李東垣(Lǐ Dōngyuán):introduction about his biography and legend,main books and academic thoughts.
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東垣老人(Dōng Yuán Lǎo Rén)
Li DongYuan, or DongYuan Li(Given/Sur Name)
Zhu Li of Zhen Ding
about 1180-1251 A.D.
《內外傷辯惑論》(Nei Wai Shang Bian Huo Lun) in 3 volumes, 《脾胃論》(Pi Wei Lun,or Treatise on the Spleen and Stomach) in 3 volumes, 《用藥法象》(Yong Yao Xiang Fa, or Rules for the Use of Herbs) in 1 volume, 《蘭室秘藏》(Lan Shi Mi Cang, or Secret Book of Orchid Chamber) in 3 volumes, 《醫學發明》(Yi Xue Fa Ming, or Inventions of Medicine) in 1 volume, 《活發機要》(Huo Fa Ji Yao), 《東垣試效方》(Dong Yuan Shi Xiao Fang, or Effective Prescriptions verified by Dong Yuan) in 9 volumes,etc.
《內外傷辯惑論》(Nei Wai Shang Bian Huo Lun), 《脾胃論》(Pi Wei Lun,or Treatise on the Spleen and Stomach) in 3 volumes, 《蘭室秘藏》(Lan Shi Mi Cang, or Secret Book of Orchid Chamber) in 3 volumes, 《東垣試效方》(Dong Yuan Shi Xiao Fang, or Effective Prescriptions verified by Dong Yuan), in 9 volumes, etc.
Introduction: ✵李杲(Lǐ Gǎo): also called Li Mingzhi, or Li Dongyuan(the year 1180 or 1182~1251 A.D.), a disciple of herbalist 張元素(Zhāng Yuánsù), who held the viewpoint that diseases, apart from exogenous affections, were mainly caused by endogenous injury to the spleen and stomach(i.e. by intemperance in drinking and eating or overwork) and advocated treatment by regulating the spleen and the stomach and nourishing the Yuan Qi(the acquired Qi). He was admitted as the founder of the School for Strengthening the Spleen and Stomach. His masterpiece is the book Pi Wei Lun(the Treatise on the Spleen and Stomach).
李杲(Lǐ Gǎo, year 1180~1251 A.D.), alias 明之(Míng Zhī), he was native to Zhu Li of Zhen Ding, for Zhen Ding area was known as Dong Yuan Kingdom at early years of the Han Dynasty, so he self titled 東垣老人(Dōng Yuán Lǎo Rén) in his late years, later folks called him 李東垣(Lǐ Dōng Yuán), ancestor of the school of invigorating the earth(school of invigorating the spleen), astronomically wealthy, 李杲(Lǐ Gǎo) followed herbalist 張元素(Zhāng Yuánsù) and took him as master, 張元素(Zhāng Yuánsù) belongs to the School of Yi Shui, a creator of the TCM theory of spleen and stomach, and proposed importance of the spleen and stomach in the human body, and for the cause in the five element theory the spleen and stomach are seen as the earth element in the middle position, so his theory was also named as the school of invigorating the earth, his major works survived till today are known include 《內外傷辯惑論》(Nei Wai Shang Bian Huo Lun, or the thesis differentiation between endogenous hurt and exogenous affection), 《脾胃論》(Pi Wei Lun, or the Treatise on the Spleen and Stomach), 《用藥法象》(Yong Yao Xiang Fa, or the methods and principles of prescription applications), 《醫學發明》(Yi Xue Fa Ming, or Inventions of Medicine), 《蘭室秘藏》(Lan Shi Mi Cang, or the Secret Book of Orchid Chamber), 《活發機要》(Huo Fa Ji Yao), etc.
李杲(Lǐ Gǎo) ever followed famous Hanlin Academician Confucian 王若虛(Wáng Ruòxū), 馮叔獻(Féng Shūxiàn) to study with confucian classics in his young age, had a large circle of friends, his friends are all personages with virtues, but he did not be friending with playboys or those not a good-for-nothing from a wealthy family, he was known as a famous Confucian scholar at 22 years age, in his young age, Li did not hold a will to save people, his study with medicine in young age was only for self health maintenance, but later his mother caught a serious disease when he was 20 years old, consulted local physicians and doctors, gave different diagnosis and treatment method, taken various herbal recipes, but the disease never relieved and his mother passed away, for not knowing treatment but only Confucianism, Li had to see the passing away of his parent and felt very sorrow for he did not know treatment, so he sweared to take a good herbalist as his teacher when met him, at that time there are two famous herbalists in the area, one is herbalist 刘完素(liú wánsù, about 1120-1200 A.D.) who lived at Hejian, and he is very old and sick, another is herbalist 张元素(Zhāng Yuánsù) who lived at Yishui, he was known well for he ever treated the cold-induced disease of herbalist Liu Wansu, when scholar Li heard herbalist Zhang Yuansu then went to Yishui 400 miles a way from his hometown and took him as teacher with “gold and silks”, he spent many years hard learning, Li learned a lot from herbalist Zhang Yuansu and basically mastered with the academic thoughts and diagnosis treatment techniques, so said farewell with his teacher herbalist Zhang and returned to hometown to help folks, all the patients treated by him, although a lot of them are suffering from difficulty miscellaneous disease, but treatment got positive effects. From his youth age, 李杲(Lǐ Gǎo) formed a character of honesty and keep a promise, treat folks with manner and politeness, and cautious with friendship, never tease others, care about his reputation and integrity, also bore with molesting from prostitutes lady.
In his 30s, 李杲(Lǐ Gǎo)'s father got him arranged as an official in the court of Jin with his relationship, devoted money and bought an official position at Ji Yuan(located in today's Henan province), but not served as a physician or herbalist, he only offers help to requests from relatives and friends in a circle for the urgent case, during this period, there was a kind of epidemic disease named "Da Tou Tian Xing"(massive head scourge, an epidemic disease characterized by swelling and redness of the face) spread here and there, its symptoms represented as red swollen on face and head, and throat is in obstruction. Many physicians that epoch looked up ancient herbal classics and never found descriptions of this kind of disease, they normally use a purgative prescription for treatment but could not get a positive effect, patients suffer from diarrhea again and again then dying one by one. Although these conditions continued, physicians did not tell its fault of treatment, and relatives of patients had no objection to this. But herbalist Li Dongyuan considered the patients may die unjustly, so he started to study this kind of disease repeatedly from the symptoms to pathogenesis, finally detected and found the pathogenesis and also found a prescription, once patients took the recipes positive results are achieved, then he engraved this prescription on a wood board and hanged it at the place where crowds gathered, and those patients who took these prescriptions all got recovered, the folks there misunderstood the recipe was given by some immortals, so engraved it on a stone tablet. Sooner or later, to avoid the coming of war and chaos, herbalist Li Dongyuan had to immigrate to Bian Liang city, during the period staying in the city Bian Liang, he treated many official patients, the result is very good, so he got known widely, once he returned from the middle earth, habitat at area Dong Ping and Liao Cheng, practice medicine as a career for 6 years. In the year 1244 A.D., Li Dongyuan returned to his hometown ZhenDing when he was 64 years old, many years' life of moving around during the war epoch, his physical condition turned weak, except for clinical practice and saving people, he put the clinical experience of many years into writing and creating the theory in which disorder of the spleen and stomach caused by internal hurt is the main content, and later finished his book 《內外傷辯惑論》(Nei Wai Shang Bian Huo Lun). In his late years around 70 years age, herbalist Li Dongyuan compiled his later works 《脾胃論》(Pi Wei Lun, or Treatise on the Spleen and Stomach) in 3 volumes, 《蘭室秘藏》(Lan Shi Mi Cang, or Secret Book of Orchid Chamber) in 3 volumes, and some parts of thesis and records from practice, before his passing away, herbalist Li Dongyuan left his manuscripts and academic writings to his disciple 羅天益(Luó Tiānyì) and told him that "these books are for your handling now, not for Li Mingzhi, or Luo Qianfu, but for folks and later generations, take care and not let them get buried, publish and let them get applications.". Later his disciple 羅天益(Luó Tiānyì) edited and compiled, published his books 《脾胃論》(Pi Wei Lun, or Treatise on the Spleen and Stomach) in 3 volumes, 《蘭室秘藏》(Lan Shi Mi Cang, or Secret Book of Orchid Chamber) in 3 volumes, he also used the book 《蘭室秘藏》(Lan Shi Mi Cang) as the basis, supplemented it with DongYuan's academic articles and records, compiled this literature as the book 《東垣試效方》(Dong Yuan Shi Xiao Fang, or Effective Prescriptions verified by Dong Yuan). Dongyuan's books survived till today are 《內外傷辯惑論》(Nei Wai Shang Bian Huo Lun), 《脾胃論》(Pi Wei Lun, or Treatise on the Spleen and Stomach) in 3 volumes, 《蘭室秘藏》(Lan Shi Mi Cang, or Secret Book of Orchid Chamber) in 3 volumes, 《脉决指掌》(Mai Jue Zhi Zhang, or Countings of the Pulse Knacks), 《活發機要》(Huo Fa Ji Yao), 《醫學發明》(Yi Xue Fa Ming) in 1 volume. There are several other ancient books ever attributed authorship to him, include 《東垣脈訣》(Dong Yuan Mai Jue, or Pulse Formula of Dong Yuan), 《食物本草》(Shi Wu Ben Cao, or Food Tonic Materia Medica), 《珍珠囊指掌補遺藥性賦》(Zhen Zhu Nang Zhi Zhang Bu Yi Yao Xing Fu, or the Supplement Herb Properties handbook in Verse of the Pearl Bag), but the authorship is doubtful, there is a lost book《傷寒會要》(Shang Han Hui Yao, or the Essentials of the Cold-induced diseases) also ever attributed its authorship to him. His major works which authorship confirmed are briefly introduced:
The book 《內外傷辯惑論》(Nei Wai Shang Bian Huo Lun) was compiled since the year 1231 A.D. and finally finished in the year 1247 A.D., total in 3 volumes, in TCM theory, he proposed the importance of the spleen and stomach viscera among all the Zang and Fu viscera; In diagnosis, he proposed the differences between the endogenous hurt and the exogenous affection, correct physicians of the epoch who mistakenly identified the endogenous hurt as exogenous affection; In treatment methods and prescriptions, he created the therapeutic method "sweet and warm tonic to eliminate great heat", and prescriptions include buzhong yiqi decoction, pointed out the special effects of the three methods(perspiration, emesis, purgative) in the treatment of endogenous hurt, proposed principles "prescriptions for four seasons", and "prescriptions of time", etc.
The book 《脾胃論》(Pi Wei Lun, or Treatise on the Spleen and Stomach) in 3 volumes, gave a systematic exploration of endogenous hurt from the spleen and stomach viscera, it was compiled after the book 《內外傷辯惑論》(Nei Wai Shang Bian Huo Lun), and finished at around the year 1249 A.D., its theory is based on the ancient book Nei Jing(the Inner Cannon), and also quoted thesis and discussions from ancient herbalists Zhang Zhongjing, Sun Simiao, Qian Yi, 63 prescriptions are listed, followed by four articles under the title "Pi Wei Jiang Li Fa (the methods for regulation of the spleen and stomach viscera)", "She Yang(health preservation)", "Yuan Yu(away from desires)", "Xing Yan Jian(sayings from reflections)", etc. The first volume is composed of seven articles, systematically explain the physiological functions of the spleen and stomach, the exterior and interior relationship of the spleen and stomach viscera, the pathological developments and transmission of deficiency and excess, quoted relevant original discussions from Nei Jing(the Inner Canon), attached with related viewpoints from himself; the second volume covered twelve articles, explained the treatment principles and treatment methods for various syndromes developed from the endogenous hurt of the spleen and stomach viscera, summarized the pathological relationship between the spleen stomach viscera and other four Zang-viscera, and four major treatment methods; the third volume explains the residual questions not discussed, the relationship between the stomach and five Zang-viscera and the nine orifices, the relationship between the spleen stomach viscera and the Yin Yang in the sky and land. The book is a symbol of the establishment of the spleen and stomach theory, it gave further interpretations on the related theory from ancient book Nei Jing(the Inner Canon), it also made some supplements to the syndrome differentiation and treatment of endogenous hurt miscellaneous syndromes from herbalist Zhang Zhongjing.
The book 《蘭室秘藏》(Lan Shi Mi Cang, or Secret Book of Orchid Chamber) in 3 volumes, it gave proof of Dongyuan's main theory from practical records, the books name came from the sentence "Cang Zhu Ling Lan Zhi Shi(hide it in the orchid chamber room)" recorded in the ancient book Nei Jing·Suwen(the Inner Cannon·the Plain Questions), it was compiled ever since the year 1249 A.D. till his death, the book was compiled and edited then published 25 years later by his disciple 羅天益(Luó Tiānyì), its main content is about the specific applications of the spleen and stomach theory in the practice of various clinical departments. It collected over 280 prescriptions and most of them were set up by herbalist Li Dongyuan himself.
The book 《東垣試效方》(Dong Yuan Shi Xiao Fang, or Effective Prescriptions verified by Dong Yuan), in 9 volumes, its main contents are the same as the book 《蘭室秘藏》(Lan Shi Mi Cang, or Secret Book of Orchid Chamber), with supplemented prescriptions and effective records, the contents of prescriptions reflect thoughts of Dongyuan, the effective records are representative, proved the theory of herbalist Li Dongyuan and the correctness of the prescriptions, its writings and forms of literature are stricter than the book 《蘭室秘藏》(Lan Shi Mi Cang).
Herbalist Li Dongyuan proposed how his specific viewpoint about the treatment values of the spleen pertaining to earth at the middle energizer, and inherited viewpoint about spleen-stomach from his master herbalist 張元素(Zhāng Yuánsù), some of his patients are those officials who eat a lot of greasy and surfeit flavor which may hurt the spleen and stomach easily, some of his patients are suffering folks eating disorder and suffering from hunger, anxiety, sorrow in the war epoch, easily hurt the spleen and stomach too, so he holds a viewpoint that new social reality need a new analysis based on characteristics of patients instead of references to ancient recipes, all these conditions became the starting point and drive for him to create the spleen and stomach theory, the core opinion of his spleen stomach theory is that: "the spleen and stomach got endogenous injury, diseases are generated.", this viewpoint is similar to related theory recorded in ancient classics 《內經》(Nei Jing, or the Inner Canon of Huangdi), “the stomach Qi supports life, dying without stomach Qi", the shares between them is an emphasis on the functions of the stomach Qi. Also, herbalist Li Dongyuan classified internal diseases into 2 big classes, exogeneous affections, and endogenous injury, this difference has strong meanings for diagnosis and treatment, for endogenous injury, he holds a viewpoint that the endogenous hurt of the spleen and stomach are most common, and there are three reasons: one is eating and drinking without temperance, another is overwork and over-rest, a third is a mental stimulation. Besides, the spleen-stomach seated at the middle of the body and its position is similar to the earth element in the five elements theory, closely related to the other four Zang-viscera, whichever Zang-viscera harmed with endogenous hurt or caught pathogenic factors, may all harm with spleen and stomach. Also, the disease of other Zang-viscera could be treated and regulated through the spleen-stomach. And herbalist Li Dongyuan did not hold a viewpoint to replenish with warm herbs and powerful tonification, istead he proposed that it is better apply according to four-season principles, treat excess syndromes with different method include diaphoresis method, emetic method, and purgative method, also he extremely emphasized on the treatment principle of syndrome differentiation, and proposed to treat deficiency syndrome with tonification method, and treat excess syndrome with purgative methods, which make his theory complete and consistent with the relevant viewpoint "supplement the middle energizer, and tonify" of herbalist 張子和(Zhāng Zǐhé), the theory of herbalist Li Dongyuan was inherited and developed by his disciples 王好古(Wáng Hǎogǔ) and 羅天益(Luó Tiānyì), herbalist 王好古(Wáng Hǎogǔ) absorbed the pharmaceutics theory of herbalist Li Dongyuan, took its clinical applications seriously, on the other side he was enlightened with his endogenous hurt and the spleen-stomach pathogenesis theory, established the Yin Syndrome theory, herbalist 羅天益(Luó Tiānyì) might inherit the spleen-stomach theory in completeness from Li Dongyuan, enriched this theory on the classification and the outline of the spleen and stomach endogenous hurt, and related clinical application experience. His academic thoughts generated a big influence on later herbalists, especially for the warm-recuperation school.
Herbalist Li Dongyuan hold specific viewpoints on women's disease and had a rich experience, most parts were recorded in his book 《蘭室秘藏》(Lan Shi Mi Cang, or the Secret Book of Orchid Chamber). His major and important achievement on gynecology is established the therapy mode of women's disease with the method based on pathogenesis including the sinking of Qi due to deficiency of the spleen, Yin-fire attack the earth, dampness invasion of the lower energizer; and the main pathogenesis is that Qi deficiency due to fire, for the cause Qi deficiency of the spleen and stomach, then the spleen's transportation and transforming function turns not sufficient, affect the origin of Zang-Fu viscera and Qi-blood generating function; for the cause Qi-deficiency of spleen-stomach, the failure of functions transporting and transforming, affect the transportation efficiency of food essence to the five Zang-viscera and six Fu-viscera, which may cause the metabolism of Zang-fu viscera turns to dysfunction, then cause different kinds of women's disease due to different pathogen.
For the morbid leucorrhea, herbalist Li Dongyuan proposed it is mainly related to Qi deficiency of spleen-stomach and Yin-fire, the clinical symptoms represented in the forms of dampness invasion of the lower energizer and lasting for a long period. The main pathogenesis caused dampness invasion of lower energizer, is the Qi-deficiency of the spleen and stomach, water dampness transformation is out of control, dampness pathogen crossed with Yin-fire, enter into the liver and kidney viscera of the lower energizer. Those morbid leucorrhea cases herbalist Li treated with, for the cause Qi-dropping for a long period, Yin-fire develops to the cold syndrome, so the cases of morbid leucorrhea mostly developed to the syndrome of deficiency, deficiency-cold, or exhaustion. The syndrome leucorrhea of deficiency caused by chronic and long period metrorrhagia, spleen yang collapsing; the syndrome leucorrhea of deficiency-cold caused by Yang-deficiency of the triple energizer; the syndrome leucorrhea of exhaustion caused by the spleen Yang-Qi collapsing to the lower energizer, which cause the cold and dampness of uterus. The syndrome of uterine bleeding and morbid leucorrhea, its pathogenesis is from deficiency and injury of the spleen and stomach, the middle Qi collapsing, the ministerial fire, dampness, and heat force blood(or leucorrhea) to move frenetically.
In the practice of women's disease, herbalist Li Dongyuan proposed to elevating Yang and discharging fire, has his specific characteristics of herbs and recipes applications, and never reached by previous generations of herbalists, disclosed those truths the predecessors never proposed. His treatment theory on amenorrhea of women, based on the viewpoint that the pathogenesis is from fire burning and blood exhaustion, advised to invigorate the middle energizer and Qi, to boost Yang and Yin, simultaneously discharge the Yin-fire, once the fire is eliminated then blood is generated, later menstruation could turn normal itself. To treat the amenorrhea caused by long weakness or deficiency of the spleen and stomach, physical weakness, the collapse of Qi and blood, he proposed to invigorate Qi and replenish blood to prompt menstrual blood generation automatically; for treatment of the amenorrhea caused by the deficiency of the spleen and stomach for a long period, deficiency of Qi and blood, collapsing of the Middle Qi, hyperactivity fire of the uterine collateral, except replenish Qi and supplement blood to regulate the blood vessels, better discharge fire pathogens in uterine collateral to prompt the generation of menstrual blood automatically.
In general, the theory of herbalist Li Dongyuan majorly came from the ancient books Nei Jing(the Inner Canon) as its source, absorbed the theory of Zhang Zhongjing, the theory of Qian Yi, theory and experience of Wang Shuhe and Sun Simiao, enlightened by the theory of his master Zhang Yuansu, and affected by the theory of herbalist Liu Wansu. Because in the theory of the five elements, the spleen and stomach viscera belong to the element earth, so the spleen and stomach theory of herbalist Li Dongyuan was also called "Bu Tu Xue Pai(the School of Supplement Earth)".
On February 25th, the year 1251 A.D., herbalist Li Dongyuan passed away, then he was buried at his hometown Huang Lin County, and his tomb was reserved and stand at the west corner of the A Dang village, A Dang township, Huang Lin county, a stone tablet stand in front of the tomb, the engraved markings read that: “master the skills and classics of Qibo and Huangdi, revive the dead, famous herbalist who shares morality to native people, fame spread from south to north, east to west." to memorize and praise his achievements.
The School of He Jian and the School of Yi Shui were regarded as two big academic schools inherited traditions and established new grounds for the later generations in the TCM history, herbalist Li Dongyuan was respected as the tower of strength of the Yi Shui School, he learned from herbalist 張元素(Zhāng Yuánsù) but had more influence on later generations, later herbalist 朱丹溪(Zhū Dānxī) was the third generation disciples of He Jian School, some of his academic thought also come from the enlightment of Li Dongyuan, ever since the Ming Dynasty, later famous herbalists include 薛立齋(Xuē Lìzhāi), 張景嶽(Zhāng Jǐngyuè), 李中梓(Lǐ Zhōngzǐ), 葉天士(Yè Tiānshì), etc, all showed respect for the academic thoughts of herbalist 李杲(Lǐ Gǎo) and developed some of his academic thoughts, other herbalist 龔廷賢(Gōng Tíngxián), 龔居中(Gōng Jūzhōng), 張誌聰(Zhāng Zhìcōng), etc, were affected by the academic thoughts of Li Dongyuan too. Although the inheritors all know clearly that put undue emphasis on spleen-stomach may be biased, but his academic theory still was respected as a milestone in the history of TCM, and herbalist Li Dongyuan was recorded in the TCM history as a great herbalist.
1.李東垣(Lǐ Dōngyuán):introduction about his biography and legend,main books and academic thoughts.