Pi Guoli studied at Phoenix Net.
Traditional Chinese medicine has a long history on epidemic diseases. As far as relevant written records are concerned, the record of "plague" first appeared in the Yin and Shang Dynasties. There has been a record of "sudden death" in Oracle Bone Inscriptions. After research, scholars think that the Yin people may judge the severity of the plague through the chastity divination, while The Classic of Mountains and Seas says: "If there are beasts, there will be a great plague in the world." There are five kinds of "phoenix birds" (the genus of phoenix) in the May Fourth Volume of the Book of Collection of Confessions in Yuhan Mountain House. One of them, "the dove’s beak and round eyes", as long as it appears, the plague will immediately follow.
The causes of infectious diseases are social politics, geographical environment, famine, traffic and other factors. According to scholars’ research, there were many infectious diseases caused by political and military factors in the epidemic history of China before Sui and Tang Dynasties. After Sui and Tang Dynasties, the geographical environment, developed transportation and frequent exchanges between China and foreign countries led to more infections of diseases. After the Song and Yuan Dynasties, the political and economic development center of China gradually moved southward. Due to the differences in climate and geographical environment, people first encountered infectious diseases dominated by parasites, and many diseases began to have differences between the northern and southern regions. These factors indirectly promoted the deepening and innovation of the theory of traditional Chinese medicine. Of course, the ancients could not know the existence of bacteria, so they could only describe the cause with the invasion of various "qi". In addition to "heat", Chinese medicine believes that wind, cold, summer heat, dampness, dryness and fire (six evils) may all lead to infectious diseases. For example, Biography of Historical Records of Huo Zhi contains: "Jiangnan is humble and wet, and her husband dies young." That is, the combination of environment (natural factors, biological environment and humanistic social environment) and the cause and effect of diseases is closely related to the development of traditional Chinese medicine, and "moisture" is one of the important factors leading to human diseases.
01
typhoid
From the descriptions of the ancient medical collections "Neijing" and "Difficult Classics", we can know that Chinese has been deeply aware of "fever" including infectious diseases for a long time. For example, "whoever suffers from typhoid fever becomes warm, the first summer solstice is the disease temperature, and the second summer solstice is the disease heat." ("Su Wen Re Lun") "There are five types of typhoid fever: apoplexy, typhoid fever, damp-warm, fever and febrile diseases, and their sufferings are different." ("Difficult to pass 58 difficult".
It is worth noting that the concept of "epidemic febrile diseases" at this time is still confined to the ancient typhoid system, and independent principles and prescriptions have not been developed, which is different from the development after the Ming and Qing Dynasties. Zhang Zhongjing experienced a great epidemic in the Han Dynasty. The preface of Treatise on Febrile Diseases reads: "There are many Yu clans, and there are more than 200 Yu clans. Since the Jian ‘an period, there are still less than ten, and two-thirds of them died, and typhoid fever ranks seventh." Therefore, since the publication of Treatise on Febrile Diseases, "injury to cold" has become the main discussion system of treating exogenous fever in traditional Chinese medicine. For a long time, Zhang Zhongjing’s medical prescription was the main force to treat the "plague".
Treatise on febrile diseases
The original meaning of "epidemic" should be related to "service" Zhang Gang pointed out in the Textual Research on the Origin of All Diseases in Traditional Chinese Medicine: People in ancient times served in the service of the country, who suffered the most from hunger, cold and hardship, so the epidemic was a disease, and it was most likely to appear when the people served. The ancients also believed that the epidemic was brought by ghosts, so there was a saying that "the epidemic is also a service, and the words are ghosts." These are all superficial understandings of diseases when ancient medicine was still in ignorance. Only after the emergence of the medical subject discussion focusing on "Qi" did the views on diseases change significantly. As for other pathogenic factors, there are relatively few references to epidemic febrile diseases in the existing Treatise on Febrile Diseases, and only a few concepts have been passed down, such as "sun disease, fever and thirst, those who don’t hate cold are epidemic febrile diseases" and "those who sweat and are already burning, are named wind and temperature in the day". It was not until the publication of Wu Youxing’s Treatise on Epidemic Febrile Diseases (1642) in the late Ming Dynasty that another system for treating fever, epidemic febrile diseases, was considered as a new way. However, not all doctors think that Treatise on Febrile Diseases does not discuss febrile diseases well. For example, Lu Maoxiu (word Jiuzhi, 1818-1886) in Qing Dynasty means that typhoid fever is the general name of all ancient fevers, and the methods for treating febrile diseases are also included in the typhoid law. He explained in the articles such as Differentiation of Radix Puerariae and Ramulus Cinnamomi and Treatise on Febrile Diseases that the clues of febrile diseases can be found in the "Yangming Disease" system in Treatise on Febrile Diseases from the aspects of diagnosis, syndrome differentiation and treatment.
02
warm disease
Another system to explain why the plague happened is Wu Youxing’s On Epidemic Febrile Diseases. He and Zhang Zhongjing had a similar experience of epidemic, and saw that doctors only used Zhang Zhongjing’s prescription to treat them at that time, causing a large number of deaths. Wu Youxing said: "There are more than dozens of people who talk about typhoid fever, which is very slight for epidemic febrile disease. It is based on the medical practitioners, what they remember and recite, and they are all typhoid fever and its clinical symptoms. They know about the epidemic and ask for its true typhoid fever. " Wu wrote down the great epidemic he experienced:
Chongzhen is full of enthusiasm, and the epidemic gas is prevalent. Shandong, Zhejiang and the north and south are both straight, and there are many people who feel it. It will benefit very much in May and June, or it will be transmitted to Hemen. At the beginning, when the teacher mistakenly ruled by typhoid fever, he never saw that it was not dangerous. Or the sick family mistakenly listens to what they want for seven days, otherwise, they will die on the fourteenth day, thus losing their treatment. There is a late death; Or use harsh agents indiscriminately, attack and make up for disorder and the dead; Or when doctors fail to understand, they are suspicious and timid, and they use slow drugs for acute diseases. Although they are not harmed immediately, they are everywhere.
Although the experience of the great epidemic was the same, the Eastern Han Dynasty did not reach the end of the Ming Dynasty, after all, after a short period of time, the prescriptions for treating infectious diseases in the original Treatise on Febrile Diseases were not enough, so Wu wrote another treatise on epidemic febrile diseases as a new thinking on treating fever. For example, it is recorded in The Theory of Epidemic Febrile Diseases and Miscellaneous Gases:
It is difficult to enumerate all kinds of diseases. About the disease is biased towards the side, delaying the door and closing the door, and everyone is the same, all of which are the qi of the times, that is, miscellaneous qi is also a disease. For all kinds of diseases, it is not necessary to know qi. Gai had a certain qi at that time, and he specialized in a certain zang-fu organ and a certain meridian, and he specialized in a certain disease. Therefore, the diseases of all people are the same, and it is not to know the qi, not to close the zang-fu organs and meridians, or to prove it. Husband’s illness can’t be arrested at the age of four, but it can’t be determined by five movements and six qi. It is knowing the qi all the time. Whether it originated in the city or in the village, it is nowhere else, and it is nowhere to be found. Epidemic qi is also one of miscellaneous qi, but it is worse than other qi, so it is quite serious, because of its name.
Wu Youxing, On Epidemic Febrile Diseases
Wu believes that all kinds of qi, collectively referred to as miscellaneous qi, may cause epidemics, but "furuncle qi" (epidemic qi) is the most serious cause. This theory officially sets the tone for the identity of the plague, subverting the cognitive system that used to respect "injury to the cold". However, it was the Qing Dynasty that the theory of febrile diseases was the most developed. Wu’s statement only opened a different way of thinking from Treatise on Febrile Diseases and did not become the only model. His so-called "miscellaneous qi" theory, which is different from epidemic qi, was replaced by the "evil qi" theory derived from the concept of six qi by most scholars of epidemic diseases in Qing Dynasty. Since then, the system of epidemic febrile diseases has become more complicated.
The war-torn between the Ming and Qing Dynasties, coupled with foreign trade since the Qing Dynasty, and the rapid population growth in southern China, made epidemic febrile diseases quickly become synonymous with local diseases in southern China. Among them, Wu Tang divided epidemic febrile diseases into wind temperature, warm temperature, epidemic febrile disease, warm poison, summer temperature, wet temperature, autumn dryness, winter temperature, warm malaria, etc. Among them, warmth, heat, summer heat, dryness, etc. are unhealthy qi in a broad sense, while "warm poison" and "epidemic disease" are caused by furuncle and foul poisonous gas. Now, these "pathogenic qi" all belong to the epidemic febrile disease, which dominates the feeling of the body when it is sick. For example, "dampness" will cause pain in bones and joints and a sense of stagnation. As Ye Gui said, "aversion to cold and fever, heavy body, joint pain, and dampness in muscles." This refers to the "hot" feeling of epidemic febrile diseases combined with "wet" qi. And because "summer heat" and "dampness" are both pathogenic factors, both of which are factors of disease occurrence, headache, body pain and fever are both symptoms of summer heat and damp heat. If the former is heavier, the situation of high fever will be more serious; If the latter is heavier, the body pain will be aggravated.
03
The barriers between cold and warm factions
The symptoms of patients become the treatment criteria. In this situation, Wang Shixiong said in "Essays of Chongqing Hall": "Summer is also wet, and it is also five qi. Summer belongs to fire, and dampness belongs to scholars, each living in the five elements, and fire and soil are in harmony. Therefore, summer and dampness are easy to combine, and righteousness is also common. " Therefore, in a word, miscellaneous qi is not only the cause of disease, but also the source of physical feelings. Fever diseases included in febrile diseases in traditional Chinese medicine are not only symptoms, but also the collection of patients’ physical feelings, and cannot be treated with an absolute single disease name. It is a unified and fixed definition based on the theory that TCM has the same symptoms, but less diseases with the same names.
Xie Liheng, a medical historian, said in The Origin of China’s Medicine: "Treatise on Febrile Diseases is an ancient book in the Han Dynasty, and warmth is a special disease today. It is said that there is no cure for febrile diseases in Treatise on Febrile Diseases. If you want to blame the people of the Han Dynasty for curing all kinds of diseases such as fever in later generations, it is too much to move. " Although the ancient books are ancient, there are thousands of diseases today, which really hit the nail on the head But interestingly, the theory of "injury to cold" still exists in the system of treating fever, and has not been forgotten as "out of date". For example, Wu Tang believes that "cold" is still the main cause of all exogenous febrile diseases, because it hides in the body and is touched in spring, so "injury to cold" is still an important inducement of fever infection. When Wu Tang criticized The Theory of Epidemic Febrile Diseases, he also said: "It is (or possible) to be ignorant of the principle that latent qi is the disease, and to regard what is the typhoid fever that is the disease, and what is the epidemic febrile disease that is" not the disease, but the spring ",so that the source of warmth is directly cut off, not the cold, and the ignorance of oneself is not blamed, but the absurdity of words is blamed." "Wu’s eyes were full of epidemic diseases when Chongzhen was fierce and wild, so he wrote the text" Winter hurts in cold, and spring will get sick and warm ". Everyone has their own prejudices and cannot be integrated. " From this point of view, it is possible that most febrile disease experts still respect Zhongjing’s theory, and the barriers between cold and warm factions are not as big as we thought.
Xie Guan, Zi Liheng, On the Origin of China’s Medicine.
Not to mention the doctors who advocate the classic prescriptions, they think that the differences between the cold and warm factions are just an excuse for doctors not to know Treatise on Febrile Diseases. For example, Tang Zonghai thought Treatise on Febrile Diseases was "the concealment of all diseases", and he refuted many doubts that "all books that were warm in later generations were called Zhongjing, only on typhoid fever, regardless of warmth". Tang believes that "differentiation of six meridians" is the outline of Zhongjing’s treatise on diseases, and Zhongjing takes into account wind, cold and warm qi. More importantly, Treatise on Febrile Diseases takes meridian diseases as a system to classify the symptoms and treatment system of exogenous fever, not just "cold" as the only basis, so it can be independent of "miscellaneous qi" and "epidemic qi", which is So in modern times, the two systems of TCM, cold and warm, can still have a dialogue with western epidemiology at the same time.
This article is taken from
Title: The Game of Modern Chinese and Western Medicine
Author: Pi Guoli
Press: Zhonghua Book Company
Subtitle: antibacterial history of traditional Chinese medicine
Publication year: June 6, 2019
Editor: _ Tong _ refers to Xinghua Village
The picture comes from the Internet.
Original title: "How does Chinese medicine understand the" plague "? 》
Read the original text
