Like modern practitioners, the great masters of Chinese medicine learned from and were influenced by each other’s work. They were not only coming up with original conclusions but were building and refining the work of previous practitioners to form expanded ideas.
Zhang Zi-He, also known as Zhang Cong Zheng, was a military physician who lived from 1156-1228 of the common era. He shared Liu Wan-Su’s belief that medicine needed to be tailored to patients and that medicines and strategies of the Han Dynasty canon were ill equipped to combat present-day illness. After serving in the military, he left to return to his home town in Henan Province to work as a doctor.
His best known theories incorporated some of Liu Wan-Su’s most important contributions to the Chinese Medical canon and are known as the “Gong Xia Pai,” or “The School of Attacking and Purging.” Specifically, Zi-He’s theory of the “Six Doors and Three Methods” referred directly to climatic influences (wind, summer heat, dampness, fire, dryness and cold) that Liu Wan-Su observed. The three methods refer to Zhang’s favored therapeutic regimens: sweating, vomiting and purging. These were not new strategies; Zhang Zhong-Jing, one of the most eminent Chinese physicians during the later years of the Han Dynasty, recorded the use of these approaches in the most studied book of Chinese medicine, the Shang Han Lun. The practice of diaphoresis, emesis and purgation are also documented by Sun Si-Miao, the patriarch and innovator of Tang Dynasty Chinese medicine.
Zhang Zi-He’s treatment strategies are very telling of his seasoned military strategist background. He believed that both life and disease should be treated like battle. Similar to a small fortress, you want to keep the external terrain strong so that disease cannot enter. In Chinese medicine this is the concept of strong Wei Qi. When our interface is strong, pathogens cannot penetrate.
Zhang was a neoconfucianist and a firm believer that pernicious influences entered the body from the heavens, the earth and through man’s actions. The evils of the heavens included the climate—wind, cold, heat, dryness and fire. Insults from the earth came as damp influences that included fog, dew, rain, hail, ice and mud. Man’s abuses centered on dietary intemperance and vices such as lack of discipline. He believed that these insults were responsible for causing disease and in order to effectively cure an ailment, the responsible influence needed to be eradicated – thus the induction of sweating, vomiting and purging.
He believed if you have problems in your life, you need to take charge to destroy the negative influence. Sweating eliminated the harmful evils on the body’s surface. Zhang Zi-He listed approximately forty herbs, many which are still used today such as Schizonepeta known as Jing Jie and Angelica Dahurica Bai Zhi. In addition to herbs, he advocated the use of hygienic practices that included moxabustion, acupuncture, massage, steaming, washing and exercising.
The category of emesis (induced vomiting) was prescribed for digestive illness in the upper gastric abdominal regions with therapies that in addition to vomiting increased salivation, lacrimation and sneezing. The most popular Chinese herbal emetics he recommended were Dichroa Root, also known as Chang Shan, and stalk of Cucumis Melo, known as Gua Di. His use of acupuncture included the activation of points which would mirror his herbal strategies. He used the upward ascension of the spleen to encourage vomiting. An acupuncture point like Spleen 8 “Di Ji,” which translates to mean “Earth Pivot,” was chosen because it could be activated to encourage vomiting. He believed that employing this strategy would quickly release an evil and restore health by purifying the patient.
He also used other acupuncture channels and points to encourage peristalsis through the bowels. Purging methods (laxative effect) treated climatic and emotional evils that when lodged in the chest or abdomen cause intense discomfort. This phenomenon is known in Chinese medicine as heat clumping. By breaking down and pushing the obstruction down and out, the pain is eliminated and healthy function is restored. Of the many purgatives he employed, several are still popular in the TCM Materia Medica such as Rhubarb, known as the Chinese herb Da Huang and the herb Croton Ba Dou.
Zhang Zi-He was a student of Liu Wan-Su’s Cooling School philosophical doctrine and expanded the use of sweating, purgation and vomiting to include more symptoms and clinical scenarios. Zhang Zi-He believed that there are a myriad of influences that can cause disease. He understood that to move difficult obstructions and obstacles in the body, one needed to initiate a treatment strategy of equal force and measure. He believed these treatment strategies to be hygienic and their use encouraged the refinement of the body, mind and spirit.