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In the history of medicine in our country, the famous Tang Dynasty physician Sun Si-miao is a very outstanding figure, who can be called the "Sage of the Medical Forest". His two works, Qianjin Fang, inherited the past and ushered in the future, with profound influence, and are worthy of our serious study and research.

I. The Academic Achievements of Qianjin Fang

1. Qianjin Fang is a comprehensive collection of medical classics and formula books before the early Tang Dynasty.

Sun Si-miao devoted his life to medical practice, as he said, "I have been devoted to learning since I was eighteen, and even in my old age, I have never put down my books." He lived to be over a hundred years old, diligently seeking and collecting extensively, thus amassing a wealth of knowledge. Lin Dang and others, in the preface to the "Revised Qianjin Yaofang," said that he collected everything from the earliest texts to the Sui Dynasty, whether they were classics or formulas. From the "Great Physician's Study" at the beginning of Qianjin Yaofang, it is evident that he valued both medical classics and formula books.

The medical classics he compiled have significant philological value and are often important references for us today in studying and collating ancient medical texts such as Neijing and Shanghan Lun. Of course, he was not a mere compiler; he both "narrated" and "discussed," making selections and reflecting his scholarly attitude and research methods. From his selection of Neijing content, it is clear that he placed particular emphasis on the Zangxiang (visceral manifestation) and Zhenhou (diagnostic) sections. The Zangxiang theory in Chinese medicine is a summary and generalization of human physiology and pathology under the guidance of the holistic concept of dynamic changes; Zhenhou is the method of recognizing and analyzing diseases. Both are the most practical in clinical practice. Jingui Yaolue was discovered by the Song Dynasty's Wang Zhu and compiled by Lin Dang and others to be made public, but Qianjin Yaofang, which predates Lin Dang by more than 400 years, almost entirely encompasses the contents of the Song edition of Jingui Yaolue. Although Shanghan Lun was once compiled by the Jin Dynasty's Wang Shu-he, when Sun Si-miao selected Qianjin Yaofang, he had not even seen this version, leading him to lament, "The masters of Jiangnan have kept Zhang Zhongjing's essential formulas secret and not transmitted them." It was not until his later years that he compiled the "Treatise on Cold Damage Diseases" he had seen into the cold damage section of Qianjin Yifang using the method of "combining formulas and syndromes, categorizing and attaching." This is essentially the earliest version of the "Treatise on Cold Damage Diseases" we can see today. The earliest pharmacological work in our country, Shennong Bencao Jing, was lost around the end of the Han Dynasty, hence Zhang Zhongjing's preface does not mention Benjing. Wu Pu, a disciple of Hua Tuo, compiled it, and Tao Hong-jing of the Liang Dynasty further edited it, but it was later lost again. What we see now are compilations from the Ming and Qing Dynasties. The Japanese scholars Mori Ritsuzo and Sun Xingyan's compilations are based mainly on Qianjin Fang, in addition to various materia medica.

The medical formulas collected in Qianjin Fang are not only numerous but also some have very early origins, some even predating Zhang Zhongjing. For example, the "Xia Ji Bitter Apricot Seed Decoction" in the miscellaneous supplement section of Qianjin Yaofang refers to Xia Ji, the daughter of Duke Mu of Zheng during the Spring and Autumn period; the "Zhou Baihou Powder" in the nourishing and dietary section of Qianjin Yifang is even earlier, and several "Baihou formulas" have been found in the recently unearthed Wuwei Han Dynasty medical texts. Additionally, some formulas in Qianjin Fang come from distant regions, such as the "Wanbing Pill," which is a formula from the ancient Indian physician Jivaka; "Agada Pill," "Xiongnu Overnight Pill," and others are also foreign formulas. The "Sui Shu. Yi Wen Zhi" records ten medical works by Nagarjuna, Jivaka, as well as Brahmin and Western Regions, totaling 80 volumes, but unfortunately, they have all been lost, leaving only these fragments in Qianjin Fang.

The flourishing of medical texts began during the Han, Wei, and Six Dynasties periods. During this time, there were over a hundred medical texts, among which Ge Hong's "Yuhan Fang," "Zhouhou Beiji Fang," Fan Wang's "Fan Dongyang Fang," Chen Yanzhi's "Xiaopin Fang," and Xu Zhicai's "Yaodui" were the most notable. The work that had the greatest influence on Sun Simiao was "Zhouhou Fang," as it contained "mostly easily obtainable medicines... found everywhere, simple and straightforward, with remedies available even in the countryside. For urgent illnesses, all necessary treatments were included. With this book at home, one might not need a doctor." ("Baopuzi") This aligns with Sun Simiao's philosophy of "extensively collecting from various texts, simplifying and condensing, focusing on practicality for emergencies." This book was once lost but was later supplemented by Tao Yinju and renamed "Buque Zhouhou Baiyi Fang," though it too was lost. What we see today is a compilation by Yang Yongdao of the Jin Dynasty, based on "Qianjin Fang," "Waitai Miyao," and "Zhenglei Bencao," titled "Fuguang Zhouhou Fang," which was published during the Yuan Dynasty. Therefore, it is reasonable to believe that "Qianjin Fang" collected many of Ge Hong's prescriptions. Additionally, "Xiaopin Fang" was once considered on par with Zhang Zhongjing's "Treatise on Cold Damage Diseases" during the Tang Dynasty. As Lin Dang and others stated in the postface of "Qianjin Yaofang": "I once read the Tang regulations, which required physicians to study Zhang Zhongjing's 'Treatise on Cold Damage Diseases' and Chen Yanzhi's 'Xiaopin Fang'... Thus, 'Xiaopin Fang' is comparable to Zhongjing's work. It is lamentable that it has been largely lost... Upon examining 'Qianjin Fang' (referring to the cold damage section of 'Qianjin Yaofang'), Zhongjing's methods account for about two to three-tenths, while 'Xiaopin Fang' accounts for about five-tenths. How refined it is!" Lin Dang and others arrived at the conclusion of "five to six-tenths" after comparing "Qianjin Yaofang" with Tao Hongjing's "Buque Zhouhou Baiyi Fang" and "Waitai Miyao." Furthermore, according to "Waitai," before the Tang Dynasty, there were eight major schools of thought on cold damage diseases, with Zhongjing being the most prominent. However, this does not mean the other schools were without merit, especially "Xiaopin Fang," which deserves our attention. As "Qianjin Yaofang" cites from "Xiaopin Fang": "It has been passed down through the ages that cold damage diseases are difficult to treat, and seasonal epidemic pestilence is caused by toxic qi. Yet, those who discuss treatment do not distinguish between cold damage and seasonal epidemic pestilence as different qi... Upon examining various texts, they are indeed different, requiring different approaches, and the prescriptions should be clearly distinguished." The recognition that cold and warm qi are different and require different treatments was quite advanced for its time. In terms of treatment, "Xiaopin Fang" both aligns with and diverges from Zhongjing's school. The cold damage section of "Qianjin Yaofang" includes many prescriptions from this school, providing valuable material for studying ancient cold damage schools. For example: the Weirui Decoction for wind-warmth, which enriches yin, clears heat, and releases the exterior; the Unprocessed Rehmannia Root Decoction for heat accumulation internally and dual damage to qi and yin, which nourishes yin, supports the righteous, and purges pathogenic factors. These truly "fill in the gaps and correct the shortcomings" of Zhongjing's teachings.

It should be pointed out that Sun Si-miao's achievements not only preserved a large number of ancient medical materials for us, but also classified these materials, systematized them with theories, and verified them with experience, forming a unique school of thought. For example, for the disease of beriberi, he combined the experiences of Zhi Fa-cun and Yang Daoren from the Jin Dynasty with the experiences of Shi Sengshen from the period between the Song and Qi dynasties, "selecting those that have been proven effective through use," and applied them clinically, "usually achieving a permanent cure within ten days."

As a comprehensive work that collected the essence of medical classics and prescription books before the early Tang Dynasty, Qianjin Fang played an important role in promoting the development of medicine. Song Dynasty scholar Ye Mengde, in his "Miscellaneous Talks on Avoiding Heat," praised it as "masterfully encompassing the essentials of ancient and modern medical books," and noted that "today, those who speak of medicine under Tongtian (BL7) all regard these two books as their guiding lights." Within a few decades of its completion, Qianjin Yaofang was transmitted abroad. The Japanese "Ishinpō" and the Korean "Uibang Yuchwi" not only included Sun Si-miao's medical theories and prescriptions but also imitated the writing style of Qianjin Fang, demonstrating its profound influence.

2. Qianjin Fang is considered a clinical practical "encyclopedia" in the history of Chinese medicine.

The content of Qianjin Fang is quite rich and has a broad practical foundation. The book covers gynecology, pediatrics, five sense organs, internal medicine (including cold-damage disease, Rebing, and Zabing), sores and abscesses, trauma, hemorrhoids and fistula disease, detoxification and emergency rescue, acupuncture and moxibustion, dietary therapy, health preservation, and more. Each subject is treated independently, categorized, and includes both theories and prescriptions, forming the rudiments of specialized fields. Therefore, the late renowned physician Huang Zhuzhai referred to Qianjin Fang as the "first clinical practical encyclopedia."

In terms of gynecology, Qianjin Fang begins with women and then moves to infants in its structure, and it was the first to separate gynecology from internal medicine Zabing, establishing independent theories and prescriptions. Its content starts with seeking children, followed by pregnancy, fetal care, prenatal diseases, difficult delivery, postpartum care, and then separately discusses menstruation, leukorrhea, Zabing, and other disorders, essentially outlining the framework of Chinese gynecology. In treatment, Qianjin Fang excels in using invigorating blood and resolving stasis for menstrual and leukorrhea diseases, such as dysmenorrhea, menstrual irregularities, Jingshui disorders, chronic fistula disease, persistent leukorrhea, hard abdominal masses, and infertility, often employing Rhubarb Rhizoma Eupolyphaga Pills, Dangdang Decoction, Cinnamon Twig and Poria Pill, and Stasis-Precipitating Decoction, among others, to remove stasis and promote regeneration, regulate qi and blood, and unblock meridians to cure diseases. For prenatal disorders, it emphasizes regulating the spleen and stomach, such as using Pinellia and Poria Decoction for morning sickness and Poria Pill for edema in pregnancy. For postpartum diseases, it advocates primarily tonifying the liver and kidneys, often using flesh and blood tonics, which were highly praised by later generations, including Ye Tianshi, who adopted and promoted the theory of regulating and tonifying the extra meridians.

Pediatric works were essentially non-existent before the Tang Dynasty. Zhang Zhongjing did not record them, and the ancient "Cranial Fontanel Classic" was lost early (the extant version is a forgery from the Song Dynasty and holds little value). Therefore, Sun Si-miao, considering that "infants with diseases are difficult to treat," compiled "Prescriptions for Infants and Young Children." This is likely the most complete and earliest pediatric monograph in extant literature. The volume includes methods for newborns, breastfeeding, maternal hygiene, and child-rearing, equivalent to a "general introduction"; fever, smallpox, eye sores, thrush, cough and asthma, convulsions from fright, food injury (dyspepsia), enuresis, and intestinal parasites, equivalent to "specific discussions." Among the four major pediatric diseases, only measles is missing, possibly because it was not yet prevalent in the Qin region at that time.

Qianjin Fang provides detailed summaries of many pediatric diseases. For example, for epilepsy (essentially infantile convulsion), it lists 20 symptoms in detail, categorizing the causes into wind, fright, and food. It also identifies eight "critical signs," such as fixed pupil movement, convulsions, opisthotonos, spine rigidity, frequent fright, abdominal distension and fullness with gurgling sounds and bloody stools, inability to latch for breastfeeding, fever with sweating, and unconsciousness during sleep, all of which are clinically significant.

Sun Si-miao adopted the method of classifying internal diseases according to the zang-fu organs in his work "Qianjin Fang." In the portion that occupies more than one-third of the entire book, he systematically and comprehensively discussed the physiology, pathology, diagnosis, and treatment prescriptions for each zang-fu organ. The book contains over 700 prescriptions, with nearly every category featuring some renowned formulas that are still widely used in clinical practice today, such as Phragmites Stem Decoction, Gallbladder-Warming Decoction, Zhuche Pill, Rhinoceros Horn and Rehmannia Decoction, and others. Many famous prescriptions from later generations also evolved from these, such as Seven-Ingredient White Atractylodes Powder, Two Old Ingredients Decoction, Pulse-Reinforcing Powder, Ten Major Tonics Decoction, Rehmannia Decoction, Fine Jade Paste, Original-Qi Preserving Decoction, Liangge Powder, Gentian Liver-Draining Decoction, and Perilla Fruit Qi-Descending Decoction. "Qianjin Fang" provides detailed descriptions of clinical symptoms and offers rich experience regarding the mechanism of disease, progression, prognosis, and outcomes. For example: "People with consumptive thirst often develop Yongju between the joints and die"; "For beriberi, swelling is usually a sign, but there are cases with swelling and cases without swelling. In cases without swelling, if there is obstinate impediment in the lower abdomen, vomiting indicates the onset of 'beriberi attacking the heart'"; "After hematemesis, although one may feel weak and short of qi, if there is no chest tightness, recovery is often spontaneous. However, if there is dysphoria, restlessness, vomiting, and the doctor prescribes Oven Yellow Earth Decoction or Donkey-hide Gelatin Powder to stop the bleeding, it often leads to a fatal outcome." These experiences are highly valuable.

Qianjin Yaofang and Qianjin Yifang have dedicated chapters on diseases of the eyes, nose, mouth, lips, teeth, throat, ears, and face, each with discussions and prescriptions. For example, the case of blindness details 16 disease causes. There are 81 prescriptions each for eye and face diseases, encompassing internal, external, compound formulas, and single remedies. The Bean Formula for Washing (fragrant medicinal soap) used for washing hands and face in the face disease section has 7 different recipes.

Volume 25 of Qianjin Yaofang, titled "Emergency Prescriptions," covers a wide range of categories with relatively simple formulas. For many emergencies, it allows for the use of locally available materials to save lives in critical moments. As an example, the rabies recorded in Qianjin Fang is the earliest and most detailed in ancient literature, with meticulous observations. For instance, it notes that a rabid dog bite causes symptoms to recur every seven days, and if no symptoms appear, the victim is safe, but must avoid dog meat for a hundred days to be completely free from risk. Additionally, it mentions that even without a bite, consuming rabid dog meat can cause rabies, consistent with current records. The treatment methods include up to 32 prescriptions, with the application of a rabid dog's brain to the wound, recorded from Zhouhou Fang, being particularly notable. Other single remedies are mostly based on Sun Si-miao's empirical formulas. Moxibustion at the bite site (also effective for poisonous snake bites) is especially effective, as the heat can coagulate and destroy the toxic proteins.

From the above, it can be seen that Qianjin Fang had a direct impact on the development of specialized medical fields after the Tang dynasty and the continuous emergence of specialized works, such as the "Immortal-bestowed Secret Prescriptions for Treating Injuries and Continuities" by Ai Daoren, "Complete Effective Prescriptions for Women" by Chen Ziming, "Key to the Treatment of Children's Diseases" by Qian Yi, and "Classic of Acupuncture and Moxibustion for Life Preservation" by Wang Zhizhong, as well as Zhang Jiegu's "Patterns of Medicinal Use for Cold and Heat, Deficiency and Excess in Zang-Fu Organs," all drew nourishment from Qianjin Fang. On the other hand, many clinical physicians directly obtained practical and effective prescriptions from Qianjin Fang, so much so that "even a slight understanding of its principles is enough to make one's medical skills renowned" (Yu Tuan, Medical Orthodoxy). All these aspects demonstrate that Qianjin Fang is indeed worthy of being called the "first practical clinical encyclopedia."

3. Qianjin Fang is a milestone that set a new medical trend.

Xu Lingtai pointed out in "On the Origins of Medicine" that "the study of Zhongjing changed by the Tang dynasty," referring specifically to Sun Simiao's Qianjin Fang. He believed that with the emergence of Qianjin Fang, "the ancient sages' methods of creating myriad prescriptions were no longer transmitted." In fact, Qianjin Fang both inherited and developed the teachings of the Neijing and Zhongjing. What Xu criticized were precisely the areas where Sun Simiao had unique insights or creative expansions.

In the past, it was generally believed that Sun Simiao made no significant achievements in medical theory, which is incorrect. Reading the original texts reveals this. Here are a few examples from volumes 13 to 20 of Qianjin Yaofang to illustrate this point.

He believed that the statement "the heart resuscitates through the tongue" was inappropriate and should instead be "heart qi communicates with the tongue." Because "the tongue is not an orifice," "the orifice of the heart is seen in the ear." Theoretically, the heart is fire and the kidney is water, with a coordination between water and fire. Additionally, the collateral of the hand shaoyin heart meridian (HT) also connects to the ear. Clinically, some tinnitus patients must be treated from the heart to be effective, such as with the Milkwort Root Decoction in the heart section of Qianjin Yaofang, which treats heart deficiency and palpitations with tinnitus.

Another example is his theory of Mingmen (GV4). He identified the fourteenth vertebra purgation point as Mingmen (GV4) and also proposed that "Mingmen (GV4) is located one inch above the heart" (Qianjin Yaofang, Heart Section), a novel assertion, though no related discussions are found.

Regarding the five zang-organs being insufficient to regulate the stomach, he said: "When the stomach is full, the intestines are empty; when the intestines are full, the stomach is deficient, alternating between fullness and emptiness. The qi moves up and down, the five zang-organs are stabilized, the blood vessels are harmonious, and the spirit resides. Therefore, the spirit is the essential qi of water and grain, and the five zang-organs are insufficient to regulate the stomach." (Qianjin Yaofang‧Stomach Organ) This is an elaboration on the Neijing's discussion of the spirit, further clarifying that the alternating fullness and emptiness of the stomach and intestines are the pivot of the body's qi movement. Water and grain are the foundation of life activities, and the idea that "the five zang-organs are insufficient to regulate the stomach" has influenced the later Earth-Supplementing School.

Regarding "when a zang-organ is overworked, supplement its child organ," Qianjin Fang proposed: "When the heart is overworked, supplement spleen qi to benefit it; when the liver is overworked, supplement heart qi to benefit it; when the spleen is overworked, supplement lung qi to benefit it; when the lung is overworked, supplement kidney qi to benefit it; when the kidney is overworked, supplement liver qi to benefit it." This proposal is a summary of empirical knowledge based on the Neijing theory of the correlation of the five zang-organs. Song dynasty scholar Xu Shu-wei further elaborated on this and provided case studies to support it. (See Benshi Fang, Volume 9)

These examples illustrate that the author of Qianjin Fang was not merely "narrating without creating." He had insightful views on many theoretical issues in medicine. Of course, his greater achievements lie in clinical practice. He devoted significant effort to collecting, verifying, and summarizing medical experiences that were not documented, achieving remarkable success and setting a new trend in medicine.

First, there is the summarization of specific formulas and medicines. The concept of specific medicines, formulas, and diseases seems to have originated from Shennong Bencao Jing and the Treatise on Cold Damage and Miscellaneous Diseases. For example, the Treatise on Cold Damage Diseases includes specific formulas and medicines for six-meridian diseases. In the Golden Chamber, Lily Bulb is used three times for lily disease, and Trichosanthes Kirilowii and Longstamen Onion Bulb are used for chest impediment, which are also specific medicines. As time progressed, the understanding of diseases deepened, knowledge of medicinal efficacy expanded, and new medicines were continuously discovered. Consequently, specific formulas and medicines inevitably increased. Qianjin Fang made the most significant contributions in this area. For instance, although Zhang Zhongjing used Dichroa Twig and Leaf for malaria, he did not use it as a specific medicine. In Qianjin Yaofang, out of 34 malaria formulas, 17 used Dichroa Twig and Leaf or Dichroa. Additionally, it was the first to document new antimalarial medicines such as European Verbena Herb, Achyranthes Root, and cuttlebone sepium. For dysentery, Qianjin Fang used Coptis Rhizome and Dried Ginger as specific medicines, applying Dried Ginger for heat dysentery and Coptis Rhizome for cold dysentery. It also recorded effective medicines for dysentery, such as pomegranate, Pomegranate Rind, Smoked Plum, and aged rice. For aphtha, it regarded rose root as a "sacred medicine," now known to be an effective antifungal agent for oral thrush. Other examples include using Rhubarb Rhizoma as a specific medicine for acute jaundice, leek seeds for seminal emission and spermatorrhea, sophora seeds for hemorrhoids, and peach kernel and waxgourd seed for internal abscesses, summarizing many new experiences.

Second, these new experiences raised new questions. That is, if these formulas and medicines are highly effective, but traditional theories cannot explain their efficacy, what should be done? Take, for example, the Mume Pill from Qianjin Fang for dampness-heat dysentery, which is said to "cure without fail." The formula contains only Smoked Plum and Coptis Rhizome. Smoked Plum is sour and astringent, and it is generally believed that dysentery should be treated with purgation in its early stages, as astringents might trap pathogens. Yet, why is it effective? In recent years, there have been numerous reports of using Smoked Plum and Coptis Rhizome powder or single-ingredient Smoked Plum powder to treat acute bacterial dysentery, with rapid symptom relief and bacterial clearance. Another example is the carp soup from Qianjin Fang, which is effective for edema in pregnancy, other types of edema, and liver cirrhosis with ascites. Using carp alone also works, but explaining it as "carp transforming into a dragon to move water" is clearly absurd. Similarly, the Jivaka's Ten Thousand Diseases Pill, a formula with dozens of ingredients, cannot be explained by traditional theories of monarch, minister, assistant, and guide. Even Sun Simiao himself admitted that this formula could be used for various chronic diseases, but its efficacy was "unknown and yet effective." Zhang Lu mentioned using this formula, and modern physician Yun Tie-qiao used it to treat his own stubborn illness. The Yue Mei Chinese Medicine Cases also recorded a successful case using this formula. These examples alone demonstrate that effective formulas have their own rationale. If traditional theories cannot explain their mechanisms, it indicates that theory has fallen behind practice. This raises an important issue: practice will drive theory to develop in new directions. Of course, given the conditions of Sun Simiao's time, this issue could not be resolved. He recognized the problem and made significant efforts, such as introducing the ancient Indian medical theory of "earth, water, fire, and wind" (Qianjin Yaofang, Volume 1, Diagnosis Chapter 4), hoping to advance theoretical understanding.

Second, the academic thought of Qianjin Fang.

1. Advocate for the universalization of medical care

Medicine originates from the production and life practices of the working people and is a common wealth of humanity. However, due to social and historical reasons, ordinary people often cannot receive treatment when they fall ill, especially in remote and impoverished areas where medical resources are scarce, and people lack even basic medical knowledge. As Sun Si-miao said, "Food has its successes and failures, yet the common people use it daily without understanding. Water and fire are close at hand, yet difficult to comprehend" (Qianjin Yaofang‧Treatise on Dietary Therapy). "There are no famous doctors in the world, and half of the deaths are in vain" (Qianjin Yaofang‧Preparations for Emergencies). Sun Si-miao was deeply distressed by this and thus clearly advocated for the popularization of medicine. We believe this is a fundamental aspect of the academic thought in Qianjin Fang.

The origin of this idea is, of course, related to his strong belief in Taoism. It should be noted that Sun Si-miao spent most of his life among the common people, deeply understanding their hardships. He himself was motivated to study medicine because "as a child, he suffered from wind-cold, repeatedly visited doctors, and exhausted his family's wealth on medicine" (Qianjin Yaofang, Preface). Therefore, in the preface of Qianjin Yaofang, he openly declared that his book "should not be passed on to the nobility, but rather to benefit the common households," aiming to "enable every household to learn and every person to understand." In case of emergencies, people could seek remedies and prescriptions to save lives in critical moments. For example, he said, "Liquorice Root can cure a hundred cases of dermatitis medicamentosa, as effective as pouring hot water on snow, almost miraculous. For poisoning by Renzhong Aconite Mother Root or Croton Fruit, Liquorice Root stabilizes the condition upon ingestion; for poisoning by wild aconite, onion soup stabilizes upon swallowing; for poisoning by wild kudzu, drinking earthen slurry stops it immediately. Such things are as easy as turning a palm, and it is essential that everyone knows them" (Qianjin Yaofang‧Detoxification and Miscellaneous Treatments). In the same book, in the "Preface to Women's Prescriptions," he also emphasized, "Teach daughters to study these three volumes of women's prescriptions, ensuring they thoroughly understand them. Then, in times of emergency, what is there to fear? Always keep a copy written out and carry it with you to guard against unforeseen events." Because he was so fervently advocating for the popularization of medicine, he also promoted medical ethics, harshly criticizing narrow-minded practitioners or those who deliberately mystified their techniques and refused to pass them on. His Qianjin Fang diligently sought and extensively collected knowledge, "broadly preparing and simulating," particularly emphasizing the treatment of common and frequently occurring diseases among the people. Many diseases not recorded in general books can almost all be found in Qianjin Fang. At the same time, simple, convenient, inexpensive, and effective single and empirical prescriptions occupy a large proportion in the book, which is related to this academic thought and gives his book a practical folk medical style.

"Small single prescriptions can cure major illnesses, and folk prescriptions can outdo famous doctors." Unfortunately, doctors who have always considered themselves "orthodox" have disdained single and folk prescriptions, dismissing them as "bell-ringing peddlers" or "using biased and mixed methods." The more they delve into medical theories, the more esoteric they become, yet their therapeutic efficacy remains poor.

2. Emphasizing the organization and research of prescriptions and medicines

Sun Si-miao devoted his lifelong efforts to prescriptions and medicines. Both Qianjin Yaofang and Qianjin Yifang are named after "prescriptions," collecting over 6,000 prescriptions, a feat unprecedented before him. He advocated that formulating prescriptions and using medicines should "be adapted to the situation," believing that previous prescriptions should be adjusted according to the condition of the illness to fit it, not rigidly adhered to without change. "Relying too much on old prescriptions without modification leads to countless problems" (Qianjin Yaofang‧Prescriptions). Not only should the ingredients be adjusted, but the dose should also be determined based on the severity of the illness—more for severe conditions, less for mild ones. "If one merely imitates the ancients, one only misleads oneself" (Qianjin Yaofang‧Medication). He also pointed out that people differ in age, gender, constitution, and strength, and that the environment varies in dryness and dampness between north and south. Therefore, prescribing and using medicines must "be adapted to the situation" and "adjusted according to symptoms" (Qianjin Yaofang‧Prescriptions). These views undoubtedly had a positive influence on later medical schools competing to innovate new prescriptions. Of course, his attitude was relatively balanced, not as extreme as that of Zhang Jie-gu and others.

He did not completely negate the previous prescriptions and medicines, especially in the aspect of inheriting and promoting Zhang Zhongjing's knowledge, he made great efforts. Some comrades said that he was not on the same path as Zhongjing. In fact, he was very good at using Zhongjing's prescriptions, such as using Prepared Liquorice Decoction to treat deficiency fatigue with intermittent pulse, and if the pulse stops, death will occur within a hundred days, not limited to cold-damage disease; using True Warrior Decoction and Aconite Decoction combined to treat cold-dampness paralysis, not limited to water qi. For example, using Kidney Qi Pill as the ancestral formula for tonifying the kidney, used for deficiency fatigue; using Angelica, Fresh Ginger and Mutton Decoction to treat various postpartum deficiency fatigue damages, menorrhagia and metrostaxis that do not stop; using cold-dampness lumbago soup (Ganjiang Atractylodes Rhizome soup) to treat cold-dampness leg pain, spleen deficiency cough with excessive phlegm, women's leukorrhea, old Renzhong deficiency urinary incontinence, all of which can grasp the essence of the original formula and further expand its use. In addition, he often flexibly modified the original formula to adapt to new conditions. For example, the carp soup for treating edema in pregnancy was derived from Zhongjing's True Warrior Decoction, removing one ingredient of Aconite Lateral Root and adding one ingredient of Chinese Angelica, thus changing the formula for warming the kidney and disinhibiting water into a formula for fortifying the spleen and disinhibiting water, harmonizing the camp and calming the fetus. Zhongjing's Oven Yellow Earth Decoction was originally used to treat bloody stool (distal bleeding), Qianjin Fang removed Aconite Lateral Root and added Dried Ginger, and used it for hematemesis, one for bloody stool, one for hematemesis, in the mechanism of disease both belong to middle qi deficiency and cold, it does not matter if the disease is different, the formula is the same, and Dried Ginger is conservative and not dispersive, especially good at warming the middle and controlling blood, unless it is a critical condition of sudden collapse of the original yin, it is actually better than Zhongjing's use of Aconite Lateral Root. The Phragmites Stem Decoction for treating lung abscess in Qianjin Fang is obviously inspired by Zhongjing's Rhubarb and Peony Peel Decoction for treating intestinal abscess, Peach Kernel and waxgourd seed activate blood, break hardness, and expel pus, they are specific medicines for treating internal abscesses, that was for intestinal abscess, so Zhongjing used the attacking and descending method of Nitre and Rhubarb; this is for lung abscess, Sun used the light and dispersing method of Reed Stem and Coix Seed, this is Zhongjing's unspoken secret, such flexibility and precision, only those with profound learning and rich experience can do it. As Zhang Shi-wan said: "Without discussing 'Jingui', how can we know the source of 'Qianjin's' methods; without reading 'Qianjin', how can we expand the changes of 'Jingui's' methods." From this point of view, Sun Simiao should also be considered a contributor to Zhongjing.

Qianjin Fang is also adept at integrating ancient formulas, empirical formulas, single formulas, and herbal medicine, combining the rigor of ancient formulas, the flexibility of empirical formulas, and the special efficacy of folk single formulas. For example, his Three Yellow Pulsatilla Decoction for treating heat toxin dysentery is based on Zhongjing's Pulsatilla Decoction, with the addition of Rhinoceros Horn and Cimicifuga Rhizome for detoxification, Sophora, Pomegranate Rind, and Chinese Taxillus Herb for treating dysentery, and Mugwort and Liquorice Root for harmonizing and relieving pain. The use of Chinese Taxillus Herb for treating dysentery began with Qianjin Fang, and later Diannan Bencao and "Yu Jiu Yao Jie" recorded cases of Chinese Taxillus Herb treating bloody dysentery. Recent studies have shown that Chinese Taxillus Herb has inhibitory effects on various intestinal pathogens. Compared to the original formula, the efficacy is even better. The author has used this formula to treat children with toxic dysentery, high fever, unconsciousness, and bloody jelly-like stools, with excellent results. Another example is swelling, "the abdomen is as hard as a stone, and taking diuretics does not control it." He believed that not only should diuresis be used, but blood circulation must also be activated, using Salvia and winged euonymus and other blood-activating and stasis-resolving medicinals, which are also very insightful. Qianjin Fang also has a large number of original formulas, such as Gallbladder-Warming Decoction, Spleen-Warming Decoction, Pillow Middle Pill, Pubescent Angelica and Taxillus Decoction, Gu Zeng Pill, Garrison Pill, Rhinoceros Horn and Rehmannia Decoction, Purple Pill, etc., all of which are clinically used today and are highly effective prescriptions.

3. Advocating the use of comprehensive therapy in clinical practice

Qianjin Fang advocates the use of comprehensive therapy in clinical practice, actively treating diseases through multiple approaches to facilitate early recovery. It should be noted that Chinese medicine, based on practical experience, has a broad range of treatment methods, not limited to internal medication alone. This issue needs to be given due attention.

(1) Combining medication with health preservation

Both Qianjin Yaofang and Qianjin Yifang have dedicated sections on health preservation. Sun Si-miao referred to health preservation as "nurturing nature" and explained that health preservation is "the theory of forming habits into nature," and "the light of treating disease before its onset is its meaning." In today's terms, it means developing good hygiene habits. Rather than being overwhelmed by illness, it is better to focus on health preservation to avoid the occurrence of diseases. This is completely consistent with the spirit of Neijing, but he did not believe in "living as long as heaven and earth, without end," but said, "those who are good at health preservation can live for one or two hundred years." In terms of health preservation methods, most of the methods he summarized are practical and feasible. For example, in terms of mental and emotional aspects, he believed that humans are not plants, who can be without emotions, but they should be moderated and not excessive. He criticized the royal families for having hundreds of beauties and indulging in excessive desires, "indulging their passions, their lives as short as morning dew," pointing out that excessive desires are very harmful and are "life-destroying things." Therefore, one should restrain desires when healthy and abstain when ill, with couples sleeping separately, "taking a hundred packets of medicine is not as good as sleeping alone." In terms of diet, he pointed out that in affluent areas, people often die young, while in frugal areas, people often live long lives. Excessive indulgence is often one of the important causes of many diseases. He criticized the harm of "eating too much during childbirth, indulging in flavors and overeating," and believed that "one should often eat less meat, more rice, and more vegetables." He did not completely agree with the method of "preserving health through stillness," believing that what Hua Tuo said about the human body "should get a little exercise, but not overdo it," and what "Lüshi Chunqiu" said about "water from a river does not rot, a door hinge does not rust" makes a lot of sense. Therefore, in Qianjin Fang's health preservation section, he included "Laozi tuina method" and "Tianzhu tuina method," which are actually two sets of simple and easy-to-do health exercises, almost including all the movements of the later "Eight Brocades." He also said that even the elderly, if they can do this one or two times a day, can achieve the effects of lightening the body, prolonging life, and maintaining health without illness.

(2) Combining medication with food therapy

He placed great emphasis on food therapy in clinical practice, often stating: "The properties of medicine are potent and fierce, akin to commanding an army. The ferocity of soldiers should not be unleashed recklessly; improper use can cause widespread harm. Similarly, indiscriminate application of medicine can lead to calamity.... Therefore, a physician must first thoroughly understand the source of the illness and the nature of the affliction. If food therapy does not cure, then medication should be prescribed." He thus prioritized food therapy over medicinal treatment. In the "Qianjin Fang," for various categories of diseases, both medicinal prescriptions and food therapy recipes are included. Examples include the use of raw radish juice for consumptive thirst, turnip juice for jaundice, Rice Bean for beriberi, animal liver for liver deficiency causing blurred vision, and sheep offal, sheep bone soup, and pig kidney soup for deficiency fatigue. It is particularly noteworthy that "Qianjin Fang" used food therapy to treat deficiency fatigue, which was an important supplement to Zhang Zhongjing's principle of focusing on the spleen and kidney and supporting yang with sweet and warm substances. For instance, in the kidney section of "Qianjin Yaofang," commonly used items included Pilose Antler, Deer Horn, ox marrow, chicken liver, horse penis, sheep kidney, pig kidney, and sheep head bone—substances rich in vital essence to tonify the kidney. Among these, Pilose Antler and sheep kidney were used in 27 prescriptions. For cases of yin essence deficiency, "Qianjin Bie" formulated prescriptions such as Peach Kernel Decoction, Asparagus Root Decoction, and the "Ten Thousand Gold Bone-Filling Paste," heavily utilizing Unprocessed Rehmannia Root,酥 (butter), honey, cow's milk, sesame, ox marrow, and Asparagus Root to nourish yin, replenish essence, and moisten dryness, opening a new realm beyond Zhang Zhongjing's methods. The "Food Therapy" section of "Qianjin Fang" records over 150 types of grains, meats, fruits, and vegetables, with concise notes on their indications, properties, and contraindications.

(3) The combination of acupuncture and moxibustion with medicinal treatment

Both of Sun's Qianjin Fang books have dedicated volumes on acupuncture and moxibustion. He believed: "The efficacy of acupuncture and moxibustion surpasses half that of decoctions," "Acupuncture and moxibustion attack from the outside, while decoctions attack from the inside, thus the disease has nowhere to hide." Therefore, "knowing both acupuncture and medicine makes a good physician."

Acupuncture and moxibustion indeed have high clinical efficacy. According to statistics, there are nearly a hundred common clinical diseases suitable for acupuncture and moxibustion. In the Nanjing region, the cure rate for acute bacillary dysentery treated with acupuncture and moxibustion reached 92.4%, demonstrating that the efficacy of acupuncture and moxibustion indeed surpasses half that of decoctions. The combination of acupuncture and medicine can certainly enhance clinical efficacy.

(4) The combination of internal and external treatments

Qianjin Fang also emphasizes external treatments. In addition to acupuncture, moxibustion, and tuina, it extensively employs various methods such as medicinal scalding, fumigation, washing, application, pasting, blowing, rubbing, and enema. External treatments not only can enhance the efficacy of internal medications but sometimes, when used alone, their efficacy is significantly higher than that of internal medications.

For example, the enema formula for dysentery recorded in Qianjin Yaofang is one such case. Sun often used pig gallbladder, clove, phelloendron bark, Chinese angelica, sophora, alum, realgar, liquorice root, musk, and salt for retention enemas. In recent years, there have been many reports indicating that this method has good efficacy for chronic dysentery and chronic nonspecific ulcerative colitis. Another example is the treatment of bi syndrome. For severe pain where internal medications have a slow effect or when the patient's constitution is too weak to withstand strong treatments, we often use the rubbing ointment recorded in Qianjin Fang (containing Chinese angelica, asarum, cassia central bark, dried ginger, big aconite root, dahurian angelica, aconite mother root, salvia, and unprocessed rehmannia root), or we follow its principle by soaking aconite mother root and kusnezoff monkshood root in alcohol and applying it with a cotton ball to the painful area, which has a good analgesic effect. Additionally, Qianjin Yifang treats chest impediment and chest and back pain by using aconite mother root, asarum, aconite lateral root, notopterygium, pricklyash peel, cassia central bark, and Sichuan lovage rhizome ground into powder, wrapped in cloth, and warmed over a low flame to apply to the chest and back. Recently, this method has been used for heart colicky pain, neuralgia, and pain caused by cancer metastasis, all with certain efficacy. The use of medicinal pillows to treat eye diseases also first appeared in Qianjin Fang. Wu Shi-ji of the Qing Dynasty, in his book "Li Yue Jiao Wen," once said: "The principles of external treatment are the same as those of internal treatment, and the medicines used in external treatment are the same as those used in internal treatment, the only difference is the method." This shows that the pathways of Chinese medicine for treating diseases are very broad. Unfortunately, currently, most treatments are limited to internal medications, not only causing many valuable ancient experiences to be lost but also making the clinical approach increasingly narrow. This is an issue worth paying attention to.