Subject Areas: Internal Medicine
Within the long history of Chinese Medicine (CM), large amount of classics like Inner Classic of Yellow Emperor (Huang Di Nei Jing), Shan Han Lun, and A-B Classic of Acupuncture (Zhen Jiu Jia Yi Jing) are well inherited and studied by their followers. The existence of these books also maintains the essence of CM. Nowadays the learners and practitioners still use the theories and experiences from the ancient times in their clinic practice. Meanwhile, various schools are gradually established based on the same origin of few books e.g. Huang Di Nei Jing and Zhen Jiu Jia Yi Jing. Distinguished linages include “School of Shang Han Lun”, “School of Wen Bing”, and “Four Schools in Jin and Yuan Dynasties” i.e. School of Removing Pathogens (Gong Xie Pai, Zhang Congzheng as leader), School of Supplementing Earth (Bu Tu Pai, Li Dongyuan), School of Cooling (Han Liang Pai, Liu Wansu), and School of Nourishing Yin (Zi Yin Pai, Zhu Danxi), etc., which make CM so diversified, individualized and charming. Every single practitioner may have unique understanding on CM based on personal knowledge structure, interest, clinical experience, and study. In CM, treatment is an individualized activity. Therefore, each school may succeed in treating certain disorders. In ancient China, especially before the paper-making and printing technology are invented, the publish and transmission of a book were usually localized and limited. Years and years of wars and fires have destroyed large amount of medical scripts. Besides, for some personal reasons, scripts from famous doctors may only be known and spread among their families, friends, linages, and religions communities, meaning the scripts are not published. These scripts are kept as private collection, funerary goods, and religious texts.
In 1974, a barefoot doctor Zhang Dachang (1926-1995) posted a hand-copied version of an ancient script entitled Fu Xing Jue Wu Zang Yong Yao Fa Yao to Chinese Academy of Traditional Chinese Medicine, Beijing, the top institute of CM. The authorship was attributed to the Taoist scholar-hermit Tao Hong Jing (451-536 A.D.) in Liang Dynasty (502-560 A.D.). Zhang Dachang believed that the text contains essential passages from the lost Taoist classic Tang Ye Jing. Tang Ye Jing, authored by Yi Yin is also regarded as the first book on formula whose content has been cited in Shang Han Lun, Book of Han Dynasty (Han Shu), Classic of Pulse Diagnosis (Mai Jing), Fu Xing Jue, Prescriptions Worth a Thousand in Gold (Qian Jin Fang), etc. Zhang Dachang’s grandfather Zhang Wonan (1867-1919) purchased the manuscript in 1918 from the Daoist abbot Wang Yuanlu who discovered the famous Library Cave (Cave 17) at Dunhuang in 1900 A.D.  . The building of the cave started in 851 A.D. which was sealed in 1006 A.D. for preventing damage from the war between Islamic Qara Khanid and Bushiest Khotan. From then on, Fu Xing Jue remains hidden and unknown. Thanks to the sealing, Fu Xing Jue could keep the original content, rather than be modified by its followers. As known to all, Huang Di Nei Jing and Shang Han Lun have been modified many times by their followers in different dynasties, leading to large amount of controversies and misunderstanding of the classics. After 1970s, Fu Xing Jue is gradually known to public. When the professionals studied the hand-copy of the scroll, they found it was complicated, because the original scroll was burnt by the Red Guards (Hong Wei Bing) during the movement of Elimination of the Four Olds (Po Si Jiu) in 1966 during the Culture Revolution. Accordingly, speculation was posted that the hand-copy text might be a fake and created by Zhang Dachang himself or one of his followers. The speculation remains until today. Because of the long history of CM, the authenticity of a book can’t be judged by the existence and availability of an original version. Obviously, like the situation of Fu Xing Jue, the original versions of some of the ancient milestone CM scripts books like Huang Di Nei Jing and Shang Han Lun are definitely unavailable. But CM practitioners will never say that Huang Di Nei Jing or Shang Han Lun is a fake. Contents of an original medical scrip may be rewritten, copied, or cited by their friends or followers.
After carefully textual research, most of the scholars and experts from Chinese Academy of Traditional Chinese Medicine, Beijing University of Traditional Chinese Medicine and other institutions agreed that the Fu Xing Jue was written by Tao Hong Jing in his later years (516 A.D.-536 A.D.) and might reflect passages from the lost classic Tang Ye Jing. Since 1990s, over 10 monographies and 100 papers have been published. Interestingly, the scholars found that Fu Xing Jue even keeps some original contents of Tang Ye Jing, which is not cited or has been modified in Shang Han Lun. For example, Gui Zhi Tang which is used to name a herbal formula in Shang Han Lun is named Xiao Yang Dan Tang in Fu Xing Jue. Xiao Yang Dan refers to minor yang of dawn. The name of Xiao Yang Dan Tang may reflect the original meaning of the herbs from Tang Ye Jing   . As the theory and herbs are attracting more and more attentions in China, it would be interest to introduce Fu Xing Jue to westerns. To our knowledge, this is the first all-round introduction of Fu Xing Jue written in English, which might expand the attraction of this book in the field of CM internationally.
2. Features of Fu Xing Jue
Fu Xing Jue inherits essence from Tang Ye Jing, Huang Di Nei Jing, Shen Nong Ben Cao Jing and other ancient classics. It is intriguingly characterized with Five-Zang differentiation and selecting herbs according to the relationship between its Wei (taste) and the structure of Ti (substance)-Yong (function)-Hua (transformation) of a certain organ. This book employs speculation of Ti and Yong to understand and explain the theory on five- phases-five-tastes. Meanwhile, Hua-transformation is applied to bridge the five phases and Yin-Yang. It also reflects the early philosophic mixture of Confucian, Taoist, and Bushiest in 6th century A.D. in China. Thus a structured, unified and self-contained system is established, which includes Zang Xiang (internal organs and external manifestations), meridians, diagnosis, and composing formulae. Shang Han Lun and Jing Kui Yao Lue have already revealed significant and valuable medical content from Tang Ye Jing. Besides, more and more international CM practitioners are keen to seek the original essence of CM. Therefore, if more passage is revealed through the translation and introduction of Fu Xing Jue, it could be of great interest and benefits in clinical practice not only domestically but internationally.
3. Yong and Ti
Yong or function refers to the appetence or preference of an organ.
Ti or substance refers to the substantial foundation which supports the function of an organ.
For example, the Yong of Liver is to free course, to extend, to smooth, while the Ti of Liver is blood, sinew, Hun, etc.  .
On the one hand, Ti maintains, controls, and regulates Yong. On the other hand, Yong functions, which must consume the Ti. Therefore, the performance of Yong influences how the Ti works or regulates and restrains Ti. The relationship of Ti and Yong i.e. mutual regulating and conditioning maintains the activities of organs, which is so called Qi-transformation. Within the process of Qi-transformation, both Ti and Yong are dynamically changing. With progressing, new functions and new substances appear, which is called Hua or transformation in this book. Hua-transformation presents a new condition of the original organ. Life is the demonstration of on-going Qi-dynamics. Once Qi-transformation stops, life ends.
4. Xu and Shi
The terms of Xu (deficiency) and Shi (excess) come from Wu (nothing) and You (something), a basic concept in Taoist. If there are some symptoms, it is Shi. If there is no symptom, it is Xu. Tao Hong Jing emphasizes on the regulating and balancing of the Ti and Yong of the five-organs other than the battlements between ZhengQi (right qi) and Xie Qi (pathogenic factors), which is conventionally understood as the reason for Xu and Shi. Usually, Xu refers to deficient Zheng Qi and Shi to existence of pathogenic factors e.g. external wind, blood stasis, etc. Symptom results from the battlement between Zheng Qi and Xie Qi. According to Fu Xing Jue, all disorders are caused by the deficiency of Zheng Qi, either Ti deficiency or Yong deficiency. In order to distinguish the Ti deficiency and Yong deficiency, Shi Zheng (excess pattern) is attributed to Ti deficiency and Xu Zheng (deficiency pattern) is attributed to Yong deficiency.
According to the unique understanding on Xu and Shi, a philosophy to compose formula is established in this book. It’s nothing to do with Bu (supplement) or Xie (reduce), but to supplement the Ti or Yong, indicating using herbs to support Ti or Yong, to activate the interaction between Ti and Yong, and to ensure the normal performance of an organ’s function. For instance, Xiao Bu Fang (Smaller Formula of Supplementing, SFS) is comprised of two herbs with the taste of Yong and one with the taste of Ti. Xiao Xie Fang (Smaller Formula of Reducing, SFR) is comprised of two herbs with the taste of Ti and one with the taste of Yong.
5. Subdivision of the Five Tastes and 25 Plant Herbs
6. Principles of Composing Formulae
The formulae are classified in to 4 groups, i.e. smaller supplementing/reducing, and larger supplementing/ reducing formulae.
Smaller Formulae (Xiao Fang)
A Jun (King) herb refers to treat the disease i.e. to supplement or to reduce; a Chen (Ministry) herb to monitor (Jian) and assist (Zuo) the King herb, whose dosage is as same as the King herb; a Shi herb (Obedience) refers to obey the Chen herb or service or assist Chen herb.
Larger Formulae (Da Fang)
Larger Formulae of Reducing (LFR, Da Xie Fang)
A LFR is comprised of SFR and modification from the SFR of the child organ/phase, i.e. the Zuo Chen as Zuo Shi of Zuo Chen and Jian Chen as Zuo Shi of Jian Chen from child-organ SFR and the subdivision with Wei which overcomes me of the phase which I overcome as Zuo Shi of Zuo Chen and Jian Chen (Table 4).
Larger Formulae of Supplementing (LFS, Da Xie Fang)
A LFS is comprised of SFS and modification from the SFS of the child-organ without Zuo Shi (Table 5).
Figure 1. Hierarchical structure of the smaller formulae.
Table 1. 25 plant herbs of subdivision of five Wei theory.
Table 2. General principles of composing Xiao Xie Fang and Xiao Bu Fang (XBF).
Table 3. SFR and SFS of the five-organs (liver, heart, spleen, lung and kidney).
Table 4. LFR the five-organs (liver, heart, spleen, lung and kidney).
7. Secret of Herbal Usage from Tang Ye Jing  
In Fu Xing Jue, the secret of understanding the organs and composing formulae from Tang Ye Jing are summarized in Figure 2.
In summary, each organ has Wei of Ti, Yong, and Hua, which is conducted according to the connection between organs and seasons. The effect of an organ is closely related to its season. Wei is not just the taste sensed by tongue but also results from Qi transformation of an herb. Combination of the herbs of Ti-Yong-Hua is the strategy in Fu Xing Jue to regulate the imbalance of an organ. Thus the lost secret from Tang Ye Jing of understanding disorder of organs and using herbs is presented, which differs from the existent successor of Tang Ye Jing i.e. Shang Han Lun and opens a new door to ancient (Han Dynasty and before) classic Chinese Medicine.
Figure 2. Secrets of Tang Ye Jing. Wei of Ti/Ku refers to herbs which reduces the organ while Wei of Yong/Yu to herbs which supplement the organ. This understanding is in accordance with the test in Su Wen, Zang Qi Fa Shi Lun. For example, bitter herbs belong to the Yong Wei of the kidneys and supplement the kidneys. Sweet herbs belong to the Ti Wei of the kidneys and reduce the kidneys. The outer layer (e.g. Salty below Water) means Wei of Hua of an organ. Hua results from the movement of previous five-phase, which is also the beginning of new transformation and development to new substance. For example, sweet is the Wei of Hua of Wood, neither Wei of Ti nor Yong, but new Wei of wood. Sweet is the Ti of the kidneys and Yong of the spleen, which could be the underlying interaction of Water, Wood and Earth. Outside each angel, a disorder is listed, which can be treated with Weis of Ti and Yong on the two sides. For example, spasm can be treated with sweet and sour herbs. In Shang Han Lun, Shao Yao Gan Cao decoction which is comprised of Shao Yao and Gan Cao is used to release spasm  .
Table 5. LFS the five-organs (liver, heart, spleen, lung and kidney).
This study was under the support of National Science Funds of China with the Grant no. 81373710. The author thanks Dr. med Josef Hummelsberg (Germany), Dr. med Velia Wottman (Germany), Dr. med. Peter Tossel (Sweden) for commenting and editing.
Conflict of Interests
The authors declare no conflict of interests.
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