Abstract
Objectives : This study aims to examine the multi-layered meanings of Li Dongyuan's concept of 'internal damage' through examining the origins of the 'internal damage' concept together with discussions derived from his 'Differentiation of Internal and External Damage'. Methods : Rather than Li's original works, those done by later doctors who were influenced by Li were thoroughly examined in this study to determine the relationships among internal and external damage, and external contraction. Results : Based on discussions related to the 'differentiation of internal and external damage' following Li, his concept of 'internal damage' could be understood as multi-layered, as it contains both spatial as well as pathogenic meaning. Therefore the meaning behind categorizations of internal and external damage, and internal damage and external contraction could be different. Li's 'internal damage' concept includes not only internal pathogen but elements of external contraction of wind and cold, which seems to have been integrated into the 'Cold Damage Theory' after Zhu Danxi, seemingly having changed the concept of cold damage. Therefore, discussions on the crossing between internal damage and external contraction have on one hand expanded the boundaries of each concept, while on the other hand, have caused confusion between the two at times. Conclusions : The concept of 'internal damage' has been widely accepted due to Li Dongyuan, on which related discussions have been centered. However, the concept was originally multi-layered, naturally leading to various discussions. Future studies should focus on the relationship of 'internal damage' with 'external damage' or 'external contraction', beyond the theories of Li.