A Weekend With Zhang Zhongjing

The State of California requires licensed acupuncturists to complete a minimum of 50 continuing education hours every two years, and I attend seminars at least once per year to keep up with these hours. This past weekend was spent in one of those seminars.

Medical continuing education is usually about the newest and greatest advances in treatment. Focus is typically on research, methodology, physiology underlying pathology, how new treatments can be used in the clinic, ways to document treatment effectiveness, and other “forward thinking” stuff. Unlike allopathic medicine, Chinese medicine has its roots in the distant past. Sometimes the best way to understand application of ancient medicine to modern practice is to go back to the source.

This year, my continuing education has me travelling backwards in time to the world of Zhang Zhongjing, a Han Dynasty physician. Dr. Zhongjing lived from approximately 150-219 C.E., and he was one of the most eminent internal medicine physicians of his time. Han Dynasty physicians were scholars. Internal medicine was separate from physical medicine which was separate from surgery. The internal medicine specialist used changes in diet and additions of herbs to treat a wide variety of conditions, many of which still occur today.

Because fevers and plagues were so common at the time, Zhang Zhongjing became an expert in treatment of infectious disease. He compiled all of the knowledge of previous Chinese physicians along with his vast clinical experience into two books, the Shanghan Zabing Lun and the Jingui Yaolue. During a series of wars which followed his life, the books were lost. But the tradition of medicine he created was passed down through other physicians, and the books were finally recreated by descendants of his students during the Jin and Song Dynasties about 1000 years later.  The oldest known copy of the Jingui Yaolue dates to approximately 1340, during the Mind Dynasty.

Ginseng and Ginko LeafThese books by Dr. Zhang Zhongjing still form the basis of Chinese internal medicine. Modern diseases are not that different from the conditions seen during the Han Dynasty, and “normal” physiology is mostly unchanged. People caught colds, got the flu,  experienced boils and pustules on various parts of their bodies, ran fevers, got upset stomachs, had difficulty getting pregnant, suffered from headaches, broke bones, were poisoned by tainted food or water, had hepatitis, were bit by spiders and scorpions and snakes, and experienced most of the other ailments which send people to the doctor today. The Chinese physicians of the era had a fantastic grasp of anatomy, physiology, and pathology. They understood how circulation works, the intricacies of digestion, the challenges of reproduction, the necessity of thermoregulation. They described respiration as effectively as they described the kidney function needed for urination. Their language seems poetic and arcane in modern America, yet the essence of their descriptions continues to be proven accurate by modern research.

This year, I am taking a series of classes to study the Jingui Yaolue. Six weekends in all, the classes go back in time and delve into the medical world of Dr. Zhongjing. Under the guidance of an herbal master the classes guide us through a maze of physiology and pathology seen through the anthropological lens of the Han Dynasty, along with the herbs which restore balance and the various mechanisms for choosing the right herbal combination.

With the Cultural Revolution in China came the Communistic approach that all patients with the same disease should be treated the same way. “Traditional Chinese Medicine” (TCM) is actually a modern invention of the Cultural Revolution which has taken the most standard treatments and applied them to everyone. This is the Chinese medicine which has been taught to the Western world for most of the last 50 years. The most common of herbal formulations from TCM have been manufactured into tablets, tea pills, capsules, and granules, and are very easy to find and easy to take. Many of the “classical” formulas of the Han Dynasty and before are not part of Traditional Chinese Medicine because they require careful assessment of the individual patient and custom modification. This makes a medicine which is more difficult to practice in modern-day America.

Chinese BowlWith 13 years practicing Chinese medicine, I have reasonable skill as an herbalist. There is ALWAYS room to grow as a practitioner, and these classes in classical Chinese medicine are allowing me to deepen my understanding of physiology and pathology as well as the herbs which treat the underlying imbalances allowing the pathology to occur. The end result, hopefully, is that I will bring even more acute skill to the treatment room.

As the year goes on, you will start to see more herbs in granule or “raw” herb form, with formulas customized in the manner of Zhang Zhongjing. Please be patient, as I may not have everything needed for a formula and may need to order ingredients or send you to a colleague with a fully stocked pharmacy to fill your prescription.

While the state requires that I continue my education, there is a more important reason to study and learn. The more I know, the more effective I can be at helping YOU to feel better and return more quickly and fully to doing all the things you love. And that, my patients, readers, family, and friends, is the whole point!

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