translated by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)
Keywords: Xue Zheng Lun (Treatise on Bleeding Disorders), Tang Rong-chuan
The following translation is a work in progress of Chapter One, Book One of Tang Rong-chuan's Xue Zheng Lun (Treatise on Bleeding Disorders).[1] Tang Rong-chuan, a.k.a. Tang Zong-hai, lived from 1863-1918 CE. Born in Peng county in Sichuan province, Tang was one of the first who tried to unite modern Western medicine and traditional Chinese medicine. Tang tried his best to show that Chinese medicine was not unscientific and that Western and Chinese medicines each have their strong points.
Chapter 1
A person's whole body [is composed of] nothing outside of yin and yang, and the two words yin and yang mean water and fire, [respectively. Further,] the two words water and fire [in terms of the human body] mean qi and blood, for water transforms the qi and fire transforms the blood.
[In that case,] one might ask, how can it be that water transforms the qi? [The answer is that] qi resides in [all] material things, and [all material things eventually] revert to water. This is clearly verifiable [from every day experience]. Indeed, the qi of the human body is engendered below the navel within the cinnabar field, [namely] the sea of qi. [The area] below the navel [is where] the kidneys and urinary bladder [are located], and this where water returns home to. This water does not itself transform the qi but depends on the nose to inhale heavenly yang. Via the lung passageways, heart fire is conducted downward to enter [the space] below the navel, there to steam this water, [and it is this which] promotes the transformation of qi. Just as [within] the I (Jing, Classic of Change's) trigram Kan (Water), one yang [line] is engendered from within water, so is the root of the engenderment of qi.
Once qi is engendered [in this way], it follows the tai yang channel and vessels to spread out and protect the exterior. This is what becomes the defensive qi. In the upper [part of the body, this qi] joins with the lungs, [where] it makes for exhalation and inhalation, and these breaths are blown into each of the five viscera and the six bowels. [Thus all human functions are dependent] on just this one qi and nothing else.
Although qi is engendered from water, it is also able to transform water. Water can transform into qi and is also able [to cause] diseases of qi. Wherever qi goes, water also, without exception, goes. Therefore, the qi of the tai yang is spread to the skin and hair thus leading to sweating. [Sweat] is qi mixed with water yin moving in the external [part of the body. When] the tai yang qi ascends and is transported to the lungs, the water yin within the urinary bladder and kidneys follows [this] qi's upbearing and lifting and becomes the fluids and humors. This qi carries water yin and moves it upward. When qi transforms below, this leads to the water passageways being freely flowing and makes for urination. This is qi moving water which [then] also moves. If water collects [literally, ceases] and is not transformed, externally, the tai yang qi is not out-thrust and sweat does not exit, [while,] internally, fluids and humors are not engendered, [but rather] phlegm and rheum join and stir. This is a disease of water but is also a disease of qi.
One can also have non-movement of the lungs'control and regulation. [In this case,] the qi does not obtain downbearing. This results in dribbling urinary block, slippery [essence], and numerous [urinations]. If this reaches the kidneys, the yang qi within [the kidneys] will not be able to settle water, thus producing rheum and producing diarrhea not once but abundantly. This is a disease of qi which is also a disease of water.
In sum, qi and water are members of the same family. [Therefore,] treating the qi means treating water, and treating water means [that one also] treats the qi. [For instance,] Ren Shen (Radix Ginseng) supplements the qi because it is grown in the northern region. [It] is yang within water, cool and sweet, enriching and moistening. It greatly engenders fluids and humors, [and, when] fluids and humors are full and abundant, then lung metal is sprinkled and moistened. The lungs govern the qi, and its downward drooping leaves [or lobes are responsible for] the intake of qi. Although Ren Shen is sweet, cold, and yin, internally it possesses a yang nature. [Therefore,] it is a good ingredients for engendering the qi and transforming water. Thus qi has a place from which to obtain supplementation and boosting. This is [also] like Xiao Chai Hu [Tang] (Minor Bupleurum [Decoction]). [In Zhang] Zhong-jing's own notes, he said: "[If] the upper burner obtains free flow and fluids and humors [therefore] obtain descent, this makes the stomach qi harmonious." It is the free flow of the fluids and humors which makes for the harmonization of the stomach qi. If fluids and humors are sufficient, the stomach ascends and transports [these to] the lungs. [Thus,] the lungs obtain moistening and nourishment. The [lungs'] lobes hang downward, and fluids and humors also follow this and descend. This is like the downbearing of rain and dew.[2] [Hence] the five viscera all become lustrous, and nothing does not flow appropriately and uninhibitedly. Turbid yin is completely dispersed and hyperactivity of yang does not occur. This is how the lungs control and regulate the five viscera.
Now, if water yin is insufficient, fluids and humors will be withered and thirsty. Above, this will lead to [lung] wilting and cough since there is no water to benefit there. Below, this leads to blockage and binding [i.e., constipation, since] control and regulation are not out-thrust from below. Externally, this leads to steaming heat. Water yin is not able to sprinkle [or moisten] the muscles and skin. All these conditions are to be treated by the method of engendering water. Therefore, Qing Zao Jiu Fei Tang (Clear Dryness & Rescue the Lungs Decoction) engenders fluids in order to supplement the lung qi, Zhu Ling Tang (Polyporus Decoction) moistens and disinhibits in order to eliminate phlegm qi, and Du Qi Wan(Capital Qi Pills) supplements water in order to boost the kidney qi. Similarly, for effusion of sweat, one should regulate the defensive qi, and, by guarding against fire, one should prevent damage to water yin. In such cases, use Bai Shao (Radix Paeoniae Albae)'s enriching of yin in order to protect the origin of sweat, and use Tian Hua Fen (Radix Trichosanthis)'s engenderment of fluids in order to rescue the sweating of humors. [If one understands] this concept, one can know why enriching water is the same as supplementing the qi.
Although Bu Zhong Yi Qi Tang (Supplement the Center & Boost the Qi Decoction), Liu Jun Zi [Tang] (Six Gentlemen [Decoction]), and Shen Qi Wan (Kidney Qi Pills) are all qi-supplementing formulas, why do they not in the least supplement water? In fact, the water yin which is engendered below [in the cinnabar field] and which benefits above is without form, and that which lifts and nourishes it is the qi. It is this water which leads to appropriate enrichment. The substantial water which has a form enters the mouth [i.e., is drunk] and is transformed below. [However,] that which conveys [this water] along the passageways is the qi. It is this water which leads to appropriate drainage [i.e., urination]. If substantial water collects, this leads to the qi becoming obstructed and stagnant. Therefore, Bu Zhong [Yi Qi] Tang uses Chen [Pi] (Pericarpium Citri Reticulatae) and [Bai] Zhu (Rhizoma Atractylodis Macrocephalae) to control water, Liu Jun Zi [Tang] uses [Fu] Ling (Poria) and Ban [Xia](Rhizoma Pinelliae) to disinhibit water, and Shen Qi Wan also uses disinhibiting medicinals to assist [Rou] Gui (Cortex Cinnamomi) and Fu [Zi](Radix Lateralis Praeparatus Aconiti Carmichaeli). [Rou] Gui and Fu [Zi] are qi medicinals [which] transform water, [while] [Fu] Ling and Ze [Xie](Rhizoma Alismatis) are water-disinhibiting medicinals which transform qi. [Similarly, within] Zhen Wu Tang (True Warrior Decoction), [Bai] Zhuand [Fu] Ling are the rulers for disinhibiting water. These [formulas'] treatment of water evils is the same as treating the qi, and their enrichment of water yin is the same as the supplementation of qi. [These principles] are congruous and compatible and are not contradictory.
If water evils are not dispelled, water yin can also not be engendered. Therefore, Wu Ling San (Five [Ingredients] Poria Powder) dispels water evils. [However, this formula] is also able to scatter fluids and stop thirst as well as being able to effuse sweat and abate fever. This is because, when water evils are dispelled, water yin spreads. But, if water yin is not enriched, water evils cannot also be dispelled. Therefore, Xiao Chai Hu [Tang] frees the flow and out-thrusts fluids and humors, which is the same as enabling the descension and regulation of the water passageways. In sum, [if] water moves, qi moves, [and if] water stops, qi stops. [Only if] one can understand this can one speak of the regulation of qi.
Then how is said that it is fire which transforms the blood? The color of the blood is also the color of fire. Fire governs everything located in the heart, [including] the transformation and engenderment of blood and fluids which sprinkle around the body [i.e., moisten the entire body]. Fire is yang but engenders the yin of the blood. In the same way, fire depends on yin blood to nourish it. Thus fire does not flame upward and blood and fluids do not pour downward. [Rather,] they are stored internally in the liver and abide in the sea of blood from which they move and out-thrust [or spread] via the three vessels of the chong, ren, and dai around the entire body in order to warm and nourish the limbs and body. [In] men, blood's conduction and transportation cannot be observed. [In] women, blood's conduction and transportation results in the moon matter [i.e., the menstruate's] periodic precipitation. [When] blood pours downward from the center of the sea of blood, heart fire follows this downward flow. Therefore exuberance of blood does not [cause] heart hyperactivity. [Consequently,] men are without disease and women can get with child.[3]
On the other [hand, there may be] blood vacuity. Then the liver loses its storage, wood [becomes] effulgent, and, moreover, there is stirring of fire. The heart loses its nourishment and fire [becomes] effulgent. What's more, [this] damages the blood. This is blood disease which is the same as fire disease and should be treated by the methods of greatly supplementing the blood [with] [Dang] Gui (Radix Angelicae Sinensis) and Di [Huang] (Radix Rehmanniae). However, the blood may causes fire's engenderment. [If] blood is supplemented without clearing fire, this may lead to fire eventually becoming hyperactive and not being able to engender the blood. Therefore, [when] enriching the blood, one must use clearing fire medicinals. Consequently, Si Wu Tang (Four Materials Decoction) uses Bai Shao, Tian Wang Bu Xin Dan (Heavenly Emperor Supplement the Heart Elixir) uses the two Dongs [i.e., Tian Men Dong, Tuber Asparagai, and Mai Men Dong, Tuber Ophiopogonis], Gui Pi Tang(Restore the Spleen Decoction) uses [Suan] Zao Ren (Semnen Zizyphi Spinosae), and [Zhang] Zhong-jing's Zhi Gan Cao Tang uses the two Dongs and E Jiao (Gelatinum Corii Asini) for the purposes of clearing fire. As for [Dang Gui] Liu Huang Tang ([Dang Gui] Six Yellows Decoction) and Si Sheng Wan (Four Uncooked [Ingredients] Pills), these are also mainly used for greatly draining fire and heat when the transformation of fire is maximally excessive [or] conversely when there is a loss of transformation. [In such cases,] restraining is the same as banking up, and clearing fire is the same as supplementing the blood.
It is also [possible] to have fire transformation not reaching and, [therefore,] blood not being able to be engendered. [Zhang] Zhong-jing's Zhi Gan Cao Tang has within it Gui Zhi (Ramulus Cinnamomi) in order to diffuse heart fire, and Ren Shen Yang Rong Tang (Ginseng Nourish the Constructive Decoction) uses Yuan Zhi (Radix Polygalae) and Rou Gui to supplement heart fire. Both these are methods of supplementing fire [in order to] engender the blood.
It is [also possible] to have blood cold and blood impediment. These lead to the use of Gui Zhi, Xi Xin (Herba Asari), Ai Ye (Folium Artemisiae Argyii), Gan Jiang, and other such medicinals endowed with fire qi in order to warm and out-thrust. Thus one [should] know that treating fire is the same as treating the blood. Blood and fire [have their] origin in the same family. Only by knowing this can one can speak of regulating the blood.
Water and fire, qi and blood are undoubtedly paired. They are also mutually interdependent and interconnected. Therefore, water disease leads to exhaustion of the blood, and blood disease leads to exhaustion of the qi. If the water yin of the qi aspect [or division] is insufficient, yang qi will assail yin and attack the blood. If the blood and fluids of the yin aspect are insufficient, fluids and humors will not descend and there will be diseased qi. Thus [also], excessively profuse sweating damages the blood, perishing of fluids and humors after precipitation [also] damages the blood, and heat binding in the urinary bladder leads to precipitation of blood [i.e., hematuria]. These are [all species of] water disease resulting in the exhaustion of blood. Spitting blood and hacking blood must simultaneously [result in] phlegm rheum, and blood vacuity leads to essence exhaustion and water binding or phlegm congelation not scattering. Loss of blood frequently results in water swelling, [but] blood stasis [may] transform water and also result in water swelling. These are blood diseases with simultaneous water [disease].
In the lower warmer, the sea of blood and the urinary bladder both reside in the same one place. In the upper burner, the lungs govern the water passageways and the heart governs the blood vessels, and these two [viscera] also abide next to each other. In the body's external [aspect], sweat exits from the skin and hairs and blood follows the channels and vessels. These are mutually dependent [i.e., sweat and blood] and move together. One is yin and one is yang, and they are mutually interdependent and interconnected.
Moreover, it is the qi which moves the blood and the blood which guards the qi. Qi is yang. [therefore,] qi exuberance is the same as fire exuberance. Blood is yin. [Therefore,] blood vacuity is th same as water vacuity. One is two, and two are one [i.e., the first is the same as the second]. Only after entering deeply and clearly into this principle can one treat the blood and rectify the qi, regulate yin and harmonize yang. Thus can right and left [i.e., seeming irreconcilable opposites] meet at the source.
It is also said: Blood is engendered by heart fire. It descends and is stored in the liver. Qi is engendered by kidney water. It ascends and is governed by the lungs. That which is between these upward and downward movements is the spleen. The two viscera of water and fire are both connected to the former heaven. [During] the initial fetus of the human, the former heaven engenders the latter heaven. [After] a person has matured, the latter heaven engenders the former heaven. Therefore, the two viscera of water and fire completely rely on the spleen. Food qi enters the stomach and the spleen channel transforms juice [or chyme]. This ascends and is lifted up to the heart fire. The heart fire obtains it and also transforms it red. This is what is called the blood. Therefore, in order to treat the blood, one must mainly treat the spleen. [Zhang] Zhong-jing's Zhi Gan Cao Tang is [based on] this principle. Similarly, Da Huang (Radix Et Rhizoma Rhei)'s precipitation of the blood is also due to Da Huang's partaking the color of the earth. Hence it greatly discharges the earth passageways. Di Huang governs the blood. This is also because Di Huang partakes of earth's moistening. It greatly enriches spleen dryness. [Ren] Shen and [Huang] Qi (Radix Astragali) move the blood and fill the blood, and both of these supplement the spleen. [Thus] by knowing that treating the blood mainly entails [treating] the spleen, one can have the essentials.
[Likewise,] in terms of treating the qi, it is also appropriate to mainly [treat] the spleen. Qi is not only engendered within the kidneys. Food qi enters the stomach, the spleen channel transforms water and descends and transports this to the kidneys. The yang qi of the kidneys then steams and boils this water and it ascends. The clear qi is upborne and the fluids and humors spread to the four [limbs]. The turbid qi is downborne and descend to move along the water passageways. If the water passageways do not move, this is like the earth which has the Jiang He [river] to carry away the malign.[4] Fluids and humors ascend and are upborne. This is like the fertile earth causing germination in response to the rain and dew. Therefore, in order to treat the qi, one must mainly treat the spleen. Liu Jun Zi Tang (Six Gentlemen Decoction) harmonizes the spleen and disinhibits water and, therefore, regulates the qi, Zhen Wu Tang (True Warrior Decoction) supports the spleen and settles water and, therefore, engenders the qi, while Shi Zao (Ten Dates), Xian Xiong (Sunken Chest), and other such decoctions protect the spleen and guard water and, therefore, free the flow of the qi. This is the method of dispelling water evils in order to supplement the qi.
One also may have water fluids not irrigating with strong fire eating the qi. In that case, use Ren Shen to enrich the spleen in order to boost the qi and [Tian] Hua Fen to clear the spleen in order to harmonize the qi. Whenever one treats the qi, one must mainly [treat] the spleen, and then one can obtain [the treatment of the qi]. Li Dong-yuan treated disease mainly via the qi. Therefore, he mainly [treated] the spleen and stomach. However, he used medicinals which tend to be harsh and drying. He did not understand that, [if] the spleen does not control water, it is definitely appropriate to dry, but, if the spleen does not upbear fluids, it is appropriate to enrich. The qi aspect is not ok with lodging of water evils, but the qi aspect is also not ok with lack of water fluids. Zhu Dan-xi mainly treated diseases via the blood. Therefore, he used medicinals which tend to be cold and cooling. He did not understand that diseases which reside in the fire viscus should be [treated with] cold and cool [medicinals], but disease which reside in the earth viscus should be [treated] with sweet, moderate [ingredients]. While this treatise is not solely focused on blood loss, one who treats blood [or bleeding conditions] must first understand [these principles] and then, in the regulation of the qi and the harmonization of the blood, there will be no errors.
Copyright © Blue Poppy Press, 2006. All rights reserved.
Endnotes:
[1]. This translation was originally started by Charles Chace more than 15 years ago. Several years ago, Lynn Kuchinski and I picked it up again and worked on it for some time. Recently, I have begun work on it yet again. Hopefully, Tang's entire book will become part of Blue Poppy's Great Masters Series.
[2]. The author is referring here to fluids and humors dripping off the downward hanging lobes of the lungs similar to rain and dew dripping off downward hanging of the leaves of a tree.
[3]. In other words, men are no subject to menstrual, gestational, birthing, or postpartum diseases.
[4]. In which case, the malign is not carried away.
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