| Dysentery,with "abdominal pain,diarrhea,purulent blood" as the main symptoms,often occurs in summer and autumn,is a kind of infectious disease.Bacillary dysentery,amebic dysentery,ulcerative colitis in western medicine belong to the category of this disease.Traditional Chinese medicine has unique advantages in the treatment of dysentery.There are a lot of contents about dysentery recorded in ancient books of traditional Chinese medicine,including etiology,pathogenesis,diagnosis,treatment principle,treatment method,prescription,prognosis and so on.These contents were created by doctors of different dynasties,and have distinct personal characteristics of doctors.The focus of this paper is how to analyze the academic development of dysentery from the perspective of historical origin and sort out the academic thoughts and clinical experience of dysentery treatment with characteristics and curative effect.This paper is divided into two parts.The first part systematically collects and sorts out the literature about dysentery before the Republic of China,and studies it with the combination of literature research and academic development history.The author divides the knowledge of doctors of previous dynasties into seven stages based on the dynasties:the pre Qin,the Han Dynasty,the Wei Jin,the Southern and Southern Dynasties,the Sui and Tang Dynasties,the two Song Dynasties,the Jin Yuan period,the Ming Dynasty and the Qing Dynasty,and comprehensively analyzed the knowledge of dysentery The academic development characteristics of dysentery in various periods include the name,pathogenesis,diagnosis,treatment principles,prescriptions and prognosis of diarrhea.The academic thoughts and experience of the physicians in treating diarrhea are summarized,and the academic development source of dysentery is clarified.The second part is the last part of this paper.Based on the first part,the author discusses the problems of dysentery,the methods of differentiation and treatment of chronic diarrhea and how to apply the experience of treating diarrhea in ancient books in modern clinical.In the pre Qin and Han Dynasties,the doctors did not have a unified name for dysentery.In the first chapter of the book of "Huangdi Neijing",the first diarrhea named "intestinal polyp" was widely accepted and recognized.After that,there are also many names in medical books,such as "small intestine discharge","big drain" and "Xiali" in Treatise on Febrile Diseases in "difficult classics".Although the name of the disease has not been unified,the doctors' observation on the symptoms of the disease is relatively consistent,such as "bloody stool","lower foam","lower abscess blood" in Huangdi Neijing;"bloody stool and abscess blood" in Nanjing;"febrile miscellaneous diseases" and "lower abscess blood","lower weight" and "sexual abscess blood" in Treatise on febrile diseases,etc.At the same time,we all advocate judging the prognosis of the disease from pulse.The understanding of etiology includes luck angle,diet angle and external pathogenic factor angle.Most of the views on disease are heat evil and supplement to cold diarrhea.The therapeutic prescriptions for diarrhea,such as BAITOUWENG decoction,Taohua Decoction and Wumei Pill,are recorded for the first time in Treatise on febrile diseases,and these famous prescriptions have been used up to now.In the Three Kingdoms,Jin,North and South Dynasties,according to the book of Sui Dynasty,the classics records of the Sui Dynasty,there was no clear academic classification in the ancient Chinese medicine books in this period,and the ancient books were called "Moumou Fang".Gehong first used the name of diarrhea in "Zhouhoubeiji Fang".Chen Yanzhi first proposed the name of "stagnant"in the "Xiaopin Fang".These two disease names were gradually recognized by all after Sui and Tang Dynasties.In this period,there were some types of dysentery.For example,yaosangyuan divided diarrhea into ten types in Jiri Fang.This is the earliest type of dysentery,and the later generations of dysentery were based on it.It can be seen that although the prescription is the name of the book,the content of which involves the theoretical part is an important Chinese medicine work.At this time,there are special prescriptions for dysentery,such as Gehong invented the basic formula of Tianxing dysentery with the effect of clearing heat,detoxification and dehumidification;Chen Yanzhi established Wenpi Decoction for treating diarrhea in cold and solid internal knot;the famous prescription for dysentery was Wumei Pill,and it appeared in both the medical books written by Chen Yanzhi and yaosengyuan,with the same name,but the composition and dosage of the prescription were different To you.It can be seen that since Zhang Zhongjing created Wumei Pill to treat diarrhea,both doctors of yaosangyuan and chenyanzhi have recognized Wumei Pill of Zhangzhongjing and applied it in clinical practice,which indicates that doctors at that time have realized the important role of Wumei Pill in the treatment of diarrhea.In Sui and Tang Dynasties,the first treatise on etiology and pathogenesis classified the occurrence of dysentery into two categories,internal and external.Among them,the internal cause is mainly the body's lack of honor and defense,weak intestines and stomach;while the external cause is mainly the feeling of external evil,including wind evil,heat evil,cold evil,dampness evil and poison evil;the internal cause's weak intestines and stomach and the external cause's feeling of a kind of evil or multiple evil together will lead to the disease.In Sui and Tang Dynasties,the classification of dysentery syndrome types was further explored.For example,the classification of dysentery syndrome types was divided into 13 types in the treatise on the origin of various diseases,4 types in Qianjin Yaofang and 15 types in waitai miyao.Although these syndrome types are not unified,there are two types of basic recognition,namely hot dysentery and cold dysentery.According to the therapeutic prescriptions,the main ones are Qian Jin Yao Fang and waitai Mi Yao.Among these therapeutic prescriptions,the Wumei Pill created by Zhongjing has been recognized and applied by more doctors.At the same time,a number of modified Wumei pills have been derived from this idea.In addition,Qianjin Yaofang flexibly cuts Wenpi Decoction to treat cold and hot dysentery,which is worthy of reference.At this time,the main high-frequency drugs were Rhizoma Coptidis and dried ginger.Based on the above analysis,we found that,from prescription to medicine,at that time,doctors used both cold and heat to treat dysentery,and adjusted the prescription according to the degree of cold and heat.In the Song Dynasty,the understanding of etiology and pathogenesis,the understanding of the external causes of dysentery was basically consistent,mainly wind,cold,dampness,heat(heat)evil;in the internal causes of dysentery,the pathogenesis of spleen and stomach weakness was unanimously recognized by doctors.At this time,Chen Yan creatively put forward the viewpoint of dysentery caused by "stagnation of visceral Qi",which provided a new idea for dysentery treatment from regulating "Qi".In addition,doctors have gradually realized the relationship between gastrointestinal retention and dysentery,and the theory of"retention causing dysentery" has emerged,and the method of "Tongli Quji" has become the first choice for doctors to treat dysentery.In the Song Dynasty,there were two new types of dysentery:Qi dysentery and wind dysentery.A large number of prescriptions for dysentery were recorded in large prescriptions in Song Dynasty.From these prescriptions,we can analyze some characteristics of medication in Song Dynasty,such as paying attention to the combination of Qi regulating and blood activating drugs,a large number of spice drugs appeared in dysentery prescriptions,and pill powder was the main drug form.The above also indirectly reflects the local characteristics of the Song Dynasty.At this time,most of the prescriptions for chronic dysentery are based on warming the middle and strengthening the spleen,and then symptomatic addition and subtraction of drugs,forming a series of prescriptions based on warming the middle and strengthening the spleen.In the Jin Yuan period,the doctors' understanding of dysentery has a new leap from the name of the disease to the symptoms and even the treatment.Especially,the four members of the four members of the Jin Yuan Dynasty have their own characteristics in their cognition and practice of diarrhea,which has accumulated rich experience for the later doctors in the treatment of dysentery.On the recognition of the name of diarrhea,Zhu Danxi first clarified the difference between diarrhea and diarrhea,from clinical manifestations to treatment methods,which laid a solid foundation for doctors to understand and treat diarrhea in the later stage.In terms of the understanding of etiology and pathogenesis,all of the four members of Jinyuan realized that the damp heat in external evil and the weakness of human spleen and stomach are the main causes of the disease.Four,the treatment of diarrhea has its own school characteristics.Liu quansu of "cold and cool school" advocated to treat diarrhea from cold and cold,and establish famous "Regulating Qi and activating blood" prescription Shaoyao Tang;Ligao of "soil supplement school" carried out his thought of invigorating spleen and stomach and rising Yang in the treatment of diarrhea,and created many prescriptions for diarrhea by himself;Zhang Congzheng,who attacked evil school,was good at treating dysentery by using sweat,vomiting and Xiaxia methods in the evil attack method;zhudanxi integrated all families,and proposed to treat dysentery from the outside cold The treatment of dysentery by syndrome differentiation of Qi and blood by heat deficiency and Qi and blood,and at the same time,a new idea was put forward for the treatment of Shigella,which was to start with Yin deficiency and coincide with the idea and thought of"Nourishing Yin school".Zhu Danxi's innovative cognition of yin deficiency in the late stage of dysentery further improved the whole diagnosis and treatment guidanceand practical thinking of TCM for diarrhea.The contents of the medical thoughts of liuhejian,lidongyuan and zhudanxi appeared in the works of doctors in Ming Dynasty.It can be seen that their diagnosis and treatment ideas have been recognized.At the same time,there were also a number of doctors who had new ideas and innovations in the diagnosis and treatmentof diarrhea on the basis of predecessors in Ming Dynasty.These innovations make people have a deeper understanding of dysentery and more detailed and comprehensive treatment of syndrome differentiation.In terms of disease name,doctors represented by Xue himself agree with the name of diarrhea and stagnation of disease.Sunyikui,on this basis,identified the two,and thought that stagnation cannot be equated with diarrhea.In the aspect of understanding the etiology and pathogenesis,the doctors' cognition is not due to three reasons,but the emphasis is different.Yu Tuan ranked the pathogenic probability of these causes from high to low.Zhang Jingyue thinks that diarrhea is mainly caused by drinking cold and drinking cold and "personnel".If people don't drink cold,they will not get sick.It is suggested that it is an important inducement factor to cause diarrhea,which suggests that people's eating habits have an effect on the disease.Qin Changyu divided diarrhea into two categories:external sense and internal injury,which was more comprehensive in syndrome differentiation.Xuyanchun,Xue Ji,Li Fei,zhaoxianke and zhangjingyue differentiate the common symptoms of diarrhea such as abdominal pain,severe internal emergency,lower abscess,thirst,small water and macroporous pain respectively from four aspects:cold and hot deficiency and deficiency.Li Yi summarized the key points of diarrhea differentiation and treatment in the form of songs for the first time,which is convenient for the introduction of primary school and made contributions to the scientific popularization of diarrhea.Wang KENTANG first proposed to distinguish the old and the new,and further deepen the connotation of the theory of "accumulation stagnation and diarrhea".In terms of treatment,Wang KENTANG proposed that the treatment of diarrhea should be divided into samples first,not from the gastrointestinal tract.Dai Sigong proposed the general principles of dysentery:"when the Qi is the first,the stomach should be appetized",which reflects the thought that Dai Sigong should take Qing as the priority in the treatment of dysentery and take the spleen and stomach care into consideration.Xue Zhi Shigella is based on the basic of weakness of spleen and stomach,which is the embodiment of his academic view on spleen and stomach Yang Qi in the treatment of diarrhea.Zhang Jingyue thinks that the majority of dysentery patients have deficiency and cold,and the treatment mostly advocates warming and toning spleen and kidney;for patients with syndrome of solid heat,the standard method is adopted to clear the heat and attack the accumulation,breaking the limitation of avoiding the remedy at the beginning of diarrhea.In terms of prescription,xuyanchun is a highly summarized and summarized prescription for diagnosis and treatment of diseases by dividing it into 13 categories according to the pathogenesis of etiology and pathogenesis.Wang Lun first set up the main prescription for diarrhea,with one side to add and reduce the treatment of diarrhea,reflecting its thought of "general treatment".The research on dysentery in Qing Dynasty mainly focused on the exploration of dysentery treatment methods and the construction of syndrome differentiation and treatment framework.In terms of etiology and pathogenesis,most doctors'understanding is basically the same as that of the previous generation,except that exogenous six evils and internal spleen and stomach injury.Most doctors focus their research on the pathogenesis of dysentery,while Chen Shiduo and Tang Rongchuan expound the pathogenesis of dysentery from a new perspective,that is,they both pay attention to the important role of liver in the pathogenesis of dysentery.Chen Shiduo thought that dysentery was mainly caused by liver wood and spleen soil.Spleen soil was damaged and its transportation was abnormal.Dysentery was caused by long illness and kidney.This is the first time that doctors clearly pointed out the important role of liver in the occurrence of dysentery.This cognition breaks away from the previous basic framework of treating dysentery from spleen and kidney,and forms a new thinking of cognition and diagnosis and treatment of dysentery.Tang Rongchuan analyzed the cause of dysentery from the relationship between lung gold and liver wood.He thinks that lung qi is in time in autumn.If the Qi of liver wood is too strong,people will be restricted by the Qi of lung gold.If the stagnation of liver wood is not sparse,fire will start fire.Fire will conquer lung gold,resulting in lung qi can not be cleared."Lung Qi transmission is too fast,resulting in excessive injection into large intestine" is diarrhea.From the perspective of five zang organs,this paper vividly explains the syndrome mechanism of excessive injection of diarrhea,which is quite consistent with clinical practice Anal obstruction,to be inconvenient",the formation of acute,and dysentery.Tang believes that although the symptoms and lesion sites of dysentery are related to the spleen and stomach,the origin of dysentery is actually liver and lung,which is the embodiment of innovative thinking on the pathogenesis of dysentery.The analysis of the above two doctors is the master of clinical practice.In terms of treatment,new treatment methods have emerged.The most famous one is Yu Jiayan's method of pulling the boat against the current,which emphasizes the role of the method of relieving exterior symptoms in the treatment of dysentery.According to the pathogenesis of Gan Mu Ke PI Tu,Chen Shiduo formulated the method of smoothing liver and treating dysentery,the method of removing blood stasis and treating dysentery due to blood stasis for a long time,and the method of tonifying Yin and treating dysentery for both damp heat and pure blood under dysentery.Kong Yuli summed up the ten commonly used treatment methods of dysentery,and created a temporary relief method to quickly relieve the severe symptoms.According to different syndrome types of dysentery,Lei Feng gave different treatment methods and formulated nine methods for dysentery.In the construction of the framework of syndrome differentiation and treatment,Kong Yuli established a set of academic system for the treatment of dysentery by integrating the theory,method,prescription,medicine and case of dysentery with the differentiation of exterior and interior cold and heat deficiency and excess.Shu Chiyuan divided dysentery syndrome into four outlines,namely "entrapment of pathogenic factors","autumn dryness","seasonal toxicity" and "slippage",It is clear in differentiation and treatment.In conclusion,the diagnosis and treatment of dysentery from the beginning to the system of Ming and Qing Dynasties experienced a long development process.The exploration of the disease name and the understanding of the main symptoms of the disease were concentrated in the pre Qin and Han Dynasties.The six classics syndrome differentiation system constructed by Zhang Zhongjing in Treatise on Febrile Diseases established a whole framework for the differentiation and treatment of diarrhea.The first treatment prescriptions,such as Baitouweng Tang,Taohua Tang and Wumei Pill,had a profound influence on the later generations.Although Zhang Zhongjing has not explained the theory of dysentery pathogenesis,the six classics differentiation and treatment system can cover eight principles of deficiency and deficiency of yin and Yang,cold and heat,and play a leading role in the construction of the framework of dysentery differentiation and treatment.The important feature of the Three Kingdoms,Jin,northern and Southern Dynasties was that there were many prescriptions for the treatment of diarrhea.These prescriptions were an exploration of the treatment of diarrhea.In many books,fangwumei pill with the same name appeared in different composition and dosage,indicating that doctors recognized Zhang Zhongjing's thinking of treating diarrhea at that time.The main characteristics of Sui and Tang Dynasties were the further deepening of understanding of dysentery diseases,such as "the origin of various diseases","three causes,one disease syndrome theory",which elaborated the pathogenesis of diarrhea.The exploration of the system of differentiation and treatment of diarrhea in this period is the four-point method of syndrome type in Qianjin Yao prescription by Sun Simiao,and the prescription and medicine of differentiation and treatment are all based on the four-point method.In the Song Dynasty,due to the government's attention to medicine,many large prescriptions were compiled by the government,which recorded a large number of prescriptions for the treatment of diarrhea.The characteristics of this period are the emergence of a large number of prescriptions for dysentery.But how to use these prescriptions,under the guidance of what differentiation and treatment system,to improve the effectiveness of these prescriptions was the blind area that doctors did not pay attention to.In the Jin and Yuan Dynasties,the four prescriptions for dysentery were all produced under the guidance of academic thoughts.Although there were some biased treatment systems in each family,compared with the two Song Dynasties,it showed that doctors began to pay attention to the diagnosis and treatment mode of diarrhea under the guidance of the differentiation and treatment system.In Ming Dynasty,the recognition of the importance of the system of differentiation and treatment was more and more prominent.Xuyanchun divides the former prescriptions for dysentery into 13 categories according to the pathogenesis of etiology and pathogenesis,which guides the doctors to follow the framework of the thirteen points method when selecting prescriptions;Zhang Jingyue puts forward the theory of"two principles and six changes",and guides the treatment of dysentery with eight principles system;Qin Jingming will treat Chen Wu in the treatment of diseases due to pulse The theory of three factors is applied to the treatment and syndrome classification of diarrhea,which can be divided into two categories:external sense and internal injury.Neither the two methods can be found in the traditional Chinese medicine.In Qing Dynasty,the exploration of the differentiation and treatment system became the choice of most doctors.The focus of doctors was not limited to a prescription,but a method,even under the guidance of a system.Kongyuli,through the theory,method,prescription and medicine of dysentery,established a set of academic system based on eight principles.Shuzhiyuan divided the dysentery syndrome into four syllabus:depression,autumn dryness,time poison and slipping off.Different types of treatment of dysentery were summarized under four classes,and each class formed a complete prescription of physical and legal methods;Lei Feng divided dysentery into nine major categories Syndrome type,each type of syndrome is detailed on its etiology and pathogenesis,diagnosis,identification,treatment and prescription,and the system of nine points method is used to guide the differentiation and treatment of diarrhea.For thousands of years,doctors have experienced a tortuous process from exploring single prescription to gradually improving the system of dysentery.Finally,doctors realized that a perfect differentiation and treatment system can guide clinical practice and improve clinical effect more effectively than an isolated prescription.The ultimate goal of literature research is not from literature to literature,but from literature to clinical level.The author listed the contents of Li,FA,Fang and Yao of dysentery in ancient books written by ancient physicians,and conducted in-depth mining and analysis based on these contents,hoping to provide TCM thinking and reference for clinicians to treat dysentery based on syndrome differentiation. |
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