Fortune-telling methods in Sui Dynasty

Character brief introduction Chao Fangyuan lived in the Sui and Tang Dynasties, and his birthplace, date of birth and death are unknown. It is said that he is a Chinese. During the great cause of Sui Dynasty (AD 605-6 15), Chao had frequent medical activities and served as a physician with outstanding achievements. However, there is no biography of the Chao family, but there is a record of the Chao family in the legendary novel Shuo Jiang in the Song Dynasty. According to legend, in August of the fifth year of Sui Daye, the general manager of Yunhe suffered from headwind and ordered Chao to see a doctor. Although Chao's life story is lost in the dust of history due to the lack of historical records, Chao's great contribution to the 5,000-year civilization of the Chinese nation will go down in history with his painstaking compilation of TCM etiology.

Mainly through the Sui Dynasty, the earliest medical education "Taiyi Department" in the history of China was established, which was also the first large-scale government-run medical education recorded in the history of world civilization. The Sui Dynasty also organized scholars at home and abroad to extensively collect information on traditional Chinese medicine, mainly ancient prescriptions and folk prescriptions, and compiled a large-scale prescription book "Four Seas Gathering Prescriptions" with 2600 volumes. China's first monograph on etiology and symptomatology, Etiology and Symptomatology, was written under this social background.

On the Pathogens and Stages of Diseases.

Academic Content The New Development of Parasitic Etiology and Parasitic Symptoms and Symptoms "On the Origin of Various Diseases" is still of great guiding significance in observing and recording the etiology of parasitic diseases, the incidence areas of different diseases, the syndrome manifestations of various diseases, the characteristics of parasites, life habits and invasion routes. When Chao discussed schistosomiasis (formerly known as Shegong, Xi Du, Shuidu, etc. ), he pointed out that the incidence of schistosomiasis has regional particularity. The caves and streams to the east of SHEN WOO (Jiangsu and Zhejiang), the moors to the south of the Yangtze River and Shui Ze are all endemic areas of schistosomiasis. The living habits of Schistosoma japonicum are in the onset season. The DPRK thinks that Schistosoma japonicum stays in the soil in winter, and Xia Yue is in the water, walking on the water and taking a bath in the water, which is easy to get sick. If the rain is too heavy, it will flow into people's bodies with the water.

The onset season is mostly in spring and autumn, and patients have experience of contacting the waters of epidemic areas. Symptoms of schistosomiasis are described as water poisoning, radiation poisoning, stream poisoning, reclaimed water and stream temperature. Mainly manifested as cold and hot at first, slight headache, orbital pain, abdominal pain, upset, cavity discharge, gingival bleeding, followed by poor diet, delirium and so on. At that time, a unique diagnosis method was put forward under possible conditions: garlic was mashed for several liters, put into warm water, and the patient was allowed to take a bath by himself. After bathing, red spots appeared all over the body, which was schistosomiasis infection. From today's point of view, this method may be outdated, but it is a bold exploration and feasible measure for the level of medical and social development more than 1000 years ago. As for people infected by sand lice (tsutsugamushi disease), Chao Fiona Fang pointed out that the invisible sand lice "attached to people" and "crawled into the skin" because they bathed in the cave of Shui Ze in the epidemic area or waded in the grass in rainy days. As for the ways to prevent this disease, Chao pointed out that people with suspicious contact history should smoke with small fire to prevent sand lice from falling to the ground on their own. In the records of sand lice disease, the ancient idea of fighting poison with poison has a budding effect in immunological sense. Chao suggested grinding sand lice into fine chips in winter and coating them with musk powder to prevent future diseases.

After detailed clinical observation, the common part of scabies is between the hands and feet, and then gradually reaches the whole body; The cause of the disease is infection of water sarcophagus; Scabies can be picked out with sharp tools at the scabies. The key to cure this disease lies in eliminating insects and diseases. These are all discussed accurately. He pointed out that the route of infection is physical contact; The good and evil after healing lies in the number and depth of scabies invading the body; Moxibustion on sore surface can kill sarcophagus. Regarding the records of intestinal parasites of taeniasis, Chao pointed out that this was caused by eating immature beef. It is called "Inch White Worm", which is one of the nine worms. Each segment is one inch long and flat and white. Or because of eating raw fish and drinking cheese, the inch white worm invaded. About ascaris, the book called it "snake gall". Ascaris is shaped like a snake, and it often twines into a ball and looks like a gall, which is caused by bad eating habits such as drinking water from unclean wells and swallowing snake-eating rat essence. Chao's exposition of various parasitic diseases is mostly practical through a large number of meticulous clinical observations and genius guesses without any available observation and inspection instruments, so that when we understand this part of the Theory of Heteropathy more than a thousand years later, we can still deeply feel Chao's rigorous scientific attitude and immortal rational brilliance.

Allergic diseases Understanding of allergic diseases: Allergic diseases belong to various allergic diseases caused by immune system dysfunction. In the Sui Dynasty, people's ability to understand the state of human immune system was still very limited, and the description of "lacquer sore" in Etiology filled the gap in this field. Chao Fangyuan observed that when he also touched paint, some people immediately felt itchy, and then his chest, arms, legs and all parts of his body became itchy and swollen. He scratched his hand and the swelling spread rapidly. In severe cases, sores are as poisonous as beans or as big as apricots and dates, and abscesses are burning and painful; Thirdly, the symptoms are still the same, and such people are "naturally afraid of paint"; There are still many people who cook paint all day, but they are not harmed. Chao believes that this is because human beings are born with poor tolerance for coatings. People, big or small, have paint tolerance and paint intolerance. This understanding of contact allergic lesions, especially the understanding of individual differences, is undoubtedly very correct.

Allergy is related to the history of penicillin's coming out around19th century. Many patients were injected without allergy test, which even caused allergy and even death. Chao's observation and profound analysis made us even more awe-inspiring. Regarding reproductive system diseases, Chao's Etiology emphasizes that the reason of male infertility is infertility caused by cold semen and infertility caused by non-ejaculation of semen, indicating that childlessness is not caused by the woman's unilateral illness. The significance of this discussion goes far beyond the medical field. In addition, the reasons for women's infertility are listed in detail, such as wind-cold entering the cell, irregular menstruation, abdominal tumor, uterine prolapse and so on. So that doctors can carry out detailed clinical examination and treatment. About neonatal tetanus (umbilical ulcer) and congenital epilepsy in children. This is expounded in Treatise on Febrile Diseases. Chao Fangyuan also discussed the most common clinical internal diseases in detail.

Truthful diseases, such as the introduction of the etiology of Truthful Diseases, Chao pointed out that the seriousness of the heart should not be hurt, and the pain of the injury is true heartache, and it will die early and later. To further distinguish the different reasons for the recovery of the disease, Chao emphasized that the fundamental reason is that those who are seriously injured die quickly, and those who are injured in other collaterals die suddenly, so they will not die suddenly-the reason is that the size of the injured artery is different. Treatise on Febrile Diseases, as a monograph on the causes and syndromes of various diseases, will naturally not ignore surgical and traumatological diseases that account for a considerable part of pain. Therefore, a large number of records about surgery and occupational therapy in the book fully reflect the medical level of surgery and traumatology in Sui Dynasty and its early days. For example, the book records the understanding of the necessity of removing foreign bodies from open wounds: "Golden Wounded Bone" emphasizes that only removing foreign bodies can promote wound healing; If broken bones or other foreign bodies are not taken out, it will make people purulent and painful; If the arrow enters, it must be pulled out first, and then it can be cured with medicine. This is consistent with the principle of debridement in contemporary trauma surgery.

In addition, the theory of pathogen and staging also surprisingly discusses the implementation methods and steps of intestinal anastomosis, postoperative matters needing attention and so on. Intestinal anastomosis should be performed in patients with intestinal rupture caused by abdominal trauma. If both ends of the intestine can be seen, use a needle and thread to continuously break the intestine, and then apply chicken blood on the seam to prevent air leakage and push it into the abdomen. The key point of postoperative care is to eat rice porridge within 20 days, not to eat enough, and eat normally after 100 days. Although we can't know how this enterostomy is disinfected, how to resist infection and how high the success rate is, it is enough to be deeply touched to think that this is the surgical record of the 7th century AD. Even more striking, the theory of pathogen and staging also records the excision of omentum, including vascular ligation of necrotic omentum and partial excision of omentum. The omental artery injured by abdominal trauma was ligated overnight with raw silk thread, causing fan-shaped necrosis in the blood supply area, and the necrotic part was removed the next day. The abdominal cavity should not be sutured immediately after resection, but the blood juice in the abdominal cavity should be drawn out (drained); There are strict horizontal and vertical differences, yin and yang differences, fluency differences, urgency differences and so on. In the suture part, the skin can heal as usual. This record proves that the level of surgical abdomen introduced in Etiology is the highest peak of human surgical medicine in the 7th century.

After six years of clinical application (AD 6 10), Chao compiled a 50-volume treatise on syndromes of various sources of diseases, which was divided into 67 chapters with 1739 syndromes, listing the causes and syndromes of internal diseases, external diseases, gynecology, children, facial features, oral teeth and bone injuries respectively, and diagnosing some diseases. This book is the first monograph on etiology and syndrome of traditional Chinese medicine in China, and it is also the first medical theoretical work written by the imperial court. It occupies an important position in the medical history of China and has a far-reaching influence on later generations.

The main characteristics of various pathogens and stage theories are as follows:

1. This book focuses on etiology and syndrome, but does not contain prescriptions: the book takes disease as the key link and describes the concept, etiology, pathogenesis and syndrome of each disease. Unprecedented collection of all diseases and syndromes, the explanation of etiology and pathology and the description of syndromes have a high level.

2. Developed the theory of TCM etiology: put forward that "grumpy" is the pathogenic factor of infectious diseases, and put forward that taking medicine in advance can prevent epidemic infection. Many human parasitic diseases are recorded in the book, and their forms and infection routes are described in detail. It is suggested that scabies is related to scabies infection. Anthrax is caused by infection; Lacquer sore is an allergy caused by "natural fear of paint"; Mountain scabies is caused by drinking "sand water", and many new ideas and records in the book have made great progress.

3. Pathology: The book has detailed records and systematic descriptions of pathological changes and prognosis of various diseases, highlighting the special syndromes of each disease, which is of great significance in clinical differential diagnosis.

4. In syndrome classification: classify diseases and make them systematic. For example, obstetrics and gynecology can be divided into five categories: miscellaneous diseases, pregnancy diseases, labor diseases, dystocia and postpartum diseases. This classification is more detailed and clear, which is beneficial to clinical application.

Anecdotal allusion Ma Shumou, who was in charge of canal construction in the fifth year of the Great cause of Sui Dynasty (AD 609), suffered from wind adverse disease in Ningling (now Henan) and his joints ached all over. After getting up, he felt dizzy and nauseous, but all the doctors failed to make a diagnosis and treatment. Emperor Yang Di ordered Fiona Fang to receive treatment. After the diagnosis, Yuan Chao's prescription thinks that the wind enters the body, and the disease lies in the chest. Be sure to use tender and fat sheep, and it is better to steam cooked food with Chinese medicine. Ma Shu prescribed a prescription, steamed it, and the medicine was not used up, so it was fine. Fiona Fang also told him to continue taking medicated diet to prevent the disease from recurring.

Character Evaluation Chao Yu's Treatise on Pathogens and Diseases and Syndrome, compiled in the sixth year of Daye (AD 6 10), is the first book devoted to the discussion of pathogens and diseases and syndromes in the history of China. Although the book does not record the treatment methods and prescriptions, it has strong information value and is a standing book on the doctor's desk. It is recorded in the book that "scabies" are the source of scabies. It is hidden in a wet scab and can be picked out with a needle. It looks like a snail in the water, and its observation is very detailed, which is also a great progress in morphology of etiology theory. The book also gives a detailed explanation of tapeworms. Among them, it is said that the white stripe worm will multiply in stages and gradually grow to four or five feet long, which is very close to the description of tapeworm in modern medicine, and it is pointed out that the occurrence of this disease is related to eating immature fish and beef. The book describes "lacquer sore", a kind of rice-like papule, which occurs in people who are allergic to lacquer. Contact with paint, only such people will appear, others will not. This is also the earliest immunological research. It can be said that the theory of etiology at this time has a very comprehensive understanding of allergy. The book records infectious diseases in detail, such as tuberculosis, smallpox, beriberi and so on, and even mentions women's induced abortion. In health care, there are also many insights: the paper puts forward that brushing teeth is the key to ensure dental health. It even describes the steps, methods, suture and nursing of intestinal anastomosis. It can be seen that the surgical operation at that time was also relatively developed.

Pathogen and syndrome are one of the important bases of TCM syndrome differentiation and medication. This book is rich in content, detailed in description, accurate in analysis, clear and easy to understand, and it is a rare good book. In addition, Etiology is an important book that records the level of medical development at that time. Judging from the understanding of the etiology contained in the book, the medical understanding of the disease at that time had reached a comprehensive and thorough level. Perhaps it is influenced by cultural orientation. In the history of medicine, most doctors pay more attention to the research and writing of principles, methods, prescriptions and medicines, and there are few monographs in this field. Treatise on Febrile Diseases is comprehensive in content and profound in thought, which just makes up for this vacancy. Up to today's medical development level, it is still a complete and good book.

The Influence of Later Generations "On the Etiology and Staging of Diseases" is the first monograph systematically summarizing the etiology, pathology and syndrome of diseases in the medical history of China, which has had a great influence on the development of two generations of medicine after Sui Dynasty. He has made outstanding contributions to the development of traditional Chinese medicine and has been highly valued by doctors in past dynasties. Create a method of "nourishing reproduction". Guidance method is widely used in medical treatment. I wrote the Guide to Prescriptions for Health Preservation and discussed the symptoms for 1,727 minutes, and mostly used the method of "nourishing propaganda" and "substituting medicine". For example, if "hands and feet don't obey due to wind arthralgia", the method of "nourishing propaganda" is: "Hold hands left and right, open arms nine times, and treat arm and foot pain, fatigue and wind arthralgia". It has a positive contribution to the development of medical gymnastics.