Sìkē Jiǎnxiào Fāng 四科簡效方
Simple-Effective Formulas in the Four Branches by 王士雄 (Wáng Shìxióng = Wáng Mèngyīng 王孟英, 1808–1868)
About the work
A four-juǎn clinical formulary by Wáng Mèngyīng, organising the jiǎnxiào (simple-effective) single-formula and few-ingredient prescriptions by the four traditional sub-disciplines of late-Imperial medicine (sìkē 四科): (i) Nèikē 內科 (internal medicine), (ii) Fùrénkē 婦人科 (gynaecology), (iii) Xiǎoérkē 小兒科 (paediatrics), (iv) Wàikē 外科 (external / surgical). The work is in the same overall pedagogical project as KR3ed138 Qiánzhāi jiǎnxiào fāng but in a more systematic and clinically-structured organisation.
Prefaces
Preface by Wáng Mèngyīng (signed Hǎiníng Wáng Shìxióng Mèngyīng zhuàn):
“The most-difficult thing in the world is medicine. Even for one single syndrome, the yīn (causes) are each different, the zhuǎnbiàn (transmissions-and-transformations) are entirely distinct. Moreover the body has xū / shí, the disease has qiǎn / shēn, the zàngxìng (organ-natures) have yīn / yáng, the tiānshí (seasonal-time) has hán / xuān. Although the formula and the disease agree, one must still modify-up-or-down according to the syndrome, in hopes that there shall be no the slightest discordance — only then can the drug-arrival end the disease, and not bequeath misfortune-and-untimely-death.
“Unless one is a shǒujīng dáquán (constancy-keeper and expedient-master), how is one to speak of this? This is what is meant by the established formula cannot be held to.
“Of old, the great Confucian-scholars and famous officials transcribed dānfāng (single-formulas) for the people’s use — truly with their lìjì wéi huái (concern-for-relief in their bosom). Only: the drug-strength of dānfāng is zhuān (concentrated), and the effect is especially rapid; if [the practitioner] does not know how to distinguish [the cases] and recklessly applies it, the harm to people is even easier.
“Moreover, since the writings of Qín Zhèng and Hàn Wǔ — the fāngshū (formula-books) — have customarily-mixed-in the shénxiān fúshí (immortal-elixir food-and-medicine) talk; and the Zhǒuhòu and Qiānjīn and similar books used poison-drugs as routine substances. Later people, without such discernment, talk-soldier-tactics on paper — how can one not sigh at the rénfèi (the human cost)?
“Even with Sū Wénzhōng’s [Sū Shì’s] yānyǎ (literary refinement) — he too over-believed chuánwén (hearsay) — extolling the Shèngsǎnzǐ, the Hēishén dān and similar formulas with full enthusiasm — and he could not avoid bequeathing error to later ages, let alone the rest!
“It must be that the formula-selector is not necessarily one who knows medicine, while the one who knows medicine either dismisses single-formulas as trivial-not-worth-speaking, or stands grandly on them as pillow-secret and does not transmit them. Therefore the single-formularies that circulate in the world — there are truly no good editions.
“I have never properly xuéwèn (formally studied), but to continue my late father’s purpose, from boyhood I have devoted my heart to medical books. In these thirty years and more, of what I have seen and heard — there is more beauty than I can take in…”
Abstract
A late-clinical-career work of Wáng Mèngyīng, in the same Qián-studio retirement period (1850s–1868) as KR3ed138 and KR3ed140. The preface develops Wáng’s substantive critical position on the inherited dānfāng literature:
- Defence of dānfāng in principle: against the conventional learned-medical dismissal, Wáng holds that single-formulas have genuine clinical value, especially for difficult or strange syndromes.
- Critical caution about dānfāng in practice: their zhuān (concentrated) action makes misapplication especially dangerous; the practitioner must know how to distinguish the cases before applying them.
- Historical-philological critique: the inherited dānfāng literature has been corrupted by (a) the shénxiān fúshí (immortal-elixir) discourse since the QínHàn period, (b) the Zhǒuhòu / Qiānjīn tradition’s casual use of toxic drugs as routine substances, and (c) the lay-publishers’ uncritical reproduction of erroneous material. Even Sū Shì (Sū Dōngpō) was not immune — his enthusiastic endorsement of the Shèngsǎnzǐ and Hēishén dān (controversial late-Sòng formulas) is cited as an example of how literati can amplify rather than correct popular medical misinformation.
Wáng’s critical methodology applied to the four sìkē sub-disciplines is one of the principal mid-19th-century contributions to literature-critical clinical pharmacology. He establishes the principle that the proper clinician must combine (i) bedside discrimination of xūshíhánrè, (ii) historical-philological discernment of which inherited formulas are reliable, and (iii) cautious adaptation to the specific patient.
Translations and research
- Wáng Mèngyīng yīxué quánshū 王孟英醫學全書, ed. Shèng Zēngxiù 盛增秀 et al., Beijing: Zhōngguó zhōngyīyào chūbǎnshè, 1999.
- Marta Hanson, Speaking of Epidemics in Chinese Medicine (Routledge, 2011).
Other points of interest
The preface’s critique of Sū Shì’s popular-medical advocacy is one of the more striking mid-19th-century rejections of an exemplary literati-medical authority. The Shèngsǎnzǐ (a Wáng Liángzhèng formulary preparation) and the Hēishén dān are both SòngYuán formulas that Sū Shì had publicly recommended; Wáng identifies them as harmful misattributions — popular pharmacology’s literary-celebrity-effect leading to clinical-harm dissemination.
Links
- See 王士雄.
- Cognate works by Wáng: KR3ed124, KR3ed138, KR3ed140.
- 四科簡效方 (jicheng.tw)
- Kanseki DB