The Four Great Classics of Chinese Medicine: A Hall of Medicine That Has Illuminated the Millennium
Huangdi Neijing · Nan Jing · Shanghan · Shennong Bencao Jing — four foundational works upholding the art of Qihuang
“The Yellow Emperor said: … Qi Bo replied: …”
“Diligently I sought the ancient teachings, and broadly gathered remedies from all sides.” (「勤求古训,博采众方。」)
— Zhang Zhongjing, Treatise on Cold Damage and Miscellaneous Diseases · Preface (《原序》), Eastern Han dynasty
If we liken Chinese medicine to a hall that has stood for a thousand years, then the Four Great Classics are the four great pillars upholding that hall.
They are:
- 🟢 Huangdi Neijing (《黄帝内经》) — establishes theory
- 🔵 Nan Jing (《难经》) — resolves difficulties
- 🟠 Shanghan Zabing Lun (《伤寒杂病论》) — sets clinical method
- 🟣 Shennong Bencao Jing (《神农本草经》) — establishes materia medica
Taken together, principle, method, formula, and medicine are all complete, and only then does the art of Qihuang unfold in its full grandeur.
I. Preface: What Are the “Four Great Classics”?
1. The Phrase “Four Great Classics” Is Not an Ancient One
The expression “Four Great Classics of Chinese Medicine” did not originate in the pre-Qin or Han period; rather, it is a summary that later physicians reached after long study and clinical verification. It is generally believed that this usage took shape during the Ming and Qing, and was formally established within the modern Chinese medical education system.
Since the Republican era, TCM schools — such as the Shanghai College of Traditional Chinese Medicine (predecessor of today’s Shanghai University of Traditional Chinese Medicine) and the forebears of the China Academy of Chinese Medical Sciences — have placed the Neijing, Nan Jing, Shanghan, Jingui, and Bencao among required foundational texts, and the name “Four Great Classics” thus became a settled convention.
2. The Four Universally Recognized Classics
“Principle must be sought in the Neijing; method, in the Shanghan; medicine, in the Benjing; difficulty, in the Nan Jing.” (「理必《内经》,法必《伤寒》,药必《本经》,难必《难经》。」)
The “Four Great Classics” universally recognized by contemporary Chinese medical scholarship are:
| № | Title | Nature | Brief Description |
|---|---|---|---|
| 🟢 | Huangdi Neijing (《黄帝内经》) | Founding Text of Theory | The foundational work of the theoretical system of Chinese medicine |
| 🔵 | Nan Jing (《难经》) | Classic of Resolving Difficulties | Expounds the difficult points of the Neijing |
| 🟠 | Shanghan Zabing Lun (《伤寒杂病论》) | Founding Text of Formulas | Source of pattern identification and treatment (bianzheng lunzhi) and classical formulas (jingfang) |
| 🟣 | Shennong Bencao Jing (《神农本草经》) | Source of the Materia Medica | The earliest extant monograph on materia medica |
3. “The Four Together Reveal the Whole”
The four texts are by no means isolated. The Neijing establishes principle; the Nan Jing clarifies it; the Benjing establishes medicine; the Shanghan sets method — principle, method, formula, and medicine form one continuous thread. Hence Xu Lingtai says:
“The Bencao, Lingshu, and Suwen are the sacred scriptures; the Shanghan and Yaolüe are the sages’ discussions. The sages’ discussions may still be pondered, but the sacred scriptures will not tolerate a single careless word.” (「《本草》《灵》《素》,圣经也;《伤寒》《要略》,贤论也;贤论犹可参悟,圣经不容一字鲁莽。」)
— On the Classics (《经典论》) from Yixue Yuanliu Lun (《医学源流论》, On the Origins of Medicine)
II. Huangdi Neijing — The Founding Text of Chinese Medical Theory
1. Compilation and Structure
The Huangdi Neijing is not the work of a single author or moment; it was compiled between the Warring States and the Qin–Han period (roughly the 5th century BCE to the 1st century CE), a collection of essays assembled, edited, and augmented by many physicians over a long period.
The text divides into two parts, each of 81 chapters, totaling 162 chapters:
| Part | Chapters | Main Content |
|---|---|---|
| Suwen (《素问》, Basic Questions) | 81 chapters | Medical principle, zang-xiang (visceral manifestation), etiology, pathogenesis, therapeutic principles |
| Lingshu (《灵枢》, Spiritual Pivot) | 81 chapters | Meridians (jingluo 经络), acupuncture, needling methods, acupoints (shuxue) |
| Total | 162 chapters | Foundation of Chinese medical theory |
The earliest cataloguing appears in the Book of Han · Treatise on Literature (《汉书·艺文志》):
“The Huangdi Neijing in eighteen scrolls; the Suwen constitutes nine scrolls of it, together with nine scrolls of the Lingshu, making the full number.” (「《黄帝内经》十八卷,《素问》即其经之九卷也,兼《灵枢》九卷,乃其数焉。」)
— Book of Han · Treatise on Literature · Records of Techniques (《汉书·艺文志·方技略》)
2. Core Idea (1) — Yin–Yang and the Five Phases (Wuxing)
“Yin and Yang are the Way of Heaven and Earth, the framework of all things, the parents of change, the root of birth and death, the dwelling of spirit and illumination. To treat disease, one must seek the root.” (「阴阳者,天地之道也,万物之纲纪,变化之父母,生杀之本始,神明之府也,治病必求于本。」)
— Suwen · The Great Treatise on the Correspondences of Yin and Yang (《素问·阴阳应象大论》)
“Wood gives rise to Fire; Fire gives rise to Earth; Earth gives rise to Metal; Metal gives rise to Water; Water gives rise to Wood.” (「木生火,火生土,土生金,金生水,水生木。」)
— Suwen · The Great Treatise on the Fivefold Circuit (《素问·五运行大论》)
Yin and Yang are the master frame; the wuxing (五行, Five Phases) are the model. United, the two compose the most fundamental worldview and methodology of Chinese medicine.
3. Core Idea (2) — The Doctrine of Zang-Xiang (Visceral Manifestation)
“The Heart is the office of the sovereign; spirit and illumination emanate from it.
The Lung is the office of the chancellor; regulation and management emanate from it.
The Liver is the office of the general; planning and strategy emanate from it.
The Gallbladder is the office of the upright middle; decision and judgment emanate from it.
The Shanzhong (Pericardium) is the office of the minister and envoy; joy and delight emanate from it.
The Spleen and Stomach are the offices of the granary; the five flavors emanate from them.
The Large Intestine is the office of transmission; transformation and passage emanate from it.
The Small Intestine is the office of reception; the transformation of matter emanate from it.
The Kidneys are the office of strength and will; skill and ability emanate from them.
The Sanjiao is the office of irrigation; the waterways emanate from it.
The Bladder is the office of the regional capital; fluids are stored therein; through qi transformation, they can be discharged.” (「心者,君主之官也,神明出焉。肺者,相傅之官,治节出焉。肝者,将军之官,谋虑出焉。胆者,中正之官,决断出焉。膻中者,臣使之官,喜乐出焉。脾胃者,仓廪之官,五味出焉。大肠者,传道之官,变化出焉。小肠者,受盛之官,化物出焉。肾者,作强之官,伎巧出焉。三焦者,决渎之官,水道出焉。膀胱者,州都之官,津液藏焉,气化则能出矣。」)
— Suwen · The Secret Treatise of the Spiritual Orchid Chamber (《素问·灵兰秘典论》)
The doctrine of zang-xiang (藏象) is the Chinese medical holistic view centered on the five zang-organs. The Heart governs blood and vessels; the Liver governs the free flow of qi; the Spleen governs transport and transformation; the Lung governs qi; the Kidneys govern water — all are laid down here.
4. Core Idea (3) — The Doctrine of Meridians (Jingluo)
“The meridians are what determine life and death, treat all diseases, and regulate deficiency and excess — they must not be left unstudied.” (「经脉者,所以能决死生,处百病,调虚实,不可不通。」)
— Lingshu · The Channels (《灵枢·经脉》)
The Lingshu discusses in detail the twelve regular meridians (three yin and three yang of the hand; three yin and three yang of the foot), the eight extraordinary vessels (Du, Ren, Chong, Dai, Yinwei, Yangwei, Yinqiao, Yangqiao), the fifteen connecting (luo) vessels, and the twelve divergent channels — forming the theoretical foundation of Chinese acupuncture.
5. Core Idea (4) — Etiology and Pathogenesis
“When righteous qi (zhengqi) is stored within, no evil can intrude; where evil gathers, that qi must be in deficiency.” (「正气存内,邪不可干;邪之所凑,其气必虚。」)
— Suwen · Treatise on the Law of Needling (《素问·刺法论》)
“Wind, rain, cold, and heat, when there is no deficiency, cannot alone harm a person. Those who suddenly encounter a violent storm yet do not fall ill — it is because there is no deficiency within, and so evil cannot harm them alone.” (「风雨寒热,不得虚,邪不能独伤人。卒然逢疾风暴雨而不病者,盖无虚,故邪不能独伤人。」)
— Lingshu · The Origin of All Diseases (《灵枢·百病始生》)
This idea remains the central principle of Chinese health cultivation to this day — supporting the upright and expelling the evil; avoiding the evil and nurturing the upright.
6. Core Idea (5) — Preventive Treatment of Disease (Zhi Weibing)
“Thus the sages do not treat disease that has already arisen, but treat it before it arises; do not seek to restore order after disorder has broken out, but to maintain order before disorder appears. To give medicine after illness has set in, or to restore order after chaos has come, is like digging a well when one is already thirsty, or forging weapons when battle has begun — is it not too late?” (「是故圣人不治已病治未病,不治已乱治未乱,此之谓也。夫病已成而后药之,乱已成而后治之,譬犹渴而穿井,斗而铸锥,不亦晚乎。」)
— Suwen · The Great Treatise on Regulating the Spirit in Accordance with the Four Qi (《素问·四气调神大论》)
The three characters “zhi wei bing” (治未病 — “treat the not-yet-diseased”) constitute one of Chinese medicine’s greatest contributions to world medicine. Prevention before illness; prevention of change once ill; prevention of relapse after recovery — a three-tiered preventive framework that predated Western thought by more than two thousand years.
7. Core Idea (6) — The Five Circulations and Six Qi (Wuyun Liuqi)
“The five circulations and yin–yang are the Way of Heaven and Earth, the framework of all things, the parents of change, the root of birth and death, the dwelling of spirit and illumination — can they be left unstudied?” (「夫五运阴阳者,天地之道也,万物之纲纪,变化之父母,生杀之本始,神明之府也,可不通乎。」)
— Suwen · The Great Treatise on the Heavenly Origin Record (《素问·天元纪大论》)
The wuyun liuqi (五运六气, five movements and six qi), in short called “yun-qi” (运气), is the specialized doctrine by which Chinese medicine studies the influence of climatic change upon disease — the wellspring of what we would today call Chinese chronomedicine.
8. Historical Status and Modern Research
The Huangdi Neijing is honored as the “Ancestral Source of Qihuang” and the “Sage of Physicians”. In the Tang dynasty it was ranked as “required reading for physicians”; in the Song dynasty it was collated by Lin Yi (林亿) and others at the Bureau of Medical Revisions (校正医书局); in the Ming dynasty Zhang Jingyue (张景岳) produced a comprehensive commentary, the Leijing (《类经》, Classified Classic).
In 2011, the project “Archives of Traditional Chinese Medicine” (「中国传统医药档案」) — submitted jointly by the National Library of China and the China Academy of Chinese Medical Sciences (comprising nine ancient works including the Huangdi Neijing and Bencao Gangmu) — was inscribed on UNESCO’s Memory of the World Register (《世界记忆名录》), marking the highest level of international recognition for the documentary heritage of the Chinese medical classics.
Source: UNESCO Memory of the World Register official page; the 2011 announcement by the National Administration of Traditional Chinese Medicine.
9. Selected Quotations
| Source | Quotation |
|---|---|
| Suwen · Treatise on the Heavenly Truth of Antiquity (《素问·上古天真论》) | “The people of high antiquity, those who knew the Way, modeled themselves on yin and yang and harmonized with the arts and numbers …” (「上古之人,其知道者,法于阴阳,和于术数……」) |
| Suwen · The Great Treatise on Regulating the Spirit in Accordance with the Four Qi | “Thus the sages do not treat disease that has already arisen, but treat it before it arises.” (「是故圣人不治已病治未病。」) |
| Suwen · The Great Treatise on the Correspondences of Yin and Yang | “Yin and Yang are the Way of Heaven and Earth.” (「阴阳者,天地之道也。」) |
| Suwen · The Secret Treatise of the Spiritual Orchid Chamber | “The Spleen and Stomach are the offices of the granary; the five flavors emanate from them.” (「脾胃者,仓廪之官,五味出焉。」) |
| Suwen · Treatise on the Law of Needling | “When righteous qi is stored within, no evil can intrude.” (「正气存内,邪不可干。」) |
| Lingshu · The Channels | “The meridians are what determine life and death, treat all diseases, and regulate deficiency and excess — they must not be left unstudied.” (「经脉者,所以能决死生,处百病,调虚实,不可不通。」) |
III. Nan Jing — Resolving the Difficulties of the Neijing
1. Compilation and Authorship
The Nan Jing, with full title Huangdi’s Classic of Eighty-One Difficulties (《黄帝八十一难经》), was compiled in the late Eastern Han dynasty (roughly the 1st–2nd century CE). It is traditionally attributed to Bian Que (扁鹊, Qin Yueren 秦越人), but this is in fact a pseudonymous attribution — a “borrowing of authority” tradition common in the Chinese medical canon, intended to lend ancient dignity to the transmission of the teachings. Modern scholarship generally regards it as compiled by an unnamed physician of the late Eastern Han.
2. Structure: The Eighty-One Difficulties
The whole book is written in the form of questions and answers: opening each section with “The classic says …” (「经云」) to quote the Neijing’s original meaning, and answering with “Thus …” (「然」). There are 81 questions and answers in all, hence the name “Eighty-One Difficulties” (八十一难).
| Range of Difficulties | Main Content |
|---|---|
| 1–22 | Pulse diagnosis (the method of taking the pulse solely at the cunkou 寸口) |
| 23–29 | Meridians and needling techniques (迎随补泻 — “ying” / “sui” tonifying and reducing) |
| 30–47 | Zang-xiang (morphology and physiology of the viscera) |
| 48–61 | Etiology, pathogenesis, needling technique |
| 62–68 | Five-shu points, yuan-source points, needling technique |
| 69–81 | Tonification and reduction in needling; miscellaneous discussions of technique |
3. Core Idea (1) — Solely Taking the Cunkou
“The twelve channels all have their arterial pulsations; yet, taking the cunkou alone to determine the life, death, fortune, or misfortune of the five zang and six fu — what is meant by this?
Thus: The cunkou is the great confluence of the pulses, the place where the pulse of the Hand Greater Yin (Taiyin) beats …” (「十二经皆有动脉,独取寸口,以决五脏六腑死生吉凶之法,何谓也?然:寸口者,脉之大会,手太阴之脉动也……」)
— Nan Jing · The First Difficulty (《难经·一难》)
This was the greatest revolution in Chinese medical pulse diagnosis — whereas earlier physicians had needed to palpate the pulses of all twelve channels (as described in Suwen · The Treatise on the Three Regions and Nine Indicators (《素问·三部九候论》)), the Nan Jing instituted the method of “taking only the cunkou” (独取寸口), using merely the cun (寸), guan (关), and chi (尺) positions of both wrists — six pulse regions in all — to survey the entire body’s five zang and six fu. This method persists to this day, becoming the standard practice of Chinese medical pulse diagnosis.
4. Core Idea (2) — The Left Kidney and the Right Mingmen
“The one on the left is the Kidney; the one on the right is the mingmen (命门, Gate of Life). The mingmen is the dwelling of spirit and essence, the root of the original qi; in men it stores the essence; in women it connects to the uterus.” (「其左者为肾,右者为命门。命门者,精神之所舍,原气之所系也,男子以藏精,女子以系胞。」)
— Nan Jing · The Thirty-Sixth Difficulty (《难经·三十六难》)
The term “mingmen (命门)” was for the first time systematically formulated here — the doctrine of “the left being the Kidney, the right being the mingmen” (左肾右命门) laid the foundation for the later “mingmen school of thought” (developed by Zhang Jingyue (张景岳), Zhao Xianke (赵献可), and others).
5. Core Idea (3) — Tonification and Reduction by “Ying” and “Sui”
“Once qi is obtained, to push and insert the needle is called tonification; to withdraw and extend it is called reduction.” (「得气,因推而内之,是谓补;动而伸之,是谓泻。」)
— Nan Jing · The Seventy-Eighth Difficulty (《难经·七十八难》)
The principle of “Ying–Sui” tonification and reduction (迎随补泻) — inserting the needle “ying (迎, against)” the direction of channel-qi arrival to reduce, and “sui (随, with)” the direction of channel-qi departure to tonify — is the central rule of acupuncture tonifying–reducing technique.
6. Core Idea (4) — The Five-Shu Points and the Yuan-Source Points
“The Jing-well (井, jǐng) point governs fullness below the heart; the Ying-spring (荥, yíng) point governs body heat; the Shu-stream (俞, shū) point governs heaviness of body and painful joints; the Jing-river (经, jīng) point governs cough, chills, and fever; the He-sea (合, hé) point governs rebellious qi and diarrhea.” (「井主心下满,荥主身热,俞主体重节痛,经主喘咳寒热,合主逆气而泄。」)
— Nan Jing · The Sixty-Eighth Difficulty (《难经·六十八难》)
The indications of the Five-Shu points (Jing-well, Ying-spring, Shu-stream, Jing-river, He-sea), and the establishment of the twelve yuan-source points (原穴), are both major contributions of the Nan Jing to the science of acupuncture.
7. Historical Status
“The Nan Jing … its theories are expansive, and all illuminate the Neijing; it is the standard of Chinese medicine.” (「《难经》……然其说宏阔,悉与《内经》相发明,而为中医之圭臬。」)
— Hua Shou (滑寿, Hua Boren 滑伯仁), Nanjing Benyi (《难经本义》, True Meaning of the Classic of Difficulties)
The Nan Jing has been praised by later generations as the “Classic among the Classics” (经中之经), and as “one of the Four Great Classics”, a vital bridge that continues the Neijing and inspires the Shanghan.
8. Editions
Principal editions include:
- The Yitong edition (《医统本》, compiled by Wang Jiusi (王九思), Ming dynasty) — the most widely circulated
- Nanjing Benyi (commentary by Hua Shou (滑寿), Yuan dynasty) — the most refined commentary
- Various other commentaries in the Guyi (《古义》) and Jizhu (《集注》) traditions
IV. Treatise on Cold Damage and Miscellaneous Diseases — The Founding Text of Pattern Identification and Treatment
1. The Author: Zhang Zhongjing
Zhang Zhongjing (张仲景), given name Zhang Ji (张机), was a celebrated physician of the Eastern Han dynasty, born about 150 CE, died about 219 CE, a native of Nanyang commandery (present-day Nanyang, Henan), honored in later tradition as the “Sage of Medicine” (医圣). According to the Tang-dynasty Gan Bozong’s Mingyi Lu (《名医录》, Records of Famous Physicians), he once served as Prefect of Changsha (长沙太守), whence the later title “Zhang Changsha” (张长沙) (an attribution still debated by modern scholars).
Note: Neither the Book of the Later Han (《后汉书》) nor the Records of the Three Kingdoms (《三国志》) contains a biography of Zhang Zhongjing; information about his life comes chiefly from later sources, such as the preface to Huangfu Mi’s Zhenjiu Jiayijing (《针灸甲乙经》, The Systematic Classic of Acupuncture and Moxibustion, Jin dynasty), Gan Bozong’s Mingyi Lu (Tang dynasty), and Lin Yi’s collated notes to the Shanghan Lun (Song dynasty).
2. The Motivation for Writing: Compassion Born of Grief
“My clan was large from of old, numbering more than two hundred. From the beginning of the Jian’an reign until now, less than ten years have passed, yet of those who have died, two-thirds have perished — seven-tenths from cold damage. Moved by the ruin of those gone before, grieved that I could not save those cut off untimely, I diligently sought the ancient teachings, and broadly gathered remedies from all sides. Drawing upon the Suwen, Jiujuan, Eighty-One Difficulties, Yinyang Dalun, Tailu Yaolu, and combining pulse-reading with pattern identification, I have written the Treatise on Cold Damage and Miscellaneous Diseases in sixteen scrolls.” (「余宗族素多,向余二百。建安纪年以来,犹未十稔,其死亡者,三分有二,伤寒十居其七。感往昔之沦丧,伤横夭之莫救,乃勤求古训,博采众方,撰用《素问》《九卷》《八十一难》《阴阳大论》《胎胪药录》,并平脉辨证,为《伤寒杂病论》合十六卷。」)
— Treatise on Cold Damage and Miscellaneous Diseases · Preface (《伤寒杂病论·原序》)
In barely a hundred characters, every line drips with grief and blood — of his clan of two hundred, within ten years fully two-thirds had died, seven-tenths of them of “cold damage” (the ancient “shanghan” (伤寒) covered all externally-contracted febrile diseases). It was from being “moved by the ruin of those gone before, grieved that I could not save those cut off untimely” that Zhongjing “diligently sought the ancient teachings, and broadly gathered remedies from all sides”, and sat down in determined resolve to write this book.
3. Transmission and Division into Two Books
The original Treatise on Cold Damage and Miscellaneous Diseases was 16 scrolls, and was scattered and lost in part amid the turmoil of the late Eastern Han. The Western Jin court physician Wang Shuhe (王叔和) (about 201–280 CE) collected and reorganized the text, splitting it into two separate books:
| Title | Scrolls | Content | Nature |
|---|---|---|---|
| Shanghan Lun (《伤寒论》, Treatise on Cold Damage) | 10 scrolls | Externally-contracted febrile diseases (six-channel pattern identification) | Treatment of external conditions |
| Jingui Yaolüe (《金匮要略》, Essentials from the Golden Cabinet) | 6 scrolls | Internal damage and miscellaneous diseases (treatment of miscellaneous diseases) | Treatment of internal conditions |
| Total | 16 scrolls | External + Internal | A complete clinical system |
Hence later generations refer to them together as the “Shanghan and Jingui” (伤寒金匮) or “Complete Works of Zhongjing” (仲景全书).
4. Core Idea (1) — Six-Channel Pattern Identification
“In disease of the Taiyang, the pulse is floating, the head and nape are stiff and painful, and there is aversion to cold.” (「太阳之为病,脉浮,头项强痛而恶寒。」)
— Shanghan Lun · Differentiation of the Taiyang Disease, Pulses, Patterns, and Treatment, Upper (《伤寒论·辨太阳病脉证并治上》)
The six channels — Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin — originate in the Suwen · Treatise on Heat (《素问·热论》) but are creatively developed: they are not merely six meridians, but six layers, six stages, and six categories of pattern-aggregates. Three outlines — exterior, interior, and half-exterior–half-interior; four aspects — cold, heat, deficiency, excess; three hinges — opening, closing, and pivoting — together generate 397 methods and 112 (or 113) formulas, later summarized as the “397 methods, 113 formulas.” Employing 151 medicinals.
5. Core Idea (2) — Pattern Identification and Treatment (Bianzheng Lunzhi)
“Observe the pulses and patterns; perceive what reversal has occurred; treat according to the pattern at hand.” (「观其脉证,知犯何逆,随证治之。」)
— Shanghan Lun · Differentiation of the Taiyang Disease, Pulses, Patterns, and Treatment, Middle (《伤寒论·辨太阳病脉证并治中》)
The four characters “bianzheng lunzhi (辨证论治)” — pattern identification and treatment — are the soul of Chinese medicine — not “treating by disease,” not “treating by cause,” but “observing the pulse and pattern” — that is, choosing the therapeutic principle and prescribing in accord with the pattern present at the moment. This is the most fundamental clinical mode of thought distinguishing Chinese medicine from Western medicine.
6. Classic Formulas
Among the 113 formulas of the Shanghan Lun, several may be called “the crown of all formulas” (群方之冠):
| Formula | Source | Indication | Sovereign Medicinal(s) |
|---|---|---|---|
| 🟢 Guizhi Tang (桂枝汤, Cinnamon Twig Decoction) | Shanghan Lun | Taiyang wind-strike (sweating, aversion to wind) | Guizhi (cinnamon twig), Baishao (white peony) |
| 🟢 Mahuang Tang (麻黄汤, Ephedra Decoction) | Shanghan Lun | Taiyang cold-strike (no sweat, panting) | Mahuang (ephedra), Guizhi (cinnamon twig) |
| 🟢 Xiao Chaihu Tang (小柴胡汤, Minor Bupleurum Decoction) | Shanghan Lun | Shaoyang disease (alternating chills and fever) | Chaihu (bupleurum), Huangqin (scutellaria) |
| 🟢 Wuling San (五苓散, Five-Ingredient Powder with Poria) | Shanghan Lun | Taiyang water amassment (dysuria) | Fuling (poria), Zhuling (polyporus) |
| 🟢 Shenqi Wan (肾气丸, Kidney-Qi Pill) | Jingui Yaolüe | Kidney yang deficiency (aching knees and lumbar weakness) | Fuzi (aconite), Guizhi (cinnamon twig) |
Guizhi Tang (桂枝汤) is hailed as “the crown of all formulas” — it nourishes yin and harmonizes yang, harmonizes the nutritive and defensive, and is the most prolific in variations (Guizhi Jia Gegen Tang, Guizhi Jia Houpo Xingzi Tang, Guizhi Jia Longgu Muli Tang …).
7. Historical Status
“Zhongjing is the sage among physicians; his formulas are revered through the ages as the standard of all.” (「仲景者,医中之圣也;其方,则古今奉为圭臬。」)
Later generations have honored the Treatise on Cold Damage and Miscellaneous Diseases as the “ancestor of formula books” (方书之祖) and the “source of the classical formulas (jingfang 经方)”. In the Song dynasty it was collated by Lin Yi (林亿), Sun Qi (孙奇), and others of the Bureau of Medical Revisions, producing the “Song-edition Shanghan Lun“ (宋本《伤寒论》), later re-carved in woodblock by Zhao Kaimei (赵开美) of the Ming dynasty, known as the “Zhao block-print edition” (赵刻本), which has been transmitted down to our own time.
8. Lineages of Transmission
The later schools of physicians dedicated to studying the Shanghan Lun number in the hundreds; the most renowned are:
- “Dislocation and Recompilation School” (错简重订派) — Fang Youzhi (方有执), Yu Chang (喻昌)
- “Preservation of the Old-Text School” (维护旧论派) — Zhang Qingzi (张卿子), Zhang Zhicong (张志聪)
- “Pattern-Identification-and-Treatment School” (辨证论治派) — Ke Qin (柯琴), Xu Dachun (徐大椿)
- “Formula–Pattern Correspondence School” (方证对应派) — Yoshimasu Todo (吉益东洞) (Japan)
- Modern scholars — Hu Xishu (胡希恕), Liu Duzhou (刘渡舟), Li Peisheng (李培生), Hao Wanshan (郝万山), and others
The classical formulas (jingfang 经方) remain the core weapons of clinical Chinese medicine to this day.
V. Shennong Bencao Jing — The Source of Chinese Pharmacognosy
1. Compilation and Authorship
The Shennong Bencao Jing (《神农本草经》, in short “Benjing” (《本经》)), compiled in the late Eastern Han dynasty (roughly the 1st–2nd century CE), has an unknown author. It is the work neither of Shennong (神农) (a legendary figure) nor of any single identifiable physician; it should rather be understood as a collective creation by several physicians who gathered and summarized the experience of long clinical practice. That it bears the name of “Shennong” is analogous to the Neijing’s borrowing of the name “Yellow Emperor” — lending the saint’s name to widen the transmission of the teachings.
2. Structure: 365 Substances, Divided into Three Grades
The book records 365 medicinal substances, corresponding to the 365 days of a year (as the text puts it, “modeled on the 365 degrees, each degree answering to one day, completing a year” (「法三百六十五度,一度应一日,以成一岁」)). They are divided into three grades — superior, middle, and inferior:
| Grade | Number | Nature | Principle of Use | Examples |
|---|---|---|---|---|
| 🟢 Superior | 120 substances | Non-toxic, nourishing destiny, aligned with Heaven | May be taken long-term (sustained, prolonged use does not harm) | Renshen (ginseng), Gancao (licorice), Dazao (jujube), Gouqi (lycium), Ejiao (donkey-hide gelatin) |
| 🟠 Middle | 120 substances | Toxic or non-toxic, nourishing nature, aligned with Humanity | Use with discernment | Danggui (angelica), Mahuang (ephedra), Shaoyao (peony), Danshen (salvia), Gegen (pueraria) |
| 🔴 Inferior | 125 substances | Mostly toxic, treating disease, aligned with Earth | Not to be taken long-term | Dahuang (rhubarb), Fuzi (aconite), Banxia (pinellia), Badou (croton), Ezhu (zedoaria) |
| Total | 365 substances |
3. Core Contribution (1) — The Four Natures and Five Flavors
“Medicinals possess the five flavors of sour, salty, sweet, bitter, and acrid; they also possess the four natures of cold, hot, warm, and cool.” (「药有酸、咸、甘、苦、辛五味,又有寒、热、温、凉四气。」)
— Shennong Bencao Jing · Prefatory Note (《神农本草经·序例》)
The “Four Natures” (四气) (cold, hot, warm, cool) and the “Five Flavors” (五味) (sour, bitter, sweet, acrid, salty) are the foundation of the theory of the properties of Chinese medicinals. Cold and cool treat yang heat; warm and hot treat yin cold; Acrid disperses, sour astringes, sweet harmonizes, bitter hardens, salty softens — each of the five flavors has its particular use.
4. Core Contribution (2) — Channel Tropism and Sovereign–Minister–Assistant–Envoy
“Medicinals have sovereign, minister, assistant, and envoy roles, by which they convey, restrain, harmonize, and unite.” (「药有君、臣、佐、使,以相宣摄合和。」)
— Shennong Bencao Jing · Prefatory Note
The categories of “sovereign, minister, assistant, and envoy” (君、臣、佐、使) — the basic structure of Chinese medical formula composition. Later developed into the formulation of “chief, deputy, assistant, envoy” (主、辅、佐、使) (Suwen · The Great Treatise on the Most True and Essential (《素问·至真要大论》)), the two formulations are of one lineage.
5. Core Contribution (3) — The Seven Relations (Qi Qing)
“Medicinals act singly; some require one another; some lead one another; some restrain one another; some dispel one another; some oppose one another; some are mutually averse. These seven relations must be considered together in combination.” (「药有单行者,有相须者,有相使者,有相畏者,有相杀者,有相恶者,有相反者。凡此七情,合和视之。」)
— Shennong Bencao Jing · Prefatory Note
| Relation | Meaning |
|---|---|
| Single action (单行, danxing) | A single substance is sufficient (e.g., Dushen Tang (独参汤), “Ginseng-Only Decoction”) |
| Mutual reinforcement (相须, xiangxu) | Two substances of similar function enhance one another (Shigao + Zhimu (石膏 + 知母) — gypsum and anemarrhena) |
| Mutual assistance (相使, xiangshi) | A chief is aided by a deputy, which enhances the chief (Huangqi + Fuling (黄芪 + 茯苓) — astragalus and poria) |
| Mutual restraint (相畏, xiangwei) | One substance restrains another’s toxicity (Shengjiang wei Banxia (生姜畏半夏) — ginger restrains pinellia) |
| Mutual suppression (相杀, xiangsha) | One substance removes another’s toxicity (Shengjiang sha Banxia (生姜杀半夏)’s toxicity) |
| Mutual aversion (相恶, xiangwu) | Combined use weakens the effect (Renshen wu Laifuzi (人参恶莱菔子) — ginseng is averse to radish seed, though in practice this is debatable) |
| Opposition (相反, xiangfan) | Combination generates severe toxicity (the source of the prohibitions “Eighteen Antagonisms” (十八反) and “Nineteen Fears” (十九畏)) |
The prohibitive theory of the “Eighteen Antagonisms” (shiba fan 十八反) and “Nineteen Fears” (shijiu wei 十九畏) is from this point founded.
6. Core Contribution (4) — Medicinal Substances “Grown of Their Native Soil”
“Medicinals from their native soil, whether genuine or adulterated, old or new, each have their proper rule.” (「土地所出,真伪陈新,并各有法。」)
— Shennong Bencao Jing · Prefatory Note
This passage is the fount of the doctrine of “daodi yaocai (道地药材, genuine-region medicinals)”. The later theory of “genuine-region medicinals”, “the Four Huai Medicinals” (四大怀药) (Huai Dihuang (怀地黄), Huai Shanyao (怀山药), Huai Juhua (怀菊花), Huai Niuxi (怀牛膝), grown in Huaiqing prefecture of Henan — today’s Jiaozuo area), and the “Zhejiang Eight Flavors” (浙八味) (Zhejiang Baizhu, Baishao, Beimu, Xuanshen, Maidong, Yujin, Yanhusuo, Juhua), all originate from this single observation.
7. Historical Status and Transmission
The Benjing is the earliest extant monograph on materia medica. The original book was lost by the Tang dynasty, its content preserved by later reconstructions from fragments (jiyiben 辑佚本).
Important lines of transmission:
- Bencao Jing Jizhu (《本草经集注》, Collected Commentaries on the Classic of Materia Medica) — compiled and annotated by Tao Hongjing (陶弘景) of the Southern Dynasties (about 456–536 CE), recording 730 substances, and originating the “general-use categories” (诸药通用) classification
- Xinxiu Bencao (《新修本草》, Newly Revised Pharmacopoeia) — compiled by Su Jing (苏敬) and others, Tang dynasty, promulgated in 659 CE, the world’s first national pharmacopoeia
- Jingshi Zhenglei Beiji Bencao (《经史证类备急本草》, Classified and Consolidated Pharmacopoeia for Emergency Use) — Tang Shenwei (唐慎微), Song dynasty, 1108 CE, gathering the achievements of all predecessors
- Bencao Gangmu (《本草纲目》, Compendium of Materia Medica) — Li Shizhen (李时珍), Ming dynasty, completed in 1578 CE, recording 1,892 substances, the great summation of Chinese pharmacognosy
In 2011 (the Bencao Gangmu together with the Huangdi Neijing and others) was inscribed by UNESCO on the Memory of the World Register (see above).
VI. The Inner Coherence of the Four Classics — Principle, Method, Formula, and Medicine All Complete
The four classics are not isolated from one another, but form four pillars of “principle, method, formula, and medicine” (理、法、方、药), united as a single thread.
1. The Neijing Establishes Principle
The Neijing answers “why” — yin and yang, the wuxing, the zang-xiang, the meridians, etiology, pathogenesis, and therapeutic principles, constructing the theoretical system of Chinese medicine. Without the Neijing, Chinese medicine would lack its theoretical roots.
2. The Nan Jing Clarifies Principle
The Nan Jing answers the “difficulties left unclarified” in the Neijing — solely taking the cunkou; the left Kidney and the right mingmen; the Ying–Sui tonifying and reducing; the Five-Shu points — supplementing, deepening, and concretizing the theory of the Neijing. Without the Nan Jing, much of the Neijing’s theory would be difficult to bring down to earth.
3. The Benjing Establishes Medicine
The Benjing answers “with what” — 365 substances, classified in three grades, the four natures and five flavors, the seven relations — constructing the system of Chinese pharmacology. Without the Benjing, Chinese medicine would have no medicine to use.
4. The Shanghan Sets Method
The Shanghan answers “how to use” — six-channel pattern identification, 397 methods, 113 formulas, 151 medicinals — constructing the system of clinical treatment. Without the Shanghan, Chinese medicine would have no method to follow.
5. The Four Texts Viewed Together
| Classic | Role | One-Sentence Summary |
|---|---|---|
| Neijing | Principle (理) | Root of theory |
| Nan Jing | Clarifier of principle | Wing of theory |
| Benjing | Medicine (药) | Source of medicinals |
| Shanghan | Method (法) and Formula (方) | Outline of clinical practice |
With “principle, method, formula, and medicine” complete, with “principle, method, formula, and medicine” as one continuous thread — this is Chinese medicine’s complete system, this is the mystery of the art of Qihuang.
VII. The Modern Significance of the Four Classics
The four classics are by no means “antiques” — they to this day continue to nourish modern Chinese medicine, guiding clinical practice, research, policy, and education.
1. Contemporary Chinese Medical Education Still Builds Upon the Four Classics
In the Standards for Undergraduate Chinese Medical Education issued by the National Administration of Traditional Chinese Medicine, and in the core curricula of all universities of Chinese medicine, the Neijing, Shanghan, Jingui, and Bencao are all required courses. “Read the classics, do clinical work, follow the great teachers” (读经典、做临床、跟名师) — these are the three great secrets of the growth of a Chinese medical physician.
2. Tu Youyou and Artemisinin — A Classic Inspires a Nobel Prize
In 2015, the Chinese pharmacologist Tu Youyou (屠呦呦) was awarded the Nobel Prize in Physiology or Medicine for “discoveries concerning a novel therapy against malaria.” In her Nobel lecture she made clear that her inspiration came from —
“Take a handful of qinghao (sweet wormwood), soak it in two sheng of water, wring out the juice, and drink it all.” (「青蒿一握,以水二升渍,绞取汁尽服之。」)
— Ge Hong (葛洪), Zhouhou Beiji Fang · Formulas for Treating Various Types of Malaria-Induced Cold and Heat (《肘后备急方·治寒热诸疟方》), Eastern Jin dynasty (about 340 CE)
(Although the Zhouhou Beiji Fang is not among the Four Great Classics, it shares the same lineage of the Chinese medical textual tradition as the Benjing.)
It was precisely Ge Hong’s record of “wringing out the juice” (绞取汁) (a low-temperature extraction) that inspired Tu Youyou to switch to low-temperature extraction with ether, and on 4 October 1971 she obtained Sample No. 191 — which inhibited 100% of the malaria parasites — and thus discovered artemisinin (青蒿素). Artemisinin and its derivatives have since saved millions of malaria patients worldwide, making Tu Youyou the first scientist on the Chinese mainland to receive a Nobel Prize in the natural sciences. (Source: nobelprize.org, Tu Youyou biography)
3. The Classical Texts Are Being Reinterpreted by Modern Science
- Systems biology — likening the doctrine of zang-xiang to a “biological network”
- Network pharmacology — using network analysis to study the multi-target actions of formulas
- Metabolomics and proteomics — decoding the biological basis of the “four natures and five flavors”
- Research on acupuncture mechanisms — the neuro-endocrine-immune network
- AI + Chinese medicine — knowledge graphs, clinical decision-support systems
The “ancient” of Chinese medicine is becoming a “rich ore” for modern research.
4. Policy Support
- On 25 December 2016, the Law of the People’s Republic of China on Traditional Chinese Medicine (《中华人民共和国中医药法》) was passed by the Standing Committee of the 12th National People’s Congress (taking effect on 1 July 2017) — giving Chinese medicine a guarantee under national basic law
- In 2019, the Opinions of the CPC Central Committee and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine (《中共中央 国务院关于促进中医药传承创新发展的意见》) was issued
- In 2023, the 14th Five-Year Plan for the Development of Traditional Chinese Medicine (《「十四五」中医药发展规划》) was issued
- Universities of Chinese medicine and tertiary TCM hospitals at all levels have all flourished
The art of Qihuang is, indeed, witnessing a great transformation unseen in a thousand years.
VIII. Conclusion: Why Should We Read the Classics?
“Establish the mind for Heaven and Earth; establish the destiny for the people; continue the lost teachings of the ancient sages; open up enduring peace for all generations.” (「为天地立心,为生民立命,为往圣继绝学,为万世开太平。」)
— Zhang Zai (张载), The Hengqu Four Sentences (《横渠四句》), Northern Song dynasty
The Four Great Classics of Chinese Medicine are not “mysterious beyond all knowing”, not “unknowable”, they are “forged a thousand times in the fire”, “the silt left by the great waves” — from the Warring States to the Eastern Han, from the Hundred Schools to a unified canon, countless physicians, countless case records, countless lives and deaths, have at last settled into these four books.
Read the Neijing, and we learn “why” — yin and yang are the root; righteous qi (zhengqi 正气) is the internal cause.
Read the Nan Jing, and we learn “how to resolve” — the perplexities and innovations of our forebears.
Read the Shanghan, and we learn “how to treat” — the clinical wisdom of pattern identification and treatment.
Read the Benjing, and we learn “with what” — the nature of grasses and trees, the substance of life and trust.
🌿 Summary in One Sentence
“Principle, method, formula, and medicine”, the four texts viewed together, reveal the whole of Chinese medicine.
“Read the classics, do clinical work”, “inherit the essence, uphold the foundation, and innovate” (传承精华、守正创新), — this is the path that “Qihuang Library” shares with you.
May you, from this day forward —
- 📜 Read the Neijing, to know its principle
- 📜 Read the Nan Jing, to break through its difficulties
- 📜 Read the Shanghan, to practice its method
- 📜 Read the Benjing, to recognize its medicines
A thousand years of Qihuang, the torch passed on — the classics do not die, and Qihuang remains evergreen.
Principal References:
- Huangdi Neijing · Suwen and Lingshu (《黄帝内经·素问》《灵枢》) (People’s Medical Publishing House photographic reprint edition)
- Nanjing Benyi (《难经本义》) (commentary by Hua Shou, Yuan dynasty)
- Shanghan Lun (《伤寒论》) and Jingui Yaolüe (《金匮要略》) (collated by Lin Yi et al., Song dynasty; woodblock-printed edition of Zhao Kaimei, Ming dynasty)
- Shennong Bencao Jing (《神农本草经》) (reconstructed edition by Sun Xingyan, Qing dynasty)
- Book of Han · Treatise on Literature · Records of Techniques (《汉书·艺文志·方技略》)
- Huangfu Mi, Zhenjiu Jiayijing (《针灸甲乙经》) · Preface, Jin dynasty (the main historical source for the life of Zhang Zhongjing)
- Gan Bozong, Mingyi Lu (《名医录》), Tang dynasty (the source of the attribution of Zhang Zhongjing as Prefect of Changsha)
- Tu Youyou, 2015 Nobel Lecture / nobelprize.org biography
- UNESCO Memory of the World Register (2011 inscription of the Archives of Traditional Chinese Medicine)
- Law of the People’s Republic of China on Traditional Chinese Medicine (《中华人民共和国中医药法》) (passed 25 December 2016, effective 1 July 2017)