Chinese Medical Journal 2009;122(16):1889-1894
detail picture of febrile diseases. From deliberate
investigation, a Japanese scholar already mentioned that
the 268 passages from the total 385 of Shan-Han Lun
were originated in the book complied by Zhang from
other texts, and the other 117 passages were added by
WANG Shu-he and other scholars in Tang or Song
Dynasties.26 Zhang (a representative doctor) formulated
his concepts on the basis of available data to provide a
rational explanation both for diseases and treatments. The
attempt to relate the manifest symptoms to an underlying
physiologic condition is perhaps the most interesting
feature of his text.1
Cultural differences in health beliefs and behavior may
affect healthcare utilization, and culture-related
differences in medication beliefs may be even stronger
for older members of the community.27 The traditional
Chinese medical academic societies in Taiwan are typical
examples of this to keep using Huang-Di Nei-Jing and
Shan-Han Lun as the certification materials. Nevertheless,
widely social and economic concerns directly impinge on
healthcare, so we need a more liberal attitude toward
medical knowledge and discovery. Because series of
research in Chinese studies have been devoted to an
exploration of the contents and foundations of TCM only
for a rather short time,23 our viewpoint in this is still
considered as preliminary and open to reassessment.
Based on the data, the utilization ratio of Shang-Han
formulae prescribed among the patients who sought TCM
for the medical service in Taiwan was not so high as we
expected. There is no six-channel transitions in the
prescriptions of Shang-Han formulae, it indicates that
although Shang-Han Lun is an essential archive of
internal medicine of TCM and the frontier of the
reason-method-formula-drug from the aspect of clinical
practice, its importance is to revealed an ancient way of
thinking about the diseases and formulae, which is
different with the classical Nei-Jing system as we usually
thought.
Further studies to observe on the patterns of Shang-Han
disorders should be carried on in order to understand the
possibility and the transition after treating with the
formulae. We also recommend that the medical education
in TCM may reexamine Shang-Han Lun with the
reference of the statistical data from clinical practice and
the fact that it may not be the follower of Nei-Jing system
for the future explanation of its importance.
Acknowledgement: The authors are grateful to Prof. Peter Davis
for comments, and Prof. Ling-Ling Tsai, Mr. Yu Chen, Ms.
Jing-Huei Shiu, and Ms. Tzu-Feng Hsieh for editing the earlier
versions of this manuscript.
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(Received December 16, 2008)
Edited by GUO Li-shao