Shìyī déxiào fāng 世醫得效方
The Hereditary Physicians’ Tested-Effective Prescriptions by 危亦林 (Wēi Yìlín, zì Dázhāi, 1277–1347, of Nánfēng, 元)
About the work
Wēi Yìlín’s mature comprehensive medical treatise, in 20 juan, organized by 8 medical specialties — the structural innovation that anticipates the YuánMíng imperial-medical-bureau “Thirteen Specialties” (十三科 shísān kē) categorical system. The 8 specialties: Dà fāngmài kē 大方脈科 (Adult-Internal-Medicine, with 91 sub-topics); Xiǎo fāngmài kē 小方脈科 (Pediatrics, 71 sub-topics); Fēng kē 風科 (Wind-disease, 14 sub-topics); Chǎn kē jiān fùrén zábìng kē 產科兼婦人雜病科 (Obstetrics-and-Women’s-Miscellaneous-Disease, 33 sub-topics); Yǎn kē 眼科 (Ophthalmology, 12 sub-topics); Kǒuchǐ jiān yānhóu kē 口齒兼咽喉科 (Oral-Dental-and-Pharyngeal-Throat, 6 sub-topics); Zhènggǔ jiān jīnzú kē 正骨兼金鏃科 (Bone-Setting and Metallic-Arrow Wound Surgery, 29 sub-topics); Chuāngzhǒng kē 瘡腫科 (Ulcer-and-Swelling, 24 sub-topics) — totalling 19 juan. The 20th juan is an appendix on Sūn Sīmiǎo’s yǎngshēng methods (a Yǎngshēng fǎ jiéwén 養生法節文). The work’s most distinctive content is the Zhènggǔ kē orthopedic chapter, including the famous Cǎowū tāng 草烏湯 surgical-anaesthetic prescription — among the earliest written records of surgical anaesthesia in any medical tradition. The work was composed 1328–1337 (Tiānlì 1 to HòuZhìyuán 3), presented to the Yuán Imperial Medical Academy in Zhìyuán 5 (1339), and circulated as imperial-bureau-collated print. The Imperial Medical Academy’s tíshí (preface-acknowledgment) and 銜名 (officials-list) are preserved at the head of the SKQS print.
Tiyao
Shìyī déxiào fāng, 20 juan, by Wēi Yìlín of the Yuán. Yìlín, zì Dázhāi, was a man of Nánfēng, holding the office of Medical Professor of his home prefecture. This compilation gathers the medical prescriptions assembled across his great-great-grandfather and the subsequent five generations. Title the parts:
- Dà fāngmài kē — 91 sub-topics;
- Xiǎo fāngmài kē — 71 sub-topics;
- Fēng kē — 14 sub-topics;
- Chǎn kē jiān fùrén zábìng kē — 33 sub-topics;
- Yǎn kē — 12 sub-topics;
- Kǒuchǐ jiān yānhóu kē — 6 sub-topics;
- Zhènggǔ jiān jīnzú kē — 29 sub-topics;
- Chuāngzhǒng kē — 24 sub-topics.
19 juan in total, with appended Sūn Zhēnrén’s Yǎngshēng fǎ jiéwén in 1 juan. The general table of contents has the Zhēnjiǔ (acupuncture-and-moxibustion) specialty listed-but-not-substantiated; checking the text, the acupuncture-and-moxibustion content is distributed across the various specialty chapters. So the list-and-not-substantiated marker is a labelling slip, not an actual lacuna.
The self-preface says the work was begun in Tiānlì 1 (1328) and completed in HòuZhìyuán 3 (1337) — the diligence is well-witnessed. At the head is a Zhìyuán 5 (1339) imperial Medical Academy tíshí (preface-acknowledgment) detailing the bureau leaders — 11 Yuànshǐ (院使), 2 Tóngzhī yuànshì (同知院事), 2 Qiān yuànshì (僉院事), 2 Pànguān (判官), 2 Jīnglì (經歷), 2 Dūshì (都事), 1 Yuànshǐ (掾史) — by name. The Jiāngxī Provincial Medical Bureau passed the manuscript to the Imperial Medical Academy, which had it cross-collated by the various Provincial Medical Bureaus and re-submitted; only after this was it printed. The procedure is most cautious.
The preface claims that Wēi Yìlín’s great-great-grandfather encountered the “Dǒng Fèng’s twenty-fifth generation [Daoist] descendant” who transmitted secret prescriptions — a fāngjì (technical-arts) self-mystification, not worth pressing on. But the ancient prescriptions recorded are most numerous, and all can be referenced. One should not dismiss the work for its lack of original analytical contributions.
(Respectfully verified, 10th month of Qiánlóng 46 [1781]. Chief Compilers Jì Yún, Lù Xīxióng, Sūn Shìyì; Chief Collator Lù Fèichí.)
Abstract
Composition window: 1328–1339, bracketing composition (1328–1337 per Wēi’s preface) and imperial-publication (1339, Imperial Medical Academy tíshí).
The work’s significance:
(a) The 8-specialty structural plan: Wēi Yìlín’s organization by clinical specialty — adult-internal, pediatric, wind, women-and-childbirth, eye, oral-throat, orthopaedics-and-arrow-wound surgery, ulcer-and-swelling — is the principal pre-bureaucratic systematic Chinese medical-specialty classification, anticipating the YuánMíng imperial-medical-bureau “Thirteen Specialties” (大方脈, 小方脈, 風科, 婦人, 瘡瘍, 鍼灸, 眼, 口齒, 接骨, 傷寒, 咽喉, 金鏃, 祝由 — the Yuán imperial shísān kē or close equivalent) classification system.
(b) The orthopaedic chapter: the Zhènggǔ jiān jīnzú kē is the most important pre-Yuán Chinese orthopaedic treatise. Wēi’s detailed descriptions of fracture-reduction techniques, joint-dislocation reduction, and arrow-wound treatment represent the high-water-mark of Chinese orthopedic surgery before the modern period.
(c) The Cǎowū tāng surgical anaesthetic: the work’s prescription of a Wūtóu 烏頭 (Aconitum-derived) and Mántuóluó 蔓陀羅 (Datura-derived) decoction as a pre-surgical anaesthetic for fracture-reduction operations is one of the earliest written records of surgical anaesthesia in any medical tradition — antedating the Western introduction of ether (1846) by more than 500 years. The pharmacology — Aconitum’s alkaloids and Datura’s scopolamine producing analgesia and unconsciousness — is sound.
(d) The Yuán imperial-bureau editorial process: the SKQS’s preservation of the Imperial Medical Academy tíshí with its detailed officials-list is one of the better-documented Yuán-period imperial-medical-publication records, useful for the institutional history of Yuán medicine.
(e) The Dǒng Fèng-twenty-fifth-generation transmission claim: a standard SòngYuán fāngjì divine-transmission framing, of the same family as the KR3e0035 Wèijì bǎoshū’s “Mt. Bùlǎo High Master” attribution. The SKQS editors are appropriately sceptical.
The catalog meta dynasty 元 is correct.
Translations and research
- No substantial Western translation of the complete work. The orthopedic chapter has been studied extensively:
- Lu Gwei-Djen and Joseph Needham. “China and the Origin of Examinations in Medicine.” Proceedings of the Royal Society of Medicine 56.1 (1963): 63–70 (broader Chinese medical-history context).
- Mǎ Jìxīng 馬繼興, Zhōng-yī wénxiàn xué 中醫文獻學, Shànghǎi: Shànghǎi Kēxué Jìshù Chūbǎnshè, 1990 (entry on the Shì-yī dé-xiào fāng).
- Liào Yùqún 廖育群, Yīxué yǔ chuántǒng wénhuà 醫學與傳統文化, Tianjin: Bǎihuā Wényì, 2002.
- Goldschmidt, Asaf. Medical Practice in Twelfth-Century China — A Translation of Xu Shuwei’s Ninety Discussions on Cold Damage Disorders, Cham: Springer, 2019 (broader Sòng-Yuán Shānghán context).
- Jia Defeng 賈得道, Zhōngguó yī-xué shǐ lüè 中國醫學史略, Tài-yuán: Shanxi Renmin, 2006 (treats the Yuán orthopaedic-surgical context).
Other points of interest
The Cǎowū tāng surgical-anaesthetic prescription is one of the most historically significant single pharmacological recipes in any Chinese medical work. The combination of Aconitum (cardio-active alkaloid analgesia) and Datura (scopolamine sedation) is pharmacologically sound for the production of an analgesic-sedated state suitable for orthopedic intervention. Wēi Yìlín’s careful description includes warnings about dosage (Aconitum is highly toxic at over-dose) and recovery (giving cold water to drink to restore consciousness).
The Yuán shísān kē (Thirteen Specialties) imperial-medical-bureau system, of which Wēi’s 8-specialty system is the proximate ancestor, is one of the most articulated pre-modern medical-specialty classifications and represents one of the more sophisticated pre-modern medical-institutional achievements.