The records of relevant symptoms, prescriptions, medications, etc. used by traditional Chinese medicine when treating diseases are often used as book titles, such as "Clinical Guidelines and Medical Records" by Ye Tianshi in the Qing Dynasty, and "Famous Doctors in the Qing Dynasty" by Qin Boyei "Medical Records" etc.

That is, medical records. It is a continuous record of doctors’ syndrome differentiation, legislation, and prescription of medications when treating diseases. Chun Yuyi, a famous doctor in the Han Dynasty, creatively recorded twenty-five medical cases he treated, which was called "Clinical Records" at the time. Including the patient's name, address, occupation, pathology, syndrome differentiation, treatment, prognosis, etc. Later generations of doctors compiled records of the medical records they treated into personal medical records. There are also those that specially select medical records from ancient and modern famous doctors and compile them into volumes, such as "Famous Doctors' Cases", "Famous Doctors' Cases Continued", "Ancient and Modern Medical Records", etc.

The origin of traditional Chinese medicine medical records is very early, and its germination can be traced back to the Zhou Dynasty. According to the "Book of Rites of Zhou" records, doctors at that time already had records on the names of diseases and treatment results, but their role was mainly to evaluate the doctor's efficacy, thereby determining his grade and paying his salary. In addition, there are scattered records about doctors' diagnosis and treatment of diseases in "Zuo Zhuan" and the works of pre-Qin scholars, which can be regarded as the prototype of medical records. The earliest medical records with actual content seen today are the medical records of Bian Que's treatment of Zhao Jianzi, Prince Guo, Marquis Huan of Qi and Chun Yuyi recorded in "Historical Records: Biography of Bian Que Cang Gong". The latter, in particular, is regarded as the origin of later generations of doctors. Chunyu Yi has 25 medical records, each of which contains the patient's surname, address, position, disease name, pulse, treatment method, prognosis, etc., covering various diseases and syndromes in internal medicine, external medicine, trauma, gynecology, and pediatrics. The diagnosis method is mainly based on pulse, and also includes analysis of pathogenesis. Treatment methods include drugs, acupuncture, fumigation, etc., and the drugs can be decoction, pills or wine. What's more valuable is that in addition to the cured patients, the medical records also recorded 10 death cases. This fact-seeking attitude reflects the unpretentious style of early medical records.

Since the Qin and Han Dynasties, medical prescriptions were highly valued. Until the Sui, Tang and Five Dynasties, medical records failed to achieve breakthrough development. During this period, medical records were scattered in medical books and literary and historical books. They were small in number and brief in content. For example, there are several cases contained in "Qian Jin Yao Prescription", most of which are Sun Simiao's autonomous cases. The purpose is mainly to prove the efficacy of a certain prescription or medicine, and lacks detailed description and analysis of disease syndromes. Despite this, the medical records of this period still have merits such as their simplicity, elegance, and integration of medicine and culture, and we can also gain inspiration from them.

The Song, Jin and Yuan Dynasties were a stage of unprecedented development of medical records. The main characteristics of the development of medical records during this period were the beginning of the emergence of medical record monographs, the gradual increase in the number of medical records attached, the establishment of medical records by doctors, and the diversified styles of medical records.

Ninety Treatises on Febrile Diseases written by Xu Shuwei of the Song Dynasty is the earliest existing medical monograph in my country. The book divides common syndrome prescriptions for typhoid fever into 90 types, with one syndrome for each case. The case is rigorously filed and the content is comprehensive and complete. It is based on classic works such as "Nei Jing", "Difficult Classic", "Treatise on Febrile Diseases" and other classics, and the analysis of medical cases is quite enlightening. Qing Dynasty doctors praised this book: "There are dozens of medical records, all with inventions, which can serve as models for future students."

Although appendices to medical books originated very early, they are relatively scattered and relatively concentrated medical books. The appendix actually began in the Song Dynasty. For example, Qian Yi's volume "Pediatric Medicine and Syndrome Direct Jue" contains 23 pediatric medical records, covering more than a dozen types of diseases and syndromes, analyzing the causes and pathogenesis, or explaining the use of prescriptions and medicines, which fully reflects Qian's pediatric academic characteristics. This book is not only characterized by its appendix, but is also the earliest specialist medical record. In addition, Xu Shuwei's "Pu Ji Ben Shi Fang" and the medical works of many doctors during this period were mostly accompanied by medical records. For example, Yang Jie, Sun Zhao, Zhang Zihe, Li Dongyuan, Zhu Danxi, Chen Ziming, Wang Haogu, Luo Tianyi, Hua Shou, etc. all have medical records handed down from generation to generation. As the number of medical cases increases, their form, style and way of narrating cases have also changed. For example, some add arguments to cases, some include arguments and cases, and some discuss cases side by side, but the purpose is to use cases to prove the truth.

For example, there are more than 200 medical cases of Zhang Zihe, which can be found in "Confucianism Shiqin". His case records the cause, dialectics, treatment methods, and prescriptions in detail. Most of the medicines used are cold and cool, and he is good at treating sweat and vomiting. , and the following three methods embody Zhang Zihe’s academic characteristics of focusing on attacking evil. Li Dongyuan's medical records are scattered in two books, "Spleen and Stomach Theory" and "Orchid Chamber of Secrets". The cases are described in detail, the dialectics are accurate, the prescribed medicines are large and the dosage is light, and he is good at using the method of raising yang and replenishing qi, which reflects that Li Dongyuan is good at strengthening the body, dispelling evil and taking care of the body. Upright style.

Zhu Danxi's medical records are widely circulated, and are mostly written in the form of narrative and discussion to illustrate its academic characteristics of nourishing yin and reducing fire.

The above-mentioned medical records not only fully reflect the different academic views and rich clinical experience of various doctors, but also lay a solid foundation for the development of future medical records.

Medical records developed into the Ming Dynasty, and all aspects became increasingly mature. The large increase in monographs on personal medical records, the emergence of medical record books, and the beginning of research on medical records are important signs of the maturity of medical records in this period. According to incomplete statistics, there are about 30 existing monographs on personal medical records from the Ming Dynasty. The more representative ones include "Shishan Medical Cases", "Zhou Shenzhai Medical Cases", "Sun Wenyuan Medical Cases", "Wang Kentang Medical Cases", "Wonderful Medical Records", "Yi's Medical Cases", "Li Zhongzi's Medical Cases", etc. . In addition, the number and types of appendices to medical books are also much greater than those of previous generations, such as "The Complete Book of Jingyue", "Compendium of Materia Medica of Southern Yunnan", "Music Readings for Medical Sects", "Compendium of Materia Medica", "Acupuncture Complete Works", "The True Story of Medicine", Books such as "Surgery Zhengzong", "Yicaoting Muke", "Jiyin Gangmu" and other books have a considerable number of attached medical records, involving various clinical departments. While the number of medical records has increased, the quality has also been significantly improved, which is mainly reflected in: ① The content is complete and objective; ② The format is diverse and standardized; ③ The reasoning is thorough and detailed; ④ The writing style is beautiful and fluent.

What is even more worth mentioning is that the first medical records book in the history of our country appeared in the Ming Dynasty - "Famous Doctors' Records". The book was compiled by Jiang Guan and has 12 volumes. It collects nearly 3,000 medical records from doctors of all dynasties before the Ming Dynasty and medical records from hundreds of classics, and is divided into 205 categories based on disease and syndrome. The medical records contained are mainly internal medicine, and also cover external medicine, gynecology, and facial features. Each case records the doctor's name and the patient's age, constitution, symptoms, diagnosis, treatment, prescriptions, etc., and many medical cases are accompanied by annotations or notes, saying "Make it clear what you have done in the past, and what you should learn from it. It is not based on the Bible, nor is it easy to change." Commonplace." This book is not only the first medical records book in my country, but also the first monograph to study ancient medical records. The cases recorded not only reflect the exquisite medical skills and clinical experience of the compiled predecessors, but also leave valuable information for the study of the academic thoughts of these doctors.

In addition to extensive research on medical records in this issue, some doctors have also begun to conduct specialized research on the writing format and standards of medical records. First of all, "Hanshi Yitong" states that medical records must be written in the "six methods of inspection, hearing, questioning, palpation, theory and treatment" and shows the format. Later, Wu Kun revised and supplemented this in "Maiyu", proposed the writing method of "seven books and one quotation", and gave a more detailed explanation of the writing content and format of medical records. The putting forward of these views played a role in promoting the standardized and scientific development of medical records, and had a positive and profound impact on the development of medical records in later generations.

The Qing Dynasty was the heyday of the development of medical records. During this period, not only did a large number of medical records come out, but writing and compilation also flourished, and theory and clinical practice became more closely integrated, thus further promoting the development of traditional Chinese medicine. To summarize the characteristics of medical records in this period, the following aspects can be summarized:

⑴ Medical records emerged in large numbers in various forms.

According to preliminary statistics, there are more than 200 medical monographs written by doctors in the Qing Dynasty. In terms of the form of the works, there are all categories and styles, including personal medical records, medical record books, and medical record series, as well as specialist medical records, special medical records, consultation medical records, medical record commentaries, and court medical records. As for the writing form, they are ingenious and have their own characteristics. For example, some narratives are brief and have profound implications; some are detailed and detailed, with clear narratives; some are good at quoting classics and focus on reasoning; some emphasize governance, Show others the rules; some pulse causes and symptoms are treated in an orderly manner.

⑵ Doctors attach great importance to medical records, and filing medical records has become a fashion.

The reason why medical records in the Qing Dynasty were successful was that doctors paid widespread attention to medical records. On the one hand, doctors cherish the medical records of previous sages. For example, Aftershock once said: "There are many cases. The methods of medicine are there, and the skills of the methods are also there. You can try to figure them out." ("Preface to Ancient and Modern Medical Records") Wang Yanchang also It says: "Famous doctors have their own experiences when filing cases, and they have been circulated for a long time, and the benefits are endless. If you have many clinical syndromes, you will be able to read and understand them well, and if you practice deeply, you will have stable prescriptions. This is why the cases of virtuous doctors in the past are valuable." ("Wang's Medical Cun· "Routine Rules") On the other hand, doctors attach great importance to personal writing of medical records. Xu Lingtai pointed out: "Therefore, in order to treat a disease, a medical record must be established first.

"Wang Dashu's "The First Edition of Medical Power" also says: "A doctor should first file a case when he makes a cube. "This shows that it was a common practice for doctors to write medical records at that time. The more influential medical records handed down from ancient times include Yu Chang's "Yuyi Cao", Ma Yuanyi's "Yin Ji Cao", You Zaijing's "Jingxianglou Medical Records", Qi Youtang's "Qi's Medical Records" ", "Wang Jiufeng's Clinical Medical Records", Gu Xiaolan's "Wumen Medical Records", "Wu Jutong's Medical Records", Wang Mengying's "Wang's Medical Records", Jiang Baosu's "Wenzhai Medical Records", Xie Yinglu's "Dexinji Medical Records" ", "Fei Boxiong's Medical Cases", Wang Xugao's "Huanxi Thatched Cottage Medical Cases", Yu Tinghong's "Diagnostic Collection", etc., there are too many to mention. It can be said that there are many famous people, and each case has its own style. However, they all reflected their unique academic thoughts and diagnosis and treatment experience, and were praised by later generations.

⑶ They attached great importance to medical case research and compiled a large number of publications.

Yu Jiayan, a physician in the late Ming and early Qing dynasties. In "Yu Yi Cao", in addition to recording more than 60 difficult and complicated medical cases, it also wrote "discussing the disease pattern with the disciples" after the opening chapter "Discuss the disease first and then use the medicine". Based on the research of Wu Kun and others, higher requirements were put forward for the content and format of writing medical records, that is, the attitude should be serious and the content should be detailed (including the time and place of diagnosis, general condition of the patient, symptoms, pulse, dialectics, Treatment principles, prescriptions, prognosis, etc.), the theory and prescriptions should be complete. This idea not only has high practical value, but is also very useful for the summary of medical experience, the improvement of medical effects, the development of medical theories, and the preservation of medical files. It is useful and still has reference value today.

In terms of the compilation of medical records, the largest existing medical records book has appeared - "Continuation of Famous Medical Records", which is a companion volume to "Famous Medical Records". , collects more than 5,000 medical records from the Qianlong period of the Qing Dynasty and before, and is scored in 345 categories. It supplements the "Famous Doctors' Records"

In addition, there were many more famous medical records published in the Qing Dynasty. Examples include "Medical Records from Three Families Together" and "Medical Records from Four Families Selected by Liu". These medical records are selected and compiled by the compilers, and most of them represent the essence of doctors' academic thoughts and treatment experiences. There are not many, but the quality and value are high. In terms of medical record commentary, it has made great progress compared with the previous generation. Among them, Yuzhen's "Ancient and Modern Medical Records" is a rare book that is a commentary on medical records. This book has selected and compiled more than a thousand medical cases from more than 60 doctors ranging from Cang Gong to Ye Tianshi, and added more than 530 comments to analyze and resolve doubts, add finishing touches, and make incisive comments, which is of great benefit to the study of ancient and modern medical cases. . Later, Wang Mengying selected the best ones and commented on them, and their reference value was even greater.

Since the Qing Dynasty, the development of medical records has not reached a new climax, but scholars’ understanding and evaluation of medical records have not reached a new climax. , it is even better than the previous generation. For example, Mr. Zhang Taiyan once said: “The achievements of traditional Chinese medicine are most remarkable. If you want to learn from the experience of predecessors, medical records are the best clues. If you follow this study, you will get twice the result with half the effort. "Also as Zhang Shanlei said in "Review of Ancient and Modern Medical Cases": "The argumentation in medical books should only record its regularity, but at the same time, the syndromes are confusing and the origin of the disease is evolving, so it cannot be analyzed in detail, and it will become chaotic. However, the medical records always follow the migration of symptoms, are lively and have no prescription, and have endless wonders, just like the patient is beside him and hears the cough. Therefore, reading more medical records is better than following famous doctors. It is like gathering all the good doctors from ancient and modern times, but they are all in the same room, and they discuss it from top to bottom. How can it be faster? "The words come from the heart and are quite true.

In terms of writing style, it may inherit the characteristics of the Ming and Qing dynasties, starting from traditional Chinese medicine methods and prescriptions, focusing on elucidating the etiology, pathogenesis, treatment methods and prescriptions. Or reform the traditional medical records and use the perspective of integrating Chinese and Western medicine to describe the medical records. The latter is represented by Zhang Xichun's appendix of "Yi Zhong Shen Xi Lu". Another example is Cao Yingfu's "Jingfang Experimental Records", in which Zhong Jing is the author. Zong's theory is a combination of Chinese and Western medicine, which is quite distinctive. The "Records of Famous Doctors in the Song, Yuan, Ming and Qing Dynasties" compiled by Xu Hengzhi and others during the Republic of China, and the "Records of Famous Doctors in the Country" compiled by He Lianchen, are both properly classified, with occasional comments, and have certain practical value.

The medical records of many doctors with different styles in various historical periods are not only the crystallization of the clinical practice experience of doctors of all generations in our country, but also a treasure in the great treasure house of the motherland’s medicine.

Among the many medical records, there are both rich medical theories and a large amount of medical experience; there are both syndrome differentiation methods and prescription medications; there are both successful experiences and lessons of failure; both detailed and surprising. It is an endless read, and some of the concise chapters are endlessly thought-provoking; there are common diseases but unique diagnosis and treatment, and there are also difficult syndromes and unique ways of treatment.

In short, TCM medical records condense and cover all aspects of TCM basic theory and clinical knowledge, which can be described as broad spirit. Studying and researching medical records can not only enrich and deepen theoretical knowledge, but also improve the level of clinical diagnosis and treatment, broaden horizons, and enlighten ideas. Therefore, medical records were a compulsory study for those who were engaged in clinical, teaching, and scientific research of traditional Chinese medicine.

(The above content is quoted from "Medical Records and Medical Talks - Foreword" edited by Liu Gengsheng)

Wu Jutong Medical Records, ancient and modern medical records, and clinical guide Medical records, the essence of Ye Tianshi's medical records, Ding Ganren's medical records, three medical records combined, Shanren's medical records, Wang's medical records, unprinted Ye's medical records, He Danan's medical records, Huayunlou medical records, Sun Wenyuan's medical records Medical cases, Ma Pei's medical cases, Zhang Yuqing's medical cases, Zhang Wanxiang's medical cases, Cao Renbo's medical cases, Cheng Xingxuan's medical cases, Cong Gui Caotang's medical cases, Wang Xugao's medical cases, Shao Lansun's medical cases, Xu's medical cases

What is a medical record? Medical records, also known as medical records, pulse records, plans, and medical records, are records of traditional Chinese medicine diagnosis and treatment activities, now called medical records (cases). TCM medical records are a concrete reflection of the comprehensive application of TCM principles, methods, prescriptions and medicines. It is not only a true record of medical activities, but also reflects the clinical experience and thinking activities of doctors. Because doctors live in different eras and have different knowledge, hobbies, and accomplishments, the number, form, genre, and style of medical records in the past dynasties are also different. The record of the process of diagnosis and treatment of diseases by traditional Chinese medicine later developed into a type of traditional Chinese medicine writings. The "clinical records" of the Western Han Dynasty physician Chun Yuyi (namely Cang Gong) are the earliest known medical records. "Historical Records" reprinted the names, hometowns, occupations, disease syndromes, relevant diagnoses, prescribed medications, and outcomes of 25 of the patients. Since then, many medical prescription books such as Sun Simiao's "A Thousand Gold Prescriptions" of the Tang Dynasty often include records of treatment cases. Medical records are convenient for summarizing clinical experience and inspiring ideas. It is said that "medical records are like the records of chess players, which can be followed and restored" ("Ancient and Modern Medical Records" by Yu Zhen in the Qing Dynasty). Therefore, the collection of medical records into books has become a distinctive type of work in traditional Chinese medicine literature. It is generally believed that "Ninety Treatises on Febrile Diseases" written by Xu Shuwei in the Song Dynasty is the earliest existing medical treatise. After the Ming and Qing Dynasties, more and more medical records were written.

According to the author, medical records can be divided into two categories: exclusive medical records and medical records compiled by various medical records. Famous exclusive medical records include Wang Ji's "Shishan Medical Records" in the Ming Dynasty, Yu Jiayan's "Yuyi Cao" in the late Ming and early Qing dynasties, Ye Tianshi's "Clinical Medical Records Guide" in the Qing Dynasty, Wu Jutong's "Wu Jutong Medical Records", and modern medical records. "Ding Ganren Medical Records" and "Pu Fuzhou Medical Records" etc. Representative works that collect medical records from various schools include "Famous Medical Records" by Jiang Guan in the Ming Dynasty, "Continued Medical Records of Famous Doctors" by Wei Zhixiu in the Qing Dynasty, Liu Baoyi's "Liu Xuan Medical Records", and Yu Zhen's "Ancient and Modern Medical Records". In addition, there are also medical records compiled according to the era, such as "Records of Famous Doctors in the Song, Yuan, Ming and Qing Dynasties" (Xu Hengzhi et al.), "Essence of Medical Records of Famous Doctors in the Qing Dynasty" (Qin Boyei), and "Records of Famous Doctors in the Republic of China" ( He Lianchen), "Selected Cases of Modern Famous Traditional Chinese Medicine" (Yu Ying'ao et al.).

TCM medical records are written in different ways, either traditional or simple, and in different styles. A good medical record should integrate theory, methods, prescriptions, and medicines, and reflect the entire process of syndrome differentiation and treatment. The medical record requires recording the patient's medical history, symptoms, pulse, tongue, etc., to explore the underlying mechanism of the disease, and to legislate, prescribe, and use medications accordingly. Although the medical records do not require that all symptoms be recorded, the main symptoms with syndrome differentiation significance must be highlighted. Some ancient medical records only have a few words per case, but they can add the finishing touch and truthfully reflect the treatment process and ideas, such as "Clinical Guide Medical Records" by Ye Tianshi in the Qing Dynasty. There are also some medical records that are composed of reminiscences and added comments, which are characterized by showing the key parts of the entire treatment process and the treatment experience, such as Yu Jiayan's "Yu Yicao". This type of medical records also has the nature of medical essays (medical essays). Modern TCM medical records gradually draw on the advantages of Western medical records and become increasingly standardized, but still maintain the characteristics of complete theories, methods, prescriptions and medicines, and play a positive role in timely summarizing and exchanging clinical experience of modern TCM.

1. "The Eighty-one Difficult Sutras of the Yellow Emperor" (It is said to have been written by Bian Que, the ancient miracle doctor. The rapid development of medicine has not surpassed it.) 2. "The Eleven Meridians of Yin and Yang Moxibustion Sutra" (silk book unearthed in Mawangdui, Spring and Autumn Period?) " "Moxibustion Sutra of Eleven Meridians of Foot and Arm" (Silk book unearthed from Mawangdui, Spring and Autumn Period?) "Yellow Emperor's Acupuncture Sutra" (Warring States Period?) 3. "Huangdi Mingtang Moxibustion Sutra" (Tang Dynasty?) 4. "Moxibustion Cream and Shu Point Method" (Northern Song Dynasty) Medical expert Zhuang Chuo) "Acupuncture and Moxibustion Zi Sheng Jing" (Southern Song Dynasty acupuncture expert Wang Zhizhong) "Emergency Moxibustion Method" (Southern Song Dynasty acupuncture expert Wen Renqinian) "Ziwu Liuzhu Acupuncture Classic" (Jin Dynasty acupuncturist He Ruoyu) "Guide to the Acupuncture Classic" (Dou Mo, an acupuncturist in the Jin and Yuan Dynasties), "Four Books on Acupuncture" (Dou Guifang, an acupuncture expert in the Yuan Dynasty), "Excerpts from the Acupuncture Classic" (Du Sijing, a physician in the Yuan Dynasty), "Bian Que Shenying Acupuncture Jade Dragon Classic" (Yuan Dynasty acupuncturist) · Wang Guorui) "Jinlan Illustrated Acupoint Selection along the Meridian" (Yuan Dynasty Hu Gongtai) 5. "Encyclopedia of Acupuncture" (Ming Dynasty Acupuncturist Xu Feng) "A Study of the Eight Extraordinary Meridians" (Ming Dynasty Li Shizhen) "Acupuncture and Moxibustion Juying (Ming Dynasty)" Acupuncture physician Gao Wu) "Acupuncture Festival Yao Ju Ying" (Ming Dynasty Gaowu) "The Complete Book of Meridians" (Ming Dynasty Xuzeng) "Acupuncture Questions and Answers" (Ming Dynasty Wang Ji) Pre-Qin: "Shen Nong's Materia Medica" Shen Nong's "Emperor" "Nei Jing" Han Dynasty: Mawangdui Han Tomb medical book "Yellow Emperor's Internal Classic Suwen", Zhang Zhongjing's "Treatise on Febrile and Miscellaneous Diseases", Zhang Zhongjing's "Synopsis of the Golden Chamber" Tang Dynasty: Sun Simiao, "Qianjin Prescription", Ming Dynasty: Wang Shuhe's "Mai Jing", Huangfu Mi "Acupuncture and Moxibustion Classics A and B", Tao Hongjing's "Compendium of Materia Medica", Ge Hong's "Emergency Prescriptions", Chao Yuanfang's "Treatise on the Causes and Symptoms of Diseases", Su Jing's "New Materia Medica", Wang Tao's "Waitai Secret Essentials", Yuan Dan Gongbu's "Four Medical Classics", "Taiping Shenghui Prescriptions", Wang Weiyi's "Tongren Acupoint Acupuncture Illustrated Classics" Northern Song Dynasty: Song Ci's "Collection of Cleansing Wrongdoes" Hu Sihui's "Drinking and Diet Essentials", Xu Guozhen's "Yu Yu" "Yuanyuan Prescription", Liu Wansu's "Suwen Xuanji Original Disease Pattern", Zhang Zihe's "Confucian Family Affairs", Zhu Danxi's "Ge Zhi Yu Lun", Li Dongyuan's "Spleen and Stomach Theory", Li Shizhen and "Compendium of Materia Medica", Liu Wentai's "Compendium of Materia Medica" "Pinhui Essence", Wu Youke's "Treatise on Warm Epidemics", Xu Chunfu's "Encyclopedia of Ancient and Modern Medical Traditions", Ye Tianshi's "Clinical Guidelines for Medical Records", Wu Jutong's "Differentiation of Febrile Diseases", Wang Mengying's "Warm and Heat Jingwei", Xue Shengbai "Differentiation of Dampness and Heat", Wang Qingren's "Yilin Correction", "Ancient and Modern Books Integrated Medical Records", "Shengji Zonglu"