Research On Xu Lingtai’s Academic Thoughts And Clinical Experience

Xu Lingtai, called Dachun, also named Daye, Zi Lingtai, was born in Wujiang, in Jiangsu Province. In his old days, he lived in Mountain Qizi, buried himself in Huixi. He was famous in medical domain, wrote many medical works such as Explanation of Nanjing, the100herbal medicines’introduction of Shen Nong’s Herbal Classic, the Origin of Medical Science, consilia of Huixi, etc. Besides, he was insightful and had his own unique style in his commentaries like Orthodox Manual of External Diseases, Guide to Clinical Practice with Medical Record. In this dissertation, the study of Xu Lingtai’s academic thoughts and clinical experience will be used in theoretical innovation and clinical practice.Objectives:To collect Xu Lingtai’s medical academic thoughts and clinical experience comprehensively, to proceed a in-depth study systematically, and to manifest Xu Lingtai’s medical theories and practical ideas.Methods:1. Use the methods of bibliography to choose a list of required books for this work, then select the corresponding books.2. Understand Xu Lingtai’s background though the Chinese medical history and literature science, study the origin of his academic thoughts, connotation and denotation by using the methods of Chinese medical history and literature too, meanwhile, analyze relevant research achievements of important modern journal literature.3. Use philology and exegetics and other methods to analyze where is unclear and doubtful, so that we can make a comprehensive elucidation and explanations of Xu Lingtai’s theories of medicine.Results:1. Xu’s research thoughts to the classics:①The most outstanding feature of the explanation of Nan Jing was to use scriptures to explain scriptures. If there were no corresponding words of the text, Xu pointed out that was the "unknown text". Xu also highlighted the text in Nan Jing that didn’t match the text and the contradictions in the context, and wrote down editor’s note combining his own understanding with text.②Xu was good at using examples to describe the characteristic, taste and effect of the herbs when annotating Shen Nong’s herbal classic. Meanwhile, he added channel tropism of some herbs and explained the reason. Besides, Xu sometimes used the theory of Huangdi’s Inner Classic to describe some kinds of herbs. As for the effect of some herbs, he quoted Shang Han Lun, Synopsis of Golden Chamber and some other books to verify them.③He divided113prescriptions into12categories. Except the last category,"miscellaneous prescriptions", there was one main prescription in the rest11categories. He put other prescriptions in the same category after the main prescription and attached original test of Shang Han Lun to illustrate which diseases the prescriptions can be used for. That’s the most significant feature of his research on Shang Han Lun. Xu summarized the basic symptoms and signs of six meridians in Shang Han Lun, and referred to other syndromes and changed ones. Apart from that, Xu listed some special methods of boiling herbs and taking medicines and prescriptions in Zhongjing’s prescriptions.2. Xu’s experience of genre of traditional Chinese medicine and medical works:①Genre of traditional Chinese medicine. Shen Nong’s herbal classic was originated from Shennong. Huangdi’s Inner Classic described the theory of physiological and pathological phenomena and organs such as the shape of organs, the theory of cause of disease such as seven emotions and six evils, and Meridian theory such as acupuncture. It was said that Yiyin could treat diseases with decoction, but it was a pity that no writings can confirm that. Later, Bianque and Canggong used decoction to cure diseases widely. Zhang Zhongjing expounded the miscellaneous diseases and typhoid etc. should be cured with herbs, so that he became the father of prescriptions. His prescriptions were based on Shennong’s book and the theory of Huangdi’s Inner Classic. They were all from previous ages. Zhang Zhongjing was just a person who induced and sorted out the prescriptions. In Yuan Dynasty, Liu Hejian, Zhang Jiegu etc. valued Huangdi’s Inner Classic. When they discussed diseases, they quoted scriptures from Huangdi’s Inner Classic firstly and took advantages of theories of all genres. At last they put forward the cure of diseases. After Yuan Dynasty, Xu thought that medical field appeared more and more malpractice. Many doctors didn’t know the essence of Shennong and Huangdi, positions of organs and meridians, medicine property and the way of using Zhongjing’s prescriptions. They were confused about the treatment methods. Thus, Xu pointed out that only if doctors knowed well about Sheng Nong’s herbal classic, Huangdi’s Inner Classic, Synopsis of Golden Chamber and Shang Han Lun, they can change the malpractice and save patients’ lives. Xu valued the medical theories and prescriptions of the Tang Dynasty and the Song Dynasty and before these two dynasties most. And he also held the view that Zhang Zhongjing was the sage of prescriptions in all ages, and Wai Tai Mi Yao and Bei Ji Qian Jin Yao Fang included all kinds of diseases and was considerate.②Medical works:Mai Jing was based on Huangdi’s Inner Classic, including main achievements since the Han Dynasty. Bei Ji Qian Jin Yao Fang discussed diseases, prescriptions and herbs according to former books and put some dissertation at that time. Wai Tai Mi Yao,"reference book of doctors", involved prescriptions since the Han Dynasty. Lei Zheng Huo Ren Shu firstly discussed meridians and then took inquiry as key to summarize the Zhongjing’s dissertation with detailed analysis. There were some prescriptions and treatment methods at last in Lei Zheng Huo Ren Shu. This book led later people to learn Zhongjing.3. Xu’s explanation to some content of treatment methods and prescriptions of traditional Chinese medicine:①He pointed out the source of the original Qi, way of keeping healthy and relation between diseases and prognosis. The original Qi emerges along with a person’s birth. People die because Qi perishes. And There was a close relationship between the rise and fall of Qi and the occurrence and development of disease. Therefore, he emphasized the check up of Qi having the special significance for disease diagnosis and prognosis. To protect Qi, in Xu’s opinion, we should attack the bad things in our body and complete deficiency instead of fierce herbs.②Diagnosis:Inquiry emphasized asking the key of the patients. The key of the patients meant the source of the disease. Pulse feeling and palpation raised the effect of feeling the pulse, including observation of stomach Qi, deducing the smooth or not of the movement of celestial body, examination of visceral-qi and distinction of abnormal pulse. Besides, Xu put forward the application principle combining pulse taking and disease, and expounded diagnosis of yang depletion and yin depletion, the true or false and sthenia or asthenia of cold and heat, differentiation methods and corresponding treatment methods. Yang depletion and yin depletion were identified mainly from the body, hand, foot, skin, sweat, taste and pulse condition. To distinguish cold and heat being true or false, we should identify from water the patient drunk. And to identify true and false appearances of deficiency and excess in combination, we should check patient’s spirit and meridians.③Xu expounded the relationship between treatment and disease. He pointed out that treat disease according to three local conditions, including time, place and person. Xu also illstrated principles of medical science and application of the theory of reinforcement of cold and heat, and put forward his view of treatment without squeamish. He pointed out the relation between celestial manager Qi and circulating Qi and disease and pulse condition. Apply different treatments according to the cause of disease, characteristic of disease, degree of seriousness of an illness and disease location. Take notice of the difference between corrosion treatment and emergency treatment when healing the sick. Apply different treatments according to progress of disease, accompanied symptom and the difference between the bodies. He reminded that doctors don’t limit in using decoction. Acupuncture, ironing bath, guidance, massage and sweet wine were other treatment methods. And there were differences among pills, medicinal powder and ointment.④Prescription:Xu put forward the thought that use medicines like troops. He pointed out that use corresponding medicines according to disease and discussed the reasons for using medicines with a result of no or little effect. One reason was the differences in telluric effluvium, type, natural, human labor, name between former herbs and present herbs which led to different function. The other reason was that medicines enter different viscera, meridians or body regions, so they took different effect. He paid attention to the relation between channel tropism of medicines and diseases and methods of medicines processing. Xu also put forward view of medical expertise and pointed out that both the method of boiling herbs and the way of taking medicines affect the effect. He put forward the requirements of using ancient prescriptions which are observing the patient correctly and going over property of medicines precisely. Xu reminded us of the investigation on the difference between the dose of ancient and the dose of present medicines, and the use of fierce or warm-benefiting medicines with cautious. As for the relation of between medicines and prescriptions, he put forward the view of separation and reunion of medicines and prescriptions.4. Acupuncture:He summarized ten aspects of losing the acupuncture. Set forth respectively his works from the method of selecting acupoint points, reinforcing and reducing method, bloodletting therapy, the state of needling sensation, using the best time, only using one kind of neeles, indications, etc. selecting acupoint points should vary with the depth and trend of the collaterals, should also vary depending on the condition of diseases. Reinforcing-reducing manipulation includes methods based on breath, speed of needling, the direction of meridians and pressing or not, etc. The disease in each season’s depth was different, so the depth of acupuncture was different, and it meant using the best time. Acupuncture can be widely used for various diseases such as malaria, typhoid fever, cough and other diseases of viscera. If there were some illness in the collaterals, we can also use the treatment of acupuncture and blood-letting. In addition, Xu put forward the requirements of acupuncture, single-minded and skillful.5. In the aspect of clinical:In internal medicine, he always used the methods of inside and outside curing at the same time, and also used the methods such as diaphoresis, emetic therapy, purgative method,etc. In curing surgical disease, he used the methods of eliminating heat through Qi system, clearing method, elimination, promoting pus discharge and tissue regeneration orally, and he paid much attention to use surrounding medicine for external use. In curing gynecologic postpartum diseases, he thought it should use the method of eliminating the stasis, or referred to Zhongjing’s method of nourishing blood and removing blood stasis. He emphasized it should be careful in using the medicine of warm character. In curing exanthema variolosum, he thought it should accord to syndromes not only using the medicine of cold character and insect drugs. In paediatrics, the causes of diseases are heat and phlegm. He thought it should adjust the cold and heat, maintain spleen and stomach Qi, and plus the medicine of eliminating phlegm and regulating Qi. In senile disease, he emphasized that it should not use tonic randomly but should use the medicine which can eliminate evil Qi and regulating Qi and blood according to sydromes.6. Xu proposed related content of the study method and theory of medical examination. He emphasized that one person should consider the reasons and results when he was reading books, and he must believe the books only after doing clinical practice, rather than heard it from others, and didn’t mistake by deception. In addition, for physician, they should have a warm heart when they were treating patient, a open mind when they were studying. They must not design to fame and wealth only. He pointed out that the tests were divided into six families, acupuncture, generous, ophthalmology, gynecology, pediatrics, dermatology, ophthalmology and surgery, and examinations include three aspects, namely theory, solution and case.7. The Xu academic genre’s influence on the later generations:Xu Lingtai’s academical characteristic was a closely combination between TCM theory and clinical practice, which attracts practitioners of later generations deeply, and his academic ideas was spread far when he was alive and his books were widespread, too.Conclusion:Xu Lingtai’s academic thoughts were from Huangdi’s Inner Classic, Nan Jing, Shen Nong’s Herbal Classic, Zhongjing’s book, or from all classes of authors’thoughts. The medical theory of his academic thoughts was believe in Huangdi’s Inner Classic and the syndrome differentiation was from Shang Han Lun and Synopsis of Golden Chamber, and it also learned essence from the Tang Dynasty’s work like valuable prescriptions for emergency, Wai Tai Mi Yao, and so on. He collected the academic thoughts before the Tang Dynasty and the Song Dynasty and had great achievement in this field and had his own style.