Zhang Xiangyun (1855 ~ 1925), male, Han nationality, from Shanghai. Born in a famous Zhang family in Shanghai. Since Zhang Jun, the fourteenth ancestor of Chongzhen in the Ming Dynasty, abandoned Confucianism to become a doctor, Zhang's family has been passed down from generation to generation. So far, he has a tradition of practicing medicine for more than 300 years, and most of the cases he treated are the so-called "total typhoid fever" in Su Wen Re Lun.
Chinese name: Zhang Xiangyun.
Nationality: China.
Ethnic group: Han nationality
Place of birth: Shanghai
Date of birth: 1855
Date of death: 1925
Occupation: doctor
Main achievements: advocating "treating typhoid fever, warming in one furnace"
Representative works: essays on doctors' diagnosis.
outline
Basic information
Zhang Xiangyun (1855 ~ 1925), also known as the bodyguard of the world, whose real name was Xiang Jun, was a curling native in his later years, and was famous for his good treatment of typhoid fever in Shanghai.
family status
Zhang was born in a doctor's family. At the end of Chongzhen in the Ming Dynasty, Zhang Jun, the fourteenth ancestor, abandoned the imperial examination and lived in seclusion. Zhang Wu, the sixth ancestor, is now practicing medicine in Shanghai county with his son, and his father Zhang Yushu is even more famous. Zhang's father died when he was 13 years old. He learned typhoid fever from his eldest brother Zhang Xiaoyun, internal injuries and miscellaneous diseases from his third brother Wei Yun, and assisted Xiaoyun clinic. Later, he opened his own clinic and worked as a doctor in a refugee shelter and a nursery school. Because of excellent medical skills and good treatment, patients are busy and have no time. Zhang is good at observing the patient's pulse, consciousness, tongue coating, macula, cold and heat, using drugs flexibly and carefully, and treating according to syndrome differentiation. For patients with persistent high fever, mental disorder, grayish yellow and rough tongue coating or burnt and rough tongue coating, a few patches are often applied to make the tongue coating dissipate heat and relieve the illness, which is called "one patch medicine". Middle-aged people are seriously ill and deaf in both ears. They rely on "loudspeakers" for hearing, so they are called "Zhang deaf?" More and more famous.
medical ethics
The patient believes in Zhang's medical skills and especially respects his medical ethics. Zhang Chang takes the belief that "medical treatment is to save people, not to do business" and "medical treatment does not distinguish between rich and poor, but only seeks solid treatment", and treats patients regardless of wealth. Often give poor patients free medical treatment. Zhang Bingxing is honest, frank and not snobbish. In the thirty-third year of Guangxu (1907), Hatong built Ai Liyuan on Yongquan Road (now Nanjing West Road), and five ancestors of Zhang were in the garden. Relying on the influence of foreigners, Hatton coerced and forced to buy a cemetery. He fought for more than ten years without fear of power and refused sternly, and finally won. Sheng Xuanhuai hired Zhang as the president of China Medical College. He lived among civilians as a doctor all his life and was praised by the world. He is the author of the manuscript "Notes on Doctor's Diagnosis", and his descendants who practice medicine often call him "Little Deaf?" .
Personal experience
Since Zhang Jun, the fourteenth ancestor of Chongzhen in the Ming Dynasty, abandoned Confucianism to become a doctor, Zhang's family has been passed down from generation to generation. So far, he has a tradition of practicing medicine for more than 300 years, and most of the cases he treated are the so-called "total typhoid fever" in Su Wen Re Lun. During this period, there were seven generations of eleven people with superb medical skills and noble medical ethics, and Zhang Xiangyun's academic thought was the representative of Zhang Medicine. Xiang Yungong is deaf in middle age, with superb medical skills, unpaid diagnosis and willing to serve the working people. Therefore, he has an excellent relationship with the masses and a high degree of credit. He is known as Zhang Longpeng and is known as "a post of Zhangjia Medicine". Until now, he still keeps talking about things and praising him endlessly. Zhang's descendants are all contemporary famous doctors.
Cultural relics donation
On June 22nd, 2005, 65438+20051October 22nd, a commendation meeting for Zhang Xiangyun's family's cultural relics donation was held in Libo. Thanks to the joint efforts of our collectors and the descendants of the Zhang family, we have collected Zhang Xiangyun's prescriptions, prescriptions, invitations, old photos, used teapots, fans and medical books, as well as horizontal plaques in the Chinese Medicine Hall, ancestors of the Qing Dynasty, braids, porcelain statues, porcelain vases, letters, tributes, fans and various plaques handed down by the Zhang family in the Republic of China. Genealogy and genealogy of Zhang family in Longhua: 80 volumes.
Since the Southern Song Dynasty Tieyi Palace took root in Longhua, the Zhang family has lived in Shanghai for 27 generations. At the end of Chongzhen in the Ming Dynasty, Shizu Zhang abandoned Confucianism to become a doctor, which was passed down from generation to generation, and Zhang Cunjun and others reached the 12 generation. In the past 300 years, there have been many Zhang families and many famous doctors. During this period, his calligraphy skills of Gao Zuyu were particularly famous.
Zhang Xiangyun (1855 ~ 1925) is the youngest son of Yu. Zhang's medical skill has reached an unprecedented height in Zhang Xiangyun's generation, whether it is prestige or profound medical skill. Zhang Xiangyun studied the principle of typhoid fever and paid attention to syndrome differentiation and treatment. In practice, we can integrate the theories of various schools, reform and innovate, and form a unique Zhang school; Diagnosis and treatment of typhoid fever, with "Zhang deaf a post medicine" and famous in Jiangnan. In the 33rd year of Guangxu reign in Qing Dynasty, Hatton, a British Jew, built Ailiyuan Garden in Yongquanbang (now Shanghai Exhibition Hall). Zhang Xiangyun's fifth ancestor was in the garden, and Harbin relied on the influence of foreigners to coerce him into buying a cemetery. Zhang Xiangyun was not afraid of power, refused sternly, fought for more than ten years, and finally won, which was widely praised by Shanghai people.
Shanghai is a famous cultural city with a history of 6,000 years of civilization, and it is also a modern international metropolis famous at home and abroad. There are rich historical relics and modern objects on the ground and underground. Shanghai History Museum collects these cultural relics and articles, preserves them for a long time, and makes research and rational use of them. Later generations of the Zhang family donated their own documents and materials about the history of traditional Chinese medicine in Shanghai to the Shanghai History Museum, which undoubtedly enriched the collection of the history of traditional Chinese medicine in the museum and provided very valuable and useful materials for studying the historical development of Shanghai urban medicine.
Academic viewpoint
Traditionally, the typhoid school holds the view that cold is the standard heat, and pays attention to the pungent warmth of hemp, cinnamon, firewood and pueraria, while the warm school holds the view that heat is the standard cold, and pays attention to the pungent coolness of mulberry chrysanthemum and Yinqiao powder. The dispute between the two is not easy through the ages. Zhang inherited the theories and experiences of Zhang Zhongjing, Wu Youke and Ye et al. In the long-term clinical research, he realized that typhoid fever and febrile diseases come down in one continuous line, typhoid fever theory is the basis of febrile diseases theory, and the theory and experience of febrile diseases school are the development and supplement of the specific application of syndrome differentiation and treatment in Treatise on Febrile Diseases. It is considered that the dispute between typhoid and febrile diseases is unnecessary. As for the different sources of disease, the treatment should be different, which is not unreasonable; However, the transmission of typhoid, fever, cold and heat is often mixed, and it is difficult to draw an absolute line. Be sure to judge the situation and be flexible, and never use rubber columns and drums. Therefore, Zhang advocated that typhoid fever and febrile diseases should be combined into one furnace. It is believed that the heat of typhoid fever is nothing more than exogenous pathogenic factors and endogenous qi stagnation. Although the new sensation is divided into cold and heat, the invasion of exogenous pathogens is from the outside to the inside, and the treatment should only be superficial and scattered; Fu qi is caused by new sensation, and it should be treated thoroughly from the inside out. In addition to internal depression, the new sensation and outlet of stagnation of qi in Yangming official syndrome are all on the muscle surface, so "exterior" and "penetration" are the central links in the treatment of typhoid fever. New sensation should be "seen from the outside" and qi stagnation should be "seen from the inside" to promote its externalization. It is also found that the "appearance" and "transparency" of lobster sauce are good. Douchi soaked in ephedra is slightly bitter and slightly warm, bitter but not cold, warm but not dry. It is not only good at relieving exterior symptoms, but also good at penetrating, sweating does not hurt yin, and it can eliminate the disadvantages of boredom and coldness. It is an extremely difficult product to treat new feelings and stagnate.
Zhang advocated that the treatment of typhoid fever should focus on "exterior-interior" and "transparency", and the functions of "exterior-interior" and "transparency" of douchi should be based on syndrome differentiation and treatment, and different compatibility should be adopted at different stages to achieve the purpose of "exterior-interior" or "transparency". If evil is prevented, add or subtract onion and black bean soup. The south is humid, and there is no cold pathogen in the north, so it is not necessary to rely on the pungent warmth of hemp and Guangxi, because the defensive points are cold, which in turn contributes to the pathogenic heat; Mulberry silver should not be cold and pungent, and cold and pungent may curb evil and dampness. At this time, only the scallion is slightly spicy and slightly wet, just right. For patients with deficiency of both qi and yin, add and subtract Zhichi Decoction; If the pathogen enters camp or blood, it is added or subtracted from the black paste. Douchi is served on all three sides. Due to compatibility, the onion fermented soybean focuses on sweating and relieving exterior symptoms, and has the principle that leaves can also prevent sweating. The principle of clearing away heat, relieving exterior and interior, and swimming in the wild is the key to treating red. Black ointment focuses on nourishing yin and generating evil, and it also has the principle that "when you first enter the camp, you can still divide the qi, and when you enter the blood, you will still be afraid of consuming blood and moving blood, so you must cool the blood and disperse the blood". However, if the evil is not divided into heat, it will never be cleared to Gardenia lightly. When evil enters the camp or enters the blood, it will rob the body fluid, and it will never be lightly given to nourishing yin and promoting fluid production. When you enter a realm, you can change your method. Douchi's "exterior and interior" and "transparency" run through the whole course of disease, breaking the strict rules and regulations of the Wen School about prohibiting sweating.
Zhang believes that the treatment of internal injuries and miscellaneous diseases is based on strengthening the body resistance, so-called deficiency of essence and qi; The premise of the treatment of exogenous pathogens is to eliminate pathogens, so-called pathogens are abundant. The new feeling is hard to understand, and the latent qi is hard to cure. Saving yin and injuring yin, eliminating evil spirits, eliminating evil spirits and restoring body fluid when fever subsides, is the most difficult thing. Instead of raising carbuncle, there is no so-called wage mutation. The purpose of sweating is to eliminate pathogenic factors, and both "exterior" and "transparency" belong to the category of sweating. However, "table" is different from publication, explanation, nourishing yin and nourishing sweat. "Penetration" is different from being clear, moist, dry and wet, and opening up evil paths. It has opened up a broad treatment path for typhoid fever.
As for the specific application of sweating method, on the one hand, Zhang pays attention to mastering moderation, which is neither superficial nor superficial. He advocated taking advantage of the situation, mainly relaxing muscles and tendons, and adopting the method of slight sweating to guide evil spirits to avoid the change of hurting yin and robbing body fluid. The so-called evil goes to heat itself, and heat retreats body fluid. On the other hand, we should pay attention to the change of sweat source. Anyone who is burned by pathogenic heat, yin injury and body fluid injury should nourish yin and increase fluid, so as to nourish the body and eliminate pathogenic factors. Even the symptoms of yin deficiency and body fluid depletion, such as dry tongue, less urine, insomnia caused by heat, etc. , should be prevented. Clinical experience lies in nourishing yin without stagnation of pathogenic factors and eliminating pathogenic factors without injury.
Empirical prescription
Scallion and black bean soup
Onion and black bean soup > It is a slightly spicy and lukewarm medicine. Although scallion tastes pungent and warm, it is pungent and moist, warm but not dry. Douchi is steamed with black beans, and the bitter and cold taste has turned slightly warmer. Therefore, the combination of scallion and lobster sauce is slightly spicy and warm, sweating does not hurt yin, and there is no concern about cooling down. At the beginning of typhoid fever, if the pathogen lies in the Wei-fen, it is most appropriate to use it, that is, the syndrome of qi stagnation caused by new sensation can also promote the stagnation of pathogenic factors from the inside out, so as to get through it as soon as possible. Principle of addition and subtraction: Exogenous pathogens such as fever, headache and bone pain are added with Bupleurum and Radix Puerariae. For example, at the turn of spring and summer, whenever wind-temperature syndrome breaks out, cough is accompanied by adverse qi, and bilateral or unilateral hypochondriac pain is called hypochondriac typhoid fever. This kind of blood stasis stays in the collaterals of lung and liver, and the collaterals are stagnant, so it is not suitable to attack with strong drugs. Only the method of dredging collaterals, removing blood stasis and clearing heat can be used. In addition to onions and black beans, there are also drugs such as Guixu, Xinjiang and Inula. In order to promote qi and blood circulation and dredge meridians, it must be added.
Zhichi decoction
Gardenia black bean soup, the main virtual trouble. Zhang's treatment of typhoid fever has not stopped, and there is heat in the upper jiao diaphragm, which is equivalent to the stage of pathogenic heat exceeding the prevention of air intake. At this stage, Zhang does not advocate the sudden use or premature use of female cold coagulation prescriptions. He believes that Douchi still needs to penetrate deeply, relax muscles and relieve exterior, and Gardenia needs to clear diaphragmatic heat, so that it can have both exterior and interior. If the internal heat is serious, Scutellaria baicalensis Georgi and Forsythia suspensa are added, and cicada slough, Xihe willow or cherry pit are found to have a slight rash.
Black paste
Black ointment is also composed of Radix Rehmanniae, Douchi, Pig Fat, Realgar, Musk, etc. Mainly used for treating fever, toxin and spots. Zhang selected Rehmannia glutinosa and fermented soybean as raw materials, and mixed with products for cooling blood, dispersing blood, calming wind, clearing heat and resolving phlegm, which were used to treat diseases such as pathogenic heat entering the camp or entering blood, robbing true yin, delirious delirium, and disturbance of liver wind. The beauty lies in nourishing yin without depressing evil, and penetrating evil does not harm righteousness, which is the therapeutic application of implementing the principle of "penetrating exterior". The key to mastering this prescription in clinic is to distinguish whether pathogenic heat enters the camp or enters the blood. There are generally no symptoms of nutrition or blood. Don't throw it wave by wave, for fear that the yin in the unfamiliar place will be soft and greasy and the summer heat will stagnate. If the symptoms of nutrients or blood are obvious, you can use them freely without hesitation. On the basis of nourishing yin, this recipe has the effect of strengthening the body resistance and eliminating evil spirits by adding fermented soybean. The main indications for using black ointment are broad or rapid pulse, yellow and thick tongue coating, gray and thick, red edge, or brown and dark, dry and cracked, crimson. Generally, after taking medicine for two or three days, if the rough and greasy tongue coating is peeled off like a shell, it becomes bright crimson, the heat potential gradually decreases, and the consciousness gradually wakes up, which is a precursor to overcoming evil spirits and restoring vaginal fluid, and the prognosis is much better.
Zhang often describes the rough or dry tongue coating as "rice shovel stagnation". It takes real efforts to "shovel rice stagnation." You can't shovel before the time is up. If shoveled properly, the excess of evil, dampness, phlegm and heat will be removed, and the source of transformation will breed again. The key here is to mainly use Radix Rehmanniae and Douchi, but also use Huang Zhu and Danxing. Zhang believes that although the bile star is ready, it is still slightly bitter and warm. At this time, most of the visible dampness evil has been transformed into invisible dryness and heat, and a large dose of nourishing yin and clearing heat can inhibit summer heat. However, there is not much damp evil left, so it is necessary to fake the penetration of lobster sauce and the timid star of bitter temperature. Without the softness of the raw land, the sweetness and coldness of cinnabar, the burnt tongue coating can't be removed; Without lobster sauce, the bitter temperature of bile star and the roughness of tongue coating can't be shoveled off. It's hard to tell the truth without experience.
Take douchi without sweat, bean rolls with sweat, the ground is hot, and Dendrobium has body fluid injury; Pathogenic heat is blazing inside, robbing body fluid, and serving Radix Rehmanniae and Dendrobium. All kinds of addition and subtraction for black paste can stand the test of practice.
Yang Dan soup
Yang Dan Soup is Guizhi Soup and Scutellaria baicalensis Georgi. Zhang adopted his suggestion and created the method of "warming the middle warmer to stop diarrhea". He used cassia twig to stir-fry Scutellaria baicalensis Georgi with fragrant lobster sauce and Su terrier to treat cold and heat, slow and thin pulse, white and greasy tongue, which aggravated the symptoms due to cold. Or combined with Radix Aconiti Lateralis Preparata, Asari and Ertoujian for dispelling cold, removing blood stasis and guiding turbidity, and treating fever, aversion to cold, deep pulse, tepid limbs and less abdominal pain caused by nocturnal emission or cold after sexual intercourse, commonly known as "typhoid fever with yin".
Yuxue Jiuku Pill
Yu Xue Jiu Ku Dan is mainly used to treat typhoid plague, headache due to cold and heat, chest tightness and joint pain, dizziness due to body heat, bad tone, excessive phlegm and saliva, throat emergencies, acne in children, sudden eruption, acute and slow convulsion, carbuncle swelling, carbuncle swelling, and nameless swelling. The whole prescription consists of 48 drugs. Each tidal grain weighs one yuan and five cents, and it weighs one yuan after drying. This pill is not warmer than Suhexiang Pill, Zhibaodan Pill, Niuhuang Pill and Zixuedan Pill, and is good at "stopping diarrhea and relieving depression". When typhoid fever comes on, it is evil, damp inhibits heat, so it can't be penetrated, so there is no sweat due to excess heat, chest tightness, tight pulse and thick and greasy tongue. When I went to Suhexiang Pills, it was too warm, and I was afraid of carrying firewood to put out the fire, which contributed to the rampant fever; If you give it to the treasure pill, you will doubt its town and worry about its evil and dampness. Yuniuhuang Pill and Zixuedan are too cold, for fear of attracting bandits into the room, leading to deep paralysis. At this time, it is not the time for jade snow to save bitter medicine. The light one is half to one, and the heavy one is two. It really has the spiritual effect of "if you are coke, you will sweat away". According to Zhang's experience in applying Jiukudan, the most symptoms are fever at first, no sweat or less sweat, tight pulse, greasy white tongue coating, or yellow and white mixed turbidity, solid constitution and excessive wet phlegm. Its "arthralgia-relieving" effect focuses on opening and closing meridian points, relieving the stagnation of dampness and turbidity in meridians, dredging meridian points, eliminating dampness and turbidity, naturally sweating out evil, clearing heat and clearing heart. For example, humidity is used to suppress heat and is on the verge of melting. Sometimes it is combined with herbs for clearing heat, calming wind and nourishing yin for treating Bao Dan. If excessive heat perspires, the tongue coating is yellow and crimson, pathogenic heat has turned dry, or old and weak, yin deficiency and fire are flourishing, it is by no means a jade snow pill to save suffering.
In a word, the premise of using Yuxue Jiuku Pill is to grasp four basic conditions, such as heat potential, pulse condition, tongue coating and physique, but its main key lies in the word "sweat". Harmony and discord depend on whether there is sweat or not, and whether it is effective or not depends on whether there is sweat or not. As for the balance of dosage, those who are physically strong can take one pill 2-4 times, and those who are physically weak can take it 2-3 times to prevent the medicine from passing through the affected area. If you take two pills, your condition still doesn't get better, or if the dampness changes from heat after taking the medicine, it's time to consider the principle of changing treatment.
appendix
The Zhang family began to practice medicine at the end of Chongzhen in the Ming Dynasty. Zhang, the ancestor, abandoned Confucianism to become a doctor, and the word was passed down from generation to generation 12. In the past 300 years, the Zhang family has multiplied and famous doctors have come forth in large numbers. Yu is particularly famous in the eighth generation, reaching its peak in the ninth generation of Zhang Xiangyun.
Zhang Xiangyun's medical skills are famous in the south of the Yangtze River, and there is a short story about "Huang Ma Jia". At that time, in the Zhangjia apartment on Wenzhou Road, Beijing West Road, famous patients had to queue up every day to get their turn, so some fake patients appeared to help queue up and "sell positions". In order to get timely treatment for the patients who came first, the Zhang family had to issue yellow vests to the patients as proof at the first time.