Theory

An overview of Xueji

By Gory ⋅ May 29, 2009 ⋅  Print This Post ⋅ Post a comment

Introduction:

Xueji (薛己) is one Chinese doctor who had the opportunity to test out and criticize the ideas of his predecessors in the Jin-Yuan era. Given his circumstances, it is not surprising that in the end – from the herbal prescriptions we observe him using – his methods fall under the auspices of the Yishui (易水) school headed by Zhang Yuansu (张元素), popularized by Ligao.

Xueji was a rich kid, whose dad was a doctor, and who ended up becoming a one too. His idea was always to support the workings of Spleen-Stomach.

Symptom and Root:

In Chinese Medicine, we like to talk about Superficial Expression (标) and Root (本). Xueji of course is adament of treating the root. “不问大小，必以治本为第一要义。” It is interesting what he thought of as the root. The root of his illnesses is apparently this abstract idea called Spleen-Stomach deficiency. It is this Spleen-Stomach deficiency that represents the essence of the disease he treats.

And what is “Superficial Expression (标)?” It’s more like the word for “Disease (病).” It’s the pain and discomfort one feels, the manifestations that come to be associated with the problem, but not the problem itself.

His thoughts on waike (外科):

Some of you might be surprised to hear this, but waike aka external diseases was his area of specialty. He was opposed to using expelling methods (泻法) without considering the need to also tonify. He applied the internal medicine (内科) idea of tonification, often using tuoli xiaodu san (托里消毒散) to support stomach qi as a base formula from which to attack the heat-poison of a wound (”当先助胃壮气，而后治其疮，不可泥于热毒内攻”). Herbs like astragalus (黄芪) were favored too – which demonstrates why it was considered an herbs for treating wounds (疮家之圣药).

All said, we need to understand Xueji’s notion of chuang (疮). The wounds he treated are often not like those treated by Zhang Zihe aka Zhang Cong Zheng. Generally more like chronic wounds that do not heal well because the patient himself is deficient. Very different from those acute wounds collected by the poor and hardy patients of Zhang Zihe. The difference is in the amount of Right Qi (正气) possessed by the patients. These days we would think of Xueji’s patients as the elderly people with bed sores; while Zhang Zihe’s patients would be the young soccer players who get injured on the playing field.

His Favorite Prescriptions:

《内科摘要》’s most used formula are:

1. Buzhong yiqi tang (补中益气汤) – used 90x
2. Liuwei dihuang wan (六味地黄丸) – used 58x
3. Bawei wan (八味丸) – used 41x
4. Liujunzi tang (六君子汤) – used 27x
5. Shiquan dabu tang (十全大补汤) – used 21x
6. Guipi tang (归脾汤)

As for those used in waike, fuke, the rankings are more or less as follow:

1. Buzhong yiqi tang (补中益气汤)
2. Liuwei dihuang wan (六味地黄丸)
3. Siwu tang (四物汤)
4. Bazhen tang (八珍汤)
5. Liujunzi tang (六君子汤)
6. Sijunzi tang (四君子汤)
7. Xiaoyao san (逍遥散)
8. Bawei tang (八味汤)
   
9. Yigong san (异功散)

And so you see, it really isn’t that difficult. Important thing though is to use these herbs over a long duration to see good effect.

Why Xueji’s ideas were different than those of Zhang Zihe (张从正) and Zhu Zhenheng (朱震亨):

1. He was of a different era. During the mid-end part of the Ming dynasty, socio-politics was relatively stable. People spent their life doing things one would do if there weren’t war. The resulting trend of disease was less to do with infectious diseases that would ravage war-striken society. Rather, people in general would fall prey to diseases of plenty that weaken the Spleen-Stomach.
2. The people he treated were the rich or scholarly types. Either Monarch types or Seer types who often show signs of Spleen-Stomach deficiency. So we see both the time period as well as his patient profile influenced his theoretical inclination to be opposed to that of Zhang Zihe.
3. As for why his disinclination toward Zhu Zhenheng, it’s like the result of Zhu Zhenheng’s post-decessors not fully understanding the subtleties of his yin-tonifying methods, the upshot of which was an overuse – often wrongly – of zhimu (知母) and huangbo (黄柏).

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