The Han to the Wei, Jin, and Southern and Northern Dynasties marked flourishing period in the development of traditional Chinese medicine (TCM), during which multiple eminent figures emerged, including Zhang Zhongjing, Hua Tuo, Wang Shuhe, Ge Hong, Tao Hongjing, and Huang Fu Mi, who collectively laid the theoretical and clinical foundations of TCM.

Zhang Zhongjing

Zhang Zhongjing, styled Ji, was a native of Nanyang Commandery in the late Eastern Han Dynasty. His work Shanghan Zabing Lun (Treatise on Cold Damage and Miscellaneous Diseases) was later divided and circulated as two treatises: Shang Han Lun (Treatise on Cold Damage) and Jin Gui Yao Lue (Synopsis of Prescriptions of the Golden Cabinet). This book systematically discusses externally contracted febrile diseases and miscellaneous diseases due to internal injury, establishing the therapeutic principles of li-fa-fang-yao (principles, methods, formulas, and medicinals). Shang Han Lun (Treatise on Cold Damage) introduced the system of liujing bianzheng (pattern identification of six meridians), encompassing Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, and Jueyin meridians. Based on the interrelationship of meridians and zang-fu (viscera and bowels), it categorises externally contracted disorders into six stages, elucidating the depth, location, and transmission of disease, thereby laying the core foundation for bianzheng lunzhi (pattern identification and treatment determination) in TCM. The text contains multiple classic formulas still in clinical use today. Among them, Guizhi Tang (Cinnamon Twig Decoction) demonstrates rigorous formula composition, in which supplementation is contained within dispersion and astringency within scattering. It comprises Guizhi (Cinnamon Twig, Ramulus Cinnamomi), Shaoyao (Peony Root, Radix Paeoniae), Gancao (Liquorice Root, Radix Glycyrrhizae), Shengjiang (Fresh Ginger Rhizome, Rhizoma Zingiberis Recens), and Dazao (Jujube Fruit, Fructus Jujubae). Their combined use harmonises yin-yang (yin and yang) and regulates ying qi (nutritive qi) and wei qi (defensive qi). The formula may be modified for both externally contracted and miscellaneous disorders, and its variations gave rise to dozens of derivative prescriptions, exemplifying the essence of classical formula construction. In the chapter Bian Taiyang Bing Maizheng Bing Zhi Fa Shang (On the Pulse, Syndrome, and Treatment of Taiyang Disease Based on Pulse and Presentation, Part I), the text states: “Observe the mai (vessel) and zheng (pattern), discern the pathological deviation, and treat according to the pattern.” This passage marks the early articulation of therapeutic methods in TCM. The text encompasses various treatment approaches, including: hanfa (sweating method) in Mahuang Tang (Ephedra Decoction), tufa (vomiting method) in Guadi San (Melon Pedicel Powder), xiafa (draining downward method) in Da Chengqi Tang (Major Order the Qi Decoction), hefa (harmonising method) in Xiao Chaihu Tang (Minor Bupleurum Decoction), wenfa (warming method) in Si Ni Tang (Frigid Extremities Decoction), qingfa (clearing method) in Baihu Tang (White Tiger Decoction), and xiaofa (dispelling method) in Wuling San (Five-Ingredient Powder with Poria). However, Shang Han Lun (Treatise on Cold Damage) did not systematically categorise these methods into a unified framework. It was not until the Qing Dynasty text Yixue Xinwu (Medical Insights) that they were organised into the Eight Therapeutic Methods.

Hua Tuo

Hua Tuo, styled Yuanhua, given name Fu, was a native of Qiao County in Pei State during the late Eastern Han Dynasty and is honoured as the “forerunner of surgery”. According to Hou Hanshu (Book of the Later Han), Hua Tuo “incised the abdomen and back to remove accumulations”, pioneering surgical techniques such as debridement and intestinal anastomosis. He was the first to propose the surgical principle, “When needling and medicinals are insufficient, incision is employed.” Owing to historical limitations, however, his operative techniques were not fully transmitted. Hua Tuo formulated Mafeisan (Cannabis Boiling Powder), regarded as the earliest recorded general anaesthetic. Traditionally said to contain datura, it enabled patients to become “intoxicated and unaware”, thereby allowing abdominal surgery to be performed successfully. Although its composition has been lost, it inspired later developments in anaesthesia. Hua Tuo also created Wuqinxi (Five-Animal Frolics), a daoyin (guiding and stretching exercise) system modelled on the tiger, deer, bear, ape, and bird. Emphasising that “movement promotes the transformation of gu qi (grain qi)”, it is the earliest extant therapeutic exercise system and is inscribed on China’s National Intangible Cultural Heritage list. Modern research confirms its rehabilitative and health-preserving benefits.

Wang Shuhe

Wang Shuhe, given name Xi, was a native of Gaoping in the Western Jin Dynasty. He compiled the Maijing (The Pulse Classic) , which formally classified 24 pulse manifestations and described their tactile characteristics. The text specifies the diagnostic site as the cunkou (inch-opening) at the radial artery, reflecting the principle of “exclusive selection of the cunkou” articulated in Nanjing (The Classic of Difficult Issues). It further divides the cunkou into cun, guan, and chi positions and correlates the left and right hands with the zang-fu (viscera and bowels), thereby systematising pulse diagnosis.

Ge Hong

Ge Hong, styled Zhichuan, also known as Baopuzi, was a native of Jurong in Dan Yang in the Jin Dynasty. His work Zhouhou Beiji Fang (Emergency Prescriptions Kept Up One’s Sleeve) is regarded as the earliest extant clinical emergency manual in TCM. In the title, zhouhou (kept up one’s sleeve) signifies portability. The text records a wealth of simple, accessible, economical, and effective emergency therapies, such as “extract the brain of the biting dog and apply it to the wound” for rabies prevention, and descriptions of smallpox, “in recent years there have been epidemics, manifesting as sores on the head and body.” In Volume III, the book records a method for treating malaria: “Take one handful of Qinghao (Sweet Wormwood Herb, Herba Artemisiae Annuae), soak it in two sheng (litres) of water, wring out the juice, and ingest it fully.” This represents the earliest known documentation of qinghao for malaria treatment. The crucial instruction lies in “wringing out the juice” rather than “boiling the herb”, aligning with modern understanding that excessive heat may degrade active constituents. In 2015, Nobel laureate Tu Youyou drew inspiration from this record and employed low-temperature extraction to isolate artemisinin, demonstrating the scientific value of traditional medical knowledge.

Tao Hongjing 

Tao Hongjing, styled Tongming, was a native of Moli, Dan Yang, during the Southern Dynasties. His Bencao Jing Jizhu (Collected Annotations to the Classic of Materia Medica), integrated Shennong Bencao Jing (The Divine Farmer’s Materia Medica) with the Han and Wei clinical experience. He further developed the theory of four qi (cold, hot, warmth, and coolness) and five flavours (sour, bitter, sweet, pungent and salty) and expanded the materia medica to 730 substances through systematic annotation. The work laid the foundation for Xinxiu Bencao (Newly Revised Materia Medica), the first state-sponsored pharmacopoeia of the Tang Dynasty. It also departed from the original sanpin fenlei (three-grade classification) by organising medicinals according to natural categories, namely grains, minerals, insects, animals, plants, vegetables, and fruits, and further subdividing them by clinical function, such as detoxifying and wind-damp dispelling medicinals. It additionally recorded the place of origin and harvesting seasons, establishing the concept of daodi (geo-authentic) medicinals.

Huang Fu Mi 

Huang Fu Mi, styled Shian, was a native of Chaona County in Anding during the Western Jin Dynasty. He synthesised the essential teachings of Huangdi Neijing (Yellow Emperor’s Inner Canon) and Zhenjing (Needling Classic) to compile Zhenjiu Jiayi Jing (Systematic Classic of Acupuncture and Moxibustion). This text systematically describes acupoints by anatomical region, specifies insertion depth and the number of moxa cones, and standardised 349 acupoints, elevating acupuncture and moxibustion from experiential practice to a structured theoretical system.