During the late Qing Dynasty, under the reigns of Tongzhi and Guangxu, the “Fu Yang School,” led by Zheng Qinan, also known as the “Fire God School,” gained immense popularity. They emphasized the importance of Yang Qi and adeptly utilized herbs such as Fu Zi (Aconite) and Gan Jiang (Dried Ginger) to treat severe conditions, making it one of the youngest schools in traditional Chinese medicine.
In recent years, representative works of this school, such as Yi Li Zhen Chuan, Yi Fa Yuan Tong, and Shang Han Heng Lun, have been reprinted. Additionally, other books advocating for the reinforcement of Yang, such as Fu Yang Jiang Ji, Fu Yang Forum, Jiang Fu Gui Clinical Applications, and Critical Illnesses Relying on Fu Zi, have also emerged.
Moreover, specialized studies on the Fire God School, such as Exploration of the TCM Fire God School and Comprehensive Analysis of Medical Cases from the Fire God School, have appeared, all of which are selling well. The China Association of Chinese Medicine has held two sessions of the Fu Yang Forum, which were exceptionally popular, indicating a significant revival of the Fu Yang School. An analysis based on historical context is warranted.
1. “Correcting Errors and Advancing through Twists and Turns” is a Law of TCM Historical Development
Throughout the long history of TCM, numerous schools have emerged, each influenced by the prevailing social context. “The academic propositions of various medical schools are proposed based on the social environment, medical conditions, and contemporary issues of their time,” and “academic debates have always been a driving force for the emergence of medical schools.”
During the Eastern Han Dynasty, the publication of texts such as the Huang Di Nei Jing and Shang Han Za Bing Lun laid the foundation for TCM theory and methods of diagnosis and treatment. “The division of Confucianism began in the Song Dynasty, while the division of medicine began in the Jin and Yuan Dynasties,” marking the start of sectarianism in TCM.
One reason for this was the popularity of the Tai Ping Hui Min He Ji Ju Fang, an official prescription manual from the Song Dynasty, which made it convenient for practitioners to select formulas based on symptoms, leading to widespread acceptance among both practitioners and patients. At that time, “the government upheld it as law, physicians transmitted it as their profession, and patients relied on it for their lives, becoming a societal norm.”
During the Song Dynasty, the official Ju Fang faced criticism, prompting physicians to correct its errors.
However, the once-popular Ju Fang led to two major issues: while it was convenient, practitioners often relied solely on its teachings, neglecting classical texts such as the Su Wen and Nan Jing, resulting in a decline in the quality of practice; additionally, the formulas in the Ju Fang often favored pungent and warming ingredients, leading to imbalances.
In this context, some physicians sought to correct these issues:
Liu Hejian studied the theories of Qi and pathogenesis in the Nei Jing and proposed that “all six Qi derive from fire” and “excessive emotions lead to excessive heat,” advocating for treatments that emphasized cooling.
Zhang Congzheng criticized the prevailing trend of excessive supplementation and the overuse of tonics, creating methods for sweating and purging as major therapeutic strategies.
Zhu Danxi believed that the teachings of the Ju Fang were superficial, and he traveled extensively to learn from various masters, integrating diverse approaches, emphasizing nourishing Yin, and rejecting warming and drying methods. His reputation soared, and many scholars regarded him as a mentor, relying on his methods for treatment.
Some physicians, however, misapplied the teachings of Liu and Zhu, favoring cold and cooling herbs, which harmed the stomach Qi and led to new issues. This gave rise to the Warm Supplementation School, where figures like Xue Ji advocated for the preservation of Yang Qi and emphasized the study of the Mingmen (Gate of Life). They either balanced the spleen and kidneys or focused on the interplay of water and fire at the Mingmen, forming a new diagnostic approach that emphasized the importance of the Mingmen in health.
TCM has developed through a series of corrections and advancements, and the emergence of the Fire God School is no exception: the theory of Warm Disease gradually rose to prominence during the Qing Dynasty. The Draft History of Qing states:
“In the south and north of the Yangtze River, physicians often regard cinnamon as the foundation, and for over a hundred years, many have followed this practice.”
Meanwhile, Warm Disease scholars like Ye, Xue, Wu, and Wang favored light and cooling herbs, applying the same principles to the treatment of miscellaneous diseases, leading to a new trend of using gentle and balanced prescriptions.
In this context, Zheng Qinan emphasized the importance of Yang Qi, opposed cold and cooling treatments, and favored the use of warming herbs like Jiang (Ginger), Gui (Cinnamon), and Fu (Aconite). He authored works such as Yi Li Zhen Chuan and Yi Fa Yuan Tong, advocating for his academic stance on reinforcing Yang, hoping to contribute to the field of medicine.
His school once thrived, and his disciple Lu Zhuzhi opened the “Yang Zheng Medical Hall” in Chengdu, later establishing the “Fu Yang Forum,” which attracted many followers.
So, what is the current context for the revival of the Fire God School?
Many TCM scholars have analyzed the current state of people’s constitution and diseases: with social development and improved living standards,
“What has been gained is merely material abundance, which corresponds to ‘Yin’ and has not diminished; on the contrary, the energy needed to consume this material (‘Yang’) has not increased, but rather decreased over time.”
At the same time, the fast-paced lifestyle and increased stress have led to a depletion of Yang Qi. Additionally, some clinical practitioners have deviated from TCM diagnostics, influenced by Western medical indicators, treating inflammation with heat-clearing methods, fever with cooling methods, hypertension with liver-cooling methods, and tumors with detoxifying methods, neglecting TCM diagnostics and overusing bitter and cold herbs, antibiotics, and hormones, all of which attack Yang Qi.
Professor Zhang Cunti summarized nine causes for the damage to Yang Qi:
“
1) Excessive exposure to cold;
2) The influence of Westernization in TCM;
3) The overuse of bitter and cold herbs due to Warm Disease;
4) Ignoring classical teachings and failing to differentiate Yin and Yang;
5) Overwork and fatigue damaging Yang;
6) Sexual exhaustion harming the kidneys;
7) Insufficient sleep leading to Yang Qi damage;
8) Overuse of antibiotics and hormones;
9) The prevalence of chronic diseases, with many suffering from Yang deficiency.
“
It is evident that Yin excess and Yang deficiency is a fundamental issue in contemporary diseases, and the overuse of bitter and cold herbs is a prevalent issue in the medical community, which has activated the thought of reinforcing Yang. The academic contributions of the Fire God School are indeed a beneficial supplement.
2. The Needs of the Times are the Driving Force for TCM Development
Looking back at history, every step of TCM’s development and the emergence of new schools and theories are closely related to the needs of the times. The prevalence of certain diseases and the challenges faced have created new demands for medicine, prompting people to focus on research and propose new theories.
During the late Eastern Han Dynasty, frequent wars led to the spread of infectious diseases, resulting in many deaths. Cao Zhi wrote in Shuo Yi Qi:
“Every family suffers from the pain of zombies, every household weeps in sorrow, some close their doors to avoid it, while others lose their entire families.”
Even Zhang Zhongjing was not spared,
“My clan had many members, around two hundred since the beginning of the Jian’an era, yet only a few survived, with two-thirds perishing, mostly from febrile diseases.”
In this context, responding to the needs of the times, he diligently sought ancient teachings and explored the principles of diagnosing and treating febrile diseases, culminating in the timeless masterpiece Shang Han Za Bing Lun.
Li Dongyuan, a master of the Soil Supplementation School during the Jin and Yuan Dynasties, lived in a time of turmoil, where people suffered from the hardships of displacement. Poor diet, excessive labor, and emotional distress severely damaged the spleen and stomach Qi, leading to a depletion of Yuan Qi. He recognized that “internal damage to the spleen and stomach leads to the emergence of numerous diseases,” thus establishing theories based on the spleen and stomach, emphasizing soil supplementation, and creating a series of formulas to support the Soil Supplementation School.
Zhu Danxi lived during a time of peace, where people indulged in rich foods and desires, compounded by the prevailing medical practices of the Ju Fang that favored warming and drying herbs. Residing in the humid and hot region of Jiangnan, he established theories based on “excess Yang and insufficient Yin,” warning people to cherish the precious “Yin essence” of the human body.
During the Ming and Qing Dynasties, the prevalence of Warm Epidemics led to the continued use of febrile disease methods to treat Warm Diseases, resulting in confusion and misdiagnosis. Throughout history, many have explored treatments, but none have systematically perfected them, leading to chaotic practices where “mild cases were treated as severe, and severe cases resulted in death,” leaving people in a state of confusion. Observant and thoughtful individuals, such as Wu Youke, proposed new diagnostic approaches based on mixed Qi, while Ye Tian Shi and Wu Ju Tong introduced new ideas for diagnosing Warm Diseases, forming the theory of Warm Diseases, leading many physicians to abandon darkness for light, all recognizing the need for change.
Since the founding of the People’s Republic of China, TCM has entered an era of academic education, with standardized textbooks for TCM education. The curriculum is a mix of Chinese and Western medicine, with public courses consuming significant time. In five years of study, the total hours for TCM courses are less than two thousand, equivalent to just one year of traditional TCM education.
Many teachers are skilled in teaching but lack clinical experience, resulting in a situation where “half of the teaching is ineffective.” Over the decades, many have been trained, but the foundation of TCM has weakened. While educational qualifications have risen, many master’s and doctoral candidates spend considerable time engaged in experimental research unrelated to clinical practice, leading to advanced experimental methods but a clinical level that does not match their qualifications. TCM education has presented an abnormal phenomenon of “many students, high qualifications, weak foundations, and bland efficacy.”
This has resulted in many TCM practitioners revering Western medical theories and clinical efficacy, adopting a clinical thinking model based entirely on Western medicine. Prescriptions are influenced by Western medical indicators, leading to a singular approach and bland efficacy. Over time, TCM has been relegated to treating chronic diseases or providing adjunctive care, while critical and acute conditions are handed over to Western medicine. TCM faces severe issues of “alienation,” “degradation,” and “Westernization,” with clinical practices regressing.
During this historical low point, outsiders have claimed to “abolish TCM,” while insiders have contemplated the future of TCM, recognizing the risks of deviating from its roots. The National Administration of Traditional Chinese Medicine has begun to adjust policies, strengthening inheritance, and has initiated programs such as “Master-Apprentice” training nationwide. The China Association of Chinese Medicine has organized reading activities such as “Reading TCM Classics, Learning from TCM Masterpieces,” where twelve renowned TCM experts have encouraged young practitioners:
“Classics are the ‘roots’ of TCM, the theories of various schools are the ‘foundation,’ and clinical efficacy is the lifeline of TCM.”
Mr. Qiu Peiran has long stated:
“The modernization of TCM must first understand the countless contributions of great physicians and philosophers over thousands of years; only on this foundation can we discuss the modernization of TCM.”
In summary, there is a consensus among renowned figures that TCM should return to its own developmental path, using its own principles to analyze contemporary constitutions and treat current diseases, seeking effective methods. Observant individuals are striving to overcome numerous challenges, focusing on warming treatments, achieving good results, and advocating for the revival of “warming Yang” thought.
It is evident that TCM is currently experiencing a period of “alienation,” “degradation,” and “Westernization,” with bland efficacy. The thought of reinforcing Yang is an advanced approach for TCM to return to its own development, using traditional theories to address contemporary diseases and improve efficacy.
3. Historical Development Often Exhibits a Tendency for Over-Correction
Looking back at history, it is evident that physicians throughout the ages have often emphasized the importance of certain formulas or sought to correct errors, warning the public, which sometimes led to extreme statements. However, in clinical practice, the principle of differentiation and treatment remains paramount. It is not the case that Liu’s school solely advocates cold treatments, Zhang’s school exclusively employs purging methods, Danxi only focuses on nourishing Yin, or Zheng’s school solely emphasizes reinforcing Yang.
In Liu Hejian’s Xuan Ming Lun Fang, of approximately 350 formulas, only 39 are cold, while 44 are warming; the rest are either balanced or use both cold and warm herbs. Zhu Danxi, while advocating for nourishing Yin, did not limit himself to this aspect; he integrated the essence of contemporary medicine and excelled in treating miscellaneous diseases, leading to the saying, “Zhu Danxi is the master of miscellaneous diseases.” As Li Zhongzi stated:
“Did Zi He not have successful experiences with tonics? Did Li Zhai not achieve results without purging? However, their writings may not reflect this.”
Those who do not understand the teachings may miss the essence and merely imitate without understanding.
Although Zheng Qinan is regarded as the founder of the Fire God School, he strongly advocated for the fundamental principle of differentiation and treatment:
“The choice of herbs is a matter of life and death. One should not rigidly adhere to formulas or herbs; what matters is the evidence of efficacy.”
In summary, whether using Jiang or Fu, one must consider the condition, balance Yin and Yang, observe the patient’s complexion, and apply cooling or warming as needed, without being overly rigid about Jiang and Fu. Thus, it is clear that Zheng did not abandon differentiation, nor did he solely advocate for reinforcing Yang. Moreover, Fu Zi is indeed a potent but toxic herb, as Wei Tieqiao stated:
“The most useful yet most difficult herb to use is Fu Zi.”
We should learn from history and avoid repeating the mistakes of over-correction, which could lead to a new trend of “using warming supplements as fashionable and judging heroes by the dosage of Fu Zi,” which would seriously deviate from the original intent of the Fu Yang School.
4. Classics are the Common Foundation of All Schools
Throughout history, the theories of various schools were not created in a vacuum; they were based on a deep understanding of the classics and the teachings of various schools, combined with the social context of their time, embodying the principle of “diligently seeking ancient teachings and broadly learning from various sources.” The “ancient teachings” refer to the classics, while the “various sources” refer to the teachings of different schools, all of which are rooted in profound cultural cultivation.
For example, Liu Wansu emphasized the theories of the Nei Jing and conducted in-depth research on the theories of the Five Movements and Six Qi, elaborating on the diseases caused by heat, thus establishing new theories, embodying the saying, “A lifetime of dedication leads to profound understanding.” Figures like Zhang Yuan Su, Li Dongyuan, Zhu Danxi, Zhang Jingyue, and Ye Tian Shi all followed this path.
The Fire God School is no exception; its founder, Zheng Qinan, studied under the renowned Confucian Liu Zhitang in his early years,
“Tracing back to the Yijing and Nei Jing, gaining insights from the heart of the Shang Han, and reviewing the writings of various physicians to integrate their strengths,”
thus establishing a solid theoretical foundation, combining the social context of his time and his clinical experience, gradually forming his academic characteristics.
Overall, the Fire God School is derived from the Shang Han School, absorbing the essence of the Warm Supplementation School, and developing into an independent academic school through years of practice.
Since every school is not built in isolation, we should not seek shortcuts by abandoning the source of the classics and rushing into a particular school. When learning the Fire God School, if one does not seek the path of the Nei Jing and Nan Jing classics but merely imitates the techniques of reinforcing Yang, it simplifies the Fire God School and prevents one from grasping its essence.
As the ancients advised, “A physician must master the classics;” the “three generations” refer to the classical texts that must be mastered in medical education. Professor Zhang Cunti stated, “To learn the Fire God School well, one must have a foundation in the Shang Han School.” Although TCM is facing challenges, we should not be impatient but rather refine our internal skills, establish a solid foundation in the classics, and learn from various sources to achieve excellence.
In summary, the Fire God School is not the ultimate development of TCM; society is changing, and new issues are emerging. Only by thoroughly exploring the roots and learning from various sources can we adapt to endless changes and become progressive physicians. In this way, TCM can maintain its charm and continue to benefit humanity!
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