Shānghán jiānzhèng xīyì 傷寒兼證析義
Analysis of the Comorbid-Syndrome Significances of Cold-Damage by 張倬 (Zhāng Zhuō, zì Fēichóu, fl. early 清, of Wújiāng)
About the work
A specialist treatise on cold-damage occurring in patients with pre-existing miscellaneous-disease comorbidities, in 1 juan, by Zhāng Zhuō (son of Zhāng Lù, brother of Zhāng Dēng of KR3e0093). The work covers 17 specific comorbidity scenarios: Zhòngfēng (wind-stroke), Xūláo (deficiency-fatigue), Zhōngmǎn (central-fullness), Zhǒngzhàng (swelling-distension), Yē gé (esophageal-blockage), Fǎnwèi (anti-stomach), Nèishāng sùshí (internal-injury and stagnant-food), Késòu (cough), Yāngān (throat-dryness), Bìsè (constipation), Tóufēng (head-wind), Xīnfùtòng (chest-and-abdomen pain), Wángxuè (loss-of-blood), Duōhàn (excessive-sweating), Jījù (accumulation), Dòngqì (stirring-qì), Shànqì (hernia), Línzhuó (urinary-cloudiness), Xièlì (diarrhea), Tāichǎn (pregnancy-and-childbirth) — presented in question-and-answer form. The work addresses a clinically important diagnostic question — how to manage cold-damage in patients with pre-existing chronic conditions — that the Shānghán lùn’s hébìng / bìngbìng (combined-and-simultaneous-disease) framework had only addressed at the channel level.
Tiyao
Shānghán jiānzhèng xīyì, 1 juan, by Our Imperial Dynasty’s Zhāng Zhuō. Zhuō’s zì was Fēichóu, of Wújiāng. The author of the Yītōng, [Zhāng] Lù, is his father.
The book exclusively discusses cold-damage occurring with miscellaneous-diseases: divided into wind-stroke, deficiency-fatigue, central-fullness, swelling-distension, esophageal-blockage and anti-stomach, internal-injury and stagnant-food, cough, throat-dryness, constipation, head-wind, chest-and-abdomen pain, loss-of-blood and excessive-sweating, accumulation, stirring-qì, hernia, urinary-cloudiness, diarrhea, pregnancy-and-childbirth — 17 categories. Set as questions-and-answers to elucidate.
The Shānghán lùn’s so-called hébìng and bìngbìng speak only of the six-channel comorbid-symptoms but do not extend to miscellaneous-disease comorbidities. Practitioners not understanding the comorbidity intent often, when pulse-and-symptom diverge, either attend to one and lose the other, or treat one and obstruct the other — the harm is considerable.
This book analyzes [the comorbidities] one by one, allowing the practitioner not to be bound to a single corner and not to be confused by the many paths. It can also be said to have benefited cold-damage [study].
(Respectfully verified, 4th month of Qiánlóng 46 [1781]. Chief Compilers Jì Yún, Lù Xīxióng, Sūn Shìyì; Chief Collator Lù Fèichí.)
Abstract
Composition window: 1668/1668 (early Kāngxī period; same period as Zhāng Dēng’s Shānghán shé jiàn, the brothers’ work being conceived as complementary).
The work’s significance:
(a) The comorbidity-specific cold-damage treatise: Zhāng Zhuō’s 17-comorbidity-category systematic treatment of cold-damage in patients with chronic underlying conditions is one of the more clinically-sophisticated early-Qīng Shānghán contributions. The work addresses a real clinical-diagnostic problem inadequately treated in the Shānghán lùn’s pure-cold-damage framework.
(b) The Q&A pedagogical form: building on the dialogic format of KR3e0072 Zhēnjiǔ wènduì and other wènduì (question-and-answer) Chinese medical works, Zhāng’s Q&A treatment makes the comorbidity-clinical-reasoning explicit and pedagogically accessible.
(c) The Zhāng-family complementary corpus: with Zhāng Dēng’s Shānghán shé jiàn (tongue-diagnostics) and Zhāng Zhuō’s Shānghán jiānzhèng xīyì (comorbidity), the two brothers’ early-Qīng works form a complementary specialist treatment of cold-damage that supplements their father Zhāng Lù’s general Yītōng.
The catalog meta dynasty 清 is correct.
Translations and research
- No substantial Western translation of this specific work.
- Mǎ Jìxīng 馬繼興, Zhōng-yī wénxiàn xué 中醫文獻學, Shànghǎi: Shànghǎi Kēxué Jìshù Chūbǎnshè, 1990.