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Abstract@#Bloodletting is a medical tradition that probably began in prehistoric times. Its rationale was based on the belief that removing blood eliminated “impure blood”. From antiquity until the beginning of the 20th century, bloodletting was considered a panacea, and it was the most common and versatile form of medical treatment. Not only was it believed to cure the sick, but also to promote vigor in the healthy. Some of the antient books of traditional medicine noted that the bloodletting tools is very importance when opening a vessel in order to bleed. Traditional medical bloodletting tools are one of the oldest archeological findings, and researchers have found many types of bloodletting tools in our country dated back thousands of years. Therefore, research on bloodletting tools an important component of bloodletting therapy, is of theoretical and practical importance. The location, indications, and tools of bloodletting therapy and bloodletting vessels are described in detail in the “Subsequent Tantra” of “Four Medical Tantras”, and its commentaries: Dar mo sman rams pa blo bzang chos grags “Dka’ phreng mun sel sgron”, Sde srid sangs rgyas rgya mtsho “Be edurya sngon po” and Luvsanchoinpil “Gces btus snying nor” so on. The first Mongolian surgical work is directly related to the historical tradition of bloodletting therapy. It is now known that the stone needles, which was discovered in the 3000th millennium BCE, may have originated from the Mongolia used to use in medicine as bloodletting tools. In the seventeenth and nineteenth centuries, Mongolian medical bloodletting tools were passed down through India and Tibet medical books, and later the science of surgery and bloodletting therapy became more sophisticated and comprehensive knowledge. At the same time, it is clear that there is every reason to say that it has been enriched by the medical knowledge of the neighboring countries and improved by their own experience.
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Introduction@#In 2018, the overall colorectal cancer (CRC) incidence rate was 3.6%, according to the National Cancer Center of Mongolia (NCCM), and the incidence of colorectal cancer has increased slightly in recent years. According to cancer stages, late stage cancer has a 5-year survival rate of 51%, while early stage cancer has a 5-year survival rate of 79%. The overall survival rate of colorectal cancer in Mongolia has not been studied in precisely. In Asia, the 5-year survival rate for colorectal cancer was 60%. Therefore, this study investigated the colorectal cancer survival rate and prognostic factors at NCCM.@*Methods@#A total of 108 patients diagnosed with CRC at NCCM’s General Surgery Department from 2013 to 2015 were used in this retrospective cohort study. The Kaplan-Meier method was used to develop the survival graphs, which were then compared using the Log-rank test.@*Results@#The median survival time was 42 months, with a 95% CI (38.55-45.66). A 5-year period, the overall survival rate for CRC was 61.2%. Survival rates at the I, II, III, and IV stages were 100%, 75%, 65.4%, and 13.5%, respectively. There was a significant difference in CRC survival rates across all stages (p=0.0001). There was a statistically significant difference in determining the relationship between adjuvant chemotherapy and survival rate (p=0.0003).@*Conclusion@#The outcome of the surgery is determined by the CRC stage. The postoperative survival rate (61.2%) is directly related to tumor stage, peripheral glandular metastasis, distant metastasis, and chemotherapy effects.
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@#In the 13th century, a wound caused by an arrowhead was healed by scorching the surface of the injury. For instance, in the early 13th century during a battle, Ugudei Khaan was shot in the neck. One of his knights, Borokhul, sucked a blood clot from the wound and carried him on his horse. When Chinggis Khaan saw them, he grieved, wept, and ordered a fire to be made. After scorching Ugudei’s wound, he gave him something to drink and waited to fight their enemies. We came across instances of curing injuries with dairy products in the Secret History of Mongolia. In one case, when he was wounded in the neck, Chinggis Khaan traveled with difficulty and camped in a battle field at sunset. </br> One of Chinggis’ knights, Zelme, nursed him by sucking blood until midnight. He cared for the unconscious Khaan by himself, not trusting others. When midnight passed, Chinggis Khaan woke up and said “blood has dried and I am thirsty.” Zelme took off his hat, boots and deel (dressing-gown), leaving only underwear and entered their enemy’s camp. He searched for eseg (mare’s milk) on carriages of commoners who camped behind the military camp. However, he couldn’t find any eseg because the refugees hadn’t milked their mares. Therefore, he stole a leather sack of tarag (a drink made by fermenting the milk of sheep, goat, or cow) and carried it back to his camp. </br> Nobody saw Zelme, God might have blessed him. Zelme gave Chinggis Khaan the tarag mixing it with water to drink. Chinggis Khaan had the drink and said he felt relieved. At that time it was dawn. One of the achievements of Traditional Mongolian Medicine of that time was curing wounds with the help of surgical means. In the beginning, the Mongolians got much knowledge of animal anatomy by dismembering joints and internal organs of different animals while slaughtering. Afterwards, based on their knowledge of animal anatomy, they set bones and cured wounds. Additionally, they broadened their knowledge by performing autopsies on dead bodies, etc. In 1263, during one of the battles between the Mongolian and South Sun nation troops, which the Sun lost, Zuukhar was hit by 3 arrows. The arrowhead in his left shoulder could not be removed. Hyavtsag opened the wound with the help of two men who were sentenced to death (these people were Sun nation) and examined if the arrow could possibly be removed. Finally, he was able to remove the arrow from Zuukhar’s body. Thence, the Mongolians of that time performed autopsies as well as surgical treatment along with medical treatment. </br> In the mid-13th century, Traditional Mongolian curing methods were rapidly developing. The Mongolian army had special doctors to cure injured soldiers. According to some sources, in the early 13th century, there was a position of “military doctor,” among Chinggis Khaan’s army. When generals or troops got injured, the military doctor was ordered to cure them by a fixed deadline.
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@#History of surgical services in Mongolian medicine began at least from New Stone Ages (Neolithic Era). However, we decided to study usage of surgical instruments in Mongolian medicine from 1578 to the XIX century. Because, the third transmission of Buddhism into Mongolia occurred during the time of the Altan Khan of the Southern branch of Central Mongols, a descendent of Kublai Khan, tried to revive Mongol strength and unification. After that Undur Gegeen Zanabazar was also holding a religious service around his residence. Furthermore, in 1651 he established 7 parts of the Monastery including Financial, Lamasery, Food service, and Personal physician’s divisions based on his attendants, people, and lamas. The Personal physician’s division was one of the basis for the sect of “Four Medical Tantras”. Since that time the sect of “Four Medical Tantras,” had been spread effectively and many medical schools were established near the Buddhist temples in Mongolia. They respected “Four Medical Tantras,” and “Shun,” as the main scripts and focused to base it on their theory and practice. </br> During the research we identified that from the XVII century, Mongolian doctors and scientists wrote many commentary books on “Four Medical Tantras” and renewed some of the content of “Four Medical Tantras.” Especially, Agvanluvsandanbijaltsan and Jambaldorj wrote a medical and medicinal books including surgical instruments. Also Ishbaljir wrote practical book about internal medicine, surgical methods, and services. </br> The major conclusion to this study was that Mongolian nation established their own medical art, comprehensive knowledge, and surgical methods as well as updated surgical instruments during the XVII and XIX Century. Particularly, they could renewed surgical methods and surgical instruments, which came from Indian Ayurveda and Tibetan medicine.