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"Treatise on Resolving Doubts about Internal and External Damage"

《内外伤辨惑论》

Jin–Yuan · 1247

李东垣(Lǐ Dōngyuán,1180–1251)

Medical theory

Last reviewed: July 3, 2026

Introduction

"Treatise on Resolving Doubts about Internal and External Damage"

This page is cultural documentation, not medical advice.

A 3-volume Jin-Yuan medical treatise by Li Dongyuan (1180–1251), completed around 1247. The founding text of the "tonify-earth" (补土派) school and a landmark in the systematic distinction between "external" and "internal" disease causation.

Li Dongyuan, styled Mingzhi and self-styled Dongyuan, was the second of the "four great masters of Jin-Yuan" and a student of the even earlier pioneer Zhang Yuansu. The treatise systematizes the distinction between "external" disease (六淫, six pathogenic factors from outside) and "internal" disease (内伤, dietary, fatigue, and emotional damage to spleen and stomach). The text contains the formula Dāng Guī Bǔ Xiě Tāng (当归补血汤, "Blood-Supplementing Decoction") in the chapter "暑伤胃气论" (Treatise on Summerheat Damaging Stomach-Qi), a 5:1 Huáng Qí + Dāng Guī formula that became one of the canonical "tonify qi to generate blood" formulas. The book is, in short, the foundational text of the spleen-stomach-centered "internal damage" school.

Historical background

The Nei Wai Shang Bian Huo Lun was composed by Li Dongyuan in 1247, two decades after the fall of the Jin dynasty and during the early Yuan-dynasty rule. The text is a companion to Li's earlier and more famous Pi Wei Lun (脾胃论, "Treatise on the Spleen and Stomach"), addressing the diagnostic confusion between external-contraction and internal-damage patterns. The book emerged in a clinical context where many patients presented with chronic disorders rooted in dietary excess, prolonged fatigue, and emotional strain. Li's systematic distinction reframed a large portion of the internal-medicine disease landscape and laid the conceptual groundwork for the tonify-earth (补土) school. The text is, alongside the Pi Wei Lun, one of the canonical theoretical works of Jin-Yuan medicine.

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About the author

李东垣(Lǐ Dōngyuán,1180–1251)

Li Dongyuan (李东垣, 1180–1251), styled Mingzhi (明之) and self-styled Dongyuan Laoren (东垣老人, "Old Man of the Eastern Wall"), was a Jin-Yuan physician from Zhengding (modern Hebei).…

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