When, in 1983, I first attempted to read Hong-yen Hsu’s English language translation of the Shāng Hán Lùn I was already aware of the line in the Yijing that reads “go hunting without the forester and you will soon be lost in the forest.” Not for a moment did it occur to me that, with the resources available to me at the time, it would be near impossible to simply read and understand this cornerstone of classical Chinese medicine. Indeed, I had no inkling that I was actually lost in the forest—in the beginner’s blissful ignorance I imagined it possible to find my own way.
At that same time, on the other side of the world, I guess that Guohui Liu was also wrestling the Shāng Hán Lùn for its secrets. His linguistic and cultural proximity to the primary sources meant that he was in a very much better position to do so. In addition, Liu’s own father was a respected Chinese medicine scholar. If further qualification were needed we could note also that, as a long-standing faculty member of the Oregon College of Oriental Medicine, Professor Liu is accustomed to communicating the ideas of Chinese medicine to English speakers. Evidence of this we have already seen in an earlier English language masterwork, his Warm Diseases: A Clinical Guide.1
As all serious students of this medicine know, the Shāng Hán Zá Bìng Lùn is the very foundation stone of scholarly Chinese herbal medicine practice and is the source of roughly a quarter of the core formulary taught to undergraduates. All undergraduates learn the rudiments of these formulas in the early years of our studies, but if we aspire to high-level practice we need to fully understand their use in the context of the explanatory models used by the Shāng Hán Lùn author Zhang Ji (aka Zhang Zhong-Jing c. +150 to 219).
Despite its pre-eminent position in Chinese medicine, the Shāng Hán Lùn has not been without its critics. I first stumbled across these controversies when, on a clinical trip to Shanghai in 1990, a senior physician assured me that the Shāng Hán formulas, despite their elegance, mostly do not work today as our patients differ from those in the Han Dynasty. This seemed a challenging thing to say. Later I became aware that he was stating his position in a very longstanding debate wherein some Ming Dynasty practitioners asserted that the ancient classical formulas style did not suit illnesses suffered by patients in their era. We might say that this debate continues today and has, alongside the increased sophistication of practitioners and scholars in the here, spread to the West.
To hold an informed position in this requires that we have a proper overview of the complexities of scholarly literature over the past thousand years—the insider’s understanding of Shāng Hán theory that Professor Guohui Liu provides here. So, by explicating the story for us, and presenting his personal scholarly interpretation, he allows us to more properly understand the issues. Liu is our forester offering guidance through the dense Shāng Hán literature forest.
When we have learned to read the language and structure of the classic Chinese herb formulas, we gain the sense that those from the Shāng Hán Lùn possess a characteristic elegance and luminosity. Here we find numerous exemplars on the use of contrasting properties such as matching the cold, sinking effect of shí gāo with the xuan-dispersing effect of xing rén, or the warm pungent dispersal of guì zhī with the cool contracting nourishment of bái sháo. We can sense the focus his formulas have on specific energetic niches in the body and the way he applied the three methods (exterior release, emesis, precipitation). In addition, we can appreciate in the Shāng Hán formulas his specific adjustment of the body’s qi mechanism and his sophisticated insight into the ba gang principles long before the idea had been formally distilled from the classic texts. If we are reasonably adept in Chinese medicine we can appreciate these aspects but, as we learn from this book, it is possible to peer deeper into Zhang Ji’s mastery.
As an aside, it is sometimes forgotten that a significant facet of the historical practice of Chinese medicine is the fight against epidemic and pestilential disease and there is confusion about the dual use of Shāng Hán Lùn theory inside and outside of this context. In modern times we can get a diluted sense of the dread associated with these diseases by reflecting on the realities of words such as plague, Ebola and cholera but few of us have actually witnessed first hand the darkness of such fatal pandemics. The three-millennia-old Shang and Zhou Dynasty jià gǔ wén writings on tortoiseshell and bone mention “disease years” and everything under the sun must have been tried to save life by combating these diseases. In his foreword to the Shāng Hán Zá Bìng Lùn, written in about +219, Zhang Ji wrote that he had witnessed the death of the majority of his relatives in an epidemic and this motivated his life quest for a medical system that was more effective in combating such strife. He adopted a schema taken from the Sù Wèn that outlined the day-by-day progress of febrile disease and refined this on the basis of his medical scholarship and experience. Some of the herb formulas he used were probably self-penned, whereas others, such as guì zhī tāng, are believed to have been in existence in the medical traditions that existed in centuries prior to his own, traditions that are now lost.
Zhang Ji’s Shāng Hán Zá Bìng Lùn text might also have been lost had it not been for the pulse diagnosis master Wang Shu-he, who recovered the writings from bamboo slats and re-ordered to these into two texts, the Shāng Hán Lùn and the Jīn Gùi Yào Lüè. In the few centuries after this rescue work it became a text that was rarely transmitted, it was tersely written, difficult to understand and so it was difficult to convey its meaning to students. Then, in the Song Dynasty it was found in the Imperial library archives and attracted interest because of its potential as a resource to help tackle the epidemics of the time. With imperial sponsorship a great deal of high-level scholarship was applied to the text and, decade by decade progress was made in unravelling its meaning. This work continued through the subsequent Jin-Yuan, Ming and Qing dynasties and has carried on right up to modern times.
As a result of this thousand-year scrutiny, the Shāng Hán Lùn has inspired a vast body of literature intended to discuss, analyze and interpret its meaning—work that is formidable both in volume and complexity. Literally thousands of books and articles are in existence and debate continues in specialist journals today. As we see from Liu’s account of the debate, the style of the historical discourse differs from modern scholarship. It presupposes a high level of understanding of the dense forest that is traditional scholarship which itself is one reason that so very few native Westerners are in a position to access this source literature in a meaningful way. Without the right guidance such as this we are lost.
One key difficulty is making sense of the six conformations (liù jīng) schema. Does it refer to the jīng luò system? The zang fu? Is it a theoretical energetic construct built upon concepts of the qiji (qi mechanism) or is it rooted in the traditional Cosmology theories? Liu carefully unravels the six conformations for us. What classical Chinese models can we best apply to its interpretation—ba gang? Traditional chronobiology? To what extent is Shāng Hán Lùn theory applicable in general medical practice outside the context of cold attack? In examining the issues Liu guides us through the complex journey the Shāng Hán Lùn has taken spanning the writings of the various commentators from the Song Dynasty through to modern times and explains the ideas that they developed.
In addition to explaining the Shāng Hán scholarly narrative Professor Liu details his own approach to its use in practice including a detailed discussion on the understanding of tai yang and shao yang layers. This is very valuable—Professor Liu is a guide in this forest, allowing us to deepen our understanding into the way we can apply Shāng Hán Lùn theory clinically in the modern world. With access to this understanding we will also be better placed to consider the relationship between Shāng Hán and Wēn Bìng (Warm Disease) theory.
Charles Buck
Chester, UK
May 2015
1Guohui Liu. Warm Diseases: A Clinical Guide. Seattle, WA: Eastland, 2001