Literature Study On Exogenous Heart Disease In "The Yellow Emperor's Internal Canon"

Objective:Rich discussion about heart disease related to exogenous diseases can be found in Yellow Emperor's Inner Classic(hereinafter referred to as the Inner Classic),and it is inherited and developed in later generations.Nowadays,disease patterns about five viscera are generally considered as internal diseases,and there is rarely any discussion that identifies them as exogenous visceral diseases.This study systematically collates the related literature of exogenous visceral diseases in Inner Classic,analyses and expounds the medical theory of exogenous visceral diseases,focuses on exogenous heart diseases,systematically combs and analyses the concepts and origins of the main related disease patterns,explains the connotation,thus to broaden the thinking and methods for the diagnosis and treatment of clinical heart diseases in traditional Chinese medicine nowadays.Methods:1.Take the name of disease as the main judgment basis,set the inclusion exclusion criteria,and screen the literature preliminarily.Some important medical books were searched manually,with online search to fill the gaps.2.Carry out in-depth excavation of the etiology,pathogenesis,onset,syndromes and prognosis of exogenous heart disease-related patterns so as to gain the integration and improvement the theory of exogenous heart disease-related patterns.Results:1.Six types of exogenous heart diseases were selected for discussion:heart wind(??),heart impediment(??),heart malaria(??),cold damage palpitation(????),wind syncope(??)and heart cough(??).2.The disease heart wind has gradually deviated from the original meaning in later generations.Especially in the process of integration with similar diseases and patterns,there has been a trend of generalization and fuzzification,which makes it difficult for later physicians to accurately grasp the connotation of heart wind,hence to be marginalized in the Ming and Qing Dynasties.3.Heart impediment is described in several chapters of Inner Classic,but the related concepts are incomplete.Although there are many discourses by later physicians,some problems remain unsolved.Its etiology is the invasion of exogenous pathogens and emotional injury,related to the heart,and its pathogenesis is that evil gathered in the heart,as well as heart vessel.Its syndrome characteristics involve two aspects:"heart governs blood vessels"and"heart governs spirit and brilliance".4.Heart malaria belongs to one of the twelve kinds of malaria in Inner Classic,which is caused by the pathogen of wind and cold in the five-zang organs,so it belongs to exogenous heart disease.5.Cold damage palpitation has its actual symptoms in Inner Classic.The related original text suggests that the occurrence of this disease is closely related to exogenous factors.Therefore,in the name of“cold damage palpitation”,the literature of this kind of disease is studied.6.Wind syncope can be found in three chapters of Inner Classic,which indicates that it is related to exogenous feelings in terms of etiology and syndrome.In addition,through in-depth interpretation of the original text,it is found that the disease is closely related to the heart.7.Heart cough in Inner Classic originally belongs to the category of exogenous cough.Thereafter,some ancient physicians put forward the view of“heart cough belongs to the internal injuries”,which made the theory of exogenous heart cough gradually weakened in the process of continuous improvement.However,within the framework of exogenous heart disease proposed in this paper,we find that these ancient diseases have deeper connotations and values,which deserve our further exploration.Conclusion:1.The theory basis of exogenous pathogen of five viscera diseases is“man who is affected by the evil qi of sky is harmed in his five viscera”(“????,??????”);“The qi of the four seasons alternately harm the five viscera”(“????,????”)explains the law of the change of qi and five elements in exogenous visceral diseases;and the condition for the occurrence of exogenous visceral diseases is“Evil qi harms yin and yang meridian may develop into diseases”(“????,????”).2.The etiology of exogenous heart disease is the six excessive pathogenic factors,and the location of the disease is in the heart.The characteristics of the syndrome mainly lie in three aspects:exogenous symptoms,heart governing blood vessels and heart governing spirit.The two physiological functions of heart governing blood vessels and mind governing mind are inseparable,so the corresponding symptoms of heart governing blood vessels and heart governing mind are often accompanied in clinic.3.Although the theory of exogenous cardiopathy emphasizes exogenous factors,it does not deny the existence of internal injury factors.4.The understanding of the exogenous causes of visceral diseases in Inner Classic was inherited and developed in Han,Tang and Song Dynasties.Although it was neglected after Jin and Yuan Dynasties,its clinical value still deserves further attention.