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钠郁泔方
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1 A CTA GEO GRA PH ICA S IN ICA V o l. 54, N o. 4 July, 1999 : (1999) (, ) :, 2500,,,, ( ),, : ; ; ; ; : R 18812; R 599 : A ( ),,, ;,,,,, ; [1 ], g g, g g ( ),, 2000, : ; : : ( ) [Foundation item: N ational N atural Science Foundation of Ch i2 na, N o ] : (19652),,,, 40, 2000 E2m ail: shshgong@ccnu21. ccnu. edu. cn

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8 F ig11 T he distribution of ancient endem ic go iter and modern endem ic cretinism in Ch ina,,,,,,,,,, ( ),,, ;,,,,,,,, ;,,,,, :

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10 (References) [1 ] W ei R ushu. A n introduction on the h isto ry of endem ic Go iter in Ch ina[j ]. Ch inese J ou rnal of M ed ical H istory, 1983, 13 (3): 135. ( In Ch inese) [. [J ]., 1983, 13 (3): 135. ] [2 ] Gong Shengsheng. M edico2geograph ical th ink ing befo re the Q in D ynasty and in the H an D ynasties[j ]. Collection of E ssay s on Ch inese H istorical Geog rap hy, 1995 (3): (3): ] ( In Ch inese) [. [J ]., [3 ] Yu W enxiu. A ncient D iseases and T heir Symp tom [M ]. Beijing: Peop le s H ealth P ress, ( In Ch inese) [. [M ]. :, ] [4 ] Cao Yuanfang (SuiD ynasty). T he Causes and Symp tom of all k inds of D iseases[a ]. In: T he A nno tation of the Book J in2kui2yao2 L ue A nd O ther Four M edical Book s[m ]. Shanghai: ShanghaiA ncient Book P ress, ( In Ch inese) [. [A ]. : ( ) [M ]. :, ] [5 ] Zhang Zuo ji, Zhang R uixian et al. FullW o rk s of M edicine King[M ]. Beijing: H uaxia P ress, ( In Ch inese) [,. [M ]. :, ] [6 ] T he M edical Section of the book Gu2J in2t u2shu2j i2chen (V o l, 8) [M ]. Beijing: Peop le s H ealth P ress, , 397. ( In Ch inese) [ [M ]. :, , 397. ] [ 7 ] Zhu Hongjie. Full T ranslation of the Book Bo2W u2zh i[m ]. Guiyang: Guizhou Peop le s P ress, ( In Ch inese) [. [M ]. :, ] [ 8 ] L i Sh izhen (M ing D ynasty). Compendium of M ateria M edica[m ]. Beijing: Ch ina Book sto re P ress, , 50, 45. ( In Ch inese) [. [M ]. :, , 50, 45. ] [ 9 ] J iang Guan (M ing D ynasty). M edical Cases of Famous Docto rs[m ]. Beijing: Ch ina T raditional Ch inesem edicine P ress, ( In Ch inese) [. [M ]. :, ] [ 10 ] R en N aiqiang. R ectification and A nno tation of the Book H ua2yang2guo2zh i[m ]. Shanghai: Shanghai A ncient Book P ress, ( In Ch inese) [. [M ]. :, ] [ 11 ] Yan Changgui, M eil i. T he imm igrants and econom ical developm ent in the area of D anjiangkou R eservo ir in them ing and Q ing D y2 nasties[j ]. Collection of E ssay s on Ch inese H istorical Geog rap hy, 1998 (1): 47.. [J ], 1998 (1): 47. ] ( In Ch inese) [,. [ 12 ] W ei Zh ixiu (Q ing D ynasty). Continuing the M edical Cases of Famous Docto rs[m ]. Beijing: Ch ina T raditional Ch inese M edicine P ress, ( In Ch inese) [. [M ]. :, ] [13 ] Institute of Geography of CA S et al. T he A tlas of Endem ic D iseases and T heir Environm ent in the Peop le s R epublic of Ch ina[m ]. Beijing: Science P ress, ( In Ch inese) [. [M ]. :, ] [14 ] Zhu X ianyi. Endem ic Go iter Ep idem io logy[a ]. In: Endem io logy V o lum e, Ch inese M edical Encyclopedia[M ]. Shanghai: Shanghai Science and T echno logy P ress, ( In Ch inese) [. [A ]. : [M ]. :, ] [15 ] Guo L aixi, J iang D ehua. A study on classification and developm ent of the poo r areas in Ch ina[j ]. Geog rap h ical R esearch, 1995, 14 (2): 3 6. ( In Ch inese) [,. [J ]., 1995, 14 (2): 3 6. ]

11 4 : Endem ic Go iterfoe in H istor ic Ch ina: Its Geograph ic D istr ibution GON G Sheng2sheng (D ep artm ent of Geog rap hy, Central Ch ina N orm al U niversity, W uhan ) Abstract: Endem ic go iter, a w o rldw ide endem ic disease w h ich relates to geo2chem ical en2 vironm en tal facto rs, has a very long p revalen t h isto ry in Ch ina. below fou r issues by analyzing a large amoun t of Ch inese h isto rical docum en ṫ 1. A ncien t Ch inese descrip tion s on endem ic go iter s symp tom s T h is thesis discu sses the A s early as years befo re p resen t, Ch inese knew the facts that endem ic go iter distribu tes mo stly in moun tainou s areas and p revails m ain ly in fem ale population. In Ch i2 nese h isto rical docum en ts, go iter w as called Y ing (go iter) at first, and then b ig2neck. A cco rding to modern m edicine, Y ing is the th ird o r fou rth degree of endem ic go iter, b ig2neck is the first o r second degree of endem ic go iteṙ Ch inese character Y ing is compo sed of w o rds disease, o rnam en t and fem ale, its in itial m ean ing m igh t relate to the though t of an tiqu ity peop le of go iter as the o rnam en t su rrounding fem ale s neck. T he fact show s ancien t Ch inese very early knew that fem ale falls endem ic go iter easier than m ale. By the Sou thern D ynasties (A. D ), Ch inese w ere ab le to distingu ish betw een diffu se go iter and nodu lar go iter. U nfo rtunately, after the Sou thern Song D y2 nasty (A. D ), go iter w as m ixed w ith tumo r by m any docto rṡ 2. A ncien t Ch inese know ledge on the link s betw een go iter and environm en t A ncien t Ch inese believed that the p revalence of endem ic go iter in som e area related clo sely to the natu ral environm en t of th is area and po in ted ou t that w ater quality and land2 scape w ere impo rtan t pathogen ic facto rs of endem ic go iteṙ A bou t years ago, they discovered that moun tainou s areas w ere m ain go iter s ep idem ic areas so that they w rongly believed endem ic go iter resu lted from drink ing ru sh ing, sandy w ater and living in p recip i2 tou s p lace. A lthough then docto rs knew how to t rea t go iter sufferers w ith rich2in2iod ine drugs, un til the early of the 20th cen tu ry, Ch inese don t knew that the real reason fo r en2 dem ic go iter s p revalence is iodine deficiency. 3. T he geograph ical distribu tion of endem ic go iter in ancien t Ch ina Becau se ancien t h isto rian s and literatu re w riter in ten tionally evaded reco rding dis2 eases, the reco rds on endem ic go iter in Ch ina s h isto rical docum en t are seldom seen and very fragm en tary. But th is paper yet co llects enough h isto rical data to recover the distri2 bu tion im age of endem ic go iter in ancien t Ch ina s h in terland. By analyzing a lo ts of h isto ri2 cal reco rds, the au tho r finds the seriou s p revalen t areas of endem ic go iter in ancien t Ch ina m ain ly include: the Q inba moun tainou s areas in Shaanx i P rovince, the w estern moun tain2 ou s areas of H enan P rovince, the w est2no rthern moun tainou s areas of H ubei P rovince, the Zhongtiao moun tainou s areas in Shanx i P rovince, the T aihang moun tainou s areas in H ebei

12 P rovince, the Y im eng moun tainou s areas in Shandong P rovince, the T h ree Go rges area, the M in shan moun tainou s areas in the no rthw estern of Sichuan P rovince, the D ieshan and L iupan moun tainou s areas in Gan su P rovince, and so on. T hese areas are situated in the cen tral part of Ch ina, so are earlier exp lo ited and are mo re reco rded. But it is no t m ean o ther areas w ithou t the reco rds are no t the p revalence areas of endem ic go iter. 4. T he cau ses of distribu tion change and the socio2econom ic harm of endem ic go iter Endem ic go iter is a geo2chem ical environm en tal disease. Ow ing to on ly a little change of geo2chem ical environm en t in the past years, the spatial distribu tion of endem ic go iter in Ch ina rem ained relatively stab ility so that the seriou s p revalen t areas of endem ic go iter in the h isto rical tim es w as generally co inciden t w ith the distribu tion areas of endem 2 ic cretin ism in the early of 1980s. But, by comparing and analyzing, w e cou ld still find, becau se of the imp rovem en t of tran slation condition and dietary compo sition, the distribu2 tion scope of endem ic go iter reduced and its harm is alleviated and even elim inated in som e areas. Fo r examp le, the w estern part of T h ree Go rges area, the eastern2foo t p lain of the T aihang M oun tain. Endem ic go iter s con tinual p revalence in h isto rical periods has done huge harm s to socio2 econom ic system of the endem ic areaṡ Key words: endem ic go iter; endem ic cretin ism ; endem ic distribu tion; ancien t Ch ina

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