Classical Case Studies from Chinese Herbalist Zhang Cong Zheng

By Michael Dell’Orfano, Lic.Ac.

Zhang Zi-He, also known as Zhang Cong Zheng, was a military physician who lived from 1156-1228. He believed that medicine needs to be tailored to the individual, and that theory and medicine from the Han Dynasty classics were ill-equipped to combat the diseases of the current time. After serving in the military he left to return to his home town in Henan province to work as a doctor.

Zhang was a neo-Confucianist, and a firm believer that pernicious influences entered the body from the heavens, earth and through man’s actions. The evils of heaven include: wind, cold, heat, dryness and fire. Insults from earth came as dampness including fog, dew, rain, hail, ice and mud. Man’s abuses were often related to poor diet and vices such as lack of discipline and excess sexual desire. He believed that these insults were responsible for causing disease and that in order to effectively cure an ailment, the responsible influence needed to be eradicated, and often he would use herbs to induce sweating, vomiting and purging through the lower orifices to heal patients.

Case Study #1

Zi He went to Chaonan County to visit his cousin who was suffering from very bad constipation. He dared not eat enough to get full, otherwise his stools turned as hard as stones. He had a bowel movement every 4 or 5 days. Sometimes when he passed stools, he got blurred vision, nasal bleeding, and severe abdominal pain referring all the way down to the anus. He had taken many different herbs, including violent herbs such as Badou, Yuanhua, Gansui. These herbs caused diarrhea, and then the constipation returned. This situation lasted for a few years and finally the patient lost hope. Zi He checked his cousin’s pulses, which were full, slippery and forceful on the both hands. Zi He prescribed Da Cheng Qi Wan first, then Shen Gong Wan, & Maziren Wan. He also told the patient to take more vegetables and to eat soup with animal blood. Three months later the patient became so healthy, with a rosy face, that people could hardly recognize him at first glance. Well, the careless doctors did not know that there are four different types of dryness: 1.Dryness on the surface cracks and chaps the skin. 2. Dryness in the interior leads to exhaustion of essence and blood. 3. Dryness in the upper Jiao causes thirst and a dry nose and throat. 4. Dryness in the lower Jiao results in constipation and scanty urine. In short, dryness is a kind of energy transformation of Yangming metal. The general treatment principle is to purge the large intestine (LI), but specific herbs are selected. Badou purges the LI due to cold, Gansui & Yuanhua purge the LI due to dampness, and Dahuang and Mangxiao purge the LI due to dryness.

Case Study #2

A 7-year-old boy suffered from Fengshui (a kind of edema). Some doctors gave him tonics such as Liu Wei Dihuang Wan, which made his condition worse. His urine became scantier, and he had no appetite, puffiness of the head and edema of the limbs. Zi He was asked to see him and said, “His edema is quite different from that of an adult. Edema in adults always results from either retention of water and dilute phlegm, or from injury to the kidneys due to excessive sexual activities. The boy, only 7 years old, is suffering from Fengshui. He needs to be treated by promoting sweating.” Zi He put the boy into a bathroom to avoid fire because the fire outside might stir up the fire inside which then might disturb the heart. The boy was given Wei Feng Tang first, then soaked in hot water, and covered with a heavy blanket. The boy produced much sweat and his edema reduced by 50%. He was treated in the same way 2 days later, and his edema was nearly gone. Since his appetite was still poor, Zi He prescribed Binglang Wan to regulate the spleen and stomach. Soon the boy was cured.

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