• Philip Niño Tan-Gatue

Li Dong Yuan and the Treatise of the Spleen and Stomach (Pi Wei Lun)

Different Strokes for Different Folks

Many of those not familiar with Traditional Chinese Medicine have the impression that Chinese Medicine and acupuncture are homogenous.  What this means is that instead of variety of hues making up a painting, it’s just one plain color.  They expect every practitioner to practice the same way, using the same techniques, the same points.  I’ve often been asked why so-and-so would use a certain set of points or a formula while another practitioner would use a different set or a different recipe.

The fact of the matter is that Chinese medicine is not homogenous.  Just like in martial arts, there are different schools of thought and different styles albeit with a common goal. In the case of martial arts, it’s to not get your butt kicked.  In Traditional Chinese Medicine, it’s to try to correct the underlying imbalance.

The Four Great Schools of the Jin-Yuan Era

Just as in the West, innovation can sometimes take a while to sink in.  the turn of the first millennium after Christ led to the High Middle Ages in Europe, superseding the Dark Ages.  Despite what naysayers would have us believe, the early 1100s paved the way towards the Enlightenment by establishing centers of learning such as universities.  In China, Neoconfucianism expanded with Zhou Dunyi and Zhu Xi.  New ways of applying the concepts of the Huangdi Neijing (see my blog entry here) became widespread.  These were collectively known as the Jin-Yuan Era.  The Schools that sprouted during this time, heavily influenced by Zhang Yuansu,  were the Cooling School of Liu Wansu, the Purging School of Zhang Congzheng, the Strengthening of the Spleen and Stomach School of Li Dongyuan, and the Yin Nourishing School of Zhu Danxi.

In this entry we focus on Li Dongyuan and his magnum opus, the Treatise on the Spleen and Stomach or Pi Wei Lun.


Li Dongyuan, image originally from http://www.taijichinesemedicine.com/lidongyuan.htm


Li Dongyuan (1180-1251)

Born in 1180 with the given name Li Gao in present day Baoding, Hebei province, Li was born into a rich family.  He was inspired to study medicine after his mother fell ill and died.  Li felt that being able to do anything while other doctors failed was a sign of his failure to practice filial piety.  Bob Flaws writes that “…he reproached himself that he should have known enough medicine to take care of her himself”. (Flaws, 2004)

He became a disciple of Zhuang Yuansu.  Based on his experience, he concluded that diseases were not just the result of environmental factors but also caused by poor function of the Spleen and Stomach.  Li emphasized that people could bring forth illness on themselves by not watching what they ate and drank, and by not taking care of themselves.  It may be said that Li observed and treated lifestyle diseases before the west even thought of the concept.  Flaws again writes, “…there was a famine in the area he was living… and people were also suffering from various epidemics.  Other doctors in the area relied on either the sweating or preciptation (i.e. purgation) methods for any and every patient, and therefore, many of these died.”  In modern terms, he people were obsessed with outside infection and other similar causes of disease while forgetting about building resistance and general health and wellness.

Pi Wei Lun

“Pi” means Spleen and “Wei” means Stomach.  In Traditional Chinese Medicine, the Spleen takes the function of the western spleen and pancreas.  To summarize, both Spleen and Stomach are needed to properly digest food and “extract” the grain (gu) Qi (glucose?)  from food to combine later with the Qi from air (oxygen, perhaps?) to provide nutrition.

In effect, Li’s emphasis could be restated thus: perhaps we could eat the right foods now, but longstanding poor diet and lifestyle has already made the digestion process inefficient, and we have less energy, so we have to restore that first before anything else could take effect. ( I recall a patient who suffered from exhaustion and insomnia.  She was referred to me by a colleague who did the usual “tonic” points like ST 36 Zusanli, etc, with little effect.  By using Yuan Source points LU9 Taiyuan and SP 3 Taibai to directly strengthen the Lungs (for the processing of Qi from the air) and the Spleen, the patient was able to have long term energy and even better sleep. But I digress.)

Li Dongyuan wrote and published his work the Pei Wei Lun in 1249.  In it he emphasized the importance of nourishing the Spleen and Stomach.  His favorite formulas include Bu Zhong Yi Qi Tang (Decoction for Reinforcing the Middle and Replenishing Qi) and Shen Yang Yi Wei Tang (Decoction for Activating Yang and Replenishing the Stomach).

This book is also the source for deficiency fire or Yin Fire.  What this means is that there are signs of Heat or Inflammation not due to external excesses but that yin deficiency leads to a seeming excess of Yang.  Hence, we shouldn’t try to drain Fire per se but clear Heat by nourishing Yin.  In my fallible opinion, this can easily apply to chronic autoimmune diseases.

This book has had such a profound influence on Traditional Chinese Medicine that Ye Tian Shi, an influential figure in the Warm Disease School, would later say, “For internal damage… one must choose the methods of (Li) Dongyuan.”

References:

Flaws, Bob.  Li Dong-Yuan’s Treatise on the Spleen and Stomach: A Translation of the Pi Wei Lun, 2nd Ed.  Blue Poppy Press, Boulder, Colorado.  2004

Zhu, Fanxie.  Classified Dictionary of Traditional Chinese Medicine.  Foreign Languages Press, Beijing, China. 2002

#LiDongyuan #PiWeiLun

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©2021 by Philip Niño Tan-Gatue, MD, CAc, CMA.