| Acupuncture case is an important part of traditional Chinese medicine (TCM). They have effectively recorded the clinical practices of TCM, no matter successful cases or mistreatment, and manifested the process of syndrome differentiation in clinic, which is the study strategy of TCM. Mr. Zhang Taiyan had said that'medical case is the most important part in the achievements of TCM. If there is anyone who wants to learn the experience from ancient doctors, the best way is to study medical cases and he will greatly benefit from it.'As to the development of TCM, Ming Dynasty is between Jin Yuan and Qing Dynasty, playing the role of bridge connecting the two ages. The acupuncture cases of that age left till now have significant academic values.This treatise aimed to analyze the characteristics of acupuncture cases in Ming Dynasty and the practice of acupuncture in that age, by collecting and sorting out acupuncture cases of that age. It's possible to infer the thoughts and methods of acupuncturists in Ming Dynasty reflected in clinic practice by summarizing the application of acupuncture and the diseases that were often treated by acupuncture in that age, and exploring the academic features and values. And the ancient experiences will be better applied to clinical practice of acupuncture in modern times.The study has tried to show the learners the characteristics of acupuncture cases in Ming Dynasty, carry forward the achievements of ancient doctors, open up the mind of acupuncturists and offer theoretical basis and new ideas for modern acupuncture cases, and the development of acupuncture.1 Conservation of acupuncture cases in Ming DynastyIt's always considered important to record and inherit medical cases. In the vast number of ancient medical books, abundant records and special issues of medical cases are well reserved.①The requirement for content and format of the medical cases were explained in details. For example, it's been suggested in Han's Medical Book that six aspects should be contained in the record of medical cases, which are inspection, listening and smelling, inquiry, feeling the pulse, diagnosis and prescription. Wu Kun had put forward that seven big categories including contents like symptoms, diagnosis, prescription and patients'reaction to the treatment should be recorded in details. Yu Chang who lived in the late Ming Dynasty also contributed to the improvement of the format of medical cases.②Acupuncture cases recorded at that age were integral, concise and substantial. The contents were comprehensive and had covered the common content and format of medical records.③There were several styles of format in recording acupuncture cases in Ming Dynasty. For example, subsequent style, flashback style, narration together with discussion, discussion following the record of case, medical cases attached to theory of prescriptions, simplified recording style, rectifying the mistreated cases, etc.2 The syndromes and diseases recorded in acupuncture cases466 acupuncture cases from Ming Dynasty have been collected and sorted out. The cases have contained diseases of internal medicine, surgical medicine, gynecology, pediatrics, ophthalmology and otorhinolaryngology, which have enriched the syndromes and diseases recorded in acupuncture cases.①Due to the different clinical experiences of different doctors, the syndromes concluded and classification for the same disease in internal medicine were different, and so with the therapeutic method, prescription, acupoints selected, and acupuncture manipulation. It has manifested the diversity of syndromes and doctors'rich experience.②Surgical diseases commonly seen in Ming Dynasty have been well recorded. According to the 46 kinds of surgical diseases referred to in collected cases, most belonged to the type of carbuncle-abscess. The cases have many kinds of diseases recorded and both internal and external therapies were applied.③7 cases of gynecology and obstetrics were included in this treatise. Although records are few in number, the therapeutic experiences are valuable for acupuncture's clinical application in gynecology and obstetrics in modern times.④Infantile erysipelas due to fetal poisoning, infantile convulsion, furuncle, and carbuncle were frequently recorded pediatric diseases in these acupuncture cases, and they were mainly treated with acupuncture and stone needles.⑤Cases of ophthalmology and otorhinolaryngology mainly referred to eye diseases, throat and nose diseases. The therapeutic methods were flexible. Doctors at that age also inherit the classic policies but not being ossified, and they were keen on innovation, though the treatment for some diseases had common points.⑥Doctors in Ming Dynasty had recorded some mistreated acupuncture cases. They treated the successful cases and failures objectively and learned lessons from both aspects.3 The theory of acupuncture being further developed and the therapeutic methods being enriched①The characteristics showed in acupuncture cases in Ming Dynasty: to get best curative effect, acupuncture, moxibustion, herbs, stone needles and massage were comprehensively applied in clinic, which had manifested the integrity of TCM; in the selection of needles, nine kinds of needles were preferred; doctors paid attention to the application of manipulation of needles, especially for some difficult and complicated miscellaneous diseases, special needling techniques were applied.②The therapeutic methods recorded in most of the acupuncture cases in Ming Dynasty had applied moxibustion. There were various methods and material to practice moxibution, and the amount of moxa was strictly regulated.③There were several cases about stone needles, which showed that doctors in that age still used this method and also did some improvement.4 Doctors in Ming Dynasty had devoted to studying medical knowledge and put forward new ideas and theories. The medical cases they left could truly prove their theory in clinic.①Yang Jizhou advocated that acupuncture, moxibustion and herbs should be used together and believed that reinforcing and reducing manipulation and taboos concerning human body and nature in acupuncture treatment should be applied in clinic. Acupuncture, moxibustion and herbs should be used together, few but the right acupoints should be taken and the manipulation skills were important to treatment. He had plentiful clinical experiences and promoted to break the rules of acupuncture taboos concerning human body and nature in emergency cases.②Although there were only 10 acupuncture cases of Ling Hanzhang selected, but these records had well performed the detailed process of syndrome differentiation and the distinctive curative effect.③Gao Wu was a famous acupuncturist in Ming Dynasty. He was not only skilled at acupuncture, but also paid attention to the education and passing-on of the theory.And he thought highly of Li Dongyuan's acupuncture theory④Wang Ji was good at curing surgical diseases with stone needles and moxibustion. He believed that needles'puncture usually functioned to reduce rather than reinforce. His method was often used to treat carbuncle, abscess and sores at the stage of pusturation with pain, but never for those cases of deficiency syndromes that pathogenic factors were strong while primordial qi was weak.⑤Following the policy of Eight Expelling Methods, Xue Ji was good at treating surgical diseases with pus-discharging and bleeding methods with needles and stone needles. On the other hand, Xue Lizhai had represented the branch of treating surgical diseases with moxibustion, which had improved ancient treatment for carbuncle-abscess and back carbuncle.⑥Chen Shigong treated surgical diseases with both internal and external therapies. He insisted on differentiating cold, heat, deficient and sthenia syndromes when applying internal therapy, and following the policy of three methods which are elimating, expelling and supplement, and laid eyes on modulating function of spleen and stomach. When with external ways, he had applied various treatments of ancient doctors and created new methods, especially the application of knife-needle, and he followed the policies like opening the door to drive out pathogenic factors, and getting rid of poison is the most important thing.5 The features and flaws of the acupuncture cases in Ming Dynasty①features: large quantity; widely recorded diseases including internal medicine, surgical medicine, gynecology, pediatrics, ophthalmology and otorhinolaryngology, and surgical cases taking the most; frequent application of moxibustion and its function in curing surgical diseases.②flaws: numbers of cases were recorded repeatedly, and not many cases applied acupuncture as the only therapeutic method. Needles were tended to become tools for surgical operation. The style of narration was conservative, and the theory was far away from clinical practice. |
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