Gangrene of the Extremities

Cui Gongrang / 唐祖宣 / Li ZaimingHenan Science and Technology Press1985

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Word count: 180K words
Chapters: 31
Series: Medical Case Series

Summary

Gangrene of the Extremities is one volume in the "Medical Case Series," collectively written by Cui Gongrang, Tang Zuxuan, Li Zaiming, and others, and published by Henan Science and Technology Press in April 1985. The term "tuo ju" in the title comes from ancient surgical literature and broadly refers to gangrene and ulcerative diseases of the extremities caused by impaired blood flow, corresponding to modern Western medicine's thromboangiitis obliterans, arteriosclerosis obliterans, diabetic foot, Raynaud's disease, and other peripheral vascular diseases. The book is divided into two chapters. Chapter One is a general introduction, outlining the concept and scope of the disease; starting from the anatomical features of the hands and feet, it analyzes the causes of gangrene, ulcers, and infection and their histological changes, sorts out clinical symptoms and signs, discusses clinical management approaches including internal and external treatment, and devotes a separate section to clinical nursing, covering mental comfort, dietary care, balanced activity and rest, strict smoking cessation, and moderation in sexual activity. Chapter Two presents proved cases of common gangrene types, divided by disease into ten categories—erythromelalgia, Raynaud's disease, multiple aortitis, cardiogenic gangrene, arteriosclerosis obliterans, diabetic gangrene, deep vein thrombosis with gangrene, thromboangiitis obliterans, infection-induced gangrene, and arterial embolism—with 118 cases in total, of which thromboangiitis obliterans is described by stage: local ischemia, nutritional disturbance, and necrosis. Each disease has an introduction before and a summary after, and most cases are followed by commentary explaining pattern differentiation and treatment and medication principles. The book concentrates the practical experience of Chinese medicine surgery and peripheral vascular disease specialists in Henan, Hubei, and elsewhere in the 1980s in treating such difficult diseases; centered on case records with theoretical generalization, it is one of the important early documents for studying Chinese medicine treatment of gangrene.

Editor's review

这是一本老书，却是一本有用的书。上世纪八十年代，崔公让、唐祖宣等一批从事中医外科与周围血管病工作的医生，把各自接触的大量脱疽病例汇为一编，形成了这部以医案为主体的专著。它难得的地方在于“全”和“实”。总论从手足解剖讲到坏疽发生的原因与组织学改变，再到症状体征、内外治法与临床护理，条理清楚；护理部分把精神安慰、饮食、动静结合、戒烟、房事节制逐项写出，今天看来仍不过时。第二章按病种分列十类，一百一十八例，从红斑性肢痛症到动脉栓塞，覆盖了当时临床上能见到的绝大多数肢端坏疽类型，血栓闭塞性脉管炎更按三期分述，层次分明。每案后附按语，说清辨证依据与用药思路，读者可以按图索骥。需要提醒的是，本书成书于1985年，其中的病名体系、检查手段与用药剂量都带有时代印记，读者应把它当作经验文献来读，而不是当作当下诊疗指南。对于研究中医外科史、整理名老中医经验的读者，这本书的一手价值很难被替代。

Who it's for

A good fit for

从事中医外科、周围血管病专科的临床医生
研究崔公让、唐祖宣等名老中医学术经验的整理者
中医医史文献与中医外科方向的研究生、教师
对肢端坏疽类疾病中医辨治有专门兴趣的资深中医爱好者

Not a good fit for

希望获得当下糖尿病足、脉管炎诊疗指南的读者
完全没有中医基础、想读科普入门读物的一般读者
习惯电子检索、需要现代检查影像与循证数据的读者

Reading tips

先读第一章总论，弄清脱疽的范围、分期与外科处理原则，再进入第二章按病种选读。
读医案时随手记录每案的证型、治法与主方，横向对比同一病种不同医家的思路差异。
注意书中药物剂量与炮制、外治法的时代背景，临床参考时须结合现行规范与法规。
可与《崔公让论治周围血管病》（2021）对读，观察同一学术脉络四十余年间的延续与变化。

About the publisher

Henan Science and Technology Press China · Founded in 1980

Henan Science and Technology Press is a publisher focused on popular science and applied technology books. Judging from the titles in our database, its publishing covers medicine and health, popular science, applied psychology and literary essays. Representative titles include health and medical works such as Goodbye Well, The Essential Family Guide to Children's Medication, Learning to See a Doctor and A Runner's Handbook of Common Pain, as well as popular science and documentary works such as The Structure of the Universe, New Scientific Concepts That Make You Smarter 2 and Twenty Thousand Miles on the Qinghai-Tibet Plateau. Its authors include both Chinese and international writers such as Kathryn Mannix, Peng Xiaohua, Liu Ziqi, Zhang Wenjing, Stephen Alexander and John Brockman, combining professional medical expertise with accessible science writing. Public information is limited, so its series system and publishing features cannot be further described at this time.

Chapter One General Introduction
I. Overview
II. Surgical Management of Gangrene
(1) Anatomical Features of the Hands and Feet
(2) Causes of Gangrene, Ulcers, and Infection
(3) Histological Changes of Gangrene, Ulcers, and Infection
(4) Clinical Symptoms and Signs of Gangrene
(5) Clinical Treatment of Gangrene
III. Clinical Nursing of Gangrene
(1) Mental Comfort
(2) Dietary Care
(3) Scientific Balance of Activity and Rest
(4) Strict Smoking Cessation
(5) Moderation in Sexual Activity
Chapter Two Proved Cases of Common Gangrene Types
I. Erythromelalgia
II. Raynaud's Disease
III. Multiple Aortitis
IV. Cardiogenic Gangrene
V. Arteriosclerosis Obliterans
VI. Diabetic Gangrene
VII. Deep Vein Thrombosis with Gangrene
VIII. Thromboangiitis Obliterans
(1) Causes
(2) Pathology
(3) Clinical Symptoms
(4) Stage One of Thromboangiitis Obliterans (Local Ischemia)
(5) Stage Two of Thromboangiitis Obliterans
(6) Stage Three of Thromboangiitis Obliterans (Necrosis)
IX. Infection-Induced Gangrene
X. Arterial Embolism

FAQ

《脱疽》和《崔公让论治周围血管病》是同一本书吗？

不是。《脱疽》是1985年河南科学技术出版社出版的多人合著医案集，崔公让为主要作者之一；《崔公让论治周围血管病》是2021年中国中医药出版社出版的传承工作室整理本，ISBN 9787513272636，二者内容与体例均不同。

这本书的作者到底是谁？

据书目著录为崔公让、唐祖宣、李在明等著，前言中还提到陈金海、马同长、牛志世等人的治疗经验。总论及各章概述由崔公让执笔，小结由唐祖宣撰写。

书中收录了多少病例？

第二章按十类脱疽病分列，共收载118例验案，其中血栓闭塞性脉管炎按局部缺血期、营养障碍期（第二期）与坏死期分期编排，篇幅最大。

这本书有ISBN吗？

原书为1985年出版物，著录为“14245·92”，属统一书号而非今日的ISBN-13，因此本条ISBN字段留空。

扫描版能直接照方抓药吗？

不建议。书中方药与剂量成于四十年前，部分药材标准、煎服法和适应证表述已变化，若需临床使用，应由执业中医师结合现代诊断与患者具体情况判断。

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About the author

唐祖宣 Author · Chinese · 1942

Tang Zuxuan, born in 1942 in Dengzhou, Henan Province, China, is a National Master of Chinese Medicine. He has long been engaged in the clinical practice of traditional Chinese medicine, particularly in peripheral vascular diseases, and in research on Zhang Zhongjing's teachings, developing a clear sense of the problems at stake between clinical practice and theoretical inquiry. His representative work, A Profound Exploration of Bi Disease in the Chinese Medical Classics, is a medical book that sorts out and elucidates bi disease, a commonly encountered condition in TCM clinical practice. As far as publicly available materials show, records of his biographical details, academic career and complete writings remain limited, and only one of his works is included in this collection, so a full assessment of his writing style and influence cannot yet be made. Readers may turn to the book's interpretation of classical discussions of bi disease to understand his clinical approach and scholarly concerns.