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Dear postgraduate students, it is my great pleasure to meet you and talk to you about [Shang Han Lun] - one of the most famous classical clinical books in Traditional Chinese medicine (TCM). As the general introduction part of [Shang Han Lun] has been lectured by Dr Jidong Wu, today we will directly start to discuss Six Meridian Disease, from page 2 to 30 of this handout.

1. The History of [Shang Han Lun]

[Shang Han Lun伤寒论],which now should be translated into “Treatise on Cold Damage Diseases”, according to [International Standard Chinese-English Basic Nomenclature of Chinese Medicine中医基本名词术语中英对照国际标准]compiled by World Federation of Chinese Medicine Societies published by People’s Medical Publishing House in 2008, was originally part of [Shang Han Za Bing Lun伤寒杂病论Treatise on Cold Damage & Miscellaneous Diseases] written by the outstanding physician Zhang Ji 张机(Zhang Zhongjing 张仲景) in the East Han Dynasty(3rd century AD, about 200-219 AD). Although Dr Zhang Zhongjing is extremely well known in Chinese medical field and considered as one of best doctors in Chinese history, very little is known about his private life. According some later sources, Zhang Zhongjing was born in Nieyang ,Nanyang Jun/东汉南阳郡涅阳,today known as Deng County , Nanyang City, Henan Province ,China 河南省南阳市邓县。During his time, with warlords fighting for their territories, many people were infected with and even died from febrile diseases, and his family was no exception. This could be the main reason for him deciding to study Chinese medicine. He started to learn Chinese medicine from his own hometown fellow Dr Zhang Bogu. Later he also held an official position—Taishou of Changsha (Governor of Changsha City) in Hunan Province according to a book [Famous Physicians Record 名医录] by Mr. Gan Bo Zhong甘伯宗 in Tang Dynasty. Dr Zhang Ji lived approximately 150-219AD, but the exact dates of his birth and death vary from source to source. However, an upper limit of 220 AD is generally accepted by most scholars today. It is also said that he was the father in law of Dr Hua Tuo 华佗 (?-208 AD), another famous Chinese surgeon in the later period of the East Han Dynasty. Dr Zhang Zhongjing studied previous classical Chinese medical literature and collected many effective herbal formulas elsewhere, finally writing his masterpiece [Shang Han Za Bing Lun].Unfortunately , shortly after being published , his book was lost during wartime. Dr Zhang Zhongjing ’s masterpieces were collected by later generations, and the part of cold damage diseases was re-arranged into a book -[Shang Han Lun]by Dr Wang Shuhe王叔和 in the Jin Dynasty.; and the part on miscellaneous diseases was also revised into another book-[Jin Kui Yao Luo 金匮要略Synopsis of the Golden Chamber ] by Dr Wang Shuhe . As result his book was separated into 2 books, [Shang Han Lun] and [Jin Kui Yao Lue].

2. The Contributions of [Shang Han Lun]

As I mentioned above, Dr Zhang Zhongjing , through the study of Chinese classical books, such as [Su Wen 素问 Plain Questions]， [Ling Shu 灵枢 Cannon of Acupuncture], [Nan Jing 难经 Classic of Difficulties ] ,and the like, targeted and collected extensively many useful herbal formulas , and finally created a new theory in Chinese medical history--“Bian Zheng Shi Zhi”/diagnosis and treatment should be according to syndrome’s differentiation, including Syndrome Differentiation of 6 Meridian Diseases , i.e. the diagnosis and treatment of cold damage and febrile diseases are based on differentiating and analyzing 6 stages and syndromes during febrile diseases, which is also the embryo of the Differentiation of 8-principle Syndrome and the Differentiation of Zang-Fu Organs. As the first Chinese clinical book, it also discussed pathogenic mechanism, therapeutic principles and methods, formulas and herbs, acupuncture and moxibustion , ect. Therapeutic principles and methods are plentiful in [Shang Han Lun], including eight methods: Sweating method, Emetic method, Harmonizing method, Purgative method, Heat clearing method, Warming method , Tonifying method Resolving method. In [Shang Han Lun], there are 8 major chapters, 113 formulas, and 398 clauses. Additionally, in [Jin Kui Yao Lue], there are 25 chapters, 262 herbal formulas, as some of the formulas are same as those introduced in [Shang Han Lun] ,hence, the total number of formulas in the 2 books are 269 in all.

3. The Main Patterns & Formulas of 6 Meridian Diseases

Dr Zhang Zhongjing classified all symptoms and signs and stages during febrile diseases into 6 groups, namely: Taiyang Disease/Greater Yang Disease Yangming Disease/Yang Brightness Disease Shaoyang Disease/Lesser Yang Disease Taiyin Disease/Greater Yin Disease Shaoyin Disease /Lesser Yin Disease Jueyin Disease/Reverting Yin Disease. Now we discuss the 6 meridian diseases one by one as following:

Chapter 1 Syndrome Differentiation and Treatment of Taiyang Disease/Greater Yang Disease

辨太阳病脉证并治

The Chapter taiyang disease/Greater Yang Disease is the first chapter of 6 meridian diseases; it is also the largest and main chapter in [Shang Han Lun]. In TCM (Traditional Chinese medicine) theory, taiyang meridian includes the bladder meridian of foot taiyang, and the small intestine meridian of hand taiyang; however in [Shang Han Lun], the bladder meridian of foot taiyang is mainly discussed. The bladder meridian emerges from the inner canthus, ascends to the forehead and then to the vertex, and then goes to the back part of the neck and descends from the neck to the lumbar region, where it enters and belongs to the bladder and connects with the kidney. Particularly, the yang-qi in taiyang meridian is strong and excessive; Taiyang meridian governs the surface of body and controls the ying/nutrient qi and wei/defensive qi , it is a barrier of 6 meridians. So, taiyang disease is the exterior syndrome caused by pathogenic wind-cold, it is an early stage of febrile disease. There are 178 clauses, 74 syndromes in the chapter. The chapter discusses not only the major exterior syndrome of taiyang disease, but also associated兼证, deteriorated坏证 and similar syndromes 类证 . However, as limitation of teaching time, I just talk about some important clauses on the outline of taiyang disease and major syndromes本证 of taiyang disease today.

1. Outline of Taiyang Disease/Greater Yang Disease太阳病脉证提纲

Clause 1: Taiyang disease/greater yang disease is characterized by floating pulse, headache with stiff neck, and an aversion to cold。 太阳之为病，脉浮，头项僵痛而恶寒。(1)

Synopsis: The outline of taiyang disease.

Explanation: The main function of taiyang meridian is governing the body surface; Taiyang is a barrier /front line of 6 meridians; Taiyang disease is the exterior syndrome caused by pathogenic wind-cold.

Floating pulse is a sign of exterior syndrome; Aversion to cold is a key symptom of exterior syndrome; Headache and stiff neck are caused by invasion of taiyang meridian by pathogenic wind-cold factors. Dear students, all the above are essential symptoms and signs of taiyang disease, we have to always remember them.

2. Classification of Taiyang Disease/Greater Yang Disease 太阳病的分类

Clause 2: Taiyang disease with symptoms and signs of fever, perspiration, an aversion to wind, and moderate pulse is termed zhongfeng syndrome/greater yang wind-invasion syndrome. 太阳病，发热，汗出，恶风，脉缓者，名为中风。(2) Synopsis: Essential symptoms and signs of zhongfeng syndrome /greater yang wind-invasion syndrome (deficiency type of wind-cold exterior syndrome).

Explanation: In this clause, at first it says “taiyang disease …..”, which means the symptoms and signs mentioned in Clause 1 such as floating pulse, headache, stiff neck are also included;

Fever is key symptom in both zhongfeng and shanghan syndromes, it is caused by the fight between the pathogenic wind-cold and defensive qi. However, some patients run it early, some later, this is the reason for some clauses such as Clause 3, saying that “taiyang disease with fever; or without fever” .

Perspiration is a very important point in distinguishing zhongfeng from shanghan, caused by functional disorder of the ying(nutrient essence) and wei(defensive qi) due to the damage and deficiency of defensive qi by pathogenic wind, as a result, the ying(nutrient essence) fails to be protected by defensive qi and leaks out.

Aversion to cold is due to pathogenic wind –cold obstructing the circulation of defensive qi in the body surface. Moderate pulse here means a floating –moderate pulse which is a sign of zhongfeng syndrome in [Shang Han Lun]. Today we generally term “zhongfeng syndrome of taiyang disease” to “deficiency type of wind-cold exterior syndrome)”.

Clause 3: Taiyang disease with fever or without fever, marked by aversion to cold, pain in the body, nausea, vomiting and tense pulse, is termed shanghan syndrome /greater yang cold damage syndrome. 太阳病，或已发热，或未发热，必恶寒，体痛，呕逆，脉阴阳俱紧者，名为伤寒。(3)

Synopsis: Essential symptoms and signs of shanghan syndrome/Greater Yang Cold Damage Syndrome (Excess type of wind-cold exterior syndrome).

Explanation: Fever is a key symptom for both zhongfeng syndrome and shanghan syndrome of taiyang disease, but it may appear early or later;

Aversion to cold is an essential symptom of shanghan syndrome, acutely it is difficult to distinguish aversion to cold; or aversion to wind . They differ just in severity;

Pain in the body is due to stagnation of yang-qi caused by pathogenic wind-cold.

Nausea and vomiting are caused by the stomach-qi affected by pathogenic wind-cold. Tense pulse is a sign of obstruction of defensive qi by pathogenic cold-wind. They fight each other tensely and so manifests as tense pulse.

Clause 6: Taiyang disease with fever and thirst, but without chills, is termed wen bing (warm disease) …… 太阳病，发热而渴，不恶寒者，为温病，………(6)

Synopsis: Characteristics of wen bing /warm disease.

Explanation: Fever is due to pathogenic wind-heat invading the body; Thirst is caused by damage of body fluid by pathogenic wind-heat.

No aversion to cold means the cause of wen bing is wind-heat, not wind –cold. In basic theory of [Shang Han Lun], wen bing is one type of febrile diseases, due to the invasion of the body surface and lung-system by pathogenic wind-heat or infectious factors, so therapeutic principle for wen bing is to dispel wind and clear away heat and toxin(including infectious factors such as bacteria, virus, etc.) . However, at that time , there were not enough formulas for treatment of wen bing in [Shang Han Lun], most formulas for treating wen bing were created by later generations; you may need to study more books such as [Wen Re Lun 温热论 Treatise on Warm-heat Disease] by Dr Ye Tianshi in 1746, and [Wen Bing Tiao Bian 温病条辨 Detailed Analysis of Warm Disease ]by Dr Wu Jutong in 1798.

3. Zhongfeng Syndrome /Greater Yang Wind-invasion Syndrome of Taiyang Disease &Guizhi Tang/Cinnamon Twig Decoction太阳中风证和桂枝汤

Clause 12: Zhongfeng syndrome/greater yang wind-invasion syndrome of Taiyang Disease is characterized by floating pulse at yang and weak pulse at yin, where floating pulse signifies fever, and weak pulse signifies perspiration, and aversion to cold and wind, stuffy nose and nausea. It could be treated by Guizhi Tang/Cinnamon Twig Decoction. 太阳中风，阳浮而阴弱，阳浮者，热自发，阴弱者，汗自出，啬色恶寒，淅淅恶风，鼻鸣干呕者，桂枝汤主之。(12)

Synopsis: Main symptoms and treatment of zhongfeng syndrome /greater yang wind-invasion syndrome (today it is usually termed “deficiency type of wind-cold exterior syndrome”).

Explanation: Floating pulse at yang: the pulse is floating when felt lightly; or the pulse is floating at cun-here means fever.

The weak pulse at yin: the pulse is weak when felt deeply; or the pulse is weak at chi-here means perspiration.

Fever results from the fight between pathogenic wind-cold and defensive qi;

Perspiration is an important symptom of deficiency exterior syndrome caused by the ying-yin /nutrient yin which fails to be protected by defensive qi and leaks out; Aversion to cold and wind is caused by pathogenic wind-cold invading the body surface and obstructing the circulation of defensive qi. Stuffy nose is due to pathogenic wind-cold affecting the lung system, as lung and nose have close relation with the body surface in TCM theory. Nausea is resulting from pathogenic wind-cold affecting the stomach which can not descend normally. Formula: Guizhi Tang桂枝汤Cinnamon Twig Decoction Ingredients: Guizhi/Cinnamon twig /Ramulus Cinnamomi 3 Liang (in the Han Dynasty)/ 9g (today’s dosage) Shaoyao/Peony root/Radix Paeoniae 3 Liang/9g Zhi Gancao/Prepared licorice root/Radix Glycyrrhizae Praeparatae 2 Liang/6 g Shengjiang/Fresh ginger/Rhizoma Zingiberis 3Liang/9g Dazao / Chinese dates/Fructus Jujubae 12 pcs.

Note: Today’s dosages of all formulas in this handout are mostly according to the Conversion of the Dosage in the East Han Dynasty into Today’s Dosage (see the table in the appendix attached) as well as our own experience.

Administration: All the above 5 herbs, should be boiled in the pot with water about 7 Sheng (198.1ml x 7) over a slow fire, until the water is to be reduced to 3 Sheng(198.1ml x 3). Remove herbal dregs to get the decoction. Drink 1/3 of the decoction when it is warm.

Notes:

1)Af1ter taking the above decoction, drink 1 Sheng(198.1ml or more ) of porridge to assist the decoction for better efficacy; Warm cover is taken for one or two hours to get perspiration; a light perspiration would be suitable.; If the sweat is too watery, it will not do any good to the treatment.

2)If the syndrome is cured , do not take the rest of the decoction; If not cured, take it again as before; If after taking it twice with no effect, the decoction may taken a 3rd time within a half day.

3) For serious cases, take the decoction day and night. If disease is not cured after taking one dose, take again, even for two or three doses.

4) During the period of taking the decoction, raw, cold, greasy dishes, and food with irritating /stimulating qualities (eg spicy) or with a peculiar or spoiled flavor or odor, alcohol, milk and its products should be avoided.

Actions: Harmonizing the ying/nutrient qi and wei/defensive qi to relieve the exterior deficiency syndrome (zhongfeng syndrome of taiyang disease).

Explanation: Of the ingredients in the above formula, Guizhi/Cinnamon twig is a herb with pungent and sweet in flavor and warm in nature, and acts as a principle herb to relieve exterior syndrome by expelling pathogenic wind and cold from body surface including muscles and skin; Shaoyao / Peony root is a herb with sour, bitter and slight cold properties and is used as an assistant herb for replenishing yin to astringe ying. The combination of Guizhi / Cinnamon twig and Shaoyao /Peony root result in the double roles of both being diaphoretic and astringent for harmonizing the ying and wei, which means that it induces sweat without impairment of yin; and arrest sweat without interference in dispelling exopathic factors . Shengjiang/Fresh ginger, possessing pungent and warm properties, can not only aid Guizhi /Cinnamon twig in expelling pathogens from the muscles and skin, but also warm the stomach and arrest vomiting. Dazao/Chinese dates, with sweet and mild properties, is used as tonics of the stomach and blood for supplementing qi and reinforcing the middle-jiao, nourishing yin and tonifying blood; and, used in combination with Shengjiang /Fresh ginger as an adjutant herb, it can harmonize ying and wei. Zhigancao/ Prepared licorice root, as a guiding herb, is used to tonify the middle-jiao and replenish qi and to coordinate all the herbs in the recipe.

Clause 13: Taiyang disease, marked by headache, fever, sweating, and aversion to cold, could be effectively treated by Guizhi Tang/ Cinnamon Twig Decoction. 太阳病，头痛，发热，汗出，恶风，桂枝汤主之。（13）

Notes: Besides Clauses 12 and 13, in [Shang Han Lun], there are other clauses on Guizhi Tang/Cinnamon Twig Decoction, including Clauses 15, 24, 42, 44, 45, 53, 54, 56, 57, 91, 95, 164,234,240,372,387; and also in Chapter 21 On Pulse, Syndrome and Treatment of Postpartum Diseases of [Jin Kui Yao Lue].

Clinical application:

1 My own experiences: I have used Guizhi Tang /Cinnamon Twig Decoction since 1982 mostly for treatments of common cold, influenza, urticaria, eczema, neuralgia and myalgia characterized by fever, aversion to wind with perspiration, floating-moderate pulse; or just spontaneous perspiration due to disharmony between ying and wei. It is really effective.

2 Dr Guan Youbo, a very famous TCM specialist in China, reported that Guizhi Tang /Cinnamon Twig Decoction plus Shigao/Gypsum/Gypsum Fibrosum 20g, Huangbai/ Phellodendron bark/Cortex Phellodendri 15g, Cangzhu / Atractylodes rhizome /Rhizoma Atractylodis 15g, and Yinchen/ Oriental wormwood / Herba Artemisiae 20g, is very effective for rheumatoid arthritis.

3 Dr Qu Sheng said Guizhi Tang / Cinnamon Twig Decoction plus Huangqi/ Astragalus root/ Radix Astragali seu Hedysari , Muli / Oyster shell/ Concha Ostreae , is very good at treating spontaneous perspiration and night sweat.

4 Dr Zhao Jinghua reported that Guizhi Tang/ Cinnamon Twig Decoction plus Shicangpu / Grassleavaf sweetflag rhizome /Rhizoma Acori Tatarinowii 6g, Yujin/ Curcuma root/ Radix Curcumae 6g, is effective for somnolence/sleepiness day and night. After 3 bags, the patient felt better , after 15 bags, she got complete recovery.

Notes: All the above can be found in the book, [Research in Classical Formulas of TCM] by me.

Modern research: Modern researches have proved that the formula possesses the efficacies of inducing sweat, reducing fever, removing phlegm, relieving convulsion and pain, promoting digestion and absorption, nourishing the body and consolidating the constitution. See the books, [A Practical English-Chinese Library of TCM”] by me.

3. Shanghan Syndrome/Greater Yang Cold Damage Syndrome of Taiyang Disease &Mahuang Tang/Ephedra Decoction太阳伤寒证和麻黄汤

Clause 35: Taiyang disease with headache, fever, pantalgia, lumbago, arthralgia, aversion to wind, no perspiration, and asthma, can be treated by Mahuang Tang/Ephedra Decoction. 太阳病，头痛，发热，身疼，腰痛，骨节痛疼，恶风，无汗而喘者， 麻黄汤主之。（35）

Synopsis: Main symptoms of Shanghan Syndrome/Greater Yang Cold Damage Syndrome (Today it is termed “excess type of wind-cold exterior syndrome”).

Note: The indications of Mahuang Tang /Ephedra Decoction can be also seen in Clauses 36, 37, 46, 51, 52, 55, 232, 235 in the book [Shang Han Lun].

Explanation: Fever results from the fight between pathogenic wind-cold and defensive qi; Aversion to cold is caused pathogenic wind-cold preventing defensive qi from warming the body surface; No perspiration is a very important point of exterior excess syndrome due to stagnation of defensive qi and ying-yin which has been blocked by pathogenic wind-cold in body surface. Headache, pains in the body, back, joints, all are caused by obstruction of defensive qi circulation; Asthma is sign of affecting the lung by pathogenic wind cold.

Formula: Mahuang Tang 麻黄汤 Ephedra Decoction Ingredients: Mahuang/ Ephedra/Herba Ephedrae (with joints removed) 3 Liang/9g, but in the UK, you may choose Xiangru 香薷Chinese Mosla/Herba Moslae 9g instead of Mahuang/Ephedra. Guizhi/ Cinnamon twig /Ramulus Cinnamomi 2 Liang /6g Zhigancao/ Prepared licorice root / Radix Glycyrrhizae Praeparatae 1 Liang/3g Xingren / Bitter apricot kernel/ Semen Armeniacae Amarum (with its skin removed) 70 pcs / 9g

Administration: Decoct Mahuang/Ephedra in water (9 Sheng= 198.1mlx9) in the pot over a fire until 2 Sheng (198.1mlx2 ) of the water is reduced , remove the foam (containing more ephedrine) floating on the water; and then add other herbs into the pot which will be boiled until the decoction is reduced to 2.5 Sheng=198.1mlx2.5. Drink 8 Ge (19.81mlx8) of the decoction when it is warm; if necessary 2 times a day. After drinking the decoction, ask the patients to stay in a warm bed to induce slight perspiration.

Actions: Inducing sweat to relieve the exterior excess syndrome, and smoothing the lung’s descending function to relieve cough and asthma.

Explanation: Mahuang/Ephedra dispels pathogenic wind-cold from the exterior by inducing sweat and relieves asthma, acting as a principle herb in the formula. In the UK, we may choose Xiangru香薷Chinese Mosla instead of Mahuang/Ephedra because the use of Mahuang is prohibited in the UK. Guizhi/ Cinnamon twig, as an assistant herb, can also dispel pathogenic wind-cold. The combination of Mahuang/Ephedra or Xiangru /Chinese Mosla and Guizhi/ Cinnamon twig has a strong diaphoretic function. Xingren/Bitter apricot kernel brings down the abnormal ascending of the lung-qi, and helps Mahuang/Ephedra to ease cough and asthma as an adjutant herb. Zhigancao/ prepared licorice root can reinforce the middles-jiao, replenish qi as well as harmonize all other herbs in the formula as a guiding herb.

Clinical application

1) My own experiences: I have used Mahuang Tang/Ephedra Decoction since 1982 to treat common cold , influenza, and upper respiratory tract infection that marked by fever, aversion to cold, no sweating, body aches, cough or asthma, floating and tense pulse. I have achieved a satisfactory result in most of my patients.

2) Dr Huang Hai proposed that Mahuang Tang /Ephedra Decoction can be used “ for asthma and cough of wind-cold excess syndrome caused by upper respiratory tract infection, pneumonia, bronchitis and asthma” ; also for “ arthralgia-syndrome of cold-wind , mainly at early stage and characterized by fever, aversion to cold, no perspiration, body aches, and floating-tense pulse”. See the book, [Introduction to Treatise on Exogenous Febrile Diseases] by Dr Huang Hai

3) Dr Liu Huimin, a very famous TCM doctor in Shandong Province, P.R. China, once treated the late Chinese leader Mao Zedong who suffered common cold but could not recover for a long time. Dr Liu Huimin used modified Mahuang Tang /Ephedra Decoction. After that Mr. Mao recovered in very short time. It was said that Dr Liu Huimin later was promoted as deputy director of Health Dept of Shandong Government as well as first president of Shandong TCM University where I graduated and lectured. Dr Liu Huimin’s god-daughter Ms Chen Luwen, a dancer, was one of my patients in London.

Modern research:

1) Modern researches have proved that Mahuang /Ephedra and Guizhi /Cinnamon Twig can excite sweat glands in the thenar of hamsters;

2) Volatile oil of Mahuang /Ephedra can inhibit activities of influenza virus (AR8) that may be a base to treat influenza.

3) A Japanese Dr Xi Ze Fang Nan (Nishi Zawa Yoshi O) found Mahuang Tang /Ephedra Decoction can inhibit histamine released by basophilic cell and mast cell during allergic reaction. For all the above, please check the book, [Research in Classical Formulas of TCM] by me .

Chapter 2 Syndrome Differentiation and Treatment of Yangming Disease/Yang Brightness Disease

辨阳明病脉证并治

In TCM theory, yangming meridian includes the stomach meridian of foot yangming and the large intestine meridian of hand yangming.

The main physiological function of the stomach is to receive, digest and transform water and food;

The main physiological function of the large intestine is to receive the contents from the small intestine and absorb excessive water from it , and forms faeces which is discharged from body through the anus.

In [Shang Han Lun], yangming disease is a more severe stage occurring the middle period of febrile diseases with nature of interior, heat and excess.`

There are 2 main essential syndromes in Yangming Disease, namely: Yangming meridian syndrome, marked by the internal excess heat, manifested as high fever without chills, profuse perspiration, great thirst, large pulse.

Yangming-fu organ/bowel syndrome, marked by abdominal distension or pain ,constipation or dry faeces, high fever or tidal fever in afternoon, restlessness, delirium and coma. The therapeutic method and recipe for yangming meridian syndrome: use cooling method, Baihu Tang/ White Tiger Decoction. And treatments for yang-fu organ/bowel syndromes, there are 3 different formulas, namely: Tiaowei Chengqi Tang/Stomach-regulating Purgative Decoctions that is for yangming-fu /bowel syndrome marked by dryness-heat in the stomach and intestine; Xiao Chengqi Tang/Minor Purgative Decoction that is for mild case of yangming-fu/bowel syndrome marked by stagnation of qi in the stomach and intestine; Da Chengqi Tang / Major Purgative Decoction that is for yangming-fu/bowel syndrome marked by excessive heat and constipation or dry faeces in yangming –fu/bowel organs. We now discuss the above as following:

1. Outline of Yangming Disease/Yang Brightness Disease阳明病提纲

Clause 180: Yangming disease is stomach excess. 阳明之为病，胃家实是也。(180)

Synopsis: The basic pathological condition of yangming disease.

Explanation:

1) Stomach here indicates the stomach meridian of foot yangming and the large intestine meridian of hand yangming.

2) Excess here means predominance of pathogenic heat in the stomach (yangming meridian syndrome) ; or dry faeces in the intestine (yangming-fu syndrome).

2. Yangming Jing Syndrome/Yang Brightness Meridian Syndrome阳明经证

Clause 182: Question: What are exterior symptoms of yangming disease? Answer: Fever, spontaneous perspiration, no aversion to cold but to heat. 问曰：阳明病外症云何？答曰：身热， 汗自出，不恶寒，反恶热也。(182)

Synopsis: Exterior symptoms of Yangming Jing Syndrome/Yang Brightness Meridian Disease.

Explanation: Fever here is symptom of interior heat; Spontaneous perspiration is caused by the evaporation of interior heat; No aversion to cold indicates there is no pathogenic wind-cold at exterior; Aversion to heat means that the interior heat is too excessive.

Clause 186: Febrile disease on the third day when yangming disease comes, the pulse is large. 伤寒三日，阳明脉大。(186)

Synopsis: Essential pulse of yangming meridian disease.

Clause 176: Baihu Tang suits the febrile disease with floating-slippery pulse, which is caused by the heat at both exterior and interior. 伤寒，脉浮滑，此以表有热，里有寒（当为“热”），白虎汤主之。((176)

Synopsis: Pulse & treatment of yangming meridian disease.

Explanation： Floating pulse here indicates heat in the exterior; Slippery pulse means heat and excess in the interior; Floating-slippery pulse here is sign of excessive heat at both interior and exterior.

Notes: According to other clauses described in [Shang Han Lun], the symptoms and signs of yangming meridian syndrome (Baihu Tang Syndrome) include 4 great symptoms: High fever, Profuse spontaneous perspiration, Great thirst Large, forceful pulse.

Formula: Baihu Tang白虎汤White Tiger Decoction Ingredients Shigao/ Gypsum/ Gypsum Fibrosum (ground) 1Jin/30g Zhimu/Wind-weed rhizome /Rhizoma Anemarrhenae 6Liang/ 15g Zhigancao/Prepared licorice root/ Radix Glycyrrhizae Praeparatae 2Liang/6g Jingmi / polished round-grained non-glutinous rice/Semen Oryzae Nonglutionosae 6 He/9 g

Administration: Decoct all herbs in water until the rice is well-done. Take 1/3 of the decoction warm orally after removal of the residue, 3 times a day.

Actions: Clearing away heat from yangming meridian and promoting the production of body fluid. Explanation: In the recipe, Shigao/Gypsum, pungent and sweet in flavour and extremely cold in nature, acts as a principle drug which is effective against excessive heat in yangming meridian; Zhimu / Wind-weed rhizome, bitter in taste and cold moist in nature, serves as an assistant herb for strengthening the action of the principle drug. Zhigancao/ Prepared licorice root and Jingmi / Polished round-grained non-glutinous rice, as adjutant and guiding herbs, can not only reinforce the function of the stomach and protect the body fluid, but also prevent the middle-jiao from being injured by bitter and cold drugs.

Notes: Indications of Baihu Tang are also recorded in following clauses in [Shang Han Lun] :

Clause 219: Syndrome involving 3 yang meridians simultaneously: there are symptoms and signs of abdominal distension, a heavy feeling in movement, difficulty in turning round, a lack of taste, dusty face, delirium and incontinence of urine. When there is spontaneous perspiration, Baihu Tang /White Tiger Decoction can be prescribed to the patient. In this case, if diaphoresis is adopted, the patient will suffer delirium. If a purgative is given, sweat over the forehead and coldness on the extremities will occur. 三阳合病，服满，身重，难以转侧，口不仁，面垢，谵语，遗尿。发汗则谵语。下之则额上生汗，手足逆冷。若自汗者，白虎汤主之。（219）

Explanation: Although the syndrome involving 3 yang meridians simultaneously mentioned in the above clause, according to the symptoms and signs in the clause, it can still be diagnosed the syndrome as an excess heat in yangming meridian. As abdominal distension, a heavy feeling in movement, and difficulty in turning round are due to excess heat in yangming meridian, and disorder of the meridian-qi. A lack of taste means excess heat in the stomach. A dusty face and spontaneous perspiration are caused by evaporation of interior excess heat. Delirium and incontinence of urine reflect excess heat misting the mind.

Clause 350: It is an interior heat syndrome with slippery pulse and coldness on the extremities. Baihu Tang /White Tiger Decoction can be adopted in this case. 伤寒脉滑而厥者，里有热，白虎汤主之。(350)

Explanation: It is a severe case of heat-jue syndrome .The patient might also have a high fever, parched mouth and tongue, thirsty for a cold drink, yellowish urine, red tongue with yellowish fur, rapid pulse, etc. Clinical application:

1. For encephalitis B, and epidemic meningitis marked by high fever, profuse perspiration, a great thirsty, large and forceful pulse, we may try to use Baihu Tang /White Tiger Decoction that should be combined with Western medicine at the same time in hospital.

2. For sunstroke, heat stroke, and infantile summer fever marked by symptoms of excess heat in yangming meridian, we can use Baihu Tang /White Tiger Decoction. It is really effective.

3. For upper respiratory tract infection, influenza, pneumonia and septicaemia marked by yangming meridian syndrome, we can choose Baihu Tang/ White Tiger Decoction.

4. For rheumatic fever, rheumatic arthritis and infective arthritis (heat bi syndrome), we may apply Baihu Tang /White Tiger Decoction with additional ingredients, such as Guizhi/ Cinnamon twig , Cangzhu/ Atractylodes rhizome, Huangbai/ Phellodendron bark. Notes: For all the above, please check the book, [Research in Classical Formulas of TCM] by me.

5. I also used modified Baihu Tang /White Tiger Decoction for the patients with diabetes marked with great thirst. It was effective to most of the cases.

Modern research Modern research has proved that Baihu Tang /White Tiger Decoction has the efficacies of allaying fever, tranquilizing the mind, subduing inflammation, quenching thirsty, lowering blood sugar level. See page 98, [Prescriptions of TCM], a part of 14books in [A Practical English-Chinese Library of TCM] by me.

3.Yangming Fu Syndrome/Yang Brightness Fu-organ Syndromes阳明腑证

1)Tiaowei Chengqi Tang调胃承气汤Stomach-regulating Purgative Decoction Clause 207: Tiaowei Chengqi Tang/Stomach-regulating Purgative Decoction suits the following symptoms and signs of yangming-fu disease: no vomiting, no stool, but there is a restlessness. 阳明病，不吐，不下，心烦者，可与调胃承气汤。

Synopsis: Restlessness -one of indications of Tiaowei Chengqi Tang. Explanation: No vomit and no stool reflect stagnation of pathogenic dry-heat staying in the stomach and large intestine; Restlessness is symptom of pathogenic dry -heat disturbing the mind.

Clause 248: With taiyang disease for 3 days, the symptom is not gone after the adoption of diaphoresis. When the patient has a fever with perspiration, it indicates that the symptom has transmitted into yangming-fu syndrome. Tiaowei Chengqi Tang is the curative. 太阳病三日，发汗不解，蒸蒸发热者，属胃也，调胃承气汤主之。(248)

Synopsis: Fever with perspiration-another indication of Tiaowei Cheng Tang.

Explanation: Taiyang disease for 3days means it came from taiyang disease; The symptom is not gone after the adoption of diaphoresis indicates now it is not Taiyang Disease but has transmitted into yangming disease. Fever with perspiration is a sign of internal heat in yang-fu organ.

Clause 249: After the adoption of an emetic to patient with febrile disease, if the patient feels abdominal distension, Tiaowei Chengqi Tang should be chosen. 伤寒吐后，腹胀满者，与调胃承气汤。(249)

Synopsis: Abdominal distension –another indication of Tiaowei Chengqi Tang. Explanation: Abdominal distension after adoption of an emetic is a sign of yangming-fu syndrome.

Summary: According to clauses 207,248,249 and 180, indications of Tiaowei Chengqi Tang include: Restlessness, Fever with perspiration, Abdominal distension, Constipation .

Formula: Tiaowei Cheng Tang调胃承气汤Stomach-regulating Purgative Decoction. Ingredients: Zhigancao/Prepared licorice root/ Radix Glycyrrhizae Praeparata2 Liang/6g Dahuang/Rhubarb/Radix et Rhizoma Rhei, 4Liang/9g Mangxiao /Mirabilite /Natrii Sulphas, half Sheng /3g

Administration: The above ingredients are decocted in water except Mangxiao which will be infused in the decoction just before the oral use.

Actions: Purging the accumulation of dry-heat in the yangming-fu organ.

Explanation: Dahuang is bitter in flavour and cold in nature, purges pathogenic heat and fire, and accumulation of food and stool to regulate stomach qi; Mangxiao is salty in flavour and cold in nature, possesses the effect of moisten the dryness, softens hard mass and purges heat as an assistant herb to Dahuang. However, here we may use Yuliren/Bush-cherry seed/Semen Pruni, instead of Mangxiao which is not allowed to be used in the U.K. as it is a kind of mineral material. Zhigancao can coordinates the above 2 herbs and regulates the stomach.

Clinical application: Today this formula can be used to treat constipation, abdominal fullness, or painful swelling of mouth, sore throat due to domination of heat –dryness in the stomach and intestine.

2) Xiao Chengqi Tang 小承气汤 Minor Purgative Decoction

Clause 213: The patient with yangming disease has a profuse perspiration. Leaking out of body fluid causes dryness of stomach (and large intestine). Consequently, hard faeces will shape, and then delirium will occur. Xiao Chengqi Tang is the remedy. When the first dose stops the delirium, the second dose should not be taken. 阳明病, 其人多汗，以津液外出，胃中燥，大便必硬，硬则谵语, 小承气汤主之。若一服谵语止者，更莫复服。(213)

Synopsis: constipation and delirium are 2 of indications of Xiao Chengqi Tang. Clause 214: Xiao Chengqi Tang should be adopted in the case where yangming disease occurs with delirium, tidal fever and slippery speedy pulse. If one dose of decoction will bring passing flatus, take the second dose. In case there is no passing flatus, do not take the second dose. If there is no stool on second day, and feeble and hesitant pulse appears, it can be diagnosed that is a case of deficient condition, which is difficult case to rescue, Chengqi Tang is no longer applicable. 阳明病，谵语，发潮热， 脉滑而疾者，小承气汤主之。因与承气汤一升，腹中转气者，更服一升；若不转气者，勿更与之。明日又不大便，脉反涩者，里虚也，为难治，不可更与承气汤也。(214)

Synopsis: delirium, tidal fever, slippery and speedy pulse are indications of Xiao Chengqi Tang. Small dose of Xiao Chengqi Tang can be used for diagnosis/prognosis.

Clause 250: After the adoption of an emetic, purgative, or diaphoretic to taiyang disease, there will be a slight restlessness, frequent urination and hard faeces. Xiao Chengqi Tang can be used to harmonize the syndrome. 太阳病，若吐，若下，若发汗后，微烦，小便数， 大便因硬者，与小承气汤，和之愈。(250)

Synopsis: Slight restlessness, frequent urination and constipation are indications of Xiao Chengqi Tang.

Formula: Xiao Chengqi Tang 小承气汤Minor Purgative Decoction Ingredients: Dahuang / Rhubarb/Radix et Rhizoma Rhei 4 Liang/12g Houpu / Magnolia bark/Cortex Magnoliae Officinalis 2 Liang/6g Zhishi/ Immature bitter orange /Fructus Aurantii Immaturus 3 pcs/9g Administration: Decoct all the herbs in water except Dahuang which should be added later; and drink the decoction in 2 separate times in a day.

Actions: Clearing away pathogenic heat, removing stagnation of qi and relieving constipation. Explanation: Among the ingredients, Dahuang is used to purge and eliminate pathogenic factors from the gastrointestinal tract; Houpu functions in promoting qi flow and to relieve abdominal distension; and Zhishi is good at removing stagnation of qi. Working together, the 3 herbs of the formulae relieve accumulation of heat and qi in the gastrointestinal tract in a not too harsh manner.

The main applications of this formula were described in Clauses 213, 214 and 250 of [Shang Han Lun]. It was used for treatment of the yangming-fu syndrome due to damages to body fluids (such as inappropriate treatments by sweating, vomiting and purging) leading to hard faeces and pathogenic heat and qi in the gastrointestinal tract, manifested as constipation, abdominal fullness and distension, tidal fever, delirium , profuse perspiration, etc. Today most TCM scholars believe that the main indications of this formula should be “Pi” (stuffiness痞) and Man（fullness”满”）in the abdomen and constipation. Clinical application: We often use this formula to treat constipation, indigestion and retention of undigested food marked by abdominal distension or pain, anorexia, and simple or paralytic intestinal obstructions.

3) Da Chengqi Tang 大承气汤 Major Purgative Decoction

Clause 220: Syndrome involving taiyang and yangming successively, when the taiyang disease is gone, the patient has tidal fever, slight perspiration over hands and feet, constipation and delirium. A dose of purgative Da Chengqi Tang /Major Purgative Decoction can be adopted to eliminate the syndrome. 二阳并病，太阳证罢， 但发潮热，手足絷絷汗出， 大便难而谵语者，下之则愈，宜大承气汤（220）。

Synopsis: Main indications of Da Chengqi Tang. Explanation: Tidal fever is one of typical symptoms of yangming-fu-syndrome. A slight perspiration over hands and feet is caused by evaporation of excessive heat in the stomach. Constipation is a sign of formation of stercoroma (accumulation of faeces in the large intestine. Delirium results from excess heat misting mind.

Clause 212: Febrile disease is not gone after adoption of an emetic or a purgative. There is no stool for 5- 6 days, or even more than 10days, with tidal fever in the afternoon but no chill. The patient speaks to himself as if he sees a ghost. In serious case, the patient becomes oblivious to people around him and subconsciously touching his clothes and bedding. He is in terror, also has a slight dyspnea and constant staring. A taut pulse will indicate a curable case, while an uneven pulse is the sign of a fatal case. In a less serious with only fever and delirium, Da Chengqi Tang/ Major Purgative Decoction can be adopted as a curative. If the first dose induces defecation, stop taking the rest of the decoction. 伤寒，若吐，若下后，不解，不大便五六日，上至十余日，日甫发潮热，不恶寒，独语如见鬼状。若剧者，发则不识人，循衣摸床，惕而不安，微喘直视，脉弦者生，涩者死。微者，但发热谵语者，大承气汤主之。若一服利，则止后服。（212）

Notes: This is a severe case of yangming-fu syndrome and its prognosis, manifested as:

(1)Serious constipation for 5-6 days, or even more than 10 days;

(2)Tidal fever in afternoon;

(3)Delirium and coma, marked by speaking to himself as if sees a ghost , oblivious to people around him and subconsciously touches his clothes and bedding;

(4)Staring eyesight (light reaction disappearance);

(5)A slight dyspnea (short breath) .

Clause 241: After the adoption of a drastic purgative, the patient has no stool for 6- 7 days, restlessness, and abdominal distension and pain. It can be diagnosed that there must be stercoroma which was caused by undigested food. Da Chengqi Tang / Major Purgative Decoction is a remedy. 大下后， 六七日不大便， 服满痛者，此有燥屎也。所以然者，本有宿食故也，宜大承气汤。（241）

Notes:

(1)After the adoption of a drastic purgative, the syndrome should have been eliminated but the patient may have no stool for 6-7 days, has restlessness, abdominal distension and pain. This is due to a combination of residual pathogenic heat and undigested food in the yangming-fu organs.

(2)In [Shang Han Lun], there are other Clauses 208,209,215,217, 238, 239,240,242,251, 252, 253, 254, 255, 256,321,322 on Da Chengqi Tang/ Major Purgative Decoction; and also be seen in [Jin Kui Yao Lue] in Chapter 2, Chapter 10 (with 4 clauses), Chapter 10(with 2 clauses), Chapter 17 (with 4 clauses),Chapter 21 (with 2 clauses) on Da Chengqi Tang/ Major Bowels-purging Decoction. Formula: Da Chengqi Tang 大承气汤 Major Purgative Decoction Ingredients Dahuang/Rhubarb/Radix et Rhizoma Rhei, 4Liang/9g Houpu/Magnolia bark /Cortex magnoliae Officinalis, Half Jin/9g Zhishi/Immature bitter orange/Fructus Aurantii Immaturus, 5 Pcs/9g Mangxiao /Mirabilite /Natrii Sulphas, 3Ge/3g Notes: 1 Jin=16 Liang in the Han Dynasty=222.72 gr. today; 1 Ge in the Han Dynasty =19.81 ml today The today’s dosages of the above herbs are mainly according to our own experience.

Administration: According to the original texts of [Shang Han Lun] and our experience, we should first decoct Zhishi /Immature bitter orange and Houpu /Magnolia bark for 20 minutes, and then add Dahuang/Rhubarb into the pot which is to be boiled for more 5-10 minutes. Get the decoction, and then add Mangxiao/ Mirabilite which is to be infused in the decoction. Take half of the decoction orally. However, if diarrhoea occurs, do not drink the remaining half of the decoction.

Actions: Expelling heat and loosening the bowels, promoting the circulation of qi to purge accumulation from the bowels. Explanation: Of the four ingredients in the formula, Dahuang / Rhubarb, bitter in flavour and cold in property, acts as a principle herb to treat the main symptoms by removing and purging pathogenic heat and fire, accumulation of undigested food and stool in the stomach and intestine and relieving constipation; Mangxiao /Mirabilite , salty in flavour and cold in nature, possesses the effect of moistening the dryness , softening hard mass and purging heat, and is used in combination with Dahuang /Rhubarb, it serves as an assistant herb to reinforce Dahuang/Rhubarb’s effects of drastic purgation. Both Houpu /Magnolia bark and Zhishi /Immature bitter orange can promote circulation of qi and relieve distension and help Dahuang/Rhubarb and Mangxiao/Mirabilite in purging away the accumulation of undigested food and stool in the stomach and intestine, acting as guiding herbs.

Clinical application

(1) We have used Da Chengqi Tang / Major Purgative Decoction for febrile diseases marked by excessive-heat syndrome of yangming-fu organ, manifested as constipation, frequent wind through the anus, feeling of fullness in the abdomen, abdominal pain with tenderness and contraction of abdominal muscles, tidal fever, delirium, polyhidrosis (sweat) of hands and feet, prickled tongue with yellow dry fur, or dry black tongue coating with fissures, deep and forceful pulse.

(2) It can also be used for the cases with “re jie pang liu” syndrome, manifested as diarrhea with watery discharge of terribly foul odor accompanied by abdominal distension and pain with tenderness and muscle contraction, dry mouth and tongue, smooth and forceful pulse.

(3) The formula can be modified to deal with infectious or non-infectious febrile diseases in their climax marked by accumulation of heat type, and in the treatment of paralytic and simple intestinal obstruction.

(4) Some doctors introduced Da Chengqi Tang/ Major Purgative Decoction can be used for the treatment of coma due to cerebral bleeding. They believed that Da chengqi Tang/ Major Purgative Decoction has the function of bringing blood from the brain down to the lower part of the body to treat cerebral bleeding.

Modern research

(1) Modern research has ascertained that this recipe has the functions of relieving inflammation, resisting bacteria, promoting blood circulation of intestine, stimulating intestinal peristalsis, purging stool, tranquilizing the mind, reducing fever, etc. See the book, [A Practical English-Chinese Library of TCM] by me.

(2) According to an animal test, Da chengqi Tang /Major Purgative Decoction can directly acts on the smooth muscle of the intestine to relieve constipation. See the book, [Research in Classical Formulas of TCM] by me.

(3) Da chengqi Tang/ Major Purgative Decoction has been shown in tests, to help the intestine of rabbits with introsusception to return normal. See the book, [Research in Classical Formulas of TCM] by me .

Chapter 3 Syndrome Differentiation and Treatment of Shaoyang Disease/Lesser Yang Disease

辨少阳病脉证并治

In TCM theory, Shaoyang meridians include the gallbladder meridian of foot shaoyang , and the sanjiao meridian of hand shaoyang. However in this chapter, the disorder of gallbladder meridian of foot shaoyang is mainly discussed.

Shaoyang disease is a special stage and condition of febrile diseases, namely, half exterior, half interior, , manifested as alternating chills and fever, chest and costal discomfort, reluctance to speak and eat, restlessness and nausea. Its therapeutic principle: harmonizing; chief formula is Xiao Caihu Tang/ Minor Bupleurum Decoction.

1. Outline of Yangming Disease/Lesser Yang Disease少明病提纲

Clause 263: Shaoyang disease is characterized by a bitter taste in the mouth, dry throat and dizziness. . 少明之为病，口苦，咽干，目眩也。(263)

Synopsis: Outline of shaoyang disease.

Explanation: This clause is an outline of shaoyang disease but doesn’t include all symptoms and signs of shaoyang disease. Bitter taste in the mouth is caused by vaporization of shaoyang gallbladder fire; Dry throat is due to body fluid exhausted by shaoyang gallbladder fire; Dizziness is an indication of pathogenic factor rising along the shaoyang meridian.

2. Major Syndrome of Shaoyang Disease/Lesser Yang Disease 少阳病本证

Clause 96: After 5-6 days during febrile disease, the patient has alternating attacks of chills and fever, feels a distension and a sensation of oppression in the chest and costal region, reluctance to speak and eat, restlessness and no nauseous, or thirst, or abdominal pain, or with mass below the costal margin, or with palpitation and dysuria, or no thirst but with a slight fever, or with coughing. Xiao Caihu Tang /Minor Bupleurum Decoction can serve as a remedy in this case. 伤寒五六日，中风，往来寒热，胸胁苦满，默默不欲饮食，心烦喜呕，或胸中烦而不呕，或渴，或腹中痛，或胁下痞硬，或心下悸，小便不利，或不渴，身有微热，或咳者，小柴胡汤主之。（96）

Note: Key indications of Xiao Caihu Tang/ Minor Bupleurum Decoction:

1) Alternate chills and fever;

2) Feeling of distension and a feeling of oppression in the chest and costal region;

3) Reluctance to eat and speak;

4) Restlessness and nausea.

There are other clauses on Xiao Caihu Tang /Minor Bupleurum Decoction, such as 37, 97, 98, 99,100, 101,103, 104, 144, 148,149, 266, 229, 230, 231, 379, 394 in [Shang Han Lun]

Formula: Xiao Caihu Tang小柴胡汤 Minor Bupleurum Decoction

Ingredients: Caihu/ Bupleurum root/ Radix Bupleuri, half jin/15g Huangqin/ Scutellaria root /Radix Scutellariae, 3Liang/9 g Renshen/ Ginseng/Radix Ginseng, 3 Liang/9g Banxia/Pinellia tuber/ Rhizoma Pinelliae, half Sheng/9g Zhigancao/ Prepared licorice root / Radix Glycyrrhizae Praeparatae 3 Liang/9g Shengjiang/ Fresh ginger/ Rhizoma Zingiberis Recens, 3 Liang/9g Dazao/Chinese dates/Fructus Ziziphi Jujubae, 12pcs/4 pcs.

Administration: According to our experience, we can decoct all the above herbs in water in the pot over a fire for 25-30 minutes. Drink ? or 1/3 of the decoction, 2 or 3 times a day.

Actions: Harmonizing the shaoyang. Explanation: Caihu /Bupleurum root, as a principle herb, has the effects of dispelling pathogenic factor located in the half exterior of shaoyang meridian by driving it out; it can also relieve the depressed liver-qi. Huangqin / Scutellaria root clears out stagnated heat located in the half interior by clearing away it thoroughly as an assistant herb. The combination of 2 herbs, one for dispelling pathogen out; and the other for clearing away stagnated heat from the interior, together can remove pathogenic factors from shaoyang. Banxia/Pinellia tuber and Shengjiang / Fresh ginger can regulate the function of the stomach and lower the adverse flow of qi. Renshen /Ginseng and Da Zao /Chinese dates invigorate qi and strengthen the middle-jiao. Zhigancao/Prepared licorice root can coordinate the actions of various herbs in the recipe. All the above can act as adjutant and guiding herbs.

Clinical application

1) Clinically, we have used Xiao Caihu Tang / Minor Bupleurum Decoction for the treatments of influenza including swine flu, common cold, malaria, infection of biliary tract, hepatitis, pleurisy, chronic gastritis, indigestion, mastosis, inter-costal neuralgia and neurosis marked by the symptoms of shaoyang disease. Of course, we often modify the recipe according to each special different condition.

2) Prof. Liu Duzhou introduced the recipe as an effective treatment for impotence caused by stagnation of the liver-qi.

3) Dr Li Xinghua reported this recipe can be used for acute pancreatitis. Notes: All the above 3 are selected from the same sources,[Research in Classical Formulas of TCM] by me.

Modern research

1) Modern research has proved that the formula has some effects in inhibiting bacteria, viruses and leptospira, relieving the reaction of the human body to the invaded pathogen, and remarkably allaying fever and resisting inflammation. See the books, [A Practical English-Chinese Library of TCM] by me.

2) The recipe also has the effects of promoting digestion, preventing vomiting, expelling phlegm, relieving coughing, protecting the liver, normalizing the function of gallbladder and tranquilizing the mind. See the same source.

Chapter 4 Syndrome Differentiation and Treatment of Taiyin Disease/Greater Yin Disease

辨太阴病脉证并治

Taiyin meridians include the spleen meridian of foot taiyin, and the lung meridian of hand taiyin. However in this chapter , the disorder of spleen meridian is mainly discussed. Taiyin disease/greater yin disease is an advanced stage and condition that can be caused by mistreatment of 3 yang meridians diseases, especially the yangming disease evolves taiyin disease, mainly marked by deficiency of the spleen-yang due to invasion by pathogenic cold-dampness, manifested as abdominal distension, poor appetite, nausea or vomiting, diarrhoea with loose stools, and occasional abdominal pain, its therapeutic principle: Warming the spleen-yang; Recipe: Sini Tang / Cold-Extremities Decoction or its like ( Lizhong Wan /Middle –Regulating Pill can be adopted. Note: a purgative is prohibited in this case.

1. Outline of Taiyin Disease/Greater Yin Disease太阴病提纲

Clause 273: The symptoms of taiyin disease are abdominal distension, vomiting, poor appetite, diarrhoea with occasional abdominal pain. If a purgative is given, hardness and fullness in the epigastrium will result. 太阴之为病，腹满而吐，食不下，自利益甚，时腹自痛。若下之，必胸下结硬。（273）

Synopsis: Essential symptoms of Taiyin disease/Greater Yin Disease.

Explanation:

1) As taiyin spleen’s function is to cooperate with stomach for digesting, transporting and transforming food essence, if taiyin is invaded by pathogenic cold-dampness; or due to inherited constitution is weak; or caused by mistreatments , all the above factors can cause deficiency of the spleen-yang , then give rise to: Abdominal distension Poor appetite Nausea or vomiting Diarrhoea with loose stools Occasional abdominal pain

2) A purgative is prohibited to taiyin disease, if a purgative is given to the case, it will damage taiyin spleen further, as a result complication of hardness and fullness in the epigastrium may occur.

2. Major syndrome of Taiyin Disease/Greater Yin Disease太阴病本证

Clause 277: Diarrhoea without a thirst is the symptom of taiyin disease. It is caused by coldness in the zang-organ (spleen). Sini Tang/ Cold-Extremities Decoction or its like can be adopted to warm the coldness. 自利不渴，属太阴，以其脏有寒故也，当温之，宜服四逆辈。（277）

Notes:

1) As the above case is a deficient -cold syndrome , so the patient feels no thirst;

2) “Zang-organ” here means the spleen;

3) “Sini Tang /Cold-Extremities Decoction or its like” means the Lizhong Wan/Middle-Regulating Pill.

Formula: Lizhong Wan 理中丸Middle-Regulating Pill Ingredients: Renshen/ Ginseng/ Radix Ginseng, 3 Liang/9g Ganjiang/Dried ginger/ Rhizoma Zingiberis, 3 Liang/ 9g Zhigancao/Prepared licorice root/ Radix Glycyrrhizae Praeparatae 3 Liang/9g Baizhu/White atractylodes rhizome / Rhizoma Atractylodis Macrocephalae 3 Liang 9g

Administration: According to the original texts of [Shang Han Lun] and our experience, we should first grind the above herbs into the fine powder, and then mix them with honey to make them into pills. Take the pills with warm boiled water, 9g each time, 3-4 times on a day, 2 times a night if necessary; or decoct the herbs with today’s dosage in water in the pot for 25-30 minutes, and then get the decoction which will be taken orally in 2-3 separate times in a day.

Actions: Warming the middle-jiao and eliminating pathogenic cold-dampness from taiyin.

Explanation: Ganjiang/Dried ginger, acts as a principle herb, acrid in taste and hot in nature, has the effects of warming the middle-jiao; Renshen/Ginseng acts an assistant herb, slightly bitter in flavour and slightly warm in nature, and is good at strengthening the spleen-qi; Baizhu / White atractylodes rhizome, serves as an adjuvant herb, with its sweet and bitter flavour and warm nature, and is used to dry dampness and strengthen the spleen; Zhigancao/Prepared licorice root, sweet and mild in property, harmonizes the spleen and stomach and tempers the effects of other herbs in the recipe, playing a guiding herb.

Clinical application

1) We often use Lizhong Tang/ Middle-Regulating Decoction for the treatments of acute or chronic gastritis, peptic ulcer, gastro-intestinal neurosis, chronic diarrhoea, chronic enteritis or non-specific colitis, and AIDS, etc.

2) Therapy on the umbilicus: Dr Li Zhongjie introduced to make an ointment of Lizhong Wan / Middle-Regulating Pill and then apply it on the umbilicus; cover it with compress and keep it for 3-7 days which can be used to treat chronic diarrhoea, edema, cough, and uterus bleeding. Notes: For more details, please see the book [Research in Classical Formulae of TCM] by me.

Modern research

1) The Pharmaceutical Dept and Microbiology Dept of Shanghai TCM University made a simulated syndrome of spleen-deficiency in a mouse by feeding Dahuang/ Rhubarb /Radix et Rhizoma Rhei, as a result the mouse showed symptoms of spleen-deficiency marked by diarrhoea, lower function of immune system and less ability against coldness; then they treated the mouse with Lizhong Tang/Middle-Regulating Decoction. After that the mouse’s symptoms were relieved. See the book, [Research in Classical Formulas of TCM] by me.

2) Many new studies have also ascertained that this recipe has the effects in adjusting the functions of the stomach and intestine, promoting blood circulation, strengthening metabolism, relieving spasm, alleviating pain, arresting vomiting and diarrhoea, and inducing diuresis. See the books, [A Practical English-Chinese Library of TCM] by me .

Chapter 5 Syndrome Differentiation and Treatment of Shaoyin Disease/Lesser Yin Disease

辨少阴病脉证并治

Shaoyin includes the kidney meridian of foot shaoyin and the heart meridian of hand shaoyin in TCM theory. Shaoyin Disease/Lesser Yin Disease is more severe stage and condition (syndrome) during febrile diseases. The causes of Shaoyin Disease include many factors: taiyin disease develops to shaoyin disease; pathogenic cold invades shaoyin meridian directly; or both taiyang and shaoyin are affected by pathogenic factors.

1. Outline of Shaoyin Disease/Lesser Yin Disease少阴病提纲

Clause 281: The essential symptoms and signs of Shaoyin Disease/Lesser Yin Disease are a feeble and thready pulse, and a desire only to sleep. 少阴之为病，脉微细，但欲寐也。(281)

Synopsis: Outline of cold syndrome of shaoyin disease

Explanation: A feeble pulse is a sign of deficiency of yang-qi of the heart and kidney; Thready pulse is a sign of deficiency of ying-blood of the heart and kidney. A desire only to sleep is symptom of deficiency of shaoyin-yang. All the above are essential symptom and sign of cold syndrome of shaoyin disease.

3. Classification of Shaoyin Disease/Lesser Yin Disease 少阴病的分类

Shaoyin disease is divided into 2 main syndromes: First, Cold syndrome: the essential symptoms and signs of cold syndrome of shaoyin disease are a feeble and thready pulse, and desire only to sleep’(i.e. Clause 281) , its therapeutic principle is described in Clause 323 ‘therapeutic method is warming, Sini Tang/Cold-Extremities Decoction should be given urgently to shaoyin disease with a deep pulse; Second, Heat syndrome, marked by yin deficiency with yang hyperactivity, manifested as in Clause 303 ‘ more than 2 or 3 days of shaoyin disease , the patient feels restless and suffers from insomnia, Huanglian Ejiao Tang/Coptis and Ass Hide Glue Decoction will act as a curative in the case. As the teaching hour is limited, today we will just discuss the following clauses on cold syndrome of shaoyin disease:

Clause 282: The patient with shaoyin disease , manifested as restlessness and nausea although he/she cannot vomit anything and tends to fall sleep. On the fifth or sixth day, if the patient has diarrhoea with thirst, it will be termed a shaoyin disease. Thirst for drinking is a reaction of self-rescue to a deficient case. When the urine is clear, all symptoms of shaoyin disease are present. The reason for clear urine is that the deficiency and cold in the lower jiao which can not control the water circulation . Thus the urine is color-less and clear. 少阴病， 欲吐不吐，心烦，但欲寐，五六日自利而渴者， 属少阴也。虚故饮水自救。若小便色白者，少阴病形悉具。小便白者， 以下焦虚有寒，不能制水，故令色白也。（282） Synopsis: Diarrhoea, and thirst with clear urine are symptoms of cold syndrome of shaoyin disease.

Clause 323: Warming method, Sini Tang/Cold –Extremities Decoction should be given urgently to the patient with shaoyin disease marked by deep pulse. 少阴病，脉沉者，急温之，宜四逆汤。（323）

Synopsis: Treatment of cold syndrome of shaoyin disease.

Explanation: This clause is very simple only talking about the pulse, the symptoms and signs are omitted, so please read the clauses 281,282,324, its clinical manifestations include: Cold extremities, A feeling of chill Huddling with cold Watery diarrhoea with undigested food in the stool, Mental fatigue and sleepiness, A deep feeble and thready pulse. Formula: Sini Tang 四逆汤 Cold –Extremities Decoction Ingredients: Fuzi/Aconite root/ Radix Aconiti Praeparatae 1 pcs/ 9g Ganjiang/Dried ginger/ Rhizoma Zingiberis 1.5 Liang/9g Zhigancao/ Prepared licorice root / Radix Glycyrrhizae Praeparatae 2 Liang/ 6 g Administration: According to our experience, Fuzi /Aconite root should be decocted one hour prior to other two; then add other 2 ingredients and boil the 3 ingredients again for 45minutes or more. Drink the decoction when it is warm. Drink half in the morning and the other half in the evening.

Actions: Warming the heart, spleen and kidney, recuperating depleted yang to rescue the patient from collapse. Explanation: Fuzi /Aconite root in the recipe, pungent and hot in the extreme, acts on the meridians of the heart, kidney and spleen, helping to warm the yang-qi and recuperate the depleted yang to rescue the patient from collapse, it is preferred as a principle herb. However, in the UK, we may use Renshen/Ginseng 9g plus Huangqi/ Astragalus root 30g instead of Fuzi/Aconite root which is prohibited to be used in the UK. Ganjiang /Dried ginger, an assistant herb in the recipe, functions in warming yang of the middle-jiao and eliminating interior coldness. The combination of Fuzi/Aconite root and Ganjiang /Dried ginger can develop drastic flavour to strengthen forcefully the effects of warming yang. Zhigancao/Prepared licorice, with the effects of strengthening the spleen and replenishing qi, as an adjuvant and guiding herb, is used in assisting Fuzi /Aconite root to recuperate depleted yang and promote blood circulation, and also in assisting Ganjiang /Dried ginger in warming and restoring yang of the middle-jiao to reduce toxin of Fuzi /Aconite root and relieving the extremely pungent property of other 2 herbs so as to make it possible to warm yang and remove cold without injuring yin.

Remarks: As Sheng Fuzi/crude Aconite contains Wutoujian (aconine) which is highly toxic and should be boiled for more than one –two hours until no numbness of the mouth and tongue is felt. Today Zhi Fuzi/Prepared Aconite is still used by TCM doctors in the world except the UK, but it should be boiled for a longer time(1-2 hours), because the long time boiling can change its Wutoujian/aconine into Wutoucijia (sub-aconine) which has only 1-2 % of Wutoujian’ toxin with the same efficacy. Additionally, if you meet patients with aconite poisoning, please give patient Atropine injection and other supporting therapies on time to save our patients in hospital.

Clinical application

1) We often used Sini Tang /Cold-Extremities Decoction for the treatments of distinct declination of bodily strength caused by chronic disorders or hypopituitarism, hypothyroidism and hypoadrenocorticism marked by symptoms of yang-deficiency. See [Research in Classical Prescriptions of TCM] by me.

2) We also tried to use Sini Tang / Cold-Extremities Decoction for yang depletion syndrome such as shock, heart failure, cardiac infarction, etc.

3) We once made a Sini Tang Injection many years ago, it was effective on animals.

Modern research

1) Recent studies have confirmed that this formula has the functions of exciting the central nervous system, promoting metabolism, improving weak conditions, preventing shock. See [A Practical English-Chinese Library of TCM] by me.

2) Dr Han Xinmin simulated hypotension in a rabbit by injecting anesthetic to the rabbit for studying the functions of each single herb in the Sini Tang /Cold -Extremities Decoction as well as the compound decoction of Sini Tang. They found a single Fuzi/ Aconite root has a cordial function, but it is weaker than compound decoction of Sini Tang; a single Zhigancao /Prepared licorice root can increase blood pressure but can not strengthen heart’s contraction at all; a single Ganjiang/Dried ginger has nothing on blood pressure and heart’s functions as well. When giving compound decoction of the Sini Tang to the rabbit, it shown strong cordial function, also can slowdown sinus rhythm as well as preventing arrhythmia caused by single Fuzi /Aconite root. This test has proved the synthesis of compound formulas in TCM .See [Research in Classical Formulae of TCM] by me.

Chapter 6 Syndrome Differentiation and Treatment of Jueyinyin Disease/Reverting Yin Disease

辨厥阴病脉证并治

Jueyin Disease/Reverting Yin Disease is a most complicated stage and condition during febrile disease. In TCM theory, Jueyin meridians include the Liver Meridian of Foot-jueyin, and Pericardium Meridian of Hand-jueyin. But in the Chapter Jueyin Disease, it mainly discuss about the disorder of Liver Meridian of Foot-Jueyin.

There are 4 main syndromes in Jueyin Disease, namely:

1) Upper-heat and lower-cold syndrome: It includes Wumei Wan /Black Plum Pill syndrome; Ganjiang Huangqin Huanglian Renshen Tang syndrome/ Decoction of Dried Ginger, Scutellaria, Coptis and Ginseng syndrome, Mahuang Shengma Tang syndrome/Decoction of Ephedra and Cimicifuge syndrome, etc.

2) Cold syndrome includes Sini Tang syndrome (Clause 353,354), Danggui Sini Tang syndrome (Clause 351); Danggui Sini Jia Wuzhuyu Shengjiang Tang Syndrome (Clause 352), etc.

3) Heat syndrome of Jueyin disease includes Baitouweng Tang syndrome (Clause 373), Xiao Chengqi Tang syndrome (374), etc.

4) The preponderance between cold and heat: such as Clause 331 “When fever occurs after a prevalence of coldness on the extremities, diarrhea will come to end”. However, because of limitation of lecturing hours, today we just discuss the following clauses on “outline of Jueyin disease” and Wumei Wan syndrome.

1. Outline of Jueyin Disease/Reverting Yin Disease 厥阴病提纲

Clause 326: The Jueyin Disease is characterized by great thirst, an uncomfortable feeling of ascending air rushing up from below to the heart, and hot and painful feeling in the heart, and a feeling of hunger but no appetite. Once food is taken, ascarides will be vomited up; if a purgative is given, it will cause continuous diarrhea. 厥阴之为病，消渴，气上冲心，心中痛热，饥而不欲食，食则吐蛔。下之利不止。（326）

Synopsis: Essential symptoms of the upper heat and lower-cold syndrome of jueyin disease.

Explanation: Great thirst—upper heat dries up the body fluid; A feeling of air rushing up and hot and painful feeling in the heart –excess & heat in the upper Feeling hunger but no appetite –a symptom of deficiency and cold in the lower-jiao; Ascarides vomited up after food—as ascarides like heat in the upper and fed up cold in the lower; Continuous diarrhoea after taking purgative-there is a deficiency and cold in the lower.

Notes: The above case should be treated with Wumei Wan. 2. Wumei Wan Syndrome

Clause 338: The illness with coldness on limbs and feeble pulse, on the 7th or 8th day, the patient suffers continuous restlessness and irritation, and coldness on the skin. It is a Zang Jue/visceral reversal syndrome, it is not Hui Jue syndrome/ biliary ascariasis. If coldness on the extremities is caused by ascarides, the patient might vomit ascarides. The patient is quiet now, but feels restless occasionally. As deficient cold of spleen and intestine exists, ascarides come into the diaphragm (biliary tract even into gallbladder), and restlessness occurs ,and then stops after a time. The patient will vomit and feel restless as soon as he eats, as ascarides sense the smell of food and crawl upward. The patient usually vomits ascarides. Wumei Wan/Black Plum Pill will be a curative for the case; it can also be used for chronic diarrhoea. 伤寒，脉微而厥，至七八日肤冷，其人躁无暂安时者，此为藏厥，非蛔厥也。 蛔厥者，其人当吐蛔，今病者静而复时烦者，此为脏寒，蛔上入其膈，故烦，须臾复止，得食则呕，又烦者，蛔闻食臭出，其人常自吐蛔。蛔厥者，乌梅丸主之。又主久利。（338）

Synopsis；

1) Differentiation between Zang Jue/visceral reversal and Hui Jue/ biliary ascariasis;

2) Symptoms &treatment of Hui Jue/biliary ascariasis. Explanation: 1) Zang Jue/visceral reversal: Symptoms and signs: Coldness all over the body, restlessness all the time, feeble pulse Pathogenesis: exhaustion of zang-organ’s yang-qi; Prognosis: a fatal case 2) Hui Jue /Biliary Ascariasis Symptoms and signs: The patient has medical history of vomiting or defecation of ascarides; The patient feels restlessness and abdominal pain occasionally; The patient feels nauseous, vomiting, restlessness after eating; Coldness only on extremities . Prognosis: it is very quickly & easily cured by herbal medicines

Notes: In Chapter 19 of [Jin Kui Yao Lue], states ‘for the patient with Hui Jue/biliary ascariasis, Wumei Wan /Black Plum Pill could be used’. Formula: Wumei Wan乌梅丸 Black Plum Pill Ingredients: Wumei/ Black plum /Fructus Mume , 300 pcs/15g Xixin/ Asarum herb, 6 Liang/3 g Ganjiang/Dried ginger, 10 Liang/ 6g Huanglian/Coptis root, 16 Liang/9g Zhifuzi /Prepared aconite root/Radix Aconiti Lateralis Praeparata, 6 Liang/9g Danggui/ Chinese angelica root, 4 Liang/9g Shujiao /Prickly –ash peel, 4 Liang/10g Guizhi/Cinnamon twig/Ramulus Cinnamomi, 6 Liang/9g Renshen/ Ginseng/Radix Ginseng, 6 Liang/6g Huangbai/Phellodendron bark/Cortex Phellodendri, 6 Liang/9g

Administration: According to the original texts of [Shang Han Lun] and our own experience, we should soak Wumei /Black plum with vinegar one night; grind the above herbs into powder to make pills, 8 pills each time, 3 time a day, then you may gradually increase its dosage according to the condition; or use today's dosage of the above herbs to make a decoction for oral use, take half in the morning and another half in the evening.

Actions: Warm the lower-interior-coldness, clearing away up-stomach-heat, and calming and removing the ascarides.

Explanation: The chief herb in the recipe is Wumei /Black plum that is soaked with vinegar again during processing. It will become a very sour substance which is quite effective in eliminating ascarides. The deputies are divided into 2 groups: The first group consists of Shujiao/prickly-ash peel, Xixin /Asarum herb, warm in nature, can expel parasites and warm the internal organs; the second group consists of Huanglian/Coptis root and Huangbai /Phellodendron bark, cold in nature, can clear away stomach-heat. Among the assistant herbs, there are Ganjiang / Dried ginger, Fuzi/ Aconite root, and Guizhi /Cinnamon twig. They can warm interior and are very useful in dispersing internal cold. Additionally Guizhi/Cinnamon twig and Xixin/ Asarum herb facilitate the flow of yang-qi and thereby help Renshen /Ginseng and Danggui /Chinese angelica root to tonify the qi and nourish blood. The vinegar used in soaking Wumei/Black plum during herbal processing is for increasing more acid to reinforce the ascarides to return to the duodenum. Dr Ke Qin in the 17th century explained the effect of this formula on ascarides, said that “When ascarides encounter sourness, they become calmed (De suan ze jing); When they encounter acridity, they are spent; When encounter bitterness, they are purged”. So this has become the standard formula for treating biliary ascariasis. However, from Wumei Wan/Black Plum Pill, we have developed and created a new formula for treating biliary ascariasis, for example, Dandao Qu Hui Tang/ Decoction for Removing Ascarides from Biliary Tract that is more effective than traditional Wumei Wan/ Black Plum Pill. It consists of Yinchen/Oriental wormwood/Herba Artemisiae Capillaris 30g, Shijunzi / Quisqualis Fruit /Fructus Quisqualis 15g, Kulianpi /Chinaberry bark/ Cortex Meliae 15g, Binglang/ Areca Seed / Semen Arecae 15g, Chuanjiao/ Pricklyash peel/Pericarpium Zanthoxyli 15g, Zhishi /Immature bitter orange/Fructus aurantii immaturus 9g, Muxiang / Aucklandia root /Radix Aucklandiae 9g, Caihu/Bupleurum root/Radix Bupleuri 15g, Huangqin/ Scutellaria root/Radix Scutellariae 9g. Decoct the above herbs for 25-30 minutes for oral use, 1-2 doses a day, generally only taking 5-6 bags is enough for recovery from biliary ascariasis. It is really effective, please try.

Clinical application

1) We usually use Wumei Wan/ Black Plum Pill for the treatment of biliary ascariasis, chronic dysentery, colitis, etc.

2) Dr Liu Xue Tang reported that Wumei Wan /Black Plum Pill is effective for diarrhoea due to bacterial imbalance after using long term antibiotics. Notes: The sources of the above can be seen in the book [Research in Classical Formulas of TCM] by me. Modern research Researching Methods: 1. Get 21 of active ascarides by operation, and then divided into 3 groups: put first group 7 into the normal saline at 37 degree centigrade , after 2 minutes, they are still active ; However , put second group 7 into 5% of Wumei Wan/Black Plum Decoction; and also put third group 7 into 30% of Wumei Wan/Black Plum Decoction.

As a results, the third group ascarides in the 30% Wumei Wan/ Black Plum Decoction were narcose or dead; while the activities of second group in 5 % of Wumei Wan/Black Plum Decoction became less. 2.Give Wumei Wan /Black Plum Decoction to the patients and animals with amphibolic fistula, they found that after drinking Wumei Wan /Black Plum Decoction , the bile excretion was increased; pH of bile is down and became more acid; Boden’s sphincter was relaxed.

From the above tests, I think that Wumei Wan /Black Plum Pill treats biliary ascariasis by following 4 ways: First Wumei Wan / Black Plum Pill can calm and paralyse ascarides and make their adhesive force to biliary tract to become less or lost; Second, the increased bile excretion can lash ascarides downward and enforce ascarides to return back to the duodenum and small intestine ; Third, relaxed Boden’s sphincter make ascarides to return back to the duodenum easily; Fourth, as ascarides have characteristics of being fed up acid and like alkali, after taking Wumei Wan /Black Plum Pill, the living condition in the biliary tract is not convenient for ascarides any more, for example, pH is down ;and the pressure from increased bile excretion is very strong, so they have to return back to the duodenum and intestines .

How to study [Shang Han Lun] 1 Master the original texts of [Shang Han Lun] [Shang Han Lun] is a very old classical book which was written in old Chinese language in the Han Dynasty (about 200-219), therefore, we should first study some archaic and ancient Chinese and then start to learn the original text/clause of [Shang Han Lun] in order to understand the meaning of the texts/clause exactly. 2 Paying more attention to the formulae The formulae in [Shang Han Lun] and [Jin Kui Yao Lue] are most valuable parts of the books. We should try our best to do more research on the formulas, including their ingredients, dosage, preparation, actions, indications, clinical applications as well as modern pharmaceutical researches. Since 1982 I have started to do some research in the formulae of both [Shang Han Lun] and [Jin Kui Yao Lue], and also wrote a book [Research in Classical Formulae of TCM], published by Yellow River Press in July, 1989. I plan to revise it and take in more results of scientific research and new developments in classical formulas in the world since 1999. Dear students, you are warmly welcomed to join the work.

3）Combination between TCM and Western medicine [Shang Han Lun] is a historical TCM book. If we can use both Chinese and Western knowledge and techniques to research [Shang Han Lun] it’s applications will be more scientific and practical. We can not just repeatedly read all old texts/clauses again and again without any new development and discovery. I heard that some of our post-graduates have strong Western medicine background. I believe that it is your advantage, not weakness. We should work together, step by step, to develop and modernize our TCM for the future.

Appendix:

Converting the Dosage in the Eastern Han Dynasty to Today’s Dosage

The Eastern Han Dynasty (25-220 AD) The Present Day: 1 Zhu 0.58g 1 Liang (=24 Zhu) 13.29g 1 Jin (=16 Liang) 222.72g 1 Fangcunbi 3.125g for herbs, 6.2g for minerals 1 Qianbi (a heaped coin’s worth) 2.0g for herbs, 4.0g for minerals 1 Ge (Ten spoons’ worth) 19.81ml 1 Sheng (=10 Ge) 198.1ml 1 Dou (=10 Sheng) 1981ml 1 Chi 23.04cm Notes: 1. The above converting table is elected from the book [Research in Classical Prescriptions of TCM] by me, published by Yellow River Press in 1989. 2. In the East Han Dynasty, the weights and measures for herbal medicine in the terms of “zhu”, “liang” and “jin” are accounted as half of the official measurements at the time. 3. Commonly used and Simplified Converting Method: 1 Liang in the Han Dynasty=1 Qian/ 3g Today. References: 1. World Federation of Chinese Medicine Societies (2008) International Standard Chinese –English Basic Nomenclature of Chinese Medicine. People’s Medical Publishing House 2. Huang H (2005) Introduction to Treatise on Exogenous Febrile Diseases. Shanghai TCM University Press 3. Zhang E (1990) Prescriptions of TCM. Shanghai TCM University Press 4. Zhang E (1989) Research in Classical Formulas. Yellow River Press 5. Li P (1985) Textbook of Shang Han Lun for TCM Universities. Shanghai Science and Technology Press Caution: All rights are reserved, no part of this publication may be reproduced without prior written permission from the author. Dear postgraduates, it has been a pleasure to be in your company. I hope to build on this lecture today and would welcome further academic exchanges on this subject in the future. If you need any more information, please do not hesitate to contact me. E-mail: prof.engincan@hotmail.co.uk Telephone: 07846193488. Many thanks to you all for listening to my thoughts on this subject and attending this lecture! About Lecturer: Prof. Enqin Zhang 张恩勤 (Engin CAN), a senior specialist in TCM and [Shang Han Lun], graduated from Shandong University of Traditional Chinese Medicine (TCM) in 1982 with a post-graduate dip., Master of Medicine and later he also obtained his M.D. and Professorship in Alternative and Chinese Medicines from 4 international and Chinese universities and institutes successively. He was a lecturer on [Shang Han Lun] & director of the Advanced Studies Department of Shandong TCM University in 1985-1991 as well as chief author and editor of many TCM books, such as TCM series [A Practical English-Chinese Library of TCM], composed of 14 books, the first English-Chinese edition of TCM textbooks in the world, published by Shanghai TCM University Press in 1990, which has been distributed to more than 66 countries. In 1991 the Academic Degree Committee of Chinese State Council & Education Ministry awarded 695 Chinese Doctor & Master Degree holders for their outstanding achievements, one of them was Dr Enqin Zhang. Since 1992 he has lectured and practiced in many countries including the U. K. . Now he mainly practices at the Everwell Chinese Medical Center, London Clinic 7.Address: 36 Gerrard Street, Chinatown, London, W1D 5QA, the U. K. Tel 02072870805 Mobile: 07846193488. For further information, please Google : Enqin Zhang.