Chinese Medical Formulae for treating Depletion Patterns: Historians meet Practitioners



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University of Oxford Institute of Social and Cultural Anthropology Banbury Road, Oxford, OX2 6PE ArgO-EMR Anthropology research group at Oxford on EASTERN MEDICINES AND RELIGIONS 8-9 December 2014 Venue: Pauling Centre, 58a Banbury Road Chinese Medical Formulae for treating Depletion Patterns: Historians meet Practitioners 9.45 Welcome note 10.00 Marta Hanson, Johns Hopkins University Interpreting pulses and depletion disorders in Zhang Shixian s 張 世 賢 Illustrated Commentary on Pulse Rhymes (Tu zhu maijue 圖 註 脈 訣, preface 1510): a philological foundation for understanding its Latin translation in Michael Boym/Andrea Cleyer s Specimen Medicinae Sinicae, 1682 11.00 Leslie de Vries, University of Westminster Formulas and cosmology in the late Ming dynasty: a comparison of Zhao Xianke's 趙 獻 可 and Zhang Jiebin's 張 介 賓 elaborations on Xue Ji's 薛 己 style of replenishing medicine 12.00-13.30 Lunch 13.30 Hugh MacPherson, University of York TCM diagnostic patterns of repletion and depletion in patients with chronic neck pain, and how they affect treatment results. 14.30 Simon Becker, Lake Hospital Horgen Stasis and accumulation as cause of depletion and aging 15.30-16.30 Gry Sagli, University of Oslo Introductory thoughts to the Discussion and Discussion

Chinese Medical Formulae for treating Depletion Patterns: Historians meet Practitioners TUESDAY, 9 DECEMBER 2014 9.00 Zhu Buxian, Oxford (presentation given in Chinese) Examining conditions of a Depletion within a Repletion (shilun shi zhong zhi xu 實 論 實 中 之 虛 ) 10.00 Chen Yunju 陳 韻 如, DPhil cand, University of Oxford The treatments of zhang 瘴 ("miasma") in Song China (960-1279): the depleted body and perceived environmental Influences 11.00 Elisabeth Hsu, University of Oxford Qinghao formulae for treating "depletion-induced fatigue 虚 勞 and contagious corpses 傅 尸 in Song China (960-1279) 12.00-13.00 Discussion 13.00 Lunch

Interpreting Pulses and Depletion Disorders in Zhang Shixian s 張 世 賢 Illustrated Commentary on Pulse Rhymes (Tu zhu mai jue 圖 註 脈 訣, preface 1510): A philological foundation for understanding its Latin translation in Michael Boym/Andrea Cleyer s Specimen Medicinae Sinicae, 1682 Marta Hanson, Department of the History of Medicine, Johns Hopkins University mhanson4@jhmi.edu In this paper, I first introduce the collobarative research I am doing with my colleague, Gianna Pomata, on the recipe form as the vehicle for the transmission of experiential knowledge between cultures. We analyze in particular the medical recipes included in Michael Boym/Andreas Cleyer s Specimen Medicinae Sinicae (1682), a text that played an important role in the transmission of Chinese medicine to Europe in the 17 th century, especially on Chinese pulse reading and related drug formulas. We use this text to examine and compare notions of experience-based knowledge in European and Chinese early modern medical cultures. As a philological foundation for this project, I am reading the Chinese origin text of this Latin translation to see what was chosen for translation and what was left out of the final edition of the Specimen. This paper uses the focus of this workshop on depletion disorders in Chinese medicine to unpack the rationale of Zhang Shixian s classification of depletion according to the pulses. It will also examine the logic of the recommended drug therapies for such depletion disorders offered in the recipes section Gianna Pomata and I have focused on in our collaborative research. Formulas and cosmology in the late Ming dynasty: A comparison of Zhao Xianke's 趙 獻 可 and Zhang Jiebin's 張 介 賓 elaborations on Xue Ji's 薛 己 style of replenishing medicine Leslie de Vries, Department of Complementary Medicine, University of Wes tminster l.devries@westminster.ac.uk During the seventeenth century, Zhao Xianke s ( 趙 獻 可, 16 th - 17 th C.) and Zhang Jiebin s ( 張 介 賓, 1563-1640) versions of warming and replenishing (wenbu 溫 補 ) medicine became popular throughout Jiangnan 江 南 China. In his major text, Yiguan 醫 貫 (1617?), Zhao Xianke emphasised that fire of the gate of life (mingmen zhi huo 命 門 之 火 ) deficiency is the root of all disorders. Referring to a Pre-Heavenly (xiantian 先 天 ) cosmogonic principle, visualised in the Diagram of the Post-Heavenly Arrangement of the Eight Trigrams (Houtian bagua tu 後 天 八 卦 圖 ), he rejected Zhu Zhenheng s ( 朱 震 亨, 1281-1358) ideas on replenishing yin with cold and bitter ingredients and clarified Xue Ji s ( 薛 己, 1487-1559) focus on formulas such as Pill with Six Ingredients (liuwei wan 六 味 丸 ), Pill with Eight Ingredients (bawei wan 八 味 丸 ), and Replenishing the Centre and Increasing Qi Decoction (buzhong yiqi tang 補 中 益 氣 湯 ) for treating depletion patterns. Cosmological considerations and warming and replenishing formulas based on Xue Ji s strategies were also primordial in Zhang Jiebin s medical writings.

Yet, he differed on more than one point from Zhao Xianke. In this workshop, I will not only compare Zhao s and Zhang s replenishing strategies, but also touch upon the objections to their approach voiced by later physicians, of whom Xu Dachun ( 徐 大 椿, 1693-1771) was the most outspoken. TCM diagnostic patterns of repletion and depletion in patients with chronic neck pain, and how they affect treatment results Hugh MacPherson, Department of Health Sciences, University of York hugh.macpherson@york.ac.uk In York we have conducted a randomised controlled trial of acupuncture for chronic neck pain. We recruited 517 patients, one third of whom received acupuncture, which involved up to 12 sessions of treatment, mostly weekly, We were interested in the longer term results of acupuncture compared to usual care, tracking outcomes to well beyond the end of treatment to the 12 month time point. We were interested in many aspects of the acupuncture that might be associated with putative beneficial effects at 12 months. Of specific interest were the TCM diagnostic patterns of depletion and repletion, as well as the related patient-practitioner interactions and lifestyle advice. Data on these aspects of treatment will be reported. By correlating the patterns with outcomes, we will explore the evidence on whether longer term change is associated with the TCM diagnostic patterns of depletion and repletion. The aging process as a result of repletion, not depletion Simon Becker MSc, dipl. Ac and CHM (SBO-TCM), MRCHM, Department of Chinese Medicine, Lake Hospital Horgen, Switzerland, s.becker@lian.ch The common Traditional Chinese Medicine theory holds that depletion lies at the root of aging and many diseases associated with it. Accordingly, supplementation and nourishing are among the most frequently used treatment strategies. I propose that the aging process and diseases of aging are primarily caused by repletion, not depletion. Accumulation and blockages, stagnation and stasis are primary, depletion secondary. In my presentation, I will explain my approach from a clinical point of view and in reference to both Wang Qingren 王 清 任 and Yan Dexin 顏 德 馨. Wang Qingren s modern classic Yi lin gai cuo 醫 林 改 錯 described blood stasis as the primary factor for a wide variety of diseases. Yan Dexin and colleagues put forth the theory of blood stasis as root cause of aging. Based on my clinical experiences with Western patients, I have expanded on their theories to include all accumulations and blockages as primary cause of aging and many other diseases. My medicinal prescriptions throughout my patient population, from children to the aged, reflect this blockage-resolving treatment style. Three cases suffering from what are commonly regarded depletion-diseases will be presented to demonstrate the proposed treatment approach in form of herbal medicine prescriptions.

Zhu Buxian 朱 步 先, Oxford 試 論 實 中 之 虛 (Examining repletions within depletions, delivery in Chinese) This paper reveals inner depletion (li xu 裡 虛 ) as concealed by observed patterns of repletion (shi zheng 實 證 ) in three aspects: (1) seeming similarities between patterns (zheng 證 ) and syndromes (hou 候 ); (2) pulse not corresponding (ying 應 ) with diseases (such as a yang disease manifests yin pulse); (3) timing of a disease which manifests and becomes more serious (such as a time at an interval between two seasonal qi). The discussion of this inner depletion can prevent physicians from misdiagnosing patterns of depletion as patterns of repletion and from misunderstanding pathogenesis. 本 文 列 舉 從 證 候 的 疑 似 脈 不 應 病 ( 陽 病 見 陰 脈 ) 以 及 發 病 與 病 變 增 重 的 時 間 ( 如 節 氣 之 交 ) 三 個 方 面 進 行 分 析, 在 實 證 的 表 象 下 發 現 裡 虛, 方 不 致 以 虛 為 實 而 貽 誤 病 機 The Treatments of Zhang 瘴 ("Miasma") in Song China (960-1279): the Depleted Body and Perceived Environmental Influences Chen Yun-Ju 陳 韻 如, DPhil cand, Faculty of Oriental Studies, University of Oxford yunju.chen@pmb.ox.ac.uk In this paper, I analyze drug therapies composed in Song times (960-1279) for depletion conditions which were considered to be brought by zhang 瘴 ( miasma ) in Lingnan 嶺 南 (literally, south of the Ling ranges), an area that is largely encompassed by the present-day Guangdong and Guangxi provinces. The sources on which this paper relies are mainly drawn from a formulary known as Prescriptions for Preserving Life in Lingnan (Lingnan weisheng fang 嶺 南 衛 生 方, presumably compiled in the early twelfth century), which is a text consisting of extensive twelfth-century examples of prescription strategy for treating zhang. The analysis in this paper will focus on how the Song authors of the formulary used their experience in medical practice and their personal observation of the regional environment in Lingnan to vindicate their own opinions on drug therapies for zhang-inducing depletion conditions.

Qinghao 青 蒿 formulae for treating "depletion-induced fatigue 傅 尸 and contagious corpses 傅 尸 in Song China (960-1279) Elisabeth Hsu, Institute of Social and Cultural Anthropology, University of Oxford elisabeth.hsu@anthro.ox.ac.uk, in collaboration with Wu Zhongping 吳 中 平 In Twice-dead (2002), where Margaret Lock problematized the concept of death that facilitates organ transplantation, she highlighted cultural differences between contemporary US and Japanese attitudes towards brain death. The contemporary Japanese attribution of cognitive and affective faculties to the heart, which associates death with the cessation of the heart beat, grounds in East Asian medical learning. The Song recipes/ formulae of the scholarly Chinese medical currents discussed in this paper contained qinghao 青 蒿, currently known for its antimalarial efficacy, in the medications to treat "depletion-induced fatigue 虚 勞 and contagious corpses 傅 尸. (They belong among the four hundred formulae in the forthcoming Handbook for the herbal antimalarial qinghao, co-edited with Prof. Wu). Patients who suffered this condition had symptoms of listlessness and fatigue (as do anemic patients as well, in regions where malaria is endemic). Without however imposing a single retrospective biomedical diagnosis on these conditions, this paper discusses conditions of depletion that were considered to arise from chong 蟲 (insect, worm, parasite) infestations and were classified as contagious.