An analysis of the national TCM master Lu Zhizheng's academic thought

Su Fengzhe（苏凤哲）*， and Yang Dan（杨丹）

Tongzhou District Hospital of Integrated TCM and Western Medicine， Beijing 100000， China*Correspondence author： E-mail：sfz1234@163.com



An analysis of the national TCM master Lu Zhizheng's academic thought

Su Fengzhe（苏凤哲）*， and Yang Dan（杨丹）

Tongzhou District Hospital of Integrated TCM and Western Medicine， Beijing 100000， China
*Correspondence author： E-mail：sfz1234@163.com

ABSTRACT

Lu Zhizheng as one of the first national TCM masters in China，has gradually formed an academic thought of his own after longterm clinical practice of TCM. Such as development of spleen and stomach theory，18-character guideline——holding central area， operating also， taking good care of emotional activities，soothing liver， moistening dryness， improving digestion， and while his conclusions have been used for clinical practice flexibly. He suggested that the key of pathogenesis may be excessive fluid together with phlegm dampness and proposed the treatment rules of diseases caused by dampness. And he attempted to expound the methods and results of the research of rheumatism diseases. If conditions of diseases change，Professor Lu Zhizheng would be agile and adjust according to the conditions. The method of herbs is principled，and King Way therapy used by TCM treatment should be promoted.

Traditional Chinese Medicine； Lu Zhizheng；Academic Thought； Overview； China

Lu Zhizheng is one of the first national TCM masters in China， it has been seventy years since he began to practice medicine. He has high-spirited medical ethics and superb skills. Combining the ancient and modern classics， Professor Lu has advanced new theoretical innovation and methods of traditional Chinese medicine. The brief overview of his academic contributions is as follows.

18-CHARACTER GUIDELINE， CREATING THE SPLEEN AND STOMACH NEW THEROPY

Professor Lu Zhizheng mastered classics of traditional Chinese medicine， advocating treatise on the spleen and stomach， poring over ancient writings of spleen-stomach theory. According to Li Dongyuan's theory， internal impairment of the spleen and stomach causes various diseases， Ye Gui's nourishing the stomach-yin，and Wu Cheng's regulating the spleen-yin had been elucidated for further analysis. And as the time passed， drink recipes and life habits changed， social environment changed， Professor Lu Zhizheng found that the old spectrum of diseases have changed from a large number of clinical practice. People usually eat and wear more in modern society， with highly developed material civilization. It's not the only cause of stomach and spleens diseases in modern society， causes such as unhealthy diet， irregular schedules， imbalance between work and leisure， and stress are equally responsible. Air pollution caused due to industrial waste and car exhaust has been a new factor， except six exogenous pathogenic factors——wind， cold， summer， damp， dryness， and fire. Pathogenic factors hurting the spleen and stomach in a new era is gloomy and can be caused by various factors as unhealthy diet， smoking and drinking， cold sorbet， excessive tired heart，overuse of brain， excessive ease， lack of exercise， and work pressure. The spleen and stomach provide the material basis of the acquired constitution. The nutrient of whole body depend on the transferring of spleen and stomach. If the function of spleen and stomach is impaired then there is more damp for stagnation of qi，and then a disease crisis is the outcome. After 30 years of clinical experience， Professor Lu Zhizheng gradually formed a system theory of regulating the spleen and stomach， which is called 18-character guideline —— holding central area， operating also，taking good care of emotional activities， soothing liver， moistening dryness， improving digestion. Then he created a new theory of the spleen and stomach.

Holding central area， operating also emphasizes the spleen and stomach and other organs. Central area means the spleen and stomach， and holding central area means taking that as a fundamental principle. All other organs shipped all around can take care of the other organs， meaning that the spleen and stomach can be used for the treatment of lesions in the other organs.

Taking good care of emotional activities， soothing liver stresses the importance of the relationship between liver and spleen and stomach. Liver is related to emotion， taking good care of emotional activities is the method of soothing the liver. Ye Tianshi said： “the liver is the thief of disease and spleen diseases”. It is pointed out that the relationship between liver andspleen and stomach disease. Professor Lu thinks that treatment according to the liver should be used in the therapy of spleen and stomach illness. That's expressing the same idea in different words. Ye Tianshi also pointed out： spleen should be up， the stomach should be down ， so the soothing liver is to restore the lifting function of spleen and stomach.

Moistening dryness， improving digestion emphasizes the character and function of the spleen and stomach， and balancing moistness and dryness in the spleen and stomach is the key to improving digestion. Spleen likes dryness and dislikes dampness whereas， stomach likes moistness and dislikes dryness； improving digestion refers to the functions of spleen and stomach. Spleen governs the transportation and transformation， and stomach receives food and drink. If there is balance of wet and dry， then the function of spleen and stomach is normal. Otherwise， it will cause contrary effects. That reflects the relationship between the character and function of the spleen and stomach.

Professor Lu Zhizheng created the spleen and stomach theory called 18-character guideline and pointed out the principle of regulating the spleen and stomach. And he explained the specific methods， which were regarded as the treatment standard of the spleen and stomach disease.

THE ETIOPATHOGENISIS AND TRETMENT OF RHEUMATISM，IMPROVING THE NEW THEORY

Physicians have been concerned about six exogenous pathogenic factors， and there has been very less discussion of dampness. But the dampness evil damages are broad， involving internal medicine， surgical department， gynecology， pediatrics and so on. Professor Lu Zhizheng， after gaining rich experience in several decades， proposed dampness is not only in southern China， but also in northern China， based on the former TCM theory of damp disease， and combined with his experience in human lifestyle changes， environment changes and changes of disease spectrum. He pointed out that： damp evil is everywhere and at omnipresent. In short， diseases rely on the damp part. Professor Lu Zhizheng thinks that dampness is indispensable in people's lives. But it's too far to be damp evil. Damp evil has been divided into inner dampness and outer dampness. Although there are geographical differences， in recent years， due to global warming and abnormal climate， the victims to the dampness in the North have often fallen. More importantly， with the improvement of people's living standards in recent years， with air-conditioning，drinking cold drinks， fat and rest disorder， insomnia at night， the number could potentially increase greatly around the world.

With the air-conditioning， cold wind caused intermingled cold and heat， skin rheumatism， muscle bi， cold frequency and so on. The cold and greasy food is not easy to digest， then “dampness disease” is caused by the loss of transportation of division i.e. spleen. That is the endogenous dampness with symptoms like heavy body burnout， chest tightness， abdominal distention and anorexia， loose stools， sticky greasy tongue. If the dampness is stopped， it will cause many diseases about warm drink，accumulated heat， wet phlegm and blood stasis， affecting many organs， such as rheumatoid arthritis， acute and chronic hepatitis，liver cirrhosis， Sjogren syndrome， Behcet's disease， acute and chronic nephritis， renal insufficiency， cerebrovascular disease，hypertension， hyperlipidemia， diabetes， gout. Both the symptoms and pathogenesis of pathogenic belongs to dampness， therefore，clinical treatment which targets at removing dampness will receive very good results.

In the treatment of rheumatism， Lu Zhizheng pointed out： muddy and sticky dampness can block Qi， so in the treatment， first of all，we should focus on the lung and spleen， the two organs. Therefore，in dampness treating process， doctors always follow the principle of “protecting lung and spleen Qi” in the first place. Whether bitter and warm dampness， clearing heat and removing dampness， light infiltration dampness and centralizer of evil， in combination with some herbs of Xuan Jiang lung Qi and Huazhuo Xingpi， such as almonds， platycodon grandiflorum， perilla stem， hopanes stems，lotus stem， patchouli， Perrin cardamom， Fructus aurantii and so on can have good clinical effect. In dispersing lung Qi and spleen，Chang Sanjiao at the same time plays a role of other drugs too. These herbs， are less in amount， had a very important role. In the treatment of damp disease， the amount of herbs is less significant，but the interpretation of the cause is more important. Professor Lu said： eating nutritious but not greasy， cold but not clotted， thinning the blood to supply， making it adjustable up to get peace and invigorating the spleen and stomach can help dampness cure.

Secondly， on the relationship between wet and dry， Professor Lu believes that wetness and dryness is the of dialectical relationship. If there is too much dampness， more dryness will also be followed. Because the causes of dryness have dampnessheat and spleen damp. Treatment of dryness is the treatment of wetness. There are some herbs that moistens dryness and promotes diuresis with drugs of tasteless flavor we can use， such as Su Terrier， loquat leaf， lotus leaf， lentils， Atractylodes rhizome，almonds， watermelon Cui garment， corn stigma， etc.， to eliminate dampness and promote the production of body fluid and do no harm to the Yin.

Thirdly， wetness and viscousness， spreading through the triple burner， can't get away quickly， so treatment should be slow through triple energizer and should not be anxious. There is a principle——When removing damp evil， we must not be quick，combining with the tea and porridge therapy method can make the best use of the circumstances.

To perfect the damp treatment theory， Lu Zhizheng guided his students （disciples）， more than 40 people in all， studied more than 20 years， finally completed a comprehensive discussion of traditional Chinese medicine dampness disease theories——TCM syndrome of dampness disease research， and in January 2007 it was published by Science Press. This book not only includes internal medicine， surgery， gynecology， paediatrics，otolaryngology syndrome in acute， chronic disease caused by the dampness， but also explains modern diseases such as AIDS and SARS new syndrome. This book contains dampness treatment of traditional Chinese medicine of 11 famous physicians. So the contents of talk to achelloeve， with intricate， fellow hailed it as one of the template inheritance and innovation of traditional Chinese medicine pharmacy， it provides important reference and guidance for the prevention and control of dampness. In 2009，the book won the excellent popular science book award.

THE INHERITANCE AND INNOVATION， OPEN FIELD OF RHEUMATISM

Lu Zhizheng is one of the founders of the National Institute of traditional Chinese medicine rheumatism.From the 80's of last century to the beginning of the new century， he was re-elected for his eighth chapter of professional committee chairman. For more than 20 years， he and colleagues had organized 12-times national and three times international Chinese medicine Rheumatology Conference. Through the organization of seminars， conducting courses， training， academic conferences，in various forms， they trained a large number of Chinese medicine professionals of rheumatic diseases. Through academic research， drug development， and international communication，they also achieved gratifying results and laid a solid foundation for the development of Chinese medicine Rheumatology. His contribution is also reflected in：

Firstly， he and his colleagues based on previous theories and experiences， systematically reviewed Bi for various diseases of rheumatism， identified by Bi， Bi disease， rheumatism disease；specification of the five body arthralgia （skin， muscles， tendons，vessels and bones） and obstructed visceral pain （heart， liver，spleen， lung and kidney） standard of diagnosis and effect， established the syndrome diagnostic criteria and principle method recipe， enriched the theoretical connotation of TCM rheumatism，laid the foundation for the standardization of Rheumatology in traditional Chinese medicine. Through clinical application and verification for more than 20 years， many standards are made feasible out of which some are adopted by the government in the national scale. They have had a positive role in promoting rheumatology research and raised the level of treatment.

Secondly， in rheumatism secondary disease research， Professor Lu combined with his own clinical experiences on the basis of previous experience proposed Dry Bi and explained the theory from the disease named， etiology and pathogenesis， syndrome classification， treatment medication and other aspects in 1989. He thinks Dry Bi is a syndrome of organ damage caused by dryness-evil （external dryness， endogenous dryness） and blood loss， deficiency of both qi and blood， limb tendons dystrophy，phlegm blended， blood stasis and context impassability， limb pain， even the skin disease. Dryness is the cause of disease and is also the result. Treatment can be done with nourishing yin for moistening dryness for urgent results， even if with other evils. Treatment should be based on nourishing yin for moistening dryness accompanied by evil spirits. In recent years， in fact，Dry Bi continues to emerge in the journals. And the Dry Bi theory proposed enriches the connotation of TCM rheumatology，promotes the inbounds and benefits patients.

Thirdly， in the ancient medical books of TCM， the name of Bi diseases on postpartum woman is irregular， varying from postpartum body pain， postpartum arthritis pain， postpartum gout， postpartum stroke ， postpartum channels detained urgent，postpartum chicken feet wind and so on. It is not difficult to find that the name of many of them overlap， which brought brought many difficulties to clinical diagnosis and treatment. Professor Lu Zhizheng thinks： the cause of postpartum paralysis is due to weakened body resistance and lack of blood or liver and kidney deficiency performance in addition to the common symptoms. So this disease is dominated by deficiency of Qi. For distinguishing and highlighting the characteristics of postpartum paralysis，Lu Zhizheng recommended： puerperal arthralgia should be the secondary name of disease， and the specific syndrome involved should be included. This proposal has been recognized by TCM colleagues.

Fourtyly， in recent years， the number of people with “gout”disease is growing. Some people think that it is a modern invention of “affluenza”. In fact， as early as the Yuan dynasty，Gezhi Yulun written by Zhu danxi included gout articles， he hasproposed the earliest discussion of gout disease in the world. Lu Zhizheng believes that the gout disease as Dan Xi said is basically the same as discussed in the modern medicine， and should be included in the rheumatic diseases. In order to clarify this issue， Lu Zhizheng checked lots of ancient and modern literature： Yiwu county annals， the Yuan Dynasty in the history of economic development， history of science and technology and so on. Astronomy， meteorology， geography of Yiwu in the Yuan dynasty， and production， economic levels were explored. The conclusion is humanistic and ecological environment in Yiwu，meet the three conditions of gout， wet， hot and comfortable living environment， which complements that the gout risk factors are consistent， but due to the limits of technology at that time，you cannot check for uric acid. According to the conclusions，Lu Zhizheng published gout discussion on and Danxi life and proposed gout， and the name of the era background of research study two articles， comprehensively expounding “gout” and the issue of attribution. These all publications produced positive effect to unify people's understanding.

The fifth： During the beginning of 1992， under the leadership of Lu Zhizheng and Jiao Shude， more than 70 experts and doctors of traditional Chinese medicine finally completed and published Practical Chinese rheumatology， the work lasted three years. Therefore， the book has a high starting point and certain authority. This is one of the most cited works of professionals. The book won the third prize of the national administration of traditional Chinese medicine science and technology progress.

BEING AGILE AND ADJUST MEDICAL PRESCRIPTION

In 70 years of career， Professor Lu Zhizheng paid attention to the scientific use of Chinese medicine theory to guide clinical usage. He has formed his own treatment ideas：the normalization of syndrome differentiation and treatment administration，identification according to the etiology， treating disease from the root， chosen according to climate， locality and individual，treating the same disease with different methods， using the same treatment in different diseases， concept of organic wholeness， agile and adjust medical compound prescription，drugs according to the changes of symptom. Learning the prescriptions of Professor Lu shows that there is no same law and， each prescription is permeated with the spirit. In the words of Professor Lu Zhizheng： it is being agile and adjust. To learn from Professor Lu， we should get detailed interrogation firstly，combined with the coating on the tongue and pulse condition， and then determine the diagnosis of TCM， etiology and pathogenesis and the legislation prescription. Such as the treatment of patients with dizziness， in the summer， the patients had dizziness giddy head， chest tightness， white greasy tongue coating， leucorrhea. Professor Lu analyzed that in the summer， damp evil diffused the triple Energizer， so the symptoms manifested. Dizziness is caused by Qing Yang stagnation of Qi， chest tightness， leucorrhea， and greasy tongue fur is caused by dampness. The key pathogenesis is dampness， and the dizziness is treated by invigorating spleen of legislation and resolving damp-turbidity using Fu Qingzhu's Wandai Decoction. Then leucorrhea， dizziness and chest tightness were reduced. He cured several patients who suffered from this disease using this method. The dialectical thinking of Professor Lu is to know more about the history and identify disease according to the etiology， pathogenesis and legislationand finally，being agile and adjusting medical compound prescription to treat the patients. His dialectical thinking reflects flexible treatment methods .

THE USE OF RATIONAL DRUGS， ACCORDING TO THE CHANGES OF SYMPTOM

The use of traditional Chinese medicine should always be compared to the rules of tactics. The method of using Chinese herbal medicines involves： first knowing well in pharmacology，and then applying such tactics. Professor Lu Zhizheng believes that the drug being processed can change the characteristics of Chinese herbal medicine， enhance the efficacy and reduce the side effects. If the processing methods are different， the functions are different too. Such as the usage of Pinellia ternata，detumescence in raw Pinellia ternata， eliminating dampness and phlegm in Pinellia ternate of lime and licorice root concocted，dampness and phlegm and Xiaopi Hewei in Pinellia ternate of alum concocted， Jiangni Zhiou in Pinellia ternate of ginger and alum concocted， clearing heat and resolving phlegm and Jiangni Zhiou in Pinellia ternate of bamboo juice concocted. Another example， radices paeoniae alba， Pinggan Lian Yin in raw radices paeoniae alba， Yangxue Tiaojing in radices paeoniae alba of fried with wine or fried， Yangxue Wenyang and Tongjing Huoluo in radices paeoniae alba of fried with Ramulus Cinnamomi. As for Rhizoma Atractylodis Macrocephalae， eliminating dampness in raw Rhizoma Atractylodis Macrocephalae， Hewei in Rhizoma Atractylodis Macrocephalae of fried， astringing in Rhizoma Atractylodis Macrocephalae of fried brown.

Professor Lu Zhizheng believes that the secret is to master the movements of Chinese herbs. Most diseases are caused by liftingQi dysfunction， we must be clear about the lifting of Chinese herbs before using， while we should understand the reasonable collocation of lifting drugs. It is not a simple drop and lifting up，coordination between ascending and descending is the key. Such as the disease caused by the insufficiency of the spleen yang and sinking of qi of middle-jiao， elevating the spleen-qi is the rule，accompanied by slightly running down， to prevent elevating too much. Just like BuzhongYiqi decoction， Cimicifuga， bupleurum，Radix Astragali， Radix Saposhnikoviae， notopterygium， Ge gen， Atractylodes are the herbs of elevating the Yang qi； dried tangerine peel of bitter orange are the herbs of coordination between ascending and descending. Usually， Professor Lu has a method of using Chinese herbs： combining ascending and descending herbs simultaneously. Such as the treatment of disease of the failure of stomach is to descend qi， Professor Lu uses the treatment of harmonizing stomach for descending adverse Qi， and Xiaqi Chuzhang with the herbs for elevating the Yang qQi， to prevent descending qi too much. He commonly used inula flower， pinellia， and hopanes stem to descend adverse qi； ginseng and ginger to ascend spleen qi. This can be described as coordination between ascending and descending. Due to spleen deficiency and qi stagnation， ginseng and astragalus membranaceus were applied in tonifying spleen and stomach by Sheng Qing Yang Qi， and Pericarpium Citri Reticulatae， perilla stem and Rhizoma Cyperi for Xingqi Tongjiang. Stomach damp heat can be treated with the rhizome of Chinese goldthread for purging fire and dried ginger for removing the damp， so-called symplectic ascending and bitter descending method.

Professor Lu also used the couplet medicines of Chinese herbs clinically， according to the properties of ascending and descending. Such as green husk and dried tangerine or orange peel all have the function of ascending. Green husk promotes qi of liver and gallbladder and warms the body for dispelling cold. Dried tangerine or orange peel promotes qi of spleen and lung. In diantheral matching， green husk promotes qi in the left， dried tangerine or orange peel regulates qi in the right. It plays the effect of dispersing stagnated liver qi for regulating stomach， regulating qi to alleviate pain， adjusting the functions of the stomach and spleen. Raw malt ascends Qi， raw millet sprouts relieves descending Qi to activate spleen. Compatibility between the two， affordable lifting completes each other， so that orderly lifting of the spleen and stomach make ease of transportation. Both of them can make supplementing effects in diantheral matching regulating the spleen and stomach thus，bringing the metabolic function to be normal. Professor Lu often used flowers of magnolia officinalis and buckeye to treat qi stagnation of spleen and for descending stomach qi respectively. Because， flowers of magnolia officinalis have pungent function for promoting qi circulation to alleviate middle energizer， and buckeye can relieve the liver and regulate qi. For the spleen and stomach qi stagnation and abdominal distension， the effect is good. Rhizoma Coptidis and dry ginger can Xin Kai Ku Jiang. Dried ginger can warm spleen and stomach for dispelling coldness， invigorating the Spleen Yang. Rhizoma Coptidis can dispel dampness heat in middle energizer. The disease of damp heat in middle energizer and distorted mixtures of cold with heat can be treated by Rhizoma Coptidis and dry ginger. The number of couplet medicines of Professor Lu are more than 100 like this，all of these couplets have extraordinary effects clinically.

GOING BACK TO THE SOURCE ORORIGINS，PROMOTING KING THERAPY OF TCM TREATMENT

Traditional Chinese medicine is rooted in Chinese traditional culture， its formation and development are affected by Chinese traditional ideology and culture， especially to The Book of Changes， Confucianism， Taoism. In the Qian Jin Fang Medical learning， Sun Simiao said： whoever wishes to be a good doctor must be familiar with Su Wen， Jia Yi， Huangdi Neijing， Mingtang streamer， the twelve meridians， Threebu Jiuhou， internal organs of the body， acupuncture points， herbal medicine， and various classical prescriptions from Zhang Zhongjing， Wang Shuhe，Ruan Henan， Fan Dongyang， Zhang Miao， Jin Shao， etc.. And if you want to be a famous doctor， you shall be familiar with Yinyang Luming， Zhujia Xiangfa， and Zhuogui Wuzhao，Zhouyi Liuren. Since then， some people said， He who knows no ZHOU， I could not become a doctor. which was passed on from generation to generation. “Medicine is based on Yi” has become a general consensus. Zhang Xugu in the Yi Men Bang He said：Medicine is based on Yi， that describes the ancient doctors have a common understanding： Medicine based on Yi. This is largely based on the book of the theory of Yin and Yang and Tai Chi theory， which is the formation of the theoretical system of the Huangdi neijing， in which there are important implications. As an important part of Chinese culture confucianism also has a direct effect on the traditional Chinese medicine， especially the doctrine of Confucius's Zhongyong and Zhizhonghe， to reconcile compromises and get harmony. The views of harmony way can prevent intensification， then we will get the pursuit of dynamic balance in contradictions and conflicts. So Chinese medicinealways focuses on balance， those theories are the therapeutic sources of open its flesh， making it up and achieve peace. Confucius advocated Zhongyong， and then righteousness and governance as well. His disciple Mencius thought to develop their proposed ideas of benevolent rule， known as King Way，advocating benevolent and overcoming people with good virtue. In contrast， be intrusive to force the world and force others to obey.

Professor Lu believes that medicine is a King therapy. The treatment of King therapy should protect Zhengqi and maintain Yin Jin. It could not only treat disease， but also save people. In TCM theory， we always focus on people-oriented idea， and use mild medicines. It is important to avoid the use of strong medicines for protecting the spleen and stomach.Supporting healthy qi and removing pathogenic factors is one method of benevolence of governance.King therapy thought is the mainstream thinking of TCM and directs TCM dialectic. It is able to exert the advantages of traditional Chinese medicine for obtaining the effects. So， King therapy thought is the only correct treatment of TCM. The formation of Lao Zi and Zhuang Zi School of Taoism played an important role in the development of preservation of traditional Chinese medicine， Chinese materia medica and prescription. Therefore， Professor Lu thinks that as a traditional Chinese medicine doctor， if you do not know the Chinese culture， it is groundless. If you want to be the authentic Chinese medicine doctor， you must firstly learn Zhouyi and the thought of Confucianism and Daoism as well. In particular，deep understanding of Confucian thought of benevolence is very important. The King Way of physicians are internal and external treatment with traditional Chinese medicine to regulate Qi and Blood， Yin and Yang. And you should reconcile the overall treatment of internal organs according to climate， locality and individual， and have being and adjusting medical compound prescription. This is also the essence and soul of Chinese medicine.

CONCLUSION

Professor Lu Zhizheng gradually formed the academic thinking in long-term clinical practice and his thoughts are： Lu Zhizheng's academic thought of spleen， wet theory of diagnosis and treatment of diseases， rheumatism of the innovative contribution，being agile and adjusting treatment according to syndrome differentiation， rigorous style of study， tracing the origin， King Way therapy. It is the crystallization of Professor Lu Zhizheng's clinical experience. The inheritance of academic thought of Professor Lu is of great significance to the development of traditional Chinese medicine and to enrich the connotation of traditional Chinese medicine.