| This research is conducted under “traditional Chinese medicine gynecology, pediatrics and orthopedics clinical diagnosis and treatment theoretical framework research(2013CB532004-2)”, which is a sub-topic of nationwide “973” project “traditional Chinese medicine clinical diagnosis and treatment theoretical framework research”. Currently the academic understanding of infantile convulsion is either from a doctor’s cognition or syndrome and therapy. No research on the theory of infantile convulsion based on etiological factor, pathogenesis, syndrome and therapy has been done. Some doctors and scholars don’t know that “xian” refers to infantile convulsion before Sui and Tang Dynasties, and they are not clear “xian”, “xiao’er ji jing feng”,“xiao’er man jing feng”,“xiao’er man pi feng” coexist in the song, Jin and Yuan Dynasties, “xian” can represent infantile convulsion but also represent “xiao’er dianxian”, so numerous research take “xian” as “xiao’er dianxian”. Therefore, it is necessary to clarify the connotation of infantile convulsion, brush up the composition and evolution of etiological factor, pathogenesis, syndrome and treatment. Finally we can construct the TCM clinical diagnosis and treatment framework of infantile convulsion. A one of the most common and severe pediatric diseases, infantile convulsion is harmful to children in China. The incidence of infantile convulsion is high, and disease condition changes quickly. The purpose of this paper is to study diagnosis and treatment theory of Infantile Convulsions in different ancient Chinese dynasties. In order to achieve this I have referred to more than 60 books including monographs of pediatric, prescription books of herbs and government-made medical book in different historical period of China.This paper consists of three parts: PART A is about culture in the name of this disease—how the name “xiao’er jingfeng” revolted over time. I have sorted out 42 disease names related to “xiao’er jingfeng”, among them 31 s are standardized and the rest are not, I also differentiated the characteristics of it and finally clarify its meaning; PART B is the diagnosis and treatment theory theoretical research of two similar-diseases: Pediatric Epilepsy and Infantile Convulsions. It mainly discuss the development situation, causes, pathogenesis, diagnosis and therapeutic principles and methods(in the eyes of Chinese medicine) of Children’s Xianbing(Pediatric Epilepsy), Jijingfeng, Manjingfeng(Pediatric acute infantile convulsion and chronic infantile convulsion) and Manpifeng(a type of Children’s Manjingfeng); PART C is the research on the framework of the diagnosis and treatment of infantile convulsions. In this part I picked representative books in history, combined the above research and constructed the framework of the diagnosis and treatment of infantile convulsion based on traditional Chinese medicine literature. The results are as follows:1. the evolution of the disease’s name “xiao’er jingfeng”From Spring and Autumn Dynasty to Sui and Tang Dynasties in China, “xiao’er jing feng” was called “xian” and there were several types of it due to different causes: “fengxian” type, “jingxian” type, “shixian” type and “reqi jingxian” type and so on. The book“youyou xinshu”records that the disease name “xiao’er jingfeng” first appeared in the book “yujue” wrote before Song dynasty, and so did “jiman jingfeng”. It also records that “xiao’er jijing feng” and “xiao’er manjing” first appeared in the book “shibi jing”. The name “man jingfeng” appeared in the book “taiping shenghui fang”was actually a type of “xiao’er jingfeng”. The book “xiao’er yaozheng zhijue” first pointed out clearly that the disease “xiao’er jingfeng” included “ji jingfeng” type and “man jingfeng” type, while the book “xiao’er weisheng zongwei lunfang” clarified that this disease consisted of “jijing”type, “man jing”type and “manpi”type. Hence in Song Jin and Yuan Dynasty, the disease names “fengxian” “jingxian” “shixian” and “erxian”, together with “ji jingfeng” and “man jingfeng” all referred to the pediatric disease “xiao’er jingfeng”. It was not until Ming Dynasty that people started to tell the difference between “jingfeng” and “xian”. “jingfeng” referred to infantile convolution and “xian” moved to epilepsy, but even until Qing Dynasty some books still kept the promiscuous names. Besides in Song and Tang Ddynasties, it was occasionally seen that “xian”, “jingxian”, “fengxian” and “shixian” referred to epilepsy. The book “yixue gangmu” first distinguished the difference between “xian” and since then it referred to epilepsy specifically. 2. study on etiologyChinese medical experts in the past dynasties thought that there are two aspects of the etiology of “xiao’er jingfeng”: external aspect and internal aspect. External aspect referred to wind, cold, hot and summer heat. “xian” is caused by wind, cold, hot and wind-hot. “ji jingfeng” is caused by wind, wind-cold, summer-heat or the combination of wing, cold and damp-warm. “man jingfeng” is caused by wind-cold or the summer-heat. Internal aspect referred to over-terrified, improper diet, lack of proper treatment or therapeutic error, vomiting and diarrhea. “xian” is mainly caused by suddenly terrifying, improper diet, vomiting and dysentery, post Typhus disease. “ji jingfeng” is caused by suddenly terrifying, improper diet, excessive use of hot herbs when treating “man jingfeng” and the influence of persistent disease. “man jingfeng” is caused by born-weakness, post serious illness, and “ji jingfeng” transfers to “man jingfeng” due to the injury of PiWei system, JingPu and Chongjigongxin. “man pifeng” is caused by vomiting and diarrhea, lack of proper treatment or therapeutic error, or transferred from “man jingfeng”. 3 research on pathogenesispathogenesis of “xian” includes heat dampness, phlegm heat epilepsy, Qi weakened then transfers to epilepsy when liver referred to wind and heart referred to fire are fighting. The main pathogenesis of “ji jingfeng” is extreme heat transferring into wind, and it can also be from extremely Yu producing hot, over heat producing fire, over fire together with phlegm producing phlegm-heat and then Jingling. Thus, pathogenesis of “ji jingfeng” and “xian” are almost the same: phlegm, heat, Jing and wind.The pathogenesis of “man jingfeng” includs yang deficiency of spleen, yang deficiency leading to wind of spleen and kidney, Promordial Qi deficiency leading to wind, yin deficiency leading to wind, blood deficiency leading to wind and relative strong wood because of weak earth. The pathogenesis of “man pifeng” are mainly over weakness of spleen Qi, over strong liver and weak spleen and lung, over weakness of Promordial Qi and pure yin syndrome. If the situation of yang deficiency of spleen and kidney of “man jingfeng” is aggravated by some reasons, it will lead to “man pifeng”. 4 “xiao’er ji jingfeng” are Yang, real, heat syndrome, while“xiao’er man jingfeng” and “xiao’er man pifeng” are Yin, deficiency and cold syndromeAbout “xian”, it is important to tell the distinction of the syndrome before and after. Before “xian” period, syndromes such as continuously high body temperature, shaking hands and wagging tongue, waking up suddenly during sleep and twitching, repeatedly clenching the teeth can tell it is about to come. After “xian” period, four types of syndromes are listed to be discussed and they are: “fengxian” “jingxian” “shixian”and “rexian”.I made a conclusion on the types of “ji jingfeng” and they are:extremely hot leading to “jingfeng”, over strong of liver wood, phlegm hot leading to “jingfeng”, terrifying leading to “jingfeng”, blood deficiency of the liver channel leading to fire and wind, incurable “ji jingfeng” and the early stage of “ji jingfeng”. Main types of “man jingfeng” are: spleen deficiency leading to wind, wood violate earth, catching cold and wind external and improper diet internal, Promordial Qi deficiency, Yin deficiency of spleen, desperate situation of “manjing”. Types of “man pifeng” are: spleen Qi deficiency leading to wind, Promordial Qi deficiency, phlegm stagnation due to spleen deficiency, unstable “shen” due to spleen deficiency, over strong liver violating spleen and lung. From the conclusion I made above, we know “xian”and “ji jingfeng” cause Yang, real and heat syndrome, while “man pifeng” cause Yin,deficiency and cold syndrome. 5 The method and principle of treatment of infantile convulsion: “jijing he liangxie” and “manjing wenbu”There are two kinds of treatments toward “xian”: before syndrome stage and post syndrome stage. In the before syndrome stage, “jiexian”method is used and in the post stage, different kinds of treatments are used due to different types. “xian”: we often use “buyang anhe” methods, bathing methods, “gaomo” methods, acupuncture and moxibustion. “jingxian”: “Lijing dingxian” methods, cooling down heat and wind method, calming the spirit and cooling down the heat, wiping body method. “fengxian”:“sanfeng dingxian” methods, spitting method, moxibustion, bathing method. “shixian”: moxibustion. “rexian”:cooling down the heat. For children with “ji jingfeng”, we should treat the secondary symptoms first for emergency and the main treatments are: purgative method, cooling down method, “jiefeng dingchu” method and eliminating phlegm method.The principle of treating “man jingfeng” and “man pifeng” is warming spleen and kidney. When treating “man jingfeng”, we should follow the main principle of “treating “manjing” at once” and “warming” together with other treatment methods such as “warming stomach”, “invigorating the spleen and restoring Yang” “warming the spleen and kidney”, “warming the spleen Qi and calming down the heart and liver”, “invigorating the spleen and blood and calming down the spirit and clearing the lung and liver”. “man pifeng”: tonifying spleen and YangQi. 6 research on the framework of the Diagnosis and treatment of infantile convulsionDuring Sui and Tang Dynasties, meaning of “xian” is the same as infantile convulsion in the book of “zhubing yuanhou lun” and “beiji qianjin yaofang”. “xian” is divided into epilepsy, epileptic seizures and taking in fledgling wind, which formed the early theoretical framework of infantile convulsion. During the period of Song Jin and Yuan, detailed classification of infantile convulsion is, “ji jingfeng” “man jingfeng” and “man pifeng” which are defined in the book of “xiao’er weisheng zongwei lunfang” “youyou xinshu” and “huoyou xinshu”. Based on the research for etiology, pathogenesis and syndrome of these diseases, a theoretical framework of infantile convulsion is constructed. And, during the period of Ming Qing dynasties, this theory is more and more rich and perfect in the book of “youke zhengzhi zhunsheng” “baoying cuoyao” and “yishu”. On the basis of this research, combined with the results of this study, a framework structure of pediatric acute convulsion and pediatric chronic infantile convulsion treatment theory is built.Through the research, the connotation of 42 basic concepts like “ying’er bingxian” “xiao’er fengxian” “xiao’er ji jingfeng” “xiao’er man jingfeng” “xiao’er man pifeng” which stand for “infantile convulsion” disease is defined; a conceptual system of TCM pediatrics diagnosis and treatment theory for “infantile convulsion ” is established; the origins and evolution of then academic history of infantile convulsion is cleared; a clear distinction between “infantile convulsion” and “pediatric epilepsy” is made since “Compendium of Medicine” in Ming Dynasty clarified that “pediatric epilepsy” stands for “children with epilepsy disease”, “epilepsy” mistaken for epilepsy is corrected.With the progress of the times and improved nutrition, although the incidence of chronic infantile convulsion decreased gradually, due to the weakness of the spleen and stomach in children and improper diet causing chronic infantile convulsion, infantile convulsion still has a serious impact on children’s health. Through this research, the system of diagnosis and treatment of infantile convulsion is improved, which has very important clinical significance. |
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