On Zhongjing’s Rules And Characteristics Of Syndrome Differentiation And Treatment Of Abdominal Fullness And Its Influence On Later Generations

ObjectiveThe cause and pathogenesis of abdominal fullness is rather complicated, and it is not sufficiently summarized by later physicians, so it is essential to clarify its concept, the relation and difference between abdominal fullness and abdominal lumps so as to generalize the rules of syndrome differentiation and treatment of this disorder, elucidate its characteristics in syndrome differentiation and treatment, all of which will have academic significance and clinical value in guiding modern medical practice.Research MethodsThe present study focused on literature search. After clauses involved in Shang Han Lun (Treatise on Cold-induced Diseases) and Jin Kui Yao Lue(Synopsis of Golden Chamber) and other relevant documents were sorted out, the author summarized the rules of syndrome differentiation and treatment of abdominal fullness, elaborated Zhongjing’s academic characteristics and probed into his influence on the later generations as well as perfection of his theory.On the basis of the discussion about abdominal fullness problem through a systematic study of Zhongjing’s ideas, the author summed up how to integrate the concept of differentiation of diseases and syndromes and then combined with modern experiments and clinical researches to achieve a thorough study of his theory and the rules of syndrome differentiation and treatment of the disorder.ResultsThere were some statements about the disease in Huang Di Nei Jing (Huangdi’s Canon of Medicine) and in the Han Dynasty Zhang Zhongjing made special discussion about it on the basis of the book. His discourse covered syndrome differentiation and treatment, which was considered as the standard principle in understanding of the disease by physicians of later generations. In the Sui, Tang and Song dynasties, contemporary physicians supplemented the theory and formulas, and in the Jin and Yuan dynasties when diverse thinking appeared in medical fields, new ideas were brought out. In the Ming and Qing dynasties, physicians focused on summary of the recognition of the disease, as a result the system of differentiation of syndromes and treatment of the disease was formed.The author made a systematic summary about the statements of the disease in Shang Han Lun and collected about 50 papers concerning the topic published in journals from 1980, and made an overview of the disease in terms of disease cause, pathogenesis, syndrome differentiation and treatment.ConclusionAccording to Shang Han Lun the sequence of syndrome differentiation is the location of the disease, cold, heat, deficiency and excess, nature of pathogenic factors, accompanied symptoms, and disease cause and pathogenesis. In this way the treating principle, methods and formulas and herbs are decided.To deal with the disease, Zhang Zhongjing has his distinguishing features, i.e firstly, on the basis of the statement in Huangdi Nei Jing his theory, syndrome differentiation and treatment of the disease are systematic elucidated, which is the first of this kind in abdominal examination, which includes abdominal palpation and observation. Secondly, it is about how to guide action according to circumstances, e.g. how to expelling pathogenic factors with sweating, emetic and purgating methods. The purgating method includes removing of accumulated heat, indigested food, dry stools, retained morbid fluid, blood stasis and retained internal heat. In the treatment of abdominal fullness due to cold pathogens it is suggested to tonify the spleen and stomach, reinforce the healthy qi to eliminate pathogenic factors. Thirdly, in the therapeutic process it is essential to protect stomach-qi by giving medicinals that work to regulate and tonify the spleen and stomach. Fourthly, Zhongjing seldom prescribes medicinals solely to regulate and move qi, instead, it should be combined with the approaches to eliminate pathogenic factors and reinforce the healthy qi. Medicinals for moving qi he administers are Immature Orange Fruit and Officinal Magnolia Bark, the former is often for abdominal fullness and the latter for chest fullness. But in most cases these two are prescribed together.Zhongj ing’s theory and formulas about abdominal fullness have far-reaching influence on the later generations, which lays the foundation of syndrome differentiation and treatment of this disorder.