jueves, 27 de marzo de 2014

Prescriptions for Fifty-two Diseases (Wu Shi Er Bing Fang) y libros mas antiguos- medicos


The first written record exclusively devoted to disease treatment was compiled sometime between 1065 and 771 BC (Sun 1986). It is the Wu Shi Er Bing Fang (Prescriptions for Fifty-two Diseases), which was only discovered in 1973 during the excavation of the Ma Wang Dui tomb at Changsha, Hunan.
The first written record exclusively devoted to disease treatment was compiled sometime between 1065 and 771 BC (Sun 1986). It is the Wu Shi Er Bing Fang (Prescriptions for Fifty-two Diseases), which was only discovered in 1973 during the excavation of the Ma Wang Dui tomb at Changsha, Hunan. Prior to that discovery, the Shen Nong Ben Cao Jing (Shennong Herbal), compiled sometime between the 1st century BC and the 2nd century AD, had been the earliest record of Chinese materia medica.
During the excavation of the Ma Wang Dui tomb (dated 168 BC), numerous drugs were found in sachets, two of which were clutched in the hand of a skeleton. The drugs positively identified include cassia or Chinese cinnamon, magnolia flower bud (xinyi, Magnolia spp.), sour date kernel (suanzaoren, seeds of Ziziphus spp.), ginger [ganjiang, Zingiber officinalis (Willd.) Rosc.], gaoben (rhizome of Ligusticum spp.), eupatorium herb [peilan, Eupatorium fortunei Turcz.], and Sichuan peppercorn [huajiao, fruit of Zanthoxylum bungeanum Maxim.]. Among other finds were some well-known Chinese classics and the silk scroll copy of the Prescriptions for Fifty-two Diseases.

The Prescriptions lists 52 diseases, with 283 known prescriptions for their treatment; over two-thirds of the prescriptions contained two or more components (Chen 1987b). Some of the identified diseases along with the number of prescriptions indicated for each disease are given below:

Disease                  No. of prescriptions
Skin ulcers and carbuncles 42
Urinary problems 29
Hernia 24
Wounds and injuries 17
Frostbite 14
Snake bite 13
Warts/tumors 10
Internal hemorrhoids 9
External hemorrhoids 4
Poison arrow wounds 7 
Lacquer sores (dermatitis) 7
Convulsions from wounds 6
Male sexual disease(s) 5
Mad dog bites 3              
Infantile convulsions 2
Malaria 2

Based on preliminary studies, there are 247 drugs listed, many of which have not been identified or found in later herbals such as the Shennong Herbal. One third are derived from mineral or animal sources. Among the identified plant drugs are the following:

Qinghao [herb of Artemisia annua L.]
Magnolia flower bud [Magnolia spp.]
Licorice [root of Glycyrrhiza spp.]
Baizhi [root of Angelica dahurica (Fisch. ex Hoffm.) Benth. et Hook. f.]
Fuling [sclerotium of Poria cocos (Schw.) Wolf]
Huangqi [root of Astragalus spp.]
Ginger [rhizome of Zingiber officinale (Willd.) Rosc.]
Aconite [main root of Aconitum carmichaeli Debx.]
Fangfeng [root of Ledebouriella divaricata (Turcz.) Hiroe]
Shaoyao [root of Paeonia lactiflora Pall.]
All above drugs are still commonly used in traditional Chinese medicine. Some have been extensively studied by modern scientific methods, including chemical analysis and biological assays, while others have barely been examined. The most extensively studied and well known to American scientists are probably qinghao, licorice and huangqi. Although modern studies of these ancient drugs have yielded the new antimalarial qinghaosu (artemisinin) from qinghao, they have not been able to derive any exciting new "modern" drugs from the other two. Yet, these herbs continue to be two of the most widely consumed in China.

One of the most widely used drugs in treating rhinitis, including allergic rhinitis (e.g. hay fever), is magnolia flower bud. Its written use record dates back to the Prescriptions and its efficacy has been repeatedly reported in modern biomedical literature, though rarely in combinations containing less than three drugs (Ren 1985). Despite the universal occurrence of hay fever and the continued interest in treating this condition, the time-tested magnolia flower has not been exploited by Western drug developers. 
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 A prescription book entitled "The Prescriptions for Fifty-two Kinds of Disease" was unearthed in 1979 from the No. 3 Han Tomb at Ma Wang Dui, Changsha, Hunan Province. It is the earliest extant medical formulary in China.

With the development of traditional Chinese medicine, the prescription itself has also become perfected and enriched. Around the Warring States period and in the Qin and Han Dynasties, a classical writing of TCM entitled "The Yellow Emperor's Canon of Internal Medicine" came out. This is the earliest book dealing with the basic theories of the science of TCM formulae, such as the principle of formulating a prescription, incompatibility of drugs in a prescription, some dosage forms and their usages. The book consisting of 13 prescriptions has laid a solid foundation for the formation and the development of the science of TCM formulae. 
Zhang Zhongjing, an outstanding physician in the Eastern Han Dynasty, after diligently seeking the ancient experience and book knowledge and extensively collecting numerous prescriptions, compiled "Treatise on Febrile and Miscellaneous Diseases" which contains 269 prescriptions. This book gives interpretations in detail to the modification of the prescriptions and their administrations. The dosage forms are also quite excellent. Therefore, the book has been honored as the "forerunner of prescription books" by all the later physicians. In the prosperous period of the Tang Dynasty, more voluminous prescription writing came out one after another and promoted the development of science of TCM formulae, such as "The Prescriptions Worth a Thousand Gold for Emergencies" and "A Supplement to the Essential Prescriptions Worth a Thousand Gold for Emergencies", compiled by Sun Simiao, and "The Medical Secrets of an Official" compiled by Wang Tao consisting of more than six thousand prescriptions. The three medical formularies representing the major achievements made before the Tang Dynasty collected famous earlier prescriptions in the previous historical periods and some foreign prescriptions used in the Tang Dynasty and preserved the materials on prescriptions. 
In the Song Dynasty, the government once organized outstanding physicians to compile "Peaceful Holy Benevolent Prescriptions" (with 16834 prescriptions), "General Collection for Holy Relief" (with approximately 20000 prescriptions), and "Prescription of Peaceful Benevolent Dispensary" (with 788 prescriptions). The last one was compiled on the basis of the revision and supplement to the formularies collected by the Official Pharmaceutical Bureau. It is one of the earliest formulary in the world compiled by the National Pharmaceutical Bureau

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