Shang Han Lun Historical Synopsis

By Yaron Seidman DAOM
Few weeks ago I taught a seminar titled ‘Breaking Shang Han Lun Code’ in Fairfax, California. In this seminar we contemplated the principle hidden behind the Shang Han Lun text. I explained why one must not believe this (or any other) text blindly but rather diligently investigate the principles behind the theory until true knowledge evolves. In medicine, more then any other field, one must seek true and real knowledge as in front of him or her sits a real person, a patient. Patients entrust their life in the hands of practitioners and therefore the responsibility is great. At the seminar’s conclusion, a participating practitioner approached me and said she had recently graduated from acupuncture school and is leading her own practice. During several years of schooling she followed a Shang Han Lun instructor in clinic. It seemed that the instructor had good clinical results, yet every time she was asked for an explanation about the herbal formulas she would answer: "Shang Han Lun is the law. We don’t ask questions about it. We simply follow this law for enough years and then get enlightened. I know why I do what I do but I can’t explain it to you.” I was saddened, all these centuries have passed since the time of Zhang Zhongjing and as if nothing has changed. Blindly believing an ancient text, without understanding it, has been practiced for centuries in Chinese medicine. Often times following a romantic notion that the older the text is, the more truthful or original it is. In this article I am not discussing the Shang Han Lun principles, but rather recounting its history. Through its historicity I hope to support Shang Han Lun enthusiasts in the exploration of its principles and the dismissal of blind belief.

Zhang Zhongjing (150-219 CE)– The Person.
In the 《后汉书 Historical Records of the Later Han》compiled during the Liu Song Dynasty (ca. 440 CE) by Fan Ye 范曄, which draws upon several earlier historical records, there is no mention of Zhang Zhongjing or his life-story. The first narration of Zhang’s life-story comes from the preface of the Song Dynasty Shang Han Lun version (1065 CE), which quotes the story from an earlier Tang dynasty work 《名醫錄 Chronicles of Famous Physicians》by Gan Bo Zong 甘伯宗 (this text was lost after the Song Dynasty). The story details: 南陽人,名機,仲景乃其字也。舉孝廉,官至長沙 太守,始受術於同郡張伯祖。時人言,識用精微過其師。所著論,其言精而奧;其 法簡而詳,非淺聞寡見者所能及。A person of Nan Yang, his given name is Ji 機, while his courtesy name Zhongjing 仲景. Passed the imperial examination and became the prefecture chief of Chang Sha. He began his study with (his uncle) from same prefecture Zhang Bozu. People of his time said that he has surpassed his teacher. His literary work reached depth and perfection, his (application) methods simple yet detailed. It is not something the shallow learned or the near sighted can grasp.

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Earlier on, Huang Fumi 皇甫谧 (215-282 CE) in his acupuncture classic《針灸甲乙經 The ABC Classic of Acupuncture and Moxibustion》narrates a story about Zhang Zhongjing's superior diagnostic skills, yet there is no description of the person’s life.

Shang Han Lun Historical Synopsis
According to Shang Han Lun preface, Zhang Zhongjing collected or at least referenced earlier texts available to him, including Su Wen, Nine Scrolls, 81 Difficulties, Yin Yang Grand Treatise, Tai Lu Medical records, as well as Healthy Pulse Differentiation, in order to compose the Shang Han Za Bing Lun or Cold Injuries and Miscellaneous Diseases Treatise. A considerable number of Shang Han Lun formulas were copied from an earlier Han dynasty classic《湯液經法 Decoction Canon》, a work lost since the Tang dynasty. In 1948, Yang Shaoyi 楊紹伊 assembling fragments from Wang Shuhe’s Pulse Canon and Sun Simiao’s Prescriptions Worth A Thousand Gold, reconstructed a 《湯液經 Decoction Canon》. The original Shang Han Lun was compiled during the end of Han dynasty ca. 180-200 CE, yet as these were times of unrest, chaos and rebellion, the work disappeared and was kept secret in the hands of unknown persons. To this day, it's original scope cannot be ascertained. What came down through history to the present is an arrangement compiled by an imperial physician from the western Jin dynasty, named Wang Shuhe 王叔和 (210258 CE). Some contemporary scholars like Liu Duzhou 劉渡舟 even consider Shuhe to be Zhongjing’s disciple. Shuhe’s compilation was later named 《張仲景傷寒 Zhang Zhongjing’s Cold Injury》、《張仲景方 Zhang Zhongjing’s Prescriptions》 or《王叔和張仲景方 Wang Shuhe and Zhang Zhongjing’s prescriptions》and was circulated widely during the eastern Jin and Northern and Southern dynasties (304-589 CE). During this time period, the content and scope of the work is unclear. Other medical texts of the same era, such as 《肘後方 A Handbook of Prescriptions for Emergencies》、《針灸甲乙經 The ABC Classic of Acupuncture and Moxibustion》、《小品方 Jotting Prescriptions》、and 《輔行訣臟腑用藥法要 Assisting Rhymes of Herbal Application to Zang Fu》quote some fragments from Wang Shuhe’s text, however, none contain the entire text. The Sui dynasty imperial physician Chao Yuanfang 巢元方 in his《諸病源候論 Treatise on Causes and Symptoms of Diseases》also included a part of Wang Shuhe’s text. In the Tang dynasty (618-907 CE) one can find more historical records of this text, even though it was not yet titled Shang Han Lun Cold Injury Treatise. In《隋書 The History Book of Sui Dynasty》chapter〈經籍志 Imperial Bibliography〉there is《張仲景方 Zhang Zhongjing Prescriptions》12 scrolls and《張仲景療婦人方 Zhang Zhongjing Gynecology Prescriptions》2 scrolls. In addition,〈經籍志 Imperial Bibliography〉 quotes an earlier text《梁七錄 7 Records of Liang》,that had《張仲景辨傷寒 Zhang

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Zhongjing’s differentiation of Cold Injuries》10 scrolls. 《舊唐書 The Old Tang Book》in chapter〈經籍志 Imperial Bibliography〉mentions a book《張仲景藥方 Zhang Zhongjing Prescriptions of Medicine》15 scrolls. In the《新唐書 New Tang Book》chapter〈藝文志 Classics Writings〉there is《王叔和張仲景方 Wang Shu He Zhang Zhongjing Prescriptions》15 scrolls,and《傷寒卒病論 Shang Han and Sudden (or fatal) Disease Treatise》10 scrolls (during the Song compilation, the two characters 卒病 ‘sudden disease’, were arbitrarily considered a typo and changed to 雜病 ‘miscellaneous diseases’). The content of the earlier Shang Han Lun versions, yet again, one cannot ascertain and therefore cannot compare to the later versions extant today. However, one can certainly tell that even earlier then the Tang dynasty there were different versions of Shang Han Lun with different numbers of scrolls. Sun Simiao in his《備急千金要方 Essential Formulas for Emergencies [Worth] a Thousand Pieces of Gold》said: 江南諸師秘仲景方而不傳 all masters south of the river keep Zhongjing’s prescriptions secret and do not transmit them. This text compiled in 652 CE, only includes very few lines from the Shang Han Lun. However Sun in his later 《千金翼方 A Supplement to Prescriptions Worth A Thousand Gold》compiled in 680 CE brings almost the entire Shang Han Lun lines arranged in six conformations. This arrangement, however, is sequenced differently then the later Song version. For example, Tai Yang section is arranged under three main methods; Gui Zhi Tang methods, Ma Huang Tang methods and Qing Long Tang methods. As of today, Sun Simiao’s version of the Shang Han Lun is the earliest we have today and it is also named the Tang (dynasty) version. Wang Tao 王燾, like Sun Simiao, in his 《外台秘要 Medical Secrets of an Official》 (compiled in 752 CE) brings forth the Shang Han Lun lines, and here for the first time one can find lines from the later version of 《金匱要略 Essential Prescriptions of the Golden Coffer》, the line arrangement again being different then the modern version. Wang Tao also references additional lines and scrolls not extant today, and one therefore clearly sees that Wang’s referenced text was different then the text Sun Simiao had available to him. Contemplating this, one may deduce that earlier then Tang dynasty there were at least two schools of Shang Han Lun; one having the Shang Han Lun six conformations system as a stand alone frame, the book containing 10 scrolls (this includes the Tang and Song versions we have today), while the other incorporated the miscellaneous diseases with the six conformations into one unified system, of which, different versions may have contained 12, 15, 16 or 18 scrolls (this includes the famous version discovered during Song of 《金匱玉函要略方 Essential Prescriptions of the Golden Coffer and Jade Case》. In Northern Song at the time of emperor Ren Zong 仁宗 (1010-1063 CE), an official in charge of academic affairs, Wang Zhu 王洙, accidentally discovered an old worm eaten book titled 《金匱玉函要略方 Essential Prescriptions of the Golden Coffer and Jade Case》in 3 scrolls. The first scroll was Shang Han cold injury, the second scroll Za Bing miscellaneous diseases, while the third contained prescriptions. in addition to this book,

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at about the same time, there was another book circulating around with the title《金匱玉 函經 Golden Coffer and Jade Case Canon》that some believed to have been another Wang Shuhe version, yet in all likelihood, it was a forgery from the Tang era, the content of which is similar to that of Sun Simiao's version. In Northern Song (992 CE) 《太平聖惠方 Sagely Benevolent Formulas of Great Peace》one finds yet another Shang Han Lun version (later named《高繼沖本 Gao Ji Chong version》), in which the content is very close to the Tang version. The Shang Han Lun version we know today comes from the Song dynasty era. There are two main versions; Zhao Kaimei version and Cheng Wuji version. In Northern Song, the time of emperor Ying Zong 英宗, the 2nd year of the era 治平 Zhi Ping (1065 CE), noted imperial physicians Gao Baoheng 高保衡、Sun Qi 孫奇、Lin Yi 林億 and others received an imperial edict to edit, compare, arrange and print the different 《傷寒論 Shang Han Lun》,《金匱玉函要略方 Essential Prescriptions of the Golden Coffer and Jade Case》and《金匱玉函經 Golden Coffer and Jade Case Canon》 versions. This publicly printed Shang Han Lun edition was in 10 scrolls and was named the Song version or Zhi Ping version. In addition, the middle scroll of 《金匱玉函要略 方 Essential Prescriptions of the Golden Coffer and Jade Case》 was printed separately as 《金匱要略 Essential Prescriptions of the Golden Coffer》. In the Jin dynasty 1144 CE, Cheng Wuji 成無己 used the Song version, both deleting and adding lines, as well as inserting his own commentary to compose his《註解傷寒論 Shang Han Lun with Annotations》. This version officially printed in 1172 CE and was later named 成註本 Cheng Annotated Version. The Song version was not annotated and therefore hard to read and comprehend. Its circulation quickly declined when Cheng version was printed and by the Yuan dynasty (1271-1368 CE) was only in the hands of few collectors. During the Ming dynasty a book collector, Zhao Kaimei 趙開美 was able, after pain staking effort, to find one copy of the Song version at the hands of a famous doctor Shen Nanfang 沈南昉. In 1599 CE Zhao took《傷寒論 Shang Han Lun》、《金匱要略 Essential Prescriptions of the Golden Coffer》and《註解傷寒論 Shang Han Lun with Annotations》and printed them together as《仲景全書 Zhongjing Comprehensive Volumes》. This was later named the Zhao version. What today we call the Song version, in reality is the block prints of the Zhao Version. This version is extremely scarce and there are only few original specimens in China and Japan. In the Qing dynasty at the era of emperor Qian Long (1736-1795 CE) by a decree of the imperial medical college, noted physician Wu Qian 吳謙 compiled 《醫宗金鑒 Golden Mirror of Orthodox Medicine》, which includes in its first chapter a revision of the Shang Han Lun. The Song version was used as a foundation, however texts by twenty or

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more commentators were consulted in this revision. Lines that were contradictory or nonconforming were deleted one after the other. After the text was finally corrected it was printed again and widely circulated. This is the standard Shang Han Lun version we have today. This version is also called the ‘Golden Mirror of Orthodox Medicine version 醫宗 金鑒版’. Since the beginning of the 20th century, several Shang Han Lun versions have surfaced, claimed to be from earlier periods, however their authenticity is contested by most historians who believe they are later texts based on Tang and Song versions with personal additions.

Conclusion
Zhang Zhongjing concludes his preface to the Shang Han Lun: 夫欲视死别生,实为难矣。孔子云:生而知之者上,学则亚之,多闻博识,知之次 也。余宿尚方术,请事斯语 When one wishes (the high level, where) he can distinguish death from life, it is truly difficult. Confucius said: “To know it (naturally in your heart) at birth is superior, to learn and know it (and make it your own) is second, (but) to study far and wide and know about it (yet not hold it as your own), this knowledge is inferior”. I have collected the arts of medicine and prescriptions as I follow (your) instructions in said affair 请事斯语. The instructions Zhang Zhongjing wishes to follow we find in the Confucian Analects: 顏淵第十二: 顏淵問仁,子曰:克己復禮為仁,一日克己復禮,天下歸仁焉。為仁 由己,而由人乎哉?顏淵曰:請問其目。子曰:非禮勿視,非禮勿聽,非禮勿言, 非禮勿動。顏淵曰:回雖不敏,請事斯語矣。 Yen Yuan asked about benevolence. The Master said, "To subdue one's self and return to propriety, is benevolence. If a man can for one day subdue himself (his ego) and return to propriety (what is truth), then everyone under heaven will return to benevolence (become a good person). Is the practice of benevolence for a man himself, or is it for others?" Yen Yuan said, "I beg to ask the steps of this process." The Master replied, "Look not at what is contrary to propriety (truth); listen not to what is contrary to propriety (truth); speak not what is contrary to propriety (truth); make no movement which is contrary to propriety (truth)." Yen Yuan then said, “Hui, though not quick, will attempt to do things in accordance with these words 請事斯語." Zhongjing concludes his preface with a bold statement: Do nothing, which is contrary to Truth! The sage’s words, methods and prescriptions may have been altered through 2000 years of editorials, arrangements and annotations, yet his heart’s intention remains clear: Do nothing, which is contrary to Truth! Blind (and romantic) belief served the political purpose throughout Chinese history of keeping an official in power, and to a degree keeping disciples close to their teachers. This, in reality, serves no purpose in the practice of medicine. Innocent and therefore one has to believe, knowledgeable and one does not have to believe.

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In the same, previously mentioned, ‘Breaking Shang Han Lun Code’ seminar another practitioner raised a concern, stating: “In my years studying Shang Han Lun my teacher told me that pulse diagnosis is very important. However when I would ask her what is it that I am looking for in the pulse? The teacher would reply: The pulse is like a beautiful landscape or calligraphy, only after you feel the pulse for many years, that you will be able to see this landscape that I am seeing.” With a touch of humor, I would reply: are you seeing the landscape of the Tang version or the Song version? Liu Yuan 刘沅 (1768-1855), a noted physician and scholar of the Qing dynasty, stated: 不實踐其功﹐馴至乎達化窮神則自身之理不明。If one cannot put his skill into its practicality, and instead develops it into the mysterious, then one fails to understand the principle of his own body.

Source: http://zh.wikipedia.org A large portion of the article was translated from the above source by the author and includes author’s own modifications and additions. ‘Breaking Shang Han Lun Code’ 2-day seminar is available online at http://www.chineseclassics.org/SFSeminar.html © Copyright 2012 Yaron Seidman Permission is granted to circulate this article in its entirety. If you quote from this article please credit: Hunyuan Research Institute at http://www.ChineseClassics.org

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