世醫得效方

Shìyī Déxiào Fāng 世醫得效方

Effective Recipes of a Hereditary-Medical [Family] by 危亦林 (Wēi Yìlín, 1277–1347, zì Dálǔ 達魯, 元) — fifth-generation hereditary physician of Nánfēng 南豐 (Jiāngxī)

About the work

The Shìyī déxiào fāng in 20 juǎn, completed in 至元三年至五年 (1337–1339) and printed in 至正五年 (1345), is the flagship clinical compendium of the late Yuán and the single most comprehensive late-imperial Chinese formulary before the Ming Pǔjì fāng (KR3ed036). Wēi Yìlín’s preface narrates his family lineage: his ancestor in the time of the Eastern Jìn alchemist Dǒng Fèng 董奉 received medical instruction from Dǒng’s 25th-generation descendant Dǒng Jīng 董京; the line continued through his great-grandfather Yúnxiān 雲仙, who studied at Dōngjīng 東京; through Wēi himself, a fifth-generation hereditary physician of the family. The work organises the entire range of medical knowledge by the Yuán-era thirteen-specialty scheme (大方脈, 雜醫, 婦人, 小兒, 風科, 瘡腫, 口齒, 咽喉, 眼科, 針灸, 接骨, 金鏃, 禁科): each kē gets its own section, with theoretical discussion and recipes.

The work’s most-cited feature is its detailed Zhènggǔ 正骨 (bone-setting) section in juǎn 18, which constitutes one of the foundational documents of Chinese orthopaedics — alongside the Xiānshòu lǐshāng xùduàn mìfāng (KR3ed004) — and which contains the first detailed Chinese description of spinal-anaesthesia using yángjīnhuā 洋金花 (Datura) for orthopaedic surgery. The recipe — Datura combined with cannabis and aconite — became the canonical Chinese surgical-anaesthetic formula and the textual ancestor of the máfèisǎn recipes that would later be retro-attributed to Huà Tuó (KR3ed005).

Prefaces

Two prefaces head the work:

1. 王充耘 序 by Wáng Chōngyún 王充耘, dated 後至元四年八月 (= 1338, 順帝 reign), signed Chéngshìláng tóngzhī Yǒngxīnzhōu shì Wáng Chōngyún yǔgēng 承事郎同知永新州事王充耘與耕. Develops the parallel between Sānshì zhī yī 三世之醫 (“medicine of three generations” — the canonical Lǐjì maxim that one should not consume medicine from a physician without three generations of family practice) and Wēi Yìlín’s five generations of hereditary practice. Compares Wēi favourably to the Sòng physician 許叔微, who had practised one generation only.
2. 世醫得效方序 by Wēi Yìlín himself (autograph). Family history; bibliographic dependency on the Shèngjì zǒnglù (KR3ed012) thirteen-specialty scheme; the work’s editorial method (gathering recipes “tested and never failing” from his own and his ancestors’ practice).

Abstract

Wēi Yìlín 危亦林 (1277–1347, CBDB 41523), zì Dálǔ 達魯 (a Mongol-style transcription suggesting partial Yuán cultural assimilation, though the family is Han Chinese), of Nánfēng 南豐 (modern Jiāngxī). The Yuán shǐ has no biography; the principal biographical sources are his own preface and the Nánfēng xiànzhì prefectural gazetteer.

The work’s significance is exceptional:

1. Foundational orthopaedic surgery. Juǎn 18 Zhènggǔ 正骨 codifies a complete surgical regime: traction (拔伸), manual reduction (捺正), bone-setting splints (杉皮夾縛), wound packing (黑龍散 / 風流散), and crucially the Datura-based anaesthetic (Wēi’s Cǎowū sǎn 草烏散 administered with wine before surgery). This is the most detailed pre-modern Chinese description of orthopaedic anaesthesia and represents a clear empirical advance over the earlier Xiānshòu tradition (KR3ed004).
2. Thirteen-specialty integration. The Shìyī déxiào fāng is the single most complete pre-modern Chinese implementation of the Yuán Tàiyī jú thirteen-specialty curriculum (大方脈, 雜醫, 婦人, 小兒, 風科, 瘡腫, 口齒, 咽喉, 眼科, 針灸, 接骨, 金鏃, 禁科). Each subsequent late-imperial general-medical compendium (Pǔjì fāng, Yīzōng jīnjiàn) is structurally indebted to it.
3. Hereditary-physician self-presentation. Wēi’s preface is one of the most articulate Yuán-era statements of the shìyī (hereditary physician) self-image, defending family-transmitted clinical experience against the yǒngyī (ordinary physician) who relies on book-learning alone.

The work was widely reprinted in the Ming and was the principal Chinese medical text exported to Japan and Korea in the late-imperial period; Korean editions of the Shìyī déxiào fāng served as the principal Chinese-medicine text in the Yi-dynasty Naeüiwon (內醫院) imperial medical bureau.

Translations and research

• Lin Jen-Chiou. 1997. History of Traumatology in Chinese Medicine. Republic of China: Renmin weisheng — extensive on the Shìyī déxiào fāng orthopaedic section.
• Hé Shíxī 何時希 (coll.). 1990. Shìyī déxiào fāng 世醫得效方 (punctuated edition). Beijing.
• Buell, Paul D. and Eugene N. Anderson. 2010. A Soup for the Qan.
• Bray, Francesca. 1997. Technology and Gender: Fabrics of Power in Late Imperial China. UCP — refers to the work’s gynaecological section.
• Wilkinson, Chinese History: A New Manual §41.3.2.

Other points of interest

The Cǎowū sǎn 草烏散 anaesthetic recipe (juǎn 18) — cǎowū aconite 5 qián, yángjīnhuā Datura 3 qián, mábó Cannabis 1 qián, plus auxiliary drugs — administered in warm wine — is the earliest precisely-described East-Asian surgical anaesthetic recipe, predating the Japanese surgeon Hanaoka Seishū 華岡青洲’s Tsūsensan 通仙散 (composed 1804–1805 and routinely cited as the first general anaesthetic in surgery) by approximately 460 years.

Links

• Wikidata Q11075019 (世醫得效方).
• Wikipedia (zh): 世醫得效方; 危亦林.
• Wikipedia (ja): 世医得効方.
• 世醫得效方 jicheng.tw
• Kanseki DB