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(1) Life and Academic Thought

Dai Tian-zhang, courtesy name Linjiao, later known as Beishan. Born in the first year of the Kangxi reign of the Qing dynasty, died in the 61st year of the Kangxi reign (1662-1722), from Shangyuan, Jiangsu (present-day Jiangning). According to the Shangyuan County Annals, Dai was a county scholar, studied under Shaoshi Lin Qinglei for the imperial examinations, was studious and had a strong memory, able to recite entire histories backwards, like pouring water from a bottle. He believed that contemporary essays for official positions were insufficient for studying useful knowledge, and delved into astronomy, geography, archery, as well as calligraphy, painting, and chess, excelling especially in medical theory, widely read and deeply thoughtful, saving countless lives.

Dai deeply felt that the schools of Hejian, Yishui, and Dongyuan only had methods for treating epidemics but lacked specialized discussions, and believed that Wu Youke integrated ancient and modern knowledge with personal insights, his book "Wenyi Lun" was groundbreaking, revealing Riyue (GB24) in the sky. However, at that time, some physicians saw his book but did not believe it, or knew it but did not use it. Witnessing this, Dai took Wu's book, annotating, revising, or deleting parts, aiming to distinguish pestilence as entirely different from cold-damage disease, especially careful in distinguishing at the onset of symptoms, thus naming his book "Guang Wenyi Lun". This book is Dai's further development based on Wu Youke's "Wenyi Lun". It mainly discusses the diagnosis and treatment of warm febrile diseases originating internally. His diagnostic approach to warm febrile diseases is unique, and his treatment principles are extensively elaborated, providing significant clinical guidance. However, his selection of prescriptions and medications still heavily mixes pungent warm dryness, which seems inappropriate. He Lianchen also believed, "Upon careful study of the original book, I found that his discussion on dampness warm disease and dry heat is very brief, lacking in innovation, and the selection of prescriptions and medications is also not fully satisfactory."

(2) Academic Experience

1. Detailed Discussion on the Differences Between Warm Heat and Wind Cold

Dai distinguished warm heat from wind cold mainly based on the nature of the pathogenic factors, the pathways of infection, and the progression of the disease. He believed that although wind and cold are different, both are cold and not hot, affecting people by causing stagnation without dispersion, initially affecting the exterior, and should be treated with warm dispersion; warm heat arises from latent-qi warm disease, is hot and not cold, affecting people by causing heat and decay, and should be treated with cool resolution from the onset. The two have different natures, and treatment should not be mistaken. Regarding the pathways of infection and the trend of disease onset, Dai believed: wind cold enters from the exterior to the interior, so sweating should not be delayed, and purging should not be rushed, as the nature of the cause is cool, and it must transform into heat internally before it can be purged and cooled; warm heat emerges from the interior to the exterior, and even when it emerges, the interior may not be completely free of lingering pathogens, so purging should not be rushed, and sweating should not be delayed, as its nature is heat, and misuse of warm dispersion can initially lead to the spread of heat toxins, and further damage the true yin. As for the progression, Dai believed: wind cold enters from the exterior to the interior, so it often progresses from Taiyang (EX-HN5) to yangming to shaoyang and into the stomach; warm heat originally emerges from the interior to the exterior, so when exterior symptoms are seen, there are always accompanying interior symptoms.

2. Emphasis on the Diagnosis of Qi, Color, Tongue, Spirit, and Pulse

Through clinical practice, Dai believed that the diagnosis of warm febrile disease should be based on the differentiation of qi, color, tongue, spirit, and pulse, especially important for distinguishing the initial stages of warm febrile disease from wind cold external infections.

Differentiating qi: this means smelling the patient's odor. Warm febrile disease emerges from the interior to the exterior, and the disease emits a noticeable odor, lightly filling the bed curtains, heavily filling the room; while wind cold pathogens converge from the exterior to the interior, so at the onset, there is no odor, only when it turns into yangming fu syndrome, occasionally an odor is noticed.

Differentiating color: in warm febrile disease, due to internal heat and qi steaming, body fluids carrying foul qi rise to the face, so the head and face often appear greasy or smoky; at the onset of wind cold, due to the cold nature causing contraction without internal heat steaming, the complexion is often tight and bright.

Differentiating tongue: Dai believed that wind cold at the exterior has no coating, even if there is white coating, it is thin and slippery; while at the onset of warm heat, there is white coating, thick and not slippery, or slightly yellow, or rough like accumulated powder.

Differentiating spirit: wind cold pathogens harm people, who know their suffering, and the spirit remains clear, such as headache and chills, all known to oneself, until it transmits internally into the stomach, like unconsciousness and delirious speech; while pestilence at the onset, the spirit is abnormal, and the suffering is unknown, mostly dry, or like stupor or drunkenness, causing palpitations due to fright.

Pulse Differentiation: Dai believes that the pulse of warm and heat diseases, after transmission and transformation, is quite similar to that of wind-cold diseases, but it is significantly different at the initial stage. Generally, at the onset of wind-cold diseases, the pulse manifestation is mostly floating, with a clear and not vague rate; at the onset of warm and heat diseases, the pulse manifestation is mostly deep, often with a vague and unclear rate, either deep and slow, or deep and rapid but weak.

3. Sweating, purging, clearing, harmonizing, and tonifying are the main methods for treating warm febrile disease.

Dai's application of the sweating method emphasizes the timing of its use, proposing that "in warm disease, sweating should not be rushed," and believes that the purpose of using the sweating method is "to unblock stagnation and harmonize yin-yang." The purpose of using the purging method is mainly to expel pathogens, "to purge stagnant heat," and "in warm disease, purging should not be delayed." Since warm disease is characterized by internal heat stagnation, using bitter and cold purging methods to remove the heat source allows the stagnant heat to dissipate. Practice has proven that for most warm febrile diseases, early use of the purging method, or its combination with other methods, can indeed facilitate the smooth movement of qi, purge stagnant heat, and expel toxic pathogens, thereby improving efficacy and shortening the course of the disease. Dai pointed out that "seasonal epidemics are heat syndromes, and there is no case where clearing is not appropriate." The clearing method mainly refers to clearing heat, purging fire, and detoxifying, using pungent and bitter cold substances to target heat stagnation in the qi aspect or heat transforming into fire. Dai's so-called harmonizing method mainly refers to the combined use of two methods and post-treatment regulation. For example, combining cold and heat, tonifying and purging, resolving both the exterior and interior, and calming excessiveness. It can be seen that Dai's harmonizing method actually encompasses sweating, purging, clearing, and tonifying methods. The tonifying method is the method of tonifying healthy qi. Dai believed that warm febrile disease often damages yin, but there are also cases where excessive cold damages yang, so "tonifying yin and yang should be balanced according to their severity and not neglected."

In addition, Dai proposed specific treatments for the five concurrent syndromes and ten accompanying syndromes, effectively addressing the complex variations of warm febrile disease by distinguishing the branch and root, prioritizing urgency, and taking different measures, which serves as a clinical guideline.

(3) Major Works

Dai authored more than ten works, including "Commentary on Cough," "Commentary on Malaria," and "Expanded Treatise on Epidemic Warm Diseases," with the latter being the most widely circulated. Originally mistakenly attributed to Zheng Dianyi of She County under the title "Clarifying Pestilence," Dai's grandson, Dai Zuqi, discovered it in a bookstore and recognized it as his grandfather's work from the Cun Cun Study, "Expanded Treatise on Epidemic Warm Diseases." Although the title was changed, the text remained unaltered. He published the original version from the Cun Cun Study in 1778 to correct the misattribution and honor his ancestor. Lu Jiuzhi believed the book "clearly discusses warm heat" and thus retitled it "Expanded Treatise on Warm Heat." He Lianchen supplemented the missing parts, corrected errors, and added proven effective prescriptions from famous doctors throughout history, renaming it "Revised Expanded Treatise on Warm Heat." He commented, "In my opinion, for a detailed and precise discussion of latent-qi warm disease and warm heat syndromes, this book by Beishan is unparalleled."

"Expanded Treatise on Epidemic Warm Diseases" consists of four volumes with an additional volume of prescriptions. Volume one discusses the early symptoms, nature, transmission routes, and concurrent syndromes of pestilence. Volume two differentiates 22 exterior syndromes. Volume three differentiates 41 interior syndromes. Volume four discusses the treatment of pestilence, divided into sweating, purging, clearing, harmonizing, and tonifying methods, along with methods for diagnosing and treating deficiency, excess, sequelae, and special populations like women and children. The appendix contains 84 prescriptions for various syndromes. The book is characterized by precise pattern identification and detailed analysis. It not only provides key points for early diagnosis of pestilence but also details common syndromes, similar syndromes, critical conditions, sequelae, and concurrent syndromes, offering accurate analysis of pathology, differentiation, and treatment prescriptions, making it highly practical for clinical use. Thus, "Expanded Treatise on Epidemic Warm Diseases" makes a significant contribution to the understanding and treatment of warm febrile disease (latent-qi warm disease) based on pulse and pattern identification.