Ancient Chinese Books Research Articles

Book cluster: a new approach to explore the evolution of knowledge organization in ancient China

Abstract Chinese ancient book catalogs have persisted for over two millennia, serving as ancient knowledge organization systems and cultural heritage of great academic value. This article introduces the concept of “book cluster,” a novel approach to studying catalog classification evolution, offering a meso-level perspective that bridges books and categories. Drawing from computational methods, we identify clusters of books with similar categorization trajectories, enabling more efficient and intuitive exploration of knowledge organization trends. We review existing research on catalog classification, highlighting the traditional qualitative analysis and emerging computational methods. We then present our data source and processing methods. The concept of book cluster is defined, along with the algorithm for cluster identification and feature extraction. A case study demonstrates the potential of the book cluster concept in analyzing classification changes and knowledge inheritance. Additionally, we introduce an online analytical platform for further exploration. Through computational analysis of book clusters, we gain insights into the evolution of ancient book recording, circulation, and academic contexts. Book clusters offer clues about the content of lost books. This research lays the groundwork for future iterations. By pioneering the study of knowledge organization evolution using book clusters, we enhance our understanding of Chinese history's academic culture and knowledge preservation.

Cataloging and the study of ancient Chinese book classification systems

Cataloging and the study of ancient Chinese book classification systems

Aging time improves adhesive performance of handmade starch paste for restoration of ancient Chinese books and its mechanism of action

In the restoration of ancient Chinese books, handmade starch paste serves as a paper adhesive, distinguished from traditional starch paste preparation methods. It involves special processes such as starch washing and aging, relying entirely on the artisanal expertise throughout the entire process. The study recreates the process of making handmade starch paste for the restoration of traditional ancient books and investigates the effects of aging time on the apparent viscosity, rheological properties, and adhesive performance of the paste. The results indicate that during aging, the pH of the starch paste decreases significantly, but it has a minimal impact on its apparent viscosity, rheological properties, and paper softness. However, it notably enhances the adhesive performance, with the optimal results observed after 3 days of aging. This is attributed to the decrease in residual protein content in the starch, as well as the significant improvement in swelling power and solubility of the starch. The results of infrared spectroscopy and XRD testing reveal that there are no significant changes in the molecular and crystalline structures of starch during the aging process. The acidic environment produced by starch fermentation promotes protein hydrolysis, emerging as the primary reason for the improved adhesive performance of the paste.

Semantic-enhanced graph neural network for named entity recognition in ancient Chinese books

Named entity recognition (NER) plays a crucial role in the extraction and utilization of knowledge of ancient Chinese books. However, the challenges of ancient Chinese NER not only originate from linguistic features such as the use of single characters and short sentences but are also exacerbated by the scarcity of training data. These factors together limit the capability of deep learning models, like BERT-CRF, in capturing the semantic representation of ancient Chinese characters. In this paper, we explore the semantic enhancement of NER in ancient Chinese books through the utilization of external knowledge. We propose a novel model based on Graph Neural Networks that integrates two different forms of external knowledge: dictionary-level and chapter-level information. Through the Graph Attention Mechanism (GAT), these external knowledge are effectively incorporated into the model’s input context. Our model is evaluated on the C_CLUE dataset, showing an improvement of 3.82% over the baseline BAC-CRF model. It also achieves the best score compared to several state-of-the-art dictionary-augmented models.

Examining the author of She Sheng Yao Yi

She Sheng Yao Yi, a medical book on how to keep fit and healthy in the Ming Dynasty, contained a variety of theoretical ideas for doing so from diverse traditional Chinese medicine physicians and had great influence. However, its author has not been identified because the author of this book in Bibliography of Ancient Books of Traditional Chinese Medicine and Bibliography of Ancient Chinese Books is claimed to be different. The authors dates of birth and death also vary in other relevant reference books. This paper examines and identifies the author of this book based on biographies, historical records, dictionaries and other relevant documents, with a view to contributing to the research of medical history literature.

Integrative analyses of metabolome and transcriptome reveal the dynamic accumulation and regulatory network in rhizomes and fruits of Polygonatum cyrtonema Hua

BackgroundAccording to Chinese ancient books, both fruits and rhizomes of Polygonatum cyrtonema Hua have medicinal and edible values. Up to now, there is no report about the metabolite profiles and regulatory network in fruits and different year-old rhizomes of P. cyrtonema.ResultsIn this study, we performed integrative analyses of metabolome and transcriptome to reveal the dynamic accumulation and regulatory network of fruits and different year-old rhizomes in P. cyrtonema. The relative content of phenolic acids, lignans and coumarins, flavonoids and alkaloids increased with growth years, while steroids and lipids decreased with it. In addition, the relative content of nucleotides and derivatives, flavonoids, organic acids, steroids and lipids in fruits were higher than rhizomes. Genes that might relate to the biosynthesis of polysaccharides, flavonoids, triterpene saponins and alkaloids biosynthesis were further analyzed by transcriptome analysis, including sacA, GMPP, PMM, CCoAOMT, CHI, ANR, CHS, DXS, GGPS, ZEP, CYP72A219 and so on, for their expressions were positively correlated with the relative content of the metabolites. Additionally, the correlation network in sugar and aromatic amino acids metabolites were constructed to further illustrate the biosynthesis of polysaccharides, flavonoids and alkaloids in P. cyrtonema, and some transcription factors (TFs) were screened, such as C2C2, MYB, bZIP, GRAS and NAC.ConclusionsThis study can deepen our understanding of the accumulation patterns and molecular mechanism of the main compounds in P. cyrtonema, and provide reference for the standardize production of P. cyrtonema.

Investigating the potential mechanism and therapeutic effects of SLXG for cholesterol gallstone treatment

BackgroundShugan Lidan Xiaoshi Granules (SLXG) is a traditional Chinese medicine (TCM) formulation frequently employed to prevent and treat cholesterol gallstones. SLXG is formulated based on the Chaihu Shugan Formula found in an ancient Chinese medical book, a traditional remedy in China for centuries, and has demonstrated successful treatment of numerous patients with gallbladder stones. PurposeThis research sought to clarify the therapeutic impact and molecular mechanisms of SLXG and its active components in the treatment of cholesterol gallbladder stones. MethodsThe study employed network pharmacology, UPLC-HRMS transcriptome sequencing, animal model experiments, molecular docking, and Surface Plasmon Resonance (SPR) to explore the molecular mechanisms of SLXG and its relationship with Traditional Chinese Medicines (TCMs) and potential targets. Furthermore, PPI network analysis, along with GO and KEGG enrichment analyses, were performed to explore the potential mechanisms through which SLXG and its active ingredient, naringenin, prevent and treat cholesterol gallstones. The mechanism of action was further elucidated using an animal model for gallbladder stone formation. ResultsThe study employed a network pharmacology and UPLC-HRMS to investigate the active compounds of SLXG for the treatment of cholesterol gallbladder stones, and subsequently constructed a network of therapeutic targets of SLXG. The results from gene enrichment analyses indicated that SLXG targets the metabolic pathway of bile secretion and the cholesterol metabolism pathway in addressing cholesterol gallbladder stones. The molecular docking results confirmed the interaction between the genes enriched in the pathways and the active ingredients in SLXG. Transcriptome sequencing results demonstrated that SLXG exerts its therapeutic effect on gallstones by regulating cholesterol and bile acid synthesis and metabolism. Furthermore, animal model experiments and SPR provided evidence that SLXG and its active ingredient, naringenin, exert therapeutic effects on cholesterol gallbladder stones by targeting the genes HMGCR, SOAT2, and UGT1A1, and influencing substances associated with cholesterol synthesis and metabolism. ConclusionsUsing systematic network pharmacology methods combined with in vivo validation experiments, we uncovered the fundamental pharmacological effects and potential mechanisms of SLXG and its active ingredient, naringenin, in the treatment of cholesterol gallstones. This research underscores the valuable role that traditional remedies can play in addressing medical challenges and suggests a promising direction for further exploration of natural treatments for the disease.

Changes in Rehmanniae Radix processing and their impact on ovarian hypofunction: potential mechanisms of action.

This study evaluates the research developments concerning Rehmanniae Radix in ovarian hypofunction diseases. It explores the processing methods of Rehmanniae Radix, the variations in its compounds before and after processing, the mechanism of Rehmanniae Radix and its active compounds in improving ovarian function, and the advancements in clinical applications of traditional Chinese medicine (TCM) compound that include Rehmanniae Radix. Comprehensive literature search was conducted using databases such as China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, National Science and Technology Library, the Pharmacopoeia of the People's Republic of China, Pubmed, and the Web of Science Database. The search utilized the following Medical Subject Headings (MeSH) and keywords: "Rehmanniae Radix," "Drying Rehmannia Root," "Rehmannia glutinosa," "Rehmanniae Radix Praeparata," "Traditional Chinese Medicine Processing," "Pharmacological Effects," "Ovarian Aging," "Diminished ovarian reserve," "Premature ovarian insufficiency," "Premature Ovarian Failure," "Ovarian hypofunction diseases". The ancient Chinese medical books document various processing techniques for Rehmanniae Radix. Contemporary research has identified changes in its compounds processing and the resultant diverse therapeutic effects. When processed into Rehmanniae Radix Praeparata, it is noted for its ability to invigorate the kidney. TCM compound containing Rehmanniae Radix is frequently used to treat ovarian hypofunction diseases, demonstrating significant clinical effectiveness. The key changes in its compounds processing include cyclic dilute ether terpene glycosides, phenylethanol glycosides, sugars, and 5-hydroxymethylfurfural. Its pharmacological action is primarily linked to the improvement of granulosa cell proliferation, antioxidative and anti-aging properties, and modulation of the immune and inflammatory microenvironment. Furthermore, Rehmanniae Radix also offers therapeutic benefits for cardiovascular and cerebrovascular diseases, osteoporosis and cognitive dysfunction caused by low estrogen levels. Thereby Rehmanniae Radix mitigates both the short-term and long-term health risks associated with ovarian hypofunction diseases. Processed Rehmanniae Radix has shown potential to improve ovarian function, and its compound prescriptions have a definite effect on ovarian dysfunction diseases. Therefore Rehmanniae Radix was garnering interest for both basic and clinical research, with promising application prospects as a future therapeutic agent for ovarian hypofunction diseases. However, further studies on its toxicology and the design of standardized clinical trials are necessary to fully establish its efficacy and safety.

Lipid Profiling of Oily Skin in Chinese Female aged 22-28 and 29-35 Defined by the Life Rhythm Theory of Huangdi Neijing

Purpose: According to the life rhythm derived from the ancient Chinese medicine book Huangdi Neijing, female growth and development culminates between the age of 22-28, with strong muscles, bones and vigorous hair. To investigate the characteristics of facial lipid profile in oily skin of female at different developmental stages classified based on seven-year rhythm, and to provide the mechanistic insight into the aging theory of Huangdi Neijing.Methods: The facial lipid composition of two groups of healthy women with oily skin (O1 group: age of 22-28; O2 group: age of 29-35) was analyzed by ultra-performance liquid chromatography-quadrupole tandem time-of-flight mass spectrometry (UPLC-QTOF-MS). Differential lipids between O1 and O2 groups were identified using an orthogonal partial least squares discriminant analysis (OPLS-DA) model.Results: No significant difference in skin barrier function was found between the O1 and O2 groups. In contrast, skin elasticity and skin radiance displayed significant changes, with the O2 group showing decreased skin elasticity and dull skin, which is consistent with the description in Huangdi Neijing. In terms of lipid profile, among eight lipid main classes, seven lipid classes [FA], [GL], [GP], [PK], [PR], [SP] and [ST] showed significantly higher relative levels in the O2 group (<i>p</i><0.05). Among the differential lipid species, myriocin, erucamide, phosphatidylserine, flavonoid compounds, and sphinganine were significantly and negatively correlated with skin elasticity (R2) and skin radiance (ITA) (<i>p</i><0.05).Conclusion: The seven lipid species identified are important for targeting markers of skin aging and developing cosmetics that maintain skin elasticity and color.

Web-based diagnostic platform for microorganism-induced deterioration on paper-based cultural relics with iterative training from human feedback

PurposePaper-based artifacts hold significant cultural and social values. However, paper is intrinsically fragile to microorganisms, such as mold, due to its cellulose composition, which can serve as a microorganisms’ nutrient source. Mold not only can damage papers’ structural integrity and pose significant challenges to conservation works but also may subject individuals attending the contaminated artifacts to health risks. Current approaches for strain identification usually require extensive training, prolonged time for analysis, expensive operation costs, and higher risks of secondary damage due to sampling. Thus, in current conservation practices with mold-contaminated artifacts, little pre-screening or strain identification was performed before mold removal, and the cleaning techniques are usually broad-spectrum rather than strain-specific. With deep learning showing promising applications across various domains, this study investigated the feasibility of using a convolutional neural network (CNN) for fast in-situ recognition and classification of mold on paper.MethodsMolds were first non-invasively sampled from ancient Xuan Paper-based Chinese books from the Qing and Ming dynasties. Strains were identified using molecular biology methods and the four most prevalent strains were inoculated on Xuan paper to create mockups for image collection. Microscopic images of the molds as well as their stains situated on paper were collected using a compound microscope and commercial microscope lens for cell phone cameras, which were then used for training CNN models with a transfer learning scheme to perform the classification of mold. To enable involvement and contribution from the research community, a web interface that actuates the process while providing interactive features for users to learn about the information of the classified strain was constructed. Moreover, a feedback functionality in the web interface was embedded for catching potential classification errors, adding additional training images, or introducing new strains, all to refine the generalizability and robustness of the model.Results & ConclusionIn the study, we have constructed a suite of high-confidence classification CNN models for the diagnostic process for mold contamination in conservation. At the same time, a web interface was constructed that allows recurrently refining the model with human feedback through engaging the research community. Overall, the proposed framework opens new avenues for effective and timely identification of mold, thus enabling proactive and targeted mold remediation strategies in conservation.

Protective Effects of Pear Extract on Skin from In Vitro and In Vivo UVA-Induced Damage.

The ancient Chinese medical book "Compendium of Materia Medica" records that pears can relieve symptoms of respiratory-related diseases. Previous research has shown that pear Pyrus Pyrifolia (Burm.f.) Nakai has antioxidant and anti-inflammatory properties. However, the anti-inflammatory, antioxidant, and anti-photoaging protective effects of Pyrus pyrifolia (Burm.f.) Nakai seed components have not been studied. Ultraviolet light (UV) causes skin inflammation, damages the skin barrier, and is an important cause of skin photoaging. Therefore, UV light with a wavelength of 365 nm was used to irradiate HaCaT and mice. Western blot, real-time quantitative polymerase chain reaction, and fluorescence imaging system were used to explore its anti-UVA mechanism. Dialysis membrane and nuclear magnetic resonance were used for the chemical constituent analysis of pear seed water extract (PSWE). We found that PSWE can significantly reduce UVA-induced skin cell death and mitogen-activated protein kinase phosphorylation and can inhibit the mRNA expression of UVA-induced cytokines (including IL-1β, IL-6, and TNF-α). In addition, PSWE can also reduce the generation of oxidative stress within skin cells. In vivo experimental studies found that PSWE pretreatment effectively reduced transepidermal water loss, inflammation, redness, and dryness in hairless mice. The molecular weight of the active part of pear water extract is approximately 384. Based on the above results, we first found that pear seeds can effectively inhibit oxidative stress and damage caused by UVA. It is a natural extract with antioxidant properties and anti-aging activity that protects skin cells and strengthens the skin barrier.

Curating the Chinese ancient book catalogs: Leveraging the dual roles of humanities scholars as experts and users in collaborative practice

AbstractChinese ancient book catalogs are important cultural heritage and academic resources for the study of ancient Chinese history and culture. These catalogs need to be curated so that their value can be fully exploited in today's digital environment. This study is based on a collaborative curation project where eight representative ancient catalogs were curated into a diachronic dataset and tools to discover and analyze the data were developed. We reviewed literature and consulted humanities scholars to derive the characteristics and curation requirements of the ancient catalogs. A collaborative model was proposed based on the requirements to guide the curation process. This model reveals the duality of humanities scholars' role in collaborative curation and depicts main curation activities including metadata and description, appraisal and selection, data processing, developing tools, access and use, and evolution. Lessons learned from the curation practice include two main issues—project personnel and humanities scholars' acceptance of visualization. The study also yields a dataset and a set of tools that can be directly used by scholars interested in knowledge organization and ancient catalog related topics.

Optimization of Bear Oil Extraction Process and Hair Growth Activity.

According to ancient Chinese books, bear grease has the effects of strengthening muscles and bones, which is beneficial for weakness, but there is relatively little research on it. Thus, the extraction of it is beneficial for compensating for research in this area. In this study, a uniform experimental design method was used to optimize the extraction process of bear grease by enzymatic hydrolysis extraction, and the extraction rate can reach 81.89% under optimized extraction conditions. Furthermore, the components of bear grease obtained by this study were analyzed by GC-MS, and the results showed that ursolic oil was rich in unsaturated fatty acids (67.51%), which was higher than that of the traditional method (66.92%). The composition of bear grease extracted by the enzymatic method was also better than that extracted by the traditional method. In addition, bear grease obtained in this study had the obvious activity of promoting hair growth. The length, weight, and number of hair follicles in the depilation area of mice in the high-dose group were significantly different from those in the blank group (p < 0.01). This study optimized the extraction process of bear grease and conducted a preliminary analysis of its fatty acid composition, which is expected to provide some reference for the development of the medicinal value of bear grease.

Study on changes of Styrax varieties

Styrax is a commonly used imported traditional Chinese medicinal material in China. It was introduced to China in the Han Dynasty and was first described as a traditional Chinese medicine in Miscellaneous Records of Famous Physicians(Ming Yi Bie Lu). In this paper, by combing ancient and modern Chinese and foreign herbal medicine books and modern literature, combined with the results of field investigations on the origin of Styrax, the changes of Styrax involving the name, quality evaluation, origin, place of origin, and harvesting and processing were systematically verified. The results show that since ancient times, the origin and place of origin of Styrax have been unclear. The medical scientists of all dynasties in China have evaluated the quality of Styrax from four aspects: texture, viscosity, odor concentration, and color. The varieties of Styrax changed twice. The first change may have occurred during the Sui and Tang Dynasties, and the base changed from Styrax officinalis to Liquidambar orientalis. The second change was in modern times, and the base changed from L. orientalis to L. styraciflua. At the same time, the place of origin changed for the first time, from Turkey, Syria, and other countries in southern Asia Minor to Honduras, Guatemala, and other countries in Central America and southern North America. This paper studied the historical evolution of Styrax in terms of quality evaluation, origin, place of origin, character, and harvesting and processing. At the same time, it summarized the application of Styrax in the western countries, which can provide a historical basis for the further development and utilization of Styrax.

Ethnobotanical Uses and Pharmacological Activities of Moroccan Ephedra Species.

Ephedra species are among the most popular herbs used in traditional medicine for a long time. The ancient Chinese medical book "Treatise on Febrile Diseases" refers to the classic traditional Chinese medicine prescription Ge Gen decoction, which consists of seven herbs, including an Ephedra species. Ephedra species are utilized all over the world to treat symptoms of the common cold and coughs, and to combat major human diseases, such as asthma, cancers, diabetes, cardiovascular and digestive disorders, and microbial infections. This study aimed at identifying specific Ephedra species used traditionally in Morocco for therapeutic purposes. The plant parts, their preparation process, and the treated pathologies were identified and analyzed. The results revealed five ethnobotanically important species of Ephedra: Ephedra alata Decne, Ephedra altissima Desf., Ephedra distachya L., Ephedra fragilis Desf., and Ephedra nebrodensis Tineo. These species are used traditionally in Morocco for treating people with diabetes, cancer, rheumatism, cold and asthma, hypertension, influenza virus infection, and respiratory ailments. In addition, they are occasionally used as calefacient agents, to regulate weight, or for capillary care. Few studies have underlined the antibacterial and antioxidant activities of some of these Moroccan Ephedra species, but little information is available regarding the natural products at the origin of the bioactivities. Further phytochemical investigations and clinical data are encouraged to better support the use of these plants.

Machine translation of classical Chinese based on unigram segmentation transformer framework

In the translation work of Chinese ancient books, traditional manual translation is difficult and inefficient. As an important field of natural language processing, machine translation is expected to solve this problem. Due to the rapid development of NLP technology, prior works mainly follow the pipeline of Transformer when dealing with the machine translation task, which can extract the high-quality feature representation with its self-attention mechanism. The great success of Transformer has inspired the direction of our ancient text translation work. In this paper, we screen the Unigram word division by exploring and comparing, and propose a solution for the translation of ancient literary texts. Specifically, we adopt the evaluation of BLEU value and achieve the BLEU values of 43.4 and 40.03 for short and long sentences respectively. When compared with the results of Baidu Translation, our BLEU values increase by 8.12 and 5.18. Additionally, our translation results are more in line with the original text than Baidu Translation, demonstrating the potential and advantage of the model in bridging the ancient and modern Chinese era rift.

Constituents, pharmacological activities, pharmacokinetic studies, clinical applications, and safety profile on the classical prescription Kaixinsan.

Kaixinsan (KXS) is a noteworthy classical prescription, which consists of four Chinese medicinal herbs, namely Polygalae Radix, Ginseng Radix et Rhizoma, Poria, and Acori Tatarinowii Rhizoma. KXS was initially documented in the Chinese ancient book Beiji Qianjin Yaofang written by Sun Simiao of the Tang Dynasty in 652 A.D. As a traditional Chinese medicine (TCM) prescription, it functions to nourish the heart and replenish Qi, calm the heart tranquilize the mind, and excrete dampness. Originally used to treat amnesia, it is now also effective in memory decline and applied to depression. Although there remains an abundance of literature investigating KXS from multiple aspects, few reviews summarize the features and research, which impedes better exploration and exploitation of KXS. This article intends to comprehensively analyze and summarize up-to-date information concerning the chemical constituents, pharmacology, pharmacokinetics, clinical applications, and safety of KXS based on the scientific literature, as well as to examine possible scientific gaps in current research and tackle issues in the next step. The chemical constituents of KXS primarily consist of saponins, xanthones, oligosaccharide esters, triterpenoids, volatile oils, and flavonoids. Of these, saponins are the predominant active ingredients, and increasing evidence has indicated that they exert therapeutic properties against mental disease. Pharmacokinetic research has illustrated that the crucial exposed substances in rat plasma after KXS administration are ginsenoside Re (GRe), ginsenoside Rb1 (GRb1), and polygalaxanthone III (POL). This article provides additional descriptions of the safety. In this review, current issues are highlighted to guide further comprehensive research of KXS and other classical prescriptions.

Research on the origin and development of "Wu shan qi e"

"Wu shan qi e"(five symptoms with good prognosis and seven with poor prognosis)is a theory used to determine the prognosis of external diseases in traditional Chinese medicine which have been mentioned in many ancient Chinese medicine books and have been valued by external doctors throughout history. However, it has been rarely discussed in modern literature. The theory were first seen in the Taiping Shenghui Fang, and the idea was originated from Ni Shun in Lingshu Yuban."Wu shan qi e"have evolved into many variants through the exertion of medical practitioners throughout history. By reviewing medical books of previous dynasties, it was found that there are two main versions: the Taiping Shenghui Fang version and its derivative versions, and the Waike Zhengzong version and its derivative versions.

The life and works of Li Shouxian, a medical doctor in the Qing Dynasty

Li Shouxian, styled as Shanshu, was a medical doctor in the Qing Dynasty. His work Zhenjiu Yixue (Easy Study of Acupuncture and Moxibustion) has numerous versions, with the most refined one being the self-engraved edition from the third year of Jiaqing's reign, housed in the Jilin Province Library. While most content of the book was drawn from Zhenjiu Dacheng (Great Compendium of Acupuncture and Moxibustion), Li's condensation and arrangement of the material achieved the purpose of making it simple and easy to learn. The book has been widely spread and holds certain academic and historical value. This paper makes a textual research on Li's life, family, and his works, clarifies the content, structure and origin of the version of Zhenjiu Yixue and corrects errors in the version records of this book in the General Catalogue of Chinese Ancient Medical Books.

Tick-Borne Rickettsiosis and Tsutsugamushi Disease Recorded in 313.

Tsutsugamushi disease was first described in China by Hong Ge in 313. In his book Zhouhou Beiji Fang, three eschar-associated febrile diseases were described: Shashidu, Zhongxidu, and Shegongdu. Shashidu was identified as being identical to tsutsugamushi disease in Japan: it occurred in riverside areas, exhibited an eschar, and was transmitted by tiny red "sand lice". The nature of Zhongxidu remains unknown, but we propose that it is another type of Orientia tsutsugamushi infection: it occurred in mountainous areas, an eschar was observed, and the causative vector was not identified. Moreover, Zhongxidu would have predated Shashidu by five centuries; thus, the first documentation of tsutsugamushi disease would date back 2.2 millennia. O. tsutsugamushi infection without eschar has not been identified in ancient Chinese literature and may be included in Shanghan. Several ancient Chinese books describe that Shegongdu occurs following a Shegong bite. Shegong is described as a bug resembling a cockroach or cicada with a crossbow-like structure, possibly the hypostome and unfolded palps of tick, in its mouth. Thus, Shegong refers to an engorged tick and Shegongdu is a tick-borne rickettsiosis. However, due to a lack of entomological knowledge, these findings have not been recognized for the past 1.7 millennia.