Línzhèng Yīdé Fāng 臨證一得方
Formulas Gained from Bedside Practice by 朱費元 (Zhū Fèiyuán, fl. mid 19th c., Qīng)
About the work
A 19th-century clinical-record formulary by Zhū Fèiyuán, organising case-by-case prescriptions for wàikē (external-medicine) conditions — tíngěr (chronic suppurative otitis), ěrjūn (ear-mass / polyp), ěrzhì (ear-haemorrhoid), ěryōng (ear-abscess), and so on for the shǒubù 首部 (head region), continuing through the standard wàikē topography. The format is the medical case-record (yīàn 醫案): each entry presents one or more case-numbers (àn 1, àn 2, …) with brief differential-diagnostic notes followed by the prescribed formula in ingredient-list form. Cases are paired with fù / fùzhèng (sequel / following-case) entries when a follow-up visit is recorded.
Prefaces
The KR source KR3ed128_000.txt carries a substantial appendix preface (fùlù Yángyī tànyuán lùn — Appendix: Discussion of the Origins of External Medicine):
“What man relies on for life is the yuánqì (primary qì). If it remains, he lives; if it is lost, he dies. — This is great and luminous, manifest at a glance. Therefore, to gauge the patient’s life-or-death, one must gauge the existence-or-loss of the yuánqì — one will not be wrong once in a hundred cases. As for the matter of the disease itself: it is valuable to protect-and-preserve the yuánqì. Hán / rè / gōng / bǔ (cold / heat / attacking / supporting), one not in accordance with the Dào, and immediately zàngfǔ (organs) suffer injury; the pathogen finds entry easily; qì loses its attachment and is harmed. — In a single human body, what part is not in need of protection? What drug can be lightly tasted? And — for the wàikē (external-medicine) syndromes, can the knife-and-needle be tried haphazardly so as to gouge out the yuánqì itself?
“Moreover, the arising of external syndromes — half of them result from internal disease. Examples like yōngjū (abscesses), fābèi (dorsal carbuncles), liúzhù (migratory abscesses), liútán (migratory phlegm), luǒlì (scrofula), rǔyán (breast-cancer) — sometimes from prior yuánqì depletion the poisonous-qì takes the opportunity to inflame internally and produces an external-presentation; sometimes the poison-qì attacks inward and damages the yuánqì. The cases are uncountable! Even contact-poisoning-and-spreading [conditions] do occasionally have an externally-produced cause; but as the Sùwèn says: ‘Where pathogenic agents converge, the qì must be deficient’ (邪之所湊，其氣必虛). There has never yet been a case where the zhèngqì (true qì) was unimpaired and pathogenic poison could harm the body.”
The preface continues with a sustained polemic against the routine use of the surgical knife in wàikē practice, citing the doctrinal authority of Lǐ Dōngyuán for the alternative three-method protocol: shūtōng (opening-and-passing) before formation, tuōlǐ (inner-supporting) for severe cases, héyíngwèi (harmonising the yíng and wèi) for the maturated lesion.
Abstract
A mid-to-late 19th-century clinical case-record formulary by Zhū Fèiyuán of whose biography very little is securely identifiable. The work is in the Xuē Jǐ – Lǐ Dōngyuán doctrinal tradition of wàikē practice (cf. KR3ed123 for the Xuē Jǐ position), with the strong anti-surgical polemical position of the preface and the corresponding clinical method of careful internal-medication-by-formula. The work’s principal historical position is as a mid-19th-century JiāngNán wàikē clinical primer preserving the doctrinal continuity from Xuē Jǐ (16th c.) through Wú Qǐ (KR3ed127, 1744) into the mid-Qīng.
The case-record format is interesting as a deliberate clinical-pedagogical departure from the standard yīfāng (medicine-formula) compilation: rather than presenting formulas indexed by syndrome-name, Zhū presents them indexed by case-number under each clinical heading, with the bedside-discrimination of xū / shí / hán / rè embedded in each case-note. This format approaches the modern medical case-report and reflects the increasing late-Qīng emphasis on individualised clinical practice.
The work was circulated in late-Qīng woodblock editions; a modern critical edition has not been issued, but the work is preserved in the late-Qīng Wèishēng cóngshū and similar collections.
Translations and research
No substantial secondary literature located. The text is briefly catalogued in the Zhōngguó zhōngyī gǔjí zǒngmù (2007).
Links
- See 朱費元.
- Cognate wàikē tradition: KR3ed123 (Xuē Jǐ), KR3ed127 (Wú Qǐ).
- 臨證一得方 (jicheng.tw)
- Kanseki DB