Research On The Achievements And Characteristics Of Pediatrics In Qing Dynasty

Related pediatrics books under the guidance of traditional Chinese medicine(TCM)theory in Qing Dynasty were reviewed in this paper,the understanding of pediatric physiology,pathology,pathogenesis,pathomechanism,diagnosis,syndrome differentiation,pediatric nursing,common disease and neonatal diseases in Qing Dynasty were summarized and the achievements as well as characteristics of TCM pediatrics theory in Qing Dynasty were analyzed,which can provide reference for the development of modern TCM pediatries theory.After Ming Dynasty,the pediatric theory in Qing Dynasty has stepped into a stable period of development,obvious improvement was seen in both theory and diagnosis-treatment for various pediatric diseases.Among the TCM masters in Qing Dynasty,many pediatric masters have risen like a star,such as WU Ji,XIA Ding,CHEN Fu-zheng,XU Yu-he,ZHOU Shi-mi,ZHIYU qiao-ke,CHENG Kang-pu,etc.most of them have their own unique school of thought.In regard to pediatric physiology and pathology,there are views of "the constitution of infant children is pure yang" and "the tender yang of a child is not sufficient and tender yin is not arose yet".With respect to overall period of transmutation and steaming,there are two viewpoints of 512 days and 576 days.As to pathogenesis and pathomechanism,there are views of "seven emotions and six carnal desires is rarely seen in infant children and the pediatric pathogenesis is nothing more than six pathogenic factors externally and fetal toxin or diet internally","all pediatric disease is ascribed to heat" and "although the symptom is various and weird,the pediatric pathogenesis is nothing more than five zang-six fu organs and qi-blood,deficiency and excess,cold and heat,wind and phlegm".With respect to diagnosis,the pediatric masters used the four examinations of inspection,listening and smelling,inquiry and palpation along with inspection of thumb web and the finger venules.Most of the pediatric masters attach importance to inspection:as said by XIA Yu-zhu:"judging the interior from observation of the exterior by inspection of the physique,complexion and signal orifices";ZHOU Zhen has created song of physique and complexion inspection,song of thumb web and finger venules inspection and complexion inspection method;Ciyou xinshu(New Text on Pediatrics)and Youke zhigui(Gist of Pediatrics)have mentioned the diagnosis method of three-finger palpation between the brows and hair boarder.In regard to syndrome differentiation,erke xing(Pediatric comprehension)advocated exterior-interior syndrome differentiation and treatment,cold-heat syndrome differentiation and treatment as well as deficiency-excess syndrome differentiation and treatment,Youke yixue zhinan(Guide to Pediatrics)advocated five zang syndrome differentiation and treatment,Yinger lun(treatise on Pediatric disease)advocatd three energizer syndrome differentiation and treatment,erke miyao(Arcane Essentials of Pediatrics)advocated eight syndrome differentiation and treatment,Yiyuan(Bases of Medicine)advocated dryness and dampness syndrome differentiation and treatment.Most of the masters gave treatment according to disease differentiation,such as Youyou jicheng(The Grand Compendium of Pediatrics)and Youke tiejing(iron mirror for Pediatrics).In the aspect of pediatric nursing,specialized exposition can be seen in part of "well nursing" written by TAN Jin-zhang,part of "cautious nursing of children" written by ZENG Ding and part of "appendix nursing method" written by ZHOU Shi-mi.School of thoughts of many predecessors were abstracted by WU Ning-lan in buoying yizhi lu(easy knowledge of children nursing),which discussed about children nursing and fetal disease.With respect to neonatal disease,various kinds of external treatment were used by pediatric masters,like neonatal trismus,neonatal pursed mouth,neonatal urinary block,neonatal cryptorchid and neonatal colic.In terms of therapeutic principles and medication,XIA Yu-zhu emphasized "the generation/restriction cycle of the five phases" theory and advocated that when a doctor gives treatment,he should avoid killing the thief with door closed or throw the door open for the robbers;Youke Yaolue(Essentials of Pediatrics)written by YE Tian-shi believed that "when the disease is caused by the pathogenic qi of the four season,time should be taken into consideration when treating",the prescription should follow the law of wind-warmth,summer-heat,autumn-dryness and winter-coldness.In Yiyuan-xiaoerke(Bases of Medicine-Pediatrics),SHI Shou-tang has divided herb into moist herb and dry herb.As to particular treatment,there sprung up magical external treatment of CHEN Fu-zheng,there were also nasal application,blowing method,suppository,application therapy,smelling method,moxibustion and dripping method.In the treatment of the four major syndrome,the academic contending was fiercest in infantile convulsion.CHEN Fu-zheng has reclassified infantile convulsion into convulsion due to erroneous treatment,non-wind convulsion and similar convulsion;XIA Yu-zhu has changed chronic infantile convulsion into chronic deficiency;CHENG Feng-chu interpreted acute infantile convulsion as dry wood causing irritable fire;ZHOU Zhen understood acute infantile convulsion as liver fire and heart fire;SHEN Jin-ao understood acute infantile convulsion as liver wind and heart fire;ZENG Ding understood acute infantile convulsion from the point of heat engendered from heart and extreme heat producing wind;ZHIYU qiao-ke believed that the mediocre doctors could not distinguish spasm caused by taiyang syndrome with convulsion due to indigestion,convulsion due to tidal fever,convulsion due to common cold and convulsions characterized by upward-facing head and eyes,convulsions with visceral colic,epilepsy,as a consequence,they treat them as infantile convulsion,for this reason,he differentiated the above mentioned syndrome.CHENG Kang-pu had special articles on "acute infantile convulsion","chronic infantile convulsion" and "chronic convulsion due to spleen disorder".In the treatment of pediatric common disease,the doctors had varied thoughts in therapy and syndrome differentiation.Among them,common cold was treated according to four seasons or ascribed to wind damage;fever was treated according to exterior-interior,deficiency-excess syndrome differentiation or five zang syndrome differentiation;cough was treated according to etiology,time or zang-fu syndrome differentiation;vomitting was treated according to cold-heat or stomach deficiency/stomach heat syndrome differentiation;diarrhea was treated according to the color of the stool;constipation and anuresis were considered to be caused by heat;sweating syndrome was classified into spontaneous sweating and night sweat;edema was treated according to qi,water-dampness or site syndrome differentiation;five types of developmental delay and five kinds of flaccidity were considered to be caused by fetal endowment.In brief,the TCM pediatrics theory in Qing Dynasty developed on the basis of predecessors,the doctors summarized distinctive theory and therapy according to their own experience and wrote many enlightening books.