Xuēshì yīàn 薛氏醫案
The Medical Cases of Master Xuē by 薛己 (Xuē Jǐ, zì Lìzhāi, 1487–1559, of Wúxiàn, 明)
About the work
The collected medical works of 薛己 Xuē Jǐ — 16 works in 77 juan total. The collection includes both Xuē’s original compositions (10 works) and his editorial revisions of earlier authorities’ works (6 works). The corpus is one of the most influential Míng-period medical-text-and-case-record-books, and a central source for the 16th-century Míng revival of Lǐ Gǎo’s Spleen-and-Stomach school combined with Bā-wèi-and-Liù-wèi yuán prescription strategy.
Xuē Jǐ’s original works (10):
- Nèikē zhāi yào 內科摘要 (Selected Essentials of Internal Medicine, 2 juan);
- Nǚkē cuō yào 女科撮要 (Synopsis of Women’s Medicine, 2 juan);
- Bǎo yīng cuì yào 保嬰粹要 (Distilled Essentials of Pediatric Care, 1 juan);
- Bǎo yīng jīnjìng lù 保嬰金鏡錄 (Pediatric-Care Golden-Mirror Record, 1 juan);
- Yuán jī qǐ wēi 原機啟微 (The Original Mechanisms, Opening the Subtleties, 3 juan);
- Kǒuchǐ lèi yào 口齒類要 (Categorical Essentials of Oral-and-Dental Medicine, 1 juan);
- Zhèngtǐ lèi yào 正體類要 (Categorical Essentials of Bone-Setting, 2 juan);
- Wàikē shū yào 外科樞要 (Pivotal Essentials of External Medicine, 4 juan);
- Lì yáng jī yào 癘瘍機要 (Mechanism-Essentials of Hansen’s-Disease Ulcers, 3 juan);
- (further works, including the Bǎo yīng cuō yào 保嬰撮要 in 20 juan, attributed by some sources to Xuē’s father Xuē Kái 薛鎧 — a question the SKQS editors note).
Xuē’s edited works (6):
- Wáng Lǚ 王履’s Míngyī zázhù 明醫雜著 (Various Notes by Famous Physicians, 6 juan);
- Chén Zìmíng’s Fùrén dàquán liángfāng (Women’s Medicine, 23 juan; cf. KR3e0038);
- Áoshì Shānghán jīnjìng lù 傷寒金鏡錄 (Cold-Damage Golden-Mirror Record, 1 juan);
- Qián Yǐ 錢乙’s Xiǎo’ér zhí jué 小兒直訣 (Pediatric Direct-Mnemonic, 4 juan);
- Chén Zìmíng’s Wàikē jīng yào 外科精要 (3 juan);
- Chén Wénzhòng’s Xiǎo’ér dòuzhěn fānglùn 小兒痘疹方論 (1 juan).
The collection includes a curious Mǐng jìshì 明紀事 (Míng-Record-of-Affairs) preserving the dream-narrative of Zhū Míng 朱明 — the publisher of the Tiānqǐ dīngmǎo (1627) reprint — who twice dreamed of Xuē appearing posthumously, first to recommend a successful medical treatment and then to ask for the work’s reprinting.
Tiyao
Xuēshì yīàn, 77 juan, by Xuē Jǐ of the Míng. Jǐ’s zì was Lìzhāi, of Wúxiàn. The book has 16 sub-titles. Xuē’s own compositions are: Nèikē zhāi yào 2 juan, Nǚkē cuō yào 2 juan, Bǎo yīng cuì yào 1 juan, Bǎo yīng jīnjìng lù 1 juan, Yuán jī qǐ wēi 3 juan, Kǒuchǐ lèi yào 1 juan, Zhèngtǐ lèi yào 2 juan, Wàikē shū yào 4 juan, Lì yáng jī yào 3 juan. His revisions of earlier authorities, with appended his-own discussions, are: Wáng Lǚ’s Míngyī zázhù 6 juan; Chén Zìmíng’s Fùrén liángfāng 23 juan; Áoshì Shānghán jīnjìng lù 1 juan; Qián Yǐ’s Xiǎo’ér zhí jué 4 juan; his father Kái’s Bǎo yīng cuō yào 20 juan; further Chén Zìmíng’s Wàikē jīng yào 3 juan; Chén Wénzhòng’s Xiǎo’ér dòuzhěn fānglùn 1 juan.
The work was first cut at Xiùshuǐ on Shěnshì blocks (now damaged); in Tiānqǐ dīngmǎo (1627), Zhū Míng reprinted it. There is an old Míng jìshì (Record of Affairs) attached, recording how Míng during his illness dreamt that Jǐ taught him a prescription, which on use cured him; he later dreamt that Jǐ asked for this book to be reprinted. The matter is most strange — but where the spirit’s attention rests, the soul will have somewhere to lodge; this is the way of things, and we may as well preserve the account.
Jǐ was originally an external-medicine practitioner; later he became known for internal medicine; in his old age, he died of an external [surgical] condition. Critics took this to mean that the warm-tonifying [school’s] disadvantage had finally turned on him. But Jǐ in treating illness sought always the underlying cause, using Bāwèi wán and Liùwèi wán directly to supplement true-yáng and true-yīn, thus enriching the source of generation-and-transformation — this is in fact something Jǐ himself first developed. In treating, he often used ancient prescriptions but with subtle additions-and-subtractions that have profound principle, often manifesting their divine subtle changes in a single ingredient. Subsequently Zhào Xiànkě 趙獻可 composed the Yī guàn 醫貫, taking [Jǐ’s] formulae as a fixed method, treating various conditions universally with Bāwèi and Liùwèi — even using Liùwèi for cold-damage thirst — gluing the bridges and beating the zither: many flow-on errors. Xú Dàchūn 徐大椿 wrote the Yī guàn biān 醫貫砭 and accordingly directed his arrows at the Xuē school. But this is not Jǐ’s original meaning — one cannot, on Lǐ Sī’s account, blame Xún Qīng [Xunzi].
The widely-circulating recension adds the Shísì jīng fāhuī 十四經發揮 and other works, neither composed nor edited by Jǐ. This is the booksellers’ new-curiosity-mongering and reckless additions, of the same kind as the Dōngyuán shíshū 東垣十書 and Héjiān liùshū 河間六書 indiscriminately collecting other authors’ works to fill out the volume-count. The present edition’s 16 sub-titles are all genuinely Xuē’s own work.
(Respectfully verified, 3rd month of Qiánlóng 44 [1779]. Chief Compilers Jì Yún, Lù Xīxióng, Sūn Shìyì; Chief Collator Lù Fèichí.)
Abstract
Composition window: 1510–1559, the 50-year span of Xuē Jǐ’s mature medical career. The 77-juan corpus represents Xuē’s lifetime medical output.
The work’s significance:
(a) The most influential 16th-century Míng medical corpus: at 77 juan and 16 sub-titles, the Xuēshì yīàn is the most comprehensive Míng-period single-author medical œuvre. Through Xuē’s works the Spleen-and-Stomach school of Lǐ Gǎo combined with the Bāwèi yuán / Liùwèi wán tonifying-prescription strategy became the dominant 16th-century clinical orientation.
(b) The case-record (yīàn) genre matured: Xuē’s editorial method — preserving prior authorities’ texts with appended his-own clinical-experience cases — represents the mature form of the yīàn genre developed earlier by 許叔微 Xǔ Shūwēi (KR3e0032). The format became standard for late-Míng-and-Qīng medical writing.
(c) The Bāwèi / Liùwèi prescription strategy: Xuē’s signature clinical method — using the Bāwèi yuán (8-Ingredient Pill, kidney-yáng tonification) and Liùwèi wán (6-Ingredient Pill / Liùwèi dìhuáng wán, kidney-yīn tonification) directly to supplement true-yáng and true-yīn — anticipates the late-Míng Mìngmén doctrine and the Zhào Xiànkě / Zhāng Jièbīn (Jǐngyuè) warming-tonifying-school synthesis.
(d) The Zhào Xiànkě extension and Xú Dàchūn critique: the tíyào’s narrative of Xuē → Zhào Xiànkě (Yī guàn) → Xú Dàchūn (Yī guàn biān) is a useful piece of late-imperial Chinese medical-historiographical analysis, distinguishing Xuē’s careful flexible application from Zhào’s rigid formula and from Xú’s misdirected critique.
(e) The Tiānqǐ Zhū Míng dream-narrative: a curious early-17th-century medical-publishing folklore-narrative, preserved in the SKQS frontmatter as testimony to the Xuē corpus’s spiritual significance to its publisher.
The catalog meta dynasty 明 is correct.
Translations and research
- No substantial Western translation of the complete corpus. Selected Xuē-attributed prescriptions are translated in modern TCM clinical literature.
- Furth, Charlotte. A Flourishing Yin: Gender in China’s Medical History, 960–1665, Berkeley: University of California Press, 1999. The standard English-language treatment of late-imperial Chinese women’s medicine; treats Xuē’s Nǚ-kē cuō yào.
- Mǎ Bóyīng 馬伯英, Zhōngguó yī-xué wén-huà shǐ 中國醫學文化史, 2 vols., Shànghǎi: Shànghǎi Rénmín, 2010.
- Hsiung Ping-chen 熊秉真, A Tender Voyage, Stanford: Stanford University Press, 2005 (treats Xuē’s pediatric works).
- Wáng Yáng 王陽, Xuē Jǐ yī-xué quán-shū 薛己醫學全書, Beijing: Zhōng-yī Gǔjí, 1999. The standard modern critical edition of the corpus.
Other points of interest
The 16-work, 77-juan output of Xuē Jǐ across his 50-year career is one of the most prolific outputs of any single author in Chinese medical history — comparable to Lǐ Shízhēn’s Běncǎo gāngmù in scope and to Sūn Sīmiǎo’s combined Qiānjīn corpus in influence.
The Xuē Jǐ → Zhào Xiànkě → Zhāng Jièbīn warming-tonifying lineage is the major late-Míng counter-stream to the dominant Dānxī yīn-deficiency school. The lineage’s emphasis on the Mìngmén (Gate of Life) as the source of true-yáng-and-yīn, and on the Bāwèi and Liùwèi prescriptions as direct supplementations of Mìngmén function, became the principal Qīng-period therapeutic alternative to the Dānxī school.