Bǎoyīng cuōyào 保嬰撮要
Distilled Essentials for Protecting Infants by 薛鎧 Xuē Kǎi (撰), edited and supplemented by 薛己 Xuē Jǐ (校補); preface by 林懋舉 Lín Màojǔ
About the work
A twenty-juǎn mid-Míng paediatric compendium of the Xuē-family medical lineage of Wúxiàn 吳縣 (Sūzhōu). The work was begun by 薛鎧 Xuē Kǎi (zì Liángwǔ 良武), continued and brought to final publication by his son 薛己 Xuē Jǐ (1487–1559, zì Lìzhāi 立齋), and printed in 1556 (Jiājìng 35, bǐngchén 丙辰) under the patronage of 林懋舉 Lín Màojǔ, then Prefect of Sūzhōu. It is the principal paediatric work of the Xuēshì yīàn 薛氏醫案 (KR3e0070) clinical-case corpus and one of the most influential mid-Míng paediatric treatises, distinguished by its case-driven yīàn 醫案 organisation: each disorder is presented through a sequence of clinical case-reports drawn from the Xuē family’s three-generation paediatric practice, followed by therapeutic discussion. Its therapeutic approach reflects the broader Xuē Jǐ doctrine of bǔyǎng píwèi 補養脾胃 (spleen-and-stomach supplementation) along 李東垣 Lǐ Dōngyuán lines and the liùwèi / bāwèi 六味/八味 prescription pair.
Prefaces
Preface by 林懋舉 Lín Màojǔ, cì jìnshì dì zhōngxiàn dàfū zhī Sūzhōu fǔ shì qián Gōngkē jǐshìzhōng (Sūzhōu Prefect, formerly Gōngkē Secretary of the Ministry of Works), dated 嘉靖丙辰歲春正月吉日 = 1556 spring first month auspicious day. Lín opens with a vivid biographical anecdote: visiting Xuē Jǐ at home, he found the imperial physician péngtóu zhí juàn, chōu yì xún sī, huǎngrán rú jīngshēng xiàwéi zhī zhuàng 蓬頭執卷，紬繹尋思，恍然如經生下帷之狀 (hair-disheveled, holding a fascicle, drawing out and reflecting upon it, transfixed as a classical-Confucian-scholar in his curtained-study posture); on examining the papers strewn on the table, Lín found Xuē’s marginalia exceeding even those of a serious classical scholar. Xuē explained that paediatric medicine is most demanding because the yīngér bù néng yán 嬰兒不能言 (infant cannot speak) and the Lǐjì injunction rú bǎo chìzǐ, xīn chéng qiú zhī, suī bù zhōng bù yuǎn yǐ 如保赤子，心誠求之，雖不中不遠矣 (caring for the infant with one’s whole heart, even if one does not exactly hit the mark one will not be far off) demands a clinical seriousness lost in the contemporary trade. Xuē set out a brief paediatric doctrine — the central role of tǔ 土 (the píwèi spleen-stomach earth) in the wǔxíng of the child’s body — and accepted Lín’s offer to fund the printing. The book was completed in the first month of 1556. Lín explicitly notes Xuē Jǐ’s official position as Tàiyīyuàn yuànshǐ 太醫院院使 (Director of the Imperial Medical Academy) and the Xuē family’s sān Wú shìjiā 三吳世家 (Wú-region lineage) status. Lín closes by linking the publication to the broader project of zàishēng 在生 (life-preservation) of the people, given the contemporary depredations of the Wōyí 倭夷 (Japanese pirates) which had reduced the agricultural population of the Sūzhōu region by shí wáng èrsān 十亡二三 (twenty-to-thirty per cent).
Abstract
The Bǎoyīng cuōyào is one of the canonical mid-Míng paediatric treatises and the principal paediatric component of the Xuēshì yīàn corpus. Its twenty juǎn cover the standard paediatric disease-categories — neonatal disorders, jīngfēng 驚風, gān 疳, yǎnmù 眼目 (paediatric ophthalmology), kǒuchǐ shé 口齒舌, hóu 喉, ěr 耳, bí 鼻, liúyínzhèng 六淫證, zázhèng 雜證, and wàikē chuāngyáng 外科瘡瘍 (paediatric surgery and sores) — but its distinctive feature is the central role of yīàn 醫案 clinical-case narrative as the principal pedagogical vehicle. Each disorder is presented through a sequence of named case-reports — usually identified by the patient family’s surname, locality, and clinical course — followed by therapeutic discussion. The work was widely reprinted through the late Míng and Qīng, and is one of the principal Míng-period paediatric sources for 萬全 Wàn Quán, 王肯堂 Wáng Kěntáng’s Zhèngzhì zhǔnshéng yòukē (KR3ej037), and 陳復正 Chén Fùzhèng’s Yòuyòu jíchéng (KR3ej013). The case-driven format also makes the work an important primary source for the social history of mid-Míng Jiāngnán medicine.
Translations and research
- Charlotte Furth, A Flourishing Yin: Gender in China’s Medical History, 960–1665. Berkeley: UC Press, 1999 — discusses Xuē Jǐ and the yīàn genre at length.
- 熊秉真 Xióng Bǐngzhēn (Hsiung Ping-chen), A Tender Voyage. Stanford UP, 2005 — discusses Xuē-family paediatrics.
- Chao Yüan-ling, Medicine and Society in Late Imperial China: A Study of Physicians in Suzhou, 1600–1850. New York: Peter Lang, 2009 — context for the Sūzhōu medical world.
- Bǎoyīng cuōyào jiàozhù 保嬰撮要校注, ed. 王玉賢 Wáng Yùxián et al. Beijing: Rénmín wèishēng chūbǎnshè — standard punctuated edition.
- No substantial English translation located.
Other points of interest
Lín Màojǔ’s preface anecdote of Xuē Jǐ as a jīngshēng xiàwéi (curtained-study Confucian scholar) studying his own medical-case materials with marginalia is one of the most vivid documentary glimpses of the working scholar-physician’s yīàn practice in mid-Míng Jiāngnán. The pirate-raid context (wōyí fújìng, 倭夷弗靖) for the publication situates the work in the catastrophic Jiājìng coastal-defence emergency of the 1550s.