Nov 25, 2015

Bian Que: A Legendary Doctor

29 Oct 2015, 22:18

I would like to share with you a famous ancient medical case report.
It was recorded in the ancient history book "Records of the Grand Historian" (
史記 Shǐjì) written by Sima Qian (145 or 135 – 86 BC)
https://en.wikipedia.org/wiki/Records_of_the_Grand_Historian

The doctor's name is "Bian Que" (扁鵲; ca. 500 B.C)

The article below came from here: http://english.eastday.com/e/zx/userobj ... 59567.html
Bian Que's real name was Qi Yueren (秦越人). He was reputed to be an excellent diagnostician, excelling in pulse taking and acupuncture therapy. He is ascribed the authorship of Bian Que Neijing (Internal Classic of Bian Que). Han Dynasty physicians claimed to have studied his works, which have since been lost. Credited with incredible healing knowledge, stories of his life and treatments are used in teaching and known to all Chinese medicine practitioners today.

In Sima Qian's book Shi Ji, in Bian Que Chronicles, An Ancient Miracle Doctor: Bian Que (I), Sima Qian described that Bian Que obtained his medical skills from personal teachings by Chang Sangjun. Sima Qian also recorded three specific medical cases that Bian Que handled. In the first case, he diagnosed Zhao Jianzi's illness by feeling his pulses. In the second case, he kept track of the state of the illness of the Crown Prince Guo through consulting, examining and feeling the pulse and finally brought Crown Prince Guo back from death. In the third case, Bian was able to describe the developing illness of Marquis Qi Huan by simply looking at him.

Once Bian Que, along with an apprentice, went to the Kingdom of Guo (what is now part of Henan province) as a traveling physician. There they saw that the people of the city were busily running around and discovered that a funeral was being prepared for the king's son. Bian Que went up to the door of the palace, asked someone what had happened. He learned that the king's son passed away from a sudden illness and had already been dead for a half day. Bian Que asked in detail about the circumstances of the prince's illness and death and came to believe that it was not certain that the prince was dead.

He requested to be let into the palace to examine the prince. After he entered the palace, Bian Que palpated the thick part of the prince's thighs, and discovered that they were warm. He also detected a very slight sound in the prince's ears, and diagnosed the prince as "body collapsed" (quite similar to shock), not dead. He then instructed his apprentice to set a single acupuncture needle, in the Baihui point (Du 20) on the head, and the prince regained consciousness. They then boiled some herbal medicine and used it for compresses applied to the prince's armpits, after which he was able to slowly sit up. The prince was then prescribed boiled herbal compounds to be taken for twenty days, and fully recovered his health. Word of this spread, everyone was saying that Bian Que could bring the dead back to life. Bian Que said "No, I can't bring the dead back to life, the prince wasn't dead. I only treated his illness, and that's what brought him around."

Since the English translation do not include the detailed thinking process of Bian Que, I found the original record written in classical Chinese. 
For those who might be interested in this case: 
其後扁鵲過虢。虢太子死,扁鵲至虢宮門下,問中庶子喜方者曰:「太子何病,國中治穰過於眾事?」中庶子曰:「太子病血氣不時,交錯而不得泄,暴發於外,則為中害。精神不能止邪氣,邪氣畜積而不得泄,是以陽緩而陰急,故暴蹶而死。」扁鵲曰:「其死何如時?」曰:「雞鳴至今。」曰:「收乎?」曰:「未也,其死未能半日也。」「言臣齊勃海秦越人也,家在於鄭,未嘗得望精光侍謁於前也。聞太子不幸而死,臣能生之。」中庶子曰:「先生得無誕之乎?何以言太子可生也!臣聞上古之時,醫有俞跗,治病不以湯液醴灑,鑱石撟引,案扤毒熨,一撥見病之應,因五藏之輸,乃割皮解肌,訣脈結筋,搦髓腦,揲荒爪幕,湔浣腸胃,漱滌五藏,練精易形。先生之方能若是,則太子可生也;不能若是而欲生之,曾不可以告咳嬰之兒。」終日,扁鵲仰天歎曰:「夫子之為方也,若以管窺天,以郤視文。越人之為方也,不待切脈望色聽聲寫形,言病之所在。聞病之陽,論得其陰;聞病之陰,論得其陽。病應見於大表,不出千里,決者至眾,不可曲止也。子以吾言為不誠,試入診太子,當聞其耳鳴而鼻張,循其兩股以至於陰,當尚溫也。」

  中庶子聞扁鵲言,目眩然而不瞚,舌撟然而不下,乃以扁鵲言入報虢君。虢君聞之大驚,出見扁鵲於中闕,曰:「竊聞高義之日久矣,然未嘗得拜謁於前也。先生過小國,幸而舉之,偏國寡臣幸甚。有先生則活,無先生則棄捐填溝壑,長終而不得反。」言末卒,因噓唏服臆,魂精泄橫,流涕長潸,忽忽承鑞,悲不能自止,容貌變更。扁鵲曰:「若太子病,所謂『屍蹶』者也。夫以陽入陰中,動胃繵緣,中經維絡,別下於三焦、膀胱,是以陽脈下遂,陰脈上爭,會氣閉而不通,陰上而陽內行,下內鼓而不起,上外絕而不為使,上有絕陽之絡,下有破陰之紐,破陰絕陽,色廢脈亂,故形靜如死狀。太子未死也。夫以陽入陰支蘭藏者生,以陰入陽支蘭藏者死。凡此數事,皆五藏蹙中之時暴作也。良工取之,拙者疑殆。」

  扁鵲乃使弟子子陽厲針砥石,以取外三陽五會。有間,太子蘇。乃使子豹為五分之熨,以八減之齊和煮之,以更熨兩脅下。太子起坐。更適陰陽,但服湯二旬而複故。故天下盡以扁鵲為能生死人。扁鵲曰:「越人非能生死人也,此自當生者,越人能使之起耳。」

Here's the same record in brief written in modern Chinese:  http://goo.gl/eEAmsd


This medical record makes us realize how good the doctors are in ancient China and we should not only take a detailed history but also exam our patient comprehensively. The most important thing is get to know the mechanism of how people get sick and treat accordingly.

No comments:

Post a Comment