| With the emerging of western medicine into the occurrence and development of plague, the virus varies day by day, and the new plague emerges continuously. On this occasion, the Traditional Chinese Medicine (TCM) becomes more and more important. The tongue diagnosis, one of the four diagnostic methods, is especially important. The information of pathological changes can be obtained from the inspecting the tongue body and the fur.In this study,152plague cases in37medical books on plague and23on plaques were chosen to be studied.set a data base of tongue diagnosis, treatment based on syndrome differentiation, therapy and drugs of plague. Combining with the conclusions from the experts, descriptive frequency statistics is used to find the potential relations of the data, and then find the characteristics of the tongue, and the relationships and principle among therapeutic method and medicines. Finally, conclude the value of tongue diagnosis in the treatment of plague and provide the new ideas for the diagnosis and treatment of modern plague.There are three parts of this thesis:Part Ⅰ literature review. The definition of plague, the evolution of the definition, the classification and the theory development are included.Part Ⅱ Theoretical study. The medical comments and words about plague in Ming and Qing Dynasty are studied to find the importance of tongue diagnosis in clinic, which is the theoretical basis of the relationship between the tongue diagnosis and treatment based on the syndrome differentiation in this research.Part Ⅲ Literature research.Research Ⅰ The clinical application of tongue diagnosis in Ming and Qing Dynasty.152plague cases in60medical books of Ming and Qing Dynasty (1368-1911) are studied to set up a data base.Research Ⅱ The statistical results of the tongue manifestations in the plague cases of Ming and Qing Dynasty are studied to find the characteristics of the tongue, the relationship and principle between the therapeutic method and medicines. Conclude the value of tongue diagnosis in the treatment of plague and provide the new ideas for the diagnosis and treatment of modern plague.Results:1The characteristics of the tongue in plague cases of Ming and Qing Dynasty1.1Red and deep red are the dominant tongue color, accounts for91.89%; Prickly tongue is the dominant tongue shape which accounts for50%, as for the tongue condition, shortened and contracted tongue and stiff tongue are the most common; the yellow fur appeared for50times, accounting for46.02%, following by grey fur and black fur with42times, accounting for38.05%; the day tongue, one of the character of tongue, appeared for42times with a proportion of51.22%.1.2The fur changes are mainly seen in tongue manifestations of plague.2The characteristics of the tongue in plaguesTepid plagues:Red and deep red are the common tongue color; Prickly tongue is the dominant tongue shape; the yellow fur and grey-black fur are the dominant fur, dry fur is the common character of tongue.Dampness-tepidity plague:the yellow fur and white fur are the common fur, the thick fur and greasy fur are the dominant.3The law of medicine application in plagues(1)The clearing heat drugs are the dominant medicine, following by the drugs for clearing heat and cooling the blood.(2)Use the drugs for tonifying qi and nourishing yin in the late stage of plague.(3)Use the drugs which can enter the ying fen.(4)Drugs for inducing resuscitation and calming endogenous wind are used to cure plagues.(5)Drugs for removing dampness and regulating qi-flowing are commonly used.(6)Drugs for removing phlegm and blood stasis are used.(7)Drugs for purgation are emphasized to cure plagues.(8)Drugs for warming the interior to cure plagues.4The similarities and differences therapy with tongue diagnosis in tepid plagues and dampness-tepidity plagues.4.1The similarities of tongue diagnosis.(1)When the tongue color is deep red, combining the symptoms and signs to use blood-cooling and nourishing yin method.(2) Purgation method should be considered when the yellow fur appears.(3) The method of blood-cooling and nourishing yin when the grey-black fur appears.(4) The appearance of dry fur is the indication of using nourishing yin method.4.2The differences of tongue diagnosis.Dampness-tepidity plagues:(1)The color changes of fur could be the evidence of using the method of clearing heat or dampness-heat method.(2)The method of clearing heat exists the whole process of dampness-tepidity plagues. The indication is thick fur and greasy fur.(3)There is little record of the tongue condition changes in the cases.Tepid plagues:(1)The prickly tongue is the indicator of endogenous heat which could decide the application of clearing heat method. And this meets the treatment principle of modern plagues and could be the guide to the study of emergency of Chinese Medicine.(2)The method of clearing heat and blood-cooling should be used when the shortened and contracted tongue and stiff tongue appear in order to prevent the occurance of severe condition.5The similarities and differences drugs with tongue diagnosis in tepid plagues and dampness-tepidity plagues.5.1The similarities of tongue diagnosis:(1) Deep red tongue:With the base of heat-cleaning and blood-cooling drugs nourishing yin drugs is increasd.Blood-cooling drugs are figwort, dried rhizome of rehmannia, the root bark of the peony tree; Nourishing yin drugs are ophiopogon root dendrobe^adenophora tetraphylla、 asparagus.When the situation is severy, turtle shell and luxuriant are choosed. Besides, some relieving exterior syndrome drugs are used, for example honeysuckle、 forsythia、 mulberry leaf. burdock mint and so on.(2) The grey-black fur:With the base of heat-cleaning and blood-cooling drugs nourishing yin drugs is focus on. Blood-cooling drugs are dried rhizome of rehmannia rhinoceros norm figwort、 root of common peony; Nourishing yin drugs are ophiopogon root> dendrobe, adenophora tetraphylla、 turtle shell.(3) Dry fur:With the base of heat-cleaning and blood-cooling drugs, nourishing yin and saliva-generating drugs is combined.For example rhizoma anemarrhenae、 ophiopogon root、 Reed Rhizome-trichosanthes root. In tepid plagues, combining the symptoms and signs to use purgation drugs.5.2The differences of tongue diagnosis.(1)Yellow fur:In tepid plagues, not only heat-cleaning drugs are used, but also regulating qi-flowing, purgation, moving blood and removing blood stasis drugs.For example dried immature fruit of citron orange, bitter orange, Chinese rhubarb, radix cureumae; in dampness-tepidity plagues, with the base of heat-cleaning and dampness-drying drugs regulating qi-flowing and removing phlegm durgs are used, for example dried immature fruit of citron orange, Magnolia officinalis.(2) The thick fur and greasy fur:In tepid plagues, with the base of heat-cleaning and blood-cooling drugs(figwort, dried rhizome of rehmannia, forsythia, honeysuckle flower, plaster, rhizoma anemarrhenae), regulating qi-flowing, removing phlegm and blood stasis drugs are used. For example dried immature fruit of citron orange, ballonflower, radix curcumae;in dampness-tepidity plagues, with the base of heat-cleaning and dampness-drying drugs(skullcap, rhizoma coptidis), regulating qi-flowing and removing dampness and phlegm drugs are used, for example dried immature fruit of citron orange, Magnolia officinalis, caulis bambusae in taenian.(3)White fur:In tepid plagues, the drugs of heat-cleaning and relieving exterior syndrome are both important, relieving exterior syndrome drugs are mostly dispersing and cool, meaningwhile the removing phlegm durgs are used, for example ballonflower; in dampness-tepidity plagues, with the base of removing dampness drugs, relieving exterior syndrome with dispersing and warm, regulating qi-flowing drugs are used. Besides, there is a set prescription called Dayuan Yin in extensional herbs(4) The prickly tongue:Besides the heat-cleaning and blood-cooling drugs are used, the purgation drugs are appeared, for example Chinese rhubarb, Glauber’s salt.(5) The shortened and contracted tongue and stiff tongue:in the late stage of tepid plague, using the heat-cleaning and blood-cooling drugs are most significant. For example rhinoceros horn, dried rhizome of rehmannia, rhizoma anemarrhenae. When it is the shortened and contracted tongue, with the base of heat-cleaning and blood-cooling drugs, the removing phlegm durgs are used, for example caulis bambusae in taenian.When it is the stiff tongue, with the base of heat-cleaning and blood-cooling drugs, nourishing yin drugs are used, for example ophiopogon root, watermelon peel and dendrobe.In terms of statistical results, the development of disease can be acquainted and the treatment and herbs of plague are guided by the dynamic alteration of tongue picture.Thus, tongue diagnosis have clinical value and provide the new ideas for the diagnosis and treatment of modern plague. |
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