|NEWS AND VIEWS
|Year : 2020 | Volume
| Issue : 2 | Page : 111-114
Appreciation of one prescription by Jin Zijiu (金子久)
Shanghai Museum of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
|Date of Submission||18-Mar-2020|
|Date of Acceptance||10-May-2020|
|Date of Web Publication||29-Jun-2020|
Prof. Lin Yu
Shanghai Museum of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai
Source of Support: None, Conflict of Interest: None
Jin Zijiu (金子久), taught by his father Jin Zhishi (金芝石), is a famous doctor in the late Qing Dynasty and the early Republican period (1840–1928). With remarkable medical skills and high medical ethics, Jin Zijiu has lots of students and is especially good at treating warm diseases. By analyzing one prescription of Jin Zijiu preserved in Shanghai Museum of Traditional Chinese Medicine (上海中医药博物馆), this article explains his academic thought and clinical experience and shows his superb literary and artistic accomplishment.
Keywords: Academic thought, Jin Zijiu (金子久), Chinese medicine, medical record, literature research, Shanghai Museum of Traditional Chinese Medicine (上海中医药博物馆), prescription
|How to cite this article:|
Yu L. Appreciation of one prescription by Jin Zijiu (金子久). Chin Med Cult 2020;3:111-4
| Brief Introduction to Jin Zijiu and His Main Academic Thoughts|| |
Jin Zijiu (1870–1921) is a famous doctor in the late Qing Dynasty and the early Republican period (1840–1928), whose another first name is Youheng. His ancestral home is in Hangzhou, Zhejiang Province. Later, he moved to Dama in Deqing County, Zhejiang Province (now in Dama Town, Tongxiang City, Zhejiang Province). Therefore, the later generations often called him Dama Jin Zijiu. Since the Southern Song Dynasty (1127–1279), the Jin family had been practicing medicine for generations. Jin Zijiu is intelligent and diligent and had learned medicine from his father Jin Zhishi since childhood. When he was 16 years old, he was able to practice medicine in the countryside. When he was 20, his parents passed away one after another. To overcome the loss and pain, he worked harder than before. After several years, he was famous for his accurate syndrome differentiation and remarkable curative effect. In 1915, Jin Zijiu provided medical service for patients regularly in Hunan Charity located in Dongjiadu of Shanghai, regardless of their identity. For orphans and widows, he gave them free treatment and subsidized medical expenses until the patients recover. In his later years, Jin Zijiu provided medical service in “Wensong Hall” in his hometown Dama, which was crowded with patients and visitors. His remarkable medical skills and high medical ethics attracted more than 150 people to learn medicine from him. His students and inheritors were mainly in Jiangsu, Zhejiang, Shanghai, Anhui, Hubei, Guangdong, and other places. He taught the students that “it is the duty of doctors to treat patients, which should not be constrained by place and time. If there is a patient in need, doctors should go to make diagnosis and give treatment. Don't ask other things before the treatment finished.” “As a doctor, we should study hard and be good at thinking, instead of being limited to certain theories or methods or ridiculing your peers. If we have more experience now, we will have less mistakes in future.” These words give a glimpse of his attitude to being a doctor [Figure 1].,
Jin Zijiu devoted his whole life to clinical diagnosis and treatment and had no time to write many books. Only three books were handed down: Jin Zijiu Yi An (《金子久医案》The Medical Records of Jin Zijiu), He Huan Yi Feng (《和缓遗风》Being like He and Huan), and Wensong Tang Yi An (《问松堂医案》The Medical Records in Wensong Hall). There are four volumes in The Medical Records of Jin Zijiu (separate edition). Being like He and Huan was recorded in San San Yi Shu (《三三医书》Double Three and Three Medical Collection) by Qiu Qingyuan. In 1923, The Medical Records in Wensong Hall was published in the Journal of Traditional Chinese Medicine issued in Shanghai. A large number of medical records and prescriptions of Jin Zijiu are still in existence, which are well deserved to be studied and appreciated by later generations. By sorting out and generalizing his medical records, predecessors summarized the academic thoughts and clinical experience of Jin Zijiu: (1) attaching importance to yin-yang theory and five-phase theory, and guiding the syndrome differentiation and treatment with the two theories in clinic; (2) paying attention to the concept of holism, seeking for the unity of the heaven and humanity, and giving prescription according to the conditions of patients, time, and place; (3) taking a comprehensive analysis of four examinations in the diagnosis and treatment of diseases, especially the pulse condition; (4) making good use of zang-fu theory, especially focusing on the physiological functions of the kidney (the root of innate endowment) and spleen (the root of acquired endowment), and emphasizing the academic thought of nursing the innate endowment and acquired endowment; (5) paying attention to the ascent and descent of qi movement and taking flexible methods in clinical treatment; and (6) having a preference for the materia medica with clear property and ancient prescription in the treatment, attaching importance to the processing of materia medica, and absorbing folk prescriptions and empirical prescriptions [Figure 2], [Figure 3], [Figure 4], [Figure 5].
|Figure 4: San San Yi Shu (《三三医书》Double Three and Three Medical Collection)|
Click here to view
| One Prescription by Jin Zijiu|| |
Many prescriptions by Jin Zijiu are handed down. This article selects one of them collected by Shanghai Museum of Traditional Chinese Medicine for appreciation:
By diagnosis, the pulse is wiry, slippery, and feeble. A wiry pulse implies the excess of liver qi, and slippery pulse indicates phlegm. As for the tongue texture, there are slight stasis in the tongue, white and scanty coating in the root of the tongue, and peeled coating in the front part. The liver pertains to wood, which is characterized by resolution. If there is no water to moisten the liver, it will be dry, which will result in eye problems like blurred vision. In addition, pathogenic wind-dampness invades the liver meridian result in limb soreness. Wood pathogen counter-restricting metal leads to cough with choking, and the downward flow of dampness results in red urine. It can be treated by subduing liver yang, dispelling wind, and draining dampness.
Raw Shi Jue Ming (石决明 Concha Haliotidis) 50g, Bai Xing Ren (白杏仁 Armeniacae Semen Amarum) 9.38g, Zuo Qin Jiao (左秦艽 Radix Gentianae Macrophyllae) 6.25g, Ming Tian Ma (明天麻 Rhizoma Gastrodiae) 4.69g (stir-bake with adjuvant), Xian Ban Xia (仙半夏 Rhizoma Pinelliae) 4.69g, Si Gua Luo (丝瓜络 Retinervus Luffae Fructus) 9.38g, Fen Dan Pi (粉丹皮 Moutan Cortex) 4.69g, Fried Zhu Ru (竹茹 Caulis Bambusae in Taenia) 6.25g, Fried Chu Ju (滁菊 Chrysanthemi Flos) 4.69g, Yun Fu Ling (云茯苓 Poria) 12.5g, Sang Ya (桑芽 Fructus Mori Germinatus) 15.63g, etc.
At the bottom left corner, there is a seal with the words “collected in Shanghai Museum of Traditional Chinese Medicine” [Figure 6].
In the case, the patient has the following symptoms: blurred vision, cough with choking, red urine, sour limbs, slight stasis in the tongue, white and slimy fur in the root of tongue and peeling fur in the front part, and string-like, slippery and feeble pulse. In Linzheng Zhinan Yi'an “Gan Feng” (《临证指南医案·肝风》Case Records as a Guide to Clinical Practice “Liver Wind”), there is the record that “liver is a viscus of wind and wood and there is ministerial fire attached. It is yin in property and yang in function. In addition, liver is a resolute zang organ and governs movement and rise. It depends on kidney to nourish and blood to moisten.” Jin points out that “In five elements, fire restrains metal. Lung pertains to metal and metal engenders water. Therefore, if the lung disease lasts for a long time, the kidney will be affected. If the kidney-water is not sufficient, the liver-wood will not be nourished, and then the kidney-fire is easy to ascend and the ministerial fire attached to the liver will be predominant, which is the source of lung injury, and also the germination of depletion syndrome.” For this patient, as liver-wood cannot be nourished and the ministerial fire attached to the liver ascends to torment lung-metal, there is the symptom of cough with choking. That is, “wood restricts metal to sound.” Moreover, as liver opens at the eyes and liver fire flames upward, there is the symptom of blurred vision. In addition, pathogenic wind-dampness invades the vessels and collaterals. The syndrome of stasis obstructing the vessels and collaterals is manifested as having an ache in limbs. The stasis in the tongue indicates blood stasis. A wiry pulse implies the excess of liver qi, and over time, the stagnant qi will transform into fire. A slippery pulse indicates internal phlegm-dampness and dampness-heat complex, which flow downward to the bladder and then result in red urine. A white and scanty coating in the root of the tongue and peeling fur in the front part show that the phlegm-dampness has not been resolved and there is the damage of qi and yin in the stomach, which suggest that the patient has a long duration of disease. By comprehensive analysis of four examinations, it can be diagnosed as the pattern of ascendant hyperactivity of liver yang and wind-phlegm and dampness obstruction, which can be treated by pacifying liver, subduing yang, dispelling wind, and draining dampness. In this prescription, Tian Ma (天麻 Rhizoma Gastrodiae) act on liver meridian. Tian Ma has the function of repressing and pacifying liver yang. The combination of Tian Ma, Ban Xia (半夏 Rhizoma Pinelliae) and Fu Ling (茯苓 Poria) can dispel wind-phlegm. The combination of Tian Ma, Qin Jiao (秦艽 Radix Gentianae Macrophyllae) and Si Gua Luo (丝瓜络 Retinervus Luffae Fructus) can relieve the discomfort in joints caused by wind-dampness. The dosage of Si Gua Luo should be large. Shi Jue Ming （石决明 Concha Haliotidis） can clear away fire and soften wood. The combination of Shi Jue Ming and Chao Chu Ju (炒滁菊 Chrysanthemi Flos) can clear the liver and improve vision. In addition, Chao Chu Ju has the function of repressing and pacifying liver yang. Xian Ban Xia (仙半夏 Rhizoma Pinelliae) can regulate qi and resolve phlegm, which is the main herbal medicine for dampness-phlegm syndrome. The combination of Xian Ban Xia and Fu Ling (茯苓 Poria) is effective for cough with choking. The combination of Xian Ban Xia and Bai Xing Ren (白杏仁 Armeniacae Semen Amarum) can warm and resolve cold-phlegm. Moreover, the combination of Xian Ban Xia and Chao Zhu Ru (炒竹茹 Caulis Bambusae in Taenia) has the function of clearing and resolving heat phlegm. It can be inferred that the patient's syndrome of having phlegm is caused by cold-heat complex. Fu Ling (茯苓 Poria) has the function of inducing diuresis to drain dampness and fortifying the spleen to tranquilize, which is effective for treating the syndrome of water-dampness retention. Bai Xing Ren (白杏仁 Armeniacae Semen Amarum), together with Sang Ya (桑芽 Fructus Mori Germinatus) can relieve the cough caused by wood-fire tormenting metal. Fen Dan Pi (粉丹皮 Moutan Cortex) has the function of clearing heat, cooling blood, activating blood, and dissipating stasis, which is effective for relieving the stasis and obstruction of vessel and collaterals.
This case embodies Jin Zijiu's medical thoughts of using the interaction among five elements (engendering, restraining, overwhelming, rebellion) to guide syndrome differentiation, as well as attaching importance to meridian entry and taking flexible methods in clinical practice. From this prescription, we can see that Jin not only has profound medical attainments but also has deep knowledge of literature. The medical cases were written in cursive style and freely flowing style, which is pleasant to eyes. Moreover, the comments were written in the pattern of parallel prose, which makes it easy to be read. Qin Bowei once gave a comment that “with profound knowledge, he is a quite well-known doctor. His comments were generally written in the pattern of parallel prose with thousands of words, which was unique in that time”.
Translator: Lin Su (苏琳)
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Conflicts of interest
There are no conflict of interest.
| References|| |
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]