The Study Of The Original Development Of Diseases Of Abdominal Masses And The Features Of Herbs,Formulas And Syndromes Related To These Diseases

ObjectiveThis research focueses on many issues based on many problems caused by incorrect treatment of chinese medicine on tumors.For example, completely directed by modern medical knowledge of treatments and thinking, abusement of anti-tumor herbs,especially lack of holism research on the abdominal masses in the ancient chinese medical books.This research comprehensively study on the medical opinions,herbs,formulas and medical cases of abdominal masses talked about in ancient times(before1911).Preliminarily summarize the features of the abodominal masses in different periods, summarize the high-frequently-used herbs in different periods,identify the symptoms and herbs of medical cases,lay the foundation for the next step to explore more deeply the relationshipa between abdominal masses and tumors.MethodsUsing the methods of philology, statistics,academic research method of Chinese medical to explore the original development of diseases of abdominal masses and the features of herbs,formulas and syndromes related to these diseases.Results1.The Overview of Theoretical Viewpoints of Ancient PhysiciansThis topic is based on the time and physicians and analysed the representative medical contents in different periods.More than one hundred medical books range from Qin-Han Dynasties to Ming-Qing Dynasties directly recorded these diseases according to the literature research.The result found that bdominal masses were researched in different periods and Summarized the contents of the related research into Table18.2.Theoretical Research on Important Ancient Doctors of These DiseasesThe research focused on the theory of the diseases of15medical books, which were decided by the time prestiges and pecularities through my extensive collections of medical books.Therefore, other physicians'medical theories are only comprehensively discussed in the part of'other physicians in each period'.In this way,this research highlighted the overview of development of these diseases.2.1Qin-Han Dynasties were the first period of the development of the theory of abdominal masses. Many books including The Medical Classic of Huangdi,Classic on Medical Problems constituted the basic theoretical framework of these diseases,which is the groundwork for the later doctors to further develop this theory.The words'Ji-ju'firstly appeared in The Medical Classic of Huangdi.According to statistical data, there are more than20kinds of related diseases in this book but the identification standard had not been established. Except that these diseases occured in the organs, The Medical Classic of Huangdi also investigated that they occurred in the meridian systems,but later physicians did not develop it.This research Preliminarily summarized the diagnosis experiences of these diseases,including pulse-taking and palpation. The Medical Classic of Huangdi basically formed etiological theory with exogenous pathogenic factors,endogenous factors and dietical factors,which laid a solid foundation for the later research. As for the treatment,It said that'to cool the heat,to heat the cold, to eliminate the mass','Ji-JU need to be treated only half'Classic on Medical Problems firstly proposed concept,location,symptoms, pathogenesis and prognosis of masses in the five internal organs and established the theoretical system, the identification standard of abdominal masses and Cun-Guan-Chi pulse taking.2.2Sui-Tang dynasties inherited the theory of former periods.It did a great contribution on herbs,formulas and acupuncture.Discussion on the Origins of Symptoms of Illnesses inherited the basic viewpoints of The Medical Classic of Huangdi and Classic on Medical Problems. For example,this book generally promoted the viewpoint 'abdominal masses are the diseases of organs'.The combination of exogenous and endogenoud factors produced these diseases.It also mentioned that if the pathogenic factors influented organs for a long time and are not cleared away,abdominal masses wil be refined.This book emphasized that Ji-Ju are formed by the long-term affect of pathogenic factors on the body and has all kinds of side-symptoms. Research showed that this book also elucidated these diseases,for example, twelve kinds of Zhen-Jia and eight kinds of Jia of females.The author of Thousand Ducat Formulas Sun Simiao thought that abdominal masses and Liver are closely related,which reflected the relationship between the activities of Qi and these diseases.The treatment methods are independent on neither young or old. There was even an academic thought which said 'different diseases need different herbs and formulas'.This book inherited the four diagnostic methods of The Medical Classic of Huangdi and Classic on Medical Problems.This book also cited12acupoints in acupuncture treatment which belonged to many meridians.The author of Necessities of a Frontier Official WangTao inherited the etiology and pathogenesis of The Medical Classic of Huangdi and Classic on Medical Problems and so on. He used moxibustion to treat the diseases.2.3Song-Yuan Dynasties were the most comprehensive and innovative periods of the theory of these diseases,which deeply influenced later physicians.San-yin Ji-yi Bing Zheng Fang Lun focused that the emotions are the basic causes of the five kinds of Ji and their names are newly interpretated. By using the basic functions of Three-Yang to understand 'Liu-Ju'.It said that "Zhengjia belongs to liver, JiJu belongs to the lungs'.The incorrect eating habits are also the cause of these diseases, and the theory of preventing diseases are also mentioned.The author of HuangdiSunwenXuanmingLunfang and SuwenXuanjiYuanbingShi Liu Wansu said that the spleen and stomach are the root of the diseases,Using 'KanghaiChengzhi' theory to explain the cause of Ji by the heat evil,which reflecting the academic thinking of the Cold School. As for the treatment,attacking method, scatterring method, eliminating method, purgating method and circulating methods are the main methods.This book also mentioned that there are differences between Zheng and Jia, Jia is based on Zheng, Zheng is the outcome of Jia.Confucian's Duties to Their Parents insisted that abnormal activities of Qi,exogenous factors,incorrect dietital habits and abnormal emotions are all the causes of these diseases from the viewpoints of etiology.Mistreatment is also an important reason to cause the diseases.He also newly understanded the five kinds of Ji.It also promoted that the treatment of five kinds of Ji were simmilar to mental diseases. Comprehensive methods such as diaphoresis,emesis and purgation are used to treat them.The author of DanxiXinfa and MaiyinZhengzhi Zhu Danxi said thatlacation, etiology and pathogenesis of the diseases are related.'Ji in the abdomen are caused by phlegm,Ji in the right side of abodomen are caused by food, Ji in the left side are caused by blood clot'.According to specific types of abdominal masses,there are four kinds of treatment such as'tonificating method, attacking method, resoluting method and leading method'.He also explained the five kinds of Ji in many ways.2.4Ming-Qing Dynasties are the mature stage of the theory of these diseases,which set up the basic current understanding of cademic ideas and thinking of abdominal masses.The author of Complete Works of Jing-yue Zhang Jingyue inherited the viewpoints of Classics and brought into playing some contents.Zhang Jingyue insisted that the diseases are closely related to vital Qi,evils and daily life.He discussed that incorrect dietital habits,cold factor, blood-gas pathogens were due to different features of the diseases.He began to talk about the viewpoint that different physiques and related to different abdominal masses. He proposed eight kinds of treatment accumulated the basic guidelines,and determined four kinds of methods which including attacking,resoluting,dispelling,tonificating methods. He distinguished Zheng from Jia and also promoted the etiology and treatment of XueZheng, Shizheng, QiJia.The author of ChishuiXuanzhu Sun Yikui insisted that the diseases can be divided by Yin-yang. Organs are related to Ji-Ju.The diseases can be divided into two kinds by their locationss,that is,inside and outside.He questioned the Spleen-Ji,Kidney-Ji.Shi-Jia and the abnormal transformative function of bladder were directly related. As for the treatment,inside and outside masses had different treatment methods.The author of ZabingYuanliuXizhuo Shen JinAo insisted that the Stagnant qi is the root cause of these diseases,phlegm and blood stasis are only side causes.He used the theory of Triple-Jiao to explain the abdominal masses.He investigated the high rate of occurrences of the diseases to some kinds of people.He realized that when being treated, Zhengjia need pills not decoction.The author of YixueXinwu Cheng Zhongling inherited the contents of abdominal masses in the ZhengzhiZhunsheng which recorded the three methods about abdominal masses according to their three stages.On the methods of treatment,he used dispelling method. Different symptoms need different herbs.3.Statistical analysis of herbs,formulas and medical cases in different dynasties3.1The Analysis of Herbs and Formulas in the Prescription BooksQin-han and Sui-tang Dynasties contained101kinds of formulas and207kinds of herbs.From frequency analysis of herbs and formulas,It shows that in the frequent number appeared more than22times,herbs of pungent-warm account for about50%, which is closely related to the viewpoint of those dynasties that pathogenic cold has colse relationship with JiJu.In the frequent number appeared more than5times,herbs of the purgation, regulating the flow of Qi and promoting blood circulation,relieving exterior disorder are frequently used. According to the results of frequency analysis,factor analysis were used to those herbs which are more than ten percentage according to herbs/formula ratio,medical features are divided into three categories:warm Yang, regulate qi and fortify the Spleen, tonify and activite blood, diffuse the lungs to resolve phlegm,purgaging the bowel movement to clear away the pethogenic heat.Song-Yuan Dynasties contained274kinds of formulas and240kinds of herbs. From the frequency analysis, ratio of the herbs of pungent-warm significantly decreased,which is different from the style of Qin-Han and Sui-Tang Dynasties. The number of herbs for relieving exterior disorder reduced. Herbs for regulating vital energy and herbs of regulating the flow of Qi and promoting blood circulation were still frequently used. According to the results of frequency analysis,factor analysis were used to those herbs which are more than ten percentage according to herbs/formula ratio.Medical features are divided into four categories:soothe the liver and regulate qi,activate blood and resove stasis and regulate qi,fortify the spleen and tonify stomach,unblock Yang to dissipate binds and activate blood.Ming-Qing Dynasties contained664kinds of formulas and342kinds of herbs.From frequency analysis,It shows that herbs for regulating vital energy and herbs of regulating the flow of Qi and promoting blood circulation, herbs for water-draining, herbs for worm-expelling were still an important varieties of herbs.According to the results of the herbs frequency analysis, factor analysis were used to those herbs which are more than ten percentage according to herbs/formula ratio. Medical features are divided into three categories: activate blood and resove stasis,soothe the liver and regulate qi,soften hardness and dissipate binds, tonify and nourish spleen and stomach. Herbs focused on Spleen and Stomach,Liver and Gallbladder meridians.Herbs for regulating vital energy, promoting blood circulation,nourishing Spleen and Stomach are major. Treatment based on Qi-blood, syndrome differentiation of Zang-Fu haD matured.Basically determined the treatment and medication type of these diseases.3.2The Analysis of Herbs of the Five Kinds of Ji in the Prescription BooksQin-han and Sui-tang dynasties,39kinds of formulas were selected.Herb features are divided into three categories:warming-Yang ang regulating qi, diffuse the lung toresolve phleg,warm yang and tonify qi and blood, fority spleen and soothe the liver,soften hardness withpurgation.Song-Yuan Dynasties,51kinds of formulas were selected. Herbs features are divided into two categories:acitvate blood and resovle stasis and activate qi,tonify qi and meridian-warming and relaxing. Ming-Qing Dynasties,135kinds of formulas were selected.Herbs features are divided into three categories:warming Yang and activate qi,activate blood and resolve stasis and relax the bowels,fortify the spleen to sweep phlegm and regulate meridians.In the aspect of herbs using, the impact of its academic opinions were significantly obvious.It is no significant changes in the combination of herbs treating five kinds of Ji.3.3The Analysis of Herbs in Medical CasesThis part of study selected700kinds of medical cases and453kinds of herbs.From the herbs frequency analysis,It shows that the following kinds of medication are included in the medical cases:herbs for promoting Qi,herbs of regulating the flow of Qi and promoting blood circulation,interior-warming medicine, disgestion-promoting medicine. The physicians of Ming-Qing Dynasties realized that qi stagnation, phlegm and the incorrect dietical habits are closely related to the syndromes of abdominal masses.According to frequency analysis results,factor analysis were used to those herbs which are more than ten percentage according to herbs/formula ratio.Medical features include two types:fortify the spleen and nourishing blood-qi,soothing the Liver, activating blood-qi and relaxing the Bowels.3.4The Analysis of Syndromes in Medical CasesThe medical cases selected is700including238kinds of symptoms.In these medical cases,only89cases recorded the ages of patients,accounting for13.7%;211cases recorded the genders of patients,accounting for30.2%.Symptoms concentrated in the stuffian plot, abdominal distension, mass, abdominal pain, string-like pulse. In addition, the symptoms of Ji-Ju are multiple and complex. Except those high frequency occurrence of symptoms,the remains are more dispersed,especially tongue manifestion and inspection of the complexion are not the high-frequency symptoms.Deep study of the clinical trials is necessary to judge if tongue manifestion and inspection of the complexion are related to Ji-Ju. According to the frequency analysis results of medical cases symptoms, factor analysis were used to those symptoms which frequently appeared more than40times.The symptoms of common factors can be divided into six kinds:f1:abdominal distension,abdominal fullness;f2: abdominal mass;f3:chest tightness,loss of appetite, constipation;f4:pulse number, pulse string; f5:abdominal pain, diarrhea, vomit;f6:thready pulse.In these medical cases,only253cases recorded the syndromes,accounting for36.1%. The medical cases selected is including42kinds of syndromes.Those symptoms concentrated in syndrome of liver depression and spleen deficiency,syndrome of depression and anger impairing the liver,syndrome of cold stagnating in the body,syndrome of qi stagnating and blood stasis,syndrome of spleen-stomach weakness,syndrome of stagnation of vital energy and phlegm-stasis, syndrome of qi stagnating and coagulated phlegm,which accounted for50%according to syndromes/cases ratio.ConclusionFrom the development of diseases,ancient physicians are not caught in the thinking of the theory of five elements to understanding the disease.They are dependent on the features of diseases to amend the five elements necessarily in order to meet the diseases'specific changes. From the content of the diagnostic methods,they are relatively stable and monotonous,even gradually reduced as time changed(Except pulse-taking).The development of etiology and pathogenesis of Ji-Ju varied from simple to complex, from general to detail,from positive to negative to re-negative.The establishment of etiology and pathogenesis of Ji-Ju are based on symptoms.Etiology and pathogenesis are necessary conditions to form formulas.The Medical Classic of Huangdi established the basic governance principles and methods,JinKuiYaoLue firstly developed formulas, ZhangZihe used diaphoresis, emesis and purgation to treat it.Li Dongyuan stressed the importance of the spleen and stomach, Zhu Danxi strengthed the doctrine of Phlegm and blood stasis. Wang Kentang proposed three degree therapies.Meanwhile, Acupuncture,massage,and external application to develop.Chang-Xun,Shi-jia were firstly recorded in LinShu. Chang-xun lies in the outside the small intestine,Shi-jia is in the matrix.In Sui-Tang and Song-yuan dynasties,physicianes were essential to stay in the former period. In Ming-qing dynasty, the physicians believed that pathogenesis of Chang-xun is disease related to qi not blood and that of Shi-jia is qi gets sick first and blood second.The treatment of Shi-jia is simmilar to tympanites and that of Chang-xun is simmilar to tumidness.On the part of therapy, regulating the flow of Qi,promoting blood circolation,removing blood stasis are regular methods.The ancient physicians realized that clinical symptoms are gist of herbs and formulas.The theories of Five Elements and Yin-yang are only reference. According to the result of the original development of theory and the study of herbs,formulas and medical cases, there are co-relationships and differences between abdominal masses and tumor.Except some tumors,Ji-Ju also include other kinds of diseases. So, the research of tumor need to learn from the research methods of the abdominal masses of ancient doctors.In addition, the syndromes of Ji-Ju mainly belong to Spleen and Stomach, which proved the close relationships between Spleen-Stomach and abdominal masses.It is worth to do deep study in this field.