《黄帝内经》神经、精神疾病研究
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摘要
本文据神经、精神疾病病变特点,对《内经》相关病症进行筛选,考辨病症名称含义,分析病候特点,探讨中医与西医学理论认识的相关性。对相关病症的梳理、分析、考证及中西对照研究,有助于准确掌握经文本义,解析疾病形成机制,为疾病诊断、治疗提供理论参考,为临床中西医结合疗法提供理论依据。
此次研究采用中国传统的象思维方法,从疾病临床证候之象出发,对疾病进行总体地、动态地、全程地比较对照。在疾病外象的观察基础上进行内在病理机制的分析探讨。共涉及神经、精神疾病相关病症25种(不包含证候)
偏枯：《内经》中偏枯主症为偏侧瘫痪、疼痛、神志清楚,此为中风中经络之证。伴有昏仆症状的偏枯为中风中脏腑之证。偏枯证候表现多见于西医学的脑血管疾病、脑占位性病变等。《内经》认为偏枯发生与饮食厚味有关,语言功能状态及发病年龄与疾病预后相关。这些认识与西医学理论一致。书中还描述了症状变化反复的偏枯,可见此时医者已经注意到脑血管病发作类型多、易于复发、逐渐加重的病变特点。
痱：《内经》痱病是由肾精亏虚所致,主要表现为身体无疼痛、四肢弛缓或痉挛性瘫痪，神伤轻重直接决定着该病的转归预后情况。据其症状表现应属于中风病的邪中五脏之证,近于西医学脑血管病中的脑出血、脑血栓形成、脑栓塞等病变。
头痛：《内经》记载了外伤性、感染性、脑实质病变、高颅内压等多种器质性的头痛。认为其形成与外感风寒、精亏失养、气逆、瘀血等因素有关。同时也描述了偏侧头痛、持续性头痛等非器质性头痛,这与西医学中的偏头痛、三叉神经痛、紧张型头痛等密切相关。
眩：《内经》已认识到眩虽为视物旋转,但病位不仅限于眼部,还与脑部感邪有关。因其有旋转动摇的病症特点,多认为眩与内外风伤、上窍失养有关。《内经》对眩的病候描述与西医学的前庭性眩晕,脑或脑膜炎、脑部血管性疾病所致眩晕的病变特点有共同之处。
癫疾：《内经》癫疾多为癫痫疾病。书中记述了癫痫发作的先兆期和痉挛期表现、全身性大发作的症状、癫痫持续状态、伴有精神症状的复杂部分性发作的自动症状等。认为癫疾形成与气机上逆、阳极阴虚、先天禀赋不足等有关。
痉：《内经》继承了《五十二病方》的观点,强调风邪、湿邪易致痉病,并也强调了精气亏虚是致痉的主要原因。书中部分痉病分别与西医学中的破伤风、狂犬病、脑及脑膜病变有关。
瘛疭：瘛为筋脉抽搐痉挛的疾病症状,多因筋脉失养所致。《内经》发热性疾病引发的瘛疭,类于西医学中的高热惊厥,在小儿尤为常见。无发热的瘛疭常见于代谢性疾病、营养障碍性疾病、各种中毒性脑病、中枢神经系统病变、疭病、癫痫等。
厥逆：《内经》中厥逆涉及头痛、眩晕、癫痫等疾病,因与气机逆行有关,所以多有胀满、疼痛之类的症状。分别与西医学中的紧张型头痛、偏头痛、癫痫简单部分性发作的自主神经性发作、复杂部分性发作等相关。
暴厥、尸厥、大厥：此三种病症都表现为突然昏厥、不省人事。为了强调发作时的症状特点,以不同名称对其加以区分。以“暴”强调病发突然,以“大”强调病势之甚,以“尸”形容晕厥后形无知觉、状态如尸的症状。西医学认为晕厥发生机制是短暂性脑缺血,可由多种原因引发。
煎厥：《内经》两处煎厥证候各异,一为精亏之人感受暑邪,阳亢阴竭而晕厥的疾病,另一处为阳气内郁不畅导致气虚善怒的情志病变。症虽不同却都是因阳气输布异常所致,故都以煎厥为名。
薄厥：《内经》薄厥是因大怒引发,发时晕厥,醒后肢体痿废不用。就其病候应属于中风病的一种,类于急性发作的脑血管病。
经脉之厥：当足太阳、少阳、手太阳经脉气机厥逆时,会出现头、项、脊背、腰、下肢等处的疼痛、痉挛症状,似为西医学中的脑膜刺激征。阳明之厥会见癫痫、神志错乱之症,与癫痫的复杂部分性发作相似。
沉厥：即寒邪所致下肢沉重逆冷之厥证。《内经》还描述了气逆上冲、下肢弛缓不收、大小便不利的症状特点,据此可初步推论此是骶髓以上的上运动神经元或自主神经损伤所致疾病。
痿：在痿的病因探讨中,《内经》提出环境、情志、劳伤、体质等因素引发痿病,此与西医学的认识有诸多相似之处。据经中原文描述,痿与急性脊髓炎、脊髓亚急性联合变性、急性感染性多发性神经根神经炎、肌营养不良症、重症肌无力、脱髓鞘疾病的某些症状、运动神经元病的某些类型、遗传性疾病或神经系统感染性而出现的瘫痪和癔症性瘫痪等直接相关。
解：解一病在《内经》不同篇章各有所指,涉及西医学中的运动神经元病、脊髓空洞症、脊髓炎、脊神经根炎、神经干损伤等疾病。
体惰：体惰是外伤后再感风寒或堕坠损伤出现四支懈惰不收的病症,似感染性或外伤性脊髓疾病。
口喎：《内经》认为口喎是由寒热之邪所致,主要症状有口部歪斜、目不合、目不开、唇胗等。经中各处记述的口喎多具有上下组面肌同时受累的特点,或者伴发口周疱疹,所以与西医学中的周围性面瘫相近。《内经》尚未对口喎的健侧、患侧加以区分讨论。
肉苛：肉苛是以形体麻木不仁、痿废不用、肌肉如故、神志虽清但不能支配躯体为主要证候特点的疾病。其与西医学中的多发性硬化病变多有相似之处。
肉烁：肉烁是肌肉为热邪销灼,四肢灼热疼痛,日渐消瘦的疾病。病在肢体,属于周围神经疾病范畴,如灼性神经痛、多发性末梢神经炎等。
风厥：《内经》中的风厥即指阳气不得伸展输布导致的惊骇、背痛、噫、欠病症,也指漉漉汗出的汗证。以西医学理论分析,这些证候与植物神经功能紊乱多有联系。
亸：主要表现为筋脉懈惰,参考其病名含义,此似为西医学中的重症肌无力、线粒体肌病、周期性麻痹等疾病。
转筋：转筋不同于痉病的脊反张,也有别于瘛疭的肢体有节律收缩,是筋脉与肌肉收引、扭转、拘急为主的疾病症状。《内经》转筋病位以下肢为多,也可见于上肢或全身。躯体或局部扭转症状多见于锥体外系病变,是由基底节神经递质的生成、转化和代谢异常以及环路活动紊乱导致的运动障碍。
狂：《内经》狂病即包括精神亢奋的阳性证候,也包括精神抑郁的阴性证候。部分狂病属于颅内感染、躯体感染、癫痫、循环系统疾病引发的器质性精神障碍。《内经》对狂病发作时的证候观察非常细微,对感知、思维、情感、记忆、动作与行为障碍等都有记载。经中狂病的阳性证候与西医学中的精神分裂症、躁狂症、偏执性精神障碍、分裂情感性精神病等相似。阴性证候与精神分裂症中的紧张型、单纯型、抑郁性神经症和躁狂抑郁症的抑郁状态等相近。
忧悲：《内经》认为许多神志失常的病症常由忧悲发展而来。忧悲多因脏气虚衰、神气不足、气机逆乱而引发。患者常见忧伤、善哭、烦乱、太息、喉中若有异物、失音等症状,属于后世所说的郁病范畴,类于西医学心境障碍中抑郁发作的轻症或部分神经症性障碍。
善忘：《内经》认为善忘多是由肾精亏虚、上窍精气不足、气血逆乱等所致,与心肺肾脾关系密切。经中非常形象地描述了善忘患者对近期事件遗忘的记忆减退特点。书中还观察到患者常伴有惊恐、烦躁、抑郁等症状,此种善忘与西医学中心境障碍或神经症性精神病关系密切。
通过对上述病症及部分证候的整理分析,可见神经系统疾病在《内经》中主要与脏腑病、经络病、肢体关节病、外感病等密切相关。这些病症遍及周围神经系统、脊髓、脑部、肌肉、自主神经系统、锥体外系统等病变。精神疾病在经中虽也涉及到阳厥、煎厥、骭厥、骨厥、风厥等病症,但记述最为详细的为狂病。除此之外更多相关内容是以证候描述为主,未有命名。
由于神经解剖、生理、病理的特殊性和复杂性,以及《内经》对神经系统认识的不足,不能以现代神经病学精准的定位诊断来衡量经中所记述的病症内容。中西对照研究应从发病过程、病变部位、病症表现、疾病转归、预后特点等几方面入手,探寻中西医记载的共同之处,对中医所述病症做以粗略的病位或西医学归属范畴的推论,为临床相关疾病的中西医结合治疗提供参考。
According to the characteristics of nerve and mental illness, the related diseases in Yellow Emperor's Internal Classic are filtered in this article. The textual research on the meanings of the name of the diseases is taken, the characteristics of the symptoms are analyzed, and relationship between theory of traditional Chinese medicine and Western medicine is discussed. These studies contribute to the understanding of the disease of traditional Chinese medicine, and can provide theory reference for the clinical diagnosis, treatment of diseases
This study involves a total of25Chinese medicine disorders class.
Pianku disease:Pianku disease in Yellow Emperor's Internal Classic means unilateral paralysis, pain with clear mind, that belongs to stroke in the meridian, or to in the Zang-Fu organs with syncope. Pian Ku has the closed relationship with cerebrovascular disease of modern medicine. The knowledge on pathogen and disease severity and language features is consistent with the theory of modern medicine. The Pianku with the changing severity of the symptoms reflects the characters of various types, easy recurrence and gradual deterioration of the cerebrovascular disease.
Fei disease:the pathology of Fei disease in Yellow Emperor's Internal Classic is deficiency of kidney essence. Its major manifestations are limbs flaccid or convulsions without body pain. Mental status of the patient determines the disease prognosis. Fei belongs to the pathological change of stroke in five zang-organs, that has the closed relationship with brain hemorrhage, cerebral thrombosis and cerebral embolism of modern medicine.
Headache:A wide range of organic headache, such as trauma, brain lesions, high intracranial pressure, infection headache are recorded in Yellow Emperor's Internal Classic. The headache can be affected by the exogenous pathogenic cold, failure in nourishing due to deficient essence, adverse flow of qi, blood stasis and other factors. The non-organic headaches in Yellow Emperor's Internal Classic are also discussed, such as unilateral headache, persistent headache, that has the closed relationship with migraine headaches, neuralgia, three truck tension-type headache of modern medicine.
Vertigo:The pathogens of vertigo in Yellow Emperor's Internal Classic is the invasion of endogenous wind or exogenous wind into the eyes or brain, that has the closed relationship with vestibular vertigo, small encephalitis, meningitis, encephalitis, or cerebral vascular disease.
Epilepsy:The first period and convulsions period of epilepsy, as well as the systemic manifestations and epileptic seizures continued status are described in Yellow Emperor's Internal Classic.
It is considered that epilepsy can be caused by adversely ascending of qi movement, excessive yang with deficient yin, and genital mutilation.
Jing disease:Jing disease in Yellow Emperor's Internal Classic can be caused by wind evil and damp evil. The pathogen of Jing is deficiency of qi and essence. Part of description of Jing disease has closed relationship with Tetanus, rabies, cerebral and meningeal lesions.
Tugging and slackening syndrome:Tugging and slackening syndrome has the symptoms of seizures and spasms caused by innutrition of tendons. Tugging and slackening syndrome in febrile diseases in Yellow Emperor's Internal Classic is similar to febrile convulsion of modern medicine with high incidence in children.
Jueni disease:Jue ni disease in Yellow Emperor's Internal Classic represents different meanings, including headache, vertigo, epilepsy and so on. The common pathogenesis of those diseases is qi inverse. These diseases have the close relationship with tension-type headache, migraine, epilepsy of modern medicine.
Baojue, Shijue, Dajue disease:These three diseases have the same symptom of suddenly blackout. The names are changed by different symptoms for the time of outburst. These syndromes have the closed relationship with transient cerebral ischemia of modern medicine.
Jianjue disease:The two kinds of Jianjue disease in Yellow Emperor's Internal Classic are respectively caused by summer-heat stroking on weak people and frequent anger with qi-deficiency.
Bojue disease:Bojue disease in Yellow Emperor's Internal Classic is caused by great anger, and it can lead to limb paralysis after waking, that has the closed relationship with cerebral vascular disease of modern medicine.
Meridian Jue:When qi of foot-taiyang, foot-shaoyang and hand-taiyang meridian is inverse, the manifestations in the region where the meridians run are similar to meningeal irritation symptoms in western medicine.
Chen jue disease:The main symptoms of chen jue include heavy and cold lower extremity, lower extremity weakness, gas counter punching, and anomalous excretion. The initial inference by its symptoms is the injury of motor neurons in the sacral spinal cord above or autonomic nerve.
Flaccidity disease:Yellow Emperor's Internal Classic thinks that the flaccidity disease is related to the factors of environment, emotion, trauma, and physical fitness, which is similar to the understanding in western medicine. Flaccidity disease in Yellow Emperor's Internal Classic has the relationship with acute myelitis, subacute combined degeneration of the spinal cord, acute infection of multiple nerve root nerve inflammation, muscular dystrophy, myasthenia gravis, certain types of motor neuron disease, hereditary diseases, nervous system infections arising from paralysis, and hysteria palsy of modern medicine.
Xieyi disease:There are several meanings in Yellow Emperor's Internal Classic about Xieyi disease which has the relationship with motor neuron disease, patients with syringomyelia, spinal cord, spinal nerve root inflammation and nerve damage of modern medicine.
Tiduo disease:Tiduo disease, which is similar to infectious or traumatic spinal cord diseases, means that the patients are attacked by wind-cold after trauma, or dysfunction of four limbs due to falling accident.
Kouwai Syndrome: Kouwai in Yellow Emperor's Internal Classic, that is related with peripheral facial paralysis of modern medicine closely.can be manifested by such symptoms as mouth skew, no closed eyes, no opened eyes and blisters on lips.
Roushuo disease:Roushuo disease means that muscles have been burned by hot evil and the patient has lost weight. Searing pain mainly occurs in limbs. That is a kind of abnormal feeling caused by peripheral nerve disease, such as causalgia, multiple neuritis and so on.
Rouke disease:The main symptoms of Rouke disease, which is very similar to the multiple sclerosis in modern medicine, include apatheti c, limb paralysis, normal muscle function, and clear mind.
Fengjue disease:Fengjue disease in Yellow Emperor's Internal Classic has two main symptoms, one including horror, back pain, belching, yawn, the other including excessive sweating. These two Fengjue have the closed relationship with autonomic disorders of modern medicine.
Duo disease:The main symptoms of Duo disease are weak tendons and inconvenient movement. The disease is similar to myasthenia gravis, mitochondrial myopathy, periodic paralysis and so on.
Zhuanjin syndrome:Zhuanjin syndrome means tendons and muscle contract and reverse. The region of Zhuanjin syndrome is mainly in the lower limbs, and can also be manifested in the upper limbs, or the whole body. The reverse symptoms often occur in extrapyramidal diseases which can cause neurotransmitter in the basal ganglia, transformation and metabolic disorders and movement disorders by loop activity disorder.
Manic psychosis:manic psychosis in Yellow Emperor's Internal Classic includes two symptoms of mental excitement and depression. Some of manic psychosis belong to organic mental disorders caused by intracranial infections, somatic infection, epilepsy and diseases of the circulatory system. The disorder of mental disease, emotions, memory, perception, thinking, behavior and other aspects are recorded in Yellow Emperor's Internal Classic. The type of mental excitement is similar to the mental disorders of schizophrenia, mania, paranoia, split the affective psychosis of modern medicine. The type of mental depression is similar to tension-type, simple type of schizophrenia, depression, psychosis, manic depression in modern medicine.
Grief-sadness:It is believed in Yellow Emperor's Internal Classic that many illnesses are caused by grief-sadness. Grief-sadness is often due to lack of qi or/and abnormal movement of qi. Patients usually presents with sadnession, crying, restlessness, sighing, foreign body feeling in the throat, belonging to depressi disease in later ages. These illnesses are similar to mild condition of depression episode in mood disorders, or part of neurotic disorders in Western Medicine.
Forgetfulness:Yellow Emperor's Internal Classic held that forgetfulness often caused by deficiency of kidney essence, shortage of essential qi in the head, and disturbance of qi and blood, which is closely related to the functions of the heart, lung, kidney and spleen. In the work the feature of ecmnesia in patients with forgetfulness was vividly described. And there were records in the work of such symptoms as fear, irritability, and depression for the patients. This is closely related to neurosis or/and psychosis in Western Medicine.
The analysis on the diseases, disorders and some syndromes mentioned above show that the diseases of the nervous system have the closed relationship with zang-fu-organs disease, meridian disease, limb and joint disease and exogenous disease in Yellow Emperor's Internal Classic. Such diseases can affect the peripheral nervous system, spinal cord, brain, muscle, autonomic nervous system and extrapyramidal system. The most detailed descriptions of related diseases of mental disorders in Yellow Emperor's Internal Classic is manic psychosis. Many articles only describe the symptoms of the disease, without specific disease name
Because of the complexity in nervous anatomy, physiology and pathology and lack of understanding of the nervous system in Yellow Emperor's Internal Classic, diagnosis with western medicine cannot be used as the standard to measure the disease and symptoms described in Yellow Emperor's Internal Classic. The similarities of traditional Chinese and Western medicine should be discussed from such aspects as the process, location, pathogenesis and prognosis of disease. The rough location and category in western medicine of diseases and disorders described in TCM is deduced, providing the combined therapy of TCM and western medicine with references.
此次研究采用中国传统的象思维方法,从疾病临床证候之象出发,对疾病进行总体地、动态地、全程地比较对照。在疾病外象的观察基础上进行内在病理机制的分析探讨。共涉及神经、精神疾病相关病症25种(不包含证候)
偏枯：《内经》中偏枯主症为偏侧瘫痪、疼痛、神志清楚,此为中风中经络之证。伴有昏仆症状的偏枯为中风中脏腑之证。偏枯证候表现多见于西医学的脑血管疾病、脑占位性病变等。《内经》认为偏枯发生与饮食厚味有关,语言功能状态及发病年龄与疾病预后相关。这些认识与西医学理论一致。书中还描述了症状变化反复的偏枯,可见此时医者已经注意到脑血管病发作类型多、易于复发、逐渐加重的病变特点。
痱：《内经》痱病是由肾精亏虚所致,主要表现为身体无疼痛、四肢弛缓或痉挛性瘫痪，神伤轻重直接决定着该病的转归预后情况。据其症状表现应属于中风病的邪中五脏之证,近于西医学脑血管病中的脑出血、脑血栓形成、脑栓塞等病变。
头痛：《内经》记载了外伤性、感染性、脑实质病变、高颅内压等多种器质性的头痛。认为其形成与外感风寒、精亏失养、气逆、瘀血等因素有关。同时也描述了偏侧头痛、持续性头痛等非器质性头痛,这与西医学中的偏头痛、三叉神经痛、紧张型头痛等密切相关。
眩：《内经》已认识到眩虽为视物旋转,但病位不仅限于眼部,还与脑部感邪有关。因其有旋转动摇的病症特点,多认为眩与内外风伤、上窍失养有关。《内经》对眩的病候描述与西医学的前庭性眩晕,脑或脑膜炎、脑部血管性疾病所致眩晕的病变特点有共同之处。
癫疾：《内经》癫疾多为癫痫疾病。书中记述了癫痫发作的先兆期和痉挛期表现、全身性大发作的症状、癫痫持续状态、伴有精神症状的复杂部分性发作的自动症状等。认为癫疾形成与气机上逆、阳极阴虚、先天禀赋不足等有关。
痉：《内经》继承了《五十二病方》的观点,强调风邪、湿邪易致痉病,并也强调了精气亏虚是致痉的主要原因。书中部分痉病分别与西医学中的破伤风、狂犬病、脑及脑膜病变有关。
瘛疭：瘛为筋脉抽搐痉挛的疾病症状,多因筋脉失养所致。《内经》发热性疾病引发的瘛疭,类于西医学中的高热惊厥,在小儿尤为常见。无发热的瘛疭常见于代谢性疾病、营养障碍性疾病、各种中毒性脑病、中枢神经系统病变、疭病、癫痫等。
厥逆：《内经》中厥逆涉及头痛、眩晕、癫痫等疾病,因与气机逆行有关,所以多有胀满、疼痛之类的症状。分别与西医学中的紧张型头痛、偏头痛、癫痫简单部分性发作的自主神经性发作、复杂部分性发作等相关。
暴厥、尸厥、大厥：此三种病症都表现为突然昏厥、不省人事。为了强调发作时的症状特点,以不同名称对其加以区分。以“暴”强调病发突然,以“大”强调病势之甚,以“尸”形容晕厥后形无知觉、状态如尸的症状。西医学认为晕厥发生机制是短暂性脑缺血,可由多种原因引发。
煎厥：《内经》两处煎厥证候各异,一为精亏之人感受暑邪,阳亢阴竭而晕厥的疾病,另一处为阳气内郁不畅导致气虚善怒的情志病变。症虽不同却都是因阳气输布异常所致,故都以煎厥为名。
薄厥：《内经》薄厥是因大怒引发,发时晕厥,醒后肢体痿废不用。就其病候应属于中风病的一种,类于急性发作的脑血管病。
经脉之厥：当足太阳、少阳、手太阳经脉气机厥逆时,会出现头、项、脊背、腰、下肢等处的疼痛、痉挛症状,似为西医学中的脑膜刺激征。阳明之厥会见癫痫、神志错乱之症,与癫痫的复杂部分性发作相似。
沉厥：即寒邪所致下肢沉重逆冷之厥证。《内经》还描述了气逆上冲、下肢弛缓不收、大小便不利的症状特点,据此可初步推论此是骶髓以上的上运动神经元或自主神经损伤所致疾病。
痿：在痿的病因探讨中,《内经》提出环境、情志、劳伤、体质等因素引发痿病,此与西医学的认识有诸多相似之处。据经中原文描述,痿与急性脊髓炎、脊髓亚急性联合变性、急性感染性多发性神经根神经炎、肌营养不良症、重症肌无力、脱髓鞘疾病的某些症状、运动神经元病的某些类型、遗传性疾病或神经系统感染性而出现的瘫痪和癔症性瘫痪等直接相关。
解：解一病在《内经》不同篇章各有所指,涉及西医学中的运动神经元病、脊髓空洞症、脊髓炎、脊神经根炎、神经干损伤等疾病。
体惰：体惰是外伤后再感风寒或堕坠损伤出现四支懈惰不收的病症,似感染性或外伤性脊髓疾病。
口喎：《内经》认为口喎是由寒热之邪所致,主要症状有口部歪斜、目不合、目不开、唇胗等。经中各处记述的口喎多具有上下组面肌同时受累的特点,或者伴发口周疱疹,所以与西医学中的周围性面瘫相近。《内经》尚未对口喎的健侧、患侧加以区分讨论。
肉苛：肉苛是以形体麻木不仁、痿废不用、肌肉如故、神志虽清但不能支配躯体为主要证候特点的疾病。其与西医学中的多发性硬化病变多有相似之处。
肉烁：肉烁是肌肉为热邪销灼,四肢灼热疼痛,日渐消瘦的疾病。病在肢体,属于周围神经疾病范畴,如灼性神经痛、多发性末梢神经炎等。
风厥：《内经》中的风厥即指阳气不得伸展输布导致的惊骇、背痛、噫、欠病症,也指漉漉汗出的汗证。以西医学理论分析,这些证候与植物神经功能紊乱多有联系。
亸：主要表现为筋脉懈惰,参考其病名含义,此似为西医学中的重症肌无力、线粒体肌病、周期性麻痹等疾病。
转筋：转筋不同于痉病的脊反张,也有别于瘛疭的肢体有节律收缩,是筋脉与肌肉收引、扭转、拘急为主的疾病症状。《内经》转筋病位以下肢为多,也可见于上肢或全身。躯体或局部扭转症状多见于锥体外系病变,是由基底节神经递质的生成、转化和代谢异常以及环路活动紊乱导致的运动障碍。
狂：《内经》狂病即包括精神亢奋的阳性证候,也包括精神抑郁的阴性证候。部分狂病属于颅内感染、躯体感染、癫痫、循环系统疾病引发的器质性精神障碍。《内经》对狂病发作时的证候观察非常细微,对感知、思维、情感、记忆、动作与行为障碍等都有记载。经中狂病的阳性证候与西医学中的精神分裂症、躁狂症、偏执性精神障碍、分裂情感性精神病等相似。阴性证候与精神分裂症中的紧张型、单纯型、抑郁性神经症和躁狂抑郁症的抑郁状态等相近。
忧悲：《内经》认为许多神志失常的病症常由忧悲发展而来。忧悲多因脏气虚衰、神气不足、气机逆乱而引发。患者常见忧伤、善哭、烦乱、太息、喉中若有异物、失音等症状,属于后世所说的郁病范畴,类于西医学心境障碍中抑郁发作的轻症或部分神经症性障碍。
善忘：《内经》认为善忘多是由肾精亏虚、上窍精气不足、气血逆乱等所致,与心肺肾脾关系密切。经中非常形象地描述了善忘患者对近期事件遗忘的记忆减退特点。书中还观察到患者常伴有惊恐、烦躁、抑郁等症状,此种善忘与西医学中心境障碍或神经症性精神病关系密切。
通过对上述病症及部分证候的整理分析,可见神经系统疾病在《内经》中主要与脏腑病、经络病、肢体关节病、外感病等密切相关。这些病症遍及周围神经系统、脊髓、脑部、肌肉、自主神经系统、锥体外系统等病变。精神疾病在经中虽也涉及到阳厥、煎厥、骭厥、骨厥、风厥等病症,但记述最为详细的为狂病。除此之外更多相关内容是以证候描述为主,未有命名。
由于神经解剖、生理、病理的特殊性和复杂性,以及《内经》对神经系统认识的不足,不能以现代神经病学精准的定位诊断来衡量经中所记述的病症内容。中西对照研究应从发病过程、病变部位、病症表现、疾病转归、预后特点等几方面入手,探寻中西医记载的共同之处,对中医所述病症做以粗略的病位或西医学归属范畴的推论,为临床相关疾病的中西医结合治疗提供参考。
According to the characteristics of nerve and mental illness, the related diseases in Yellow Emperor's Internal Classic are filtered in this article. The textual research on the meanings of the name of the diseases is taken, the characteristics of the symptoms are analyzed, and relationship between theory of traditional Chinese medicine and Western medicine is discussed. These studies contribute to the understanding of the disease of traditional Chinese medicine, and can provide theory reference for the clinical diagnosis, treatment of diseases
This study involves a total of25Chinese medicine disorders class.
Pianku disease:Pianku disease in Yellow Emperor's Internal Classic means unilateral paralysis, pain with clear mind, that belongs to stroke in the meridian, or to in the Zang-Fu organs with syncope. Pian Ku has the closed relationship with cerebrovascular disease of modern medicine. The knowledge on pathogen and disease severity and language features is consistent with the theory of modern medicine. The Pianku with the changing severity of the symptoms reflects the characters of various types, easy recurrence and gradual deterioration of the cerebrovascular disease.
Fei disease:the pathology of Fei disease in Yellow Emperor's Internal Classic is deficiency of kidney essence. Its major manifestations are limbs flaccid or convulsions without body pain. Mental status of the patient determines the disease prognosis. Fei belongs to the pathological change of stroke in five zang-organs, that has the closed relationship with brain hemorrhage, cerebral thrombosis and cerebral embolism of modern medicine.
Headache:A wide range of organic headache, such as trauma, brain lesions, high intracranial pressure, infection headache are recorded in Yellow Emperor's Internal Classic. The headache can be affected by the exogenous pathogenic cold, failure in nourishing due to deficient essence, adverse flow of qi, blood stasis and other factors. The non-organic headaches in Yellow Emperor's Internal Classic are also discussed, such as unilateral headache, persistent headache, that has the closed relationship with migraine headaches, neuralgia, three truck tension-type headache of modern medicine.
Vertigo:The pathogens of vertigo in Yellow Emperor's Internal Classic is the invasion of endogenous wind or exogenous wind into the eyes or brain, that has the closed relationship with vestibular vertigo, small encephalitis, meningitis, encephalitis, or cerebral vascular disease.
Epilepsy:The first period and convulsions period of epilepsy, as well as the systemic manifestations and epileptic seizures continued status are described in Yellow Emperor's Internal Classic.
It is considered that epilepsy can be caused by adversely ascending of qi movement, excessive yang with deficient yin, and genital mutilation.
Jing disease:Jing disease in Yellow Emperor's Internal Classic can be caused by wind evil and damp evil. The pathogen of Jing is deficiency of qi and essence. Part of description of Jing disease has closed relationship with Tetanus, rabies, cerebral and meningeal lesions.
Tugging and slackening syndrome:Tugging and slackening syndrome has the symptoms of seizures and spasms caused by innutrition of tendons. Tugging and slackening syndrome in febrile diseases in Yellow Emperor's Internal Classic is similar to febrile convulsion of modern medicine with high incidence in children.
Jueni disease:Jue ni disease in Yellow Emperor's Internal Classic represents different meanings, including headache, vertigo, epilepsy and so on. The common pathogenesis of those diseases is qi inverse. These diseases have the close relationship with tension-type headache, migraine, epilepsy of modern medicine.
Baojue, Shijue, Dajue disease:These three diseases have the same symptom of suddenly blackout. The names are changed by different symptoms for the time of outburst. These syndromes have the closed relationship with transient cerebral ischemia of modern medicine.
Jianjue disease:The two kinds of Jianjue disease in Yellow Emperor's Internal Classic are respectively caused by summer-heat stroking on weak people and frequent anger with qi-deficiency.
Bojue disease:Bojue disease in Yellow Emperor's Internal Classic is caused by great anger, and it can lead to limb paralysis after waking, that has the closed relationship with cerebral vascular disease of modern medicine.
Meridian Jue:When qi of foot-taiyang, foot-shaoyang and hand-taiyang meridian is inverse, the manifestations in the region where the meridians run are similar to meningeal irritation symptoms in western medicine.
Chen jue disease:The main symptoms of chen jue include heavy and cold lower extremity, lower extremity weakness, gas counter punching, and anomalous excretion. The initial inference by its symptoms is the injury of motor neurons in the sacral spinal cord above or autonomic nerve.
Flaccidity disease:Yellow Emperor's Internal Classic thinks that the flaccidity disease is related to the factors of environment, emotion, trauma, and physical fitness, which is similar to the understanding in western medicine. Flaccidity disease in Yellow Emperor's Internal Classic has the relationship with acute myelitis, subacute combined degeneration of the spinal cord, acute infection of multiple nerve root nerve inflammation, muscular dystrophy, myasthenia gravis, certain types of motor neuron disease, hereditary diseases, nervous system infections arising from paralysis, and hysteria palsy of modern medicine.
Xieyi disease:There are several meanings in Yellow Emperor's Internal Classic about Xieyi disease which has the relationship with motor neuron disease, patients with syringomyelia, spinal cord, spinal nerve root inflammation and nerve damage of modern medicine.
Tiduo disease:Tiduo disease, which is similar to infectious or traumatic spinal cord diseases, means that the patients are attacked by wind-cold after trauma, or dysfunction of four limbs due to falling accident.
Kouwai Syndrome: Kouwai in Yellow Emperor's Internal Classic, that is related with peripheral facial paralysis of modern medicine closely.can be manifested by such symptoms as mouth skew, no closed eyes, no opened eyes and blisters on lips.
Roushuo disease:Roushuo disease means that muscles have been burned by hot evil and the patient has lost weight. Searing pain mainly occurs in limbs. That is a kind of abnormal feeling caused by peripheral nerve disease, such as causalgia, multiple neuritis and so on.
Rouke disease:The main symptoms of Rouke disease, which is very similar to the multiple sclerosis in modern medicine, include apatheti c, limb paralysis, normal muscle function, and clear mind.
Fengjue disease:Fengjue disease in Yellow Emperor's Internal Classic has two main symptoms, one including horror, back pain, belching, yawn, the other including excessive sweating. These two Fengjue have the closed relationship with autonomic disorders of modern medicine.
Duo disease:The main symptoms of Duo disease are weak tendons and inconvenient movement. The disease is similar to myasthenia gravis, mitochondrial myopathy, periodic paralysis and so on.
Zhuanjin syndrome:Zhuanjin syndrome means tendons and muscle contract and reverse. The region of Zhuanjin syndrome is mainly in the lower limbs, and can also be manifested in the upper limbs, or the whole body. The reverse symptoms often occur in extrapyramidal diseases which can cause neurotransmitter in the basal ganglia, transformation and metabolic disorders and movement disorders by loop activity disorder.
Manic psychosis:manic psychosis in Yellow Emperor's Internal Classic includes two symptoms of mental excitement and depression. Some of manic psychosis belong to organic mental disorders caused by intracranial infections, somatic infection, epilepsy and diseases of the circulatory system. The disorder of mental disease, emotions, memory, perception, thinking, behavior and other aspects are recorded in Yellow Emperor's Internal Classic. The type of mental excitement is similar to the mental disorders of schizophrenia, mania, paranoia, split the affective psychosis of modern medicine. The type of mental depression is similar to tension-type, simple type of schizophrenia, depression, psychosis, manic depression in modern medicine.
Grief-sadness:It is believed in Yellow Emperor's Internal Classic that many illnesses are caused by grief-sadness. Grief-sadness is often due to lack of qi or/and abnormal movement of qi. Patients usually presents with sadnession, crying, restlessness, sighing, foreign body feeling in the throat, belonging to depressi disease in later ages. These illnesses are similar to mild condition of depression episode in mood disorders, or part of neurotic disorders in Western Medicine.
Forgetfulness:Yellow Emperor's Internal Classic held that forgetfulness often caused by deficiency of kidney essence, shortage of essential qi in the head, and disturbance of qi and blood, which is closely related to the functions of the heart, lung, kidney and spleen. In the work the feature of ecmnesia in patients with forgetfulness was vividly described. And there were records in the work of such symptoms as fear, irritability, and depression for the patients. This is closely related to neurosis or/and psychosis in Western Medicine.
The analysis on the diseases, disorders and some syndromes mentioned above show that the diseases of the nervous system have the closed relationship with zang-fu-organs disease, meridian disease, limb and joint disease and exogenous disease in Yellow Emperor's Internal Classic. Such diseases can affect the peripheral nervous system, spinal cord, brain, muscle, autonomic nervous system and extrapyramidal system. The most detailed descriptions of related diseases of mental disorders in Yellow Emperor's Internal Classic is manic psychosis. Many articles only describe the symptoms of the disease, without specific disease name
Because of the complexity in nervous anatomy, physiology and pathology and lack of understanding of the nervous system in Yellow Emperor's Internal Classic, diagnosis with western medicine cannot be used as the standard to measure the disease and symptoms described in Yellow Emperor's Internal Classic. The similarities of traditional Chinese and Western medicine should be discussed from such aspects as the process, location, pathogenesis and prognosis of disease. The rough location and category in western medicine of diseases and disorders described in TCM is deduced, providing the combined therapy of TCM and western medicine with references.
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