Below are my own thoughts on and interpretations of Huang Huang’s approach to Chinese Herbal Medicine, based on my readings of his materials. It is written as a guide for those interested in his learning his approach to Jing Fang.
Professor Huang Huang presents Jing Fang not simply as a collection of ancient prescriptions, but as a clinical method inherited from the Shang Han Lun and Jin Gui Yao Lue. Its defining principle is Fangzheng, usually translated as “formula pattern”: the observable clinical evidence that indicates when a particular formula can be used safely and effectively.
This emphasis places Huang within a long tradition of formula-centered Jing Fang physicians. He cites figures such as Ke Yunbo, Xu Lingtai, Wang Xugao, Hu Xishu, Liu Duzhou and past and modern Kampo physicians, all of whom treated identification of the correct formula pattern as the practical endpoint of diagnosis. Huang’s distinctive contribution is to develop this tradition through a strong emphasis on constitution, bodily appearance, vivid clinical imagery, and the combined assessment of disease and person; next to his approachable teaching and literature which, thanks to pioneering and resourceful scholars and practitioners, is available in the English language.
Pattern Means Evidence
For Huang Huang, a pattern is not primarily an abstract explanation of pathology. It is not simply “Liver qi stagnation,” “Spleen deficiency,” or another theoretical label. A pattern is the concrete evidence that justifies using a formula.
This evidence may include:
- The chief complaint and characteristic symptoms
- The course and progression of the disease
- Body shape, musculature, complexion, and skin
- Abdominal findings
- Tongue and pulse
- Sign and symptoms such as appetite, sleep, sweating, and bowel function
- Emotional expression and behavior
- Past illnesses and recurring disease tendencies
The original passages of the classical texts preserve condensed descriptions of such evidence. Huang calls them clinical “handles” or “codes.” The practitioner’s task is to turn these brief descriptions into vivid, three-dimensional images of real patients.
Thus, “restlessness in the heart, unable to sleep” which can be found in classical texts, should not remain an abstract phrase. It should evoke a particular person: visibly agitated, exhausted, unable to settle, perhaps also suffering from palpitations, bleeding, hair loss, or skin problems.
The disease dimension includes the main disorder, its symptoms, course, structural or functional changes, and sometimes a modern biomedical diagnosis. Huang rejects the common assumption that Chinese medicine treats patterns while Western medicine treats diseases. The classical Chinese tradition also identified diseases, including conditions such as zang zao, pi disease, and hu huo disease.
The person dimension concerns the kind of patient in whom the disease is occurring. Two people may have the same biomedical diagnosis but require different formulas because their constitutions, physical reserves, emotional states, and reactions to illness differ.
Once disease and person are understood together, the practitioner identifies the matching formula pattern. The three elements can therefore be expressed as:
Disease + person → formula pattern → formula
For example, Zhu Ye Shi Gao Tang is associated with a disease situation, often the aftermath of a serious febrile illness, but also with a recognizable person: emaciated, weak, thirsty, lacking appetite, and possibly nauseated. Xiao Chai Hu Tang may correspond to recurrent fever or inflammation (disease), but the person may also appear withdrawn, depressed without appetite. The formula is selected because both dimensions correspond.
Constitution as the Clinical Image of the Person
Huang’s concept of constitution is broader and more practical than a fixed constitutional classification. Constitution is the relatively stable bodily and psychological state that shapes how a person becomes ill, displays illness, and responds to medicine.
It can include:
- Fatness or thinness
- Muscle development and abdominal tension
- Skeletal and facial structure
- Skin color, texture, and moisture
- Strength or weakness of the pulse
- Emotional tendencies, such as anxiety or depression
- Appetite, sleep, and energy
- Medical and family history
- Susceptibility to particular disorders
- Environmental and geographical influences
Some formulas therefore appear to “treat the person” more than a single disease. A person can show a presentation, which is not necessarily instantaneous symptoms; but rather a tendency or predisposition.
In that sense, Gui Zhi Tang, in Huang’s interpretation, corresponds to a fatigued, sweating, vulnerable person with reduced resilience. It’s not simply a formula for the common cold, it regulates the person as a whole. Bai Hu Jia Ren Shen Tang corresponds to intense thirst and heat combined with depletion and fluid deficiency. Such formulas may be used across several biomedical diseases when the same constitutional image is present.
Constitution is not necessarily permanent. Severe infection, surgery, aging, malnutrition, or chronic illness can produce a new constitutional state. A formerly strong person may become thin, depleted, dry, and weak. That altered state becomes essential to formula selection.
Constitution does not replace disease diagnosis. It makes treatment more precise by showing which person with that disease is likely to match the formula.
To summarize: Disease identifies the territory → person differentiates the patient → fangzheng selects the formula.
Huang Huang and Modern TCM Zang Fu Theory
Huang’s criticism of modern TCM is not that zang-fu theory is useless, but that it is often allowed to replace direct clinical recognition. In his view, labels such as “Liver yang rising,” “Kidney deficiency,” “Heart blood deficiency,” or “Spleen deficiency” are broad and potentially ambiguous. They may offer a conceptual interpretation of the illness, but they do not by themselves establish which formula should be prescribed. He objects especially to reducing isolated symptoms to standardized mechanisms, such as headache to Liver yang rising or loose stools to Spleen deficiency, while neglecting the actual disease, the individual patient, and the concrete evidence required for a particular formula.
Zang-fu analysis may therefore serve as a secondary explanatory framework, alongside six-channel, eight-principle, or modern pathophysiological analysis, but it should not be the endpoint of diagnosis. All such differentiation must ultimately arrive at fangzheng, the observable evidence for a specific formula. The decisive question is not simply, “Which organ system or mechanism explains this case?” but, “What disease is present, what kind of person has it, and which formula corresponds to this total clinical image?”
Learning Huang Huang’s Method
Huang recommends repeatedly reading the classical passages, studying detailed case records, observing patients closely, and documenting their appearance, posture, expressions, words, and behavior. Formula-pattern recognition is not merely theoretical knowledge. It is a trained clinical ability.
Recently translated books such as Classic Formulas for Primary Care or the older Ten Key Formula Families will be a great next step.
This overview is educational and is not guidance for self-prescribing Chinese herbal medicines.