The Treatise on the Spleen and Stomach: A Translation of the Pi Wei Lun

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Summary: Notes by the master of supplementing-earth
Review: The Pi Wei Lun, or Spleen-Stomach Treatise, is the magnum opus of Li Gao, styled Li Dong-yuan, one of the four great masters of Chinese medicine during the Jin and Yuan dynasties. Li was the founder of the bu tu pai, or supplementing-earth school of medical thought, which continues to exert a profound influence on modern Chinese herbal medicine; many standard herbal prescriptions used in teaching and in practice were first recorded or devised by Li Gao. In the Pi Wei Lun, Li outlines both the classical and practical foundations of this school.

One of the most fascinating portions of the Pi Wei Lun is Li's commentaries on earlier classic works, including the Nei Jing, Nan Jing, and the works of Zhang Ji (Zhang Zhong-jing). Indeed, by revealing his thoughts on these sources, he makes it clear that the importance of spleen-stomach theory had been realized well in advance of the Jin and Yuan. It was, however, the Chinese medical "renaissance" of that period that recapitulated so much of what had earlier been said on the subject and advanced it as an integrated basis for the practice of internal medicine.

Li's writing is not straightforward or systematic. Rather, the Pi Wei Lun is a collection of notes and essays on spleen-stomach theory. Although many example prescriptions are listed, relatively little is offered by way of explanation. As in many historical works on the subject of Chinese medicine, it is assumed that the reader is both astute and very learned. The translators thoughtfully included many footnotes and glosses for the benefit of modern readers, but even these assume a level of proficiency at least commensurate with professional practice. It is a book to be lived with, as opposed to merely read. Nevertheless, for its information on composing prescriptions, the variations of treatment through the seasons, comments on classical references to spleen-stomach issues, food damage, "yin fire," and clinical applications, the Pi Wei Lun is essential reading.