The Yellow Emperor's Inner Classic (hereinafter referred to as the Inner Classic) discusses a wide range of meanings. As far as paralysis is concerned, it refers to the general term for a type of disease that causes the meridians, skin, blood veins, muscles and bones, and blood to run poorly, and even from shallow to deep, involving the occlusion of qi and blood in the internal organs, and the functional disorders such as limb pain, numbness and heaviness, and limited activity. In addition to two monographs on "paralysis", there are more than 40 chapters in the "Neijing", and there are more than 50 kinds of disease evidence in the name of "paralysis", which shows the importance it attaches to this disease.
<h1 class= "pgc-h-center-line" > the meaning of "paralysis" in the Neijing</h1>
Looking at the paralysis discussed in the Inner Classics, there are four connotations:
One is the general term for the illness in the yin, such as "the sick in the yin is paralyzed" ("Lingshu Shou Yao Gang Rou");
The second is to refer specifically to the occlusive disease mechanism, such as "one yin and one yang knot, for the throat paralysis" ("Su Qing Yin and Yang Farewell Theory"), and "eating paralysis and vomiting" ("Su Qing • True to the Great Theory"), the "paralysis" here is the meaning of the disease mechanism. Zhang Jiebin believes that "it refers to the meaning of occlusion" ("Class Classic, Volume XVII: Disease Class");
The third refers to stubborn symptoms, such as "paralysis ... The One Who Is Not Painful and Unkind" (Su Qing Paralysis);
The fourth refers to gout history disease, that is, rheumatism and joint muscle diseases.
This is exactly what Danbo Yuanjian called "the four meanings of paralysis in the Sutras: there is a general term for illness in yin; there is a paralysis of 'paralysis', and Wang (Wang Bing) zhuyun '㿏 paralysis' is also; there is a sense of gout and calendar, such as paralysis, pain paralysis, and paralysis in this article" (Su Qing Zhi Zhi, Vol. 5). In short, the meaning of paralysis is not far from the meaning of closedness and incomprehensibility, and it should be studied in detail when witnessing.
<h1 class="pgc-h-center-line" > mechanism of "paralysis"</h1>
For example, if we want to fully understand the mechanism of "paralysis" discussed in the "Neijing", we must use the reading method of "vertical and horizontal connection" and integrate the relevant articles in it, so as to have a deep understanding and identification of the pathogenesis of this disease. If you combine the theory of "Lingshu Thief Wind" with "the three qi of wind and cold and wetness, they are combined into paralysis." The winner of the wind is paralysis, the winner of the cold is the pain, and the winner of the moisture is paralysis... After combining the analysis of the original texts such as those who meet this in winter as bone paralysis, those who meet this in spring as muscle paralysis, those who meet this in summer as those who encounter this as muscle paralysis, and those who meet this in autumn as skin paralysis" ("Su Qing And Paralysis Theory"), and the discussion of "wind and cold and moisture, between the external flesh, urgent and foam, foam and cold gathering, gathering to divide the flesh and split also, splitting (squeezing) is painful" ("Lingshu Zhou Palsy"), it is not difficult to find that the occurrence of paralysis discussed in the "Inner Classic" is a person who has both external feelings and internal injuries. There is a compound pathogenesis with many factors superimposed.
The prime body has the "old evil" hidden
The "Inner Classic" believes that the patient's body has the "old evil" hidden in the body, which is the internal basis for infection and paralysis. According to the connotation of the original text, there are 6 categories of "old evil".
01 Physical factors
Although people have different physique types such as "just soft, weak and strong, short and long, yin and yang", in clinical pathogenology, some people are prone to "wind" diseases of "disease in yang"; some people are prone to "paralysis" diseases of "disease in yin") ("Lingshu Thief Wind"). Even if you suffer from "paralysis" at the same time, you can also have different types of clinical manifestations such as "pain, or pain, or no pain, or unkindness, or cold, or hot, or dry, or wet" and other different types of clinical manifestations of "paralysis", this is because, "less yang, more yin, and the disease benefits, so the cold is also." Those who are hot have more yang qi, less yin qi, sick qi wins, and yang suffers from yin, so it is paralysis. Those who sweat a lot and are wet, less yang, yin qi, two qi sense, so sweat out and wet also" ("Su Qing Paralysis Theory"). Therefore, the constitution of people's innate endowments has important and non-negligible factors for whether they suffer from the disease and the type of manifestation after the disease.
02 Adverse environmental factors
The living environment of human beings has a great impact on the health of the body, if the living environment is harsh, cold and humid, it will also become a potential factor for "paralysis" to be infected with wind, cold and wet evil. For example, "Something hurts the moisture, hides in the blood veins, divides the flesh, stays for a long time and does not go ... Then it is cold paralysis" ("Lingshu Thief Wind"), which emphasizes bad environmental factors, and can also be called another potential factor in the occurrence of this disease.
03 Seasonal climatic factors
If the living environment is harsh and the human body is difficult to adapt to the climate change of "cold and temperature from time to time" ("Lingshu Thief Wind"), it is also known as the potential cause of the disease, so there is a theory that "the paralysis, each of them feels the cold and humidity of the wind and humidity at the same time" ("Su Qing , Paralysis"). Clinical epidemiology has found that in cold and humid climates, the probability of such diseases is significantly higher than in other regions, and the disease is relatively severe.
04 Emotional factors
If there is "moodiness ... The underlying cause of the closed and incomprehensible reason is that "in the case of wind and cold, the blood condenses, and when it attacks the evil, it is cold" ("Lingshu Thief Wind"). It can be seen that if the ordinary people are not in good spirits and depressed, they will inevitably cause the "old evil" of stagnation and blood stasis to hide, and when the "wind, cold and damp" paralysis and evil invade, the evil of the "new old" is superimposed, and the occurrence of this disease is often inevitable. Moreover, the injury of emotions is still aggravated, spreading and spreading, so that the internal organs are affected, and it evolves into an important factor of "five visceral paralysis", such as "yin qi, quiet is hidden, and mania is dead" ("Su Qing Paralysis"), the original text is an expression of the internal mechanism of the occurrence of five visceral paralysis.
05 Dietary factors
The "Neijing" believes that the "eating discomfort" and other factors caused by hiding in the body, and then with the "wind cold and wet" caused by the evil of paralysis, it will lead to the "blood gas condensation" of the human body, and the cold paralysis will occur. In particular, the evil that causes paralysis is "the guest of the six intestines" and the evidence of the six intestines is even more so, so there is "this is also its place of food and drink, and it is also the root of its disease." The six intestines also have their own Yu, and in the wind and cold and humidity, they should eat and drink, follow the Yu, and give up their intestines" (Su Qing Paralysis).
06 Traumatic factors
After any trauma, it can leave different degrees of qi and blood stasis in the body, although there are no obvious sequelae or related symptoms, but it may become a hidden factor for paralysis, such as "If there is a fall, the evil blood is inside and does not go... In the case of wind and cold, the flesh and qi condense, and when they attack the evil, they are cold" ("Lingshu Thief Wind"). For example, one of the causes of knee arthritis today is trauma, which corresponds to the scriptures.
All of the above factors, the "Inner Classics" refer to it as "old evil", or make people "qi and blood coagulate", or make people "camp guard disorder", these are all potential factors for paralysis, once they are superimposed with the new sense of "wind and cold and wet qi" of the human body, paralysis will occur. This is what the Lingshu Thief Wind says: "Something hurts the moisture, hides in the blood vein, divides the flesh, stays for a long time and does not go; if there is a fall, the evil blood does not go; the pawn is moody, the diet is uncomfortable, the cold and temperature are from time to time, and the heart is closed and not clear." When it is opened and the wind is cold, the blood and qi condense, and when it attacks the evil, it is cold. If it is hot, it sweats, and when it sweats, it is affected by the wind, although it does not encounter the evil qi of the thief's wind, it will have the full connotation of "because of the addition"
<h1 class = "pgc-h-center-line" > the human body's new sense of cold and damp evil</h1>
"The wind and cold and wet are mixed, and the combination is paralyzed" "The spirit of Rongwei is also paralyzing... If it does not merge with the wind and cold and humidity, it is not paralyzed" ("Su Qing , Paralysis"). The original text believes that the camp guard abnormality is an important pathogenesis of paralysis. Only the cold and damp evil qi can become paralysis when it encounters the camp guard disorder disease machine, affirming that the camp guard disorder is an important mechanism for paralyzing evil to hurt people and causing paralysis, of which "the spirit of the rongwei is also paralyzing" and "the disease against its qi" affirms that the camp guard disorder and the new sense of wind and cold and wet evil are superimposed on each other, which is an important mechanism for the occurrence of paralysis. The mechanism of causing the camp guard disorder or the potential paralysis mechanism of qi and blood coagulation is nothing more than the above reasons, which is also the mechanism of paralysis.
In summary, the core mechanism of the occurrence of paralysis discussed in the Neijing is "the inheritance of new and old" and "the occurrence of addition". The external feeling of wind and cold and wet evil and the evil of the inner hidden "old evil", resulting in the body's qi and blood paralysis, camp guard disorder, meridian blockage, and the occurrence of paralysis. Emotions hurt the intestines, and evil spreads within, forming the "five viscera paralysis"; eating and drinking, the stomach and intestines are damaged, and the evil qi is transmitted internally, forming the "six internal organ paralysis".
<h1 class="pgc-h-center-line" > clinical differentiation and classification of paralysis</h1>
According to the relevant original text of the "Neijing", the clinical identification of "paralysis" should focus on the main clinical symptoms, and on the basis of the analysis of the main symptoms, the identification and classification should be made. Synthesizing all the original texts of the paralysis discussed, the original text has the following 3 categories of this evidence.
Etiology classification
The etiological classification of paralysis is to carry out clinical identification and classification method according to the proportion of wind, cold, wet and evil. For example, because "its wind is victorious", "moisture is victorious", "cold is victorious", that is, when infected with "wind and cold and wet three qi mixed to" and it is paralyzed, when the proportion of wind, cold, and wet evil is relatively large, the diseases suffered are named as the classification of wind paralysis, cold paralysis, and wet paralysis, which can be found in the "Su Qing Paralysis Theory" and "Lingshu Zhi Jing" and so on.
Classification of pathogens
The pathogenic classification of paralysis is a classification method for clinical identification according to the cold and heat properties of the paralysis. The type of constitution of the patient often affects the nature of the lesion, such as "less yang, more yin, and the benefit of the disease, so the cold also ... There is more yang, less yin, sick qi wins, and yang suffers from yin, so it is paralysis" ("Su Qing Paralysis Theory"). The classification of the cold and heat attributes of paralysis has multiple roles, and can also be attributed to the etiological classification or symptom classification.
Symptom classification
The classification of symptoms of paralysis is a classification method for clinical identification according to the characteristics of the clinical symptoms of paralysis. For example, "Xingqing", "Painful Paralysis", "Shu Paralysis", "Zhou Paralysis", "Zhongzhuo", etc., are found in "Su Qing Paralysis", "Lingshu Zhou Paralysis" and so on.
< h1 class= "pgc-h-center-line" > site classification</h1>
The classification of the site of paralysis is a classification method for clinical identification according to the specific location of the paralysis. Under this concept of classification and identification, the Neijing divides paralysis into three types.
01 Pentasomythia
The five bodies refer to the five levels of skin, flesh, tendons, veins and bones at the cross-section of the human body, which belong to the five organs of the lungs, spleen, liver, heart and kidneys under the overall concept, which is the so-called "five organs and five bodies" theory. When the evil of paralysis injures different levels of the body at different times and causes paralysis in the corresponding parts of the body, it will suffer from the paralysis of the skin, muscle paralysis, tendon paralysis, pulse paralysis, and bone paralysis of the corresponding clinical symptoms ("Su Qing Paralysis").
02 Visceral paralysis
If the five body paralysis persists for a long time, and then feels paralysis and evil again at the time of the corresponding main qi of the five viscera, and then there is a potential factor of "old evil" that hurts the internal organs first, it will cause the paralysis of the five bodies to pass on the visceral paralysis that is compatible with it and form a related visceral paralysis, such as "bone paralysis is endless, compound in evil, and renounce in the kidneys" is an example of kidney paralysis. This is the result of "those who have been sick for a long time, the inner body is combined", and it is also determined by the interconnection of the five internal organs and the five bodies, and the five bodies are combined with the five internal organs ("Su Qing Paralysis"). Others such as pulmonary paralysis, heart paralysis, spleen paralysis, and liver paralysis are all the same.
03 Six intestines paralysis
"The stomach, the large intestine, the small intestine, the trifocal, the bladder... The House of Transmission" ("Su Qing, Five Visceral Treatise"), in charge of the digestion of diet. If there is a hidden "old evil" in the body that is damaged by eating disorders and gastrointestinal function, and then there is a paralysis infection of "wind and cold and wet three qi mixed to", then the evil qi will be transmitted along the meridians of the six intestines to the place where the "old evil" is hidden and suffer from related paralysis. This is the meaning of the so-called "six intestines also have their own Yu, and in the wind and cold and humidity, they should eat and drink, follow The Yu, and give up their own intestines" ("Su Qing Paralysis Theory").
In summary, it is the thinking path of differentiating and classifying according to the patient's clinical symptoms, combined with the additive performance, and then treated separately.
< h1 class= "pgc-h-center-line" > prognostic evaluation of paralysis</h1>
Paralysis is a compound lesion in which the external sensation is superimposed with the internal injury, so it is necessary to evaluate its prognosis from multiple angles. As far as the purpose of the Neijing is concerned, the first is the prognosis trend: the original text of "all paralysis is endless, but also beneficial to the inside", indicating that the development of limb paralysis can cause aggravation of the disease and cause visceral paralysis. Second, the difference in the proportion of partial victory of complex comprehensive causes will also affect its prognosis, such as "the winner of the wind, its person is easy to have", because the wind is yang and evil, its nature is clear, so the clinical treatment is easy to eliminate and make it healed; the scripture implies here, if the cold and wet are the evil of yin, with stickiness, absorption, injury, and heavy turbidity, it is difficult to eliminate clinical medication, so the evil of cold and wet is often lingering, long-lasting, repeated, and difficult to heal. Third, the disease position affects the prognosis: it is believed that "those who leave the skin are easy to have", indicating that those with superficial disease positions are easy to heal; "those who stay between the muscles and bones are painful for a long time", indicating that the disease position is deep, the disease is lingering and long-lasting; "the death of the person who enters the organs" suggests visceral paralysis, which is difficult to treat, and the prognosis is poor. Fourth, the patient's physique affects the prognosis: if the young and middle-aged patients are vigorous, their yang qi is exuberant, and the paralysis is easy to treat; if the elderly are weak, the yang qi is insufficient, and the paralysis is long-lasting and difficult to treat.
<h1 class = "pgc-h-center-line" > the diagnosis and treatment of paralysis</h1>
Qin Jingming of the Ming Dynasty was a member of the clinical diagnosis and treatment of paralysis in traditional Chinese medicine, and his clinical treatment experience of this disease was found in the "Cause and Pulse Treatment". For the treatment of external sensory paralysis, according to the "Inner Classic" to reduce the treatment experience of each family, it is believed that those who perform paralysis and wind paralysis use windproof soup, and blood scattered pain soup and other prescription medicines; those with pain paralysis and cold paralysis should use ten flavor Qianghuo soup and other formulas; those who are wet and paralyzed can be treated with Qianghuo dehumidification soup; those who are hot paralysis, use four-flavor relaxation soup, tiger diving pills, etc.; later generations will be paralyzed and have bone node deformation, called paralysis, and then according to the three stages of the initial onset of illness, prolongation, and late disease, to supplement the kidneys to dispel cold and cure the soup (Chuan Break, Bone Fat, Obscene Sheep Worm, Du Huo, Gui Zhi, and Preparation of Attachments , White Peony Ox knee, Cang Shu, Welling Immortal, Bone Fragment Supplement, Zhimu, Windproof, Stretching Grass, Cooked Ground, Ephedra, Pine Knot, Burning Mountain Beetle, Natural Copper, Bone Seeking Wind) as the basic formula, respectively, will be cut and used.
Qin Jingming collectively referred to visceral paralysis as "internal wound paralysis", which is not only in line with the purpose of the "Neijing" on paralysis, but also in line with the mechanism of visceral paralysis. According to the clinical pulse of pulmonary paralysis, equivalent to COPD, selenium lung, pulmonary fibrosis lesions, etc., he used diarrhea white powder, ginseng flat lung dispersion cut; heart paralysis including rheumatic valvular disease, cardiomyopathy, coronary heart disease and other cardiac dysfunction diseases, commonly used to guide chi ge half soup, Tianwang tonic heart Dan and other treatment; liver palsy including chronic hepatitis liver function damage, liver fibrosis, cirrhosis, etc., with diarrhea pills, liver powder and other prescription drugs treatment; kidney paralysis including chronic kidney function damage, etc., with river car sealing myelin, home secret kidney pills treatment Spleen paralysis is equivalent to chronic dyspepsia, with five flavors of heterogeneous dispersion, citrus pills and other treatment; intestinal paralysis is equivalent to chronic colitis, intestinal polyps, intestinal repulsions, stress enteritis, postoperative syndrome of bowel cancer, etc., with Zhimu gypsum soup, green skin drink and other prescription drugs treatment; cell (bladder) paralysis is equivalent to cystitis, chronic urinary tract infection, urinary system postoperative syndrome, etc., with Eight Positive Scatter, Lotus Seed Pure Heart Drink, etc.
In summary, the "paralysis" discussed in the Inner Classics is rich in meaning. The medical evidence involved covers a wide range. As far as its pathogenesis is concerned, it is caused by the comprehensive mechanism of multi-factor superposition, so clinical dialectical treatment should broaden the thinking and follow the clinical characteristics of patients and flexibly identify and treat like clinical medical scientists such as Qin Jingming.
Wen | Zhang Dengben of Shaanxi University of Traditional Chinese Medicine
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