The Contention of Qihuang: Four Hundred Years of Medicine in the Song, Jin, and Yuan Dynasties
The Bureau of Medical Revisions Establishes Official Medicine; the Four Masters of the Jin and Yuan Open New Schools — The Era of Hundred Schools in Chinese Medicine
“Confucianism’s schools divided in the Song; medicine’s schools divided in the Jin and Yuan.」 (「儒之门户分于宋，医之门户分于金元。」)
— Ming · Wáng Lún (王纶), Mingyi Zazhu · On Medicine (《明医杂著·医论》) (quoted in the Qing Siku Quanshu Zongmu Tiyao)
In 960 CE, Zhào Kuāngyìn (赵匡胤) launched the Chénqiáo mutiny, and the Northern Song arose; in 1127 CE, the Disaster of the Jingkang Reign occurred, and the Southern Song ruled from a corner of the realm; in 1234 CE, the Mongols extinguished the Jīn (金); in 1271 CE, Kublai (忽必烈) fixed the dynastic name “Dà Yuán (大元)”; in 1368 CE, the Míng army captured Dàdū (大都), and the Yuán fell.
A full four hundred and eight years — the Central Plains went through the unification of the Northern Song, the partial rule of the Southern Song, the confrontation of the Liáo, Jīn, and Yuán, and the Mongol horsemen — politics moved toward plurality, thought moved toward freedom, and medicine —
welcomed her unprecedented “contention of a hundred schools.”
- The Northern Song’s Bureau of Medical Revisions (校正医书局, 1057–1100) collated and fixed all the canonical medical texts;
- The Song Imperial Medical Bureau (太医局)’s “Three Lodges and Promotion Tribute System (三舍升贡法)” divided nine specialties for examination;
- The Four Masters of the Jīn and Yuán — the School of Cold and Cool, the School of Attacking Evil, the School of Spleen and Stomach, the School of Nourishing Yin — burst upon the scene;
- Qián Yǐ (钱乙), Key to Therapeutics of Children’s Diseases (《小儿药证直诀》), founded Chinese pediatrics;
- Sòng Cí (宋慈), Collected Cases of Washing Away Wrongs (《洗冤集录》), founded forensic medicine in the world;
- Chén Zìmíng (陈自明), Comprehensive Good Formulas for Women (《妇人大全良方》), systematized Chinese gynecology;
- The great flourishing of the Song’s movable-type printing, paper money, and the compass, for the first time made it possible for Chinese medicine to be transmitted on a large scale, at low cost.
This was Chinese medicine’s “age of a hundred schools.”
At Qihuang Library, today we shall take you back to that age when “five cartloads of books” (学富五车), “Cheng–Zhu Neo-Confucianism” (程朱理学), and “the Four Masters of the Jīn and Yuán” shone together, to see how Chinese medicine moved from “craft” to “scholarship.”
I. Historical Background: Why Did the “Hundred-Schools Contention” Happen Only in the Song, Jin, and Yuan?
“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。」)
— Northern Song · Zhāng Zài (张载), The Hengqu Four Sentences (《横渠四句》)
1. Three Major Background Factors
📚 The Revolution of Printing
During the Qìnglì years of the Northern Song (1041–1048), Bì Shēng (毕昇) invented movable-type printing — China’s “fourth great invention,” and also a great revolution in the history of world communication.
For medicine, this meant:
- Medical books could be printed in large editions;
- Formularies could be widely circulated;
- Collation could be done with precision and accuracy;
- Learning medicine was no longer confined to master-disciple transmission.
The Bureau of Medical Revisions was established precisely against this background.
🎓 The Rise of the Confucian-Physician Class
Tang Sūn Sīmǐao’s “Great Physician, Sincere Dedication” had opened the spiritual height of the physician; in the Song, the collective aspiration of scholars to “if one cannot be a good minister, then one shall be a good physician” (Fàn Zhòngyān 范仲淹) led great numbers of Confucian scholars to abandon Confucian study and take up medicine — the “Confucian physician (儒医)” class arose.
Fàn Zhòngyān’s saying “if one cannot be a good minister, then one shall be a good physician” is recorded in the Song work by Wú Zēng (吴曾), Nenggai Zhai Manlu (《能改斋漫录》), Scroll 13:
“When Fàn Wénzhōng (the posthumous title of Fàn Zhòngyān) was young … he once said: ‘ If I cannot be a good minister, I would be a good physician ’ …」
Southern Song physicians Chén Zìmíng, Zhū Zuǒ, Xǔ Shūwēi, Yán Yònghé, and Lǐ Dōngyuán were all Confucian physicians.
🌐 The Great Fusion of Peoples
Song, Liáo, Jīn, and Yuán — multi-ethnic polities stood side by side — the constitutions, diets, climates, and diseases of the northern peoples differed from those of the south; physicians had to face new problems —
- The north’s climate was cold and dry; the people ate much beef, mutton, milk, and cheese, and were prone to internal heat and stagnation;
- The south’s climate was warm and damp; the people ate much rice, fish, fruit, and vegetables, and were prone to internal damp-heat.
It was precisely these clinical differences of “north and south”, “cold and heat”, “deficiency and excess” that gave birth to the differing academic doctrines of the Four Masters of the Jīn and Yuán.
Source: Dèng Tiětāo, ed., General History of Chinese Medicine · Ancient Volume, People’s Medical Publishing House, 2000, Chapter 5, “Song, Jin, and Yuan Medicine”; Joseph Needham, Science and Civilisation in China, Volume 6, “Medicine.”
2. A Snapshot: What Did Those 408 Years Leave Behind?
| Discipline | Representative Work | Author | Nature |
|---|---|---|---|
| Collation | The Suwen, Shanghan, Jingui, Bencao and 7 other works (11 total) | Bureau of Medical Revisions (Lín Yì et al.) | Official canonical texts |
| Formularies | Taiping Huimin Heji Jufang (《太平惠民和剂局方》), 10 scrolls | Chén Shīwén and others | Ancestor of official formularies |
| Formularies | Taiping Shenghui Fang (《太平圣惠方》), 100 scrolls | Wáng Huáiyǐn and others | First officially compiled formulary |
| Formularies | Shengji Zonglu (《圣济总录》), 200 scrolls | Compiled by decree of Emperor Huīzōng of Song | The largest Chinese medical encyclopedia |
| Pediatrics | Key to Therapeutics of Children’s Diseases (《小儿药证直诀》), 3 scrolls | Qián Yǐ (edited by Yán Xiàozhōng) | The ancestor of Chinese pediatrics |
| Gynecology | Comprehensive Good Formulas for Women (《妇人大全良方》), 24 scrolls | Chén Zìmíng | The ancestor of Chinese gynecology |
| Forensic Medicine | Collected Cases of Washing Away Wrongs (《洗冤集录》), 5 scrolls | Sòng Cí | World’s earliest forensic medicine |
| Internal Medicine | Jisheng Fang (《济生方》), 10 scrolls | Yán Yònghé | A great clinical master |
| Internal Medicine | Benshi Fang (《本事方》), 10 scrolls | Xǔ Shūwēi | A great master of the classical formulas |
| Internal Medicine | Shanghan Jiushi Lun (《伤寒九十论》) | Xǔ Shūwēi | Early case records and medical essays |
| External Medicine | Waike Jingyao (《外科精要》), 3 scrolls | Chén Zìmíng | Theorization of surgery |
| Foundation | Zangfu Biaoben Yaoshi (《脏腑标本药式》) | Zhāng Yuánsù | Theory of drug channel-entry |
| Cold-Damage Studies | Shanghan Mingli Lun (《伤寒明理论》), 4 scrolls | Chéng Wújǐ | Earliest commentary on the formulas of the Shanghan |
| Materia Medica | Jingshi Zhenglei Beiji Bencao (《经史证类备急本草》), 32 scrolls | Táng Shènwēi | Cumulative achievement of materia medica |
| Education | Imperial Medical Bureau’s “Three Lodges and Promotion Tribute System” (三舍升贡法) | Imperial Medical Bureau | Specialization of official schooling |
| Schools | “The Four Masters of the Jīn and Yuán” | The four great physicians | Opening of the age of schools in Chinese medicine |
| International | Chinese medicine’s eastward transmission to Goryeo | Goryeo · Wáng Yǔ (王俣) | Embryonic form of Korean medicine |
Seventeen “firsts”, each of which moved Chinese medicine from “experience” to “scholarship.”
II. The Bureau of Medical Revisions: The “National Definitive Edition” of the Chinese Medical Classics
“The illness of the people is a great matter of the state; the medical classics are the public instruments of the world.」
1. Its Establishment
In 1057 CE (the 2nd year of the Jiāyǒu reign of Emperor Rénzōng of Northern Song), Hán Qí (韩琦), Chief of the Privy Council (枢密使), memorialized the throne:
“Medical books such as the Lingshu, Suwen, Jiayi, Guangji, Qianjin, and Waitai … none of them is without errors … I pray that Confucian officials be ordered to collate them.」
Emperor Rénzōng approved the memorial, and established the “Bureau of Medical Revisions (校正医书局)” at the Institute for Compiling and Editing (编修院), appointed Zhǎng Yǔxī (掌禹锡), Grand Master of Light and Virtue and Director of the Imperial Archives (光禄卿直秘阁), and others to oversee it, with Lín Yì (林亿), Sūn Qí (孙奇), Gāo Bǎohéng (高保衡), Sū Sòng (苏颂), and others as collators, concentrating the highest-level Confucian officials to systematically collate the medical texts.
During the years 1057–1100, the Bureau of Medical Revisions collated and printed 11 medical works:
| № | Book Name | Collator | Date / Note |
|---|---|---|---|
| 1 | Chong Guang Bu Zhu Huangdi Neijing Suwen (《重广补注黄帝内经素问》) | Lín Yì, Sūn Qí, Gāo Bǎohéng | 2nd year of Jiāyǒu (1057) |
| 2 | Huangdi Neijing Suwen Yipian (《黄帝内经素问遗篇》) | — | Jiāyǒu years |
| 3 | Mai Jing (《脉经》) | Lín Yì and others | Mid-Jiāyǒu |
| 4 | Zhenjiu Jiayijing (《针灸甲乙经》) | Lín Yì and others | Xīníng years |
| 5 | Nan Jing (《难经》) | — | Jiāy�u years |
| 6 | Jiayou Buzhu Bencao (《嘉祐补注本草》) | Zhǎng Yǔxī, Lín Yì, and others | Mid-Jiāyǒu |
| 7 | Bencao Tujing (《本草图经》) | Compiled by Sū Sòng | Mid-Jiāyǒu |
| 8 | Shanghan Lun (《伤寒论》) | Lín Yì and others | 2nd year of Zhìpíng (1065) |
| 9 | Jingui Yaolüe Fang Lun (《金匮要略方论》) | Lín Yì and others | 3rd year of Zhìpíng (1066) |
| 10 | Beiji Qianjin Yaofang (《备急千金要方》) | Lín Yì and others | 3rd year of Zhìpíng (1066) |
| 11 | Qianjin Yifang (《千金翼方》) | Lín Yì and others | — |
| 12 | Waitai Miyao (《外台秘要》) | — | Xīníng years |
| 13 | Jingui Yuhanjing (《金匮玉函经》) | Lín Yì and others | Zhìpíng years |
This was the first state-organized, highest-level Confucian-officed systematic-collating project in the history of Chinese medicine.
2. Three Major Contributions
First, the fixing of the “definitive edition”: The collated medical books became known as the “Song editions (宋本)”, and all Ming and Qing re-carvings and modern punctuation and collation have used the Song edition as their base — the “Song edition” is the most authoritative version of ancient Chinese medical books.
Second, the method of collation: The Bureau of Medical Revisions was the first to formulate the “four methods of collation” — collation by parallel, by the same book, by other books, and by reasoning (对校、本校、他校、理校)” — the earliest norm of ancient-book collation in China.
Third, the eternal preservation of the classics: Without the Bureau of Medical Revisions, many canonical medical books might have been lost or distorted in the course of manuscript transmission — this was a “national-level” rescue project of Chinese medicine.
3. A One-Line Summary of the Bureau of Medical Revisions
“The merit of collation lies not in a single book at a single moment,
but in the tens of thousands of physicians who can read correct medical books;
the Bureau of Medical Revisions — the ‘Eight Principles of the Yong character (永字八法)’ of Chinese medicine.」
Source: Song · Zhǎng Yǔxī, Lín Yì et al., Preface to the Chong Guang Bu Zhu Huangdi Neijing Suwen (《重广补注黄帝内经素问·序》); Qián Chāochén, Introduction to the Complete Works of Collation of Ancient Chinese Medical Books, Xueyuan Press, 2000.
III. The Official Song Formularies: From “Private Formulas” to “Official Standards”
1. Wáng Huáiyǐn and the Taiping Shenghui Fang
In 978 CE (the 3rd year of the Tàipíng Xīngguó era of Emperor Tàizōng of Song), Wáng Huáiyǐn (王怀隐), Director of the Hanlin Medical Office (翰林医官使), and others were commissioned by decree to compile, taking 14 years (978–992 CE), and produced the Taiping Shenghui Fang (《太平圣惠方》) in 100 scrolls, 1,670 categories, and 16,834 formulas.
This was the first officially compiled large-scale formulary in China.
2. Shěn Kuò and Sū Shī’s Su Shen Liangfang
Shěn Kuò (沈括, 1031–1095) and Sū Shī (苏轼, 1037–1101) co-authored the Su Shen Liangfang (《苏沈良方》) in 10 scrolls — the joint authorship of two great scientists and great literary men, and was the true embodiment of the Song scholar’s aspiration: “if one cannot be a good minister, then one shall be a good physician.”
3. Emperor Huīzōng’s Shengji Zonglu
Emperor Huīzōng of Song ordered the compilation, completed in 1117 CE, 200 scrolls, nearly 20,000 formulas, divided into 60 categories and over 600 disease-patterns — the largest formula-and-medicine encyclopedia of the Song.
4. Chén Shīwén’s Taiping Huimin Heji Jufang
In the Dàguān years of Emperor Huīzōng (1107–1110), Péi Zōngyuán (裴宗元), Grand Physician (太医令), and Chén Shīwén (陈师文), Consultative Gentleman (奉议郎), among others, were commissioned to collate the Taiping Huimin Heji Jufang (《太平惠民和剂局方》) in 5 scrolls, 21 categories, and 297 formulas — the “Heji Bureau (和剂局)” was a state pharmaceutical bureau (government-run pharmacy), and this formulary was the standard formula set for prepared medicines produced by the official pharmacy.
It was supplemented repeatedly in later years, and by the Southern Song had grown to 10 scrolls with 788 formulas; it became the most influential formulary of the Song, Jīn, and Yuán, and the Qing physician Wāng Áng (汪昂) commented:
“The Jufang is the most refined of the officially compiled formularies of the Song … its influence reached into the Jīn and Yuán, and has not ceased to this day.」
Representative formulas: Zhì Bǎo Dān (至宝丹, Greatest Treasure Elixir), Zǐ Xuě Dān (紫雪丹, Purple Snow Elixir), Sū Hé Xiāng Wán (苏合香丸, Storax Pill), Huò Xiāng Zhèng Qì Sǎn (藿香正气散, Agastache Powder to Rectify Qi), Xiāo Yáo Sǎn (逍遥散, Free and Easy Powder), Sì Wù Tāng (四物汤, Four-Substance Decoction) … they remain in clinical use as commonly prescribed Chinese patent medicines to this day.
Source: Song · Chén Shīwén, Taiping Huimin Heji Jufang (original), People’s Medical Publishing House punctuation-and-collation edition, 1985; Zhāng Qíwén, Studies in the Origins of Chinese Formula Studies, Xueyuan Press, 2003.
IV. Song Specialization and Education: The Imperial Medical Bureau’s “Three Lodges and Promotion Tribute System”
“To learn and to practice from time to time — this is so for medicine as well.」
1. The Song Imperial Medical Bureau
The Song Imperial Medical Bureau (太医局) (inheriting the Táng Imperial Medical Academy) was in charge of medical education — in the Yuánfēng years (1078–1085), the Imperial Medical Bureau was formally incorporated into the system of the National University (国子监), and medical practitioners were required, like jinshi (进士) graduates, to take the imperial examinations.
2. The “Three Lodges and Promotion Tribute System”
In 1080 CE (the 3rd year of Yuánfēng), the Imperial Medical Bureau implemented the “Three Lodges and Promotion Tribute System (三舍升贡法)”:
| Grade | Status | Quota | Curriculum |
|---|---|---|---|
| Upper Lodge (上舍) | National University student | 40 persons | All 9 specialties |
| Inner Lodge (内舍) | National University inner-lodge student | 60 persons | 9 specialties |
| Outer Lodge (外舍) | National University outer-lodge student | 200 persons | Foundations of the 9 specialties |
The “Three Lodges” are the three ranks “Outer Lodge — Inner Lodge — Upper Lodge”; “Promotion (升)” means promotion through layer upon layer of examinations; “Tribute (贡)” means those who passed the examination could be admitted to the National University or be granted official posts.
3. The Division into Nine Specialties
In the Song, medicine was divided into nine specialties:
| Specialty | Content | Táng Equivalent |
|---|---|---|
| Great Vessel-Pulse (大方脉) | Internal medicine | Body-treatment (体疗) |
| Small Vessel-Pulse (小方脉) | Pediatrics | Young and Small (少小) |
| Wind (风科) | Stroke, fright-wind | — |
| Eye (眼科) | Eye diseases | Ears/Eyes/Mouth/Teeth |
| Sores, Swellings, Fractures, Ulcers (疮肿折疡) | External medicine | Ulcer and Swelling (疮肿) |
| Obstetrics (产科) | Gynecology | Obstetrics merged in |
| Mouth, Teeth, Throat (口齿咽喉) | Five sense organs | Ears/Eyes/Mouth/Teeth |
| Acupuncture (针灸科) | Acupuncture | Acupuncture (针科) |
| Metal and Arrow (金镞) | Battlefield surgery | Horn-method (角法) |
Compared with the Táng’s five specialties, the Song’s nine specialties were markedly more detailed — the specialization of Chinese medicine moved toward maturity.
Source: Song · Yuánfēng, Yuánfēng Beidui (《元丰备对》); History of Song · Treatise on Officials (《宋史·职官志》), article on “Imperial Medical Bureau”; Fàn Xíngzhǔn, Brief History of Chinese Medicine, Zhongyi Guji Chubanshe, 1986.
V. The Jingshi Zhenglei Beiji Bencao: The Cumulative Achievement of Materia Medica
“The study of materia medica reached its great synthesis with Táng Shènwēi.」
1. The Man
Táng Shènwēi (唐慎微, c. 1056–1136), courtesy name Shěnyuán (审元), a native of Jìnyuán, Shǔzhōu (晋原, 蜀州) (present-day Chóngzhōu, Sìchuān), the greatest materia medica scholar of the Song.
According to Song author Yǔwén Xūzhōng (宇文虚中)’s Postscript to the Zhenglei Bencao:
“Táng Shènwēi … was plain-featured and unadorned, but his learning was broad … he never missed a case once in a hundred … whenever a scholar or commoner had a medicinal formula, he would always call on them to ask about it, record it and place it in a register … for several decades he accumulated material, and compiled it into this book.」
2. The Jingshi Zhenglei Beiji Bencao
Commonly called the Zhenglei Bencao (《证类本草》), composed between 1082 and 1108 CE, 32 scrolls, recording 1,746 medicinal substances (over 600 newly added), it gathered the cumulative achievement of all previous materia medica — Táo Hóngjǐng’s Bencao Jing Jizhu, Sū Jìng’s Xinxiu Bencao, Chén Cángqì’s Bencao Shiyi, Mèng Shēn’s Shiliao Bencao, Chén Shìliáng’s Shixing Bencao, Rì Huázǐ’s Rì Huázǐ Bencao, and others were all cited, and drug illustrations were appended.
3. Three Major Contributions
First, the cumulative synthesis of materia medica: Before the completion of the Bencao Gangmu in the Qīng, the Zhenglei Bencao was always the most authoritative materia medica source-book — Lǐ Shízhēn (李时珍) wrote:
“That the various schools of materia medica and the simple formulas of each drug have been preserved through the ages without being lost, is entirely his merit.」
Second, nearly 3,000 formulas appended: For the first time formulas were appended to the drugs — the ancestor of the “drug-with-formula” layout followed by later generations.
Third, the link between past and future: In the Song, Dàguān, Zhènghé, and Shàoxīng three reigns the work was collated three times, producing the “Dàguān Bencao,” “Zhènghé Bencao,” and “Shàoxīng Bencao” three official editions; Táng Shènwēi’s privately compiled book became the official standard.
Source: Song · Táng Shènwēi, Chongxiu Zhenghe Jingshi Zhenglei Beiji Bencao, People’s Medical Publishing House photographic reprint, 1957; Shàng Zhìjūn, Lín Qiánkāng, Zhèng Jīnshēng, Essentials of the Literature of Materia Medica Through the Ages, Scientific and Technical Documents Publishing House, 1989.
VI. Qián Yǐ and the Key to Therapeutics of Children’s Diseases: The Foundation of Chinese Pediatrics
“Children’s diseases cannot be spoken of in the same way as those of adults; whoever treats them must have a separate art.」
1. The Man
Qián Yǐ (钱乙, c. 1032–1113), courtesy name Zhòngyáng (仲阳), a native of Yùnzhōu, Shāndōng (郓州, 山东) (present-day Dōngpíng, Shāndōng), the most famous pediatrician of the Song, venerated by later generations as the “Sage of Pediatrics”, placed on a par with the “Medicine Sage” Zhāng Zhòngjǐng.
According to Song author Liú Qí (刘跂)’s Biography of Qián Zhòngyáng (《钱仲阳传》):
“Qián Yǐ first became famous in Shāndōng for his skill with disorders of the fontanelle … he would treat all who came, whether noble or humble … the number of those he treated was great, and he did not seek fame.」
2. The Key to Therapeutics of Children’s Diseases (Xiao’er Yaozheng Zhijue)
The work was collated by Qián Yǐ’s disciple Yán Xiàozhōng (阎孝忠) (also written Yán Jìzhōng 阎季忠), 3 scrolls, completed in 1119 CE — the earliest extant monograph on Chinese pediatrics.
📊 Three Major Contributions
First, establishing the “five-zang pattern-identification” system of pediatrics:
“The heart governs fright … the liver governs wind … the spleen governs lassitude … the lung governs panting … the kidney governs deficiency …」
— Key to Therapeutics of Children’s Diseases · The Governing Powers of the Five Zang (《小儿药证直诀·五脏所主》)
Second, the doctrine of the “soft and weak viscera” of children:
“The five zang and six fu of children are formed but not yet complete … complete but not yet robust … prone to deficiency and prone to excess … prone to cold and prone to heat …」
— Key to Therapeutics of Children’s Diseases · The Transformations of Growth (《小儿药证直诀·变蒸》)
Third, the creation of the six-ingredient Dìhuáng Wán (地黄丸, Rehmannia Pill): The ancestor of the famous “Six-Ingredient Rehmannia Pill (六味地黄丸)” — Qián Yǐ took Zhāng Zhòngjǐng’s “Shènqì Wán (肾气丸, Kidney-Qi Pill)” (with Fùzǐ and Guìzhī, eight ingredients in all), removed the Fùzǐ and Guìzhī, producing the “Dìhuáng Wán (地黄丸)” (Shúdì, Shānzhūyú, Shānyào, Zéxiè, Dānpí, Fúlíng) — six ingredients — the “Six-Ingredient Rehmannia Pill” has been used to this day, and is one of the most commonly used formulas in Chinese clinical medicine.
📊 Famous Formulas Transmitted to Later Generations
| Formula | Indication | Influence |
|---|---|---|
| Liù Wèi Dìhuáng Wán (六味地黄丸, Six-Ingredient Rehmannia Pill) | Kidney-yin deficiency | Millennium-famous formula |
| Xiè Bái Sǎn (泻白散, Drain the White Powder) | Lung-heat cough | Still in use today |
| Xiè Huáng Sǎn (泻黄散, Drain the Yellow Powder) | Latent fire of spleen and stomach | Still in use today |
| Dǎo Chì Sǎn (导赤散, Guide the Red Powder) | Excess heart-fire, mouth and tongue sores | Still in use today |
| Yì Gōng Sǎn (异功散, Extraordinary Merit Powder) | Spleen deficiency with qi stagnation | Still in use today |
Source: Song · Qián Yǐ (original author), Yán Xiàozhōng (editor), Key to Therapeutics of Children’s Diseases, People’s Medical Publishing House punctuation-and-collation edition, 1991; Song · Liú Qí, Biography of Qián Zhòngyáng (《钱仲阳传》).
VII. Chén Zìmíng and the Comprehensive Good Formulas for Women: The Systematization of Chinese Gynecology
1. The Man
Chén Zìmíng (陈自明, c. 1190–1270), courtesy name Liángfǔ (良甫), a native of Línchuān, Southern Song (临川, 江西抚州), a third-generation hereditary physician, the most outstanding gynecologist of the Southern Song, served as Medical Instructor (医谕) of the Mingdào Academy in Jiànkāng Prefecture (建康府).
2. The Comprehensive Good Formulas for Women
24 scrolls, completed in 1237 CE, gathering the cumulative achievement of gynecology and obstetrics in the Song and earlier.
📊 Content Structure
| Scrolls | Content |
|---|---|
| 1–3 | Regulating menstruation |
| 4–8 | Various diseases |
| 9–11 | Seeking offspring |
| 12–15 | Fetal education, pregnancy |
| 16–20 | Gestational diseases, difficult labor |
| 21–24 | Postpartum diseases, miscellaneous diseases |
📊 Three Major Contributions
First, systematization of Chinese gynecology: From the scattered formularies of the past, such as the Chanbao (《产宝》), Chanlun (《产论》), and Baoqing (《宝庆》), Chén Zìmíng gathered more than 300 formulas and 49 essays, and for the first time systematized them into a single complete monograph on gynecology.
Second, founding of the theory of “essentials of external medicine”: Chén Zìmíng also authored the Waike Jingyao (《外科精要》) in 3 scrolls — for the first time elevating external medicine from the empirical level of “ulcers and sores” to a theoretical system of “principle, method, formula, and medicine.”
Third, detailed pattern differentiation: The section on “menstruation” is divided into “blood heat,” “blood deficiency,” “blood stasis,” “blood cold,” “flooding” and 12 other discussions — the model of later gynecological pattern identification.
Source: Song · Chén Zìmíng, Comprehensive Good Formulas for Women (original), People’s Medical Publishing House punctuation-and-collation edition, 1992.
VIII. Sòng Cí and the Collected Cases of Washing Away Wrongs: The Ancestor of World Forensic Medicine
1. The Man
Sòng Cí (宋慈, 1186–1249), courtesy name Huìfù (惠父), a native of Jiànyáng, Fújiàn (建阳, 福建), the famous forensic physician of the Southern Song, four times served as Commissioner of Justice (提点刑狱公事) (provincial-level judicial officer), dealing with murder cases for many years.
2. The Collected Cases of Washing Away Wrongs
5 scrolls, completed in 1247 CE, is the earliest extant monograph on forensic medicine in the world, 354 years earlier than Europe’s earliest forensic monograph (written by Fortunato Fedele of Italy in 1601).
📊 Five World-Firsts
First, the “four-fold distinction of the corpse”: Discriminating between human, animal, self-inflicted, and inflicted-by-others causes of death.
Second, bone-examination method: Distinguishing bone injuries received in life from those received after death.
Third, distinction of various causes of death: Hanging, strangulation, drowning, and other causes of death — the first time various causes of death were described in forensic detail.
Fourth, discrimination of poisons: Methods of discriminating arsenic and arsenic-related poisoning.
Fifth, emergency care and scene preservation: Standardization of corpse preservation, scene investigation, and examination procedure.
3. International Influence
In the Míng and Qīng the work was transmitted to Korea and Japan; in the 18th–19th centuries it was transmitted to Europe:
- 1779 French translation;
- 1863 English translation at Cambridge University;
- 19th century translations into Dutch, German, and other languages, and in the United States.
“From the appearance of the Collected Cases of Washing Away Wrongs, the world of forensic medicine at last had a systematic monograph.」」
— [American] S. Avicenne, Introduction to Forensic Medicine, New York, 1924.
Source: Song · Sòng Cí, Collected Cases of Washing Away Wrongs (original), Fujian Science and Technology Publishing House collated and annotated edition, 2006; Jiǎ Jìngtāo, History of Chinese Forensic Medicine, Liaoning Education Press, 1995.
IX. The Four Masters of the Jīn and Yuán: The Opening of the Age of Schools in Chinese Medicine
“Medicine’s schools divided in the Jīn and Yuán.」」
— Qing · Siku Quanshu Zongmu Tiyao · Medical Section (《四库全书总目提要·医家类》)
The “Four Masters of the Jīn and Yuán” are the marker of Chinese medicine’s true “age of schools” — Liú Wánsù’s (刘完素) “School of Cold and Cool (寒凉派)”, Zhāng Cóngzhèng’s (张从正) “School of Attacking Evil (攻邪派)”, Lǐ Dōngyuán’s (李东垣) “School of Spleen and Stomach (脾胃派)”, Zhū Dānxī’s (朱丹溪) “School of Nourishing Yin (滋阴派)” — the four masters all inherited the ancient teaching of the Neijing, and created new doctrines in the Jīn and Yuán.
1. Liú Wánsù (School of Cold and Cool)
📜 The Man
Liú Wánsù (刘完素, c. 1120–1200), courtesy name Shǒuzhēn (守真), styled Tōngxuán Chǔshì (通玄处士) and Héjiān Jūshì (河间居士), a native of Héjiān, Héběi (河间, 河北), a famous physician of the Jīn dynasty, venerated by later generations as the “ancestor of the School of Cold and Cool.”
📜 Academic Doctrine
“The six qi all transform into fire”:
“The root of all diseases lies in fire … the excess of the five emotions all become intense heat …」
He believed that most diseases arose from “fire” and “heat” — in clinical practice he made much use of cold and cool drugs (huánglián, huángqín, zhīzǐ, shígāo) to clear heat and drain fire.
Representative works:
- Suwen Xuanji Yuanbing Shi (《素问玄机原病式》, 1182) — 1 scroll, taking the Suwen’s “Nineteen Items on Disease Mechanism (病机十九条)” as its outline, and developing the doctrine of “the six qi all transforming into fire”;
- Xuanming Lunfang (《宣明论方》), 15 scrolls — representative formulas Fángfēng Tōngshèng Sǎn (防风通圣散, Ledebouriella Sage-Inspired Powder) and Shuāng Jiě Sǎn (双解散, Double Resolution Powder);
- Shanghan Zhige (《伤寒直格》), 3 scrolls — a new reading of the six channels as all being heat;
- Sanxiao Lun (《三消论》, Treatise on the Three Wasting-Thirsts) — treating diabetes from “heat.”
📜 One Line
“The six qi follow fire; a hundred diseases are all heat; Héjiān established the cold and cool; the Jīn and Yuán opened a new page.」
2. Zhāng Cóngzhèng (School of Attacking Evil)
📜 The Man
Zhāng Cóngzhèng (张从正, c. 1156–1228), courtesy name Zǐhé (子和), styled Dàirén (戴人), a native of Suīzhōu, Jīn dynasty (睢州, 河南睢县), a famous physician of the Jīn dynasty, served as Grand Physician of the Imperial Medical Academy, inherited the teaching of Liú Wánsù, venerated by later generations as the “ancestor of the School of Attacking Evil.”
📜 Academic Doctrine
“To attack evil is to support the upright”:
“Disease is a thing, and not something the body originally has … It enters from without, or arises from within … all are evil qi … When evil qi invades the body, it can be swiftly attacked, it can be pulled out, why tolerate it?」」
— Rumen Shiqin (《儒门事亲》), Scroll 2, “The Three Methods of Sweating, Vomiting, and Purging Exhaust the Whole Meaning of Treating Disease”
“The three methods — sweating, vomiting, and purging — exhaust all of treating disease”: Sweating method (resolving the exterior), vomiting method (inducing ejection), purging method (draining downward) — the three methods can encompass a thousand diseases.
Representative work:
- Rumen Shiqin (《儒门事亲》), 15 scrolls (c. 1228) — the chief work, with an appended “system of three methods and six categories”.
📜 One Line
“Disease is born of evil; to attack evil is to support the upright; Zǐhé established attacking evil, and the three methods of sweating, vomiting, and purging opened a new heaven.」
3. Lǐ Dōngyuán (School of Spleen and Stomach)
📜 The Man
Lǐ Dōngyuán (李东垣, 1180–1251), given name Gǎo (杲), courtesy name Míngzhī (明之), later styled Dōngyuán Lǎorén (东垣老人, “Old Man of the Eastern Wall”), a native of Zhēndìng, late Jīn (真定, 河北正定), of wealthy family background, studied under Zhāng Yuánsù (张元素) (the “ancestor of the Yìshuǐ School (易水学派)”), a famous physician of the early Yuán, venerated by later generations as the “ancestor of the School of Spleen and Stomach” and the “patriarch of the School of Supplementing Earth (补土派).
📜 Academic Doctrine
“Internal injury to the spleen and stomach gives rise to all diseases”:
“Reviewing the various chapters of the Neijing, one finds that what allows the qi of man to rise, is none other than the qi of the stomach that nourishes it … If the qi becomes disordered, it is always the result of weakness of the spleen and stomach.」」
Creation of “Bǔ Zhōng Yì Qì Tāng (补中益气汤, Tonify the Middle and Augment Qi Decoction)”:
“Bǔ Zhōng Yì Qì Tāng — huángqí (astragalus) is the sovereign … rénshēn, báizhú, zhì gāncǎo are the ministers … dāngguī harmonizes the blood; chénpí conducts the qi; shēngmá and cháihú raise the fallen clear yang …**」
“Sweet and warm to remove great heat”: He first established the use of sweet and warm drugs (huángqí, rénshēn) to treat great heat (fever of internal injury) — this revolutionary doctrine allowed Chinese medicine to extend from externally-contracted heat disease to internally-injury heat disease.
Representative works:
- Piwei Lun (《脾胃论》, Treatise on the Spleen and Stomach), 3 scrolls (1249) — the chief work;
- Nei Wai Shang Bian Huo Lun (《内外伤辨惑论》, Treatise on the Differentiation of Internal and External Injury), 3 scrolls (1247) — distinguishing external contraction from internal injury;
- Lanshi Micang (《兰室秘藏》, Secretly Preserved in the Orchid Chamber), 3 scrolls — clinical formula-and-doctrine.
Representative formulas: Bǔ Zhōng Yì Qì Tāng, Shēng Yáng Yì Wèi Tāng (升阳益胃汤, Raise Yang and Augment the Stomach Decoction), Dāng Guī Bǔ Xuè Tāng (当归补血汤, Chinese Angelica Blood-Supplementing Decoction), Zhǐ Shí Dǎo Zhì Wán (枳实导滞丸, Immature Bitter Orange Stagnation-Guiding Pill) …
📜 One Line
“The spleen and stomach are the root of the postnatal; Dōngyuán established the School of Supplementing Earth; the doctrine of fallen qi opened a new heaven.」
4. Zhū Dānxī (School of Nourishing Yin)
📜 The Man
Zhū Dānxī (朱丹溪, 1281–1358), given name Zhènhēng (震亨), courtesy name Yànxiū (彦修), a native of Yìwū, Yuán dynasty (义乌, 浙江义乌), before the age of thirty he studied Confucianism, and later studied Neo-Confucianism under Xǔ Qiān (许谦) (a fourth-generation disciple of Zhū Xī); after the age of forty he studied medicine under Luó Zhītì (罗知悌) (Luó was conversant with the teachings of all three — Liú Wánsù, Zhāng Cóngzhèng, and Lǐ Dōngyuán), fusing the strengths of all three schools and creating new doctrines.
He is venerated by later generations as the “ancestor of the School of Nourishing Yin”, the “Sage among Physicians” (Dài Liáng 戴良, Biography of Old Man Dānxī, 《丹溪翁传》), and “the foremost of the Four Masters of the Yuán.”
📜 Academic Doctrine
“Yang is ever in excess; yin is ever deficient”:
“That by which man lives is qi and blood … qi is ever in excess, blood is ever deficient … Yin is hard to perfect and easy to lose …**」」
— Gezhi Yulun (《格致余论》, Further Discourses on the Investigation of Things, 1347)
The doctrine of “ministerial fire (相火)”: “Ministerial fire moves recklessly and becomes a thieving evil” — emphasizing the protection of yin essence, and in clinical practice making much use of formulas that nourish yin and descend fire.
Representative formulas:
- Dà Bǔ Yīn Wán (大补阴丸, Great Yin-Supplementing Pill) (huángbǎi, zhīmǔ, shúdì, guībǎn);
- Yuè Jú Wán (越鞠丸, Yueju Pill) (resolving all six stagnations);
- Zuǒ Jīn Wán (左金丸, Left Metal Pill) (huánglián and wúzhūyú in a 6:1 ratio).
Representative works:
- Gezhi Yulun (《格致余论》), 1 scroll (1347) — the doctrine of “yang ever in excess, yin ever deficient”;
- Jufang Fahui (《局方发挥》, Elucidation of the Heji Jufang), 1 scroll (1347) — criticizing the abuse of warming-drying drugs in the Heji Jufang;
- Danxi Xinfang (《丹溪心法》, Master Dānxī’s Heart of Medicine), 5 scrolls — compiled by his disciples.
📜 One Line
“Yang is ever in excess, yin is ever deficient; Dānxī established nourishing yin, and supplemented where Dōngyuán had not yet reached.」
📊 Comparison of the Four Masters of the Jīn and Yuán
| Physician | Era | Core Doctrine | Representative Formula | Later Influence |
|---|---|---|---|---|
| Liú Wánsù (Héjiān) | Jīn | “The six qi all transform into fire” | Fángfēng Tōngshèng Sǎn | Ancestor of the warm-disease school |
| Zhāng Cóngzhèng (Zǐhé) | Jīn | “Attacking evil is supporting the upright” | Yǔgōng Sǎn (禹功散), Jùnchuān Sǎn (浚川散) | Ancestor of the School of Attacking Evil |
| Lǐ Dōngyuán (Dōngyuán) | Late Jīn | “Internal injury to the spleen and stomach gives rise to all diseases” | Bǔ Zhōng Yì Qì Tāng | Ancestor of the School of Supplementing Earth |
| Zhū Dānxī (Dānxī) | Yuán | “Yang is ever in excess, yin is ever deficient” | Dà Bǔ Yīn Wán | Ancestor of the School of Nourishing Yin |
Source: Jīn · Liú Wánsù, Suwen Xuanji Yuanbing Shi (People’s Medical Publishing House punctuation-and-collation edition); Jīn · Zhāng Cóngzhèng, Rumen Shiqin (Shanghai Science and Technology Publishing House punctuation-and-collation edition); Jīn · Lǐ Dōngyuán, Piwei Lun (People’s Medical Publishing House punctuation-and-collation edition); Yuán · Zhū Dānxī, Gezhi Yulun (People’s Medical Publishing House punctuation-and-collation edition); Yán Shìyún, Theories of the Various Schools of Chinese Medicine, China Press of Chinese Medicine, 2003.
X. Medicine in the Song, Jīn, and Yuán: A Master Table
“Four hundred years of Song, Jin, and Yuan saw the medical Way move from ‘craft’ to ‘scholarship.’」
| Period | Dynasty | Physician / Institution | Representative Work | Contribution |
|---|---|---|---|---|
| 960–1127 | Northern Song | Bureau of Medical Revisions (Lín Yì and others) | 11 canonical texts | National-level collation of ancient books |
| 978–992 | Northern Song | Wáng Huáiyǐn and others | Taiping Shenghui Fang | First officially compiled formulary |
| 1032–1113 | Northern Song | Qián Yǐ (edited by Yán Xiàozhōng) | Key to Therapeutics of Children’s Diseases | Ancestor of Chinese pediatrics |
| 1056–1136 | Northern Song | Táng Shènwēi | Jingshi Zhenglei Beiji Bencao | Cumulative synthesis of materia medica |
| 1031–1095 | Northern Song | Shěn Kuò | Mengxi Bitan and Su Shen Liangfang | Scientist, medical writer |
| 1037–1101 | Northern Song | Sū Shī | Su Shen Liangfang | Literary giant, medical writer |
| 1117 | Northern Song | Emperor Huīzōng, commissioned compilation | Shengji Zonglu, 200 scrolls | Largest formula-and-medicine encyclopedia |
| 1107–1110 | Northern Song | Chén Shīwén | Taiping Huimin Heji Jufang | Ancestor of official formularies |
| 1120–1200 | Jīn | Liú Wánsù | Suwen Xuanji Yuanbing Shi | Ancestor of the School of Cold and Cool |
| 1156–1228 | Jīn | Zhāng Cóngzhèng | Rumen Shiqin | Ancestor of the School of Attacking Evil |
| 1180–1251 | Late Jīn | Lǐ Dōngyuán | Piwei Lun | Ancestor of the School of Spleen and Stomach |
| 1186–1249 | Southern Song | Sòng Cí | Collected Cases of Washing Away Wrongs | World’s earliest forensic medicine |
| 1190–1270 | Southern Song | Chén Zìmíng | Comprehensive Good Formulas for Women | Ancestor of Chinese gynecology |
| 1281–1358 | Yuán | Zhū Dānxī | Gezhi Yulun | Ancestor of the School of Nourishing Yin |
Thirteen physicians and institutions, leaving Chinese medicine with the “school” gene that would last forever.
XI. Why the Song, Jin, and Yuan Was the “Academic Age” of Chinese Medicine
1. From “Classics” to “Schools”
The Han had laid the classical foundation, the Táng had produced the clinical encyclopedia — the Song, Jīn, and Yuán was the age of “schools” — four schools — Cold and Cool, Attacking Evil, Spleen and Stomach, and Nourishing Yin — stood together, laying the foundation for the later diversification of Chinese medicine.
2. From “Private Schooling” to “Official Schooling”
The Bureau of Medical Revisions fixed the classics for all time; the Imperial Medical Bureau’s “Three Lodges and Promotion Tribute System” made medicine one of the branches of the imperial examination; medical books were printed in large editions — this was Chinese medicine’s “knowledge popularization movement.”
3. From “General Practice” to “Specialization”
Pediatrics (Qián Yǐ), gynecology (Chén Zìmíng), external medicine (Chén Zìmíng), forensic medicine (Sòng Cí), traumatology (the earlier Táng Lìn Dàorén) — the true specialization of Chinese medicine took shape.
4. From “Central Land” to “East Asia”
The Song, Jīn, and Yuán was the age in which Chinese medicine was transmitted in full to Goryeo, Japan, and Annan:
- Goryeo’s Wáng Yǔ (王俣) Goryeosa (《高丽史》) recorded that hundreds of Chinese medical texts entered Goryeo;
- In Japan’s Kamakura and Muromachi periods (13th–16th centuries CE), Chinese medicine was transmitted to Japan;
- In Annan (Vietnam), Chinese medicine became the mainstream of “Southern medicine (南医).”
XII. Echoes in the Modern World
🏛 The Bureau of Medical Revisions and the Protection of Ancient Books
Today’s Chinese “National Administration of Traditional Chinese Medicine” and the “National Center for the Preservation of Ancient Books” — are the continuation of the thousand-year tradition of the Bureau of Medical Revisions; in 2011 the “Archives of Traditional Chinese Medicine” was inscribed on the UNESCO Memory of the World Register — this is the thousand-year echo of the Bureau of Medical Revisions.
🏥 Qián Yǐ and Today’s Pediatrics
In the clinical formulas used at Beijing Children’s Hospital and the Capital Institute of Pediatrics, formulas of Qián Yǐ such as “Liù Wèi Dìhuáng Wán” (六味地黄丸), “Xiè Bái Sǎn” (泻白散), and “Dǎo Chì Sǎn” (导赤散) are still in routine use.
⚖ Sòng Cí and Today’s Forensic Medicine
The forensic experts at institutions such as China’s Supreme People’s Procuratorate’s Judicial Authentication Center (最高人民检察院司法鉴定中心), must read as their first book the modern application of the principles of the Collected Cases of Washing Away Wrongs.
💊 Dōngyuán and Modern Digestive-Immune Theory
Today’s “spleen–stomach doctrine” is being re-interpreted by modern medicine as: “digestion + immunity + neuro-endocrine-immune (NEI) network” — Dōngyuán’s “Treatise on the Spleen and Stomach” is now being recognized anew by modern science for its value.
XIII. Coda: Why Contention Became Greatness
“The glorious Tang was a ‘summit’; the Song, Jin, and Yuan were a ‘plateau’;
a summit can be looked up to, a plateau can be lived on.」
Three Great Reasons
1. The “Information Revolution” of Printing
Movable-type printing allowed knowledge to be transmitted on a large scale, and the Bureau of Medical Revisions fixed the classics for all time — this was a leap in “knowledge infrastructure.”
2. The “Scholarization” of the Confucian Physician
The aspiration of “if one cannot be a good minister, then one shall be a good physician” led the scholar class to study medicine by the standards of scholars — medical books for the first time possessed academic depth.
3. The “Clinical Diversity” of Multi-Ethnic Fusion
The multi-ethnic polities of the Song, Jīn, and Yuán standing side by side forced physicians to confront the real differences of north and south, cold and heat — the birth of the schools was a clinical inevitability.
🪶 A One-Line Summary
“The four hundred years of Song, Jin, and Yuan saw Chinese medicine complete its transition from ‘craft’ to ‘scholarship’; the contention of the four great schools allows Chinese medicine to this day to retain its vitality and creativity.」
XIV. A Word from Qihuang Library
“The Song’s Bureau of Medical Revisions was Chinese medicine’s ‘national infrastructure’;
the contention of the Jīn and Yuán Four Masters was Chinese medicine’s ‘academic freedom’;
the specialist works of Qián Yǐ, Chén Zìmíng, and Sòng Cí were Chinese medicine’s ‘disciplinary refinement’ —
the four hundred years of Song, Jīn, and Yuán saw the medical Way come to full maturity.」
Today, when Chinese medical education is divided into internal medicine, external medicine, pediatrics, gynecology, acupuncture, orthopedics and traumatology and many more specialties — this is the specialty tradition opened by Qián Yǐ and Chén Zìmíng; when Chinese clinical practice is divided into cold-cool, warm-heat, tonify-deficiency, drain-excess and many more schools — this is the school-gene laid down by the Four Masters of the Jīn and Yuán; when the canonical texts of Chinese medicine are taken to be the Song editions — this is the thousand-year merit of guarding the foundations of the Bureau of Medical Revisions.
This is the Song, Jīn, and Yuán — the “academic age” of Chinese medicine.
“The Bureau of Medical Revisions, with Lín Yì at its head, established the canon;
Liú Wánsù of Héjiān opened the cold and cool;
Zǐhé attacked evil, Dōngyuán supplemented earth;
Dānxī nourished yin to protect the true yang.」
Qihuang Library, together with you, will continue to walk through the great synthesis and the warm-disease school of the Ming and Qing, will continue to walk through the modern “voyage abroad” of Qihuang — walking the three thousand years of Chinese medicine to the end.
In our next installment, we shall go to Qíchūn in the Ming (Húběi), to see Lǐ Shízhēn spend twenty-seven years of blood and sweat writing the Compendium of Materia Medica; to the Qīng in Sūzhōu and Huáiyīn, to see Yè Tiānshì and Wú Jūtōng “defending qi, nutritive, and blood,” and the “three burners,” to differentiate warm diseases; to the capital, to the home of Wáng Qīngrèn, who dissected corpses to observe the organs, and saw how he wrote the Correction of Errors in the Forest of Medicine.
📜 The contention of Qihuang, a hundred schools become one school;
The school-gene is passed on to a thousand years later.