Study On Theoretical Basis And Clinical Experiences Of The Four Traditional Chinese Medicine Masters About Treating Macule Of Febrile Illness

Since ancient times, infectious disease is a key factor threatening human life and health. Macule is a special and important sign of infectious diseases, it is highly valued by generations of physicians. The concept of macule was early recorded in the Synopsis of the Golden Chamber. Along with the human diseases spectrum changing and the traditional Chinese medicine developing, generations of physicians have different understandings about the etiology and pathogenesis of macule. Zhang Zhongjing considered "Yang toxin" as the pathogenic factor of macule. Chao Yuanfang thought that incubation of warm-toxin or cold-toxin during winter season leads to the macule attack in spring or summer season. Li Dongyuan divided the causes of macule into three kinds-"purge too early", "purge not in time", and "severe heat in stomach". Zhang Zihe thought that macule is caused by accumulated heat in Heart Channel. Zhang Jingyue thinks that misuse of diaphoresis, purgation, heat-clearing, and tonifying could lead to macule. In late Ming period, Wu Youke’s knowledge about the etiology of macule had been well improved, he agreed that the diseases which incubated in the blood system and cannot be eliminated always lead to macule. Zhang Guxu believed that warm pathogen which transports from Moyuan into the stomach induces macule, wind-heat pathogen which invades to meridians induces efflorescence, and heat pathogen which blocked in the nutrient-blood always induces macule and efflorescence. In a word, macule was considered as a result of blocked heat-toxin. Wu Jutong believed that misusing diaphoresis in Taiyin febrile disease when body is unable to sweat, macule comes as follow. Ye Tianshi classified efflorescence into lesion of qi system and macule into lesion of blood system. Zhang Guxu pointed out that efflorescence derives from superficial venule and the heat pathogen exists in pericardium meridian, being different from macule which derives from muscle and the heat pathogen exists in stomach. Lu Zixian classified efflorescence into Taiyin wind-heat type and macule into Yangming heat-toxin type. As a special and important sign of febrile disease, macule had been discussed and comprehended repetitiously by expert on febrile diseases. They found that macule is of diagnostic significance in febrile illness since its shape, color and distribution may reflect the virulence of a pathogen, the physical condition and how critical the disease is.With the concept of macule clearer and clearer and the syndrome identification increasingly complete, the treatment of macule was becoming more and more ersmature and effective. This article will focus on studying the traditional chinese medicine mast in Ming and Qing Dynasties such as Ye Tianshi, Wu Jutong, Wang Mengying, Yu Shiyu and describes their treating theory and clinical experiences about macule. To treat the macule, Ye Tianshi would firstly inspect the attribute of pathogenic and which level the pathogens involve. The prescription mainly applied to macule including Qingxin Lianggesan, Qingjie Yunretang, Xijiao Dihuangtang and Huanglian Jiedutang. The herb most often used are with light texture such as Jingyinghua and Bohe. The primary therapy idea of Ye is promoting the flow of qi and expelling the heat pathogenic factor in a mild and light way. The prescription mainly applied to macule in febrile diseases by Wu Jutong including Puji Xiaoduyin with Shengma, Chaihu, Huangqin, Huanglian taken out, Huaban Tang, Zhuye Shigaotang, Qinggong Tang, Yinqiao San with Dandouchi taken out and Shengdi, Danpi, Daqingye and double Yuanshen added in. The key therapy idea of Wu is expelling the pathogenic factors away from collaterals, muscles and blood by using aromatic, pungent-cool and sweet-cold herbs. The prescription mainly applied to macule in febrile diseases by Wang Mengying including Xijiao Dihuangtang, Baihu Tang, Huangqin Dingluantang, Qianjin Weijingtang, Qingjie Yunretang, Zhuye Shigaotang and Qingxin Lianggesan. In the therapy idea of Wang, clearing heat from Ying system is placed first, with ventilating lung and Yin-nourishing in the second place.