經方學

When I studied Chinese in Taiwan, I always recorded my classes into a little MP3 player. I found that usually I needed to listen to the recording about three times before I really heard and understood everything the teacher said.

All of Huang’s lectures in October were recorded for the same reason. There is always something that slips by in the moment of an intrusive car horn honk, or slamming hotel door, or moment of mental stutter as Chinese and English words play ping-pong with meaning across a frayed synapse.

So, the other day I caught this on the way to work

Huang: Cinnamon is the Chinese 阿斯匹林. It acts like aspirin to invigorate the blood, improve circulation and keep the heart healthy.

Simple. Effective.
And one of the few Chinese herbs that actually is tasty.

If you are a reader of The Lantern, then you perhaps have already seen this interview with Dr. Huang. If you are not a reader of The Lantern, and you are the kind of practitioner that would rather read the Classics, than sift through modern research. If you are the kind of person that prefers to noodle through the thoughts and clinical experience of seasoned doctors, instead of following the latest on how MRI’s say acupuncture works. Then The Lantern is certainly worth your time and money!In the last issue, they published this interview which came from an afternoon discussion of medicine, and in particular, the origins of his book The Ten Major Formula Families. It is a good introduction, not only to his particular style of clinical reasoning, but also touches on the history of this method of treatment.Of course, if you would actually like to sit down with Dr Huang and discuss medicine, that is also a possibility. We have just a couple more spaces left in the fall trip to Nanjing.Come join us!

It is not just that one can see more patients with a particular illness in a morning, than you might see in an entire year. Nor, is it that there is something about the busy as a bus station feel of a Chinese clinic, where patients jostle for position like horses at the starting gate.

It is not that it seems a bit odd that patients come in talking of body centered complaints like too much fire, stuffy chest feeling, or dizziness, instead of the oft heard Western psychological constructs of anxiety, depression or fatigue. And it is not that there are magic formulas that Chinese doctors use over on the Eastern side of the Western sea.

But, there is something.

A friend of mine that was recently studying for two weeks in Nanjing had this to say about her time there:

“While I’ve written all kinds of notes about formulas, herbs, tongues and their assorted coatings, what I notice is that I am just different in how I am with my patients, more directive, and without apology.”

There is something about as the Chinese say “opening your world eyes”, seeing how things are different precisely because your usual filters for how to see the world simply don’t work here. There is something about learning to navigate the Qi flow of traffic and crowds that force a completely different sense of movement and space. And then there are the ever present “why do they do it like this?” annoyances of life as it unreels in ways that bring us toe with toe with our assumptions, expectations and unspoken preferences.

Learning medicine in China comes peppered with fragrances and flavors we don’t have in the West. It can offer other views than those we have preciously cultivated. It is not always particularly pleasant, but it can be uniquely informative.
And vastly worthwhile.

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I have been fortunate in my time in Asia to have come across a number of doctors who have inspired and contributed to my journey of learning medicine. Doctor Huang has been particularly unique, as I’ve grown to know him through both his written words and the time we have spent together in his clinic, classes and discussing his book “shi da lei fang.” He is that rare combination of doctor, scholar, and teacher.

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This fall in early October we will hold in Nanjing the very first 2 week intensive for western practitioners. This course will be based on Dr. Huang’s understanding of constitutional types, formula families, and how it all comes together in the clinical setting. It will be an unusual opportunity to learn first hand how to use the classic formulas of the Shang Han Lun and Jin Gui Yao Lue to treat patients on both a constitutional and illness basis. Watch for more information here as we work out the details.

For more information, and to get on a mailing list so you can be immediately updated with the latest news on this event, send an email to: michael@classicformulas.com and prepare to deepen your own understanding of how these ancient formulas work in the modern world!

Most Westerner’s exposure to the Shang Han Lun is that is an an old book that has something to do with the common cold, and the various complications that result. We get a smattering of it in acupuncture school, but it is a book that really has nothing to do with acupuncture. It does, however, have a lot to do with herbal medicine.

I am no expert in the Shang Lan Hun, but I have been fortunate enough to have teachers and friends who are. And Dr. Huang is no slouch when it comes to this classic text of herbal medicine. In fact, he reads it not as a book about the progression of acute infectious disease, he reads it as a manual of how to use herbs to treat a wide wide range of issues.

My time in Nanjing is winding down, three weeks goes by in the blink of an eye. We share a home-cooked meal and discuss history. He loves history, and in fact, history of medicine and medical theory is what his Master’s study was about.

“War is a catalyst for medical advancement”, he says.

Of course, this is true. Plastic surgery got its start in treating the injuries of WWII, and most people are aware of the advances in prosthetics that has resulted from America’s current adventure in Iraq.

The late Han dynasty was a turmoil of war and upheaval. The usual story is that Zhang Zhong Jing, the author of the Shang Han Lun cultivated his skill because so many people were suffering the resulting effects of scarcity, injury and want. Dr. Huang agrees on this point, but his opinion has a twist.

“Those days were not so different from now, all the good stuff went to the army. The best of the food, clothing and medical care too. ZZJ, a doctor of his skill and talent was most likely an army doctor. All the good ones were.”

It is never boring around being around Dr Huang. He has bright quick eyes, iconoclastic opinions, a distaste for the status quo, and a fierce dedication to helping people get better. He is a rare voice in committee approved and sanctioned China. It is never a dull moment.

“Gui Zhi Tang (Cinnamon Twig Decoction)”, he says with a smile as he knifes through golden ginger that is on its way to becoming the soup for our lunch.
“You know, it is not just for colds and those miscellanious sweating conditions.”

Think about it this way. Imagine a soldier who has seen battle, he is beat and weary. Probably in a state of shock from the bloodshed and watching his friend’s head rolling about on the ground. Imagine exposure to the elements, days of not eating well, no real rest. He stumbles into camp, half death and starving. What do you do?

He is certainly not in a state to eat much solid food. He has lost blood and is cold and without vital energy. His spirit is disordered, anyone’s would be after this kind of experience.

Now, think about Gui Zhi Tang. Cinnamon and ginger to warm, peony to nourish the blood and calm the heart, licorice to settle the frayed nerves, and plums to build the digestion. Chase it down with a nice easy to digest bowl of rice gruel, and have a nap.

The thing about Dr. Huang is that he makes a lot of sense, even when he is talking about medicine in ways I’ve never heard or imagined.

I’m thinking Gui Zhi Tang would be the perfect thing for those people that get lost in the woods for a few days.

It is not uncommon in life that failure opens a gate that otherwise would not have appeared. I’d gone to Beijing in the fall of 2002 to study with a Shang Han Lun doctor I’d been introduced to, but my Chinese just was not yet up to the task. It took jaw grinding days to read a few paragraphs, and my listening ability was like trying to tune in a broken radio. I gave up.

About that time Craig Mitchell was in Beijing, and sympathetic to my situation he encouraged me by handing me a thin book titled The Ten Major Formula Families (十大類方 shí dà lèi fäng). Told me that this Chinese stuff takes time, keep at it, and in the meantime read this. It is kind of an Idiot’s Guide to the Shang Han Lun. It’s a fun read, and has some really interesting ideas.

It has taken a few more years for the black holes in my understanding of Chinese to generate light and understanding. He was right, it is a fun read, and there are some tremendously interesting ideas. But, it is not an quite an idiot’s guide. In fact, it is a concise, thoughtful and clinically useful text. In it, Dr Huang looks at the “jing fang” the classic formulas of the Shang Han Lun and Jin Gui Yao Lue, not from the perspective of illness patterns and disease progression, but from the point of view of herb confirmations and formula presentations. In essence, he has taken the way we usually consider practicing Chinese herbal medicine, and turned it on its ear.

As Dr Huang says:

“In my practice I look at the what. I look at what kind of person is sitting in front of me. What is the condition of their muscular, their skin, their manner and eyes. This is how I come up with what kind of constitution they have. I then look to see what kind of signs and symptoms with which they present. Instead of tying all these to some abstract concept like liver fire, spleen xu, or qi stagnation, I map them to the well known functions of herbs that have been used in China for thousands of years.”

There is a saying in Chinese that sums this up:
“By the presentation, prescribe the herbs”
(對證下藥 duì zhèng xià yào).
That is what is helpful!

I’ve been thinking for a while that I would like to see this book in English. Last fall when I was traveling in China, I tossed it in my pack as the read on the train book. One day a Chinese friend asked me why the book was interesting to me. I told her it was one of the best books I’d read in any language on prescribing herbs. One day I’d love to translate it. She gave me a funny look and asked “So, what’s stopping you?”

Uh, the author’s permission to do so?
Um! Let’s call him and see if he would like to have it read by the English speakers of the world.
Twenty minutes, and a big dose of “yuan fen” later, I was talking to Dr Huang on the phone. Thus, began the journey of the “shi da lei fang” into English.

I’m spending most of the month of April here in Nanjing, sitting in Dr Huang’s clinic, attending his classes and discussing the book. This book might be thin compared to some of the tomes that have been written about our medicine, but in fact, it is the flower of tradition of looking at “jing fang” the classic formulas, from the perspective of the “herbs being the key.”

This website is dedicated to bringing that tradition to English speaking practitioners in the West. There will be occasional excepts from the book that I think are of clinical use, portions of discussions I’ve had with Dr Huang, and my own thoughts about herb confirmations and formula presentations as they relate to our daily clinical work.
I invite your comments and discussions. And most of all, hope that this information will serve to inform your practice in ways that allow you to help more people.