Institute of Classics in East Asian Medicine – San Diego

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Programs

September 15, 2011

Canonical Chinese Medicine Training™

Shanghan Lun Training Sequence, Los Angeles 2015 -2016

Weekend 1, The Energetics of the Five Flavors and Zhang Zhongjing Formulas
Weekend 2-4, The Inner and Outer Circles of Zhang Zhongjing’s Herb and Formula Archetypes
Weekend 5, Shanghan Lun Pathophysiology and Basic Patterns
Weekend 6, Shanghan Lun Pulse Diagnosis*
Weekend 7, Shanghan Lun Fukushin
Weekend 8, Shanghan Lun Formula Families
Weekend 9, Shanghan Lun Formula Modification System + Shanghan Lun Acupuncture
Weekend 10, Shanghan Lun Case Studies

Curriculum Description

The Energetics of the Five Flavors and Zhang Zhongjing Formulas (Taught by Arnaud Versluys)
Chinese herb actions are by no means arbitrary. The actions are rooted in the tastes and nature of the herbs as described in the materia medica classics and as proofed by centuries of clinical application. When herb classics like the Divine Farmer’s Materia Medica recorded these basic qualities; and theoretical classics like the Yellow Emperor’s Internal Canon instructed on their therapeutic indication and application, they came to clinical maturation in medical manuals like the Treatise on Cold Damage. From the architecture of the classical herbal formulas documented in the latter, we can observe how it is consistent with its theoretical predecessors.

The contemporary application of Chinese medicinals though, nowadays relies almost exclusively on the allopathic action an herb possesses. These actions may be superficially explained by the herb’s flavor and nature, but in many scenarios, even the best contemporary herbalist cannot explain ‘why’ many an herb does what it does or why a certain herb is applied in the stead of another. Only when one takes the understanding of the subject back to the original energetics, can one gain insight into the infinite knowledge of materia medica and increase clinical effectiveness.

This course is intended to explore the profound mechanisms behind the workings of the most commonly used herbs. First there will be an in-depth explanation of the physiology of the flavors, followed by an explanation of their many pathological aspects. In the second part of the lecture, a detailed description will be given of the most common herbs’ mechanism of action through an elaborate five phase model.

This seminar will allow both the beginning as well as the advanced herbalist to gain a deeper understanding of how the herbs work and through what pathway of action they achieve their therapeutic results. This knowledge will then directly contribute to a more detailed prescription behavior, better understanding of formulas and overall enhanced clinical effectiveness.


The Inner and Outer Circles of Zhang Zhongjing’s Herb and Formula Archetypes (Taught by Stephen Bonzak, LA ICEAM Branch Director)
This two weekend course is the instruction of specialized Materia Medica and formula
studies in the service of canonical Chinese medicine as practiced by Zhang Zhongjing in
the Shanghan Lun and the Jingui Yaolue.

The Treatise on Cold Damage shanghan lun and the Essentials of the Golden Cabinet
jingui yaolue are considered the ancestral books on formulaic science in Chinese
medicine. The books written in Han dynasty (approx. 200 CE) by Zhang Zhongjing are
the foundation of Chinese herbal medicine and the first clinical handbooks in the history
of human medicine.

Canonical herbal medicine is practiced according the rules of the Yellow Emperor’s Inner
Classic huangdi neijing, the Divine Farmer’s Materia Medica Classic shennong bencao
jing and the Yiyin Decoction Classic yiyin tangye jing. They still function to this day as
the foundation of all herbal formulas. It is widely considered that every herbal
prescription to date can be traced back to its roots in one of these classics. As such, the
importance of these single herb ingredients and the formulaic science of these
prescriptions are to this day unrivalled.

Zhang Zhongjing did not use large amounts of different ingredients but rather employed a
core selection of very simple and plain herbs, combined with the greatest scientific
perfection to design the most efficacious and safe herbal prescriptions existing. The herbs
used were all based on profound insights into the nature of our cosmos and showed
explicit and implicit correlations with both nature and the universe. Both single herbs and
formulas were seen as stars and constellations at an imaginary firmament and were often
even named as such, thus producing the famous names of prescriptions such as the Black
Warrior Decoction, or the Blue-green Dragon Decoction, to name but a few.
The first weekend is the authoritative introduction to the inner circle of Zhang
Zhongjing’s herbal world and introduces the participant to the core cabinet of the
archetypical twenty-five single herbs and their representative prescriptions. The herbs
and prescriptions will be introduced in a format of canonical monographs presenting
much more than the conventional pieces of information of actions and indications. A
monograph will instruct on the symbolism and star constellations related to the herb, the
signature of the plant, its qi and flavors and their respective density, movement
directionality and organ and channel affinity, herb actions and dosages, possible
acupuncture point equivalents, disease indications and lastly representative formulas with
their common modifications.

Sources referenced include the commanding Han dynasty Divine Farmer’s Materia
Medica shennong bencao jing, the Jin dynasty Records by Famous Physicians mingyi
bielu, and Japanese Shanghan Lun and Kampo master Yoshimasu Todo’s Herb Types
yakucho, to name but a few.

Both for beginners of herbal medicine as for advanced and seasoned practitioners, this
seminar is the gateway into herbal medicine practiced along the tenets of the Han dynasty
classics and doorway into canonical Chinese herbal medicine as practiced by Zhang
Zhongjing in the Shanghan Lun and Jingui Yaolue. The seminar introduces the
participant to Zhang Zhongjing’s inner circle of herbs and is prerequisite to the second
weekend follow-up course instructs The Outer Circle of Zhang Zhongjing’s Herb and
Formula Archetypes which is a selection of another 75 of the most important secondary
herbs of the Zhang Zhongjing universe.


Shanghan Lun Pathophysiology and Core Patterns (Taught by Stephen Bonzak, LA ICEAM Branch Director)

The Treatise on Cold Damage or Shanghan Lun is one of the most prominent Eastern
Han-dynasty (circa CE 200) classics in Chinese medicine and the first clinical handbook
in China’s medical history. It is also the center of the Canonical Chinese Medicine
Training.

The differentiation system and consequent text is outlined along a grid of six channels or
confirmations. This course aims to provide an in-depth understanding into the nature of
six confirmation pathologies as well as their systematic treatment.
The introduction will present the book and its author in the social and geo-political
setting of the Eastern Han dynasty. The concept of Cold Damage shanghan will be
explained from the Inner Classic of the Yellow Emperor huangdi neijing and the Classic
of Difficulties nanjing perspective as a class of externally triggered illnesses of
potentially contagious and lethal nature.

The second part of the instruction will focus on providing clear insight in the core
physiological functioning of the confirmations. Various models from the Neijing will be
used to analyze and explain the physiology and consequent pathology of the six
conformations.

Following, the instruction will focus on the understanding of the conformation
pathologies at hand. Insight will be acquired into the sequential time-based nature of the
confirmation pathologies and their passage patterns including pathological progression
and therapeutic regression possibilities.

The remainder focuses on the core conformation pathologies. First we will study the
standard or straight-up zheng patterns of all six conformations. The collective of these
patterns forms the complete outline of the Shanghan Lun and its system of six
conformation differentiation. The yang conformation patterns will be presented
categorized as surface patterns biaozheng, conformation or channel patterns jingzheng
and bowel or internal hollow organ patterns fuzheng along with their standard treatment
scenarios as embodied by the archetypical formulas. The straight-up yin conformation
patterns will be categorized according the nature of their presentation. The
aforementioned patterns will be taught in the form of formula patterns tangzheng which
will correspond to the pulse patterns maizheng as taught in the pulse weekend and the
abdominal patterns fuzheng as taught in the abdominal diagnosis weekend. Each pattern
will be presented from the perspective of its hallmark symptoms.

Lastly, the combined diseases hebing and co-existing patterns jianzheng, often identified
as diseases due to mistreatment huaibing will be presented. Regardless of how the
illnesses came about, the combined diseases will be categorized as yang conformation
combined patterns, yin conformation combined patterns, and lastly yin-yang
conformation combined patterns. In total, the sixty core conformation patterns, both
simplex and complex, of the whole Shanghan Lun will be covered.


Shanghan Lun Pulse Diagnosis from the Tian-Zeng Lineage (taught by Arnaud Versluys)

The Treatise on Cold Damage shanghan lun is the oldest surviving clinical handbook in
the history of Chinese medicine. Written by Eastern Han dynasty (circa 200 CE) imperial
envoy Zhang Zhongjing, it is an integral part of his collective writings once labeled the
Treatise on Cold Damage and Complex Diseases shanghan zabing lun. But the contents
of the Shanghan Lun as we know it in current day is far from complete. The present
versions studied in Chinese medical schools as well as in the West, do not include the
original first three chapters of Rules for Pulse Differentiation bianmai fa, Rules on Pulse
Assessment pingmai fa and Cold Damage Outline shanghan li. Regardless whatever
motivation was behind the historical deletions of these passages, of the aforementioned
chapters, the chapters on pulse instructions are crucial for anyone desiring to fully grasp
Zhang Zhongjing’s clinical instructions. Especially since the pulse patterns maizheng
form the core diagnostic parameters in the establishment of the formula patterns
fangzheng by which the canonical clinician categorizes disease and therapy.
The importance of the pulse instructions is best illustrated with the words of the late
Beijing Shanghan Lun scholar Liu Duzhou: “The Treatise on Cold Damage comprises of
one scroll on Rules of Pulse Differentiation and Rules on Pulse Assessment, which shows
that the study of Zhongjing puts great emphasis on regular pulses and pulse
differentiation. This needs no further elaboration. The pulse methods of Zhongjing
originate from the Inner Classic neijing and the Classic on Difficulties nanjing, while it
also has its proper areas of innovation. It uses yin and yang as basic statutes for the
classification of the pulse’s floating or sinking; strong or weak; and slow or fast qualities;
as well as the [pulse’s] changes through the chi and cun positions. It uses five element
theory to assess lengthwise zong and transverse heng, compliant shun or adverse ni
[passage] of unseasonal feishi pulses. It stresses that it is imperative to feel chi when
feeling cun, and to feel the foot as well as the hand as diagnostic methods. It indicates the
importance of the integrated assessment of the radial cunkou, instep fuyang and carotid
renying pulse divisions, and especially stresses the ultimate truth that the pulse is rooted
in stomach qi and that the presence of stomach qi leads to prosperity, while the absence
of stomach qi leads to death. In the discourse on pulse assessment, emphasis is placed on
the relationship of nutritive and protective with the abundance or demise of the three
burners, spleen, stomach and ancestral qi to indicate that the strength or weakness of the
person, and the presence or absence of disease is always intimately linked with nutritive
and protective. Therefore, the use of Zhongjing’s rules on pulses rests on the
understanding of disease and the decision between life and death. Hence, for mastery of
the theory behind the six conformations differentiation, one must imperatively study the
pulse differentiation methods for the benefit of one’s six conformation differentiation.”
In the practice of Shanghan Lun medicine according to the lineage of master Tian
Heming and his disciple Dr. Zeng Rongxiu, diagnosis is performed with the greatest
emphasis on pulse differentiation. Every prescription answers to a limited number of
pulse patterns. These pulse patterns maizheng thus form the basis for the identification of
the formula patterns fangzheng in a lock-and-key fashion. As such the actual steps taken
by the classical clinician to move from clinical differential diagnosis to treatment is
always and exclusively decided by the pulse. This is a process for which profound
understanding of the pulses becomes a crucial prerequisite of preceding importance over
the eventual in-depth mastery of the classical formulas.


Shanghan Lun Abdominal Diagnosis Fukushin (taught by Tracey Thorne, ICEAM Senior Instructor)
Japanese abdominal diagnosis or Fukushin is the diagnostic art developed in medieval
Japan based on the canonical writings by Zhang Zhongjing. Careful inspection of the
Shanghan Zabing Lun reveals countless references to abdominal conditions that could
only have been diagnosed by actual palpation of the abdomen. The skill however never
fully developed in China but flourished in Japan. Throughout history, two major trends
and types of abdominal diagnosis developed, being the Nanjing and Shanghan Lun
schools, which respectively diagnose the abdomen in service of either acupuncture or
meridian treatment, and herbal treatment. Fukushin refers specifically to Shanghan Lun
style of abdominal diagnosis developed by Japanese scholars during Edo period (1603-
1867 CE) for the purpose of prescribing the Han dynasty formulas of Zhang Zhongjing.
Japanese herbal medicine or Kampo translates as ‘the Han Method’. Of the two main
schools in Kampo, the Kohoha or School of the Ancient Method, teaches the medical
practice exclusively based on the Han Dynasty formulas of the Shanghan Lun and the
Jingui Yaolue. The Kohoha instructs on abdominal patterns and findings for virtually
every Zhang Zhongjing formula.

As an integral part of the Canonical Chinese Medicine Training™ of Dr. Arnaud
Versluys, Fukushin is taught to match the abdominal patterns with formula methods and
formula families. The pulse diagnosis seminar introduces a lock-and-key system for
recognizing pulses as herb methods. The Fukushin part of the canonical training
introduces the second leg of Zhang Zhongjing’s original diagnostic methods as a mirror
to the practice of pulse diagnosis, allowing for a failsafe system of diagnostic checks and
balances.

Through this training, the participant will learn the theory behind abdominal diagnosis
including an in-depth understanding of the pathomechanism of the abdominal patterns, as
well as the interpretation of these actionable findings and their direct translation into
herbal treatment with classical formulas. The second part of the course will instruct in the
hands-on procedure of the abdominal examination.


Shanghan Zabing Lun Formula Families (taught by Stephen Bonzak, LA ICEAM Branch Director)

The Shanghan Zabing Lun or the Treatise on Cold Damage and Complex Diseases is
considered the forefather of all formula books. The original work was lost to the tooth of
time, but most of its contents are preserved in two extant works called the Treatise on
Cold Damage shanghan lun and the Concise Essentials of the Golden Cabinet jingui
yaolue. The first work primarily addresses externally triggered disorders while the latter
work describes the pathology and treatment of complex diseases generated internally.
The herbal prescriptions or formulas recorded in this work form the basis for the practice
of Chinese herbal medicine. And only in-depth understanding of the architecture of these
formulas will ensure their effective and safe use in clinic. Furthermore, only an
encompassing insight in the inter-connectedness of the formulas and their modular nature
will allow a practitioner to expand on their clinical application ion modern clinic settings.
As such, when studying these formulas, it is imperative to cross-reference the
aforementioned two works because only cross-reference will allow the practitioner to see
the greater picture and reveal the full application context of a prescription. Since complex
diseases are often compounded versions of simplex conformation illnesses, Jingui
formulas are often hybrid modifications of the Shanghan formulas and vice-versa.
The course will instruct on the architecture of the classical herbal formulas of the
Shanghan Lun and the Jingui Yaolue in cross-reference, demonstrating how they relate to
each other and illustrating the full breadth of their clinical indications. The Shanghan Lun
and Jingui Yaolue formulas are related like family members and their architectural
characteristics will be taught in a modular pedigree fashion. As a starting point, the
formulas will be categorized in formula families which will show their mutual
relationships. The very concept of formula families was introduced by Zhang Zhongjing
in the taiyin chapter of the Shanghan Lun, and was greatly expanded upon by two Qing
dynasty Shanghan Lun specialists and commentators, Xu Lingtai in China and Todo
Yoshimasu of Japan.

Practically the course will provide an in-depth discussion on a core selection of formulas,
including both formulas for external invasion, as well as internal damage, all categorized
along core formula families. The familial affinity of formulas revolves around shared
herb methods. Herb methods represent the full spectrum functions of an herb in different
formulaic contexts. The course will instruct on the formula families of some of the most
central herbs methods of the Zhang Zhongjing universe. The families are: Guizhi family,
Mahuang Family, Fuling family, Shigao Family, Dahuang Family, Huanglian Family,
Chaihu Family, Ganjiang Family, Renshen Family, Banxia Family, Fuzi Family,
Shengdihuang Family, and the Danggui Family, etc. These are the very herb methods
whose diagnostic parameters were taught in the pulse and abdomen seminars. In total
around 200+ prescriptions will be discussed, which is approximately 60% of the Zhang
Zhongjing formula collective.


Day 1: Zhongjing Formula Modification Method (taught by Stephen Bonzak, LA ICEAM Branch Director)

During this day, a strict system of clinical modification will be taught. The system was
developed by Dr. Versluys over the course of the last ten years by analyzing both Zhang
Zhongjing’s prescriptions as well as the characteristics of the Tian-Zeng lineage’s clinical
practice. It is fully grounded and based in the classical writings of the original designer of
the formulas, Zhang Zhongjing. The system is organized along a hierarchical system of
formula modifications and provides a failsafe method for modification to adapt to a
broader collection of complex clinical manifestations as often encountered in Chinese
medicine clinic in the West. A waterproof modification system forms the basis of
classical herbal practice and the elimination of random clinical variables which are the
greatest cause for failure in clinic.

Weekend 9, Day 2: Shanghan Lun Acupuncture (taught by Stephen Bonzak, LA ICEAM Branch Director)

The six confirmations grid along which the Shanghan Lun is outlined, lends itself
remarkably as a clinical guide for acupuncture and moxibustion treatment. The six
channels or confirmations are the physical representations of the six climate influences or
six qi liu qi in nature. In the body they form the six pairs of hand and foot channels
directly linked to these six qi. Zhang Zhongjing, though being an ardent herbalist and
protagonist of the Shennong lineage in Chinese medicine, recommends acupuncture
protocols throughout the Shanghan Lun and Jingui Yaolue. He is the first historical
physician to actually recommend the integrated and streamlined use of herbal medicine
and acumoxa.

When using six conformations in diagnosis and differentiation, the identified pattern
dictates the treatment by stipulating a narrow selection of herbal formulas to be used.
These herbal formulas can then be extrapolated into an acupuncture model that follows
the same aforementioned physiological and pathological differentiation models, to obtain
ultimate consistency between herbal and acupuncture treatment for mutual enhancement
and increased clinical results. All this happens while eliminating the use of random
arbitrary point selections out of symptomatic considerations.

The goal of this course is to provide a framework for acupuncture and moxibustion
therapy based on Shanghan Lun rationale of the six confirmations. Specific point
prescriptions will be discussed, but even more importantly a methodology for point
selection that can be applied to any Shanghan Lun-based herbal therapy will be taught.
The methodology for point selection will consider the same many factors that the original
author has considered in the design of his herbal formulas.

The extrapolation process into a point prescription evidently considers the specific
attributes of point qualities as a basis for their selection. But the point selection goes far
beyond individual, sometimes symptomatic, actions and delves deeply into the realm of
channel specificity, yuan and luo qualities, transport point actions, back shu and front mu
points, channel intersections, local and distal combinations, hand and foot channel
connections, specific functions of points, and needling versus moxibustion, etc. As in an
herbal formula, the single ingredient is subordinate to the whole and the goal of the
acupuncture prescriptions is to employ the points as a balanced team on a joint mission.
Point selections for the discussed disorders are further influenced by the three conditions
of biao-ben-zhongqi physiology of the affected channel within the six confirmations, the
control ke cycle of the five elements as part of the pathomechanism, and the patterns of
disease progression in six confirmation pathology as outlined in chapter 31 of the Internal
Classic of the Yellow Emperor huangdi neijing. The point prescriptions become
simulations or holograms of the herbal prescriptions, though not necessarily in number of
ingredients/ points, but by all means in over-all therapeutic action and channel affinity.
This course instructs the participant in acupuncture point protocols to match the core
archetypical formulas of the Shanghan Lun. These very protocols have been developed
by Dr. Versluys and have been effectively used in clinic for many years, thus
demonstrating a solid track record. Upon completion, the participant will have mastered a
methodology to translate or extrapolate any classical herbal formula into an acupuncture
and moxibustion prescription, thus allowing for greater consistency in clinic, increased
efficacy and full herb-needle integration.


Shanghan Lun Case Studies (taught by Arnaud Versluys)

The Shanghan Zabing Lun is the first historical manual to teach the treatment of both
acute and chronic complex diseases that have been triggered externally or have arisen
from internal damage. Though a classical work, it is of great clinical value for modern
day practice.

During this seminar, Dr. Versluys will provide a case-based instruction on the
pathomechanism and herbal treatment of a core selection of modern diseases as analyzed
and regarded through the classical lens of Zhang Zhongjing. The cases all come from Dr.
Versluys’ personal clinic and are of great relevance in modern Chinese medicine clinic in
the West. Dr. Versluys has for years exclusively been practicing the classical style of
internal medicine as instructed in the Shanghan and the Jingui, and has amassed a great
amount of experience in this field.

The lectures are divided in clinical specialties such as Respirology, contagious illnesses,
gastroenterology, etc. [fill in all specialties here]. And some of the diseases discussed will
be: Hypertension, Meniere’s Disease, Crohn’s Disease, Depressive Disorder, Insomnia,
Coronary Heart Disease, Emphysema, Chronic Fatigue Syndrome, Hemophilia,
Cerebrovascular Accident, Rheumatoid Arthritis, Asthma, Cancer (benign and malignant
tumors), Arrhythmia, Infertility, Dysmenorrhea, Amenorrhea, etc.
These will correspond to the classical diseases of: Taiyang disease, Yangming disease,
etc, and combinations thereof, as well as more complex disorders such as Glomus pi,
Running Piglet bentun qi, Water Qi shuiqi, Chest Bind jiexiong, Phlegm Rheum tanyin,
etc.

The lecture will provide the student with an in-depth and advanced instruction on how to
effectively treat common disorders with herbal medicine. Insight in the pathomechanism
of the disorders will be obtained through case analysis and herbal formulas will be
explained and discussed with practical examples from clinic.

To register, or for more information on the courses, please visit http://chicago.iceam.org
or email sbonzak@chicago.iceam.org.