| A medical record is a record of a doctor’s diagnosis and treatment of a disease,which contains the description and analysis of the patient’s symptoms,etiology and pathogenesis,tongue and pulse,principle and methods of treatment,herbs,and many other elements.Since the medical record can reflect the thinking process of physicians in diagnosis and treatment,the rules and theories based on these real clinical events can best represent the academic thinking and clinical experience of medical practitioners.Since the Chronicle of History:Biography of Bian Que Cang Gong contains Chunyu Yi’s "diagnostic record",Chinese medical cases have gradually developed and grown to become one of the important categories of Chinese medical literature.The medical records are classified into various categories due to the differences in the arrangement and editing,among which individual medical cases can especially reflect the treatment characteristics and academic features of medical practitioners,therefore,this paper is dedicated to individual medical records as research materials.Febrile disease is a type of external disease with a warming nature,and its clinical manifestations are mainly fever.As early as the The Yellow Emperor’s Inner Canon and Nan Jing,there were discussions on febrile diseases.After several generations of development,marked by Wu Youke’s first monograph on febrile diseases in the Ming Dynasty,Wenyi Lun,it finally became a system through the succession and development of the four great therapists,including Ye,Xue,Wu,and Wang.In the context of today’s times,the epidemic of febrile diseases is threatening the life and health of the public.In recent years,several public health emergencies have occurred at home and abroad,such as SARS,human avian influenza,human swine streptococcal disease,Ebola virus,etc.The global outbreak of the COVID-19 in early 2020 continues to have a profound impact on people’s lives today.The importance of ancient Chinese medical literature,especially literature related to febrile disease medical records,has been gradually highlighted by the notable achievements of TCM treatment in a series of epidemics.In the process of the development of Chinese medicine,many healers have included medical records of febrile diseases in their medical works,which contain valuable experience and ideas on the prevention and treatment of febrile diseases and are in urgent need of further collation and excavation.It is of great importance to organize and study the medical records of febrile diseases in Chinese medical literature for the development and innovation of the basic theories and clinical practice of Chinese medicine,as well as to improve the ability of Chinese medicine to prevent and treat various types of febrile diseases.This is the main purpose,meaning and background of this study.The thesis firstly uses traditional bibliographic research methods,and a combination of cataloging,edition,and proofreading methods,then medical records were collected in strict accordance with the inclusion-exclusion criteria developed in the study,and the parts of them concerning febrile disease medical records were compiled.The research idea comes from Shi Changyong’s bibliographic viewpoint of"as human books" and the "three-dimensional" evaluation method of "healers,ancient texts,and knowledge".Starting from the information of doctors who have treated cases of febrile diseases in medical records,the study collected relevant information and wrote short biographies of medical practitioners,organized the geographical areas where they were located,and further classified them into nine regions accordingly.They are the ancient Huizhou Xin’an area,Huaiyang area,Changzhou area,Suzhou area,Wuxi area,Shanghai area,Hangjiahu area,Shaoxing area,and Xujiang area.Secondly,the study used the knowledge element-based method of digitizing ancient books to organize and process the contents of the literature of febrile disease medical records.According to the characteristics of febrile diseases,a proprietary indexing template for the medical records of febrile diseases is created,and the templates were cited in the "Traditional Chinese Medicine Ancient Books Knowledge Processing Platform" to obtain the data files according to the logical data model.Where the knowledge body records,knowledge element records,and statistical information are maintained.After the data were obtained,each disease type of febrile disease was counted by the knowledge body results according to the 9 geographical regions after classification,and each knowledge element of different types of febrile diseases was extracted and summarized for analysis.The medical records of febrile diseases in the ancient Huizhou Xin’an area are divided into eight categories:① Warm disease:Cheng Wenying called it "heat disease",with a syndrome of exuberant heat in Yangming.②Plague:there are three categories:plague,warm epidemic,and spring epidemic.Both Sun Yikui and Cheng Wenshu suggested that the plague was contagious.Sun Yikui emphasized the etiology of relapse due to dietary irregularity,and created Xiaobai Tang,which was mainly composed of Bupleurum and gypsum.Cheng Wenying also referred to this idea of dispensing prescriptions.The case of Cheng Yuanzhong’s treatment is called a warm epidemic,emphasizing that people with internal injuries and physical insufficiency are caused by diseases.Sun Yikui believes that the spring epidemic is an infectious plague that occurs in spring,and its typical symptoms are severe diarrhea.③Spring warmth:Cheng Wenying thought that it was a latent-evil warm disease,while Sun Yikui’s treatment of spring warmth is a recurrence of fever due to improper diet.④Summer syndrome:there are four categories:sunstroke coma,summer heat,heat stroke and summer heat injury.Sunstroke coma is the kind of summer syndrome with signs of moving wind.Cheng Wenjhu summarized the "initial,middle,and final"stage treatment method,using external treatment to cool down the temperature,and also believed that summer heat is easily transformed into sunstroke coma.Zheng Chongguang and Cheng Yuanzhong believed that there are many deficiency syndromes in heat stroke,and summer heat injury is similar to that.This is because the body’s vital energy is damaged by summer heat evil.⑤Dryness syndrome:In the case of Yu Guopei,several warming evils were briefly summarized into dryness and dampness.⑥ Latent summer heat:Yu Guopei believes that it is easy to relieve dryness during summer,and It is necessary to take the meat soup which is flesh,sweet,and juicy,to relieve sweat and promote fluid production.⑦Anemogenous febrile disease:Cheng Wenying advocated Fengwen Decoction in the treatment,and only had three flavors of glutinous rice,liangdou,and licorice.The treatment of anemogenous febrile disease based on this formula has many effects.⑧Damp thermosis:Cheng Wenying believed that the damp thermosis belonged to the latent-evil,and it was brewed from the mouth and nose and then subdued in the membrane and expressed itself.The medical records of febrile diseases in the Huaiyang area are divided into nine categories:①Warm disease:Yuan Zhuo proposed several ways for the disease to escape,such as perspiration following chills,dry stool,white herpes,and epistaxis.It provides ideas for the clinical judgment of disease progression and curative effect.②Plague:Wu Jutong’s treatment of the case is called "warm epidemic".However,the etiology in the case did not mention the plague-like evil,and on the whole,it was more like a febrile disease that occurred in spring and summer.③Spring warmth:Wang Jiufeng believes that it is a kind of febrile disease that occurs in spring.④Summer syndrome:there are four categories:sunstroke coma,summer heat,heat stroke and summer hygrosis.The cases of Wu Jutong,Jiang Baosu,and Du Zhongjun’s treatment of summer heat are evidence of the greatness of the heat.The heat phenomenon is obvious,and even there is the performance of dizziness and lameness.Jiang Baosu believes that summer hygrosis is closely related to the seasonal characteristics of the disease.Long summer contains dampness and the dampness injures the spleen and stomach,thus the treatment should pay attention to nourishing the spleen.Jiang Baosu classified excessive heat generating wind as summer wind.He Danan’s summer heat evil treatment case is that the heat pathogen damages the lungs,resulting in phlegm.⑤Winter febrile syndrome:There are three types of symptoms of winter febrile syndrome treated by Wu Jutong.Including superficiessyndrome,heat evil due to yin asthenia,evil heat into the blood.⑥latent summer heat:Wu Jutong,Wang Jiufeng,and Jiang Baosu all believed that the internal heat and dampness were triggered by external evils in autumn and winter,so the treatment is mainly to evacuate external pathogens and dampness.Yuan Zhuo believed that latent summer heat was the accumulation of heat and dampness in the middle energizer,and the treatment mainly focused on clearing and benefiting the middle energizer’s dampheat,but did not take into account the evacuation of external evils.⑦latent pathogens:Jiang Baosu believed that the latent pathogens occurred in all seasons,and the unhealthy qi led to the onset of the internal heat pathogens.Distinguish latent pathogens from typhoid fever,the latent pathogens treated have the phenomenon of transforming heat and injuring yin.And Yuan Zhuo’s treatment of latent pathogens is a deep illness with heat.⑧ Anemogenous febrile disease:Both Wu Jutong and Wang Jiufeng believe that anemogenous febrile disease is a febrile disease that feels the evil of wind and temperature.⑨ damp thermosis:Wu Jutong,Yuan Zhuo and Wang Jiufeng believe that damp thermosis are internalized by external dampness and warmth.Jiang Baosu,on the other hand,considers damp thermosis as a latent-evil warm disease.The medical records of febrile diseases in the Changzhou area are divided into nine categories:①Warm disease:Yu Tinghong’s treatment of the case is to afferens warm pathogen,and the disease is cured with sweat.Ding Ganren and Shen Dengjie treated the case as warm pathogen injuring the yin.②Plague:Ding Ganren believed that the plague entered from the nose and mouth,straight to the middle energizer,and passed through the pericardium.Wang Kentang believed that the plague was an epidemic.The disease occurs in the year of water,because the lesser yin retrogradely while Ding fire flourishes,resulting in the disease.③Spring warmth:Chen Tingru believes that spring warmth is the cold evil caused by winter.④Summer syndrome:there are four categories:summer hygrosis,sunstroke coma,summer heat and heat stroke.⑤ Winter febrile syndrome:The winter febrile syndrome treated by Yu Shenghong is a cold-drinking disease that develops in winter,while the febrile syndrome treated by Ding Ganren is a latent-evil warm disease.⑥Latent summer heat:Ding Ganren’s treatment of latent summer heat is triggered by the coolness of autumn.⑦Latent pathogens:also is called ’latent warmth’by Ding Ganren.⑧Anemogenous febrile disease:Ding Ganren’s case was due to heat in the wind warmth,which blocked the lung and stomach.⑨Damp thermosis:The case of Yu Tinghong emphasized that the factors of seasonal and harmonious residence are easy to cause the evil of damp thermosis.The medical records of febrile diseases in the Suzhou area are divided into ten categories:① Warm disease:several cases were investigated.For example,Cao Renbo and Ye Tianshi both treated cases with heat coming from the yin.②Plague:Ye Tianshi’s treatment can be summarized as two types of plague.③Spring warmth:Ye Tianshi,Gu Xichou,Shen Anbo,and Gu Jinshou believed that spring warmth is the evil of feeling the wind heat.④Summer syndrome:there are four categories:summer hygrosis,sunstroke coma,summer heat and heat stroke.⑤Autumn dryness:Ye Tianshi treated a case of dryness invading the lung and injuring Yin and fluid.⑥Winter febrile syndrome:The cases treated by Ye Tianshi,Xu Jin,Gu Xichu and Shen Anbo were all cases of winter warmth and depression-heat occlusion of the lungs.⑦Latent summer heat:Gu Xichu and Ye Tianshi treated the case as a case of summer dampness inside the ambush and autumn coolness outside the bundle.⑧Latent pathogens:The treatment cases of Ye Tianshi,You Yi,and Shen Anbo were heat injury to fluids.⑨Anemogenous febrile disease:The cases treated by Ye Tianshi and Cao Cangzhou were due to internal wind-heat depression.⑩Damp thermosis:The cases treated by Ye Tianshi and Xue Xue were dampness stagnating the spleen and stomach in the middle energizer.The medical records of febrile diseases in the Wuxi area are divided into ten categories:① Warm disease:The warm diseases treated by Wang Xugao,Zhou Xiaonong,Wang Yixiang,Zhang Yuqing,and Fang Gengxia are mainly caused by heat,phlegm,accumulation,and dampness.②Plague:Zhou Xiaonong believed that the plague was an epidemic that occurred in spring,and it was a kind of latent-evil warm disease.③Spring warmth:Zhou Xiaonong’s case is due to the warm pathogen in spring.④Summer syndrome:there are four categories:summer hygrosis,sunstroke coma,summer heat and summer heat evil.⑤Autumn dryness:Both Wang Yixiang and Zhang Iqing believe that dryness originates from the dryness of the weather.⑥ Winter febrile syndrome:Zhang Yuqing,Fang Gengxia,and Zhou Xiaonong treated the case for internal stagnation of phlegm and heat.⑦ Latent summer heat:Fang Gengxia treated the case as dampness trapping hidden heat,expounding the point of view that latent summer heat is actually a febrile disease.⑧Latent pathogens:The case treated by Zhou Xiaonong’s is nostalgic for deep-lying evil.⑨Anemogenous febrile disease:The healers all take the cause of the disease as wind and heat,and Zhang Iqing,Liu Bao Yi,Wang Yixiang,and Zhou Xiaonong treat cases with phlegm and heat as the main cause.⑩Damp thermosis:The cases of Zhang Yuqing,Wang Yixiang,Wang Xugao,Zhou Xiaonong,Huang Tang,and Liu Baoyi were all treated by steaming with heat and humidity,which blocked the lungs and stomach and caused the Qi movement blocked.The medical records of febrile diseases in the Shanghai area are divided into nine categories:①Warm disease:He Yuanchang treated the case as a warm pathogen in lesser yang not yet cleared.②Plague:The plague treated by Chen Lianfang is highly contagious,which belongs to the evil of heat and dampness,and is related to abnormal climate changes.③Spring warmth:Shen Fan believed that the temperature in spring is a disease of subduing pathogenic heat,and the pathogenic heat in winter will develop until spring,and he also emphasized the influence of seasons on the disease.④Summer syndrome:there are three categories:summer hygrosis,sunstroke coma,and summer heat.⑤Winter febrile syndrome:The case treated by Shen Fan was due to winter warmth blocking the lung,which is mainly superficial evidence of lung health.⑥Latent summer heat:Shen Fan’s case was caused by the wind in the late autumn,which triggered the internal heat,dampness,and heat.⑦ Latent pathogens:He Yuanchang’s treatment of latent pathogens is a disease that is restrained by evil and stagnant in lesser yang.⑧Anemogenous febrile disease:Chen Lianfang’s treatment of anemogenous febrile disease is a case of wind-warm evil offending the lung and internalized phlegm-heat.⑨Damp thermosis:The cases treated by Sheneven,He Yuanchang,and Chen Lianfang were all caused by feeling the evil of dampness and warmth.The medical records of febrile diseases in the Hangjiahu area are divided into ten categories:①Warm disease:The focus of Ling Xiaowu and Jin Zijiu’s treatment of the case was phlegm heat.②Plague:The cases of Yang Chengliu,Lu Fu,and Jin Jiuyuan were all critical and dangerous cases in which the onset of the epidemic was rapid and dangerous.③Spring warmth:Jin Zi’s long-term treatment of the case is to suppress the evil and warm disease,the winter to suppress the cold evil,and is motivated by exogenous factors in spring.④ Summer syndrome:there are three categories:summer hygrosis,sunstroke coma,and summer heat.⑤Autumn dryness:Zhang Qianli and Ling Xiaowu believe that autumn dryness is a unique wind warmth evil in autumn.⑥Winter febrile syndrome:Zhang Qianli’s case was winter warmth blocking the lung.⑦Latent summer heat:The five cases of Zhang Qianli,Wang Mengying,Jin Zijiu,and Ling Xiao were all caused by the evil of summer dampness,which was triggered by new coolness.⑧Latent pathogens:Yang Chengliu’s treatment of the case is caused by outside coolness,especially the outside cold and inside heat.⑨ Anemogenous febrile disease:Zhang Qianli,Jin Zijiu,Wang Mengying,and Ling Xiaowu all think that anemogenous febrile disease is triggered by the evil of feeling wind warmth.⑩Damp thermosis:Zhang Qianli,Jin Zijiu,and Ling Xiao’s five cases were all hindered by the evil of feeling dampness and warmth.The medical records of febrile diseases in the Shaoxing area are divided into nine categories:①Warm disease:Shao Lansun and Zhang Wanxiang both treated the case because they felt warm pathogens.②Plague:The plague caused by Xu Shouyu’s case was the pathogenic plague stagnant in the stomach.③Summer syndrome:there are two categories:summer hygrosis and sunstroke coma.④Autumn dryness:Shao Lansun and Xu Shouyu believe that feeling dryness leads to disease.⑤Winter febrile syndrome:Zhang Wanxiang and Shao Lansun both managed the case to feel the evil spirits of winter warmth.⑥Latent summer heat:Shao Lansun’s treatment of Fushu is yang2 brightness’s dampness and heat.⑦Latent pathogens:The latent pathogen that Zhang Wanxiang treats was the invasion of dampness and heat to the lungs.⑧Anemogenous febrile disease:The case treated by Shao Lansun occurs in spring and autumn when wind-heat invades the lungs.⑨Damp thermosis:Both cases treated by Shao Lansun and Zhang Wanxiang were due to the feeling of dampness and warmth.The medical records of febrile diseases in the Xujiang area are divided into four categories:①Warm disease:According to Xie Xinghuan,a warm disease is caused by the warm pathogen entering through the mouth and nose and directly into the stomach,with a rapid onset of heat.②Plague:Huang Gongxiu treated a case of plague that occurred in spring and was caused by poisonous gas transmission.③Summer syndrome:Xie Xinghuan’s treatment of summer syndrome is the result of exposure to the evil of summer heat.④Anemogenous febrile disease:Xie Xinghuan’s case occurred in the spring.The disease is caused by the closure of the upper burner due to the pathogenic resistance of wind and warmth.In this study,the individual medical records of healers in 9 regions were summarized.In terms of the types of febrile diseases involved,it covers 10 categories of febrile diseases caused by warm disease in the narrow sense,plague,seasonal febrile disease,latent-evil warm disease,anemogenous febrile disease and damp warm disease.Summarizing the understanding of the same warm disease by medical practitioners in each region separately,it was found that their understanding of the warm disease,summer syndrome,autumn dryness,latent summer heat,latent pathogens,and anemogenous febrile disease was relatively consistent.For plague,spring warmth,winter febrile syndrome,and damp thermosis there is a difference between the newly infected febrile disease and the latent-evil warm disease,but no regional differences were found.In addition,this study summarizes the characteristics of various types of knowledge elements of febrile disease medical cases,including some core knowledge elements and sub-core knowledge elements,by taking febrile disease medical records as the research object and using the knowledge element method to organize and study them at the same time,which provides a case study for the application of the knowledge element method for digitizing ancient Chinese medical books and has some reference value. |
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