Zheng QinAn's "Exposition on the Nature of 'ShangHan'"

From ZhengQinAn's Collected Works

Chapter entitled "伤寒溯源解", or "Exposition on the Nature of 'ShangHan'"
Note: The two characters 伤寒 from the title of the classic work by Zhang ZhongJing can be literally translated as "damage or injury" and "cold", a concept that Zheng QinAn broadens to explain the physiological breakdown in energy flow through the invasion of a pathogenic factor, as we will see below. This is radically different from the way it is commonly rendered in English as referring to the resulting "febrile disease"

仲景为医林之祖,著《伤寒》一书，以开波世津梁，提出三阳三阴，包含乾坤二气之妙，后贤始有步趋。注家日多，纷纷聚讼，舍本逐末，以至于今，故读《伤寒》书 者寡矣，亦并不知伤寒何所取义也。即注伤寒者，亦只是照原文敷衍几句，并未道及伤寒宗旨，与万病不出伤寒宗旨，教后人何由得入仲景之门，余特直解之。夫曰 伤寒者，邪伤于寒水之经也，太阳为三阳三阴之首，居于寒水之地，其卦为坎，坎中一阳，即人身立极真种子，至尊无二，故称之曰太阳,如天之日 也。太阳从水中而出，子时一阳发动，真机运行，自下而上，自内而外，散水精之气于周身，无时无刻无息不运行也。故《经》云："膀胱者州都之官,津液藏焉, 气化则能出焉。"气化二字，乃伤寒书一部的真机。要知气化行于外，从皮肤毛窍而出水气，气化行于内，从溺管而出水气。外出者，轻清之气，如天之雾露也；内 出者，重浊之气，如沟XX之流水也。

太阳之气化无乘，一切外邪，无由得入，太阳之气化偶衰，无论何节何侯中不正之气干之，必先从毛窍而 入，闭其太阳运行外出之气机，而太阳之经证即作，故曰伤寒。今人只知冬月为伤寒，不知一年三百六十日，日日皆有伤寒。太阳为六经之首，初为外邪所侵，邪尚 未盛，正未大衰，此际但能按定太阳经旋治，邪可立去，正可立复。因近来不按经旋治，用药不当，邪不即去，正气日衰，邪气日盛，势必渐渐入内，故有传经不传 腑，传腑不传经，二阳并病，三阳并病，两感为病，渐入厥阴，邪苟未罢，又复传至太阳，迁延日久，变证百出，邪盛正衰，酿成阴阳脱绝，种种危候，仲景立三百 九十七法，一百一十三方，以匡其失，而扶其正。

As one of the founding fathers of Chinese medicine, Zhang ZhongJing authored the ShangHanLun as a tool for the clinical treatment of human afflictions. He outlined the three Yang/three Yin meridian theory of diagnosis, representing the subtleties of Qian and Kun(1), so that generations of physicians to come might deepen their understanding of medicine. Over time, there have been many commentaries, all with different opinions that argue over key points of the original text. The overall result has been to branch out away from its original meaning, so that now there are few people who even bother to read the ShangHanLun, and those that do, are confounded as to how to understand its true meaning. In their perfunctory work on the text itself, these commentators have failed to grasp the deeper essence of the ShangHanLun, which extends to all forms of disease. How, then, can those who come after gain access to the genius of Zhang ZhongJing? I shall explain here in no uncertain terms.

The concept of 'shanghan' begins with the introduction of a pathogen to the meridian of cold and water. The TaiYang meridian lies at the head of the three Yang and three Yin channels, and is the domain of cold and water. Its associated trigram is Kan, whose single Yang element is the primary source of all human life. In this, it resembles the awesome life-giving power of the sun and is thus referred to as 'TaiYang'(2). The sun rises out of the water and during the Zi period, the single Yang element comes to life, and the dynamics of the qi mechanism begin, moving upwards and outwards, it spreads water and essence to the surface of the body, constantly moving without rest. The NeiJing states, "The bladder is the official of the central capital, fluids are stored there and emerge with qi transformation."(3) This process of "qi transformation" lies at the heart of the ShangHanLun. One must be familiar with the process of qi transformation in the surface of the body, where water vapor is expelled from the skin and pores; and with qi transformation in the interior of the body where water is expelled through the urinary ducts. Vapor at the surface of the body is light, arid qi, much like mist or fog; water expelled from within the body is heavy and turbid, much like the flow of a drainage stream.

If the qi transformation of the TaiYang meridian remains unimpaired, then there is no avenues through which pathogenic qi may enter the body. When TaiYang qi transformation is weakened, no matter what the season or time of day, pathogenic qi will invade. It must first enter through the pores and block the expulsion process of TaiYang qi transformation. This leads to the development of the TaiYang meridian condition, thus, referred to as 'shanghan'.(4) Practitioners today believe that cold damge is limited to only the winter months, and do not realize that it can occur at any time throughout the year. The TaiYang meridian is the first of the six meridian stages to be afflicted by cold damage. At this stage, the pathogen is still relatively weak and the vital qi (zheng qi) is still very strong. If the practitioner is able to correctly diagnose and provide treatment according to the TaiYang meridian condition, the pathogen can be immediately dispelled and zheng qi can immediately recover. However, because people no longer practice this system of meridian diagnosis, they use herbs incorrectly and the pathogen is not dispelled, thus further weakening zheng qi and increasing the strength of the pathogen. The illness will gradually grow deeper and transform from meridian to meridian or from fu to fu, leading to an overlapping TaiYang, YangMing complex, TaiYang, YangMing, ShaoYang complex, or simultaneous complex of two meridians. Eventually, it reaches the JueYin stage, with its roots still intact, it reemerges at the TaiYang stage and slowly over time develops into various diseases. In the end, this leads to the separation of Yin and Yang and various life-theatening conditions. Therefore, Zhang ZhongJing established the 397 methods and 113 prescriptions of the ShangHanLun in order to dispell pathogens and tonify zheng qi.

(1) The two trigrams from the Book of Changes representing pure Yang and pure Yin repsectively.
(2) In addition to its Chinese medical meaning of the 'greater Yang' channel, TaiYang also means 'sun'.
(3) This passage from the NeiJing is and often quoted piece used to explain the formation and excretion of urinｅ. However, if you carefully consider it under the lense that Zheng QinAn has provided here, this emergence of fluids is not referring merely to urination. It points to the transformation of water into light, arid qi that is then transported to the surface and extremities of the body primarily through the TaiYang meridian and eventually excreted through the skin.This clearly explains why patients suffering from Yang qi deficiency have frequent, clear urinations. dry mouth and constant thirst, dry skin etc. - the driving force of qi transformation is insufficient and therefore fluids are passed directly out of the body without reaching the TaiYang meridian.
(4) Zheng QinAn uses the parallelism of this passage to indicate that the 'han' or 'cold' being damaged does not refer to the external pathogen as is commonly mistaken. It refers, instead, to the basic cold nature of the TaiYang meridian and the damage that is incurred upon the dynamics of the TaiYang qi mechanism. Therefore the first stage of all illnesses, regardless of the nature of the external pathogen, falls by necessity within the scope of 'shanghan'. This point is essential for cutting through the ongoing debate of modern TCM over cold-wind invasion versus warm-wind invasion. The nature of the pathogen is secondary in regards to its effect on the qi mechanism of the patient. According to Zheng QinAn, what is referred to as 'WenBing' is nothing more than the transmission of this damage to the qi mechanism from the initial TaiYang stage to that of the YangMing stage.

二零零八年重阳节