• The Journal of Internal Korean Medicine
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• v.19 no.1
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• pp.524-552
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• 1998

Purgation therapy has played an important role as a influential remedy from the begining of the Chinese medicine. Especially purgation therapy is raised as the effective remedy on the acute infectious disease in the book of 'Treatise on Febrile Disease'. But It was inclined to cold-nature and available only in the excess syndrome. Nevertheless it is evident that the book has showed an example of this therapy. During the middle age, purgation therapy is classified into several subtype; hydrogogue therapy, laxation with lubricants, purgation with cold-natured drugs and purgation with warm-natured drugs. Comparing with the ancient times, it must be a progression. It was investigated earnestly by a school leaded by Zhang Congzheng. They were not restricted to several diseases, but applied it to the wide range of diseases. They thought as following. 'One is ill from pathogenic factor so that you should eliminate it from the human body'. Hence, they frequently used three major remedies such as diaphoresis, emesis and purgation. In this process, purgation therapy had showed eye-opening progress. But opposition to it was not little. Li Gao was a representative man on the opposite side. He expressed a critical opinion and placed great importance on the genuine energy, the natural healing force. Under his influence, a large number of doctors evaded purgation and put it under taboo. On account of these trend, purgation therapy had took a backward step and retrograded. Therefore cathartics such as Rhei Radix et Rhizoma, Rharbitidis Semen, cold drugs such as Gypsum Fibrosum, etc. had been excluded for preservation of the genuine energy, and came about an obnoxious custom to value only 'tonity deficiency', or 'warm and tonify'. As it had came into fashion to approach most disease from the point of view, purgation therapy was merely fall into a remedy of constipation. After the eighteenth century purgation therapy encountered the new period of rivival. It was introduced by them who strived for the study of Epidemics to the new current of thought, so called '增水行舟'. It was because 온병 was apt to dissipate one's Yin fluid. Therefore purgation therapy of this period was characterized by establishing nourishment Yin and body fluid with or without use of timely purgation of accumulation of heat. From the time of Zhang Congzheng, it was accomplished by Lee Je-ma to the most epoch-making change. He caused an improvement in the use of purgation therapy by regarding innate constitutional contradiction as importance than representing clinical symptoms. He warned that existing remedies that depend only upon symptoms and signs, not upon individual characteristics including constitutional features didn't bring round to but kill them. And he understood all the pathologic processes in his constitutional theory, investigated specific drugs on four constitution, made indications of each prescriptions clear. For giving to differentiation of constition before differentiation of syndrom, his new slant on the pathologic phenomena overcome the limitations of 변증시치, and revaluate purgation therapy from remedy impaire the genuine energy to that restore it by recover the balance between the internal organ. It is the product of him to fundamentally upset the cause to be in disregard of purgation therapy.

• Journal of Korean Medical classics
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• v.31 no.2
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• pp.105-126
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• 2018

Objectives : This paper aims to study the educational meaning of Shanghanjiushilun in Shanghanlun education focusing on purgation therapy. Methods : Clinical medical records in Shanghanjiushilun associated with purgation therapy were chosen, analyzed and its educational meaning was studied. Results & Conclusions : 1. Xushuwei's clinical medical records are significant as it helps the readers think of various disease mechanisms by not omitting mistreatment of the other doctors. 2. Xushuwei's clinical medical records are significant as it helps the readers become aware of the importance of a differential diagnosis through questions and answers. 3. Xushuwei's clinical medical records are significant as it helps the readers avoid looking at one side of things through taking a comprehensive look at disease syndrome in various fields. 4. Xushuwei's clinical medical records are significant as it helps the readers escape unreasonableness by suggesting practical aspect managing the patient. 5. Xushuwei's clinical medical records are significant as it enable the readers to draw a new disease mechanism interpretation by making up for explanations of the pathogenesis quoting medical classics. 6. Consequently, in learning and teaching Shanghanlun, Xushuwei's clinical medical records have enough educational meaning as mentioned above.

• The Journal of Korean Medicine
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• v.24 no.1
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• pp.181-189
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• 2003

Background : Patient, family, society and country are badly damaged by stroke (CVA : cerebrovascular accident). To reduce sequelae and return rapidly to society, treatment in the acute stage is very important. In many studies on purgation therapy (下法) used in acute stages of stroke, the changes of blood pressure, pulse and so on before and after purgation therapy were reported. However, the changes in the human body according to the day elapsed after defecation were not reported, so study was needed to confirm such changes. Methods : Seventy-six patients were studied. We observed forty-three patients at acute stroke and thirty-three patients at convalescent stroke. To confirm the importance of regular defecation in stroke patients, we analyzed blood pressure according to the day elapsed after defecation. Results : The following result were obtained. 1. In stroke group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute stroke group. 2. Especially in stroke and acute stroke groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. 3. In the infarction group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute infarction group. 4. Especially, in the infarction and acute infarction groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. Conclusion : In stroke patients, regular defecation is important, so we think that purgation therapy (下法) is needed in stroke patients over the third day elapsed after defecation. We think that the bowel movement control in acute stroke patients is more important than in convalescent stroke patients.

• Journal of Korean Medical classics
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• v.21 no.3
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• pp.27-36
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• 2008

在"四庫全書提要"上把張從正的"儒門事親"解題爲'惟儒者能明其理,而事親者當知醫也'. "儒門事親"的大旨主張驅邪而安正, 而且詳論汗, 吐, 下三法的理論和各科病証的臨床實踐, 因此論議着把當時的弊端弄正. 尤其張氏按照汗, 吐, 下三法的治病而採用的,不但好长时间研究"內經", "傷寒論"的結果,而且他经过运用另外治疗法并失败后, 探索的方法. 早就他說,'世之磨積取積之藥,余初學醫時,亦曾用之. 知其不效,遂改爲撤. 因考"內經"驟然大悟. "內經"曰: 木鬱達之,火鬱發之,土鬱奪之,金鬱泄之,水鬱折之', 把它进一步并解释'五鬱中木鬱達之者,吐之令其條達也. 汗者是風隨汗出也. 下者是推陳致新也', 积累臨床實踐的經驗并主张'所論三法,至精至熟,有得無失,所以敢爲來者言也'. 因此張氏通过使用'汗法'而疏通營衛, 使用'吐法'而條達, 使用'下法'而推陳致新,诱導了流畅气血并流通血气的作用. 尤其在"靈樞"的"平人絶穀"上寫着'胃滿則腸虛, 腸滿則胃虛, 更虛更實, 故氣得上下, 五臟安定, 血脈和利, 精神乃居', 胃腸不但正常地交替虛實和纳运幷轉化五穀的过程,而且對氣血臟腑的生理機能也有影響. 關于人體的'下法'作用機轉, 張氏主張'腸宜通暢', 也就是以这樣的认识爲基本. 論者已经在大韓韓醫學原典學會誌上投稿了關于"儒門事親"之'汗法'和'吐法'的研究,本论文上關于张氏的'下法',槪念, 種類及方法, 範圍, 規律, 禁忌, 調宜, 治療機轉方面上,通轣简單的研究而结束.

• The Journal of Dong Guk Oriental Medicine
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• v.9
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• pp.95-110
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• 2000

The main purpose of this study is to lay the groundwork of mutual assistance between Shanghanlun and Sa-sang Constitutional Medicine by looking into their differences and similarities in the concept and the medical treatment in the diaphoretic therapy and the purgative therapy. The study compared Shanghan Jomun quoted in Soeumin. Dongyi-Soose-Bowon with Je-ma, Lee's Theory of Medicine. And its conclusion is the following: 1. Both Shanghanlun and Sa-sang Constitutional Medicine connote the concept of pathogenic factors in the Nae-Kyung Medicine as the medicinal substances. And both of them have the fundamental structure of exterior-to-interior movements in the symptoms of disease to appear when pathogenic factors penetrate into the bodies. 2. Sa-sang Constitutional Medicine has treated the causes and the mechanism of disease in the symptoms of disease differently from other therapies: focusing on the body's constitutional symptom of disease. namely Soeumin's lack of the Yang-Qi and the poor Ascending Yang, not an attack on pathogenic factors as a interior-exterior symptom. Therefore Ascending-yang Supplying Qi, which fills up the lacking parts of the body and keeps the balance of the body fitted in one's constitution, has been used rather than the diaphoretic and purgative therapy. 3. As Shanghanlun and Sa-sang Constitutional Medicine have the similarities in the interior-to-exterior structure, pathogenic factors. and the notion of diaphoresis and purgation, they do so in the principle of the medicinal substance and the therapy. However, there are actually differences of carrying out the diaphoretic and purgative therapy and other treatments between Shanghanlun and Sa-sang Constitutional Medicine by the reason of the dissimilarities in the mechanism of disease and focal points.

• Journal of Korean Medical classics
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• v.21 no.1
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• pp.1-11
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• 2008

Jangjahwa(張子和) was influenced by "Hwangjenaegyeong(黃帝內經)" and Yuhagan(劉河間)'s theory, and other classics. Also, his clinical experience was helpful to theorize his thought. Thus, he improved medical theory by combining previous medical theory and his own experience. The essence of his thought is the importance of pathogenic Gi[邪氣] as the cause of disease and is Sambeop(三法) of Hantoha(汗吐下) as the methodology for removing pathogenic Gi[邪氣] away. He regarded pathogenic Gi as the cause of disease, and eliminated pathogenic Gi for the remedy. Namely, Sambeop(三法) of Hantoha(汗吐下) was selected as the best efficient method for driving pathogenic Gi away. Sambeop of Jangjahwa(張子和) have different meaning from previous one. Traditionally, Diaphoretic Therapy[汗法] was regarded as therapy for exogenous disease[外感病], and its effect was regarded as Balhanhaepyo(發汗解表). Emetic therapy[吐法] was throwing up Dameumsuksik(痰飮宿食) of stomach and above diaphragm. Purgation therapy[下法] means Tongbyeon(通便), Hajeok(下積), Sasil(瀉實), Chuksu(逐水) were regarded as therapy for Yangmyeongsiljeung(陽明實證) of Sanghan(傷寒). He submitted a new extensive concept of Sambeop adding traditional one, and expanded the application range of Sambeop. All methods, can cause circulation of Gihyeol(氣血) by opening the 'Hyeonbu(玄府)', like Moxibution therapy[灸薰], Steaming[蒸], Washing[洗],Heat therapy[慰], Cauterization[烙], Acupuncture therapy[鍼刺], Stone needling, Physical and breathing exercise[導引], Massage[按摩] were regarded as Diaphoretic Therapy[汗法]. Especially, he thought that Diaphoretic Therapy and venesection[瀉血] have same medical implication. If we examine the process of pushing out pathogenic Gi[邪氣] by means of Sambeop(三法), we can find the intermediation, that is circulation of Gihyeol(氣血). Its meaning is implied in the word of 'opening Hyeonbu(玄府)'. He thought that the circulation of Gihyeol(氣血) is the key to control health. Gihyeol(氣血) was circulated well under the physiological balance, but it was not circulated well under the invasion of pathogenic Gi[邪氣]. In other words, pathogenic Gi is the immediate cause of bad circulation of Gihyeol(氣血) and disease. Naturally, the doctor must remove pathogenic Gi that cause bad circulation for healing by means of Sambeop(三法). In my opinion, because the ultimate goal of Jangjahwa(張子和) was circulation of Gihyeol(氣血) by removing pathogenic Gi[邪氣], the concept of Sarnbeop(三法) could be expanded.

• Journal of Korean Medical classics
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• v.23 no.2
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• pp.205-223
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• 2010

In Korean Traditional Medicine(abbreviated to K.T.M.), hyperhidrosis and anhidrosis are the targets of the medical treatment. Furthermore sweating appearance is also one of the important symptoms which explain a particular situation of the patient in K.T.M. And at "Sanghanron(傷寒論)" which is a traditional chief clinical bible written by Jang Gi(張機) later Han dynasty(漢代) in China made full use of the various kinds of diaphoresis[汗法] as a main medical treatment with purgation therapy[下法] and emetic therapy[吐法]. So the sweat in itself not only is the disease, but also is one of the symptoms explain a disease pattern. This thesis inquires into "Hwangjenaegyeong(黃帝內經)" referring to sweat which is the origin of recognition to the sweat in K.T.M. Some theses similar to this research had been made progresses and already reported, but most of them have classified the contents into biology, pathology, diagnosis, treatment after the model of western medical theory. In the aspect of comparative studying with other literature and clinic practical using, we found characteristics of referring to sweat in "Hwangjenaegyeong(黃帝內經)". And we classify the characteristics into some categories as follows. 1. There are some terms which make a title including sweat and symbolize the characteristics, for example sweat of soul[魄汗], sweat of death[絶汗], sweat of streaming[灌汗], sweat of weakness[白汗], sweat of sleep[寢汗], sweat of bright and heat[炅汗], sweat of kidney[腎汗], sweat of escaping[漉汗], cold sweat[寒汗], sweat on the head[頭汗], hyperhidrosis[多汗], heavy sweat[大汗]. But there aren't spontaneous sweat[自汗] or sweat like a thief[盜汗] which are the normal terms referring to sweat in history of K.T.M. And there are several descriptions about sweat appearance such as sweating in half of body[汗出偏沮], sweating in the rear end and thigh and knee[汗出尻陰股膝], hyperhidrosis in the neck and aversion to wind[頸多汗惡風], hyperhidrosis in the head and face and aversion to wind[頭面多汗惡風], cannot stopping the sweating under head[頭以下汗出不可止], make a person sweat to one's feet[令汗出至足], sweating like escaping[漯漯然汗出], sweating like soaking[汗出如浴], sweating become moist[汗出溱溱], hardly escaping sweat[汗大泄], escaping sweating[漉漉之汗], sweat moisten the pores [汗濡玄府], ceaseless sweating like pouring[汗注不休] sweating like pouring and vexation[汗注煩心], damp with sweat[汗汗然], sweating spontaneously[汗且自出], removal of fever with sweat drying[熱去汗稀]. That can be divided into sweat region and sweat form. 2. There are detailed explanations of the principle of perspirations caused by hot weather, hot food, hard working and meeting damp pathogen. 3. There are some explanations of the principle of removing fever due to the excessive heat from internal and external body through sweating by replenishing the body fluid. And many descriptions about overcoming the febrile disease by dropping temperature through sweating and many diaphoresis for curing. 4. There are some descriptions about five Jang organs perspirations and attachment of five mucous body fluid to five Jang organs. 5. There are pathogenic progresses after sweating affected by the Six Atmospheric Influences and water. And detailed explanations of disease mechanism a sweat leading to another disease. 6. There are descriptions about various sweat absent situations.