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 effectively 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 “Complete Analysis of Medical Cases from the Fire God School”, have also appeared, all of which have been well-received. The China Association of Chinese Medicine has held two Fu Yang Forums, 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 Difficulties” is a Law of TCM Historical Development
Throughout the long history of TCM, numerous schools have emerged, each arising from its historical context. “The academic propositions of each medical school are 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 “Huangdi Neijing” 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 sectarian divisions in TCM.
The reasons for this can be partially attributed to the popularity of the “Taiping Huimin Heji Ju Fang”, an official prescription manual issued during the Song Dynasty. This book provided convenient guidelines for herbal preparation, leading practitioners to easily select prescriptions based on symptoms, which was widely welcomed by both physicians and patients. In a short time, it became a norm for practitioners to rely on it for their practice.
During the Song Dynasty, the official prescription manual caused two major issues: while it was convenient, it led practitioners to avoid deeper learning, favoring the manual’s teachings over classical texts like the “Su Wen” and “Nan Jing”, resulting in a decline in the quality of practice. Additionally, the manual often favored pungent and warming herbs, leading to a bias in treatment.
In this context, some practitioners sought to correct these errors:
Liu Hejian studied the theories of Qi and pathogenesis in the “Neijing”, proposing that “all six Qi derive from fire” and that “excessive emotions lead to excessive heat”. He advocated for the use of cooling treatments based on his theories of heat.
Zhang Congzheng criticized the prevailing trend of excessive supplementation and the overuse of tonics, creating methods for sweating and purging to treat diseases effectively.
Zhu Danxi believed that the teachings of the prescription manual were superficial, and he sought knowledge from various masters, integrating the strengths of different schools, advocating for nourishing Yin and rejecting warming and drying treatments. His reputation soared, and many scholars regarded him as a mentor.
Some practitioners, however, did not grasp the teachings of Liu and Zhu, leaning too heavily on cooling herbs, which harmed the stomach Qi and led to new issues. This gave rise to the Warm Supplementation School, with practitioners like Xue Ji advocating for the maintenance of Yang Qi and emphasizing the study of the Mingmen (Gate of Life). They either balanced the Spleen and Kidney or focused on the interplay of water and fire in 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, as noted in the “Draft History of Qing”:
“In the south and north of the Yangtze River, practitioners often regard Gui (Cinnamon) as the foundation, and for over a hundred years, many have followed this approach.”
Practitioners like Ye, Xue, Wu, and Wang favored cooling and light herbs, applying the same principles in treating both warm diseases and miscellaneous ailments, leading to a new trend of using gentle and stable prescriptions.
In this context, Zheng Qinan emphasized the importance of Yang Qi, opposing cooling treatments and bland prescriptions, and advocated for 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”, promoting his academic views on reinforcing Yang, hoping to contribute to the field of medicine.
His school once thrived, and his disciple Lu Zhizhi opened the “Yang Zheng Medical Center” in Chengdu, later establishing the “Fu Yang Forum”, which attracted many followers.
What is the current context of the revival of the Fire God School?
Many TCM scholars have analyzed the basic state of people’s constitution and diseases today: with social development and improved living standards,
“What has been gained is merely material abundance, which represents ‘Yin’, while the energy needed to utilize 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 practitioners have deviated from TCM diagnostics, influenced by Western medical indicators, treating inflammation with cooling herbs, fever with cooling blood-clearing herbs, hypertension with liver-cooling herbs, and tumors with detoxifying herbs, 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 misuse of bitter and cold herbs due to the influence of warm diseases;
4) Ignoring classical teachings and failing to differentiate Yin and Yang;
5) Overwork and stress damaging Yang;
6) Sexual exhaustion harming the kidneys;
7) Insufficient sleep leading to Yang Qi damage;
8) Misuse 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 problem 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 external diseases, resulting in many deaths. Cao Zhi, in his “Discussion on Epidemic Qi”, stated:
“Every family suffers from the pain of corpses, every household weeps in sorrow, some close their doors to avoid infection, while others lose their entire families.”
Even Zhang Zhongjing’s family was not spared,
“My clan had many members, around two hundred since the Jian’an era, yet only a third survived, with seven out of ten dying from typhoid fever.”
It was in this context that, responding to the needs of the times, he diligently sought ancient teachings and explored the principles of diagnosing and treating typhoid fever, culminating in the timeless masterpiece “Shang Han Za Bing Lun”.
Li Dongyuan, a master of the Earth Supplementation School, lived during a time of turmoil in the Central Plains, where people suffered from a life of hardship, leading to irregular diets, excessive labor, and emotional distress, severely damaging the Spleen and Stomach Qi, and consequently harming the 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 Earth supplementation, and creating a series of Spleen-regulating formulas, founding the Earth Supplementation School.
Zhu Danxi lived during a time of peace, where people indulged in rich foods and desires, combined with the prevailing medical trend of using warming and drying herbs from the prescription manual, and being 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 typhoid treatment methods for warm diseases, resulting in confusion and misdiagnosis. Throughout history, many have explored treatments, but none have been systematically perfected, leading to a lack of guidelines for practitioners, resulting in “light cases treated heavily and severe cases leading to death”, leaving people in a state of confusion. Observant and thoughtful individuals, such as Wu Youke, proposed new diagnostic approaches for warm diseases, leading to the development of warm disease theory, with many practitioners abandoning 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, where courses are a mix of Chinese and Western medicine, consuming much energy. In five years of study, the total hours of TCM courses are less than two thousand, equivalent to only one year of traditional TCM study.
Many teachers are skilled in teaching but lack clinical experience, leading to a situation where “half of the teachers are mute”. Over the decades, many have been trained, but the foundation of TCM has weakened. While educational levels have risen, many master’s and doctoral graduates spend significant time on experimental research unrelated to clinical practice, leading to advanced experimental methods but a clinical level that does not match their education, resulting in an abnormal phenomenon in TCM education characterized by “many students, high degrees, weak foundations, and bland efficacy”.
This has resulted in many TCM practitioners “worshiping 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 only chronic diseases or providing auxiliary treatment, while critical and acute conditions are handed over to Western medicine. TCM faces a severe phenomenon of “alienation” and “degradation” of talent and thought, with clinical practice regressing.
During this historical low point for TCM, outsiders claim to “abolish TCM”, while insiders ponder the future of TCM, realizing the risks of deviating from its roots. The National Administration of Traditional Chinese Medicine has begun to adjust policies, strengthening inheritance, and promoting initiatives such as “famous doctors mentoring apprentices”. The China Association of Chinese Medicine has organized reading activities such as “Reading TCM Classics, Learning 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 sages 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 various issues, focusing on warming treatments, achieving good results, and the thought of reinforcing Yang should be revived in response to the times.
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, addressing contemporary diseases and improving efficacy.
3. Historical Development Often Exhibits a Tendency for Overcorrection
Looking back at history, it is evident that practitioners throughout the ages have often emphasized the importance of certain prescriptions or sought to correct errors, warning the public, which sometimes led to extreme statements. However, in clinical practice, the principle of differentiation and treatment has always been upheld. It is not that Liu’s school solely advocated for cooling treatments, Zhang’s school exclusively used purging methods, Danxi only focused on nourishing Yin, or Zheng’s school only emphasized reinforcing Yang.
In Liu Hejian’s “Xuanming Lun Fang”, of the approximately 350 prescriptions, only 39 are cooling, while 44 are warming, with the rest being a mix of both or neutral prescriptions. Zhu Danxi, while advocating for nourishing Yin, did not limit himself to this aspect; he was a master of 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 cases with tonics? Did Li Zhai not achieve results without purging? But in terms of writing, they may not compare to others.”
However, those who do not grasp the essence may merely imitate and lose the core.
Although Zheng Qinan is 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 be rigidly attached to prescriptions or herbs; what matters is the evidence of efficacy.”
In summary, whether using Jiang (Ginger) or Fu (Aconite), one must consider the patient’s condition, Yin and Yang, and observe their complexion; use cooling when necessary and warming when needed, without being overly rigid about the use of Jiang and Fu. This shows 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 noted by Wei Tieqiao:
“The most useful yet most difficult herb to use is Fu Zi.”
We should learn from history and avoid repeating the mistakes of overcorrection seen in the past, which could lead to a new problem of “using warming supplementation as a trend and judging practitioners 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 study 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 integrating various methods”. The “ancient teachings” refer to the classics, while the “various methods” 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 “Neijing” 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”. This applies to Zhang Yuanxu, Li Dongyuan, Zhu Danxi, Zhang Jingyue, Ye Tiandi, and many others.
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 “I Ching” and “Neijing”, gaining insights from the principles 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 the time and his clinical experience, gradually forming his academic characteristics.
“Overall analysis shows that the Fire God School is derived from the Shang Han School, while also absorbing the essence of the Warm Supplementation School, combined with years of practice, thus developing into an independent academic school.”
Since every school is not built in isolation, we should not seek shortcuts by abandoning the source of the classics and directly entering a specific school. When studying the Fire God School, if one does not seek the path of the “Neijing” and “Nan Jing” classics but merely imitates the techniques of reinforcing Yang, it simplifies the Fire God School and makes it impossible to grasp its essence.
As the ancients advised, “A physician must master the classics for three generations to be able to use their medicine”; the “three generations” refers to the classic 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 should diligently cultivate 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 problems are emerging. Only by thoroughly exploring the roots and learning from various sources can we adapt to endless changes and become great physicians who progress with the times. In this way, TCM can continue to thrive and benefit all living beings!
This article is excerpted from “Medicine and Philosophy: Humanities and Social Medicine Edition”, 2009, Issue 4
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[Famous Doctor] Li Ke: Discussing the Treatment of Disease Prevention and the Application of Reinforcing Yang
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Reading the Reinforcing Yang Thought of Old TCM Doctor Li Ke (Wind Heart Disease, Lung Heart Disease, Coronary Heart Disease)
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The Core and Application of Reinforcing Yang Thought
The Great Role of “Reinforcing Yang” Herbs Lies in Warming and Unblocking the Twelve Meridians, Not Just Supplementing Kidney Yang
The Continuation of the Great Role of “Reinforcing Yang” Herbs – Reflections on Chengdu People’s Fear of “Ma Huang”
The Core of Reinforcing Yang is to Support the Right and Not Just Warming Methods
Liu Lihong: Utilizing the Thought of Reinforcing Yang
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