Nèikē zhāiyào 內科摘要
Selected Essentials of Internal Medicine by 薛己 (Xuē Jǐ, zì Xīnfǔ 新甫, hào Lìzhāi 立齋, 1487–1559)
About the work
Xuē Jǐ’s case-record collection in 2 juǎn, the seminal Míng-period exhibit for the clinical application of Mìngmén 命門 doctrine. The work is conventionally dated to Jiājìng 8 = 1529 (date of completion of the core text) but contains case-records dated as late as Jiājìng 24 = 1545, indicating successive additions during the 1530s and early 1540s; the principal preface by 朱佐 Zhū Zuǒ is dated Jiājìng jiǎchén = 1544. The composition window 1529–1545 reflects this. Today the text usually circulates within the Xuē shì yīàn èrshísì zhǒng 薛氏醫案二十四種 corpus, but it is the foundational Xuē monograph in its own right.
Abstract
Xuē Jǐ — a Sūzhōu-born hereditary physician who served at the Tàiyī yuàn 太醫院 in Beijing under Jiājìng — is the central figure in the consolidation of the late-Míng wēnbǔ 溫補 (warming-tonifying) doctrinal current. The Nèikē zhāiyào is the work in which he first systematically applies the Mìngmén doctrine — the early-Míng innovation that the gate-of-life between the kidneys is the source of the body’s yuányáng 元陽 fire and the engine of píwèi function — to internal-medicine clinical practice. Xuē reads many of the seemingly excess-heat or yīn-deficient presentations brought to him as cases of Mìngmén fire decline failing to generate the spleen-and-stomach earth, and treats with Bāwèi wán 八味丸 (the Liùwèi dìhuáng wán with fùzǐ and ròuguì added — the canonical Mìngmén prescription) and with Bǔzhōng yìqì tāng 補中益氣湯 modified with shēngjiāng and ròuguì for added warming.
The cases preserved in the work are some of the most-cited in Míng-Qīng medical literature. Notable: the 1542 case of “Dàyǎ’s mother” — driven near death by misapplied cooling drugs and revived by Xuē’s emergency salt-and-aconite compress to the abdomen, then maintained over fifty doses of warming-tonifying decoction; Lù shì’s mother (1545), with “true cold within and false heat without” 內真寒外假熱 syndrome, treated with Bǔzhōng yìqì tāng 加味 to immediate effect; Zhū Shào’s case (Jiājìng yǐwèi = 1535) of zàngdú xiàxuè 臟毒下血 with abdominal distension, treated with rénshēn–báizhú as ruler, shānyào, huángqí, ròuguǒ, jiāng, fùzǐ as ministers.
The Nèikē zhāiyào is therefore foundational for the Míng-Qīng wēnbǔ lineage that runs through 孫一奎 Sūn Yīkuí (the first to give Mìngmén explicit doctrinal definition), 趙獻可 Zhào Xiànkě, 張介賓 Zhāng Jièbīn, and 李中梓 Lǐ Zhōngzǐ. The combination — Mìngmén fire decline as the unrecognised root of nominally heat- or yīn-deficient syndromes; aggressive use of fùzǐ and the Bāwèi wán against contemporary physicians’ caution — is one of the great clinical intuitions of Míng medicine and the foundation of the wēnbǔ school’s distinctive therapeutic profile.
The catalog meta gives the dynasty as 明; the Xuē family is hereditary Sūzhōu medical, with Xuē Jǐ’s father 薛鎧 Xuē Kǎi also a court physician and the joint-authorship of several texts (especially in paediatrics) attributed to “Xuēshì” reflecting the family’s continuous practice.
Translations and research
- Nèikē zhāiyào punctuated edition, in Xuē Lìzhāi yīxué quánshū 薛立齋醫學全書, Beijing: Zhōngyī gǔjí chūbǎnshè, 1999.
- Charlotte Furth, A Flourishing Yin: Gender in China’s Medical History, 960–1665. Berkeley: UC Press, 1999 — extensive treatment of the Xuē family medical practice, esp. in gynaecology and obstetrics.
- L. Carrington Goodrich and Fang Chaoying, eds., Dictionary of Ming Biography 1368–1644 (New York: Columbia, 1976), entry on Xuē Jǐ — standard English-language biographical reference.
- Marta Hanson, Speaking of Epidemics in Chinese Medicine. London: Routledge, 2011 — situates the wēnbǔ school in late-Míng / early-Qīng context.
- No standalone English translation of the Nèikē zhāiyào located.