by Eric Brand

When we study Chinese medicine, we cannot help but notice that many of our teachers have a deep appreciation for the classics in Chinese medicine. Most Western students that read books like the Shang Han Lun (On Cold Damage) find them difficult to understand and difficult to incorporate into the modern clinic, yet invariably many of our teachers emphasize that these classical texts are of vital importance. Why is there such a reverence for these ancient classics?

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In most situations, practitioners look to classical texts as a pragmatic source of inspiration for solving clinical problems. Chinese medical classics don’t typically elicit faith-based reverence like ancient religious texts but they are well-respected and frequently analyzed. In general, Chinese medicine and Chinese culture have a respect for history and the wisdom of those who came before us. China’s continuity of language and culture is relatively unique in the world, and one of Chinese medicine’s greatest strengths lies in its long recorded history and the constant development of new ideas and refinement that has occurred over the centuries. While there are some people who invariably look to the early days of CM as a golden age (esp. the Han dynasty when the Nei Jing and Shang Han Lun came out), many important ideas have evolved over the long history of Chinese medicine and the number of resources available at present is more diverse that ever before. Historical texts allow us to see this development of ideas so that we can gain perspective on our modern understanding and find new (old) ways of thinking about the clinical challenges that we encounter in the modern day.

Over its long history, Chinese medicine has witnessed many new developments. For example, Li Dong-Yuan developed many important theories relating to yin fire and the importance of the spleen and stomach during the 13th century, and the formulas that he developed based on these theories have remained incredibly popular. Key traditional formulas such as Bu Zhong Yi Qi Tang (Center-Supplementing Qi-Boosting Decoction) came from Li’s pioneering new theories, and these formulas continue to be employed in many modern applications today. (For example, see this blog and this blog).

Similarly, warm disease scholars in the 18th century created innovative formulas and an entire theory based on their experience with warm disease epidemics in Southern China. They left us with Yin Qiao San (Lonicera and Forsythia Powder) and many other valuable formulas. In the modern day, warm disease theory has been used to create innovative approaches to conditions such as H1N1 and SARS, along with common contagious diseases and even complex autoimmune disorders. After the early arrival of Western medicine in the 19th century, Wang Qing-Ren developed new ideas about blood stasis that brought us formulas such as Xue Fu Zhu Yu Tang (House of Blood Stasis-Expelling Decoction).

In the modern day, Chinese medicine has experienced profound developments using both old and new approaches. There is a renaissance for traditional techniques and theory, as well as a newly emerging field of integrative medicine. In the midst of all the new developments, we still find that there is steady and profound interest in ancient classical texts such as the Shang Han Lun. Note: When we speak about classical texts in the narrow sense (vs. pre-modern texts) in Chinese medicine, it technically should refer to early books such as the Shang Han Lun, Jin Gui Yao Lue, Nei Jing, Mai Jing, etc; as I am doing in this blog, it is common to talk about later historical works as classical texts but it isn’t strictly accurate to do so.

When I lived in Taiwan, my teacher Feng Ye was a dynamic clinician with an incredible mastery of classical texts. Feng Ye was the powerhouse behind Paradigm Publications’ English version of the Shang Han Lun, and the man can literally recite many of the major Chinese classics from memory. Ask about any random quote and he will rattle off a dissertation in the idea and how it evolved. As a clinician, he truly integrated this knowledge into practice, and he remains one of the most inspirational experts that I have ever known.

Feng Ye always emphasized the importance of the classics, but I didn’t fully appreciate his words of wisdom until I started teaching formula classes at PCOM San Diego. I quickly realized that the very fabric of herbal medicine as we know it today came out of early classics like the Shang Han Lun. The simple and eloquent combinations of herbs in Shang Han Lun and Jin Gui formulas appear in dozens and dozens of derivative formulas, and many of the core actions of the herbs themselves can be traced to their applications in these key representative formulas. For example, when we say that Chai Hu courses liver qi, we are thinking back to its combinations with Bai Shao and Zhi Shi in Si Ni San, an idea that was further elaborated in later formulas like Chai Hu Shu Gan San and Xiao Yao San. When we say Chai Hu treats shaoyang disease, this action can be linked to its use with Huang Qin in Xiao Chai Hu Tang. When the modern textbook says that Chai Hu raises yang, it is because it was used in Bu Zhong Yi Qi Tang for this purpose. This logic goes on and on with most items in the materia medica.

Many classical formulas, especially those found in the Shang Han Lun and Jin Gui, are rather concise and focused. Fewer medicinals were in use back then, and subtle modifications in ingredients were used to take the therapeutic effect in different directions. The study of classical texts deepens our knowledge of Chinese medicine while also providing insight into how the body was viewed in days gone by.

However, studying classical texts is limited by one major factor- language. Even for Chinese readers, classical literature requires special study. The most important thing is commentary because the classics themselves are very terse. Multiple potential meanings are common and extensive commentary is necessary to understand the different potential interpretations and the evidence behind them. Chinese readers have a natural advantage because they have many books of commentary available. By contrast, English versions of TCM classics are relatively few in number, and only a few of them have the depth of commentary required to truly make them meaningful.

People often point to Paradigm Publication’s Shang Han Lun as the gold standard for translation of classical texts. This translation, by Feng, Mitchell, and Wiseman has Chinese, Pinyin, the English translation, and truly exceptional commentary. Ideally, classical texts should use literal translation rather than connotative translation so that the reader can see exactly what the original work said. This is then complemented by smooth, natural translation of the commentary so that the meaning can be elaborated effectively. Skipping the literal translation of the original text and going straight into interpretation makes the book no longer about what Zhang Zhong-Jing said, but rather about the interpretation of a translator who may or may not be correct about their understanding.

If we look at any other versions of the Shang Han Lun in English, it is easy to see the importance of commentary. Most other versions simply offer a straight translation and gloss over all the challenging issues and places where there are differences of opinion. Any classical text that is translated straight through without commentary and footnotes is, by nature, a poor translation. It is essential to see which parts of the text have a clear meaning and which parts have unresolved debates that have persisted for centuries. If a translator adds artificial clarity by making executive decisions about the meaning of every sentence, the reader is deprived of the entire debate, which is to say that they are deprived of the very depth that makes the classics valuable.

Seeing a classical text that lacks commentary really stands out. For example, a doctor in Taiwan named Chen Yi-Li 陳怡吏 recently plagiarized the entire Paradigm Shang Han Lun. She put the whole thing up on her website and tried to pass it off as her own. For shame, Dr. Chen, for shame. How could you possibly think that you could get away with that? At first glance, it seemed to be a good translation, which is not surprising once you realize that it is a verbatim copy of the Paradigm original, which three scholars worked on for years. But once you look closely, it is obvious that it lacks the critical commentary that makes the Paradigm version so special. For example, the discussion on Gui Zhi Tang’s contraindication for “sick drinkers” is totally lacking in depth- the controversy between different interpretations is the entire beauty of that particular section (see here for a bit more on this). It is truly a disgrace that Dr. Chen, a Canadian educated TCM doctor, thinks that she can get away with taking credit for Feng, Mitchell, and Wiseman’s work. (It is even worth a brief note in Chinese to scold her here so that all her patients see that she is a fake when they google her. 陳怡吏偷用別人翻譯的傷寒論內容, 假裝是她自己翻譯的, 這樣子真的沒有水平. 什麼樣的中醫師會這樣子搞啊?)

Fortunately, there are more and more good quality translations of major Chinese classics out there. At Blue Poppy, we carry the Paradigm Shang Han Lun, and we also have several key historical books such as the Yi Lin Gai Cuo, Mai Jing, Pi Wei Lun, Nan Jing, and the Jia Yi Jing. In particular, Bob Flaws’ version of the Pi Wei Lun is an excellent read with rich commentary. Paradigm also has published the gynecology section of the Yi Zong Jin Jian, a good book on warm disease, and they are currently finishing up the Jin Gui Yao Lue.

Beyond books published by Blue Poppy and Paradigm, Sabine Wilms did a nice version of the gynecology section of Sun Si-Miao’s Qian Jin Fang. Paul Unschuld is also apparently done with the first ever full translation of the Nei Jing, which will be a great addition to the literature. Next up I hear he is working on the Ben Cao Gang Mu. As these important titles fill in the English literature, the collection will be getting more and more complete. Sadly, there are too many classical texts in Chinese to translate them all, and these texts are a labor of love because they sell very poorly. Some books, such as Zhang Jing-Yue’s awesome Jing Yue Quan Shu, are simply too large and too unknown in the West to even think about producing them in an English version. Maybe someday we’ll have more scholars with generous university funding so that more and more of these projects can happen.

I’d like to end this blog with a great quote from Dr. Jiao Shu-De, one of the great modern masters in Chinese medicine. Jiao summarizes the controversy between camps perfectly when he says: “Those who love using classical formulas criticize physicians who use post-antique formulas, saying that they are traitors to classical orthodoxy. Similarly, those who love to use post-antique formulas disparage physicians who use classical formulas, saying that they can only follow the beaten path and that they cling to the past.”

Thanks for reading!