The plague, or a major plague, is not as simple as a minor disease or disaster, and we should not just blame it on misdiagnosis and mistreatment
"Renchen Medicine Disaster" was first proposed in the preface written by Yuan Haowen to Li Dongyuan (Li Gao)'s "On the Spleen and Stomach". It has never appeared elsewhere. This is considered false propaganda now!
There is a famous "Renchen medicine disaster" in Chinese history, but it was an unjust case.
Even if it is misdiagnosed and mistreated, it can only cause death in a small area. How can it cause 900,000 deaths? Even if one or even 100 doctors misdiagnose and mistreat so many doctors in Bianjing, have they misdiagnosed and mistreated? In the Jin and Yuan Dynasties, Chinese medicine was very developed, several times stronger than today! Is everyone else a fool? Are you, Li Gao, the only one who is good? If you cured a group of people, wouldn't the officials in the capital immediately invite you to preside over the overall situation and treat the people?
It was a major epidemic at all, and no one could cure it at the time, so don't think about it after the fact, don't want to brag about your awesomeness. Li Dongyuan, like Zhang Zhongjing, reflected on the ineffectiveness of predecessors’ treatments and summed up the reasons for their ineffectiveness, and thus discovered some solutions that could be used to treat the diseases at that time, which also laid the foundation for their writings (said If it sounds bad, it means stepping on other people's corpses to establish your own academics), but it cannot be said that they were all misdiagnosed and mistreated. At that time, everyone was treating diseases according to Zhongjing's treatise on febrile diseases, and no one dared to break through. You, Li Dongyuan, have made a breakthrough, so you can't hurt others.
After every plague, a group of great people will emerge. For example, "Treatise on Febrile Diseases" was also published after the 51-year epidemic in the late Eastern Han Dynasty. The epidemic in Bianjing gave birth to "Spleen and Stomach". Ke's "Plague Theory" gave birth to the febrile disease school. From here, we can also see a little way: different times, different climates, and different causes of illness, so it is necessary to combine the five lucks and six qi to prevent and control diseases or plagues. But the person who first breaks through the rules and discovers the problem is very awesome. Such a person only comes out once in a few dynasties, and not everyone can be that kind of person.
The Bianjing rat plague at the end of the Jin Dynasty and the beginning of the Yuan Dynasty lasted for more than two months, killing more than one million people. Limited to the medical level at that time (no microorganisms were known), doctors mostly treated "typhoid fever" caused by external diseases. Li Dongyuan, a famous physician who experienced it himself, later wrote a book "Distinguishing Confusion from Internal and External Injuries", arguing that the epidemic was not an exogenous disease, but an internal injury caused by diet and fatigue. So many people died because of misdiagnosis and misdiagnosis by doctors. Caused by treatment. His good friend, great poet and famous physician Yuan Haowen bluntly stated in the preface to "On the Spleen and Stomach" written for him that the Bianjing epidemic was a "disaster caused by Renchen medicine". If Li Dongyuan's prescription was followed, so many people would not die. people.
From today's perspective, this is clearly an unjust case. What kind of diet and fatigue can cause millions of deaths? Li Dongyuan's knowledge was not as good as that of ordinary doctors at that time. After all, they still knew that it was an exogenous disease.
In fact, Li Gao had his own judgment on the nature of the epidemic, and regarded it as an injury within the group caused by "improper diet and injuries caused by hard labor". However, many scholars are not satisfied with this answer, thinking that this cannot explain the death of so many people in a short period of time, so they try to seek a breakthrough from modern epidemiology.
The most significant impact of the Bianjing epidemic was the massive reduction in the population in Henan. The epidemic caused more than 900,000 deaths, not including the "poor people who cannot be buried". As mentioned earlier, at that time, "the sick and dead people continued to follow. There were two out of ten gates in the capital, and every day each gate sent more than two thousand, and the few were no less than one thousand." On the other hand, the raging epidemic caused serious social panic. Even those who were not infected wanted to flee this "dead city" as soon as possible.
Leaving aside whether Mr. Dongyuan’s diagnosis of the nature of the epidemic is accurate or not, the book "Distinguishing Puzzles from Internal and External Injuries" written by him after experiencing the Bianjing epidemic is indeed a treasure of Chinese medicine culture, and it still guides clinical practice to this day. effect. The book distinguishes exogenous pathogenesis and internal injury in detail, emphasizes the importance of the ups and downs of the spleen and stomach in the development of internal injuries, and creates a series of tonic prescriptions such as Buzhong Yiqi Decoction, which will serve as a basis for the future development of Li's theory of spleen and stomach and "yin fire" theory. Foundation. Wang Lu, a well-known medical expert in the Yuan Dynasty, once said: "Trying the distinction between internal and external injuries in my husband Dongyuan Li's book, it is said that diseases caused by external injuries, wind and cold, and excess evils should be treated with improper diarrhea, and internal injuries with insufficient food and labor. Since then, the theory came out, and later generations in the world have come to know the difference between internal and external injuries. However, Zhongjing's method cannot be used as an example.
Wang Lun of the Ming Dynasty also commented: "External senses should be used for Zhongjing, internal injuries should be used for Dongyuan, fevers should be used for Hejian, and miscellaneous diseases should be used for Danxi." Fan Xingzhun believed that "Distinguishing Puzzles from Internal and External Injuries" "is really a follow-up to this great tragedy. "A Big Mistake" is a bit extreme, obliterating Li Gao's medical achievements to a certain extent.
After the founding of the People's Republic of China, many experts re-examined the plague. Combining modern western medical theory, they questioned Li Gao's internal injury theory: how could the physical damage caused by improper diet be less than three months old? What about the deaths of millions of people within a time period? The culprit of the plague must be some kind of severe infectious disease, most likely the plague.
From the point of view of symptoms, the patients of the Bianjing epidemic had "fever", "coughing blood" and "vomiting", while the clinical symptoms of pneumonic plague included "high fever, chills, chest pain, coughing up sputum, and the sputum was in a state of mucus, fire and bloody foam". It is quite similar.
Some experts also believe that the Bianjing epidemic belongs to infectious hepatitis for the following reasons:
First of all, the incidence rate is high, and the infection is clustered in one place in a short period of time, which is consistent with the characteristics of infectious hepatitis. In 1988, the hepatitis A outbreak in Shanghai caused 300,000 infections within two months.
Secondly, the time of onset was after Mongolia withdrew its troops, and the food in the city kept up, and the starving soldiers and civilians began to eat freely, which is in line with the characteristics of hepatitis spreading through food.
In addition, according to some patients, "chest turns yellow", similar to the characteristics of hepatitis jaundice, "fever" and "vomiting" are also symptoms of hepatitis.
However, there are also problems with the theory of hepatitis. According to the records, the patient had profuse phlegm, cough, and respiratory failure. These symptoms did not fit well with hepatitis. The patient's complex symptoms should be an acute systemic disease. Some scholars believe that it is leptospirosis.
