Zhao Xuemin: A Celebrated Doctor of Folk Medicine

Fng Hui(方輝), Zhng Chun(張純), nd Xio Dngsheng(肖黨生)c＊

Zhao Xuemin: A Celebrated Doctor of Folk Medicine

Fang Hui(方輝)a, Zhang Chun(張純)b, and Xiao Dangsheng(肖黨生)ac＊

a: The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, China

b: Academe of Southeast Health Science & Technology, Zhejiang province, Hangzhou 310000, China

c: Institute of Zhao Xuemin Traditional Chinese Medicine, Academe of Southeast Health Science & Technology, Zhejiang province, Hangzhou 310000, China

Traditional Chinese Medicine originated from the application of herbs and other natural materials. Since Tang Dynasty, there are two mainstreams during the development of TCM: folk TCM and classic TCM. Without any support from the government, folk TCM got fade away. However, during Qing Dynasty, Zhao Xuemin collected a large amount of folk prescriptions which were called zoufang and edited into Chuanya Neibian and Chuanya Waibian. Zhou Xuemin was respected as a celebrated medical scientist of Qing Dynasty due to his great contribution.

Traditional Chinese Medicine, herbal medicine, folk medicine

Traditional Chinese medicine originated from the application of herbs and other natural materials. Huangdi Neijing, an ancient theoretical document of medicine, is the fi rst milestone in the history of TCM. In this book, many understandings on the functions of organs in our body were recorded and some basic principles had been presented which must be followed in treating patients until now. Shanghan Zabing Lun, a bridge between the medical theory recorded in Huangdi Neijing and clinic application, was another milestone which is the first guideline of clinical therapeutics. Until Tang Dynasty, government began to involve in the development of TCM. Tang Ben Cao in Tang Dynasty was the first official monograph of Chinese medicine. The examination for electing medical officer was the evidence that government paid some attention to medicine. Later in Song Dynasty, the government not only revised and published Shanghan Lun, but also established the pharmaceutical administration for producing Chinese patent medicine. Since then, there are two mainstreams during the development of TCM: folk TCM and classic TCM which got some supports from government. Zoufang belongs to the folk TCM.

What is zoufang? In the history of TCM, some folk doctors raised and recorded the folk therapies and traveled around the world with their medical kit for rescuing patients. The medicines and Chinese medical formulas used by these folk doctors were called zoufang. Bian Que and Hua Tuo could also be regarded as the pioneering doctors in the utilization of zoufang. Later, some of TCM documents, for example Zhouhou Beiji Fang edited by Ge Hong, Qianjin Fang edited by Sun Simiao and Jiuhuang Bencao edited in Ming Dynasty also recorded many zoufang. The principles for utilization of zoufang were dif f erent from those of classic TCM which were laid down in Huangdi Neijing and Shanghan Zabing Lun. Acupuncture, moxibustion and oral medicines were the main treatments for folk doctors to utilize zoufang, which were abstracted as “ding”, “chuan”, “jin”, “jie”. In all, the doctors who used zoufang, must relieve the symptoms and complains of a patient as soon as possible without any consideration of etiology, pathogenesis, the constitution and tolerance of the patients, the side effects of medicines, etc. All medicines in zoufang had three characteristics: fi rstly, all medicines were very inexpensive; secondly, all medicines were very ef f ective; thirdly, all medicines must be gotten as easily as possible. All pharmacological properties of zoufang were abstracted into ding, chuan, jie. The medicines which can cause vomiting were regarded as ding while the medicines which can cause diarrhea were regarded as chuan. Those medicines which could inhibit or reverse the pathological process were regarded as jie. According to these, ding, chuan, jie are just diaphoresis, emetic therapy, and purgative method in the classic TCM respectively. As for an excellent doctor who always used zoufang, he must be good at comprehensive application of ding, chuan, jie.

After Tang Dynasty, because of the support of governments and many intelligentsias attending in the medical practice, classic TCM became the mainstream of TCM with Huangdi Neijing and Shanghan Lun as the classic textbooks. On the other hand, those folk doctors who used zoufang always had lower social status while some of medicines in zoufang had the narrow range of application and always brought serious toxicity and side ef f ects to the patients. So, zoufang was getting fade away. However, during Qing Dynasty, Zhao Xuemin, a medical scientist in Hangzhou was celebrated due to his great contribution in his application of zoufang.

BIOGRAPHY OF ZHAO XUEMIN

Zhao Xuemin, a celebrated medical scientist, lived from 1719 to 1805 (the Qing dynasty) in Qiantang, which is called Hangzhou now, Zhejiang province. His father, as an official in Yongchun and Longxi, was also a doctor. It is reported that some epidemic diseases broken out in Xiasha during Emperor Qianlong (1736-1795). His father recruited doctors and produced Chinese patent medicine for treating these diseases. So, thousands of patients were rescued. Following the wishes of his father, Zhao Xuemin and his brother Zhao Xuekai began to study Confucianism and TCM when they were young. After Zhao Xuemin grew up, he had no interests in becoming an official or politician. Instead, he paid more attention to the TCM and collected many herbal medicines, parts of which were planted in his garden for further researches. Zhao Xuemin was also keen on reading many books in the fields of medicine, astronomy as well as calendar and always noted his understandings and experiences in TCM so that his manuscripts were more than thousands of volumes. He had a garden named as Yang Su Yuan for planting and researching herbal medicines. Zhao Xueming and his brother had managed a clinic named as Li Ji Tang for rescuing patients.

ACHIEVEMENTS OF ZHAO XUERMIN

Zhao Baiyun, a Clansman of Zhao Xuemin, was also a folk doctor who always used zoufang in treating diseases. Zhao Baiyun donated all ef f ective zoufang to Zhao Xuemin. With these zoufang and other prescriptions that he had recorded, Zhao Xuemin edited tow books: Chuanya Neibian and Chuanya Waibian, in which more than one thousand prescriptions were recorded. Chuanya Neibian and Chuanya Waibian, are the representative works of Zhao Xuemin. In these books, all prescriptions were classif i ed for treating certain diseases. In Chuanya Waibian, a large number of prescriptions were recorded for treating animal diseases, which are helpful for the prevention and treatment of modern animal diseases.

In 1765, Zhao Xuemin finished another book Bencao Gangmu Shiyi which was of ten volumes. In this book, 716 Chinese medicines, which had not been recorded in Bencao Gangmu, were classified into eighteen categories such as water, fire, soil, gold, stone, grass, wood, rattan, fl owers, fruit, grains, vegetables, devices, birds, beasts, scales, shells, insects. In order to revise the mistakes in Bencao Gangmu, Zhao Xuemin listed his revision in the initial part of Bencao Gangmu Shiyi. In all, this book enriched the contents of the Chinese medicines.

Furthermore, Zhao Xuemin had fi nished other books, such as Yang Su Yuan Chuan Xin Fang, Qi Fang Bei Kao, Yao Xing Yuan Jie, etc, all of which had been lost. In all books that we could read, we could not find out his understandings or notes on Huangdi Neijing and Shanghan Lun, which implied that Zhao Xuemin paid more attention to herbal medicines and folk prescriptions than TCM theory or classic TCM.

ZOUFANG HAD AFFORDED MANY EFFECTIVE PRESCRIPTIONS FOR CLASSIC TCM( SOME EFFECTIVE ZOUFANG IN CHUANYA NEIBIAN)

Zoufang stemmed from the folk application of nature materials such as herbs, mineral and so on. After some doctors in classic TCM used these zoufang and discussed pharmacological effect, these zoufang would become the classic medical formula in TCM. Daige San is the just example. It was heard that in Song Dynasty, a concubine of Huizong (one of emperors in Song Dynasty) got serious cough with sputum production, facial edema, breathless so that she could not get a good sleep during the whole night. Emperor Huizong ordered doctor Li (one of imperial physicians):” cure of f her disease in three days or your head will be cut of f.” Dr. Li prescribed for the concubine of Huizong at once, but all medicines did not work and the concubine of emperor got more serious than ever. In the last night before the deadline, Dr. li felt so helpless that he could do nothing but crying with his wife. At this time, he heard that someone was selling medicine for treating cough and declared that his medicine could cure cough in addition to guaranteeing a good sleep during night. With little hope, Dr. li bought fi ve doses of this medicine (a green power called Daige San) which was made of Indigo naturalis (Qingdai) and Concha meretricis (Geqiao). After taking orally 3-fold dose of Daige San and conf i rming that the medicine had no toxicity and serious side ef f ects, Dr. li immediately took the medicine to the concubine of Huizong. After taking the medicine, the concubine of Huizong had no cough and slept well during the night and the next morning, her facial edema was also relieved. Since then, Daige San had been a classic medical formula in TCM as the therapy of cough.

Some ef f ective prescriptions in Chuanya Neibian

Daige San is a classic folk medicine. Some famous folk medicines recorded by Zhao Xuemin are following:

Qingnang Wan: This medicine was made of Rhizoma cyperi (Xiangfu), and Radix lindera aggregatae (Wuyao). After being ground into powder, Rhizoma cyperi 500g and Radix lindera aggregatae 160g were boiled with vinegar and then made into pills. Noted: according to our clinic experience, our viewpoint is that this medicine should be used to relieve chest tightness and abdominal distension especially for women.

Fahan San: This medicine was made of Vigna radiata (Lvdou), Herba ephedrae (Mahuang), Radix et rhizoma glycyrrhizae(Gancao). Equivalent amount of the three drugs were ground into powder and taken orally with water.

A medical formula for the therapy of headache: This medicine was made of Rhizoma chuanxiong (Chuanxiong) 30g, Radix glehniae (Beishashen) 30g, Fructus viticis cum calyce (Manjingzhi) 6g, Radix et rhizoma Asari (Xixin) 1.5g. All herbal medicines are boiled with two bowls of water until 0.8 bowls of decoction were gotten. This decoction should be taken orally with half bowl of Yellow Wine in morning.

Fenshuishen San: This medicine was made of Rhizoma atractylodis macrocephalae (Baizhu) 30g and Semen plantaginis (Cheqianzhi) 15g. The two herbal medicines should be boiled and the decoction will be taken orally for curing watery diarrhea.

Dingtai Dan: This medicine was made of Cortex eucommiae (Duzhong) 250g, Radix dipsaci (Chuanduan) 60g, and Rhizoma dioscoreae (Shanyao) 150～180g. All herbal medicines were ground into powder so as to be made into pills which were as big as the seed of Phoenix Tree (Wu tong). Every time, fifty pills would be taken orally. This medicine was much benef i cial to pregnant woman and fetus.

Si Jingang: This medicine was made of Radix angelicae sinensis (Danggui)24g, Radix astragali (Huangqi) 15g, Radix et rhizoma Glycyrrhizae (Gancao) 6g, Flos lonicerae (Jinyinhua) 30g. This medicine was used to treat suppurative inf l ammation.

Sanmiao San: This medicine was made of Spica prunellae (Xiakucao)15g, Flos lonicerae (Jinyinhua) 15g, Herba taraxaci (Pugongying) 15g. All herbal medicines were boiled with half water and half wine. The decoction was used orally to treat tuberculum and scrofula in neck.

Other ef f ective prescriptions in Chuanya Neibian

In TCM, some Chinese medical formulas were made of food. Such prescriptions were also recorded in Chuanya Neibian. Jiegu Fang is the just example. A black crucian, about 400g in weight, were fi lled with Ferrous sulfate (Heifan) 1.5g, Songluo Tea 10g and seven or eight garlic cloves in abdomen after the internal organs being removed. And then, the black crucian would be steamed in china as a dish for patient. It would be better for patient to eat the tea and the garlic. Noted: we suspect that this prescription can be used for the therapy of ascites.

The prescriptions for the prevention of Smallpox: Fructus toosendan (Chuanlianzhi) can be used to prevent smallpox. Xidou Dan, made of Semen phaseoli (Chixiaodou) 30g, semnen gsojae nigrum (Heidou)30g, Radix et rhizoma Glycyrrhizae (Gancao) 30g, could also be used in the prevention of Smallpox.

In Chuanya Neibian, some prescriptions for treating rare and/or stubborn diseases were also recorded. For example, rabies is a serious disease with high mortality. If one was bitten by a rabid dog, he would get rabies without correct treatment of wound. In Chuanya Neibian, the treatment of being bitten by dogs was recorded. After being bitten, fi nding a place with no wind and washing the wound with cold water as quickly as possible. And then, the patient must take orally a bowl of leek juice. After a week, the patient must take the second bowl of leek juice. In all, the patient must take seven bowls of leek juice once in a week within forty-nine days. Since then, the patient should not eat the acid and/or alkaline food within one hundred days as well as fi shes in one year. Dog meat was also not permitted since then. Skin defect in newborn is a rare disease at present1. Zhao Xuemin considered the etiology of this disease was the def i ciency of earth qi in pregnancy. The treatment of this disease was the external application of loess, which was gotten road for three days. Another prescription is external application of rice which was used to cover all over the body of the fetus after being ground into powder. This was also an ef f ective prescription for the treatment of skin defect in newborn and would help the newborn to get earth qi.

The characteristics of zoufang in Chuanya Neibian and Chuanya Waibian

Most of prescriptions recorded by Zhao Xuemin were every simple. Most of the prescription were of no more than ten herbs. The most complex prescription is Ling Yi Gao, an external application medicine which is made up to 47 kinds of herbal medicines.

In most prescriptions, the routine dosage of each herb is 6-10g. In a few prescriptions, the dosages of herbs are very high. For example, in the prescription of Zhi Toutong, the dosages of Rhizoma chuanxiong (Chuanxiong) and Radix glehniae (Beishashen) were as much as 30g. In another prescription for the treatment of “Weizheng”, the dosage of Radix ophiopogonis (Maidong), Radix rehmanniae preparata (Shudihuang) and Radix scrophulariae (Xuansen) were more than 200g. The prescription is following: Radix ophiopogonis (Mai Dong) 250g, Radix Rehmanniae preparata (Shudihuang) 500g, Radix scrophularia (Xuanshen) 350g, Schisandra chinensis(Wuweizhi) 30g. All of herbs with 20 bowls of water are decocted into 6 bowls of decoction. 3 bowls of decoction are drunk in morning and 2 bowls are drunk in afternoon while 1 bowl is drunk in evening. It can be sure the patient begins to sit after two days of treatment. And then, the patient will take the second prescription which is made of Radix rehmanniae preparata (Shudihuang) 400g, Scrophularia ningpoensis (Xuanshen) 150g, Fructus schisandrae (Wuweizhi) 9g, Fructus corni praeter nucem (Shanzhuyu) 12g, and Radix cyathulae (Chuanniuxi) 30g. All of herbs with 10 bowls of water are decocted into 2 bowls of decoction which will be drunk in the morning and evening respectively. After 10 days’of treatment, the patient can begin to walk and will recover in one month.

Noted: according our experience and pharmacology of these herbs, we concluded that weizheng here was perhaps a serious primary myasthenia2.

THE VALUE OF ZOUFANG IN CHUANYA NEIBIAN AND CHUANYA WAIBIAN IN MODERN CLINIC APPLICATION

Effectiveness, inexpensiveness and rapid-acting are the main characteristics of zoufang. However, it should not be ignored that spectrums of diseases for most of zoufang is too narrow and some herbs have the toxicity and serious side ef f ects. Therefore, most of zoufang can only be used in folk and the components of zoufang are kept in secret which are only known in a family and in private. So, it is difficult and praiseworthy for Zhao Xuemin to collect and publish these prescriptions of zoufang in his works. On the other hand, although Zhao Xuemin recorded so many zoufang, we cannot assure that every prescription had been applied by Zhao Xuemin in clinic. For example, Zhao Xuemin had recorded some prescriptions for the treatment of skin defect in newborn which is a rare disease, but we always wondered whether these prescriptions had been used by Zhao Xuemin or Zhao Xuemin recorded these prescriptions only for emergency.

In Chuanya Neibian and Chuanya Waibian, Zhao Xuemin only recorded the components and effectiveness of prescriptions with no discussions on the pharmacology of herbs in the prescriptions. Some herbs in Chuanya Neibian have toxicity and serious side effects. These disadvantages limited the clinic application of zoufang. So, a doctor, who wants to apply zoufang in clinic, must comprehend correctly the theory of TCM including Huangdi Neijing and Shanghan Zabing Lun and have rich clinic experiences especially in the applications of herbs. Once some side effects even toxicity of herbs occurred in patient, he must fi nd out the just prescriptions to deal with such cases.

In all, from Zhao Xuemin’s works, we can conclude that Zhao Xuemin did not attend the arguments among the Classical Prescriptions School, Current Prescriptions School, Shanghan School and Epidemic Febrile Disease School. In contrasting, he paid much attention to the collection of folk prescriptions and he finally became a celebrated medicine scientist. Today, the inheritance and development of traditional Chinese medicine are our responsibility while the combination with modern medicine is one direction for the development of TCM. So, we should not only pay some attention on folk medicine and choose the most effective prescriptions for clinic application but also do our best to construct a novel theory to connect Traditional Chinese Medicine and modern medicine so as to promote Traditional Chinese Medicine to the world3,4.

REFERENCES

1 Duan X, Yang GE, Yu D, et al. Aplasia cutis congenita: A case report and literature review. Exp Ther Med, 2015, 10(5):1893-1895.

2 Fan Yongping. Origin of theory of atrophy syndrome. Journal of Beijing University of Traditional Chinese Medicine, 2011,34(1):12-17.

3 Fang Hui, Li Shengjie, Zhu Qiuhong, et al. A novel understanding about oxidation of glucose in term of wuxing TCM theory. World Journal of Intergrated traditional and western Medicine, 2016,2(1):31-36.

4 Xiao Dangsheng, Li Shengjie, Zhu Qiuhong, et al. Energy has the same characteristics of Qi in traditional Chinese medicine. World Journal of Intergrated traditional and western Medicine, 2016,2(2):14-18.

（Accepted: August 29, 2016）

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