丁毅1，傅延龄2
Analysis of the Reasons for the Popularity of Powdered Medicinal Formulas in the Song Dynasty
The popularity of powdered medicinal formulas in the Song Dynasty has historical roots and social backgrounds. Firstly, it is related to certain medical activities in the early Song Dynasty. In the sixth year of the Kaibao era (973 AD), Emperor Taizu of Song ordered the imperial physician Liu Han, Daoist priest Ma Zhi, and Hanlin medical official Qu Xu, among others, to compile the “Kaibao New Detailed Materia Medica” based on references such as “Bencao Shiyi” and “Xinxiu Bencao”. The following year (974 AD), they were commanded to revise it, and it was finally named “Kaibao Revised Materia Medica”. Secondly, in the seventh year of the Taiping Xingguo era (982 AD), Emperor Taizong of Song ordered Daoist priests Wang Huaiyin, Wang You, Zheng Qi, and Chen Zhaoyu to compile a large medical formula book titled “Taiping Shenghui Fang”, which was prefaced by the work “Zhubing Yuanhou Lun” by the famous physician Chao Yuanfang from the Sui Dynasty, followed by various formulas. These medical activities prominently featured Daoist practitioners. Furthermore, in the preface of “Taiping Shenghui Fang”, Emperor Taizong mentioned, “In my past, I sought to collect famous formulas, and I obtained the essentials of various techniques, gathering over a thousand miraculous formulas, all of which were personally verified, and there are standards. The value lies in saving the people and alleviating their suffering, and I have also relied on the Hanlin medical officials to gather effective prescriptions from family traditions, totaling over ten thousand.” This indicates that “Taiping Shenghui Fang” contains miraculous and verified formulas personally collected by Emperor Taizong, who must have had an understanding of the efficacy and distinctions of various medicinal formulas.
Daoism and Powdered Medicinal Formulas
Since ancient times, China has had the concept of the “Four Occupations”, which are scholars, farmers, artisans, and merchants, representing a basic classification of civilian professions, though their order has varied throughout history. The famous scholar Gu Yanwu from the late Ming and early Qing dynasties stated in his “Rizhi Lu”: “The four occupations of scholars, farmers, artisans, and merchants originated from Guan Zi”, referring to the order established by Guan Zhong, the chancellor of the Qi state during the Spring and Autumn period, which has been used ever since. The text of “Guan Zi” records: “The four occupations are the foundation of the state and the people.” By the Song Dynasty, this concept expanded to the “Six Occupations”, which included soldiers and religious practitioners (Buddhists and Daoists) as special types of “people”. The famous politician Fan Zhongyan of the Northern Song mentioned in his “Collected Works of Fan Wenzheng” that “In ancient times, there were four occupations, and under the Qin and Han, there were six, including soldiers and religious practitioners.” This understanding reflects that Daoists and Buddhists had become subjects under the secular rulers of the Song Dynasty. To some extent, practitioners of Daoism and Buddhism had become a common profession.
Daoism is a native religion of China, defined by the highest belief in the “Dao”. The establishment of Daoism is based on ancient concepts of ghost and deity worship, with the philosophical foundation of Huang-Lao Daoism, inheriting the alchemical practices that evolved since the Warring States period. The “Book of Wei: On the Teachings of Laozi” states, “The origin of Daoism comes from Laozi.” The famous thinker and founder of Daoism, Laozi, wrote the “Dao De Jing” at the request of Yin Xi at Hangu Pass. Another representative figure of Daoism, Zhuangzi, authored the book “Zhuangzi”. These two works are regarded as essential classics to be recited by later generations of Daoists, indicating that Daoism evolved from Daoist philosophy.
The early formation of Daoism occurred during the Western Han period, primarily developing among the people. After nearly a thousand years of development through the Han, Wei, Jin, Southern and Northern Dynasties, Daoism underwent transformation and enrichment, gaining good promotion and popularity among the populace and the gentry. The Sui Dynasty marked a turning point in the development of Daoism, which reached its peak during the Tang Dynasty. Although various feudal rulers continued to believe in and support Daoism from the late Tang to the early Song, it was generally in a period of decline.
The rulers of the Northern Song inherited the policies of the previous dynasties that emphasized Confucianism, Daoism, and Buddhism, and supported Daoism. The initiators of this trend were Emperor Taizu and Emperor Taizong of Song. Before becoming emperor, Zhao Kuangyin (Emperor Taizu) had close interactions with Daoists and utilized talismans to create public opinion for seizing power when he overthrew the Later Zhou regime. After becoming emperor, he continued to pay great attention to the development of Daoism. Emperor Taizong not only inherited and implemented Emperor Taizu’s policies towards Daoism but also showed even greater reverence for Daoism than his elder brother.
With the exemplary role of the two emperors in the early Song, Daoism became widely popular in society. By the end of Emperor Renzong’s reign, the Northern Song’s Five Masters, led by Sima Guang, and the Shu School led by Su Dongpo, as well as Wang Anshi’s Jinggong New Learning, all exhibited Daoist thought to varying degrees. For instance, Zhou Dunyi’s “Taiji Diagram”, Shao Yong’s “Meihua Yishu” and “Huangji Jingshi Shu”, and Cheng Yi’s “Yichuan Yizhuan” all reflected the influence of Daoist Chen Tuan’s “Xiantian Tu”.
The Huang-Lao school, in addition to practicing internal and external alchemy, also provided medical guarantees for achieving immortality and improving quality of life. Therefore, the study and application of medicine became inevitable. The “Baopuzi: Inner Chapters” states: “In ancient times, those who sought the Dao all practiced medicine.” Chen Yingning also mentioned in “Detailed Discussion on Immortal Studies” that the relationship between medical and immortal paths is very close; anyone who studies Daoist techniques knows medicine. Ge Hong’s “Records of Immortals” documents 84 immortals, 14 of whom are related to medicine. The “Huangdi Neijing”, “Shennong Bencao Jing”, and “Nanjing” are all related to Daoist thought and were likely compiled and organized by Daoists. Additionally, historical records mention figures such as Ge Hong from the Jin Dynasty, Tao Hongjing from the Southern Dynasty, Xu Jian from the Northern Dynasty, Yang Shangshan and Sun Simiao from the Sui and Tang Dynasties, and Wang Huaiyin from the Song Dynasty, all of whom were Daoist physicians who made significant contributions to the development of medicine.
We believe that powdered formulas evolved from elixirs. Elixirs have a history of thousands of years in China, with records in the “Rites of Zhou” stating, “For treating sores, use the five poisons to attack them.” Han Dynasty scholar Zheng Xuan commented: “The five poisons are the toxic substances among the five medicines. Nowadays, there are five poisonous medicines made from them, combining yellow centipede, stone gall, cinnabar, realgar, and alum, burned for three days and nights, with the smoke collected using chicken feathers to apply to the wound, which eliminates rotten flesh and decayed bones.” This shows that the “five poisons” are the earliest documented elixirs. Later texts such as “Huainanzi” and “Shennong Bencao Jing” also contain some materials related to alchemy. The famous alchemist Wei Boyang (100-170 AD) authored the “Zhouyi Cantong Qi”, which is the earliest existing work on alchemy in the world. Historically famous elixirs like Hongsheng Dan and Baijiang Dan were made by turning medicines into powders.
The most famous and influential powdered formula in history is Wushi San, also known as Hanshi San. The “Baopuzi: Golden Elixir Chapter” records its composition as “cinnabar, realgar, white alum, zengqing, and cishi”. The “Guisi Cangao” states: “The ‘Cold Food Powder’ is said to have originated with He Yan. It is also said to be made from refining milk and vermilion, which can avoid fire food, hence called ‘Cold Food’. According to the cold food prescription, the food should be cool, and clothing should be thin, only slightly warm wine is allowed; it is not fire food. The method is from Han Zhang Ji’s ‘Jin Kui Yao Lue’.” In the Sui Dynasty, Chao Yuanfang quoted the famous physician Huangfu Mi from the Jin Dynasty, stating, “Cold food and herbal stone formulas come from Zhongjing.” The “Shishuo Xinyu: Yanyu Pian” states: “He Pingshu: Taking Wushi San not only treats diseases but also makes the spirit clear.” The use of Wushi San peaked among the gentry during the Jin and Wei dynasties. Lu Xun specifically discussed this in “The Wei-Jin Style and the Relationship Between Literature, Medicine, and Wine”, believing that the attire and lifestyle of Wei-Jin literati were related to the use of Wushi San.
In fact, there are records of Wushi San in the “Records of the Grand Historian: The Biography of Bian Que and Cang Gong”. The doctor of the King of Qi, due to his own illness, “refined Wushi San and took it”, and Chunyu Yi diagnosed him, telling him, “You have internal heat. It is said that ‘internal heat without urination cannot take Wushi San’. The essence of the stone is potent; if you take it, you will not urinate for a while, so do not take it. The color will become swollen.” He analyzed, “What you said is far from the truth. Although Bian Que said this, he must have examined and measured, established rules, weighed, and matched colors and pulses. There are methods for excess and deficiency, and the person’s movements and breathing must correspond to the diagnosis. It is said that ‘yang diseases are internal, and yin forms respond externally; do not add potent medicines and stones.'” This indicates that the use of Wushi San may have existed as early as the pre-Qin and Western Han periods, and the self-medication of physicians gradually became a common health product for gentry literati during the flourishing of metaphysics in the Wei and Jin periods. Additionally, the contemporary famous bibliographer and ancient literature scholar Yu Jiaxi also authored “A Study on Hanshi San”, providing in-depth analysis of the background, historical trajectory, treated diseases, causes of diseases, symptoms after taking it, and methods of moderation, concluding that “the formula originated from Zhang Ji, but it is unknown how the Wei and Jin people took it, as it has undergone many modifications, no longer the old formula of Zhongjing.”
Another famous powdered formula is the anesthetic used in surgical operations, known as Mafeisan. The “Records of the Three Kingdoms: Biography of Hua Tuo” states: “For those who need to be cut open, they should take Mafeisan with wine, and in a moment, they will be as if drunk and unaware, allowing for surgery. The pain in the abdomen can be cut, washed, and sewn, and within four or five days, it will be fine, and the person will not awaken, and within a month, they will recover.” The inventor of Mafeisan, Hua Tuo, was also a Daoist believer, and the “Book of the Later Han: Biography of Hua Tuo” describes him as “nearly a hundred years old, yet still robust, and people regarded him as an immortal”; the “Records of the Three Kingdoms: Wei Book: On Techniques” also states, “He understood the techniques of nurturing life, and people regarded him as a hundred years old, yet with a youthful appearance.”
Perhaps the earliest powdered formula was the Bingyu San taken by Chisongzi, but the clinical application of powdered formulas has indeed existed for thousands of years. The “Fifty-Two Disease Formulas” discovered in the Mawangdui Han tomb in Changsha in 1973, dating back to the end of the 3rd century BC, is currently the earliest known formula book in China, which contains powdered formulas. Powdered formulas are the most numerous dosage forms in this book, but unfortunately, they are not named as such, such as “One formula: crushed peony, half a cup, take a three-finger pinch to drink.” The classical medical text “Huangdi Neijing”, dating back to the Spring and Autumn and Warring States periods, also records powdered formulas, such as in the “Suwen: On Disease Capabilities”, which states: “If there is a disease with body heat and sweating like a bath, with aversion to wind and shortness of breath, what disease is this? Qibo said: The disease is called ‘wine wind’. The Emperor asked: How to treat it? Qibo said: Use Ze Xie and Bai Zhu (White Atractylodes) each ten parts, and Mi Xian (Milled Rice) five parts, combine and take three-finger pinches as a meal.” In the late Eastern Han, Zhang Zhongjing’s “Shanghan Zabing Lun” contains many powdered formulas and was the first to propose the name “San”, such as Wuling San, Sini San, Guati San, Muli Zexie San, Danggui Chixiaodou San, and Danggui Shaoyao San, all of which are still in clinical use today. Subsequently, more powdered formulas appeared in Daoist-related medical texts, such as the first clinical emergency manual “Zhouhou Beiji Fang” compiled by the famous physician, alchemist, and Daoist Ge Hong from the Jin Dynasty, and the earliest existing surgical monograph on abscesses and traumatic injuries, “Liu Juanzi Gui Yi Fang” (also known as “Shenxian Yi Lun”), which contains a large number of powdered formulas.
Additionally, powdered formulas are also related to Daoist dietary practices, as practitioners must emphasize the consumption of herbal and mineral medicines to seek longevity. Besides the commonly understood elixirs made from minerals, there are also herbal medicines. The “Shennong Bencao Jing” records a total of 365 medicinal substances, divided into superior, middle, and inferior categories, stating: “Those who consume herbs are strong and vigorous, those who consume meat are brave and light in illness, those who consume grains are wise and clever, those who consume stones are plump and do not age, those who consume mushrooms prolong life, and those who consume primordial qi cannot be buried by the earth or killed by heaven. Therefore, consuming good medicines is in harmony with heaven, and the sun and moon guide them, and they will not perish on earth.” Among them, the so-called “mineral medicines” require “refining and consuming them.” Ge Hong quoted from the “Four Classics of Shennong”, stating: “Superior medicines make the body safe and prolong life, ascending to become celestial beings.” In the “Baopuzi: Volume on Immortal Medicines”, it records: “Asparagus… can be steamed and cooked in the mountains, and if taken for a long time, it can stop grains. If there is strength, it can be made into powder, and its juice can be made into wine, and taking the powder is especially good.”
The large Daoist book “Yunji Qiqian”, compiled by Zhang Junfang, includes all ancient Daoist texts before the Song Dynasty, and it records: “Just take this leaf, either pound it into powder or make it into honey pills, and taking it will lead to immortality”; “… taking pills and powders should be done with caution”; “There are methods for refining, and it must be fine; otherwise, it will harm the intestines and cause exhaustion, and for pills and powders, it must be properly pounded and sifted, which is especially important”; “The nature also prefers to consume pills, and there are those who throw in elixirs and give pills and powders.” In the “Fangyao Section”, many formulas can be both powders and pills, such as “Huangdi’s Four Fan Powder: pine resin, Ze Xie, dried ginger, dried Rehmannia, mica, cinnamon heart, Bai Zhu, and Shishang Changpu, these eight ingredients, finely processed, make equal parts, and pound them with forty thousand pestles… in the morning, take three spoonfuls with wine, or with water, or make honey pills the size of soybeans, twenty to thirty pills…” Sun Simiao also recorded in “Beiji Qianjin Yaofang: Nurturing Life” that “It is said that in spring, one should take five doses of the small longevity soup, and one dose of various nourishing powders; in summer, during the heat, take three doses of kidney essence soup; in autumn, take yellow pills.” This indicates that not only pills, pastes, and elixirs, but also most powders are related to Daoist practices.
Moreover, the earliest records of “boiled powders” are also related to Daoists. One is in the “Zhouhou Beiji Fang”, which records in the “Volume Two: Treating Pestilence, Epidemics, and Warm Toxins” that “to avoid epidemic diseases, use powdered medicines… if the illness has lasted four or five days, boil three liters of water, boil the powder, and take one liter to induce sweating.” The other is Sun Simiao’s “Beiji Qianjin Yaofang”, which contains eleven instances of “boiled powders” including Dan Shen and Niu Xi boiled powder, Dan Shen boiled powder, and Anxin boiled powder. However, the application of boiled powders can be traced back to Zhang Zhongjing’s “Shanghan Zabing Lun”. Although it does not mention “boiled powders” by name, it includes practical applications, including both taking the residue and taking it with the residue. The popularity of boiled powders, according to existing historical materials, began in the late Tang and Five Dynasties, peaked in the Song Dynasty, and declined in the Ming and Qing Dynasties. We believe that “powdered formulas” and “boiled powders” are not fundamentally different, merely differing in preparation methods.
It can be seen that with the rise of external alchemy in the early Tang to its decline in the late Tang, certain consumption methods and formulas were absorbed and refined by physicians, which may be one of the reasons for the popularity of powdered formulas in the Song Dynasty.
The Early Song Emperors and Powdered Formulas
Of course, it would be difficult for Daoists alone to promote the widespread use of powdered formulas in the Song Dynasty; the promotion of powdered formulas also benefited from the emperors’ endorsement. The “Song History” records that the founding emperor Zhao Kuangyin and his brother Zhao Kuangyi were born into a military family, and both spent the first half of their lives in military careers, but they both had knowledge of medicine. Such a unique profession and experience inevitably made their understanding and handling of medicine different from ordinary people.
According to historical records, the capital of the Northern Song, Kaifeng, once faced a shortage of medical supplies. The “Song Huiyao Jikao: Zhi Gong” records, “In the eighth year of the Yuanyou era (1093 AD), on April 26, an edict stated: It has been reported that recently, military and civilian personnel in the capital have difficulty obtaining medical supplies, and the Kaifeng government should investigate. If there are many patients, they can be assigned to the Taiyi Bureau to select doctors, and they will be sent to military camps and neighborhoods for diagnosis and treatment. The government will provide the necessary medicines and daily allowances, and if the number of patients decreases, they will be dismissed.” In the first year of Shaoxing (1131 AD), on November 12, the Taiyi Bureau’s chief physician Fan Yanduan reported: Recently, nine students from the capital have come to the Taiyi Bureau, requesting to be appointed to the bureau, following the old practices of their ancestors, specifically treating the palace guards and various military units, and in case of urgent illnesses, they will establish rules for diagnosis and treatment. This was approved.” In the second year of Chongning (1103 AD), a discussion in the council mentioned this matter, stating that “it is very beneficial, but it has not yet been implemented nationwide. The continuation of this matter”. This indicates that this was limited to the capital and not implemented nationwide.
Given the difficulties in promoting administrative orders under the Song government, it is even more challenging considering the century between the late Tang and early Song, with military governors in control, and the rapid succession of five dynasties and thirteen monarchs in a short period. Ouyang Xiu lamented in the “New History of the Five Dynasties”, stating, “During the Five Dynasties, the rise and fall of nations depended on military power”; “At this time, the world was in chaos, and the disasters of China were frequent, with usurpation and assassination occurring one after another.” Even by the early Northern Song, regimes such as Later Shu, Southern Tang, and Wuyue still existed. The prolonged warlord conflicts caused significant destruction to the productivity of the time, leading to widespread suffering and hardship among the people. Feudal monarchs relied on military power to gain authority, and they paid little attention to medical work and the health of soldiers, while being extremely meticulous about court medicine, employing specialized personnel such as “imperial physicians”. The Tang Dynasty military physician Cui Zhiti described the reason for writing his book, stating, “I have been studying the classics and history, and have also delved into medicine. Now I have selected various formulas and combined my thoughts; if they are not essential, how could I record them? I have written this book in a lonely city, empty of the four wonders, seeking medicine and the Dao, and finding many doubts. How could I sit and wait for death? This book is based on my experiences and is not meant for future generations, but I believe it will be important, and I do not hide it.” This also reflects the cruelty and destructiveness of war, as well as the harsh living conditions in border areas, with poor transportation and low quality of life, leading to a shortage of medicines in the military.
How to effectively manage limited medical supplies in the military not only relates to the lives of soldiers but also to the stability of military power for commanders. The ancient military book “Taibai Yinjing”, written by Li Quan, the military governor of Hedong, provides some insight. In the “Taibai Yinjing: On Medicinal Types”, 20 formulas are listed, with 15 being powdered formulas, indicating that powdered formulas were widely used in the military. For example, “For treating seasonal heat diseases: twenty pieces of gardenia, five taels of dried ginger, two taels of Artemisia, five taels of Radix Isatidis, five taels of rhubarb, and five taels of Glauber’s salt. These six ingredients should be ground into powder, mixed with rice juice, and taken on an empty stomach, three qian per dose; if it does not work, warm porridge should be given, and if it works too much, stop with thin water; yin and yang poisons cannot be taken. For treating red spots and sores: twenty pieces of gardenia, three taels of Huai Mu, two taels of Huang Qin, and five taels of Glauber’s salt. Grind these into fine powder, mix with food and drink, and take three qian per dose, adjusting according to the effect.”
According to the statistics of formulas cited in “Wai Tai Mi Yao” compiled by Wang Tao, Cui Zhiti’s formulas also include many soups, pills, and powdered formulas, with powdered formulas making up a significant portion. It can be seen that processing medicines into powdered formulas in the military may be the most cost-effective method, as they are easy to store, transport, and consume. Thus, it is evident that the military careers of Emperor Taizu and Emperor Gaozong, along with their understanding of military medical care, led to the recognition and promotion of powdered formulas.
Conclusion
Before the Song Dynasty, the four most frequently recorded dosage forms in the top 21 medical texts were powders, soups, pills, and pastes, with powdered formulas appearing in all 21 texts, soups and pills appearing in 20 texts, and pastes in 18 texts. This indicates that powdered formulas were already widely used in clinical practice before the Song Dynasty, and their use became even more widespread and popular during the Song Dynasty.
Additionally, it is essential to mention the role of Buddhism in promoting and facilitating powdered formulas. For instance, the stone-carved prescriptions in the Longmen Grottoes predominantly feature powdered formulas, and their methods of use reflect the characteristics of folk medicine at that time. Furthermore, the Daoist priest Lin Daozhen from the Tang Dynasty authored the “Secret Formulas for Healing Wounds and Rejoining Limbs”, which contains 46 formulas, 15 of which are powdered formulas. All of these have had a profound impact on the later application of powdered formulas.
In summary, the powdered formulas invented and created by Daoists gradually entered the field of medicine as Daoism spread among the populace and the gentry, with their simplicity, convenience, and affordability deeply ingrained in people’s hearts. Coupled with the exemplary role and promotion by the emperors of the Song Dynasty, the application of powdered formulas reached its peak during this period.
This article is sourced from the “Chinese Medicine Journal”, 2014, 55 (11)
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