| Qi is the basic element that makes up everything in the universe. Qi of yin and qi of yang interact to yield everything in the universe including human. The five zang-organs, the six fu-organs, the four limbs and the numerous bones form an organic whole through the meridian system. Qi is constantly circulating inside the human body. Movement of qi is called qi activities. If qi activities are normal, human body will be in harmony; otherwise, it will be subject to illness. Th ere is a saying "all diseases originated from qi" in Huangdi Neijing, it points out that dysfunction of qi activities is an important pathogenesis. The theory of falling and rising of qi activities has been elaborated and enhanced by many doctors in the past through their clinical experiences.Seasonal febrile disease is another type of exogenous diseases and its onset, etiology, pathogenesis are different from that of febrile diseases." Yang-heat stagnation" and "qi stagnation" is the basic pathogenesis of seasonal febrile diseases. Detail analysis of the application of the theory of falling and rising of qi activities turns out to be a good method for clinical guidance. Since1840(Opium War), the Lingnan region has been increasingly open to the world including the acute season febrile diseases. Lingnan doctors were able to cure these diseases successfully using local herbs according to the foundation theory of Chinese medicine and the theory of seasonal febrile disease. Unfortunately, writings on these experiences were either few due to heavy clinical load or lost due to warfare.The theory of seasonal febrile diseases of Lingnan is a combination of three-causes thinking and clinical application. Due to its different and special geography, climate and people’s constitution, Lingnan seasonal febrile diseases have unique characteristics like hyperfunction of heat or qi stagnation caused by dampness-heat over the entire course of the diseases. As a result, Lingnan doctors are good at using treatment principles such as qing, xuan and tong.ObjectiveThis study attempts to summarize clinical experiences and the prescription pattern from the Lingnan doctor’sclinical records on season febrile diseases. The result of this study could guide prescription treatment on tackling new seasonal febrile diseases happened lately in the region.MethodsThis study collected62medical cases with145medical records from18Lingnan doctors from all sorts of journals and clinical literatures from sources such as CNKI. It then applies statistical analysis (using Microsoft Excel2007software) and literature research method to generalize prescription patterns and characteristics of the Lingnan doctor’s clinical experiences.ContentThe study begins with qi, the philosophy of qi, and its relationship to Chinese medicine, especially on the saying "all diseases originated from qi" in Huangdi Neijing and the holistic view about the Heaven and Human. It also analyzes and summarizes types of rising and falling of qi activities, and its relationship with human body in physiological and pathological terms.The study looks at the origin and development of the theory of rising and falling of qi activities with an emphasis on its application on seasonal febrile diseases from the doctors of the Ming and Qing periods, its relationship with the rising, falling, floating and sinking properties of Chinese medicine, and the characteristics of the related prescriptions.According to the three-causes principle, the study analyzes how geography and climate factors affects the constitution of people in the Lingnan region, and how Lingnan doctors developed their method on differentiation of syndromes and the selection of herbs in their treatment based on these factors. Through collection of the clinical records of the Lingnan doctors on seasonal febrile diseases, statistics method is applied to summarize the common herbs used including their properties, flavors, functions, meridian system belonged, etc. With these results and the review of the related literatures from these doctors, experiences and thinking are concluded from them.ResultsThe thinking of qi in Huangdi Nei jing is originated in the ancient Chinese philosophy. It applies to human physiology and pathology and the attainment of healthy state, and focuses on the concept of rising and falling of qi. The past.doctors applied this thinking in clinical treatment and further developed the thinking of qi in Huangdi Nei jing by forming many innovating theories. In the Ming and Qing period, doctors of the seasonal febrile diseases stressed heavily on the theory of rising and falling of qi activities on their clinical applications, especially on the prescriptions and herbs used.Contemporary Lingnan doctors adopted the thinking of these doctors from the Ming and Qing period based on the characteristics of the geography of the Lingnan region, further developed the theory of rising and falling of qi activities on their clinical applications. Based on statistic analysis on these clinical applications, results are as follows:1. On treatment, Contemporary Lingnan doctors heavily stressed on regulating the lung meridian system (application%:20.65%), then on spleen and stomach meridian system (application%:16.13%and21.94%respectively.) with use of other minor Chinese medicine.2. Contemporary Lingnan doctors were good at applying the properties and flavors of Chinese medicine and the theory of rising and fall of qi activities to regular the qi mechanism of the human body. Among them, Chinese medicine with sweet, bitter and spicy flavors were used the most (application%: sweet:32.22%, bitter:26.67%, slightly bitter:8.89%, spicy:18.89%). Since hyperfunction of heat is usually resulted in Lingnan’s seasonal febrile diseases, Chinese medicine with spicy and cold properties were heavily used (application%:cold:31.67%, slightly cold:25.00%, cool:3.33%, extremely cold:1.67%). Be sides, since Lingnan’s seasonal febrile diseases are usually seen with dampness, Chinese medicine with spicy warm or spicy slightly warm properties was used selectively (application%:warm:11.67%, slightly warm:5.00%). Conclusion1. To inherit the essence of the theory of rising and falling of qi activities in Huangdi Neijing and follow the thinking of Lingnan doctors on seasonal febrile diseases, contemporary Lingnan doctors were good at treating seasonal febrile diseases.2. Seasonal febrile diseases in the Lingnan region are mainly caused by qi stagnation by dampness-heat. The Lingnan doctors on seasonal febrile diseases were good at applying the properties and flavors of Chinese medicine such as rising, falling, floating and sinking properties in their prescriptions to restore the balanced state of yin and yang of the human body. In fact, regulating the qi mechanism is the first priority of treamtment on seasonal febrile diseases in the Lingnan region. Lung presides over breathing and breathing is crucial to the entire body. As such, regulating the qi mechanism must be addressed first before any other method. To regulate lung’s qi, Lingnan doctors applies the rising, falling, floating and sinking properties of Chinese medicine, focuses on the stomach and spleen together with the qi mechanism of other zangfu-organs like liver, gallbladder and kidney, selects prescription and Chinese medicine that can restore the balanced state of yin and yang of the human body and likes to use herbs with lightness and fragrance properties in order to remove dampness caused by the spleen.3. To regulate the qi mechanism of the stomach and spleen, Chinese medicine of the liver branch of the meridian system is usually used such as Flos Chrysanthemi, Periostracum Cicadae, Radix Cynanchi Atrati, He bra Artemisiae Annuae and Radix Paeoniae Alba. This Chinese medicine is usually spicy, slightly bitter, slightly cold and belonged to the liver meridian systm. Th is follows the theory of the rising and fall of qi activities such that the rising of the liver and the falling of the lung are harmonized.4. With regard to the treatment on the seasonal febrile diseases, if differentiation of syndromes based on Wei-qi-ying-xue, the triple jiao and the rising-falling-out-in principles is used skillfully, the result would be promising because, for example,further development of the diseases would be halt and overuse of Chinese medicine with cold property would be safeguarded. |
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