The Cumulative Synthesis of Qihuang: Five Hundred and Forty-Three Years of Medicine in the Ming and Qing Dynasties
The Compendium of Materia Medica Reaches Its Summit, the Four Masters of Warm Diseases Open a New Heaven — The Cumulative Synthesis of Chinese Medicine and the Birth of New Schools
“The physician embodies the Changes; thus Confucius discussed medicine through the Yi;
The physician embodies benevolence; thus Mencius discussed medicine through benevolence.」 (「医者，易也，故孔子以《易》论医；
医者，仁也，故孟子以仁论医。」)— Ming · Zhāng Jǐngyuè (张景岳), Leijing Fuyi · The Meaning of the Medical Changes (《类经附翼·医易义》)
In 1368 CE, Zhū Yuánzhāng (朱元璋) proclaimed himself emperor at Yīngtiān Fǔ (应天府, modern Nánjīng), and the Míng arose; in 1644 CE, Lǐ Zìchéng (李自成) captured Běijīng, and Chóngzhēn (崇祯) hanged himself; in 1911 CE, the Xīnhài (辛亥) Revolution occurred, Xuāntǒng (宣统) abdicated, and the Qīng fell.
A full five hundred and forty-three years, China passed through the two dynasties of Ming and Qing — the Yǒnglè Encyclopedia (永乐大典), Zhèng Hé’s voyages to the Western Seas, the Kāng–Qián flourishing age, the Opium War, the Self-Strengthening Movement, the Wùxū Reform, the Xīnhài Revolution …
And medicine — she in these five hundred years —
- gathered the cumulative synthesis of three thousand years,
- opened the forerunner of new schools,
- inherited the ancient and ushered in the modern,
- faced the eastward spread of Western learning —
- laying the groundwork for the modern century’s storms in Chinese medicine.
On this stretch — Lǐ Shízhēn spent thirty years to write the Compendium of Materia Medica; Wú Yǒuxìng in the Chóngzhēn plague put forward the doctrine of “pestilential qi (戾气)”; Yè Tiānshì created the “defense, qi, nutritive, and blood” pattern identification; Wú Jūtōng established the “three burners” as an outline; Wáng Qīngrèn personally visited the pauper’s cemetery to observe the viscera and draw diagrams …… They both guarded the foundations, and dared to break the old.
At Qihuang Library, today we shall take you back to that age of “Jin Ping Mei (金瓶梅),” “Dream of the Red Chamber (红楼梦),” and “Liaozhai (聊斋)”, to see how Chinese medicine gained its cumulative synthesis and opened a new heaven.
I. Historical Background: The “Two Faces” of Ming and Qing Physicians
“Though Zhou was an ancient state, its mandate was ever new.」 (「周虽旧邦，其命维新。」)
— Book of Songs · Greater Odes of the Royal Domain · King Wen (《诗经·大雅·文王》)
1. Three Major Background Factors
📚 The Cumulative Synthesis of the Classics
The Míng and Qīng was the summarizing period of Chinese classical scholarship:
- The Míng Yǒnglè years’ Yǒnglè Dàdiǎn (《永乐大典》, 1403–1408) included more than one hundred medical books;
- The Qīng Qiánlóng years’ Sìkù Quánshū (《四库全书》, 1773–1782) set up a special “Masters Section · Medical Subsection”, with 97 medical books catalogued and 94 more in the supplementary list.
This was the “grand inventory” of the Chinese medical classics — Lǐ Shízhēn, Wáng Kěntáng, Zhāng Jǐngyuè, Xú Língtái, Chén Xiūyuán, and other members of the “School of Cumulative Synthesis” arose in response.
🦠 The “Midwife” of Plagues
The Míng and Qīng was a period of frequent plagues — records of “great epidemics” never cease in the books:
- Míng Yǒnglè 6th year (1408), great plague in Zhèjiāng;
- Míng Chóngzhēn 16th year (1643), great plague in Běijīng (History of Ming · Treatise on the Five Elements 《明史·五行志》);
- Qīng Kāngxī 34th year (1695), great plague in Běijīng;
- Qīng Qiánlóng 33rd year (1768), great plague;
- Qīng Jiāqìng 19th year (1814), nationwide great plague.
The plagues forced physicians “to have to” break out of the framework of cold-damage — the warm-disease school arose in response.
🌏 The “Shock” of the Eastward Spread of Western Learning
In the 10th year of the Míng Wànlì era (1582 CE), Matteo Ricci entered China, and Western medicine and missionary work entered China together — Míng and Qīng physicians for the first time faced the “Western physician” as a powerful opponent — this was the curtain-raiser of Chinese medicine’s “modern century.”
Source: Dèng Tiětāo, ed., General History of Chinese Medicine · Ancient Volume, Chapter 7, “Ming and Qing Medicine.”
2. A Snapshot: What Did Those 543 Years Leave Behind?
| Discipline | Representative Work | Author | Nature |
|---|---|---|---|
| Materia Medica | Bencao Gangmu (《本草纲目》), 52 scrolls | Lǐ Shízhēn | Cumulative synthesis of materia medica; 1,892 medicinals |
| Materia Medica | Bencao Pinhui Jingyao (《本草品汇精要》), 42 scrolls | Liú Wéntài and others | Ming official materia medica |
| Materia Medica | Bencao Gangmu Shiyi (《本草纲目拾遗》), 10 scrolls | Zhào Xuémǐn | Supplements omissions of the Gangmu; 716 newly added |
| Medical Classics | Leijing (《类经》), 32 scrolls | Zhāng Jǐngyuè | Complete commentary on the Neijing |
| Medical Classics | Neijing Zhiyao (《内经知要》), 2 scrolls | Lǐ Zhōngzǐ | Introduction to the Neijing |
| Clinical | Jingyue Quanshu (《景岳全书》), 64 scrolls | Zhāng Jǐngyuè | Clinical encyclopedia |
| Clinical | Zhengzhi Zhunsheng (《证治准绳》), 44 scrolls | Wáng Kěntáng | Ming clinical encyclopedia |
| Clinical | Yixue Zhengzhuan (《医学正传》), 8 scrolls | Yú Tuán | Comprehensive medical book |
| Clinical | Yizong Bidu (《医宗必读》), 10 scrolls | Lǐ Zhōngzǐ | Clinical introduction |
| Warm Diseases | Wenyi Lun (《温疫论》), 2 scrolls | Wú Yǒuxìng | Ancestor of warm-disease studies |
| Warm Diseases | Linzheng Zhinan Yian (《临证指南医案》), 10 scrolls | Yè Tiānshì | Foremost of the Four Masters of Warm Diseases |
| Warm Diseases | Wenre Tiaobian (《温热条辨》), 6 scrolls | Wú Jūtōng | Three-burner pattern identification |
| Warm Diseases | Shire Tiaobian (《湿热条辨》), 1 scroll | Xuē Xuě | Damp-heat diseases |
| Warm Diseases | Wenre Jingwei (《温热经纬》), 5 scrolls | Wáng Mèngyīng | Cumulative synthesis of warm-disease studies |
| External Medicine | Waike Zhengzong (《外科正宗》), 4 scrolls | Chén Shígōng | Orthodox school of external medicine |
| Gynecology | Fu Qingzhu Nyuke (《傅青主女科》), 2 scrolls | Fù Shān | Innovative school of gynecology |
| Anatomy | Yilin Gaicuo (《医林改错》), 2 scrolls | Wáng Qīngrèn | Anatomy at the pauper’s cemetery |
| Diagnostics | Wangzhun Zunjing (《望诊遵经》), 2 scrolls | Wāng Hóng | Systematization of inspection |
| Medical Essays | Yixue Yuanliu Lun (《医学源流论》), 2 scrolls | Xú Dàchūn | Medical theory, medical essays |
| Medical Essays | Yixue Sanzi Jing (《医学三字经》), 4 scrolls | Chén Xiūyuán | Popularization of medicine |
| Acupuncture | Zhenjiu Dacheng (《针灸大成》), 10 scrolls | Yáng Jìzhōu | Cumulative synthesis of Ming acupuncture |
| Pulse Diagnosis | Bihu Maixue (《濒湖脉学》), 1 scroll | Lǐ Shízhēn | Classic of pulse diagnosis |
| Throat Medicine | Chonglou Yuyao (《重楼玉钥》), 2 scrolls | Zhèng Méijiàn | Founding of throat medicine |
| Eye Medicine | Shenshi Yaohan (《审视瑶函》), 6 scrolls | Fù Rényǔ | Compilation of eye medicine |
| Massage | Xiao’er Tuina Guangyi (《小儿推拿广义》), 3 scrolls | Xióng Yìngxióng | Pediatric massage |
| Forensic Medicine | Lüli Guan Jiaozheng Xiyuan Lu (《律例馆校正洗冤录》), 4 scrolls | Bureau of Laws and Regulations | Officially compiled forensic text |
Twenty-five “firsts,” each of which made Chinese medicine deeper, broader, and newer.
II. Lǐ Shízhēn and the Compendium of Materia Medica: The Summit of Materia Medica Studies
“The excellence of the physician lies in the investigation of things; investigating things, one comes to know the root.」 (「医者，贵在格物；格物，然后知本。」)
— Ming · Lǐ Shízhēn, General Rules of the Bencao Gangmu (《本草纲目·凡例》)
1. The Man
Lǐ Shízhēn (李时珍, 1518–1593), courtesy name Dōngbì (东璧), styled Bīnhú (濒湖), a native of Qíchūn, Húběi (蕲春, 湖北) (present-day Qíchūn County, Huánggāng, Húběi), from a three-generation hereditary medical family — his father Lǐ Yánwén (李言闻) was a famous physician of Qíchūn; Lǐ Shízhēn three times failed the provincial examinations (in his 14th, 17th, and 20th years), and from the age of 23 he carried on his father’s practice, at last becoming the greatest materia medica scholar of the Ming, and a world-class natural scientist.
“Lǐ Shízhēn … did not study the classics in the conventional way, but was devoted solely to medicine … he collected from the works of the hundred schools, and sought out information from all directions … He began in the Jiājìng rénzǐ year (1552), completed in the Wànlì wùyín year (1578), and revised the manuscript three times.」」
— Qing · Gù Jǐngxīng (顾景星), Biography of Lǐ Shízhēn (《李时珍传》)
2. The Compendium of Materia Medica in 52 Scrolls
Completed in 1578 (the 6th year of Wànlì), first printed in 1596 (3 years after Lǐ Shízhēn’s death, the Jīnlíng (金陵) edition of Hú Chénglóng 胡承龙), 52 scrolls, recording 1,892 medicinal substances, 1,109 illustrations, and 11,096 appended formulas.
This was the summit of Chinese materia medica studies, and also a milestone in the botany of the world.
📊 Three Major Systems
First, the “outline and detail” classification system:
- 16 categories (water, fire, earth, metal and stone, herbs, grains, vegetables, fruits, woods, clothing-and-implements, insects, scaled creatures, shells, fowl, beasts, humans),
- 60 classes,
- each drug recorded under seven items: “explanation of the name — collected explanations — preparation — qi and flavor — main indications — elucidation — appended formulas”.
“Taking the section as the outline, the class as the detail, from the small to the great, from the humble to the noble.」」 (「以部为纲，以类为目，从微至巨，从贱至贵。」)
— General Rules of the Bencao Gangmu (《本草纲目·凡例》)
This was the most complete classification system in Chinese materia medica studies — it came 157 years after Linnaeus’s Systema Naturae (1735), but was more detailed and more practical.
Second, the materia medica view of “things of the same kind together; things classified by their kind”: breaking through the crudity of Táo Hóngjǐng’s “three grades” classification — this was a revolutionary innovation at the time.
Third, the research method of “truth comes from practice”: Lǐ Shízhēn did not merely organize the ancient texts, but “walked ten thousand li, seeking information from all directions” — he himself gathered herbs, cultivated herbs, dissected herbs, cooked herbs, tasted herbs in person — records exist of his firsthand account of the narcotic effect of mántuóluó (曼陀罗, jimsonweed).
3. International Influence
The Compendium of Materia Medica was transmitted abroad:
- 1606: transmitted to Japan; in the first half of the 18th century translated into Japanese;
- 1659: translated into Latin by the Pole Míchael Boym (a continuation of the Flora Sinensis);
- 1735: largely cited in the French Du Halde’s Description de la Chine (The General History of China);
- 18th–19th centuries: translated into English, French, German, Russian and many other languages.
“The Compendium of Materia Medica is not only the summit of Chinese materia medica studies, but also a milestone of world pharmacognosy. Linnaeus’s Systema Naturae is ‘artificial classification,’ while Lǐ Shízhēn’s Compendium of Materia Medica was on the path of ‘natural classification.’」」
— [English] Joseph Needham, Science and Civilisation in China, Volume 6
Source: Ming · Lǐ Shízhēn, Compendium of Materia Medica, Jīnlíng edition (1596), Shanghai Science and Technology Press punctuated edition, 1993; Qián Chāochén and Wēn Chánglù, Comprehensive Studies on Lǐ Shízhēn, Zhongyi Guji Chubanshe, 2003.
4. Companion Works
Lǐ Shízhēn also authored the Bihu Maixue (《濒湖脉学》), 1 scroll (1564) — recording 27 pulse types in seven-character verse — to this day still a required introduction to pulse diagnosis in Chinese medicine.
III. Zhāng Jǐngyuè and the Jingyue Quanshu and Leijing: Medicine and the Changes of One Origin
1. The Man
Zhāng Jǐngyuè (张景岳, 1563–1640), given name Jièbīn (介宾), courtesy name Huìqīng (会卿), styled Jǐngyuè (景岳) and Tōngyīzǐ (通一子), a native of Miánzhú, Shāndōng (绵竹, 山东) (present-day Jǐnán, Shāndōng), one of the greatest clinical physicians of the Ming, studied medicine under Jīn Mèngshí (金梦石), “in his prime he was fond of military strategy, in his middle years he studied medicine” — he was at once a general and a famous physician.
2. The Leijing: The Systematization of the Unity of Medicine and the Changes
The Leijing (《类经》), 32 scrolls — Zhāng Jǐngyuè classified and commented on the entirety of the Suwen and Lingshu — it is China’s second (the first being the Suí Yáng Shàngshàn’s Taisu (《太素》)) complete classified commentary — divided into 12 categories: nurturing life, yin–yang, zang-xiang, pulse and complexion, meridians, root and branch, qi and flavor, treatment, disease, needling, yun-qi, comprehensive understanding — Zhāng Jǐngyuè fused the Yi (Book of Changes) into medicine — his doctrine of “the unity of medicine and the Changes” is a deep extension of Chinese medical theory.
“The Yi is change itself, embodying the wonders of yin and yang in motion and stillness;
medicine is the mind, embracing the pivot of the waxing and waning of yin and yang.」」 (「易者，易也，具阴阳动静之妙；医者，意也，合阴阳消长之机。」)— Leijing Fuyi · The Meaning of the Medical Changes (《类经附翼·医易义》)
3. The Jingyue Quanshu in 64 Scrolls: A Clinical Encyclopedia
Completed in 1624 (the 4th year of Tiānqǐ), 64 scrolls, c. 1,000,000 characters — Chuanzhong Lu, Maishen Zhang, Shanghan Dian, Zazheng Mo, Furen Gui, Xiaoer Ze, Douzheng Quan, Waike Qian, Bencao Zheng, Xinfang Bazhen, Gufang Bazhen and others — the cumulative synthesis of Chinese clinical medicine — the model of the “School of Warming and Supplementing” — Zhāng Jǐngyuè vigorously advocated “yang is not in excess, yin is ever deficient” — the opposite of Zhū Dānxī’s “yang is ever in excess” — his doctrine later became one of the mainstream views of Ming and Qing clinical practice.
Source: Ming · Zhāng Jǐngyuè, Jingyue Quanshu (original), People’s Medical Publishing House punctuation-and-collation edition, 1991; Ming · Zhāng Jǐngyuè, Leijing (original), Xueyuan Press collated and annotated edition, 2005.
IV. Wáng Kěntáng and the Zhengzhi Zhunsheng: The Ming Clinical Encyclopedia
Wáng Kěntáng (王肯堂, 1549–1613), courtesy name Yǔtài (宇泰), styled Sǔn’ān (损庵), a native of Jīntán, Jiāngsū (金坛, 江苏) (present-day Jīntán District), a famous physician of the Ming — a jìnshì (进士) of the 17th year of Wànlì (1589) — “When Grand Secretary Zhāng Jūzhèng fell ill, the entire court had no one who could treat him; Kěntáng cured him with a single dose” — he authored the Zhengzhi Zhunsheng (《证治准绳》), 44 scrolls — the cumulative synthesis of Ming clinical medicine — the “standard” of every clinical specialty — still today a commonly consulted reference in Chinese clinical medicine.
Source: Ming · Wáng Kěntáng, Zhengzhi Zhunsheng (original), Shanghai Science and Technology Publishing House photographic reprint, 1984.
V. The Warm-Disease School: The Greatest Medical Revolution of Ming and Qing
“The study of cold-damage reached its extreme in the Jīn and Yuán;
The study of warm-disease only began to flourish in the Míng and Qīng.」
The rise of the warm-disease school — the second “school revolution” in the history of Chinese medicine — inheriting the ancient teaching of cold-damage — opening the new teaching of warm-disease — from this point onward the clinical pattern-identification system for “externally-contracted heat disease” was complete.
1. Wú Yǒuxìng and the Wenyi Lun: The Ancestor of Warm-Disease Studies
Wú Yǒuxìng (吴有性, 1582–1652), courtesy name Yòukě (又可), a native of Wú Xiàn, Jiāngsū (吴县, 江苏) (present-day Sūzhōu), a famous physician of the late Ming.
In the 14th–16th year of Chóngzhēn (1641–1643 CE), a great plague swept north and south of the Yangtze — “a lane of more than a hundred households, not one family escaped;
a single household of ten mouths, not one mouth survived” — “the physicians of the time, using cold-damage methods to treat it, invariably failed” — Wú Yǒuxìng, in grief and reflection, composed in 1642 the Wenyi Lun (《温疫论》), 2 scrolls.
His core doctrine: the “pestilential qi (戾气)” theory:
“The disease of warm-pestilence is not caused by wind, nor by cold, nor by summer-heat, nor by dampness; it is due to a special kind of strange qi between Heaven and Earth, by which one is infected … let it be called ‘pestilential qi (戾气).’」」 (「温疫之病，非风非寒，非暑非湿，乃天地间别有一种异气所感……名之曰「戾气」。」)
— Wenyi Lun · The Origin of Disease (《温疫论·原病》)
This is the earliest hypothesis of “pathogenic agent” in the history of Chinese medicine — the doctrine of “pestilential qi” and “miscellaneous qi” — it preceded the European “germ theory” (Pasteur in the 1870s, Koch in 1876) by 230 years — and already implicitly contained the concepts of “species specificity,” “airborne transmission,” and “entry through the mouth and nose” — remarkably consistent with modern epidemiology.
Even more remarkable — Wú Yǒuxìng put forward the idea of “routes of infection”:
“Pestilential qi … enters through the mouth and nose” (perfectly consistent with modern respiratory-transmission theory) “Cattle fall ill but sheep do not; chickens fall ill but ducks do not; humans fall ill but birds and beasts do not” — “species specificity” was recognized hundreds of years before modern understanding.
Source: Ming · Wú Yǒuxìng, Wenyi Lun (original), People’s Medical Publishing House punctuation-and-collation edition, 1990; [Japanese] Yamamoto Noriko (山本德子), “Wenyi Lun and the History of Epidemiology,” Journal of the Japan Society of Medical History, 1985.
2. Yè Tiānshì: The Foremost of the Four Masters of Warm Diseases
Yè Tiānshì (叶天士, 1667–1746), given name Guì (桂), styled Xiāngyán (香岩), a native of Wú Xiàn, Jiāngsū (吴县, 江苏) (present-day Sūzhōu), the most outstanding warm-disease physician of the Qīng — the foremost of the “Four Masters of Warm Diseases” — from the age of ten he studied medicine under a teacher; he followed father and teachers, seventeen in all — “whenever he heard of someone skilled at treating disease, he would immediately go and study under them” — he was the most famous “learn from many teachers” figure in the history of Chinese medicine.
📜 The Case Records as a Guide to Clinical Practice (Linzheng Zhinan Yian)
Compiled by his disciple Huá Xiùyún (华岫云) and others, completed in 1764 — 10 scrolls — recording more than 2,500 clinical cases of Yè Tiānshì — the cumulative synthesis of Yè’s scholarship — to this day still a required clinical book in Chinese medicine.
📜 Defense-Qi-Nutritive-Blood Pattern Identification
Yè Tiānshì in the “Treatise on Externally-Contracted Warm-Heat” (preserved in Wáng Mèngyīng’s Wenre Jingwei) first created — “after defense comes qi, after nutritive comes blood” — the four stages of warm-disease pattern identification:
- Defense stage (wèi fèn) (exterior pattern) —
- Qi stage (qì fèn) (interior heat) —
- Nutritive stage (yíng fèn) (heat sinking in) —
- Blood stage (xuè fèn) (heat entering the blood chamber) —
clinically each is treated respectively with pungent-cool resolution of the exterior, clearing heat and rescuing the qi, clearing the nutritive and cooling the blood, cooling the blood and dispersing stasis — the core pattern-identification framework of warm-disease studies — guiding Chinese clinical practice to this day (epidemic hemorrhagic fever, Japanese encephalitis, influenza, COVID-19, etc.).
“Warm evil enters from above, first invading the lung, and counter-transmits to the pericardium.
The lung governs qi and pertains to defense; the heart governs blood and pertains to nutritive.」」 (「温邪上受，首先犯肺，逆传心包。肺主气属卫，心主血属营。」)— Linzheng Zhinan Yian (《临证指南医案》)
📜 Tongue Diagnosis and Tooth Examination
Yè Tiānshì originated the “examination of the teeth” in warm-disease differentiation — “when the tongue coating is white and thin, it is externally-contracted wind-cold … when the tongue is red and the coating is yellow and rough, heat has entered the qi stage … when the tongue is crimson and glossy, heat has entered the nutritive stage …” — still today an important tool of clinical pattern identification in Chinese medicine.
Source: Qīng · Yè Tiānshì, Linzheng Zhinan Yian (original), Shanghai Science and Technology Publishing House, 1959; Qīng · Wáng Mèngyīng, Wenre Jingwei (original), People’s Medical Publishing House punctuation-and-collation edition, 2003.
3. Wú Jūtōng: The Three-Burner Pattern Identification of Warm Diseases
Wú Jūtōng (吴鞠通, 1758–1836), given name Táng (瑭), courtesy name Pèihéng (配珩), styled Jūtōng (鞠通), a native of Huáiyīn, Jiāngsū (淮阴, 江苏) (present-day Huái’ān) — a famous warm-disease physician of the Qīng — at the age of 19 his father died of illness — he resolved to study medicine — and authored the Wenbing Tiaobian (《温病条辨》), 6 scrolls (1798).
His core doctrine: “Three-Burner Pattern Identification”:
- Upper Burner (上焦) (heart, lung) —
- Middle Burner (中焦) (spleen, stomach) —
- Lower Burner (下焦) (liver, kidney) —
complementing Yè Tiānshì’s “defense-qi-nutritive-blood” — the core pattern-identification system of warm-disease studies — laying the foundation for the clinical standardization of warm-disease studies.
Representative formulas:
- Yín Qiào Sǎn (银翘散, Honeysuckle and Forsythia Powder) (“mild pungent-cool formula”) —
- Sāng Jú Yǐn (桑菊饮, Mulberry Leaf and Chrysanthemum Beverage) (“light pungent-cool formula”) —
- Qīng Yíng Tāng (清营汤, Clear the Nutritive Decoction) —
- Ān Gōng Niú Huáng Wán (安宫牛黄丸, Calm the Palace Bovine Bezoar Pill) (foremost of the “Three Treasures for Opening the Orifices with Cool Drugs”) —
- Zhì Bǎo Dān (至宝丹, Greatest Treasure Elixir), Zǐ Xuě Dān (紫雪丹, Purple Snow Elixir) (the “Three Treasures for Opening the Orifices with Cool Drugs”) —
“Treat the upper burner as a feather — only the light can lift it;
Treat the middle burner as a balance — only the even can steady it;
Treat the lower burner as a weight — only the heavy can sink it.」」 (「治上焦如羽，非轻不举；治中焦如衡，非平不安；治下焦如权，非重不沉。」)— Wenbing Tiaobian · Miscellaneous Discussions (《温病条辨·杂说》)
Source: Qīng · Wú Jūtōng, Wenbing Tiaobian (original), People’s Medical Publishing House punctuation-and-collation edition, 2005.
4. Xuē Xuě’s Shire Tiaobian
Xuē Xuě (薛雪, 1681–1770), courtesy name Shēngbái (生白), styled Yīpiáo (一瓢), a native of Wú Xiàn, Jiāngsū (吴县, 江苏) (present-day Sūzhōu) — a famous warm-disease physician of the Qīng — of equal renown with Yè Tiānshì — he authored the Shire Tiaobian (《湿热条辨》), 1 scroll — specifically treating “damp-heat disease” — complementing Wú Jūtōng’s three-burner pattern identification — “in damp-heat patterns one may not use cold-and-cool alone” — still today guiding the clinical treatment of damp-heat infections, liver diseases, and intestinal diseases.
5. Wáng Mèngyīng’s Wenre Jingwei: The Cumulative Synthesis of Warm-Disease Studies
Wáng Mèngyīng (王孟英, 1808–1868), given name Shìxióng (士雄), courtesy name Mèngyīng (孟英), a native of Qiántáng, Zhèjiāng (钱塘, 浙江) (present-day Hángzhōu) — a famous warm-disease physician of the Qīng — the “rear guard” of the “Four Masters of Warm Diseases” — he authored the Wenre Jingwei (《温热经纬》), 5 scrolls (1852) — the cumulative synthesis of the warm-disease teachings of the Neijing, Zhòngjǐng, Wú Yǒuxìng, Yè Tiānshì, Xuē Xuě, Wú Jūtōng, Zhāng Xūgǔ and others — taking “jing” (经, warp) and “wei” (纬, weft) as its title — taking “jing” as the outline (the original canonical text) — taking “wei” as the detail (the commentaries of the various schools) — the grand inventory of warm-disease studies — to this day still the “encyclopedia” of warm-disease studies.
Source: Qīng · Wáng Mèngyīng, Wenre Jingwei (original), People’s Medical Publishing House punctuation-and-collation edition, 2003.
📊 Comparison of the Four Masters of Warm Diseases
| Physician | Era | Representative Work | Core Idea |
|---|---|---|---|
| Wú Yǒuxìng (Yòukě) | Late Ming | Wenyi Lun | “Pestilential qi” doctrine |
| Yè Tiānshì (Xiāngyán) | Early Qīng | Linzheng Zhinan Yian and Treatise on Externally-Contracted Warm-Heat | “Defense-qi-nutritive-blood” pattern identification |
| Xuē Xuě (Shēngbái) | Mid-Qīng | Shire Tiaobian | “Damp-heat” specialized treatise |
| Wú Jūtōng (Pèihéng) | Mid-Qīng | Wenbing Tiaobian | “Three-burner” pattern identification |
| Wáng Mèngyīng (Shìxióng) | Late Qīng | Wenre Jingwei | Cumulative synthesis of warm-disease studies |
VI. Wáng Qīngrèn and the Yilin Gaicuo: Anatomy at the Pauper’s Cemetery
1. The Man
Wáng Qīngrèn (王清任, 1768–1831), courtesy name Xūnchén (勋臣), a native of Yùtián, Zhílì (玉田, 直隶) (Yùtián County, Héběi Province) — a famous physician of the Qīng — and in the history of Chinese medicine a rare physician who “personally visited the pauper’s cemetery to observe the viscera.”
2. The Yilin Gaicuo
2 scrolls — completed in 1830 — Wáng Qīngrèn in the years 1791–1830 — defying the Qīng law “whoever disturbs a grave shall receive one hundred strokes and be exiled three thousand li” — personally observed the corpses of more than 300 dead children — drew the “Diagram of the Viscera as Personally Observed” — vigorously corrected the errors of the ancients in their understanding of the viscera — he was the sole representative of the “empirical-anatomy school” in the history of Chinese medicine — and the first “empirical physician” of China.
Major corrections:
- “The heart governs thought” — wrong — Wáng Qīngrèn believed that the “seat of memory” was “the brain marrow” — “Spirit and memory are not in the heart but in the brain” — hundreds of years earlier than Western “brain function localization”;
- On-site observation of the form of the liver, lung, spleen, stomach, and other viscera — with many corrections — still today the most important document in the anatomy of Chinese medicine.
Wáng Qīngrèn’s “stasis of blood” doctrine:
- “When qi is in excess it becomes fire; when blood is in excess it becomes water” —
- “When a chronic illness enters the network vessels, it becomes stasis” —
- he created the “Five Stasis-Expelling Decoctions” (Tōngqiào, Xuèfǔ, Gēxià, Shàofù, Shēntòng Zhúyū Tāng) —
- still today commonly used formulas in Chinese clinical medicine —
- modern research has found that “activating blood and resolving stasis” has definite effects on cardiovascular disease, tumor metastasis, and diabetic kidney disease —
- this is a successful example of the modernization of Chinese medicine.
Source: Qīng · Wáng Qīngrèn, Yilin Gaicuo (original), People’s Medical Publishing House punctuation-and-collation edition, 1976; Qián Chāochén, History of Chinese Medicine, Shanghai Science and Technology Press, 1984.
VII. Ming and Qing External Medicine: Chén Shígōng and the Waike Zhengzong
Chén Shígōng (陈实功, 1555–1636), courtesy name Yùrén (毓仁), styled Ruòxū (若虚), a native of Nántōng, Jiāngsū (南通, 江苏) — a famous external-medicine physician of the Ming — the “ancestor of the ‘Orthodox School’” among the “Three Great Schools of External Medicine” — he authored the Waike Zhengzong (《外科正宗》), 4 scrolls (1617).
Main contributions:
- He summarized “the Twelve Principles of External Medicine” — the “combined internal and external treatment” principle — emphasizing the three methods of “resolving (消), expressing (托), and supplementing (补)”;
- He recorded more than 40 external-medicine surgical procedures — “nasal polyp removal,” “oral mucous cyst excision,” “tracheal suturing,” and others — his “reduction of mandibular dislocation” is still a part of orthopedic teaching to this day;
- He created “Bā Èr Xiān Xiāoyáo Tāng (八二仙逍遥汤, Eight-Two Immortal Free-and-Easy Decoction),” “Tòu Nóng Sǎn (透脓散, Penetrate the Abscess Powder),” and other famous external-medicine formulas.
Source: Ming · Chén Shígōng, Waike Zhengzong (original), Shanghai Science and Technology Publishing House, 1989.
VIII. Ming and Qing Gynecology: Fù Shān and the Fu Qingzhu Nyuke
Fù Shān (傅山, 1607–1684), courtesy name Qīngzhú (青竹), then Qīngzhǔ (青主), styled Zhūyī Dàorén (朱衣道人, “Daoist in Crimson Robes”) — a native of Yángqǔ, Shānxī (阳曲, 山西) (present-day Tàiyuán) at the turn of the Ming and Qing — a “left-over subject of the Ming” — he became a recluse after the fall of the Ming — he never served the Qīng in his life — he was the most famous thinker, calligrapher-painter, and physician of the Ming–Qing transition — he authored the Fu Qingzhu Nyuke (《傅青主女科》), 2 scrolls — taking “liver depression” as the core — he created “Dìng Jīng Tāng (定经汤, Stabilize the Menses Decoction),” “Xuān Yù Tōng Jīng Tāng (宣郁通经汤, Diffuse Depression and Free the Menses Decoction),” and others — still today core formulas of Chinese gynecology.
Source: Qīng · Fù Shān, Fu Qingzhu Nyuke (original), Shanghai Science and Technology Publishing House, 1959.
IX. Yáng Jìzhōu and the Zhenjiu Dacheng: The Cumulative Synthesis of Ming Acupuncture
Yáng Jìzhōu (杨继洲, 1522–1620), a native of Sānqú, Shāndōng (三衢, 山东) (present-day Qúzhōu) — a famous acupuncture physician of the Ming — the “ancestor of the ‘Great Compendium School’ of acupuncture” — he authored the Zhenjiu Dacheng (《针灸大成》), 10 scrolls (1601) — the cumulative synthesis of all earlier acupuncture studies — recording 359 acupoints, collecting the needling methods and verse-formulas of the previous masters — to this day still the core textbook of acupuncture.
Source: Ming · Yáng Jìzhōu, Zhenjiu Dacheng (original), People’s Medical Publishing House punctuation-and-collation edition, 2006.
X. Medicine in the Ming and Qing: A Master Table
“Five hundred years of Ming and Qing, the medical Way achieved its cumulative synthesis and opened a new heaven.」
| Period | Dynasty | Physician | Representative Work | Contribution |
|---|---|---|---|---|
| 1518–1593 | Ming | Lǐ Shízhēn | Bencao Gangmu, 52 scrolls | Summit of materia medica; 1,892 medicinals |
| 1563–1640 | Ming | Zhāng Jǐngyuè | Jingyue Quanshu and Leijing | Unity of medicine and the Changes; doctrine of the Gate of Life |
| 1549–1613 | Ming | Wáng Kěntáng | Zhengzhi Zhunsheng, 44 scrolls | Ming clinical encyclopedia |
| 1555–1636 | Ming | Chén Shígōng | Waike Zhengzong, 4 scrolls | Orthodox school of external medicine |
| 1522–1620 | Ming | Yáng Jìzhōu | Zhenjiu Dacheng, 10 scrolls | Cumulative synthesis of Ming acupuncture |
| 1582–1652 | Ming | Wú Yǒuxìng | Wenyi Lun, 2 scrolls | Ancestor of warm-disease studies; pestilential-qi doctrine |
| 1607–1684 | Ming–Qing | Fù Shān | Fu Qingzhu Nyuke | Innovative school of gynecology |
| 1667–1746 | Qīng | Yè Tiānshì | Linzheng Zhinan Yian | Foremost of the Four Masters of Warm Diseases; defense-qi-nutritive-blood |
| 1681–1770 | Qīng | Xuē Xuě | Shire Tiaobian | Specialized treatise on damp-heat disease |
| 1758–1836 | Qīng | Wú Jūtōng | Wenbing Tiaobian, 6 scrolls | Three-burner pattern identification |
| 1768–1831 | Qīng | Wáng Qīngrèn | Yilin Gaicuo, 2 scrolls | Visits to the pauper’s cemetery; activating blood and resolving stasis |
| 1808–1868 | Qīng | Wáng Mèngyīng | Wenre Jingwei, 5 scrolls | Cumulative synthesis of warm-disease studies |
| 1719–1805 | Qīng | Xú Dàchūn | Yixue Yuanliu Lun, 2 scrolls | Medical theory, medical essays |
| 1749–1829 | Qīng | Chén Xiūyuán | Yixue Sanzi Jing | Popularization of medicine |
| 1736–1820 | Qīng | Zhào Xuémǐn | Bencao Gangmu Shiyi, 10 scrolls | Supplements the omissions of the Gangmu |
Fifteen physicians — making Ming and Qing medicine both profound and vivid.
XI. Why the Ming and Qing Was the “Cumulative Synthesis” of Chinese Medicine
1. From “Craft” to “Encyclopedia”
The Míng and Qīng was the era of clinical encyclopedias in every specialty of Chinese medicine — the Bencao Gangmu, Zhengzhi Zhunsheng, Jingyue Quanshu, Wenre Jingwei, Zhenjiu Dacheng — these are the “encyclopedias” of Chinese clinical medicine — still today the core references of Chinese clinical practice.
2. From “Cold-Damage” to “Warm-Disease”
The rise of the warm-disease school — the second school revolution in the history of Chinese medicine — the two great pattern-identification systems of “cold-damage” and “warm-disease” — became the two great pillars of Chinese clinical pattern identification — “cold-damage treats externally-contracted cold evil; warm-disease treats externally-contracted heat evil” — still today guiding Chinese clinical treatment of epidemic diseases.
3. From “Theory” to “Empirical Evidence”
Wáng Qīngrèn’s “empirical anatomy” — the rare “empirical” spirit in the history of Chinese medicine — the forerunner of Chinese medicine’s move toward “empirical medicine.”
4. From “China” to “the World”
The Míng and Qīng was the pivotal period in which Chinese medicine went out into the world — the Compendium of Materia Medica was translated into Japanese, Korean, Latin, English, French, German, and Russian — seven languages — this was the brilliance of Chinese medicine’s “going out” — and it planted the seed for the modern “voyage abroad” of Chinese medicine.
XII. Echoes in the Modern World
🦠 Warm-Disease Studies and SARS, COVID-19
In 2003, SARS — in 2020, COVID-19 — Chinese clinical medicine drew on “warm-disease studies” to identify patterns — defense-qi-nutritive-blood and three-burner pattern identification — became the core weapons of Chinese medicine against emerging infectious diseases — the “three formulas and three medicines” (Qīng Fèi Páidú Tāng, Huà Shī Bàidú Fāng, Xuān Fèi Bàidú Fāng) — are to this day the core formulas for COVID-19 treatment — and their source is precisely the thinking of Wú Jūtōng’s Wenbing Tiaobian.
💉 Wáng Qīngrèn and Activating Blood and Resolving Stasis
Today — “activating blood and resolving stasis” is the golden field of Chinese–Western medical integration — the research of Academicians Chén Kějì and Wēng Wěiliáng — has found the effects of activating blood and resolving stasis on cardiovascular disease and tumors — this is the modern continuation of Wáng Qīngrèn’s “Five Stasis-Expelling Decoctions.”
📚 The Compendium of Materia Medica and World Pharmacognosy
Lǐ Shízhēn’s “Compendium of Materia Medica” — is a milestone of world pharmacognosy — Needham called it “the summit of China’s sixteenth-century natural science” — to this day — the Compendium of Materia Medica is still the “source” of Chinese-medicine research — Tū Yōuyōu drew inspiration from the Compendium of Materia Medica, citing it repeatedly, in pursuing further leads in the search for artemisinin.
🧠 Wáng Qīngrèn’s “Brain-Marrow Doctrine” and Modern Brain Science
Wáng Qīngrèn’s “Spirit and memory are not in the heart but in the brain” — the earliest doctrine of “brain center” in the history of Chinese medicine — hundreds of years earlier than the Western “cerebral cortex localization” — today’s Chinese medical brain science — its root lies precisely here.
XIII. Coda: Why the Ming and Qing Became the Era of “Cumulative Synthesis”
“Cumulative synthesis is more than just gathering the ancient;
opening a new heaven is more than just breaking the old.」
Three Great Reasons
1. The Grand Inventory of the Classics
The Yǒnglè Dàdiǎn and the Sìkù Quánshū — two state-level cultural projects — gave Míng and Qīng physicians the material foundation for “cumulative synthesis.”
2. The Midwifery of the Plagues
Frequent Míng and Qīng plagues — forced physicians to break out of the cold-damage framework — the warm-disease revolution — was the pushing of clinical reality.
3. The Shock of Western Learning
Míng and Qīng physicians for the first time faced the real opponent of “Western medicine” — not a closed-door refusal — but absorbing the nourishment of Western learning — as in Wáng Qīngrèn’s anatomy, Xú Língtái’s empiricism — this was the early experiment of “Chinese substance, Western application” (中体西用) in Chinese medicine.
🪶 A One-Line Summary
“Five hundred years of Ming and Qing, Chinese medicine completed the transition ‘from the classical to the modern’; it was both the summit of the classical age and the beginning of the modern age.」
XIV. A Word from Qihuang Library
“Lǐ Shízhēn walked for thirty years, painting the summit of materia medica;
Wáng Qīngrèn defied the Qīng law, visiting the pauper’s cemetery to draw the viscera;
Wú Yòukě cut straight to the heart, his pestilential-qi doctrine shocking Heaven and Earth;
Yè Tiānshì and Wú Jūtōng, the warm-disease school opening a new chapter —
Míng and Qīng physicians both guarded the correctness of the classical tradition and opened the path of new scholarship.」
Today, when Chinese clinical pattern identification is performed — we use Wú Yǒuxìng’s “pestilential qi” thought to combat emerging infectious diseases; when Chinese medicine studies cardiovascular disease — we use Wáng Qīngrèn’s “activating blood and resolving stasis” formulas; when Chinese medicine teaches materia medica — we use Lǐ Shízhēn’s “Gangmu” classification; when Chinese medicine fights COVID-19 — we use Wú Jūtōng’s “three-burner pattern identification.”
This is the Míng and Qīng — the era of “cumulative synthesis and new heaven” of Chinese medicine.
“Shízhēn for thirty years wrote the Gangmu, Jǐngyuè fused medicine and the Yi in one body;
Yòukě’s pestilential qi opened warm-disease, Jūtōng’s three burners fixed the new ford;
Qīngrèn personally visited to observe the viscera, the light of empiricism shining for a thousand springs.」
Qihuang Library, together with you — looking back on the Ming and Qing’s cumulative synthesis — moving forward to the modern era’s storms — moving forward to Chinese medicine’s “voyage abroad” and “rebirth” — walking the three-thousand-year road of Chinese medicine to its end.
In our next installment — taking “the person” as our outline — we shall review “Biǎn Què, Huà Tuó, Zhāng Zhòngjǐng, Huángfǔ Mì, Gě Hóng, Sūn Sīmǐao, Qián Yǐ, Lǐ Dōngyuán, Lǐ Shízhēn, Yè Tiānshì” — ten great physicians — to see their legendary lives — to see their formulas famous through the ages — to see their medical virtue and bearing — to see the “epic of persons” in the three-thousand-year history of Chinese medicine.
📜 The cumulative synthesis of Qihuang, five hundred years of completion;
Opening a new heaven while guarding the foundations, the torch passed on through a thousand autumns.