As Chinese medicine evolved, practitioners began to realize that patients did not live in a vacuum and they could not be treated as such. Every patient affected by an ailment needed to be treated individually because many factors beyond just physical disease were playing a role and required attention. For Master Li Dong-Yuan, lifestyle was a major factor in the preservation of a patient’s well being. He felt that patients’ emotions could heavily influence the qi’s integrity and that physical illness could be eroded by the socio-economics of a war-torn society plagued with famine, epidemics and poverty.
Li Dong-Yuan, also known as Li Gao (1180 – 1251 c.e.), began his medical studies under one of the most famous physicians in the Hubei Province: Zhang Yuan-Su. Li Dong-Yuan’s family was wealthy, so he was afforded a great opportunity to apprentice closely with Zhang Yuan-Su and the teachings of the Yi Shui School. It was from this direct influence that he formulated his own school of thought that became known as the Earth School.
Once he completed his studies with Zhang Yuan-Su, Li Dong-Yuan became involved in managing his family’s property. After the decades of harsh Mongol conquests, he left home in Hubei to utilize his medical knowledge and training to treat the masses that were adversely affected by the unrest and upheaval of being a conquered region.
It was then that he began to deeply develop his thesis that the etiology of most diseases was a result of injury to the digestive system. The principle organs of the digestive system from a Chinese medical model are the Stomach and the Spleen, which are responsible for taking food and drink and transforming the raw material into energy (qi) for the body’s core functions. Li Dong-Yuan believed that the cause of damage to the stomach and spleen occurred as a result of three main factors: intemperance in eating and drinking (especially consumption of excess amounts of cold, raw, fatty or unclean foods), overwork which leads to exhaustion, and from the effects of excessive and habituated emotional expression — excessive emotions agitate the body and consequently weaken digestion.
When the conquered people were left powerless, poor and unable to access proper nutrition, opportunistic disease processes were able to also overcome and vanquish health physically, mentally and spiritually. This becomes the basis of the Earth School’s doctrine.
Weak digestion on a physical level leads to exhaustion and listlessness with loss of appetite, loose stools and visceral prolapse. On a mental level the organs of the stomach and spleen when distressed have lost the ability to problem solve and use intellect. There becomes a tendency to over-ruminate on the same subject without the ability to act on a resolution. This creates the concept of yin fire. Yin fire is the pathological state of habituated unresolved emotions that are unable to be expressed and manifested, which leads to a noxious feedback cycle culminating in repression and suppression of negative emotions.
Because these feelings have no outlet for expulsion from the mind or body, they become lodged internally. Over time, this leads to the generation of heat trapped in the body which further exhausts resources and causes further debility. We may recognize these states from a Western lens as syndromes of chronic inflammation or autoimmune responses.
Two of Li Dong-Yuan’s most important Chinese herbal formulas to treat digestive qi’s lack of strength and integrity along with the discharge of the injurious heat were Sheng Yang Yi Wei Tang (Yang Ascending and Stomach Nourishing Decoction) and Bu Zhong Yi Qi Tang (Tonify the Center and Regulate the Qi Decoction). Both formulas include ginseng (Ren Shen), astragalus (Huang Qi), and white atractylodes (Bai Zhu) to strengthen the weakened person.
Another common feature is the use of bupleurum (chai hu) to ease emotional tension, allow unencumbered flow and to lift – holding the body’s structures in place. Historically, we are now at a turning point in the crafting of Chinese herbal formulas. Li Dong-Yuan is using a bi-directional strategy of both uplifting and rehabilitating the body’s resources while simultaneously draining out of the body injurious heat and dampness. He is also revolutionary in assigning directionality of herbs to ascend or descend when ingested and also creating a mapping of an herb’s proclivity to affect change certain organs and channels.
He also credited for the herbal formula Sheng Mai San (Pulse Generating Powder), which is still widely used in modern Chinese hospitals for cardiovascular cases, as well as Dang Gui Bu Xue Tang, which is a combination of astragalus (Huang Qi) and Dang Gui (in a ratio of 5:1), used to quickly and deeply nourish the qi and blood following extensive blood loss.
The addition of the Earth School’s ideas to Chinese Medicine helped to further incorporate the concept that exogenous pestilent factors were not the only etiology of disease – and that it was necessary to self cultivate to nurture and build health in order to maintain well-being. Li Dong-Yuan taught a way to live a proactively healthy life as well as a path to reclaim health when afflicted.