive science and the scientific organization form have achieved perfect unity.
“Shen Nong Ben Cao Jing (Shen Nong’s Herbal) divided drugs into three grades, high-grade drug, medium-grade drug and low-grade drug. Tao Hongjing doubled the number of drugs and divided them into categories. Compilers in Tang and Song Dynasties revised the drugs, either adding or deleting them. Although some of these books printed the drugs mentioned in Shen Nong Ben Cao Jing (Shen Nong’s Herbal) in red and other drugs in black, the three grades were actually in disorder. The same drugs were put into several categories, two different things were put in the same category. Wood drugs were put in the Herbs category, Insect drugs were put in the Category of Woods. Water and Earth drugs were in the same category, Insect and Fish drugs were mixed. Even the names of the drugs remained unclear.” (Compendium of Materia Medica, Volume 1, Preface) The above-mentioned points out clearly the malpractice of disorder of previous classification of drugs. Since the “three grades” first created in Shen Nong Ben Cao Jing (Shen Nong’s Herbal) and “seven categories” classified by Tao Hongjing, the classification method had continued for more than a thousand years, resulting in the accumulation of conventions without any change. Li Shizhen studied the strengths and weaknesses of the works of materia medica and broke away from conventions of “three grades”. He invented the classification system of “Gang (category) and Mu (subcategory)”, which makes the substantial and complicated content of Chinese drugs “complex but in order.”
(1)Programmatic system of drug classification
The programmatic system of drug classification is the general introduction of the book. “It begins with the categories of Water and Fire, then followed by Earth, as Water and Fire appeared the earliest among all things and Earth is the mother of everything. Then followed by Metals and Stones, because they are related to Earth. Then followed by Herbs, Cereals, Vegetables, Fruits and Woods, showing the evolution from minor to major. After this, followed by Fabrics and Utensils, since they are related to Herbs and Woods. Then listed Insects, Animals with Scales, Shells, Fowls, Animals and finally Humans, showing the less developed to the most advanced.” (General Introduction) In a few words, the classification principles and methods of nearly 2,000 drugs have been clearly ascertained. 1,892 kinds of drugs are divided into 16 categories and 60 subcategories.
The 16 categories start with Waters, followed by Fires, Earth, Metals, Stones and Minerals, Herbs, Cereals, Vegetables, Fruits, Woods, Fabrics and Utensils, Insects, Animals with Scales, Shells, Fowls, Animals, and Humans. Its arrangements show the scientific evolution from minor to major, the less developed to the most advanced. The classification and arrangement of the old materia medica works were added, dismantled and reedited. The drugs belonging to different categories but put into one wrongly have been corrected and put in the right categories; the same drug has been put into two or more categories, it has been rectified; those put into wrong categories have been corrected; the newly collected ones have been added. The Category of Herbs, Insects and Fishes has been separated into Insects, Animals with Scales and Shells. The category of drugs that “names recorded but not yet in use is attached to every category. Drugs that are similar but not in use are provided for reference. Those that are similar and effective but not yet known are also appended for reference. For the drugs having nothing to be recorded, they are appended at the end of the entry. Four categories (Water, Fire, Earth, and Fabrics and Utensils) have been added. And 32 kinds of Waters and 39 kinds of Earths that scattered in category of jade and stone in old works have been put in the categories of water and earth. In previous materia medica works, these drugs were collected in the categories of Herbs, Woods, Jade and Stone, Insects and Fish, and Humans. Now all these things are combined into the category of Fabrics and Utensils, all together 79 kinds (Compendium of Materia Medica, Volume 38, The Category of Fabrics and Utensils). To summarize, four categories (Waters, Fires, Earth, and Fabrics and Utensils) have been added based on the old materia medica works. One category of Insects and Fishes has been separated into three categories: Insects, Animals with Scales and Shells. One category of drugs that names recorded but not yet in use is removed. Names of two categories have been changed: “Jade and Stone” have been changed into “Metal and Stone”, “Rice and Cereal” have been changed into “Cereal”.
16 categories are given with 60 subcategories, including two subcategories of Waters, one subcategory of Fires, one subcategory of Earth, four subcategories of Metals, Stones and Minerals, ten subcategories of Herbs, four subcategories of Cereals, five subcategories of Vegetables, six subcategories of Fruits, six subcategories of Woods, two subcategories of Fabrics and Utensils, three subcategories of Insects, four subcategories of Animals with Scales, two subcategories of Shells, four subcategories of Fowls, five subcategories of Animals, one subcategories of Humans. A total of 16 categories, 60 subcategories, 1,892 kinds of drugs are listed distinctly. And each kind of drug is arranged according to its similar attribute, appearance, medicinal position, use and kinship. For example, the Category of Herbs includes mountain herbs, fragrant herbs, herbs from swampland, toxic herbs, creeping herbs, aquatic herbs, herbs from rocky land, mosses and miscellaneous herb, arranged according to their living environment. The Category of Cereals includes wheat and rice, millet, beans and brewed and prepared items, listed by using position (seed) and processing method. The Category of Animals with Scales includes dragon, sneak, fish and fish without scales, arranged according to the morphological characteristics and living environment of animals. The category of Metals and Stones includes metals, jades, stones and halogen, listed by similar chemical qualities. The arrangement not only reflects Li Shizhen’s scientific method of “drugs of one kind put together, category followed by the subcategory” (Compendium of Materia Medica, Volume 1, Preface), but also opens the way for the classification of zoology, mineralogy, botany, etc. becoming the source of the classification thoughts of later generations in the world.
(2)Programmatic system of various drugs
The programmatic system of various drugs is the main part of the book. Among the 1892 kinds of drugs, each drug has complex contents. Li Shizhen, in order to collect and record the information of each drug, has also adopted the “programmatic method” arrangement for each drug. He says: The first is the “Explanation of Names” to make sure of the names of the drug. Then followed by “Previous Explanations” to explain the drug’s original place, shape and collections. Then “Analysis of Dubious Points” analyzes the doubts and corrects the mistakes. “Preparation” is about the drug’s processing. “Quality and Flavor” focuses on its effect. “Indications” is about the therapeutic effect. Then “Explication” explains the function. Lastly, “Prescriptions” is about its use. In the “first” and “second” way, the information of each drug is presented in an orderly manner. Take Huanglian/rhizome coptidis/gold thread for example. Huanglian is the general name of the drug, which is the category. Then the Explanation of Names, Previous Explanations, Preparation, quality and Flavor, Indications, Explication and Prescriptions, which are subcategories. In “Explanation of Names”, it is also named “Wanglian”, and “Zhilian”, which are subcategories of its official name. In its byname, a note is given. “Huanglian/rhizome coptidis/gold thread, the root is yellow, and is like pearls linked to each other. Hence it is called Huanglian, of which Huang is the Chinese pinyin of yellow, and Lian is linked.” This note is a minor subcategory, the two by names are the minor category. For Category of Waters, it can be seen that Waters is the general name, which is the category, then the subcategory “Tianshui/Waters from Heaven”, then it’s subdivision is rain water (minor category), then rain water is subdivided into rain water at the beginning of Spring and rain in the plum season (minor subcategory). This kind of program style can be seen everywhere. For example, the main Explication is the category, the Prescription is the subcategory and so on. Of the 1892 drugs in the book, there are actually 1,892 categories. Each drug is analyzed in programmatic system. Just as Li Shizhen says: Each entry belongs to one category. A general name is given, then followed by Quality and Flavor and Indications. Then differentiations of Explanation of Names, Previous Explanations and Explication... After the general name, the three grades of Shen Nong Ben Cao Jing (Shen Nong’s Herbal) are listed to show its history. Then sources of explanations taken from previous doctors are demonstrated... So the readers can understand the structure and history of the drug clearly (Compendium of Materia Medica, Volume 1, Preface).
3.2.3Botany
Ben Cao Gang Mu is also an important botanical material because Li Shizhen adds two parts when analyzing each plant drug: Explanation of Names and Previous Explanations. In these two parts, he records in detail the medicinal plant’s morphology, characteristics, planting essentials and uses, which is of precious botanical heritage and rich modern botanical value. It is worth our studying, digging and utilizing so as to promote the development of modern botany.
(1)The plants recorded in Ben Cao Gang Mu
Ben Cao Gang Mu consists of 52 volumes, 16 categories and 60 subcategories, introducing a total of 1,892 kinds of drugs. Among them, a total of 26 volumes, 5 categories, 31 subcategories and 1,096 kinds of plants are recorded, accounting for 58% of all drugs recorded. Obviously, plants is an essential part of Ben Cao Gang Mu. We can say this book is a small encyclopedia of plants. This can be proved by the comparison with the works of modern plants in China. Hu Xiansu’s Jing Ji Zhi Wu Xue (Economic Botany) (published in 1953) and He Nan Jing Ji Zhi Wu Xue (Economic Flora of Henan) (published in 1962) are two important modern and contemporary botanical books in China. By comparison, it can be found that 388 kinds of plants recorded in Ben Cao Gang Mu are also recorded in this two works, accounting for more than half of the total number. This is the evidence of the high modern botanic value of this book. Although not recorded according to the classification of modern botany, the plants are divided into herbs, cereals, vegetables, fruits and woods from the perspective of people’s daily life. This way of classification is somewhat random, but conforms to the traditional cultural customs of Chinese people, which is undoubtedly of great significance to the traditionalization of modern botanical research in China. In addition, the vivid summarization and descriptions of roots, stems, leaves, flowers, fruits of plants can make up for the deficiency in the description of some nearly vanishing plants in modern botanical works. The planting methods recorded are essential to the protection of the diversity of plants in China.
(2)The modern botanical value of Ben Cao Gang Mu
(a)Abundant information for modern botany has been provided. In modern botany research, people should study not only the growth of modern plants, but growth condition of ancient plants as well. Only through the comparison of modern and ancient plants can the development law of plants be founded. Therefore, the study of ancient plants is an important content of modern botany. However, the study of ancient plants can only be carried out in ancient books, and Ben Cao Gang Mu is one of the most important ancient documents. In the records of more than one thousand kinds of plants, there are 171 kinds of plants that complete the research on modern botany. As a major achievement of research on plants before the 16th century, it is the most integral and comprehensive book of economic plants. The contribution mainly lies in two points. Firstly, identification of names of some ancient plants. Because of different customs and cultural customs, the ancient literature of economic plants had different names for certain plants, and there were a lot of homologous and synonymous plants, which was not conducive to the exertion of their pharmacological function. Recognizing this, Li Shizhen collects, sums up and identifies the names of certain plants. Renshen/radix ginseng/ginseng is called Huangshen in Wu Pu Ben Cao (Wu Pu’s Herbal), Xueshen, Shencao or Mujing in Ming Yi Bie Lu (Miscellaneous Records of Famous Physicians), Renxian or Guigai in Shen Nong Ben Cao Jing (Shen Nong’s Herbal), and Dijing, Haiyu or Zoumianhuandan in Guang Ya. Secondly, explanations of some plants. He explains the sources of the names of all kinds of plants. For instance, he explains that “the leaves of Machixian/herba portulacae/purslane herb are arranged in the way that looks like horse’s teeth, and the quality is slippery, similar to Xian.” One more example, Huluobo/daucus carota L. var. sativa DC./carrot was introduced from the Hu area during the Yuan Dynasty. Its taste is slightly similar to Luobo/raphanin/radish, so it is called Huluobo/daucus carota L. var. sativa DC./carrot. The origin of carrots, the time that they were introduced, and the reason they were called so are all accounted accurately. The explanations of the origin and meaning of the plant’s name not only help people to know all kinds of plants correctly, but also provide important evidence for modern plant research.
(b)The forms and characteristics of plants are vividly recorded, which provide the basis for the development and utilization of economic plants. Modern botany study had not yet been established when Ben Cao Gang Mu was finished, so Li Shizhen’s understanding of various plants could only be described through the senses, that is to say, through vision, smell and touch, he records plant morphology and qualities. Despite the limitation, on the basis of actual investigation, his observation of all kinds of plants is elaborate, his records of plant morphology and qualities are detailed. Even modern botany study fails to find the characteristics of many plants mentioned in this book. Besides, Li Shizhen describes the planting methods and some important problems in detail, which is meaningful for the protection and development of some plants. It can be seen from the recording of Qiaomai/fagopyri esculenti moench/buck wheat. “Qiaomai/fagopyri esculenti moench/buck wheat is found both in the south and north. Sow the seed around the day of the beginning of Autumn, harvest the crop in August and September. It is easily damaged by frost. The seedling is one or two chi tall, with red stalk and green leaf. It looks like Wujiuye/folium sapii radices/leaf of Chinese tallow tree. The flowers are white and blooming riotously. The fruit is abundant, similar to Yangti/frutus rumicis japonica/fruit of Japanese dock. The seed is triangle in shape, and turns black when ripe.” From this description, we can find that Li Shizhen records the distribution of buckwheat, the time of planting and harvesting, the shape and color of leaves, stems, flowers and fruits in detail, and points out that frost weather should be avoided when people plant buckwheat. This kind of description is very vivid, which is a big help to the farmers. He also gives detailed description of Lvdou/semen phaseoli radiati/mung bean. “Lvdou/semen phaseoli radiati/mung bean is planted everywhere. Sow the seed in March or April, the leaf is small and hairy. Small flowers bloom in autumn, the pod is similar to that of rice bean. That with bigger seed and bright color is called Guanlv, which has thin skin and produces more flour. That with small seed and dark color is called Youlv, which has thick skin and produces less flour. That sowed earlier is called Zhailv, which can be picked often. That sowed later is called Bolv, which should be harvested by pulling out the plant.” From the above we can see that he not only mentions the distribution and planting time of Lvdou/semen phaseoli radiati/mung bean, but also describes the shape of the flower and fruit. What’s more, he emphasizes the classification and the characteristics of Lvdou/semen phaseoli radiati/mung bean planted at different times, which is even more elaborate than the modern research.
(c)The economic use of many plants are introduced. Ben Cao Gang Mu also makes more detailed account of economic utility of the plants recorded, which is beneficial to the development of economic crops and the satisfaction of people’s production and life needs. For example, the use of dates is recorded. “Clean the land and put the dates on a straw mat, dry them in the day and leave them in the open at night, then get rid of the fat and decayed ones, dry and collect them. The ones cut into two pieces and dried are called preserved dates. The ones stewed and squeezed are called date paste. When stewed, Zaojiao (greasy date) is got, which can be blended with sugar and honey and then steamed. Thus, it will be sweeter. When stewed with Zhimaye/folium sesami/sesame leaf, it becomes moister. When Zaojiao (greasy date) is pounded, date oil is got. Boil red and soft dry dates in a pot, with enough water to cover them. When they have boiled, get the dates out and grind in a pottery pot. Squeeze the paste to get juice, spread it in a plate and dry it in the sun. It looks like greasy oil. Collect it with fingers rubbing it into powder. Put one spoon of the powder in hot water, the soup tastes sour and sweet. If we blend the delicious soup with rice, the food can suppress hunger and quench thirst and benefit spleen and stomach as well.” It can be seen that Li Shizhen records the methods and production of dates in detail, such as date cake, greasy date, etc. It is quite significant for the full development of economic value of dates and the people who cultivate dates, and is consistent with the purpose of modern botany research. The research of modern botany, especially economic botany research, is to protect plant diversity better. What’s more important is to improve the economic value of the plant and provide theoretical basis for the development of regional agricultural economy. For example, Shandong Leling date is the result of the diversification of the date processing. With date industry as its pillar, an agricultural product processing industry is constructed. Date is utilized to its best, including the development of food, beverage, medicine and other aspects, thus contributing to the local economic development.
In a word, Ben Cao Gang Mu is of high value for modern botany research, which embodies in its plant research and protection as well as the comprehensive utilization of plants. It plays an important role in promoting modern agriculture and forestry, providing a theoretical guidance on enriching the processing of agricultural products and improving their economic benefits.
3.2.4Zoology
Ben Cao Gang Mu records 462 kinds of animals, accounting for 24% of the total number of drugs. The names, morphology, life habits and medicinal value of animals are well documented.
Ben Cao Gang Mu has improved traditional Chinese classification method. The layout is unified, the narrative is scientific and precise. For example, the generalized “insects” are expanded to 106 kinds, including 73 kinds of insect drugs. They are divided into three categories, “oviparity”, “metaplasia” and “humidogene”. It is of great significance for the taxonomic development of animals and plants.
Ben Cao Gang Mu classifies animal drugs according to the order of insects, animals with scales, shells, fowls, animals and humans, which is arranged from least advanced to the most advanced, reflecting the author’s biological evolution view.
Take the description of animal drugs for example, Ben Cao Gang Mu has a general definition of each drug, and can always grasp the biological characteristics of all animals. “If the bird grows up in the forest, its feathers are like leaves. If the animal grows up in the mountain, its hairs are like grass”. And “the hairs vary according to the seasons, the color varies according to five regions”. The descriptions correctly reflect the variable characteristics of the animals’ adaptation to the environment. In the aspect of related animal variation, the book correctly points out that “to identify black-bone chicken is to examine its tongue”.
Li Shizhen has dissected pangolins, and obtains about a liter of ants from their stomachs, proving that the pangolin eats ants. He also observes that the pangolin sets a tongue trap instead of spreading the scales to lure the ants. He also corrects the erroneous arguments that “the grass becomes fish” and “the crane is viviparous”, pointing out that they are oviparious. And as in Suoyang/herba cynomorii/songaria cynomorium herb, he corrects some unscientific ideas, “According to Tao Jiucheng’s Chuo Geng Lu (South Village Dropout), Suoyang/herba cynomorii/songaria cynomorium herb was produced in the fields of Dada. When wild horsed and dragons spilled their sperm on the ground, it would sprout like bamboo shoots, but I doubt this view.”
Li Shizhen vividly uses the Trigram to explain and analyze the use of fowl and animal drugs. He said: “In the Eight Trigrams, Ji/gallus gallus domesticus brisson/chicken is related to xun, representing Wind. When the time of xun is approaching, chicken senses the atmosphere and then crows. If a patient who suffers from the diseases related to the Wind eats chicken meat, his disease will reoccur. This proves that chicken is related to the xun Trigram.” Zhu/sus scrofa domestica brisson /pig is the animal representing Water and is related to kan in the Eight Trigram. Gou/canis familiars L./dog is the animal representing Wood and is related to gen in the Eight Trigram. Yang/capra hircus L./sheep is the animal representing fire, so it develops fast and its meat is hot in quality. It is related to dui in the Eight Trigram, so the sheep is soft outside and hard inside. Ma/horse is the animal representing Fire, and is related to wu or Metal in the Eight Trigram. Niu/bos Taurus domesticus gmelin/ox is the animal representing Earth and is related to kun in the Eight Trigram. The Earth is mild, so the ox is obedient. The different qualities of Niu /bos Taurus domesticus gmelin/ox and Ma/horse are analyzed by trigrams. In Eight Trigrams, the horse is related to qian and yang, and the ox is related to kun and yin, so the horse hooves are round and the ox hooves are cleft. When the horse is sick, it lies down, indicating yin prevails. When the ox is sick, it still stands, indicating yang prevails. When the horse gets up, it begins with the front feet, while lying down, it begins with the hind feet. This indicates the yang prevails. When the ox gets up, it begins with the hind feet, while lying down, it begins with the front feet. This indicates the yin prevails. This is one example to illustrate the saying: “When the yang gets strong, the yin will be obedient”.
When explaining tortoise, he says: “The shape of Shuigui/chinemys reevesii/tortoise is like li in eight trigrams. Its divinity is in kan... Shuigui/chinemys reevesii/tortoise and Lu/deer are divine animals that lives a long life. The tortoise tends to retract its head into its abdomen, connecting the ren meridian, so its shell can be used to nourish yin by tonifying heart, kidney and blood. Whereas the dear rubs its tail with its nose, connecting the du meridian, so its antler can be used to nourish yang by tonifying life, essence and qi.” The statement vividly illustrates the tortoise’s and deer’s medicinal qualities from their habits.
3.2.5Mineralogy
Among all the works of materia medica, Ben Cao Gang Mu contains the largest number of mineral drugs, all together 265 kinds, accounting for 14% of the total number of drugs. There are 61 kinds of earth drug and 161 kinds of stone and jade drug. Some of these drugs are metallic, some natural inorganic compounds containing impurities, or inorganic chemicals that have been prepared or synthesized. Li Shizhen analyzes the names, distribution, variety, shape, nature, function, identification method of the mineral drugs and discusses the methods of prospecting, mining and smelting. The rich content is important mineralogical information.
Jin/aurum/gold belongs to the Category of Metals, Stones and Minerals, listed as drug of medium-grade in Ming Yi Bie Lu (Miscellaneous Records of Famous Physicians) and also recorded in Bao Pu Zi. It was used to stabilize emotions, tranquilize the spirit and prolong life. Li Shizhen says: “Jin/aurum/gold can be classified as mountain gold and sand gold. The colors of gold could be seven kinds of cyan, eight kinds of yellow, nine kinds of purple, and ten kinds of red. The red is the best. When blended with silver, it becomes softer. When stuck against stones, it leaves cyan marks.” At that time, the analysis of the purity of gold and the test of gold containing silver was in line with the actual situation. He also states that gold is incompatible with mercury, which is concluded according to the practice of making gold foil and mercury into “amalgam” in ancient times. It is also recorded that “Gold flakes were not found in ancient prescriptions, but gold foil was frequently used, which was convenient.” According to the textual research, in the late Shang dynasty (before the 12th century AD), in the unearthed relics in the Yin ruins, gold foil found was as thin as 0.01 mm. Until now, some valuable Chinese medicine are still wrapped by gold foil. In modern times, some British scholars prepared gold as colloid gold to treat rheumatoid arthritis, while in Italy, some scholars used minute gold injection to treat lion’s arthritis.
Yin/srgentum/silver was listed as medium-grade drug in Ming Yi Bie Lu (Miscellaneous Records of Famous Physicians). It can tranquilize the spirit and stop fright and palpation. According to Li Shizhen’s research, silver is Baijin (white gold) recorded in Er Ya. In Tang Ben Cao (The Tang Materia Medica), the way how alchemists would use silver flake was recorded. “Grind silver foil with mercury until it’s totally melted. Then blend it with Xiaoshi/sal nitri/niter and salt, and grind the mixture to powder. Burn to get rid of mercury, and rinse it to get rid of salt and Xiaoshi/sal nitri/niter. Then a fine powder will be got.” But in Li Shizhen’s view, “when applying to drugs, it’s easy to grind silver foil to fine powder. If blended with salt and Xiaoshi/sal nitri/niter, it will be toxic.” This indicates his close observation. In the amalgam method of getting sliver powder, mercury might be left, which is inappropriate for drug use.
Shuiyin/hydrargyrum/mercury was called as Gong in Ming Yi Bie Lu (Miscellaneous Records of Famous Physicians), and was listed as medium-grade drug in Shen Nong Ben Cao Jing (Shen Nong’s Herbal). According to Ben Cao Gang Mu, Hu Yan, in his Dan Yao Mi Jue (Secret of Pellets), recorded the delicate method of processing Shuiyin/hydrargyrum/mercury from Dansha/cinnabaris/cinnabar and charcoal in a detailed way.
In ancient times, alchemy was popular because people wanted to live forever. Ge Hong, a famous alchemist, recorded in his Bao Pu Zi the methods of alchemy and some practical knowledge of chemistry in detail. Li Shizhen says: “When Dansha is burned, it turns into mercury. Mercury accumulates and becomes pellets.” The pellets were considered to prolong one’s life. Li Shizhen comments: “A large number of people who are greedy of life ate too many pellets and died. Alchemists are not reliable, It is not proper to believe in all what they said.” It shows Li Shizhen’s preciseness in medication and excellence in medicine.
Hongsheng Pills (Red Powder) is made from Shuiyin/hydrargyrum/mercury, Xiaoshi/sal nitri/niter, Baifan/alumen/alum, etc. The red one is Hongsheng Pill (Red Powder), and the yellow one is Huangsheng Pill (Yellow Powder), just different crystalline forms of mercury oxide (HgO). In Zhou Li: Tian Guan (256 A. D.) recorded the way of making pellets. The statement of “Shuiyin/hydrargyrum/mercury melts back to Dan (HgO)” was recorded is Bao Pu Zi and Ming Yi Bie Lu (Miscellaneous Records of Famous Physicians). Some scholars believed that refining of Shengdan (HgO) was the earliest record of humans’ efforts to fix oxygen elements. Swedish scientist C. W Scheele confirmed oxygen in 1773.
Yinzhu/vermilion recorded in Ben Cao Gang Mu and Lingsha recorded in Zheng Lei Ben Cao (Classified Materia Medica) are both synthesized by grinding and refining Shuiyin/hydrargyrum/mercury and Liuhuang/sulfur/sulfur which has the same composition as Dansha/cinnabaris/cinnabar. But Dansha/cinnabaris/cinnabar is a natural cinnabar ore, Lingsha is processed product with “bunches of needles. Yinzhu/vermilion is also smelted synthesis of red mercury sulfide. The latter is often used for coloring in ancient times.”
Qingfen/calomelas/calomel was first found in Ben Cao Shi Yi (A Supplement to the Herbal) (739 AD). Li Shizhen sums up three kinds of preparation methods, mainly mixing Shuiyin/hydrargyrum/mercury and salt to smelt and process it. It is low mercury chloride (Hg2Cl2), now known as “calomel” (Calomel), is used as purgative.
In Qingfen/calomelas/calomel, Li Shizhen summarizes that “Shuiyin/hydrargyrum/mercury is a toxic substance of extreme yin, produced by burning Dansha/cinnabaris/cinnabar. When mixed with salt and Lvfan/melanterite/melanteritum, Dansha/cinnabaris/cinnabar will be processed. When mixed with Liuhuang/sulfur/sulfur, Yinzhu/vermilion will be processed.” This analysis of the toxicity of Shuiyin/hydrargyrum/mercury and its products, and the chemical preparation of Shuiyin/hydrargyrum/mercury, Qingfen/calomelas/calomel, Yinzhu/vermilion is fairly accurate.
Pishi/arsenicum sublimatum/arsenic mine was first recorded in Kai Bao Ben Cao (Materia Medica of Kaibao) (973 AD). Li Shizhen says: “Pishi/arsenicum sublimatum/arsenic mine is named after Pi, a legendary fierce animal, because the drug is really powerful.” In Bao Pu Zi, it is recorded: “When Xiaoshi/sal nitri/niter and Xionghuang/realgar/realgar are smelted together, its sublimation flies like smoke clouds, as white as ice.” In Ben Cao Bie Shuo, it says: “When Pishi/arsenicum/arsenic is burned, it produces smoke and turns into white frost. Then it becomes Pishuang (the processed drug), which is quite toxic.”
Among all the works of materia medica, only in Ben Cao Gang Mu is Huoyao/gunpowder listed as a drug. It’s pungent and slightly toxic, mainly used to treat sores and tinea, kill insects, and disperse dampness and epidemics. It is a mixture of Yanxiao/sal nitri/niter, Liuhuang/sulfur/sulfur, and Shanmutong/charcoal of wood of Chinese fir, normally used for military purposes. This further proves that black powder was invented in the practice of medicine preparation.
3.2.6Others
In the discussion of drugs, Ben Cao Gang Mu emphasizes the nature of biological changes when creature’s living habits have been intervened by artificial means. The wild animals could be domesticated, the house plants could be better than wild ones, all these indicates that there was some knowledge about the genetic characteristics of biology at that time. In the field of pharmaceutical chemistry and experimental research, Ben Cao Gang Mu also makes a prominent achievement. The recorded pharmaceutical chemistry contains many chemical reactions including distillation, evaporation, sublimation, recrystallization, and weathering, precipitation, drying, burning, and dumping. For instance, Qianshuang/lead acetate could be prepared. Qiandan/lead pellet could be prepared by the decomposition and oxidation of Xiaoshi/sal nitri/niter and Fanshi/alumen/alum. Wubeizi/galla chinensis/Chinese gall could produce precipitate when brewed with strong tea; white crystallization of gallic acid could be obtained by fermentation of aspergillus. These examples of pharmaceutical chemistry all reach a high scientific level, and even make the earliest records in the world. In terms of scientific experiments, Li Shizhen verifies the function of Luolezi/ocimum basilicum L./basil to treat eyes and takes Mantuoluohua/flos daturae/flower of stramonium to observe the therapeutic and anesthetic effect in person, and conducts animal experiments on the pharmacological effects of some drugs. He observed the pharmacological effects of Dadou/semen sojae/soybean seed and Jichangcao/herba centipedae/small centipeda herb, and dissected the various kinds of less advanced animals such as the pangolin and snake to confirm the similarities and differences in the anatomical structure, and carried out some comparative studies. These methods are a pioneering work in the scientific community at the time. Of course, the unknown or the less known was more common at that time and it was difficult to know the unknown in such a condition. Therefore, in his account of the drugs, Li Shizhen objectively points out that “it hasn’t been tested” or “it hasn’t been confirmed. The information is provided here only to broaden the horizons”, which is enough to prove his scientific attitude of seeking truth from facts.
Ben Cao Gang Mu has also made brilliant achievements in the field of humanities, such as Philosophy, History, Geography, Philology, Linguistics, Phonology, Exegesis, and Philological studies, providing valuable data for the later generations.
In the process of establishing the theory of evolution and arguing for the principle of artificial selection, the great British biologist Charles Darwin referred to Zhong Guo Bai Ke Quan Shu (Ancient China’s Encyclopedia), the content of which is from Ben Cao Gang Mu. For example, when Darwin discussed the variation of chicken and the history of goldfish domestication, he absorbed and quoted the contents of Ben Cao Gang Mu. When Dr. Joseph Needham evaluated this book, he wrote: “Without a doubt, one of the greatest scientific achievements in the Ming Dynasty, is Li Shizhen’s Ben Cao Gang Mu that reaches the summit in the Chinese materia medica books.” “Li Shizhen, as a scientist, reached the highest level that nobody could achieve, except for isolation from Galileo and Vasari’s science activities.” So far, Ben Cao Gang Mu is still an inexhaustible source of knowledge in the research of the history of chemistry and other various sciences.
11 Jin = 16 liang = 500 grams
21 liang = 10 qian = 31.25 grams
31 qian =10 fen = 3.125 grams
41 fen = 10 li = 0.3125 gram = 312.5 mg