History of dry syndrome

  Dry syndrome has been precisely documented for more than 100 years. From the medical history, as early as 1888, Polish surgeon Hadden first described a patient with both salivary and tear deficiency; in 1892, Mikulicz reported a patient with bilateral parotid, bilateral submandibular and lacrimal gland enlargement, which showed a large infiltration of lymphocytes in the biopsy tissue of parotid gland, then called Mikulicz syndrome. 1925 Gougerot described three patients with dryness syndrome due to salivary gland atrophy. By 1933, Sjogren, a Swedish ophthalmologist, described 19 patients with dry keratoconjunctivitis, all of whom had dry mouth signs, and 13 of them also had chronic arthritis. Although he did not name this type of disease at the time, his inference was that the disease was a systemic, systemic disorder and occurred mostly in women. In 1953 Morgan and Castleman concluded that Mikulicz’s syndrome and Sjogren’s syndrome were one and the same disease. 1965 Bloch et al. analyzed 62 patients and evaluated the combination of other connective tissue diseases, such as rheumatoid arthritis, systemic arthritis, and systemic arthritis. Based on the analysis of a large sample of cases, they firstly put forward the concept of primary dry syndrome, more comprehensively elaborated the clinical and pathological aspects of this disease, and discovered that this disease has some connection with lymphoma. In 1981, Montborpe proposed the diagnostic criteria of dry keratoconjunctivitis and dry mouth and eye syndrome, and divided it into two categories: primary and secondary, secondary refers to those who overlap with other connective tissue diseases, primary refers to those who are not accompanied by any of the classified connective tissue diseases. The two are significantly different in terms of clinical manifestations, severity, prognosis, genetic factors, and immunological changes. In the mid-1970s, anti-SSA (Ro) and anti-SSB (La) antibodies among autoantibodies were shown to be closely related to the disease. In 1977, the Copenhagen standard, which is still in use now, was formulated, and in 1992, the European diagnostic standard was formulated, and the European diagnostic standard revised in 2002 is the more commonly used diagnostic standard at home and abroad now.  The understanding and research on dry syndrome in China started late, and the literature about dry syndrome in the middle and late 1970s was limited to case reports, and at that time, dry syndrome was considered a rare disease in China. it was not yet included in the unified textbook of the 2nd edition of Internal Medicine edited by Chen Guodong in 1981, and at that time, clinicians nationwide did not know enough about dry syndrome. Due to the general lack of understanding of dry syndrome, the rate of misdiagnosis is high. It is also one of the hot spots of research to analyze the causes of misdiagnosis in combination with our national conditions, so as to formulate the diagnostic criteria of dry syndrome in line with our national conditions.  Although there is no disease name of “dry syndrome” to be found in ancient medical texts of China, there are many discussions of “dryness evidence”. For example, Su Wen. To the true to the great treatise said: “the age of Yangming in the spring, the dryness of the prostitution of the victory, …… people like to vomit, vomit with bitter, good tai breath, the heart and the pain can not be reversed, and even quarrel dry face dust, body without cream, outside the foot counter-heat”, the first proposed to feel the etiology of dryness, and described the dryness of the evil It also describes the symptoms similar to this disease, such as dryness of the mouth and skin, painful redness of the eyes, painful joints, and weakness of the body. In the Ling Shu Jing Yin, there is: “The pulse of the large intestine hand Yang Ming …… is the main fluid sickness, yellow eyes and dry mouth ……”, “the pulse of the kidney hand Shao Yin …… is the main kidney by the sick person, hot mouth and dry tongue, swollen throat and upper gas.” Connecting the disease of dry mouth with the kidney and large intestine. In later times, this pathogenesis of dry mouth is generally divided into three categories: deficiency of fluid and deficiency of heat, kidney deficiency and strain, and loss of fluid elevation. In the Ming Dynasty, Zhang Jiebin’s “Jing Yue Quan Shu” has been able to distinguish the difference between dry mouth and thirst in detail, with the following statement: “The thirst is due to the excess of fire and dryness, while the dryness is due to the deficiency of fluids. And “The Golden Horoscope” has recorded: “five labor deficiency extremely thin, abdominal fullness can not eat …… within the dry blood, skin nail wrong, two eyes dull black. Slow the middle to supplement the deficiency, rhubarb V worm pill main.” It describes the “dryness” caused by “dry blood” and creates Dahuang Sting Worm Pill to treat the skin nail fault caused by blood stasis. Modern Chinese medicine research on dryness syndrome began almost simultaneously with Western medicine. In the 1990s, the National Committee for Paralysis in Chinese Medicine called this disease “dryness paralysis” in its “Treatments of Paralysis”. However, its complex and variable clinical symptoms and their treatment are scattered throughout the Chinese medical literature, and its main symptoms, such as dry mouth and tongue, dry eyes, and joint pain, are included in the broad definition of “dryness” or “paralysis”. The main content is included in the discussion of “dryness” or “paralysis”.