What is the difference between typhoid fever and febrile diseases in traditional Chinese medicine?

Discussion on typhoid and febrile diseases Since the theory of febrile diseases was unique in the medical forest, there has been a dispute between typhoid and febrile diseases. The difference between typhoid and fever depends on the symptom response. During the Ming and Qing Dynasties, some experts on typhoid fever subjectively thought that "typhoid fever is the evil of typhoid fever" and "febrile disease is the evil of warming" without making clear the difference between typhoid fever and febrile diseases. Syndrome differentiation and treatment in traditional Chinese medicine actually refers to the symptoms and syndromes reflected by the human body's struggle with healthy qi after it feels exogenous pathogens such as wind, cold, summer, dampness and fire dryness, and it is not judged according to what exogenous pathogens it feels. After feeling cold pathogen, it can reflect cold syndrome or heat syndrome. Feeling heat pathogen can also reflect cold syndrome or heat syndrome. Epidemic febrile diseases pay special attention to the role of pathogenic factors. For example, Wu Youke pointed out in Treatise on Epidemic Febrile Diseases: "Those who are infected feel the strong qi of heaven and earth", "No matter how strong or weak this qi comes, it will be sick at the touch." In Exogenous Fever, Ye said: "Warm pathogen must attack the lung and spread to the pericardium first", "Heat pathogen will consume kidney and body fluid if it does not dry stomach and body fluid", "Warmth will dry wind, clear orifices will dry, dampness and warmth will be combined, steaming depression will be blind, and clearing orifices and blood stasis will harm clearing orifices" and so on. Epidemic febrile diseases think that the changes of epidemic febrile diseases are mainly determined by the nature of the pathogenic factors of epidemic febrile diseases, while ignoring the human body's response to the struggle against the pathogenic factors. The study of "evil" in traditional Chinese medicine can not be divorced from clinical symptoms and syndromes, and must follow the principle of "from syndrome differentiation to syndrome differentiation". In other words, it is "syndrome" that determines "evil", not "evil" that determines "syndrome". Typhoid fever in Treatise on Febrile Diseases includes typhoid fever and miscellaneous diseases in a broad sense and typhoid fever in a narrow sense. Fifty-eight difficult classics: "Typhoid fever is divided into five types: stroke, typhoid fever, damp heat, fever and fever." The former typhoid fever is generalized, while the latter typhoid fever is narrowly defined. With regard to the concept of epidemic febrile diseases, Article 6 of Zhang Zhongjing's Treatise on Febrile Diseases says: "Those who have fever and thirst and do not hate cold are epidemic febrile diseases." This is a simple and clear judgment method, that is, judging by the characteristics of symptoms, rather than judging by the E Lai of six evils. The essence of the Six Classics in Treatise on Febrile Diseases is the focus of debate among physicians for a long time, as Yun Tieqian said in Treatise on Febrile Diseases: "The first essence of Treatise on Febrile Diseases is the Six Classics, and the first difficulty is the Six Classics." The rule of TCM treatment is "treatment based on syndrome differentiation" or "symptomatic treatment", and it is functional adjustment therapy to give corresponding drug treatment according to the symptoms of patients after illness. Professor Pang Zhuru summarized it into three points: first, it is non-particularity, that is, almost all diseases can be applied; Second, it pays attention to promoting the physiological mechanism of patients, but does not directly eliminate pathogens and symptoms; The third is integrity, that is, taking care of the overall physiological mechanism of patients and taking appropriate comprehensive treatment according to systemic syndromes. According to the reflex phenomenon of the body's physiological mechanism of disease resistance, corresponding assistance and adjustment are given to make the body return to normal. Professor Feng summed it up as: on the basis of the general regular response of the sick human body, the whole body adapts and emphasizes the general treatment of the disease. The best embodiment of this treatment law in traditional Chinese medicine is Zhongjing's Treatise on Febrile Diseases. According to the reaction of human body after illness, Chinese medicine is divided into eight types: yin, yang, deficiency, excess, cold, heat and exterior-interior, that is, eight categories. For example, "History of Han, Art and Literature" records: "Those who pass the prescription, the cold and warm of herbal stones, the shallow and deep diagnosis of diseases, are suitable because of qi, distinguish five pains and six pains, and draw the sum of water and fire to open and close the knot, and vice versa. Those who lose their health will benefit from heat, increase cold with cold, and have internal injuries in essence. This is the only loss. " "Classic of Decoction" also contains: "Daqinglong Decoction can cure heaven, but the exterior and interior are puzzled" and "Xiao Xie Decoction can cure ... internal cold and external heat." The concept of differentiation of symptoms and signs based on eight cardinal principles is earlier than that of differentiation of symptoms and signs based on six meridians in Treatise on Febrile Diseases. According to the article 148 of Treatise on Febrile Diseases: "On the fifth and sixth day of typhoid fever, the head sweats, with slight aversion to cold, cold hands and feet, full heart, no appetite, hard stool and thready pulse. This is a mild knot of yang, and there must be exterior symptoms, and the pulse is heavier than interior. Sweating is a slight knot in pure yin, and no symptoms can be repeated. Although the pulse is heavy and tight, it can't be caused by Shaoyin disease, so if it is, Yin can't sweat. Today, my head is sweating, so I know it's not shaoyin. It can be served with Xiaochaihu soup. If you can't stand it, you will get a solution. " Zhang Zhongjing added the concept of "semi-exterior and semi-interior" to the concept of "exterior and interior" on the basis of the eight principles of syndrome differentiation, thus establishing the syndrome differentiation system of six meridians. The so-called exterior, interior, semi-exterior and semi-interior are the reactions of symptoms in the sick place after the human body is sick. The so-called yin, yang, cold, heat, deficiency and excess are all reactions of diseases. The condition must be reflected in the position of the disease, and the position of the disease must also be displayed because of the reaction of the condition. Therefore, exterior syndrome, interior syndrome and half exterior syndrome are bound to be accompanied by symptoms of yang, yin, cold, heat, excess or deficiency. Similarly, the so-called yin syndrome, yang syndrome, cold syndrome, heat syndrome, excess syndrome and deficiency syndrome are bound to be accompanied by symptoms of exterior or interior. Some people think that Treatise on Febrile Diseases is a "typhoid fever" for treating cold pathogens, not a "fever" or miscellaneous diseases with internal injuries, so they do not really understand the spirit of Treatise on Febrile Diseases. In fact, Zhongjing used six meridians to treat all diseases, regardless of exogenous diseases, internal injuries and febrile diseases, which did not belong to the category of six meridians. Therefore, Ke Qin put forward the view that "all diseases are caused by six meridians", and Xu Dachun also said: "The knowledge of medicine lies in the principle of treating typhoid fever in Ming Dynasty; If typhoid fever is bright, all diseases will pass. " The author believes that all six meridians are clear and all diseases are common. Article 182 of Treatise on Febrile Diseases, a generalized epidemic febrile disease, is expressed as: "The exterior syndrome of Yangming disease ... body heat and spontaneous sweating is not aversion to cold, but aversion to heat." The exterior syndrome here is the exterior syndrome and exterior syndrome different from the sun and shaoyang, which is the fever mentioned in Article 6. Article 197 of Treatise on Febrile Diseases: "Diseases include Taiyang Yangming, Zhengyang Yangming and Shaoyang Yangming ... If the sun is Yangming, the spleen is similar; Zhengyang Yangming, the stomach is true; Those with less yang and Yangming have more sweat and less urine, dry stomach and difficulty in defecation. " The so-called Taiyang Yangming means that Taiyang Yangming is both a disease and a fever. Prescriptions for treating complications of Taiyang Yangming include Gegen Decoction, Gegen Qinlian Decoction, Maxing Shigan Decoction, Maxing Yigan Decoction, Daqinglong Decoction, Yuemai Decoction, Yuemai Jiashu Decoction, Yuemai Plus Banxia Decoction, Guizhi Yuemaiyi Decoction, Baihu Plus Guizhi Decoction, Bamboo Leaf Gypsum Decoction, etc. Is actually a prescription for treating fever. Therefore, Lu Jiuzhi said, "There are five kinds of typhoid fever, and when it is introduced into Yangming, it becomes fever." He also said: "The source of typhoid fever is in Treatise on Febrile Diseases, and the prescription for treating typhoid fever is not outside the Treatise on Febrile Diseases." Ke Yunbo also put forward the viewpoint that "syndrome differentiation and treatment of febrile diseases are scattered in the six meridians" and "Yangming is the source of warming", pointing out that "those who suffer from febrile diseases are also Yangming" and "those who start from Yangming are also warm, and those who enter Yangming from the sun are also warm." He also analyzed the empirical prescriptions of some typhoid experts, and thought that it was nothing more than Yangming Classic Prescription in Treatise on Febrile Diseases. For example, in Fifteen Prescriptions for Epidemic Febrile Diseases, Qin, Lian, Gao, and others were specially added to the silkworm cicada, making people look like Yang Xinfang, and the Treatise on Febrile Diseases was unconsciously added. It is believed that although there are many theories of fever, in fact, only the names of other meridians or other syndromes have replaced Yangming's reality. In fact, many prescriptions for febrile diseases are closely related to typhoid prescriptions. For example, Geliang powder comes from Gardenia black bean soup; Huaban decoction originated from Baihu decoction; The newly added Huang Longtang, Baixuan Chengqi Decoction, Daochi Chengqi Decoction, Niuhuang Chengqi Decoction and Zengye Chengqi Decoction originated from Daxiaohe Chengqi Decoction. Fumai decoction is modified. One nail, two nails and three nails Fumai decoction originated from roasted licorice decoction. Shaoyin disease Huanglian Ejiao decoction is the foundation of nourishing yin and clearing heat for future generations. Some experts on epidemic febrile diseases claim to have "jumped out of typhoid fever circle", but in fact they have not left this foundation. Instead, they have made creative development in combination with new problems raised by medical practice, such as distinguishing tongue and teeth, observing eruption, and creating some prescriptions with stable curative effect. They have made new breakthroughs in theory, such as establishing Wei Qi Xue Ying and differentiating triple energizer syndrome.