Text|Sir Wang
Editor|heavy building
Yellow obesity disease, also known as yellow swelling, is a typical manifestation of yellowing of the body skin, puffy feet, or accompanied by fatigue, excessive food and hunger, hair fingers, palpitations and shortness of breath and other systemic manifestations, severe cases can be accompanied by heterophile.
Yellow fat as a disease name first appeared in the "Medical Compendium", its successive titles are numerous, and often confused with jaundice, fatigue and other diseases, until the Ming and Qing dynasties, the name of this disease gradually unified into yellow fat, yellow swollen, became an independent internal medicine disease.
Due to the chaotic descriptions of yellow obesity by previous generations of doctors, this paper systematically sorts out yellow obesity from three aspects: the evolution of the disease name, the etiology and pathogenesis and the treatment methods. It aims to clarify the name of yellow fat disease and its mechanism and treatment law.
Evolution of disease names
Although there is no exact record of the name of "yellow fat disease" in the medical documents before the Ming and Qing Dynasties, according to the discussion of doctors and its symptoms, it can be seen that this disease appeared as early as the Two Han Dynasty.
Due to historical limitations and other factors, yellow obesity in this period mostly appeared in medical literature as single or multiple scattered symptoms. Since the Song Dynasty, the number of medical literature recording yellow fat disease has increased significantly, and a system has gradually formed.
During the Ming and Qing dynasties, doctors had a deeper understanding of yellow fat disease. Therefore, taking the Song Dynasty as the boundary, its related symptoms and disease names are sorted out as follows.
Stomach boils and food also stomach boils are found in "Suwen" "drowning yellow, lying down, jaundice; Those who have eaten like hunger, stomach boils; Wang Bing's note: The stomach is hot, and the heat is gone, so the food is like hunger."
It can be known that stomach boils have the manifestation of valley hunger and yellowing of the body, about the disease of stomach boils, ancient doctors mainly hold 3 different views, medium elimination, gluten and jaundice.
See Sui Chao Yuanfang's "Treatise on the Origin of Diseases", which classifies gastric boils as one of the nine boils, and believes that its disease is due to yellowing of the muscle surface caused by spleen and stomach stasis. Another example is the Song Dynasty's "Shengji Zonglu Huang Sickmen": "Stomach boils, already hungry, upset and yellow, urine red".
None of these accounts of gastric boils mention yellowing of the eyes and urine. In addition, Han Zhang Zhongjing's "Jin Kui Essentials, Jaundice Disease Evidence and Treatment" discusses that jaundice has a "full belly" disease, and it is unlikely to see "eating more and being hungry".
The symptoms of gastric furuncle disease "yellow skin, easy to eat and hungry, and irritated" and yellow fat disease "easy to eat and hungry, palpitations and shortness of breath" are similar, such as the Ming Dynasty's "Notes on Awakening Zhai Medicine" in the Ming Dynasty, "Yellow disease has accumulated gods and prescriptions to give every treatment of demobilization, yellow face can eat, and limb weakness".
The Qing Dynasty's "Wang Xugao Lin's Medical Case" also said that "the face is yellow, the face is weak, the ability to eat and breath, and the evidence of detachment and injury to the spleen." Therefore, gastric boils may belong to the category of yellow fat disease.
"Food" is also known as "food", which is found in "Suwen Qi Theory" "The large intestine is hot in the stomach, good food and thin people, it is called food." The stomach is hot in the gallbladder, and it is also known as food."
In the digestive system, the stomach main accommodates the rotten water valley, and the stomach mainly descends, descending to the large intestine, so the stomach communicates with the large intestine.
If the large intestine fever spreads to the stomach, the stomach heat dissipates the water valley faster, and the water valley essence cannot be infused to spread the limbs to nourish the muscles, then it is easy to eat and hunger, and the body is thin.
If the stomach heat and evil qi move into the gallbladder, affecting the biochemistry of the bile meridian yang, symptoms such as laziness, vomiting, and yellowing of the skin may occur.
Most of the existing studies classify the disease of "food also" as the category of medium elimination and hyperthyroidism, but it has been confirmed in the clinical treatment of food disease by Du Yumao that food can also be seen as a symptom in other diseases except for medium elimination and hyperthyroidism.
Therefore, "food" should be a disease, which can be seen in a variety of diseases. In addition to yellowing, eating more and being hungry, and losing weight, many doctors also believe that food also shows laziness, burnout and weakness.
Ruqing Zhang Zhicong's "Yellow Emperor Neijing Suwen Collection Notes" "Also, Xie 㑊 also. Although it can eat, the body is lazy, so it is also called food."
According to the symptoms of excessive eating, hunger, yellowing and slackness, it can be speculated that the famous food of ancient diseases may also be a symptom stage of yellow obesity or yellow obesity. Spleen labor and spleen labor, one of the five labors, refers to a debilitating disease caused by eating and drinking fatigue and hurting the spleen.
In Tang Wang Tao's "Outer Taiwan Secret Formula: Spleen Labor", spleen labor is divided into real heat and virtual cold, and the treatment prescription is recorded.
Among them, the spleen labor is hot and there is ""Deletion Complex" treats the spleen and labor fever, and the body, eyes, mouth, and lips are yellow; There are white worms that grow an inch, and they are sick in the spleen, which is disgusting; "Qianjin" treats the spleen and hard work, the limbs are not used, and the five internal organs are well-behaved. The skin is full. Shoulder breath is restless" and other discussions.
And the spleen labor deficiency cold see that ""Deletion Complex" treatment spleen labor weakness and emaciation, limbs are not lifted, hair is emaciated; and cure the spleen deficiency and cold, eat and drink, fatigue and flatulence, and sorrow and incomprehension."
After comparison, it was found that the symptoms of spleen and labor described were similar to those described in previous medical texts on the symptoms of yellow obesity. And the "spleen labor yellow" that appears in the medical books of the Song Dynasty is the alias of yellow fat disease, and it can be speculated that it should be derived from the name "spleen labor".
Therefore, it is reasonable to suspect that the spleen labor in "Deleting Traditional Formulas" originally referred to the later yellow fat disease and today's hookworm disease.
"Deleting Traditional Fang" was written by Xie Shitai during the Southern and Northern Dynasties, and it can be inferred that there have been records of diseases similar to yellow fat disease and hookworm disease during the Southern and Northern Dynasties.
In the Sui Dynasty's "Treatise on the Origin of Diseases", there is a kind of yellow disease, see "Fu rheumatism lies in the internal organs, and when it fights with heat, it occurs in yellow, that is, urine or red or white, so lying down and the heart is weak and black, called wind jaundice".
From the manifestation of its symptoms, it is obviously different from jaundice, red or white urine, good sleeping, heart vibration, and dull complexion are compatible with yellow obesity, which may be yellow obesity.
And the epilepsy yellow in the Song Dynasty's "Shengji Zonglu Huang Sickness" is also different from today's jaundice, "the body is like gold, not much speech, weak limbs, good sleep", similar to the spleen and stomach deficiency symptoms of yellow fat disease, or yellow fat disease.
Yellow obesity related disease name
During the Jin Yuan period, doctors recognized that the occurrence of yellow fat disease was related to factors such as food accumulation, fatigue, and chancre accumulation, and called it food labor yellow or food labor boil yellow.
For example, Jin Zhangzi and the two medical cases contained in "Confucian Affair": "Cai Zhai became a child, swollen and weak, but salt and scorched things" and "Another man was sick, good at food and thin, not lifting his limbs, and his face was yellow and weak."
According to the patient's symptoms in the medical case, it can be seen that it should be the same symptom as yellow obesity. The later physician Yuan Luo Tianyi's "Health Treasure Guide" listed "food labor and boil yellow" as a separate article, but still mixed some jaundice diseases into the treatment of yellow obesity.
The name "yellow swelling" first appeared in the Yuan Dynasty's "Danxi Heart Method" "Great Wen Zhong Pill, Cure Food Accumulation and Yellow Swelling". Yuan Wei Yilin's "World Medicine Formula" refers to Huang Fat Disease as Accumulation of Yellow.
The earliest trace of the disease of virtual yellow can be traced back to the period of Han Zhang Zhongjing, and the "Outline of Jin Kuai" said: "A man is yellow, urinates for self-interest, and should be built with a small soup with virtual labor". The same pathogenesis as yellow due to spleen and stomach deficiency in yellow fat, Xiao Jianzhong Tang Jianzhong Jiao Yang Qi.
Later Song Chen Wuji's "Three Causes and One Disease Evidence Theory" put forward: "Five boils and weak feet, light heart, slight cold ears, fever and shortness of breath, white urine." as a waste of labor". The "five decalices" here are different from jaundice, and Chen Wujie attributes them to deficiency.
Zhiqing Wang Xugao's "Wang Xugao Evidence Medical Case" clearly put forward that "there is another false yellow evidence, not yellow gall, its yellow and pale, urine unchanged, weak pulse, weak mouth, can eat but weak, common name lazy yellow, is the disease of fatigue and internal injury".
In addition, because of the symptoms of yellow obesity and fatigue, it is also called lazy yellow disease in Jiangsu and Zhejiang, which means "can't eat well".
Ruqing Feng Menglong's "Awakening Hengyan": "Because I have a lazy yellow disease, I can't eat well." "Therefore, yellow and lazy yellow are other names for yellow fat disease.
During the Ming and Qing dynasties, Ming Louying's "Medical Compendium" set up a separate article on food and labor chancre yellow, and officially proposed "food labor chancre yellow, a yellow fat".
Houming Sun Wenyuan's "Dantai Jade Case" inherited and developed Lou Ying's cognition of yellow obesity, clearly distinguished the two, and proposed that insect accumulation was an important factor in yellow obesity disease, which was later inherited by Qing dynasty physicians Shen Jinao, He Mengyao, Wang Kentang and so on.
During this period, doctors also recognized that de-strain injuries can also lead to the occurrence of yellow obesity disease, and called yellow obesity disease de-fatigue yellow. Ruqing You Zaijing's "Jin Kui Wings" "De-energetic strain, yellow face can eat, weak limbs, called de-strength yellow".
Qing Zhao Zhuquan's "Medical Supplement" refers to yellow fat disease as true yellow disease, and the proposed "white fingernails and jumping heart" is of great significance for diagnosing insect accumulation.
Etiology
The etiology and pathogenesis of yellow fat disease can be mainly summarized into three categories: spleen and stomach deficiency, dietary sputum and stagnation, and insect and internal injury, which are discussed from the following points.
The etiology and pathogenesis of yellow fat disease are more comprehensively discussed in the "Medical Supplement", see "The stomach is accommodated, the spleen is digested, and it lives in the human body; It is a yellow color of the earth, steaming rotten water valley, respectively clear turbidity and rise and fall, to vitality and blood, help the spirit. An abnormality, that is, easy to get sick, the body is weak and the body is yellow, if the eyes are not yellow, it is not jaundice, but the spleen is deficient, and the soil is cured."
Another example is "The Source of Miscellaneous Diseases, Rhinoceros Candles, Zhu Zhu Yuanliu", "Forced people are injured by hard work, and they also become yellow fat diseases". Therefore, yellow fat disease is also called decompression yellow. "Quasi-Evidence Treatment" also said that "labor injuries also become yellow fat, can eat easily hungry, tired and weak, commonly known as de-strength yellow".
It can be seen that the spleen and stomach are the foundation of the day after tomorrow, and the spleen and stomach deficiency causes serious injuries to the qi, which can cause yellow fat, and at the same time, overwork damages the spleen and stomach, and yellow fat disease can also occur. The reason is that engaging in physical labor hurts qi and blood, and then damages the spleen and stomach.
And easy to occur de-strain injuries are more common in farmers, so de-li huang is also known as peasant xantis disease, such as Dai Yuanli "peasant xantis disease, because of full work, temper is not comfortable".
Before the Song Dynasty, yellow obesity was mostly scattered in medical literature as individual symptoms, or classified as yellow disease and other debilitating diseases, without forming a complete disease system.
By the time of the Song and Jinyuan dynasties, although yellow fat was still classified as a boil, most doctors had recognized the difference between the two diseases, and summarized their causes as labor, food accumulation, and chancre accumulation, and the "Health Baojian" listed it as a separate article.
During the Ming and Qing dynasties, doctors had a deeper understanding of yellow obesity, put forward important pathogenic factors such as insect accumulation and demobilization, and pointed out that the incidence of yellow obesity had a professional tendency, so it was called peasant yellow swelling disease.
Ming Sun Wenyin made a clear distinction between yellow fat and jaundice in "The Dantai Jade Case".
By combing through the discussion of the etiology, pathogenesis and treatment of yellow obesity by previous generations of doctors, it can be found that its etiology and pathogenesis are mainly three aspects: spleen and stomach deficiency, sputum and food stagnation, and insect accumulation and internal disturbance.
The treatment method is mainly based on internal treatment, which is based on regulating the spleen and stomach qi and blood and killing insects and accumulation. It has reference significance for the clinical treatment of today's qi and blood deficiency, hookworm disease, and spleen and stomach deficiency diseases.
In addition, the method of medicinal cake patch in the external treatment method should be used dialectically, sulfur and croton are both hot products, combined with light powder to remove water and accumulate, mostly used to treat edema, swelling severe disease or stagnant diet into empirical yellow swollen disease.