辨舌指南

Biàn Shé Zhǐ Nán 辨舌指南

Compass for Differentiating Tongues by 曹炳章 (Cáo Bǐngzhāng, zì Chìdiàn 赤電, 1878–1956, 民國)

About the work

A six-juan early-Republican encyclopedic synthesis of Chinese tongue-diagnostic literature, the most comprehensive single work in the genre. The book consolidates the entire tongue-diagnostic tradition from Áo / Dù KR3eb051 through 張登 Zhāng Dēng KR3eb054 and Liáng Tèyán’s Shé jiàn biàn zhèng into a single, doctrinally integrated treatise of thirty-two chapters organised into six juan; it integrates a substantial Western anatomical and physiological account of the tongue with the classical zàngfǔ 臟腑 framework, and it includes 144 tongue figures with 122 colour plates and six monochrome plates — the largest illustrated tongue-diagnostic atlas in the Chinese tradition. The work cites over 150 Chinese medical sources and over 30 translated Western medical works, drawing also on contemporary medical periodicals; it is therefore not only a tongue manual but the most systematic Republican-era account of the integration of Chinese diagnostic semiotics with Western anatomy.

Prefaces

KR3eb056_000.txt carries two front-matter pieces:

• A foreword by Zhōu Bǐngchí 周炳墀 (hào Yuèmíng 越銘) of Gǔ Yuè 古越, dated Mínguó 9, late winter = early 1920, written at his Liánxī Biéshù 濂溪別墅 / Xiǎoyǐnlú 小隱廬. Zhōu opens with the canonical sì zhěn yǐ wàng jū qí xiān (inspection is first among the four diagnostics) and observes that within inspection, the tongue is most important — “較之西醫用器探病，尤為確切” (more precise than the Western practice of using instruments to probe disease) — and that this fact has not previously been matched by a comprehensive Chinese tongue-diagnostic treatise. He praises Cáo’s project as filling the gap.
• Cáo’s own Xù yán 緒言 (i.e. extended preface), dated 中華民國九年九月重九日 = the Chóngyáng festival, 9 October 1920, signed Sìmíng Cáo Chìdiàn Bǐngzhāng 四明曹赤電炳章 at his Héjì yào jú 和濟藥局 in Shàoxīng. This preface is itself a major piece of late-Qīng / Republican medical historiography: it surveys the entire pre-existing tongue-diagnostic literature (the Sù wèn and Jīn guì foundations; the Yuán Jīnjìng lù; the post-Yuán Guān shé xīn fǎ; Zhāng Dèng’s Shé jiàn; the Wáng Wénxuǎn 王文選 Huó rén xīn fǎ; Liáng Tèyán’s Shé jiàn biàn zhèng; Xú Huíxī 徐洄溪’s Shé jiàn; the Shānghán shé biàn 135-figure scheme; the work of 周學海 Zhōu Xuéhǎi KR3eb049; Yè Tiānshì’s 葉天士 Wēn rè lùn; and recent Western anatomical literature including Kē Wéiliáng 柯為良, Líu Jírén 劉吉人 = 劉恆瑞 KR3eb053, and so on). Cáo’s Xù yán is therefore the most thorough Republican-era bibliographic survey of the tongue-diagnostic field.

Abstract

Cáo Bǐngzhāng (1878–1956) was a Shàoxīng physician, bibliophile, and editor; co-founder of the Shàoxīng Medical Society 紹興醫學會 with 何廉臣 Hé Liánchén in 1908; chief editor of the great Republican medical anthology Zhōngguó yī xué dà chéng 中國醫學大成 (1935–37, 365 titles); donated over 3,400 medical volumes to the state in 1952.

The book’s structural scheme (set out in the Xù yán) divides the field into:

• Chapters 1–9: anatomy, physiology, and semiotics of the tongue — including the cranial-nerve innervation, the salivary glands, the lingual papillae, the relation of tongue regions to specific zàngfǔ, the formation mechanism of the coating (food chyle → gastric efflorescence → papillar deposit), the integration of the Wàng and Xíngsè axes;
• Chapters 10–15: morphology and quality of the tongue — softness/hardness, swelling/atrophy, trembling/withering, deviation, extension/retraction; spike, fissure, star, fluke; thickness, paleness, turgidity; moisture, slipperiness, rot, viscosity; colour (eleven colour categories: white, yellow, red, crimson, grey, black, purple, blue-green, indigo, etc.);
• Chapters 16–21: clinical-doctrinal frameworks — Zhāng Zhòngjǐng’s tongue-diagnostic remarks, Hú Yùhǎi’s 胡玉海 differential method, Wú Kūnān’s 吳坤安 Biàn zhèng gē 辨證歌, the differential analytic (xū / shí, hán / rè, zhēn / jiǎ, yīn / yáng, shùn / nì, shēng / sǐ), and a full pathology-and-therapeutics for tongue lesions themselves (tumor, abscess, cancer, furuncle, aphthous ulcer, epistaxis from the tongue, etc.);
• Chapters 22–29: the 144-figure atlas — 34 white tongues, 25 yellow, 32 black, 14 grey, 20 red, 13 purple, 3 sauce-coloured, 3 indigo;
• Chapter 30: supplementary tongue notes;
• Chapter 31: a casebook of tongue-diagnostic yī àn 醫案;
• Chapter 32: a concluding biàn zhèng yào fāng 辨證要方 of selected prescriptions.

Cáo’s signature methodological move is the integration of contemporary Western physiology into the Chinese tongue-diagnostic discourse. He cites Kē Wéiliáng 柯為良 (Wang Tuhui Liang, missionary anatomist), Líu Jírén 劉吉人 (劉恆瑞), Chén Bǎolián 陳保廉, 周學海 Zhōu Xuéhǎi, and the Republican-era translations of Jiā Yuēhàn 嘉約翰 (John G. Kerr) and others; he reproduces an anatomical diagram of the tongue with cranial-nerve innervation labelled, and adopts the vasculature and salivary-gland terminology directly from the Western anatomical literature. At the same time, he preserves the entire classical zàngfǔ / yùnqì framework as the interpretive layer above the anatomical substrate. The result is the model for the integrated Western-and-Chinese (中西匯通) tongue-diagnostic teaching that became standard in PRC-era TCM curricula.

The 1920 dating is firm and well-attested by both prefaces. The work was issued in Shàoxīng through Cáo’s Héjì yào jú and later anthologised in the Zhōngguó yī xué dà chéng (1935–37).

Translations and research

• No full Western-language translation exists.
• Modern reprint: Biàn shé zhǐ nán 辨舌指南, in Zhōngguó yī xué dà chéng (Shanghai: Dàdōng shūjú, 1935–37; reprint Beijing: Zhōngguó zhōngyīyào, 1990).
• Standard critical edition: Biàn shé zhǐ nán jiào zhù 辨舌指南校注 (Beijing: Rénmín wèishēng, 2007).
• Discussed at length in Volker Scheid, Currents of Tradition in Chinese Medicine, 1626–2006 (Seattle: Eastland Press, 2007), in connection with the Shàoxīng / Mènghé physician networks.
• Liào Yùqún 廖育群, Yī zhě yì yě — Zhōng yī xué de wén huà fēn xī 醫者意也——中醫學的文化分析 (Taipei: Dōngdà, 2003), discussion of Cáo’s Western-physiology integration.
• Shàoxīng Shì zhì 紹興市志 entry on Cáo Bǐngzhāng.

Other points of interest

The book closes the long arc of Chinese tongue-diagnostic literature that begins with the Yuán Jīnjìng lù: from Áo’s 36 figures (1341) to Shēn Dǒuyuán’s 137 (late Míng), to Zhāng Dēng’s 120 (1668), to Cáo’s 144 (1920). After 1949 the genre transforms into TCM-curriculum textbooks; Cáo’s Biàn shé zhǐ nán is effectively the closing summa of the classical tradition.

Links

• Antecedents: KR3eb051 (Áo / Dù, 1341), KR3eb054 (Zhāng Dēng, 1668).
• Companion Republican-era tongue manual whose Western-anatomical framing Cáo adopts: KR3eb053 (Liú Héngruì, 1916).
• Sister diagnostic work: KR3eb049 (Zhōu Xuéhǎi, 1894).
• Cáo as editor of the parent anthology Zhōngguó yī xué dà chéng — into which most of the other Republican tongue manuals were incorporated.
• 辨舌指南 jicheng.tw
• Kanseki DB