A Diachronic Study on the Concepts of Jeokchwi(積聚)-related Disease

摘要

Purpose: To examine the process of change on the conceptsof the ‘Jeokchwi’ and to investigate the process of change oncategorization and classification system of these diseases.Methods: Eighteen comprehensive medical books publishedbetween the third century and the eighteenth centurywere included. Lesion location, pathophysiology, and symptomsof the ‘Jeokchwi’ and its subordinate diseases wereextracted from each book.Results: The ‘Jeokchwi’ has been recognized since thethird century. There has been little change on the conceptof the ‘Jeokchwi’ until the Jin-Yuan Dynasties( ? ).After Zhuzhenheng( ) reestablished the theory for etiologyof the ‘Jeokchwi’, two pathophysiologic concept of thisdisease have coexisted since the Ming Dynasty( ). Fourcriteria(lesion location, lesion mobility, mobility of painfulareas, and existence of an obvious lesion border) whichclassified the ‘Jeokchwi’ into the ‘Jeok’( ) and the ‘Chwi’( )in the Nanjing ( ) have been used until the Ming-QingDynasties( ? ). As Zhuzhenheng’s theory for etiology of the‘Jeokchwi’ also applied to the theory for etiology of the ‘Jeok’and the ‘Chwi’, pathophysiologic concepts of these diseasesreestablished. The ‘Jeok of five viscera’( ), which is aprincipal subordinated disease of the ‘Jeok’, is the collectivedisease for five diseases(‘Bigi’( ), ‘Bokryang’( ), ‘Bigi’( ),‘Sikbun’( ), and ‘Bundon’( )). Three criteria(lesion location,size or pattern of local lesion, mutated symptoms) in theNanjing , and two criteria in the Maijing ( ) for classifyingthe five diseases have been passed down until the Ming-QingDynasties. The concept of the ‘Chwi’ and the ‘Six Chwi’( )has been developed in detail than that of the ‘Jeok’ and the‘Jeok of five viscera’.Conclusion: The pathophysiology and symptom of the‘Jeokchwi’ were mostly recognized before the third century,and most of them have been passed down until the Ming-Qing Dynasty. Some concepts about this disease term changedthrough the process of creation, extinction, integration, or separation.