| The typhoid's Diagnosis and treatment theory framework is through constant experience inheritance and clinical summary from the after thousands of years of countless Chinese scholars, it is clinical refinement of TCM, not a simple academic theory, nor is it a simple system of syndrome differentiation, but is numerous traditional Chinese medicine theory and countless traditional Chinese medicine academic thought around “typhoid', combination of generic model and personalized experience forms. It is the skeleton of traditional Chinese medicine in treating typhoid disease. The author studies the academic thoughts of the representative figures of classical Chinese classics and various schools of Chinese medicine. The author studies the academic thoughts of the representative figures of classical Chinese classics and various schools of Chinese medicine in the time dimension, finish the common theory and individual experience of Chinese medicine treatment of typhoid fever, to sort out the historical context of the development of typhoid fever and the specific research scope of the diagnosis and treatment of typhoid fever so far, and according to it that constructions framework. Through research. The framwork of typhia was developed through three historicol stages. The first stage is foundation. Wu Shi Er Bing Fang first mentioned how to cure it. This book adopted the way of heating patients to cure them caused by evil cold. Huang Di Nei Jing expounded lesion and cure of typhia from basic theory perspective. It regarded typhia as a generic term of exogenous disease and holds the view that evil cold is the most serious among reasons of diseases caused by exogenous pathogenic factor. From the etiological agent perspective, it elaborated the precondition of typhoid from corporeity and climate. From the pathogenesis and plus condition, it analyzed performance of typhoid and pathology of disease performance and described pulse condition through the impact of cold on skin, regulating bodily functions, and organics and tripe from the point of cold has the effect of contract and easy to do damage to Yang Qi. From the cure principles and method, it proposed the cure principle that is add what one when one is short,and purge what one has overed. Moreover, it proposed prescription and acupuncture and moxibustion from four aspects, that are disease position, medicine characteristic, disease's characteristic and pathogenic factors. It stress on pathogenic factor during cure process. On other aspects, it proposed cure methods' compatibility and incompatibility on the basis of disease location in therapy and improve taboo in daily life and diet and condition anticipation. Huang Di Ba Shi Yi Nan Jing discussed it from basic theory and clinical test. From the illness arrangement, people in Qin state and Yue state, divided it into generalized sense and narrow sense. The generalized sense is the generic term of extrnal infection. Extrnal infection is divided into five categories and typhoid is one of those. As for diagnosis, it was distinguished by five plus manifestations and analyze pathogenesis alone from the perspective of dialectical relation between lung and tripe which holds the point that the heretic of lung systems into heart causing the symptom of ravings which is typhoid's pathogenesis. As for therapy, it was within the limitation of three days to decide patients' prescription, and definite the clearing of viscus system by diarrhea. It also analyzed compatibility and incompatibility of the sweating and purgative method application. The second stage is the initial formation. Two relatively complete typhoid framework was initially established. The first is Liu Bu San Fa by Hua Tuo. The other is syndrome-differentiation of the six meridians by Zhang Zhongjing. Both two were established base on the view of pathogenic inside the body and disease was developed from shallower to deeper. Zhang zhongjing's syndrome-differentiation of the six meridians can be regarded as an extension of the system of typhoid's treatment according to syndrome differentiation in HuangDi NeiJin-the Chapter of Re Lun, while we can not found origin of Hua Tuo's Liu Bu San Fa. In Sui Dynasty, Cao Yuanfang summarized predecessor's experiences and different disease performance appeared in typhoid, forming a diagnosis and treat pattern around the core of symptom characteristics. During this time, tree typhoid frameworks were formed. According to onset date of illness, Hua Tuo's Liu Bu San Fa divided typhoid into six stages, which can be regarded as six disease locations, that were skin, the natural fibre line of meat, muscle, chest, tripe, and stomach. Skin macula maybe appear if uncured in time. This is the earliest elaboration of typhoid performance. About therapy, different parts have each treatments relatively which are perspiration, vomiting and purgative method. Except when pathogen arrive at stomach, it is forbid to use purgative method. What's more, perspiration over two times is incompatibility. Zhang zhongjing's treatment according to syndrome differentiation system of the Liu Jing, setting “symptom-prescription” as expression stylistic and layout, involved eight aspects including pulse syndrome, pathogenesis, progress of disease, therapy, prescription, decoction, taboo, and prognosis and six stage of course of disease which are called diseases of the six meridians in the late time, that are Tai Yang disease, Yang Ming disease, Shao Yang disease, Tai Yin disease, Shao Yin disease, and Jue Yin disease. In addition to the diseases of the six meridians, Zhang Zhongjing also proposed the bad impact of the failure and mistreatment. At the end, he made the framework of pulse syndrome, pathogenesis, treatment, prescription and decocting. Syndrome diagnostic system, which was establish by Cao Yuanfang in Sui Dynasty, was a thorough summarize for predecessors' experiences on Typhoid fever. Its was established by the core of specific symptom, including syndrome pathogenies, date syndrome, disease syndrome, Symptom syndrome, hiccup syndrome, and dyspnea, etc, total 47 cases. Among them, symptom syndrome is the most significant. In symptoms' elaboration, Cao separated typhoid fever of pregnancy, typhoid fever of woman and typhoid fever of children from typhoid fever which was the earliest branch for typhoid. The third stage is development. Wang Shuhe, who in Jin Dynasty, classified all relevant terms in Shang Han Lun into integrity according to treatment taboo. From the perspective of syndrome differentiation, Wang added prognosis of forty symptoms. On treatment, he put forward the academic thought that choose medicine according to regional characteristic, which has profound impact on later time. Typhoid have not gotten much reform until Sui Dynasty. Yang Shangshan have the idea firstly that typhoid is combined by pyreticosis, malaria and flaccid paralysis. Sun Si'miao, in Tang Dynasty, integral apoplexy into typhoid, separated febrile disease, and calenture from typhoid. At this time, record relevant with typhoid have narrowed its range. As for the development of Liu Bu San Fa, Sun laid stress on the description of the relationship between evil and stomach, proposed the pathological changes mechanism, development, treatment, and prognosis after pathogenic into tummy. During the development of treatment according to syndrome differentiation system of the Liu Jing, Sun proposed that typhoid mainly hurt Ying Qi and Wei Qi. It holds the idea that wind hurt Ying Qi, and cold hurt Wei Qi which is the pathogenesis of typhoid. At the end, it became the embryonic form of the typhoid's”San Gang Ding Li'theory for later time. On treatment, Zhang Zhongjing make Cassia Twig Decoction, Mahuang Decoction, and Qinglong Decoction as the main prescription for the system of distinguish and diagnose typhoid by six meridians. And according these three prescriptions, he created many prescriptions which was changed on the basis of Jing Fan, as well as four new prescriptions created by himself. Those prescriptions he created are mainly cure for external cold but heat interior. Sun complemented another 14 cases' diagnosis and treatment including lack of sweat and perspire during sleep on the distinction and diagnosis of symptom. In addition to the development of above three machinery, based on his self experience, Sun complement framework of typhoid's diagnose and treatment from the prevention and treatment, dietetic contraindication, and nursing after recovery. In Song Dynasty, Xu Shu wei elaborated the dialectial of exterior and interior, chills and fever, deficiency and excess and yinyang in Shang Han Lun detailedly and laid stress on dialectical relationship between exterior and interior and based on this two points to diagnose typhoid. Besides, Xu integrate the treatment according to syndrome differentiation system of the Liu Jing and the system of distinction and diagnosis of symptom and summarized 72 cases under the classification of the diseases of the six meridians. Zhu Gong classified exogenous disease into 12 types. He separated apoplexia and febrile diseases from typhoid. And he laid stress on the rise and fall of typhoid patients' stomach Qi and kidney Qi from the basic theory. On diagnose, Zhu put in order from inquiry and form a systematic description. On differentiation, he distinguished diseases of the six meridians by using the channels and collaterals theory and explained pathogenesis. On pathogenesis, Pang An shi elaborated the relationship between six meridians and viscera, holding the idea that the transition of San Yang Disease is in main and collateral channels, while San Yin Disease just transmit in viscera. Essential research was thus completed. On therapy, Pang put forward a principle that preserve body fluid, and gastric Qi. Guo Yong analyzed syndrome-differentiation of the six meridians from the perspective of Ying Qi and Wei Qi which promote the thought of “San Gang Ding Li'. Guo classified the appearance of speckle into 3 categories and 5 types which was an extension of the speckle's appearance on skin caused by hot stomach. He also supplement the treatment as well as macula prescription lacked before. Sheng Ji Zong Lu edited by Song Dynasty's authority, summarized predecessors' experiences. Totally 58 cases was recorded in it, typhoid was re-classified into Zhong Feng typhoid, Shang Han Shi Wen, Shang Han Shi Qi, Shang Han Yi Li and Shang Han Jie Xiong. Before the Jin Dynasty, the study of typhoid fever with cold pathogen invasion of the body. Liu Wansu's break the normal procedure, he created the academic thought that hot evil is the pathogenesis of typhoid, and discuss it from theory and clinical. On diagnose, Liu created the pathological changes happened in typhoid thought of “Bi-Yu-Re”. On therapy, he created the treatment of Kai Bi, Jie Yu and Qingre. When illness has not attached the vital organs of the human body, relieving the exterior syndrome with drugs pungent in flavor and cool in property can be used. What' s more, Liu studied the infectiousness of typhoid and mentioned “Hui Du” which started the research of exogenous infectivity. Zhu Dan xi developed and perfect the academic thought of typhoid treatment according to body constitution and complement the diagnose and treatment framework of the case when typhoid infect predomination of Yang Qi of the body essence. Zhang Zihe classified typhoid into four types and also separated febrile diseases and apoplexia from typhoid. He thought that diseases of the six meridiansis same as disease of adverse rising qi. He distinguished typhoid by Five Circuit Phases and Six Atmospheric. On therapy, he abide by Hua Tuo, and held that diaphoresis is proper within three days. And he created many methods to induce perspiration. Li Gao also improved and perfected the theory of treatment for typhoid base on body constitution. What's more, he also complement the diagnose and treatment for typhoid for people of weak digestive system and created a treatment with Bu Zhong Yi Qi decoction. Ao Shi Shang Han Jin Jing Lu, in Yuan Dynasty, added 36 tongue symptoms which were called tongue manifestation for typhoid diagnosis which improved and perfected the framework of diagnosis and treatment of typhoid. In Ming Dynasty, Fang Youzhi Completed the establishment of “San Gang Ding Li”. Zhang Jingyue complemented the diagnosis of eyes in diagnosis of look and established the method of perspiration couple with add and “Han Jia San Biao Fa”. On symptoms, he complemented the diagnose and treatment of Zhan Han symptom. According to climate change, Li Yan, in Ming Dynasty, innovated a new treatment from viscera perspective. Wang Kentang, in Ming Dynasty, summarized symptom parts from typhoid and integrated the symptom of nearly recovery apart from others. Chen Shiduo summarized forty three symptoms similar to typhoid in the form of medical record which was a peep of typhoid differential diagnosis and enriched the framework of diagnosis and treatment of typhoid. Following predecessors, Zhang Lu who in Qing Dymasty analyzed the transition and change of six channels from the perspective of the theory of viscera and developed the transition and change of evil in six channels among viscera in detail. On rules of treatment, he mainly adopted nourishing yin, holding the idea that medicine can be stopped when Yang Qi increased. Qing Dynasty Ke Qin put forward “Liu Jing Zong Heng”s' academic point of view, the treatment according to syndrome differentiation system of the Liu Jing's essence is both the dialectical model of Heng and dialectical model of Zong. This is a new way to interpret the treatment according to syndrome differentiation system of the Liu Jing. Huang Yuanyu of the Qing Dynasty follows Liu Wansu, according to the theory of Wu Yun Liu Qi to analysis of typhoid fever, and make the analysis of pathogenesis and choice of treatment with the treatment according to syndrome differentiation system of the Liu Jing. Wu Qian in the Qing Dynasty rearrange the sentences of Shang Han Lun, put the sentence of symptom about Chai Hu prescription into the chapter of Shao Yang disease. Wu perfects disease division of treatment according to syndrome differentiation system of the Liu Jing. Other practioner of TCM in ancient time were all have significant contribute to the typhoid's syndrome differentiation and its essence understanding. From the above elaboration, theoretical framework of typhoid's diagnosis and treatment is base the cause, pathogenesis, symptom, therapy from Huang Di Nei Jing and Huang Di Ba Shi Yi Nan Jing, take treatment according to syndrome differentiation system of the Liu Jing and syndrome diagnostic system as the core. The framework of diagnosis and treatment of typhoid get into a prosperity period in Tang Dynasty, Song Dynasty, Jin Dynasty and Yuan Dynasty. By the time of the Qing Dynasty, formed a two-in-one's structure as essence and cause, symptom, location(conversion),criterion and taboo. Symptom, pathogenesis, treatment-method and prognosis, prescription, decoct and eat-method, recovery. |
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