What are the famous medical records in ancient times?

Records of symptoms, prescriptions, drugs, etc. In traditional Chinese medicine, treatment is often used as a title, such as Ye's Clinical Guide Medical Records and Qing Dynasty Famous Doctors Medical Records in Qing Dynasty.

That is, medical records. It is a continuous record of syndrome differentiation, legislation and prescription when doctors treat diseases. Chunyu Kun, a famous doctor in Han Dynasty, creatively recorded 25 medical records he treated, which was called "diagnosis book" at that time. Including the patient's name, address, occupation, pathology, syndrome differentiation, treatment, prognosis and so on. Some doctors in later generations sorted out their medical records and made them into personal medical records. There are also famous doctors in ancient and modern times, such as "famous doctors", "continuing doctors" and "ancient and modern medical records".

The origin of TCM medical records is very early, and the bud can be traced back to the Zhou Dynasty. According to Zhou Li, doctors at that time had recorded the names of diseases and treatment results, but their main function was to evaluate the doctors' curative effects, so as to determine their grades and pay their salaries. In addition, there are scattered records about doctors' diagnosis and treatment of diseases in Zuo Zhuan and the works of pre-Qin philosophers, which can be regarded as the embryonic form of medical records. At present, the earliest medical records with actual contents are the three cases of Zhi, Prince Guo, Qi Huanhou and Chunyu Kun's medical records contained in Historical Records, Biographies of Bian Que and Cang Gong. Especially the latter, is regarded as the origin of later physicians. There are 25 medical records in Chunyu Medicine, each with the patient's surname, address, location, disease name, pulse condition, treatment and prognosis, involving internal and external diseases, injuries, gynecology and pediatrics. The diagnosis method is mainly pulse diagnosis combined with pathogenesis analysis. Treatment methods include drugs, acupuncture, fumigation and washing. Use medicine or soup or pills or wine. What's more, in addition to being cured, there are 10 deaths recorded in the medical records. This attitude of seeking truth reflects the unpretentious style of early medical records.

From the Qin and Han dynasties, medicine advocated prescription books, and until the Sui, Tang and Five Dynasties, medical records failed to make a breakthrough. The medical records of this period are scattered in medical books and literature and history books, with a small number and simple content. For example, several cases in Qian Jin Fang Yao are mostly independent cases in Sun Simiao, the main purpose of which is to prove the curative effect of a certain medicine, and there is no detailed description and analysis of the disease. Nevertheless, the medical records of this period still have some merits, such as simplicity and elegance, and the combination of medicine and literature, which can also be enlightening.

The Song, Jin and Yuan dynasties were the unprecedented development stage of medical records. The main characteristics of the development of medical records in this period are the emergence of medical record monographs, the gradual increase of medical records and attached cases, the popularization of doctors' filing, and the rich and colorful style of medical records.

Ninety Treatise on Febrile Diseases written by Xu in Song Dynasty is the earliest extant monograph on medical records in China. The book divides the common syndromes of typhoid fever into 90 kinds, one case for each syndrome. The case is strictly filed and the content is comprehensive and complete. Based on classic works such as Neijing, Difficult Classics and Treatise on Febrile Diseases, it is enlightening to analyze medical records. Aftershock, a physician in Qing Dynasty, praised this book: "There are dozens of medical records, all of which have inventions, which can be used as a model for future generations to learn."

Although the attached medical records originated very early, they were scattered and concentrated, and actually began in the Song Dynasty. For example, the Guide to Pediatric Medical Certificates contains 23 pediatric medical records, involving more than ten kinds of diseases and syndromes, or analyzing the etiology and pathogenesis, or clarifying the application of prescriptions and medicines, which fully embodies Qian's pediatric academic characteristics. The feature of this book is not only the case attached, but also the earliest special medical record. In addition, Xu's "Puji Shu Fang" and the medical works of many doctors in this period are mostly accompanied by medical records. Such as Yang Jie, Sun Zhao, Zhang, Chen, Wang, Tianyi Luo and Hua Shou, all have medical records handed down from generation to generation. With the increase of medical records, their forms, styles and narrative methods have also changed. For example, some are attached, some are attached, some are attached, and some are attached, but the purpose is to prove the case.

For example, there are about 200 medical records of Zhang, which are described in detail in terms of etiology, syndrome differentiation, treatment and prescription. Many drugs are used to control cold and make good use of sweating, vomiting and purgation, which embodies Zhang's academic characteristics of attacking evil. Li Dongyuan's medical records are scattered in two books, Spleen and Stomach Theory and Shi Lan's Secret Collection. They are meticulous, dialectical and accurate, and their prescriptions are big and light, and they make good use of the method of tonifying yang and benefiting qi, which embodies Li Dongyuan's style of being good at strengthening vital energy and eliminating evil spirits and caring for healthy qi. Zhu Danxi's medical records are widely circulated, and most of them are written in the form of narration to clarify its academic characteristics of nourishing yin and reducing fire.

The above medical records not only fully reflect the different academic viewpoints and rich clinical experience of doctors, but also lay a solid foundation for the development of medical records in later generations.

Medical records developed to the Ming Dynasty, and all aspects gradually matured. The increase of personal medical record monographs, the appearance of medical records and the beginning of medical record research are important signs of the maturity of medical records in this period. According to incomplete statistics, there are about 30 kinds of personal medical records in Ming Dynasty. Representative cases include Shishan medical case, Zhou Shenzhai medical case, Sun medical case, miraculous medical case, Yi medical case and Li Zhongzi medical case. In addition, the number and types of supplementary cases in medical books are much more than those in the previous generation, such as The Complete Book of Jingyue, Herbal Medicine in Southern Yunnan, Essential Reading for Physicians, Compendium of Materia Medica, Masterpiece of Acupuncture, True Story of Medicine, Authentic Surgery, Compendium of Materia Medica, Compendium of Benefiting Yin and so on. The attached medical records are considerable and involve clinical practice. While the number of medical records has increased, the quality has also improved obviously, which is mainly manifested in: ① the content is complete and objective; (2) Diversified and standardized formats; ③ Thorough and clear reasoning; ④ The writing style is graceful and fluent.

What's more worth mentioning is that the first medical record book in Chinese history, The Record of Famous Doctors, appeared in the Ming Dynasty. The book, edited by Jiang Huan, has a volume of 12, and contains nearly 3,000 medical records of physicians in past dynasties, as well as hundreds of classics and histories before the Ming Dynasty, which are divided into 205 families according to disease syndromes. The medical records included are mainly internal medicine, including surgery, gynecology and five senses. Each case recorded the doctor's name, the patient's age, constitution, symptoms, diagnosis, treatment and prescription. And many medical records are accompanied by notes or annotations to "show that learning is not complicated in the Bible, but easy to understand". This book is not only the first of its kind in China, but also the first monograph to study ancient medical records. The cases contained not only reflect the superb medical skills and clinical experience of compiling sages, but also leave valuable information for studying the academic thoughts of these doctors.

During this period, in addition to extensive research on medical records, some doctors also began to study the writing format and norms of medical records. First of all, Hanyitong proposed that medical records should be written in six ways: looking, smelling, asking, cutting, discussing and treating, and showed the format. Later, Wu Kun modified and supplemented this with pulse language, put forward the writing method of "seven books and one citation", and explained the writing content and format of medical records in more detail. These viewpoints have promoted the standardized and scientific development of medical records and had a positive and far-reaching impact on the development of medical records in later generations.

The Qing Dynasty was the heyday of the development of medical records. During this period, not only a large number of medical records came out, but also writing and compilation were in full bloom, and the combination of theory and clinic was closer, which further promoted the academic development of traditional Chinese medicine. Summarizing the characteristics of medical records in this period, there are the following aspects:

(1) A large number of medical records appear in various forms.

According to preliminary statistics, there are more than 200 kinds of medical records written by doctors in Qing Dynasty. As far as the form of works is concerned, there are many kinds and styles, including personal medical records, medical records books and medical records series, as well as specialist medical records, special medical records, consultation medical records, medical records comments and court medical records. As far as the writing form is concerned, it is unique and has its own characteristics. For example, some narratives are short and meaningful. Some elaborate and explain in detail, and the narrative is clear; Some are good at quoting classics, focusing on reasoning; Some emphasize the rule of law and show people the rules; Some pulse conditions are orderly due to syndrome differentiation and treatment.

⑵ Physicians attach importance to medical records, and filing a case has become a fashion.

The success of medical records in Qing dynasty lies in doctors' general concern for medical records. On the one hand, doctors cherish the cases of former sages, such as the aftershock Ceng Yun: "There are many cases, the medical method is right, and the skill of the method is right, so we can try to figure it out." Rebecca often said, "Famous doctors put on record, each has his own experience, which has been circulated for a long time and benefited a lot. After building a clinic, learning the essence and practicing deeply, the prescription will be stable. Prior to this, benign medical cases were so valuable. " On the other hand, doctors attach great importance to personal writing of medical records. Xu Ling pointed out: "Therefore, the method of treating diseases must first establish medical records." Master Wang's "First Edition of Medical Rights" also said: "The doctor is right, and the case is filed first." It shows that it has become common for doctors to write medical records at that time. The most influential medical records handed down from generation to generation are: Yu Chang's Medicine, Cathode Grass, Jingxianglou Medical Record, Qi Youtang's Qi Medical Record, Wang Jiufeng's Clinical Medical Record, Gu Xiaolan's Wumen Medical Record, Wang Medical Record and Jiang Baosu's Wenzhai Medical Record. Although each case has a different style, it embodies its unique academic thought and experience in diagnosis and treatment, which is praised by future generations.

⑶ Pay attention to the research of medical records and compile a large number of publications.

At the end of Ming Dynasty and the beginning of Qing Dynasty, physician Yu recorded more than 60 medical records of incurable diseases in "Medicine", and wrote "Discuss the disease type with the master" at the beginning. On the basis of Han Mao, Wu Kun and others, the "formula for discussing diseases" puts forward higher requirements for the content and format of writing medical records, that is, the attitude should be serious and the content should be detailed (including the time and place of diagnosis, the general situation of patients, symptoms, pulse conditions, syndrome differentiation, treatment principles, prescriptions and prognosis, etc.). ), and prescriptions and medicines should be complete. This idea is not only of high use value, but also conducive to the summary of medical experience, the improvement of medical effect, the development of medical theory and the preservation of medical files, which is still of reference significance.

In the compilation of books, the largest existing medical record book "Continued Medical Record" appeared, which is a companion book of medical records, and collected more than 5,000 medical records of Qingganlong and previous medical records, divided into 345 books, and supplemented the medical records.

In addition, many medical records were published in the Qing Dynasty, among which three medical records were jointly engraved and four medical records were selected by Liu Xuan. This kind of medical records are compiled by editors and can represent the essence of doctors' academic thoughts and treatment experience. Therefore, although the number of records is small, the quality and value are high. In terms of medical record interpretation, it has also made great progress compared with the previous generation. Among them, Aftershock's Ancient and Modern Medical Records is a rare work to comment on medical records. Based on evidence, this book contains more than 1000 medical records of more than 60 doctors, including Ye * * *, with more than 530 annotations, which is helpful to the study of ancient and modern medical records. After that, Wang Mengying will choose the best one, and then evaluate it, which will be of greater reference value.

Since the Qing dynasty, the development of medical records has not reached a new climax, but scholars' understanding and evaluation of medical records is even worse than that of the previous generation. For example, Mr. Zhang Taiyan once said: "The medical record is the best achievement of Chinese medicine. To the experience of predecessors, medical records have the most clues to find, and get twice the result with half the effort. " Another example is Zhang's comment on ancient and modern medical records, saying: "Medical books have arguments, while discipline is constant, while syndrome is chaotic, and the source of the disease is never unknown, which leads to confusion. However, the medical records are always moving with the symptoms, vivid, unreasonable and infinitely wonderful, just like the patient is coughing and listening. Therefore, instead of accompanying famous doctors, it is better to read more medical records, not gather good doctors from ancient and modern times, and talk from top to bottom. How fast? " His words came from the heart and were quite true.

In the style of writing, it still inherits the characteristics of Ming and Qing Dynasties, starting with the prescriptions of traditional Chinese medicine, focusing on the etiology, pathogenesis and treatment prescriptions. Or change the traditional medical record and describe it with the view of combining traditional Chinese and western medicine. The latter is represented by the attached case of Zhang Xichun's medical enthusiasm and learning from the West. Another example is Cao's Classic Prescription Experiment Record, in which Zhongjing is the main party, and the integration of Chinese and Western reasoning is quite distinctive. During the period of the Republic of China, the medical records of famous doctors in Song, Yuan, Ming and Qing Dynasties compiled by Xu and the national medical records compiled by He were properly classified and occasionally annotated, which had certain practical value.

The medical records with different styles of many physicians in different historical periods are not only the crystallization of the clinical practice experience of China physicians in past dynasties, but also the treasure in the treasure house of traditional Chinese medicine. In many medical records, there are not only rich medical theories, but also a lot of medical experience; There are both dialectical methods and prescription drugs; There are both successful experiences and lessons of failure; There are both details that make people tired of reading, and concise ones that make people think endlessly; There are common diseases, unique diagnosis and treatment methods, difficult cases and unique treatment methods.

In a word, TCM medical records condense all aspects of basic theory and clinical knowledge of TCM, which can be described as broad spirit. Studying and studying medical records can not only enrich and deepen theoretical knowledge, but also improve the level of clinical diagnosis and treatment, broaden our horizons and enlighten our thinking. Therefore, medical record is a compulsory course for clinical, teaching and scientific research workers of traditional Chinese medicine.

(The above content is quoted from "Introduction to Medical Theory by Combining Medical Records" edited by Liu Gengsheng. )

Three medical records, namely, Medical Records, Ancient and Modern Medical Records, Clinical Guide Medical Records, Ye Medical Records Essence and Ding Ganren Medical Records, are also medical records, Wang Medical Records Annotation, Ye Medical Records, He Lian 'an Medical Records, Huayunlou Medical Records, Sun Medical Records and Ma Pei's Medical Records respectively.

What is a medical record? Medical records, also known as diagnostic records, pulse records, plans and medical records, are records of TCM diagnosis and treatment activities, and are now called medical records (cases). Traditional Chinese medical records are the concrete embodiment of the comprehensive application of principles, methods, prescriptions and drugs of traditional Chinese medicine. It is not only a true record of medical activities, but also reflects the clinical experience and thinking activities of doctors. Because doctors live in different times and have different knowledge, hobbies and accomplishments, the number, form, genre and style of medical records in past dynasties are also different. The record of TCM diagnosis and treatment process later developed into a TCM work. This is the earliest known medical record, written by Cang Gong, a doctor in the Western Han Dynasty. Historical Records reprinted the names, nationalities, occupations, symptoms, diagnosis, prescriptions and prognosis of 25 patients. Since then, many medical prescriptions, such as Sun Simiao's "Thousand Gold Prescriptions" in the Tang Dynasty, have often recorded treatment cases. Medical records are convenient for summarizing clinical experience and inspiring ideas. The so-called "medical records, such as playing music, can be repeated" (Yu Zhen's Ancient and Modern Medical Records in Qing Dynasty). Therefore, the medical record has become a distinctive work in the literature of traditional Chinese medicine. It is generally believed that Xu's Ninety Treatises on Febrile Diseases in Song Dynasty is the earliest extant monograph on medical records. After the Ming and Qing Dynasties, there were more and more medical records.

According to the author's understanding, there are two types of medical records: exclusive medical records and medical records compiled by various families. The famous exclusive medical cases include Shishan Medical Case by Wang Ji in Ming Dynasty, Yuncao in late Ming Dynasty and early Qing Dynasty, Clinical Medical Case Guide by Ye in Qing Dynasty, Wu Jutong Medical Case, Ding Ganren Medical Case in Modern Times and Pu Fuzhou's Medical Case. Masterpieces of medical records collected by various schools include Jiang Yin's Medical Records in Ming Dynasty, Wei Zhi's Medical Records in Qing Dynasty, Liu Baoyi's Four Medical Records in Liu Xuan and Yu Zhen's Ancient and Modern Medical Records. In addition, there are medical records compiled according to the times, such as the famous medical records of Song, Yuan, Ming and Qing Dynasties (Xu et al. ), Medical Records of Famous Doctors in Qing Dynasty (Qin Bowei), Compilation of National Medical Records of Famous Doctors in the Republic of China (He), Selected Cases of Modern Famous Chinese Medicine (Yu et al. ).

Chinese medical records are written in different ways, either complicated or simple, with different styles. A good medical record should integrate theory, method, prescription and medicine to reflect the whole process of syndrome differentiation and treatment. Medical records require recording the patient's medical history, symptoms, pulse, tongue picture, etc. To explore the internal mechanism of diseases, and to legislate, prescribe and use drugs accordingly. Although medical records do not require that all symptoms must be remembered, they must highlight the main symptoms with dialectical significance. Some ancient medical records have only a few words in each case, but they can make the finishing point and truthfully reflect the treatment process and ideas, such as Ye's Clinical Guide Medical Records in Qing Dynasty. Some medical records are memories and comments, which are characterized by showing the key parts of the whole treatment process and the treatment experience, such as Yu's Moral Grass. This type of medical record also has the nature of medical talk (medical essay). Modern Chinese medical records have gradually absorbed the advantages of western medical records and become more standardized, but they still maintain the characteristics of complete theories, methods and prescriptions, and have played an active role in timely summarizing and exchanging clinical experience of modern Chinese medicine. 1, the Yellow Emperor's Eighty-One Classic (it is said that it was written by Bian Que, an ancient imperial doctor, and the rapid development of medicine has not surpassed it so far. 2, "Yin and Yang Eleven-pulse Moxibustion Sutra" (silk book unearthed in Mawangdui, Spring and Autumn? ) "Moxibustion Sutra of Eleven Veins in Foot Arms" (Silk book unearthed in Mawangdui in the Spring and Autumn Period? ) "The Yellow Emperor Needle Sutra" (Warring States? 3. Huangdi Moxibustion Classic (Tang? ) 4. Moxibustion of Shu points (Northern Song Dynasty Medical Village). ) Acupuncture Classic (Southern Song Dynasty acupuncturist Wang Zhizhong), Preparation for Urgent Moxibustion (Southern Song Dynasty acupuncturist Wen Rennian), Acupuncture Classic (Jin Dynasty acupuncturist He Ruoyu), Four Books of Acupuncture (Dou Guifang, an acupuncturist in Yuan Dynasty) and Acupuncture Collection (a doctor in Yuan Dynasty), Complete Works of Acupuncture (Ming Dynasty acupuncturist Xu Feng) and Examination of Eight Veins of Strange Classics. Zhang Zhongjing's synopsis of the Golden Chamber in Tang Dynasty: Sun Simiao's Thousand Golden Prescriptions, Ming Dynasty's Pulse Classic, Huangfu Mi's Acupuncture Classic A and B, Tao Hongjing's Notes on Materia Medica Classic, Ge Hong's Anxious Prescription, Chao's Theory of Etiology, the newly revised Compendium of Materia Medica, Wang Dao's Taimi, and Yuan Dan's Four Medical Codes. Liu's Original Disease Style, Zhang's Scholars, Ge Zhi Yu Lun, Spleen and Stomach Theory, Li Shizhen's Compendium of Materia Medica, Liu's Compendium of Materia Medica, Wu Youke's Treatise on Febrile Diseases, Complete Works of Ancient and Modern Medical Systems, and Ye Tianshi's Clinical Guide Medical Records.