Abstract
Objectives : To determine the background against which Zhishi has been applied to treat Pi pattern, through examination of changes in Pi pattern treatments in a historical context. Methods : The properties and nature of Zhishi as written in multiple bencao texts were analyzed. In addition, understanding of the Pi pattern, the changes in its treatment were examined diachronically based on opinions of Zhang Zhongjing, Zhugong, and Li Dongyuan. Examples of Zhishi application in Pi pattern treating formulas were collected and their mechanisms analyzed. Results : Zhishi is strongly effective in relieving accumulation and stagnation, due to its properties of dispersing and lowering. The early view of contrasting Pi with Jiexiong shifted to viewing the Pi pattern as an inner damage, from the perspective of rising and lowering of the Qi mechanism based on the Spleen and Stomach. As a result, Zhishi became a key ingredient in the treatment of the Pi pattern. Conclusions : As the perspective of seeing Pi as one end of the Yin-Yang coupling with Jiexiong from the Shanghanlun shifted to seeing it as a problem of Qi mechanism of the Spleen and Stomach, Zhishi became a key ingredient in the formulas to treat Pi pattern. The complexity of Zhishi's direction made it appropriate to treat the changed Pi pattern.