Chapter 8 Chapter 5 Traditional Chinese Medicine - "Huangdi Neijing", "Treatise on Febrile and Miscellaneous Diseases", "Compendium of Materia Medica"
Chinese medicine has a long history, and it is the wisdom crystallization of our people's struggle against diseases for thousands of years.According to legend, Shennong and Huangdi are considered the founders of Chinese medicine.It is said that Shen Nong was poisoned more than 70 times a day after he tasted all kinds of herbs and learned about their properties.It is indeed a myth to be poisoned more than 70 times a day without dying, but behind the myth, it reflects the difficult journey of our ancestors to understand medicine.One thing in this myth is in line with the historical facts, that is, the medicines used by the ancestors in the early days were indeed mostly grasses, so that the whole ancient times of our country have always called pharmacology "herbal medicine".The Yellow Emperor is regarded as the distant ancestor of our Chinese nation today.It is said that he and his ministers Qibo, Bogao, Shaoyu, Leigong, etc. are all medical masters, and they often discuss and study medical issues together and make contributions to the development of Chinese medicine.Although myths and legends may not be true, Shennong and Huangdi represent an important era when our ancestors entered civilization from ignorance. Therefore, early medical works in my country, such as "Huangdi Neijing", etc., are mostly named after Huangdi. , Shennong, among them there is a feeling of admiration for the pioneering work of the ancestors.
In our country, the record about medicine begins with the oracle bone inscriptions of the Shang Dynasty.Among the more than 100,000 pieces of oracle bone inscriptions unearthed at Yin Ruins, 323 pieces are related to diseases, including more than 20 kinds of diseases such as internal diseases, external diseases, women's diseases and children's diseases.From the Western Zhou Dynasty to the Spring and Autumn Period, the records about medicine in ancient documents gradually increased.For example, there are more than 80 kinds of plants used as medicine in later generations; although the book was written in the Warring States Period, the information in it has a long history. Not only the number of medicines recorded in the book has expanded to more than 120 kinds, but they are generally related to the diseases they treat , explaining its efficacy and method of use.In ancient times, doctors and witches were inseparable, that is, witches not only engaged in ghost activities, but also took care of the treatment of human diseases.By the time of the Western Zhou Dynasty, witches and doctors had begun to separate, full-time doctors appeared, and there were simple divisions, and a medical system was established.At that time, the "physician" was in charge of medical affairs. He was not only responsible for the year-end evaluation of doctors, but also responsible for collecting case records and reports.The emergence of full-time doctors and the establishment of the medical system have created conditions for the accumulation of medical experience and the improvement of medical standards.
From the Spring and Autumn Period and the Warring States Period to the Han Dynasty, ancient Chinese medicine has achieved great development, especially for the establishment of the basic theory of traditional Chinese medicine. This is a golden age.As early as the late Spring and Autumn Period, some famous medical scientists began to systematically organize and summarize ancient medical experience and knowledge.According to "Zuo Zhuan", the physicians of the State of Qin once attributed the causes of disease to the six qi of yin, yang, wind, rain, darkness, and light.The theory of six pathogenesis is the earliest theory of etiology in my country.Later, the famous doctor Bian Que (from Qinyue) used the "four diagnosis methods" of looking, smelling, asking, and feeling in medical activities, which are the basic methods and means for diagnosing diseases in later generations of Chinese medicine.Along with the summary and collation of medical experience and knowledge, medical monographs also began to appear. In 1973, a large number of bamboo slips and silk scripts were unearthed in Mawangdui Tomb No. 3 in Changsha, including 14 kinds of medical books, including meridians, pulse methods, medical prescriptions, health preservation, and fetal birth.These medical books were produced roughly between the end of the Spring and Autumn Period and the Qin and Han Dynasties.Among them, "Moxibustion Classic of Eleven Channels of Foot and Arm", "Moxibustion Classic of Eleven Channels of Yin and Yang", "Fifty-two Disease Prescriptions", etc., are all the earliest medical monographs discovered so far.In addition to the medical books unearthed at Mawangdui, there are many medical works produced during this period.According to "Hanshu Yiwenzhi", when Li Zhuguo, a physician in the third year of Emperor Cheng of the Han Dynasty (26 BC), edited the medical books collected by the government, there were seven medical classics with 216 volumes and 11 medical prescriptions with 274 volumes.Among the many medical books, the emergence of four medical books, "Huangdi Neijing", "Nanjing", and "Treatise on Febrile and Miscellaneous Diseases", is of great significance in the history of the development of Chinese medicine. The "Huangdi Neijing" was written in the Warring States Period. The book introduced the theory of qi, yin and yang, and the five elements, systematically summarized ancient medical theories and treatment experience, and laid the theoretical foundation of traditional Chinese medicine. Many fundamental medical views and theoretical principles of traditional Chinese medicine have been Still based on the book. The full name of "Nanjing" is "Eighty-One Nanjing of the Yellow Emperor", which is a work from the late Western Han Dynasty to the Eastern Han Dynasty.This book supplements the deficiencies of "Huangdi Neijing" from the aspects of pulsology, meridians, viscera, diseases, acupuncture, acupoints, etc., and perfects the TCM theory in "Huangdi Neijing". The pulse-diagnosing method of "taking the Cunkou alone" proposed in the book has been clinically used for thousands of years and has far-reaching significance.It was written roughly from the late Western Han Dynasty to the early Eastern Han Dynasty. It is the earliest pharmacy monograph extant in my country.The book contains 365 kinds of medicines, which are divided into upper, middle and lower grades according to the functions of the medicines. It also puts forward many important theories of pharmacology, such as the monarch, minister, adjuvant and envoy of medicines, the compounding relationship of medicines, and the composition of medicines. The collection time, processing and storage, etc., thus laid the foundation for the development of pharmacology in later generations. "Treatise on Febrile Diseases and Miscellaneous Diseases" was written by Zhang Zhongjing in the Eastern Han Dynasty. It is the earliest surviving masterpiece of clinical medicine in my country.This book discusses the syndrome differentiation treatment methods for exogenous febrile diseases and other miscellaneous diseases. It organically combines principles, methods, prescriptions, and medicines, establishes the theoretical principles of syndrome differentiation and treatment, and becomes the originator of clinical syndrome differentiation and treatment for later generations.The above four medical works are called the four medical classics by later generations, and their appearance marks the formation of the theoretical system of traditional Chinese medicine.
During the 700 years from Jin, Southern and Northern Dynasties to Sui, Tang and Five Dynasties, Chinese medicine has developed at an unprecedented speed, which is manifested in the prosperity of various disciplines of clinical medicine, pharmacology, and prescription science.The reason for the above phenomena is mainly due to the frequent wars and natural disasters, which have caused a large number of wounded and sick people. The society's demand for medicine is very urgent, and the society's needs force the rulers of various regimes to pay attention to the arrangement of medicine. Summary and research.Since the Southern and Northern Dynasties, the establishment of medical officials has been increasing. The Liu Song regime set up the imperial medical office and medicine, creating government-run medical education; the Northern Wei regime also organized personnel to write medical books, and popularized medical knowledge to all parts of the country and even to the countryside.In addition, during this period, Taoism flourished, and the technique of alchemy and taking stones became popular in society, which promoted the development of medicine from another aspect.The development of medicine has brought about a large number of medical works.There are 256 medical books in "Sui Shu·Jing Ji Zhi" alone, totaling 4510 volumes.There are three important medical books in the Jin Dynasty, namely Wang Shuhe's "Mai Jing", Huang Fumi's "Huangdi Acupuncture and Moxibustion A and B Classics" and Ge Hong's "Elbow Reserve Emergency Prescription". "Mai Jing" is the earliest relatively complete monograph on pulse science in my country. The book summarizes the experience of pulse diagnosis before the Han Dynasty, divides pulse conditions into 24 types, and discusses pulse shape, pulse diagnosis method, relationship between pulse condition and viscera, and pulse condition Yin and Yang. The distinction and identification of women's and children's veins, etc.This book laid the foundation for the diagnosis of pulse science in traditional Chinese medicine. Although pulse science has developed in later generations, it is basically developed and evolved on the basis of "Mai Jing". "Huangdi Acupuncture and Moxibustion Jiayi Jing" (referred to as "Jiayi Jing") is the earliest existing monograph on acupuncture and moxibustion, and it is also a classic work of acupuncture and moxibustion. There are 300 acupoints, a total of 349 acupoints, and specified the acupuncture depth, needle retention time and moxibustion time, as well as the indications and contraindications of acupuncture, etc., which had a great impact on the acupuncture and moxibustion science of later generations. "Elbow Reserve Emergency Prescriptions" is the most famous prescription book popular since the Eastern Han Dynasty. It is equivalent to the current "First Aid Manual". Therefore, the selection of prescriptions in the book is simple and effective, and most of the medicines are easy to get and cheap. It is very suitable for the poor. It is used by the poor households in the countryside for emergencies.This book records scrub typhus and smallpox for the first time, and its method of using rabies brain to prevent and treat rabies is the germination of TCM immune thought.During the Jin Dynasty and the later Southern and Northern Dynasties, TCM surgery also developed very well. The reasons were, firstly, that there were so many war wounds, and secondly, that carbuncles, back sores and other frequently-occurring diseases were caused by refining alchemy and taking stones.At that time, there were many medical books on this aspect, with nearly 20 kinds, but only "Liu Juanzi Ghost Legacy Prescription" by Gong Qingxuan of the Southern Qi Dynasty survived, which became the earliest surgical monograph seen so far.During the Southern and Northern Dynasties, great achievements were made in the research of pharmacology.First, Tao Hongjing of the Liang Dynasty wrote "Shen Nong's Materia Medica Collection Notes". This book abandoned the classification method of upper, middle and lower grades, and created a new method of classification based on the source and natural properties of drugs. There are 730 kinds of drugs in the book, divided into Jade, vegetation, insects and animals, fruits, vegetables, rice, and famous and unused seven categories are all developed on the basis of later herbal works.During the Liu and Song Dynasties, Lei Chen [Xiao Xiao] edited the earliest monograph on drug processing technology in my country - "On Cannonball".The original book has been lost. Judging from the content quoted by later generations, its processing methods and techniques are very extensive, basically including the main methods of processing traditional Chinese medicine.Physicians in the Sui Dynasty paid more attention to the study of etiology and symptoms, and made great achievements in this area.In the sixth year of Sui Daye (AD 610), Chao Yuanfang, a doctor of imperial medicine, and others were ordered to compile "On the Causes and Symptoms of Various Diseases", which is the first monograph in the history of our country to systematically discuss the etiology and symptoms.The book lists more than 1,700 symptoms, including the etiology, pathology, and symptoms of various diseases such as internal medicine, surgery, gynecology, children, and five sense organs. There are many original ideas, such as the discovery that scabies is caused by scabies, which is earlier than in Europe. More than 1,000 years, and the methods of suturing broken intestines and ligating blood vessels are also 500 to 800 years earlier than those in Europe, and so on.This book is the monograph with the richest content in the history of our country on etiology and pathogenesis, reflecting the development of medical theory and the improvement of clinical practice in our country.The Tang Dynasty attached great importance to medicine, and Chinese medicine was further developed.The "Xinxiu Materia Medica", which was officially compiled in 659 AD, contains 844 kinds of medicines, and is rich in pictures and texts. It is the earliest pharmacopoeia promulgated by the state in my country and in the world.After that, there appeared "Supplements to Materia Medica", "Diet Therapy Materia Medica", "Haiyao Materia Medica" and other herbal works, reflecting the prosperity of herbal science research in the Tang Dynasty.The Tang Dynasty also made remarkable achievements in clinical medicine, and a large number of prescription books appeared. The representative works are Sun Simiao's "Qian Jin Fang" and Wang Tao's "Waitai Secret Yao". "Thousands of Gold Prescriptions" is the abbreviation of "Thousands of Gold Prescriptions" and "Thousands of Gold Prescriptions". Pediatric nursing is placed in an important position; the latter is a supplement to the former, including herbal medicine, typhoid fever, stroke, miscellaneous diseases, etc.The book is based on medical prescriptions and indications, and contains more than 6,500 prescriptions. It has become a master of medical prescriptions before Tang Dynasty.In addition, the book also made great achievements in pharmacology. "Qian Jin Fang" contained more than 800 kinds of medicines at that time, described in detail the collection and processing of more than 200 kinds of medicines, and added many treatment methods and foreign medicines. medical knowledge.Sun Simiao was also honored as the "King of Medicine" by later generations because of his achievements in medicine.There is also an important medical work in the Tang Dynasty, that is "Four Medical Codes" compiled by Yu Tuo Yuandan Gonpo.The book is rich in content, absorbing both the medical experience of the Han nationality and the medical experience of neighboring India, thus forming a unique Tibetan medical system, which is a wonderful work in traditional Chinese medicine.
During the Song, Liao, Jin and Yuan dynasties, the development of printing and papermaking effectively promoted the writing and dissemination of medicine.The rulers of the Song Dynasty also attached great importance to medicine. They ordered the collection of medical classics collected by the people, and promulgated many prescription books and herbal pharmacopoeias.Since the Song Dynasty, literati began to join the ranks of medical research. Fan Zhongyan had a famous saying, "If you are not a good minister, you are willing to be a good doctor." Therefore, it has become a fashion for literati to understand medicine, which greatly improves the level of medical research teams. .Due to the above reasons, medicine in the Song and Yuan dynasties developed in an all-round way.The first is the emergence of a large number of books on herbal medicine.The "Kaibao Materia Medica" compiled by the Song government collected 983 kinds of medicines, and the number of medicines in the subsequent "Jiayou Materia Medica" increased to 1082 kinds. Later, Su Song compiled the "Illustrated Classics of Materia Medica" according to the pictures of medicinal herbs submitted by various places. ".Around the time of Zhezong Yuanyou (1086-1094 A.D.), Tang Shenwei, a doctor in Chengdu, Sichuan, compiled a book called "Classic Materia Medica", which occupies an important position in the history of the development of Materia Medica.The book contains more than 1,700 kinds of medicines, with drawings for each medicine, and there are more than 3,000 single prescriptions and more than 1,000 prescriptions. The content is rich, surpassing the previous herbal works of all dynasties.This work was revised several times by the Song government and promulgated by the government, becoming the best book on herbal medicine before it appeared.There are also many prescription books in the Song Dynasty. Among them, the official prescriptions include "Taiping Shenghui Prescription", "Shengji Zonglu" and "Taiping Huimin Hejiju Prescription". As for "Su Shen Liang Fang" (Su Song, Shen Kuo Co-authored) and other private parties more than 100 kinds.The achievements of clinical medicine in the Song and Yuan Dynasties were also outstanding, especially the division of disciplines was very detailed.For example, there are Qian Yi's monographs on pediatrics, "Pediatric Medicine and Syndrome Straight Jue", Chen Wenzhong's "Pediatric Acne Prescription", etc., gynecology monographs include Chen Ziming's "Women's Complete Prescriptions", etc., surgery monographs include Chen Ziming's "Surgery Essence "Yi", etc., ENT monographs include "Xing Mingshi's Experience Eye Medicine Prescription", "Xing Mingshi's Throat Articulation Prescription", etc., anatomy monographs include "Five Viscera Map" and "Cunzhen Map", and forensic medicine has the world's first The first monograph on forensic medicine - "Winning Injustice Collection".Among clinical subjects, the development of acupuncture and moxibustion is worth noting.The only "Bronze Man Acupuncture and Moxibustion Illustrated Classics" written by Wang in the Song Dynasty and the "Fourteen Classics" written by Huashou in the Yuan Dynasty unified the different opinions on acupoints in the past.The major achievement in medical theory during the Song and Yuan Dynasties was the emergence of the four major schools of medicine in the Jin and Yuan Dynasties.The emergence of medical schools and medical disputes reflects that medical theory has made a major breakthrough on the basis of accumulated experience in the past dynasties.For example, Liu Wansu in the Jin Dynasty studied the theory of "luck" and concluded that "fire" is the main cause of disease. In terms of treatment, he advocated the use of cold and cool medicines, known as the "cold and cool school". His main work is "Su Wen Xuan Ji Yuan Shi Shi" ", "Su Wen Pathogenesis Qi Yi Bao Ming Ji" and "Xuan Ming Lun Fang" etc.; Zhang Congzheng of the Jin Dynasty believed that evil qi was the root of all diseases and was not inherent in the human body, and advocated the use of sweating, vomiting, and lowering to attack evil Dispelling diseases, known as the "Attacking Evil School", whose main work is "Confucianism and Relationships"; Li Gao, a doctor in the Jin and Yuan Dynasties, pointed out that the spleen and stomach are the source of vitality, "internal injury to the spleen and stomach, all diseases arise from it", and advocated that the treatment of diseases should be promoted. Qi, warming and invigorating the spleen and stomach are the main ones, known as the "butu faction" (the five elements of the spleen and stomach belong to the soil), and wrote "Discriminating Confused about Internal and External Injuries" and "On the Spleen and Stomach". Insufficient ", damp-heat phase fire consumes most of the diseases, and the method of nourishing yin and reducing fire is advocated in treatment. It is called "Yin Nourishing School", and its works include "Ge Zhi Yu Lun" and "Ju Fang Fa" and so on.The four masters of the Jin and Yuan Dynasties inherited and developed the medical theory of the "Huangdi Neijing" from different aspects, which brought the medical system of our country to a new height.
Capitalism sprouted in the middle of the Ming Dynasty, and a group of intellectuals turned to practical learning. In addition, some intellectuals in the early Qing Dynasty were unwilling to serve in the Qing Dynasty and switched from Confucianism to medicine. This greatly strengthened the power of medical research in the Ming and Qing Dynasties, and the number of medical works increased sharply.In the individual works of Ming and Qing physicians, the characteristics of combining theory and practice are more reflected. For example, the works of Li Shizhen, Wang Qingren, and the febrile disease school are all written on the basis of a lot of practice.During the Ming and Qing Dynasties, there were two important achievements in medicine, one was the large-scale summary of pharmacology, and the other was the formation of febrile disease school.The Ming and Qing dynasties did not pay as much attention to the books of Materia Medica as the government of the Song Dynasty. Only during the reign of Emperor Xiaozong of the Ming Dynasty, the Imperial Hospital compiled a book called "The Essence of Materia Medica", which included 1,815 kinds of medicines, but it was not published at that time and had little impact.However, folk research on Materia Medica has made great achievements. Among them, Li Shizhen collected 1892 kinds of medicines, with reasonable classification, detailed description, and rich materials.Before and after its creation, there were several important works on herbal medicine, such as "Southern Yunnan Materia Medica" written by Lan Mao in the Ming Dynasty, which is a local drug work that specifically summarizes the experience of medicines and medications in Dianchi, Yunnan, my country; "Compendium of Materia Medica" written by Zhao Xuemin in the Qing Dynasty. Supplements contains 921 kinds of medicines, of which 716 kinds have not been collected or are not described in detail.Febrile diseases mainly refer to acute febrile infectious diseases, as well as some epidemic diseases and seasonal diseases.Doctors since Zhang Zhongjing mostly diagnosed and treated exogenous wind-cold (typhoid fever).In the Ming and Qing dynasties, infectious diseases were prevalent, and febrile diseases had a deeper understanding in clinical practice.The febrile disease school that emerged at this time believed that acute febrile disease was caused by feeling warm evils in different seasons, and gradually formed a relatively complete set of theories in terms of etiology, pathology, and treatment principles that were independent of the Shanghan theory.As early as the first year of Hongwu (1368 A.D.), Wang Lu's "Medical Classics Suhui Collection" clearly pointed out that febrile diseases are different from typhoid fever from pathology, thus opening up a new way to understand infectious diseases.In the late Ming Dynasty, Wu Youxing discussed in detail the etiology, transmission route and corresponding treatment methods of febrile diseases in "On Epidemiology of Warm Diseases", especially he would induce infectious diseases and boils, carbuncles, erysipelas, and spots The causes of diseases such as acne and acne are attributed to "hostile energy", and it is explained that "hostile energy" "enters from the mouth and nose", which has high scientific value.The appearance of this book reflects the innovation of epidemiology in my country and lays the foundation for the formation of febrile disease theory.In the middle of the Qing Dynasty, the theory of febrile diseases developed again, and four great masters of treating febrile diseases appeared—Ye Gui, Xue Xue, Wu Tang, and Wang Shixiong.Ye Gui is considered to be the founder of febrile disease school. He wrote "On Heat and Heat", which theoretically summarized the pathogenesis and transmission of exogenous febrile diseases, and proposed four pathological changes of "Wei, Qi, Ying, and blood". stage, in order to better dialectical treatment. "On Warm Heat" was later regarded as a classic work of the febrile disease school.After that, Xue Xue's "Warm and Heat Tiao Bian", Wu Tang's "Warm Disease Tiao Bian", and Wang Shixiong's "Warm and Hot Jingwei" respectively summarized and developed the theory of febrile disease and brought it to a mature stage.During the Ming and Qing Dynasties, great achievements were also made in other aspects of medicine, and some important medical works were left behind, such as "Pox Ke Jin Jing Fu Ji Jie" and "Vaccination Heart Method", which recorded the invention of smallpox vaccination in my country; "Famous Doctor Class Cases" is a treasure house of medical experience, which is a collection of doctors' medical records; "Puji Prescriptions" is a masterpiece of medical prescriptions that collected prescriptions from various schools before the Ming Dynasty; Sexual works; "Yi Lin Gaicuo" is an important anatomical work on the study of human viscera; and so on.
Around the end of the Ming Dynasty and the beginning of the Qing Dynasty, Western medicine began to be introduced into my country. After the Opium War, Western medicine spread more widely.At that time, some people were not only familiar with Chinese medicine, but also had a strong interest in Western medicine, and compared the two, trying to combine Chinese and Western medicine.Such as Luo Dingchang's "Viscera Diagrams, Syndrome and Treatment", Tang Rongchuan's "Chinese and Western Medical Classics Essence", Zhu Peiwen's "Huayang Viscera and Xiangyue Compilation", etc.It can be said that the road of combining Chinese and Western medicine has begun since then.
"Huangdi Neijing", referred to as "Neijing", is the earliest extant medical theory work in my country.The whole book is not written by one person at a time, but is summarized by the experience, experience and theory of many medical scientists over many years.It is generally believed that the main content of the book was completed in the Warring States Period, and some content from later generations was added to the biography later.
The "Nei Jing" has 18 volumes, which are divided into two parts: "Su Wen" (nine volumes) and "Lingshu" (nine volumes), each with 81 chapters.The content of the book is discussed in the form of question-and-answer discussions between the Yellow Emperor and his courtiers Qi Bo, Bo Gao, Shao Yu, Lei Gong and others.Since it was not written by one person, the compilation of each article is rather scattered, the style of the words and sentences is not consistent, and the content is repetitive or even contradictory.Generally speaking, the content of "Su Wen" focuses on the basic theories of human physiology and pathology and drug therapy in traditional Chinese medicine. Theories, viscera theory, treatment principles and methods of various diseases, etc.; "Lingshu" focuses on acupuncture theory, meridian theory and human anatomy, and discusses the shape, usage, taboos, human meridians, acupoints, and Human body surface and visceral anatomy, acupuncture methods and principles, constitution types, etc. The "Nei Jing" systematically summarized and improved the medical experience and knowledge of the pre-Qin period, forming a complete set of basic theories of traditional Chinese medicine.
The theory of Yin Yang and Five Elements is a philosophical thought that originated in the Spring and Autumn Period and the Warring States Period.It uses the unity of opposites of yin and yang and the mutual generation and mutual restraint of metal, wood, water, fire and earth to illustrate the laws of motion and the universal connection of existence in nature. It is an ancient spontaneous materialism and simple dialectical thought. "Nei Jing" absorbs, uses and develops these theories, combines them with medical practice, and establishes the overall concept of Chinese medicine. "Nei Jing" believes that the relative balance and coordination of yin and yang in the human body is a necessary condition for maintaining normal physiological activities. If this relative balance and coordination is lost, people will develop diseases.For example, the surface of the human body is yang, while the inside is yin; the heart, liver, spleen, lung, kidney, and five internal organs are yin, and the stomach, large intestine, small intestine, bladder, gallbladder, and triple burner are yang; then, for diseases, heat is yang, and cold is yin.In terms of viscera, in addition to distinguishing yin and yang, it also corresponds to the five elements. The lungs belong to metal, the liver belongs to wood, the kidneys belong to water, the heart belongs to fire, and the spleen belongs to earth. "Stakes. The "Nei Jing" also believes that the external world also has the relationship between Yin and Yang and the five elements, and "human beings correspond to heaven and earth", so changes in four seasons, geographical environment, lifestyle and psychological emotions all have an impact on the condition of the human body.In this way, in the "Internal Classics", the various organs of the human body, and even between man and nature, constitute an organic whole that is not only different from each other, but also related to each other and interacts with each other. Then, corresponding to it, in medical practice it must be Comprehensively grasp the complex and delicate relationship between diseases and various factors, and adopt different treatment methods and principles.The overall concept is one of the main ways of thinking in the diagnosis, treatment and analysis of diseases in traditional Chinese medicine. It runs through all aspects of the internal organs, meridians, anatomy and treatment in the "Neijing".
The theory of viscera and meridians is an important theory used by Chinese medicine to explain physiology and pathology. The narration of this theory in "Internal Classics" has been relatively systematic and comprehensive.The five internal organs refer to the heart, liver, spleen, lungs, and kidneys; the six internal organs refer to the stomach, small intestine, large intestine, bladder, and gallbladder. The viscera and six fu organs in the "Internal Classics" are not exactly the same as the anatomical concepts of modern medicine, and it focuses more on the functions of the body.It believes that the function of the five internal organs is to contain the essence of the human body, and the function of the six internal organs is digestion and operation.Meridians are the roads through which Qi and blood run in the human body. The main lines are called meridians, and the branches are called collaterals. The "Nei Jing" divides the meridians of the human body into twelve meridians, and there are also eight extra meridians and other running channels.Meridians connect and communicate all parts of the human body, viscera and organs from the inside to the outside into a unified whole. The "Nei Jing" mentioned that diet is absorbed by the stomach and digestive system, and the subtle qi of water and grain is dispersed in the liver, and the thick and turbid part of essence qi goes up to the heart. "Nei Jing" also pointed out that "the heart governs the blood vessels of the body", "the meridians circulate endlessly, and circulate endlessly", "the meridians circulate blood and qi to promote yin and yang", "the internal irrigates the five internal organs, and the external moistens (moisturizes) the skin 〕Principle (skin)".These narratives express the overall understanding of human physiological activities in the "Neijing", among which the relationship between the heart and blood vessels, as well as the description of blood circulation, are earlier in the world.Hippocrates in Greece in the 4th century BC did not know that blood was flowing, while the theory of blood circulation in the West was put forward as late as the 17th century.
There is already a lot of anatomical knowledge in the "Nei Jing". The "Lingshu" pointed out that the anatomical parts of the human body surface can be determined by measurement, and the anatomy of the internal organs must be observed by cutting the chest and abdomen after death. Although not very accurate, the human skeleton, length of blood vessels, and size and capacity of internal organs recorded in the "Nei Jing" are basically in line with the actual situation.The practice of anatomy has deepened people's understanding of the structure, function and connection of the human body, and provided a basis for the establishment of medical theories.
Regarding the mechanism of pathogenic factors and pathological changes, there are rich discussions in the "Internal Classics". The "Neijing" refers to external factors such as wind, heat, dryness, dampness, and cold that cause diseases as "evil qi". The "Nei Jing" also puts forward the view of the unity of body and mind, and believes that mental factors and physical conditions are mutually influential, and the root of emotional changes such as joy, anger, sadness, fear, and thinking lies in the functions of the viscera, which in turn affects the function of the viscera. The "Nei Jing" also discusses the role of natural conditions such as geographical environment and climate on the occurrence of diseases. It is believed that different geographical environments and people's living habits are different, and the diseases they suffer from have their own characteristics. The "Nei Jing" has begun to classify diseases according to the five internal organs, six internal organs, tendons, meat, meridians, bones, and muscles.The book records and analyzes 311 clinical diseases in 44 categories, including many common diseases.Classifying diseases is the basic work of medical science. The narration in "Nei Jing" provides extremely valuable clinical reference materials for future generations to study diseases in depth.
As for the diagnosis of diseases, as early as the 5th century BC, Bian Que had already started to diagnose diseases by combining pulse pulse and inspection.In the era of "Internal Classics", it was summarized, supplemented and developed. "Nei Jing" calls the pulsating blood vessels "arteries". It talks about cutting pulses. In addition to the radial arteries of the two wrists that are still used today, it also records the temporal [nie ru Nieru] arteries of the head and face and the anterior tibial arteries of the lower limbs. , as the three cut veins on the human body surface.Pulse diagnosis is a summary of the long-term practice of ancient Chinese medical scientists.The study of pulse was later spread to Japan, Korea, Arabia, and Europe, making contributions to world medicine.As for inspection, the experience in the "Nei Jing" is more abundant, and the content tends to be more complete.The book also places particular emphasis on the combined use of methods such as pulse detection and inspection to prevent one-sidedness in diagnosis.
In the treatment of diseases, the "Internal Classics" brilliantly analyzed the principle that "curing a disease must focus on the root", and discussed how to treat the symptoms and root causes in clinical practice.In the specific treatment, the "Nei Jing" uses a variety of treatment methods such as oral administration, external treatment, acupuncture, massage, and guidance.Among them, acupuncture therapy has the most records, such as the preparation of equipment, the distribution of acupoints, the rules of holding needles, the skills of purging and tonifying, the dosage of acupuncture and contraindications, etc., are discussed in detail, and they are still of great significance today.It is worth mentioning that there are detailed records of paracentesis in the treatment of ascites in the Canon of Internal Medicine, which reflects the ingenuity and medical level of ancient Chinese physicians.
"Nei Jing" puts special emphasis on "preventive treatment of disease", that is, the medical thinking that focuses on disease prevention.It is pointed out in the book that if a person is already in a state of disorder and takes medicine for treatment, it is like digging a well when he is thirsty. Isn’t it too late? "Nei Jing" believes that a good doctor must prevent the disease before it occurs, or at least should be able to control the disease when it is just formed, so as not to make it develop to the point where it is difficult to treat.In order to prevent diseases, the book proposes methods such as adapting to climate change in the four seasons, maintaining hygiene in diet and daily life, controlling lust, and cultivating a healthy mental state, all of which are feasible and have contributed to the development of health preservation.
The achievements of "Huangdi Neijing" in medical theory have laid the foundation of traditional Chinese medicine theory, and its influence is far-reaching.Many people in history have done a lot of research and annotation work on this book, and it is still a must-read book for us to study and study the theory of Chinese medicine today.Part of the book has also been translated into Japanese, German, English, French and other languages, and it is an important document for European and American countries to study Chinese medicine.
"Treatise on Febrile Diseases and Miscellaneous Diseases" written by Zhang Zhongjing in the Eastern Han Dynasty is the first monograph on clinical syndrome differentiation and treatment in my country.Zhang Zhongjing, whose name is Zhongjing, is a native of Nanyang, Henan today.In the last years of the Eastern Han Dynasty, politics was extremely dark, warlords fought in chaos, and famines continued. Coupled with the prevalence of epidemics, they brought great suffering to the people. "The bones of the dead are exposed in the wild, and there is no rooster crowing for thousands of miles", which is the portrayal of the desolate scene at that time.Zhang Zhongjing lived in such an era.It is said that there were more than 200 people in his family, and 2/3 of them died of the epidemic in ten years, and 7/10 of them died of "typhoid fever".Zhang Zhongjing witnessed the poverty and sickness of the people, and felt extremely sad for the death of his relatives, so he determined to study medicine.Zhang Zhongjing hated the phenomenon of quack doctors misleading people and superstitious belief in ghosts, gods and witchcraft at that time.In his view, to overcome the disease, only to provide people with effective treatment.In order to achieve this goal, on the one hand, he "diligently sought ancient precepts", studied medical classics such as "Su Wen", "Nine Volumes", "Nanjing", "Yin and Yang Dalun", and absorbed the precious heritage of his predecessors; Learn from famous doctors at that time, extensively collect empirical prescriptions circulated among the people, and test them in clinical practice.After decades of hard work, he finally completed the medical masterpiece "Treatise on Febrile Diseases and Miscellaneous Diseases" in his later years.
"Treatise on Febrile Diseases" is divided into two parts, "Treatise on Febrile Diseases" and "Treatise on Miscellaneous Diseases", but due to endless wars, it was lost shortly after it was written.Wang Shuhe, a medical scientist in the Jin Dynasty, once collected and sorted out the book, and he was the one who sorted out "Treatise on Febrile Diseases". However, this book does not have a part on miscellaneous diseases, which may be because it was lost and not handed down.During the Northern Song Dynasty, Wang Zhu, a Hanlin scholar, found a part of bamboo slips in the Royal Library Pavilion, and the main content of it was "Treatise on Febrile Diseases and Miscellaneous Diseases".Later, Sun Qi and Lin Yi, who corrected the medical bookstore, reorganized and edited it. Because the "Treatise on Febrile Diseases" compiled by Wang Shuhe had already been published in the part on Shanghan, only the content on miscellaneous diseases was selected, which was called "Treatise on Febrile Diseases". The Prescriptions of the Golden Chamber and the Jade Letter, referred to as "The Golden Chamber".Therefore, "Treatise on Febrile Diseases" was officially divided into two works, "Treatise on Febrile Diseases" and "Synopsis of the Golden Chamber".
"Treatise on Febrile Diseases" has 10 volumes, 22 articles, 397 methods, and 113 prescriptions, which specifically discusses the syndrome differentiation and treatment of typhoid fever. The term "typhoid fever" is different from the "typhoid fever" caused by typhoid bacillus in modern medical disease names. It generally refers to all fever diseases caused by the invasion of external "cold evil", including some acute infectious diseases.Zhang Zhongjing used the four diagnostic methods of looking, smelling, asking, and cutting to analyze and study typhoid fever.In "Treatise on Febrile Diseases", according to the various symptoms of typhoid fever, the strength of the human body, and the different stages of disease development, he summarized it into the three yang diseases of the sun, Yangming, and Shaoyang, and the three yang diseases of Taiyin, Shaoyin, and Jueyin. There are six categories of Three Yin Diseases.The book points out the basic symptoms and pulse conditions of each type of disease as the basis for distinguishing the disease, and distinguishes the pathological changes from the development of the disease to grasp the essence of the disease.This is the "Six Classics Differentiation". "Treatise on Febrile Diseases" also puts forward eight dialectical methods of yin, yang, exterior, interior, cold, heat, deficiency, and excess, which are called "eight principles" in later generations, which are the specific application principles of syndrome differentiation and treatment.Among the eight principles, yin and yang are the general principles.Because ancient Chinese medicine believes that all diseases are caused by the excess or decline of yin and yang, so it is necessary to distinguish the yin and yang of the disease and determine which type it belongs to.On this basis, it is necessary to distinguish the depth of the disease site (exterior and interior), the nature of the disease, cold and heat, and the ups and downs of evil and righteousness (deficiency and excess), and then a diagnosis can be made.The relationship between the Eight Principles and Syndrome Differentiation of the Six Meridians is very close, and it is the basic theory of clinical syndrome differentiation and treatment.This theory makes the analysis and induction of many complex diseases very systematic and clear, making it easy for people to grasp.
"Treatise on Febrile Diseases" also summed up a set of treatment principles and methods, that is, "treatment" based on syndrome differentiation.The book divides the treatment principles into two aspects: exorcising evil and strengthening the body. It is believed that some diseases with rapid onset and little consumption of human body, such as Sanyang disease, should focus on expelling evil and quickly eliminate the focus; while for some diseases with slow onset or long course 1. For diseases that consume a lot of physical energy, such as three-yin diseases, it is necessary to adopt the method of strengthening the body to restore the patient's disease resistance and mobilize the positive factors of the human body itself.In addition, the book also puts forward the principle of "treating according to the symptoms", advocating that "the root of the disease should be treated slowly, and the symptoms should be treated urgently", combining strict regularity with necessary flexibility.In terms of treatment methods, "Treatise on Febrile Diseases" used methods such as sweating, vomiting, pouring, and so on.The sweating method is to use drugs to make people sweat and expel pathogenic factors from the body; the vomiting method is to make the patient vomit and remove the poison and food in the chest and abdomen; the lower method is to use drugs to make the patient excrete the virus in the stomach; Use drugs to neutralize the virus in the body.The book points out that these methods should be carefully selected according to the specific situation of the patient, and should not be messed up.As for which method to choose under what circumstances, "Treatise on Febrile Diseases" has given a detailed description.
"Synopsis of the Golden Chamber" consists of three volumes, 25 chapters, and 262 recipes.Its first chapter, "Viscera, Meridians and Collaterals, and Syndrome of Diseases and Syndromes", is the general outline of the book, discussing the general theories and principles of etiology, diagnosis, treatment and prevention.The main difference between this book and "Treatise on Febrile Diseases" is that it mainly discusses miscellaneous diseases in internal medicine, so the pathogenesis of viscera is used to guide syndrome differentiation.But the two books are consistent in the general spirit of dialectical treatment.
Zhang Zhongjing has also made great achievements in Chinese medicine prescriptions. "Treatise on Febrile Diseases" and "Synopsis of the Golden Chamber" contained more than 300 prescriptions and used more than 200 drugs.张仲景大胆创新，调制了不少新的复合方剂，大大发展了方剂学。 《伤寒杂病论》中的药方，大都有用药灵活和疗效显著的特点；对每一味药的应用都比较明确、谨慎，并指出了药物相互配合和增减的基本原则；对药物的煎法、服法、禁忌也都作了详细的规定。为了使药物便于吸收，充分发挥作用，张仲景使用了多种剂型，并对一些传统剂型进行了改造。 《伤寒杂病论》所载的药物剂型就有汤剂、丸剂、散剂、酒剂、洗剂、浴剂、薰剂、滴耳剂、灌鼻剂、膏剂、栓剂、灌肠剂等等，扩大了药物的使用范围。后世许多医家称《伤寒杂病论》中的药方为“众方之祖”，或称它们为“经方”。现在中医临床上不少常用方剂都是由它们加减变化而来的。
《伤寒杂病论》系统总结了汉代以前的医学理论和临床经验，奠定了中医辨证施治的基本原则，创制了众多疗效可靠的方剂，成为中国传统医学最重要的经典著作之一。而它的作者张仲景也由于在医学上的杰出成就，被后世尊为“医圣”。1700多年来，《伤寒杂病论》不仅为中国历代医家所推崇，而且还流传到日本、朝鲜，产生了很大影响。直到今天，人们还在对它进行研究。
明末李时珍所著的是我国古代药物学的集大成者，被誉为“东方医学巨典”，对我国乃至世界医药学的发展都有着巨大贡献。李时珍(公元1518—1593年)字东璧，晚年号濒湖山人，湖北蕲〔qi其〕春县人。他的祖父和父亲都是医生。李时珍幼时常随父兄一起到山中采药，听父亲讲解草药，因此获得了许多药物学知识。他在三次参加举人考试失败后，决心放弃科举的途径，立志研究医学。由于李时珍的医名遍及大江南北，于是在1551年楚王府聘他掌管良医所，后又被推荐任太医院院判。但是，他认为在太医院工作，难以达到济世救人的目的。于是任职一年后，李时珍便托病回家了。
图4 李时珍
在长期的医疗实践和大量阅读古代医学文献的过程中，李时珍发现前人的本草著作存在的问题很多，如分类不详、名目错乱，以及新发现的药物没有著录等等。由此，他萌发了重修本草的决心。从1552年开始，他经常头戴斗笠，身背竹筐，亲自到许多产药的地方访问，采集标本，描绘图像。他还查阅了800多种有关图书。经过30多年的呕心沥血，三次大的修改，李时珍终于完成了这部药物学巨著。这部书在李时珍晚年开始雕版，但没有等到出版，他便去世了。
共52卷，190多万字，是一部宏篇巨著。李时珍分析了前人撰写本草著作的得失经验和古今药物利用的兴废规律，提出了“不厌详悉”的编写原则。他汇集了历代本草著作，对其中的药物重新加以整理，去粗取精，删除重复，合并种类，收入的有1518种。同时他又深入民间，采访四方，增补了374种前人没有收录的药物。共收药物1892种，成为历代本草中载药最多的一家。该书还继承了《新修本草》首创的描绘药图的成功经验，绘有药图1160幅，同时注意了描绘药图的特征的准确性，为后人认识、采集和鉴别药物提供了方便。李时珍还非常重视药方的收集工作。附录药方11096首，几乎包括了所有医学典籍中的经验良方。因此，本书不仅集本草之大成，也是医方的全书。这种以药带方，以方附药的方式，既证实了药物的功效，又加深了对药物的认识，集中了临床经验，大大提高了本草的实用价值。另外，经史子集各种古书中有关医药的资料，也在考证、分析的基础上加以采纳，使本草的内容更为丰富。
虽然内容极为丰富，但并不杂乱，这要归功于它的分类体系和编排体例。中将药物分为水、火、土、金石、草、谷、菜、果、木、服器、虫、鳞、介、兽、人16部。可以看出，这16部明显地将自然界分成了无机物界、植物界和动物界三大层次，它的次序体现了自然从无机到有机、从低级向高级、从简单到复杂的发展规律。各部之下，李时珍又进行分类，如草部下分山草、芳草、隰草、蔓草、毒草、水草、石草、苔草、杂草等。各部总共又分60类。分类的科学性在当时世界上是领先的，许多方面与现代科学分类相吻合。它比西方生物学家林奈在1735年出版的《自然系统》要早一个半世纪，内容也更为丰富，有的分类也更详明。
在解说药物时，在每种药物下标一个总名，作为该种药物的纲，下面又分列栏目，其中：
释名列举该药通常的名称和别名，并说明其由来等。
集解说明该药的产地、形状、性质、特点，以及对类似药物的鉴别等。
气味指出其甘、苦、寒、热、温、凉、平、咸、淡、辛、酸、有毒、无毒等特性。
正误对该药进行辨释，如有错误则予以纠正。
修治介绍把原料加工成药物的方法。
主治列举该药的主治功能及所根据的药书出处。
发明叙述该药使用的源流并进行理论上的探讨。
附方附录使用该药的新、旧药方。
这种结构和体例条理分明，便于检索，切合实用。
从文献考证和实际调查入手，对前人本草中的疑难问题和错误，进行了大量的辨别和订正工作。如中说穿山甲以蚂蚁为食。李时珍亲自做了解剖，在穿山甲胃里发现了大量蚂蚁，证明它确是食蚁动物。又如，以往的本草书中，对萍、苹、莼〔chun纯〕、荇〔xing杏〕四种水生植物的具体区别都没有讲清楚。李时珍通过向农夫请教，终于弄清了它们的区别。在中，李时珍还对炼丹服石以求长生不老的神仙术进行了坚决的批判，指出它们不足信，是“邪说”。这些证明李时珍的医药学研究态度严谨，思想进步。他还对许多不能解决的问题存疑，不盲目下结论。
对医学研究也做出了贡献，书中记载了一些宝贵的医学史料。如首次记录了铅中毒、汞中毒、一氧化碳中毒、肝吸虫等病症；首次记录的医疗技术有冰块冷敷退热、蒸汽消毒等。李时珍还创造性地提出了“脑为元神之府”的观点，认为脑是精神意识的聚集之处，与现代医学基本一致。
对现代医药学的研究有很大参考价值。书中所载的药物和药方，许多至今仍在广泛使用，而且已被科学证明是正确的。现代中药研究工作者，常从中得到启迪，发掘出新药。例如，治夜盲症的羊肠、胡桃，治哮喘的麻黄，治杆菌性痢疾的马齿苋等的药理和疗效的发现，都是从中得到线索的。
不仅对医药学的研究有重要价值，而且对化学、生物学、矿物学、冶金、地质和物候学等多种学科也具有重要的价值和作用。如在制药中，记载了蒸馏、蒸发、升华、风化、沉淀、干燥等化学反应和方法。又如书中记载了大量关于动物的习性、变异、遗传特征、人工方法改变动物习性等生物学资料，对生物学研究有启发作用。达尔文在研究动物变异等现象时，曾直接和间接引用过的内容，并称赞它是“中国古代的百科全书”。
是一本划时代的巨著，它一出版，就引起了巨大反响。国内重版达二三十次，成为其后本草著作的楷模。后世对它的研究也为数众多。还流传到国外，先后被译成拉丁、日、法、德、英、朝、俄等国文字，成为国际科学界的重要文献之一。
Notes:
图4 李时珍
Notes: