World Integrated Medicine Master TANG You-zhi—Doctor of Ophthalmological Surgery for Chairman Mao

ZOU Jian-hua (邹建华), ZHAO Hui-ru (赵惠茹), LU Li-zhu (陆丽珠),SUN Yi-nuo (孙一诺), ZHANG Wei-han (张巍翰)

1. Center for Translation, World Federation of Chinese Medicine Societies, Beijing 100101, China

2. Ophthalmological Hospital, China Academy of Chinese Medical Sciences, Beijing 100040, China

3. Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China

4. Beijing University of Chinese Medicine, Beijing 100029, China

INTRODUCTION OF TANG YOUZHI

TANG You-zhi , alias Kunwu, born in July 1926 in Hangzhou, Zhejiang province,is an Ophthalmological scientist on Chinese medicine. From 1942 to1947, he learned from Lu Nanshan, a famous doctor of Traditional Chinese Medicine Ophthalmology in Shanghai. After returning to Hangzhou, he opened up the TANG Kunwu Eye Clinic. In 1952, the Ministry of Health enrolled students to train Chinese medicine researchers,so he went to the School of Medicine, Peking University to study western medicine for 5 years. After graduating in 1957, he was assigned to the Xiyuan Hospital, China Academy of Chinese Medical Sclences affiliated to the Ministry of Health, China working on clinical medical practice and research in traditional Chinese medicine. In January 1963, he was transferred to the department of ophthalmology of Guang'anmen Hospital, China Academy of Chinese Medical Sciences. In 1978, he served as the vice president of the China Academy of Chinese Medical Sciences until 1995. Later he has been served as the honorary president of the China Academy of Chinese Medical Sciences until now. He is now the honorary president, researcher, chief physician and doctoral tutor of Opthalmolgical Hospital of China Academy of Chinese Medical Sciences (from the year of 2015, it changed the name from China Academy of Traditional Chinese Medicine to China Academy of Chinese Medical Sciences). He is also a visiting professor and doctoral tutor of Guangdong Provincial Hospital of Chinese Medicine of Guangzhou University of Chinese Medicine.

He is the president of the Specialty Committee of Ophthalmology of World Federation of Chinese Medicine Societies, lifelong director of China Association of Chinese Medicine, chief editor of Chinese Journal of Ophthalmology of Traditional Chinese Medicine, honorary chairman of Chinese Ophthalmological Association of Integrated Traditional Chinese and Western Medicine and Chinese Ophthalmological Association. He enjoys the special subsidies from the Government of the State Council. He once served as honorary professor of ophthalmology and optics institute, Hong Kong Polytechnic University, representative of the 5thto 8thNational People's Congress, chairman of Chinese Ophthalmological Association of Integrated Traditional Chinese and Western Medicine and Chinese Ophthalmological Association, member of the Academic Committee of the Ministry of Health, deputy director of the First New Drug Evaluation Committee of the Ministry of Health Member,chairman of the Chinese Medicine Group of the 2ndto 4thNew Drug Evaluation Committee, executive Director of the Chinese Ophthalmology Society, executive vice president of the Chinese Association of Integrative Medicine,honorary Chairman of the European Society of Ophthalmology and Traditional Chinese Medicine, Editorial Board of Encyclopedia of Chinese Medicine, editor-in-chief of theChinese Medicine-Ophthalmology Volume of Traditional Chinese Medicineetc. In May 2009, he won the first batch of honorary title of the "National Master of Traditional Chinese Medicine" and the "May 1 Labor Medal" of the central state organs.

OHTHALMOLOGICAL RESEARCH AND PRACTICE

Cataract Needle Extraction

The traditional concept of ophthalmology in Western medicine held that "cataractopiesis with metal needle" not only causes serious inflammation,but also contains the serious threats of secondary glaucoma, retinal detachment, intraocular hemorrhage and vitreous opacity, so it has been abandoned. Since 1958, Dr. TANG You-zhi has been engaged in clinical and experimental research of ophthalmology in traditional Chinese medicine,and integration of traditional Chinese medicine and Western medicine. Through inheriting the"cataractopiesis with metal needle" in The Great Compendium of Classics on Ophthalmology and combining with modern anatomy, after thorough research, finally, the problem of incision in the level of ciliary body has been innovatively solved. He believed that the plain part of ciliary body had fewer blood vessels, mainly veins, with muscle fibers and there is less chance of bleeding through the incision.Referring to the experience accumulated in ancient China for more than one thousand years, this part of the ciliary body had the advantages of simple procedure, safer operation and better effect. After many years of clinical operation, long-term followup and pathological observation of the eyeball after operation, it was proved that it was safe, feasible and scientifically to make an incision at the level of the ciliary body. And the problem of preventing and overcoming the complications of glaucoma and other operations has been studied, so that the old"cataractopiesis with metal needle" can be reborn.

In April 1966, the research on "cataract needle extraction" was appraised by the Ministry of Health.Famous ophthalmologists such as GUO Bingkuan of Shanghai First Medical College, MAO Wen-shu of Guangzhou Zhongshan Medical College, LU Jia-qi and LI Feng-ming of Beijing Medical College,LU Dao-yan of Shanghai Second Medical College,ZHANG Xiao-lou, ZHANG Shu-fang of Beijing Tongren Hospital, LUO Zong-xian and HU Zheng of Beijing Union Medical College and other professors were organized to serve as appraisal committee.After careful review and approval, the research result was highly appraised and was awarded. But this failed to achieve because of a decade of "Cultural Revolution" occurred after a month and a half, until 1978, they was commended at the National Science and Technology Congress.

Left picture:Chairman MAO Ze-dong and Medical Staff (Left 3 TANG You-zhi as the leader of Chinese medicine team) in 1975

Right picture:1975 Needle Dialing Technology Commemorative Stamps

Since 1968, the research on "cataract extraction by needle sleeve" has been carried out.By improving the design of surgical methods and instruments, the shortcomings of cataract needle extraction have been overcome and creative achievements have been achieved. In 1985, it won the second prize of national scientific and technological progress. The International Congress of Ophthalmology, held every 4 years, is an internationally recognized platform for ophthalmology and the largest academic event. In May 1986,with the Report on cataract extraction by needle extraction, TANG went to Rome, Italy, to express his research results of national medicine in English at the 25thInternational Ophthalmological Congress.Later, he hosted many international conferences on Integrated Medicine in Ophthalmology.

The contribution of cataract needle extraction is: firstly, it is proposed that 4 mm outside the corneal limbus of the ciliary body is the incision site, and that the incision should be parallel to the corneal limbus. The advantages of the incision are illustrated from the aspects of anatomy, tissue,physiology and pathology, so as to avoid the complications that may occur during the internal eye operation on the corneal limbus incision in the past, thus changing the previous international view that the above incision site is a "dangerous area". And it is more than 10 years earlier than that proposed by American scholar Dr. Machemer in 1974. The research, application and popularization of couching for cataract and cataract extraction by needle extraction have played an important role in the prevention and treatment of blindness in China from the 1960s to the 1990s, which has influenced the present day. Because of the advantages of short operation time, small incision, simple operation,quick recovery, good visual acuity and less pain, this method has been widely used and is suitable for the elderly.

Dr. TANG You-zhi successfully performed cataract surgery with couching technique combined with traditional Chinese and Western medicine for chairman of MAO Ze-dong and former Prime Minister of Cambodia, Prince Binnu, and other leaders at home and abroad. Chairman MAO Ze-dong, who was 82 years old at that time,suffered from a variety of diseases. He could not bear the cataract extraction of Western medicine at that time. He was more suitable for couching for cataract of integrated traditional Chinese and Western medicine. After summarizing the past medical records, observing the patients made by each person at that time, studying and analyzing again and again, Premier Zhou finally decided that TANG You-zhi's should be the chairman of the operation. At the beginning of the preparatory work, TANG You-zhi asked to see Chairman Mao every day and observe his daily habits. Careful discussion and thorough technical preparation took more than 7 months, including explaining the causes of cataract and various therapies to Premier ZHOU and Chairman MAO. He compared Chairman Mao's hand to the eyeball, explaining the eyeball anatomy, what is cataract, the effectiveness of drug treatment, the necessity of surgery, Western medicine, traditional Chinese medicine, etc. Finally,Chairman Mao promised to do surgery. Late on the night of July 23, 1975, TANG You-zhi successfully performed cataract needle extraction for Chairman Mao. After the operation, Chairman Mao wrote poems to TANG You-zhi and signed them as a souvenir. The most difficult operation for former Cambodian Prime Minister Binnu was because his head could not control its tremor by any means (120 times per minute when he was nervous). So TANG You-zhi repeatedly practiced shaking his hands and Binnu's head at the same time, keeping the distance between his hands and his head relatively fixed, and finally completed the arduous task.

Traditional Chinese Medicine Treatment of Glaucoma: Filtering Operation of Pars Plana Corporis Ciliaris

Glaucoma is the second leading cause of blindness after cataract. Refractory glaucoma is a kind of glaucoma whose intraocular pressure can not be controlled in normal range by various surgical and drug treatment methods. It is one of the difficult clinical problems in ophthalmology. In order to explore a new way of surgical treatment for this kind of glaucoma, TANG You-zhi reviewed the clinical and pathological studies of cataract needle extraction, and put forward the ideas and methods of traditional Chinese medicine anti-glaucoma surgery.From the study of cataract needle extraction, he used the pars plana corporis ciliaris as an incision to perform cataract surgery in thousands of cases.When encountering secondary glaucoma, he used a self-designed scleral ring drill in the flat part of the ciliary body for scleral and ciliary ring resection,which effectively solved this kind of glaucoma.

Trihedral mirror examination and pathological study confirmed that the pars plana corporis ciliaris was no longer healing, and found that the incision site was still in the posterior chamber area, which provided a basis for glaucoma filtering operation.After repeated thinking and research, he designed a filtering operation program in the pars plana corporis ciliaris, named "filtering operation of pars plana corporis ciliaris". Its advantages are: no bleeding,no prolapse of ciliary body, no damage to iris and corneal endothelium, no shallow anterior chamber,no sympathetic ophthalmitis after operation, no damage to the function of anterior chamber angle,no influence on the recovery of anterior chamber,no adhesion of anterior chamber angle, the incision located in the pars plana corporis ciliaris,no damage to lens and suspension ligament, the posterior portion does not affect the serrated edges of the retina. The operation is relatively simple,the incision is easy to locate, the operation range is large, and the effect on the original corneal refractive state is minimal. This operation has changed the traditional location and method of glaucoma surgery. The traditional incision site of traditional Chinese medicine is used to build the socalled "eye hole" of traditional Chinese medicine to dredge aqueous humor, so as to achieve the goal of"no stagnation of hepatic duct" and restore normal intraocular pressure. The project funded by the National Natural Science Foundation of China-Basic Research on the application of filtering operation of pars plana corporis ciliaris in the treatment of refractory glaucoma, which he chaired, has passed the acceptance test. The operation has been widely applied in ophthalmology hospitals of the China Academy of Chinese Medical Sciences (CACMS),Guang'anmen Hospital, CACMS and Guangdong Hospital of Traditional Chinese Medicine.

Integrated Traditional Chinese and Western Medicine Clinical Study of Retinitis Pigmentosa

TANG You-zhi led the research group to start the integrated traditional Chinese and Western medicine clinical study on retinitis pigmentosa (RP)in 1987. The treatment of RP was mainly based on traditional Chinese medicine, combined with acupuncture and moxibustion. The therapeutic effects were evaluated by the results of ophthalmic electrophysiology and dynamic quantitative television field, and the effective mechanism was explored. Through summery of 199 eyes cases,67% of the patients had improved in visual acuity,visual field, electrophysiology, immunology, trace elements and free radical scavenging. This study shows that this kind of hereditary and progressive ophthalmopathy may be alleviated by traditional Chinese medicine treatment, and a considerable number of patients have improved vision, enlarged vision, and electroretinogram (ERG) is low wave or waveless before treatment. After treatment, ERG of some patients improved or reappeared waveform,which proved that traditional Chinese medicine treatment could improve the retinal function of patients with retinopathy.

Standardization of Cataract Diagnosis

In order to standardize the diagnosis of cataract, in 1997, Dr. TANG You-zhi carried out the research on" Rotary Lens Tomography Analysis System". Through digital camera, the dynamic section image was transmitted to the computer,and the image was selected for light scattering intensity analysis to quantify the lens turbidity.Based on basic experiments and clinical research,the project completed the development of rotary lens tomography analysis system, and proposed for the first time a quantitative grading diagnostic criterion for galactose-induced cataract in rats, and determined the turbidity area and gray value in each stage of senile cataract. It provides an objective,quantitative and repeatable diagnostic method for cataract clinic, and provides a reliable detection instrument for early diagnosis of cataract, monitoring of disease changes and evaluation of drug efficacy.Corneal curvature, corneal thickness, anterior chamber depth and lens thickness of human eyes are measured by rotating lens tomography analysis system, and the computer storage and retrieval methods of lens tomographic images are studied and determined. The remote transmission function of images is realized. The cataract screening, drug efficacy observation and operation screening can be carried out in different places. The objective quantitative digital record of lens turbidity of cataract can be used to compare the therapeutic effects before and after drug treatment, and it also provides an objective and repeatable evaluation instrument for the pharmacodynamic study of new cataract drugs, which is of great significance for the prevention and treatment of blindness.

Development and Research of Traditional Chinese Medicine Eye Drops

In the external therapy of ophthalmology of traditional Chinese medicine, TANG You-zhi carried out the development and research of traditional Chinese medicine eye drops through modern technology and testing methods. He provided prescription and guidance to the project of National Administration of Traditional Chinese Medicine called "The Clinical and Experimental Study on Virus No. 1 Eye Drops in the Treatment of Herpes Simplex Keratitis". The project had carried out research on the efficacy and mechanism of Chinese medicine ophthalmology. The results showed that the virus No. 1 eye drops was significantly effective in the treatment of herpes simplex keratitis and it provided theoretical and clinical basis for the development of similar ophthalmic external medicines.

In 1991, the project won the second prize of the National Administration of Traditional Chinese Medicine (NATCM) for scientific and technological progress. In order to transform the research results into productivity as soon as possible, on the basis of the study of "Virus No. 1 Eye Drops", a project funded by the Ministry of Science and Technology under his charge, "Development and Research of Refined Shuangqin Eye Gel" is under intensive development.

Difficult Ocular Fundus Diseases - Treatment on the Basis of Qi and Blood

TANG You-zhi has accumulated rich experience in the treatment of difficult ocular fundus diseases, emphasizing "syndrome differentiation on the basis of qi and blood", believing that the disorder of qi and blood is the basic contradiction throughout the whole course of ocular fundus diseases, and putting forward a diagnosis and treatment model of integrated traditional Chinese and western medicine which carried on the syndrome of ocular fundus diseases on the basis of the theory of qi and blood and combined syndrome differentiation with disease differentiation.

Age-related macular degeneration, central exudative chorioretinopathy, diabetic retinopathy,central retinal artery or vein occlusion, retinal periphlebitis, ischemic optic neuropathy, retinitis pigmentosa, high myopic retinopathy, optic atrophy,etc., in a certain stage of the course or the whole course of the disease, there will be "qi and blood depression". Correspondingly, there are choroidal and retinal vasculopathy in the fundus of the eye and the treatment is very difficult. Professor TANG You-zhi called it "fundus blood syndrome".

Wet age-related macular degeneration,macular area neovascular hemorrhage was the main cause of vision loss. He achieved therapeutic effects according to "qi and blood theory"treatment. He sponsored a project called "Study on the Effect of Liangxue Huayu Formula on Inhibiting Neovascularization and Ageing of Macular Degeneration in Elderly Patients" funded by the National Natural Science Foundation of China,and has been completed and has achieved initial results.

His National Science and Technology Department's Eleventh Five-Year Science and Technology Support Program on Chinese medicine Treatment and Efficacy Evaluation of Difficult Diseases - "Research on Traditional Chinese Medicine Intervention Therapy and Efficacy Evaluation of Wet Age-related Macular Degeneration" and National Natural Science Foundation Project "The study on Mingjing Granules in the Intervention of Bone Marrow-Derived Cells Involved in Choroidal Neovascularization" have been completed.

Chinese Medicine Ophthalmology Observation of "Macro Syndrome Differentiation and Micro Syndrome Differentiation"

Dr. TANG You-zhi guided the scientific research and clinical work with the idea of "making the past serve the present, making the foreign serve the Chinese, weeding out the old and bringing forth the new" which integrates and innovates. Whether it is the study of cataract needle extraction, the study of incision of internal eye operation on the pars plana of ciliary body, the study of cataract extraction by needle sleeve, and the study of "pars plana filtering"for refractory glaucoma, all followed this idea.

His research on the rotary lens tomographic image analysis system solved the problem of objective quantitative diagnosis of cataract. He used modern examination methods to observe the pathological changes of the fundus and conduct syndrome differentiation and treatment, focusing on evidence-based medicine.

He believes that with the invention and innovation of medical instruments, such as OCT,UBM, FFA, ICGA, mERG, HRT, HRF etc., which make the "inspection" more subtle and intuitive. On this basis, the diseases and syndroms differentiation can be more accurate, so that prescription based therapeutical principles is more appropriate.

He put forward the viewpoint of "the integration of macro syndrome differentiation and micro syndrome differentiation", which pushed the diseases-syndromes differentiation of Chinese medicine ophthalmology to a new height, made the diagnosis and evaluation of curative effect more objective, digital, scientific and repeatable, so as to make the clinical diagnosis and treatment of Chinese medicine ophthalmology meet the requirements of evidence-based medicine, promote the development of evidence-based Chinese medicine, and promote the modernization and internationalization of Chinese medicine ophthalmology.

TANG YOUZHI'S OUTSTANDING ACHIEVEMENTS

Dr. TANG You-zhi is easily approachable and responsible for the patient regardless of his position.In scientific research and graduate students work,he sets himself an example to others, holds the view that teaching better than words and education,respects science, seeks truth from facts, leads a decent style of study, comes down to earth, explores and innovates. He places great emphasis on practice and believes that only by mastering the firsthand materials, analysis and processing problems can be objective and accurate.

He advocates that patients should be taken as teachers. Because different patients have different syndromes and symptoms, they should be examined carefully and carefully, so that doctors can get different information and acquire new clinical experience.

In his health care work for the leaders, he was meticulous and conscientious. He not only successfully performed cataract surgery for Chairman Mao and Binnu - former Prime Minister of Cambodia,but also was appointed by Premier ZHOU En-lai and Vice Premier DENG Xiao-ping as Chairman Kim Il Sung of Korea as an ophthalmologist for a long time since the end of 1975. In 1992, he was awarded the National Medal of Friendship of Korea.Since December 1999, he has visited Indonesia for President Wahid several times to treat eye diseases and achieved good curative effect. In addition,President Wahid's paralyzed corneas miraculously fully regained consciousness. This practice highlighted the vitality of Chinese medicine in the international society.

TANG You-zhi is diagonsing and examing foreign leaders

TANG You-zhi's free consultation in the nursing home

TANG You-zhi is in the ward

TANG You-zhi has been treating eye diseases for many leading cadres and revolutionary predecessors in China, such as CAI Chang, JI Pengfei, GU Mu etc. Comrade LI Shu-tong, who had recovered from eye disease treated by Dr. TANG You-zhi in that year, returned to Hunan province and wrote a special poem "Die Lian Hua (Butterfly loves flowers)" written by Chairman MAO for TANG You-zhi. ZHOU Jianren, brother of LU Xun and former vice chairman of the Standing Committee of the People's Congress, gave him a calligraphy "Dr TANG, master of Chinese and western medicine".

The former President Kim Il Sung of the Democratic People's Republic of Korea (D.P.R.K)awarded TANG You-zhi the firstclass Korean Medal of Friendship

The former President Wahid of Indonesia and TANG You-zhi in 2000

Dr TANG You-zhi and the former President of the US Dr. Bush shaked hands at the China-US relationship meeting in November 2003

The former Minister of health Gao Qiang attended the 60th anniversary celebration of TANG You-zhi's medical practice in 2006 and delivered a speech

Dr. TANG You-zhi hosted the international conference on ophthalmology of integrated traditional Chinese and Western medicine

In May 2009, he won the first batch of honorary title of the "National Master of Chinese Medicine" and received by Wu Yi, former vice premier of China

TANG You-zhi is one of the founders and academic leaders of the ophthalmology of integrated Chinese and western medicine in China. Former Minister of health of China, Mr. GAO Qiang called him "a model of integrated Chinese and Western medicine in our country" when he spoke at the celebration of TANG You-zhi's 60thanniversary of his medical career. He explored and innovated on the basis of inheriting and developing the knowledge of the predecessors, and worked hard for the modernization and development of ophthalmology of traditional Chinese medicine. He was upright,modest and prudent, and united with his comrades.

With his advocacy and efforts, and with the support of the leaders and the help of colleagues and friends, since 1985, he has successfully established the Ophthalmological Branch of China Association of Chinese Medicine and the Ophthalmological Committee of Chinese Association of Integrated Medicine. A modern ophthalmic hospital of traditional Chinese medicine and integrated Chinese and Western medicine was finally established at the end of 2002, which further promoted the development of Chinese medicine ophthalmology and integrated traditional Chinese and Western medicine, and the process of modernization and internationalization of Chinese medicine ophthalmology.

In view of his contributions to ophthalmology of Chinese medicine, scientific research, clinical medicine, health care, etc., National Science Conference of 1978 awarded him the "National Science Conference Advanced Workers". In 1984,Ministry of Personnel awarded him the certificate of"Outstanding Young and Middle-aged Experts". In 1986, Ministry of Health awarded him the honorary title of "National Health and Civilization Advanced Worker".

Since 1990, he has enjoyed special subsidies from the State Council. The Mexican Council of World Culture awarded him the "Einstein World Science Award" in 1988, He Li Foundation awarded him the "1996 Science and Technology Progress Award". The Guangzhou Zhongjing Chinese Medicine Award Foundation awarded him the"Outstanding Achievement Award" in 1998, and the Chinese Association of Integrative Medicine awarded him the "Contribution Award of Integrated Traditional Chinese and Western Medicine" in 2001. In July 2006, the Pharmaceutical Association awarded him the certificate of "Model Chinese Medicine" and the award of "Special Contribution Award for the Inheritance of Traditional Chinese Medicine" in December.

In 2008, World Federation of Chinese Medicine Societies (WFCMS) awarded him the "WANG Dingyi Cup of International Contribution Award of Traditional Chinese Medicine" and the honorary title of "Capital Chinese Medical Master" in the same year; in May 2009, he gained the first batch of the"National Chinese medicine Master" honorary title and the "May 1 Labor Medal" of the central state organs; in June, the "Life Achievement Award by the China Association of Chinese Medicine"; in July 2010, the Chinese Association of Integrated Medicine awarded him the "China Special Contribution Award for Ophthalmology of Integrated Chinese and Western Medicine".