The Dynamics of Shang Han Lun ④

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Sign Symptoms Are the Keys to Use Sang Han Lun Formulas

Sign Symptoms has dual characteristics: theoretical reason and practical technique.

By Jubong Kang, K.M.D.

<2> From the preface Shang Han Lun, author Zhong Jing writes that he had gathered various formulas from all over China, and quoted from six other books. These six books were important classics at his time like Shang Han Lun is an important classic in these days.

The formulas widely collected by Zhong Jing contained information on various empirical results which had been passed down from ancient times or records of experiences. These ancient practitioners had been using formulas to understand the relationship between symptoms, herbs, formulas and patterns of diseases.

From the six books, that included these widely collected formulas, quoted in the preface of Shang Han Lun, experimental studies and theoretical bases were already complied and developed even before Shang Han Lun was written.

Out of the six books, two of the books are ‘Su Wen(素問)’ and ‘Ling Shu(靈樞)’ of today’s ‘Nei Jing(內經)’, which have been passed down to us.

The other three books were lost in the transition of history and the last book has a same name as Nanjing(難經) but it tis said that the contents of the older version might have been slightly different from the current version.

Even though Nei Jing contains many important theories related to practice, the contents about sign symptom are not addressed specifically in the book. While, in the three books that were list in the transition of history, one of the book’s name implies that the book might have been about practical properties of herbs.

Therefore, essential information on practical techniques from widely gathered formulas and one of the lost books was transferred into Shang Han Lun and through Nei Jing, Nan Jing and other quoted books, theories relating to yin yang, channel theory, patterns of six channels, three burners theory had been passed down.

 

<3> In provisions of Shang Han Lun, sign symptom has dual characteristics in its function: one is a theoretical reason why we have to use formulas for a patient and the second function is a practical technique on how use a formula on a patient in a practice.

For example, in the former, if a patient has symptoms including sign symptoms, such as fever, floating pulse, slight sweating, headache, scant urination, aversion to cold, join pain, then he has ‘cold damage’ on ‘greater yang channel’; therefore, ‘Guizhi Decoction’ is selected for his treatment.

In this case, symptom and sign symptoms indicate ‘channel disease pattern’ which is a theoretical reason based on ‘Nei Jing’, in which ‘channel disease pattern’ are written in some sentences of Shang Han Lun.

The latter, sign symptoms of Guizhi Decoction indicate unique usage of this formula from other various formulas. This sign symptom used in a process of a diagnosis is practical experience based upon trial and error rather than theoretical.

In other words, sign symptom has a character of a connector between ideal theories and practical formulas in Shang Han Lun.

We can understand the different route between ideal theories and practical techniques as a process of exerting influences on Shang Han Lun. The ideal theories and practical techniques accumulated from long period of usage before Shang Han Lun were combined by a connector-sign symptom, which was found by Zhong Jing a creative idea of his.

 

(4) Example of Symptoms and ‘Sign Symptoms’ a Formula

‘Danggui Shaoyao Powder’ is one of good example of using a formula to observe symptoms and sign symptoms compared with related textual prescriptions.

 

Clause (1) When a woman was in a state of pregnancy, if there is cramp in the abdomen, then Danggui Shaoyao Powder governs.(in 『Jin Gui Yao Lue(金匱要略)』; the Essentual of Golden Cabinet-Line 20-05, translated in English fron Chinese Letter by Kang.)

Clause (2) If a woman has many kinds of illnesses with pain(in the version of 『Gui Lin Gu Ben(桂林古本)』, a version found recent days in China) in her abdomen, then Danggui Shaoyao Powder governs(.(in 『Jin Gui Yao Lue(金匱要略)』 Line 22-17)

In the first sentence, sign symptom of this formula is abdominal cram of a pregnant woman, and it means that abdominal cramps of a pregnant woman can be relieved by taking Danggui Shaoyao Powder.

The world cramp is a more severe state than abdominal hypertonicity and the following five articles will explain the process how cramp and hypertonicity can be resolves by Danggui Shaoyao Powder.