Cǐshì nánzhī 此事難知
This Matter Is Difficult to Know by 王好古 (Wáng Hǎogǔ, zì Jìnzhī, hào Hǎicáng, fl. 1308, 元)
About the work
Wáng Hǎogǔ’s compilation of his teacher 李杲 Lǐ Gǎo’s previously-untransmitted clinical material, in 2 juan, dated to Zhìdà 1 (1308) per the preface. The title — “This Matter Is Difficult to Know” — derives from Wáng’s own preface, expressing his sense that the medical art is essentially difficult and only directly transmissible from teacher to disciple. Wáng’s compilation focuses especially on cold-damage (Shānghán) — Lǐ Gǎo’s Shānghán writings (the Shānghán huìyào 傷寒會要 prefaced by Yuán Hàowèn) had already been lost by Wáng’s day; the Cǐshì nánzhī preserves much of Lǐ Gǎo’s Shānghán material indirectly. Of particular note is the Sānjiāo 三焦 (Triple Burner) discussion, which discriminates the shǒu and zú (hand and foot) Triple Burner — a clinical-diagnostic precision the Míng physician Sūn Yīkuí praised. The work is incorrectly attributed to Lǐ Gǎo in the Míng compilation Dōngyuán shíshū 東垣十書 (Ten Works of Dōngyuán); the SKQS editors restore the correct attribution to Wáng Hǎogǔ.
Tiyao
Cǐshì nánzhī, 2 juan, by Wáng Hǎogǔ of the Yuán. Hǎogǔ, zì Hǎicáng, was a man of Zhàozhōu — a senior disciple of Lǐ Gǎo. This compilation is wholly an exposition of Gǎo’s threads-of-discussion; on cold-damage symptom-and-treatment it is particularly detailed. The discussion of the Triple Burner — how many there are, distinguishing hand-and-foot — was strongly praised by the Míng’s Sūn Yīkuí 孫一奎. But its claim that the Mìngmén 命門 and the Bāoluò 包絡 (Pericardium-Channel) are diagnosed together at the right chǐ pulse-position, and that the Bāoluò also has the Triple-Burner appellation, somewhat misreads the classical meaning.
The history records that Lǐ Gǎo was strong on cold-damage; the Huìyào (his cold-damage book), prefaced by Yuán Hàowèn, has now been lost — so Lǐ Gǎo’s discussion in this area survives only through this work, in which one or two of his pieces are preserved.
At the head is a self-preface dated Zhìdà yuánnián (1308), saying: “I obtained from my teacher his untransmitted secret material; over weeks-and-months I gathered, gradually forming this volume.” So the work was compiled by Wáng Hǎogǔ himself.
The current Míng Dōngyuán shíshū 東垣十書 attributes this to Lǐ Gǎo — which is wrong.
(Respectfully verified, 12th month of Qiánlóng 45 [1780]. Chief Compilers Jì Yún, Lù Xīxióng, Sūn Shìyì; Chief Collator Lù Fèichí.)
Abstract
Composition window: 1308/1308, the date of Wáng’s preface (Zhìdà 1 qiū qī yuè èrshíyǒu yīrì — the 21st day of the 7th month of autumn).
The work’s significance:
(a) The principal indirect witness to Lǐ Gǎo’s cold-damage doctrine: with Lǐ Gǎo’s Shānghán huìyào lost in independent transmission, the Cǐshì nánzhī is the major surviving witness to Lǐ Gǎo’s Shānghán-school approach. Through Wáng’s compilation we have access to Lǐ Gǎo’s clinical reasoning on cold-damage that would otherwise be entirely lost.
(b) The Triple Burner anatomical-diagnostic discrimination: Wáng’s discussion of the hand-and-foot Triple Burner is one of the more clinically precise treatments of this difficult anatomical-functional concept in pre-modern Chinese medicine. The doctrine became foundational to the YuánMíng Triple-Burner school.
(c) The YuánYuán “nánzhī” stance: the title’s claim that “this matter is difficult to know” is a Yuán-period medical-pedagogical position — that medicine is essentially a master-disciple transmission rather than a textually-acquired learning. Wáng’s compilation, paradoxically textualizing what he says cannot be textualized, is a key witness to the Yuán-period tension between transmission-by-text and transmission-by-master-disciple lineage.
(d) The Míng Dōngyuán shíshū misattribution: a useful case-study in late-imperial-Chinese medical-corpus-compilation editorial slippage. The SKQS editors’ correction restores the Lǐ Gǎo / Wáng Hǎogǔ teacher-and-disciple distinction.
The catalog meta gives Wáng’s fl. as 1297; corrected here to 1308 per the work’s own preface evidence. The prose makes the KR3e0056 companion work clear.
Translations and research
- No substantial Western secondary translation of this specific work.
- See KR3e0050 for references on the Zhāng Yuánsù → Lǐ Gǎo → Wáng Hǎogǔ transmission line.
- Mǎ Jìxīng 馬繼興, Zhōng-yī wénxiàn xué 中醫文獻學, Shànghǎi: Shànghǎi Kēxué Jìshù Chūbǎnshè, 1990 (entry on the Cǐ-shì nán-zhī).
- Liào Yùqún 廖育群, Yīxué yǔ chuántǒng wénhuà 醫學與傳統文化, Tianjin: Bǎihuā Wényì, 2002 (chapter on the Spleen-and-Stomach school).
Other points of interest
The “This Matter Is Difficult to Know” 此事難知 title is one of the more philosophically loaded titles in Chinese medical literature, and reflects the late-Yuán medical-pedagogical position that medical art is essentially mysterious and master-transmitted. The position is in productive tension with the Lǐ Gǎo / PíWèi school’s strong commitment to systematic textual exposition (the Píwèi lùn, the Lánshì mìcáng, etc.). Wáng’s title may be read as both a tribute to and an extension of his teacher’s textualizing project.
The Sānjiāo 三焦 doctrine — the Triple Burner as a functional rather than strictly-anatomical entity, with hand-and-foot variants in the channel system — is one of the most distinctive Chinese medical conceptual structures and one of the more clinically useful diagnostic frameworks. Wáng’s discrimination remains foundational in modern TCM.