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Background: Chapter XI of the Synopsis of Golden Chamber: “Pulse of Dead Lung is deficient when pressed lightly and as weak and rootless as the leaves of a Chinese onion when pressed deeply. This indicates a fatal case.” Only 17 words, but the lack of critical syndrome has led to many doubts in the interpretation, which affects the iagnosis of the “Dead Lung” and therapeutic usefulness.
Purpose: Define and reinterpret the “Dead Lung”.
Methods: Classics research and integration of anatomy and Radiology.
Results:
1. “Dead Lung” describes the pathological transformation of the lungs rom normal to failure, not just a description of pulse changes.
2. “Deficient when ressed lightly” means that the lungs in physiological state are full of gas and appear o be empty, floating on the water surface.
3. “Weak when pressed deeply” is an natomical view of the lung tissue, which is fragile.
4. “As the leaves of a Chinese nion” describes the pathological pattern of “Dead Lung” as comparable to the“honeycomb lung” characteristic of Idiopathic Pulmonary Fibrosis (IPF) under high esolution computed tomography, indicating that doctors at that time had observed
the anatomical pathology of “Dead Lung” in order to accurately depict the term.
5.“Rootless when pressed deeply” refers to the gradual loss of gas exchange following nterstitial fibrosis of the lung and eventual death from lung failure. 6. Chapter XXII
of the Maijing written by Wang Shuhe, the six symptoms of “The Lung Qi is exhausted due to febrile illness......the Lung Failure first” are: (1) wheezing, (2)cough, (3) spitting blood, (4) swelling of the hands, feet and abdomen, (5) yellow face,and (6) shivering and inability to speak, to make up for the lack of symptoms of “Dead Lung”.
Conclusion: The term “Dead Lung” in the Synopsis of the Golden Chamber describes the pathological transformation of the lungs from normal to IPF.
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271.4《金匱要略》「肺死臟」重新詮釋
