| According to the correspondence between nature and human,"Plain Questions—Study on time and method of Visceral Qi's nurturing" said that spasm does harms to the liver,thus one should take something sweet at once to relieve it.This therapeutic principle,together with the rules that "Since the liver like being unconstrained,one should take something pungent to sooth it" and that "Taking something pungent to reinforce it and taking something sour to discharge it",is respected by the doctors at the late ages as the tree methods of the liver therapy in "the Yellow Emperor's Internal Classic"."Plain Questions—Study on corresponding signs of Yin-yang" said, "The wind and liver share some basic natures".And the "Plain Questions" also said,"syndromes characterized by shaking,dizziness and vertigo induced by wind are all related to the liver." Liver is a viscera of wind-wood and reverting yin and It stores ministerial fire.It's impatient and this impatience could be transformed into fire and wind easily."the lung qi failing to bear downward,the kidney failing to receive qi,and the stomach qi ascending counterflow",all of these could induce ascendant hyperactivity of liver qi and finally become the syndromes that "spasm does harms to the liver".The method of treatment of those syndromes should be "taking something sweet at once to relieve it" since the sweet herbal is good at relieving spasm,and it also does well in nourishing the viscera and bowels. The pungent,sweet and cold herbs are good at treating the metal to subdue the wood.Then the sweet and warm herbs are good at strengthening the earth to constrain the wood.And the sweet,cold and moist herbs are good at enriching the water to nourish the wood.If it could be diagnosed and treated on the basis of syndrome differentiation,the liver could return to its nature of being unconstrained.This thesis includes five parts.The first part is a discussion on the original meaning of "gan ku ji". According to the definition of "gan" "ku" "ji" in the ancient literature and the discussion on "gan ku ji" of physicians of past generations,the author get its connotation from its extension.It's embodied in two kinds of pathological mechanism,i.e.over ascending of liver qi and lack of liver blood.The second part is the analysis on etiology and syndromes of "spasm does harms to the liver".On the basic of the study results of its original meaning, this part has made a profound conclusion and discussion on its etiology and pathogen(including climate factors,depressed wood engendering wind, depressed wood transforming into fire,hurt by seven emotions,mutual inducing of wind and yang due to the depletion of yin blood,liver yang harassed and stirring for abusing warm-dry medicinal,liver wind induced by abusing ascending and dispersing medicinal,fail to descend gallbladder-stomach qi with liver yang ascending,liver wind induced by external contraction of wind-heat,evil qi invading into liver due to the deficiency of spleen and kidney),its characteristics of pathologic changes(including liver overwhelming spleen,liver rebelling lung,liver fire depleted liver blood, internal exuberant liver yang blazing the fluid into phlegm) and its clinical performance(including 99 diseases related to surgery,internal medicine and gynecology such as stroke,dizziness,spirit-emotion disease,cough,vomiting, dysentery cause by reversal yin,diarrhea,pain in stomach duct,hematemesis, epistaxis,hemoptysis,hiccupping,throat block,spasm and reversing,morning sick,metrorrhagia and metrostaxis,abortion,miscarriage and scrofula)The third part is about the original meaning and clinical application of the theory "ji shi gan yi huan zhi".That each of the sour,the bitter,the sweet,the pungent and the salty has its own function and distinctive medical value in clinic has been known to the traditional Chinese medicine for a long time,just as it's mentioned in "Plain Questions—Study on time and method of Visceral Qi's nurturing" that "The pungent has the function of dispersion; the sour has the function of astringency;the sweet has the function of relief; the bitter has the function of preserving;and the salty has the function of softening." Since the sweet herbal is good at relieving spasm,and it also does well in nourishing the viscera and bowels,it plays a key role in the treatment of the disease "spasm does harms to the liver" According to that, this part classified the method of the treatment that "taking the sweet medicinal at once to relieve the harms to liver done by spasm" into three kinds:Dispersing the wind with pungent-sweet herbs;strengthening the spleen with sweet-warm herbs;nourishing the yin with sweet-cold herbs.According to this classification,the author discussed them from four aspects of theory, method,formula,and drugs followed with proved cases of famous physicians in order to make it could actually serve for the clinical practice.The forth part is the Statistical Analysis of the medication in those formulae guided by the theory "spasm does harms to the liver,thus one should take something sweet at once to relieve it".Taking "A Guide to Clinical Practice with Medical Records" and "Classified Medical Records of Famous Physicians" as data sources,from which the author chose the cases whose pathogen are fit for "spasm does harms to the liver" and does a Statistical Analysis on their frequency of medicinal in formulae in order to find out the guiding significance of the theory "one should take something sweet at once to relieve the harms to liver done by spasm" and the rules of medicating in the treatment of this kind of disease.The final results indicated that in those formulae who treat the disease that "spasm does harm to liver",the sweet-cold substances whose function is clearing heat,nourishing yin, engendering fluid were used most with a use rate of 27%.According to their use frequency,the substances belong to this categorization were listed as following from top to low:shengdi,tiandong,maidong,shihu,xuanshen and guijia.Then,with a use rate of 19%,the sweet medicinal whose function is nourishing blood and yin were taken as the second most used medicinal, including ejiao,gouqi,zhishouwu,shudi,danggui and heidoupi.The obvious difference use frequency between the two mentioned categorization above and others completely revealed Ye's understanding on disease and pattern as "spasm does harm to liver",namely,"liver is a wind viscus,and due to the depletion of essence and blood,the water fails to nourish the wood,thus liver yang hyper activates and internal wind induced." Over more,the results also gave evidence to Ye's therapeutic principle:"nourishing humor and distinguishing fire,moistening and nourishing nutrient aspect and collaterals,nourishing yin and descending yang ".While the results of formulae from "Classified Medical Records of Famous Physicians" used to treat the same disease showed that the most used medicinal were the sweet, qi reinforcing substances,mainly including gancao,renshen,baizhu,huangqi. And the second most used medicinal were the pungent-warm,qi regulating and phlegm resolving substances,including chenpi,banxia,shengjiang,nanxing. This rule of medication had reflected the profound influence of the thought giving prominence to yang and the medicating method characterized by mainly using the warm-dry substances in Chinese medicine before Ming dynasty.The fifth part is a conclusion and discussion of this thesis.Beginning with the original meaning of "gan ku ji,ji shi gan yi huan zhi"(from "Plain Questions—Study on time and method of Visceral Qi's nurturing"),with the help of study method in Documentation Science and medical statistics,from those ancient traditional Chinese medical(TCM) literatures,this thesis finally got a conclusion of etiology of the disease "spasm does harms to the liver",i.e.over ascending of Liver Qi and lack of liver blood.And it also got a specific conclusion of its etiology, disease mechanism and clinical performance.Then,on the aspect of it disease and pattern,taking the theory "one should take something sweet at once to relieve the harms to liver done by spasm" as a cut-in point,combined with the proved cases of famous physicians and the author's personal clinical experience,this thesis discusses in detail the therapeutic characteristics and the thinking process of famous physicians in diagnosing the pathogenic factors based on the differentiation of syndromes in order to make sure that it could finally serve for the clinical treatment.It's necessary to return to the root in the study of TCM theory.One should discuss the original meaning of the theory and find out its concept connotation,and at the same time,should combine it closely with the clinical practice to make a judgment and analysis on whether it could match the theory well or not.Only if one could comprehensively master the concept,one could really put the theory into practice very well and could really get the clinical therapeutic effect improved. |
PDF Full Text Request