Three Books Of The Yu Chang Medical Academic Thought

Yu Chang(1585-1664),styling himself Jia Yan,alias Xichang Laoren in his late years,Xinjian native people(nanchang city,jiangxi province today),was a celebrated doctor in late Ming dynasty(1368-1644)and early Qing dynasty(1636-1912).Pursuing his studies and researches scrupulously from Neijing and Nanjing to the masters' hundred schools,Yu Chang was specialized in Zhong Jing' s theory. Emphasizing on identification of the disease before prescription and treatment based on syndrome differentiation,he obtained miracle achievements in internal miscellaneous disease and other rare illness by means of classical formula.As the doctor lived in late Ming dynasty and early Qing dynasty,Yu Chang,together with Wu Qian and Zhang Luyu, was noted as one of the three famous doctors in early Qing dynasty in history.He has left over ten precious works for us,such as Yimenfalv, Shanglunpian and Yuyicao,which were also regarded as his masterpieces and laid important contribution to the development of TCM.Therefore,in order to clarify his position and his contribution, this article starts with Yu Chang' s three masterpieces,Shanglunpian, Yimenfalv and Yuyicao,arrange,generalize,explain and evaluate his medical ideology from six parts as follows:First,exploration of ShanglunpianYu Chang denied the revision of Shanghanlun made by Wang Shuhe and Lin Yi,but agreed to Fang Youzhi' s three principles.Afterwards he recompiled Shanghanlun according to three principles and principles commanded by prescriptions.Yu Chang holds that Shanghanlun should contain principles and items, in which seasonal exogenous,especially the cold damage must be the primary principle.Three yin and three yang must be the primary principle to differentiate the cold damage syndrome.In Taiyang section, internal,wind damaging defense,cold damaging nutrient,wind and cold damaging both nutrient and defense are the primary principles to analyze the taiyang disease syndrome.That is to say,six meridians are the primary principles to analyze cold damage syndrome,moreover,internal wind damaging defense,cold damaging nutrient,wind and cold damaging both nutrient and defense are the primary principles to differentiate the syndromes.As a result,he established the theory of three principles.In addition,Ramulus Cinnamomi Decoction,Ephedra Decoction and BlueDragon Decoction are considered as the three primary prescriptions under the three principles.Yu Chang established six sections in accordance with six meridians. In each section,brief syndrome differentiation and treatment were related before prescription,then list clauses and notations after it. Combination of diseases,overlap of diseases,refractory diseases and phlegm diseases were added in the postscript of three yang meridians, while incomplete recovery,easy relapse of yin and yang caused by overexertion after three yin meridians,which make the section a coherence and integrity of principles,therapeutic methods,formulas and prescriptions.Although his revision was controversial,he initiated innovation of compile and analysis about Shanghanlun,which was creative in history and resulted in academic debate between classic-abided school and classic-predigested school,boosted further research of Shanghanlun and invention of classification,such as syndrome classification based on prescription and syndrome classification based on therapeutic method,in terms of methodology, it was influential.Meanwhile,Yu Chang extracted and classified the clauses of warm syndromes into three parts,which have been mentioned in Neijing.one is if cold damage happens in winter,warm damage must occur in spring; another is if essence isn't stored in winter,warm damage must occur in spring;the third is if cold damage happens but essence isn't stored in winter,both of them must occur in spring.His therapy emphasizing on protecting yin exerted huge effects on ideology of febrile disease doctors.Second,exploration of etiology of six excesses,four parts included.â… )As to treatment of middle cold syndrome,Yu Chang opposed Zhu Danxi' s view of "Yang is usually redundant while yin is frequently deficient",demonstrated his opinions of pathogenesis casused by yin pathogen and its syndrome differentiation and treatment.Comparing and analyzing the statements in Shanghanlun,Jinkuiyaolue and other ancient doctors about the disease caused by yin pathogen,he supplemented the treatment of middle cold syndrome.â…¡) Apoplexy can be caused by external wind and internal wind.The former takes yang deficiency damaging orifices as its rooting reason. If wind pathogen attacks externally,it must hold constant pathogens and takes either fire,evil qi or phlegm as manifestations.Yu Chang was the first to put forward the theory of internal wind which holds that apoplexy is caused by sudden onset of accumulative internal wind.â…¢) Rectify dampness damaging in autumn into dryness damaging because dryness is a major seasonal qi in autumn.Dryness prevalence resultsin thirsty,so a decoction for clearing away dryness and saving lung was invented by means of its flavor-pungent-cool, sweet-moistening,which was appreciated by later doctors.â…£) Heat,dampness and summer heat are put together because they always interact and are difficult to separate.From above,Yu Chang' s theory of six excesses,compiling principles and other points are so original and comprehensive that they are worthy exploring.Third,statement of Yu Chang' s disease-discussion style.As a standard instrumentation,Yu Chang's disease-discussion style has profound theoretic foundation in which every item and clause combine the practice under the guidance of classical theory.Specific regulations were demanded in medical record as a formal pattern.With the increasing attention of standardization,this formal pattern is meaningful at present to trace back ancient literature and explore the record in diagnosis.Four,discussion of Yu Chang's treatment of miscellaneous diseases include malaria,dysentery,phlegm-fluid retention,coughing,block and repulsion disease,consumptive thirst,consumptive disease,edema, jaundice,lung abscess,lung flaccidity.Each disease was discussed in sequence of etiology,pathogenesis,various medical records,reasons of misdiagnosis and prescription was written strictly.Most of them are based on comparison with Jinkuiyaolue and explained clearly.Five,exploration of theory of TCM through medical records and notes.Four parts are included as follows:â… ) Clearing up the misunderstanding of infantile convulsion,which should be divided into three steps.Concluding(discussing?) the therapeutic principles with emphasis on spleen and lung through specific medical records.â…¡) The senile diseases should be treated from the perspective of spleen and lung,refreshing the healthy qi,warming and restoring the lower source and from the angle of phlegm.â…¢) Treatment on blood syndromes from four sections:calm the kidney qi and promote qi reception to suppress hematemesis;eliminate phlegm and engender blood to treat combined syndromes;treat blood vessel damage of stomach with salty and cold medicine.â…£) Statements include vertex disease treated by descendant and subdued method,five syndromes of hematochezia caused by intestine wind can be cured,and syndrome differentiation of blood tympanites. All the internal miscellaneous cases or cold damage cases recorded in Yuyicao were treated by Yu Chang himself.Trying to reach prudence and clarity,each case aims at detailed pathogeny and situation, especially syndrome differentiation by means of inference,inquiry and specific analysis.By this token,Yu Chang extremely stressed medical practice and clinical treatment.Most of his ideologies were distributed on various medical records and notes.Yu Chang was apt at putting forward newly theory and method through the precious experiences which endowed his research with strongly practical characteristic.Six,there are three characteristics in Yu Chang' s book:first, he is expert in prescribing gingseng,not only making an exclusive section discuss it,but also applying gingseng to warm and tonify lower source and treat various dysenteries and other internal miscellaneous cases.Aside from,once he served as a monk in his complicated experience, so Buddhism was frequently induced in his book.Yu Chang established medical law through imitation of Buddhism mitzvah.Last,he combined the four doctrines of Buddhism with the theory of yin-yang in TCM and yin syndrome was stressed as well.He also paid attention to mental nourishment and put emphasis on light diet.At the end of the article,Yu Chang' s position in medical history was discussed from the perspective of his classical research, prominence of key point,original notation and comparison.In conclusion,Yu Chang shouldn't be overlooked because the traditional situation in studying Shanghanlun was broken by his view of three principles which aroused discussion.His initiative of medical compiling law and the establishment of disease-discussion style with the extraction of clauses in warm syndrome had a huge influence in history.Yu Chang' s medical practice and experience turned out to be his book and theory.In particular,his ideology of misdiagnosis aims at guiding clinical syndrome differentiation and enlightening later generations.