Yòukē qièyào 幼科切要
Pressing Essentials of Paediatrics by 王錫鑫 Wáng Xīxīn (撰); preface by 杜價祿 Dù Jiàlù
About the work
A single-juǎn mid-Qīng paediatric handbook by 王錫鑫 Wáng Xīxīn (zì Yàzhuō 亞拙, hào Yúquán 魚泉), composed in Chóngqìng (Yúchéng 渝城) and printed in Dàoguāng 27 dīngwèi 1847 桂月朔日 (eighth lunar month first day). The work distils the principal paediatric diagnostic and therapeutic essentials in gē 歌 (rhymed verse) form for clinical memorisation, drawing on the teaching of Wáng’s master 覺來先生 Juélái xiānshēng. Wáng’s autobiographical self-preface gives a small yīhuà 醫話 (medical-anecdote) sketch of his student-teacher conversation with Juélái xiānshēng on the paediatric yǎkē (silent department) problem.
Prefaces
Preface by 杜價祿 Dù Jiàlù (zì Bīnwǔ 賓五) of Jiāngyīn 江陰, lǐnshēng 廩生 (stipended licentiate), dated Dàoguāng 27 (1847) 桂月 (eighth lunar month) first day. Dù characterises paediatric diagnosis as relatively yì 易 (easy) compared to adult medicine — jǔmù kě jiàn 舉目可見 (it can be seen at a glance) by attention to facial coloration and crying sound — and praises Wáng Xīxīn’s lǐ jīng fǎ mì, zhǐdiǎn qīnqiè 理精法密，指點親切 (refined doctrine, dense method, intimate guidance). Author’s self-preface (自序), dated the same day, by Yúquán Wáng Xīxīn Yàzhuō shì 魚泉王錫鑫亞拙氏. Wáng recounts his apprenticeship to 覺來先生 Juélái xiānshēng: he had asked his master whether paediatric medicine, being yǎkē (silent department), is exceedingly difficult; the master replied that paediatric medicine is in fact relatively easy, since the infant body is not yet damaged by the qīqíng liùyù 七情六慾 (seven emotions, six desires) nor the bāzhēn wǔwèi 八珍五味 (rich foods of the wealthy) — like the líhuò zhī fù 藜藿之腹 (the porridge-fed peasant’s belly) more responsive to medication than the gāoliáng zhī biàn 膏粱之變 (rich-food complications) of the gāoliáng class. The master then taught Wáng a systematic paediatric diagnostic procedure: (1) observe yuánqì hòubó 元氣厚薄 (constitutional strength); (2) palpate hand and breath for hánrè 寒熱; (3) examine lip-tongue rùnzào 潤燥 (moist or dry); (4) check finger-vein (guānwén 關紋) sèqì 色氣 (colour and vital signs); (5) inquire after diet and èrbiàn 二便 (urine and stool). Wáng compiled the work over years and published it in 1847 with the patronage of his three Chóngqìng friends 傅怡如 Fù Yírú, 艾頊堂 Aì Xūtáng, and 邱東山 Qiū Dōngshān.
Abstract
The Yòukē qièyào is a compact mid-Qīng paediatric handbook structured around a series of seven-character rhymed gē (verse mnemonics) suitable for clinical memorisation. The principal verses include: Kàn xiǎo’ér bìngzhuàng gē 看小兒病狀歌 (observing-paediatric-symptoms verse — facial zàngfǔ coloration, finger-vein finger-temperature differential), fùzhěn zhǐwén jì gējué 復診指紋記歌訣 (finger-vein examination verse — the sānguān 三關 fēng qì mìng 風氣命 schema, with prognostic indications for each guān and each colour-pattern), and a pulse-and-tongue verse. The therapeutic frame draws on 張景岳 Zhāng Jǐngyuè’s authority for the position that paediatric medicine is in fact easier than adult medicine (the Jǐngyuè quánshū 景岳全書 maxim bìng zhī tòngyǎng yòu bùnéng yǐ yán chuán 病之痛癢又不能以言傳，wéi yǒu wàng wén qiè ér yǐ 惟有望聞切而已). Wáng’s prescription preference is for qīngjì 輕劑 (light prescriptions): the conventional Xiāngsū sǎn 香蘇散 and Xīngxīng sǎn 惺惺散 for surface (biǎo 表) disorders; Píngwèi sǎn 平胃散 and Huòxiāng sǎn 藿香散 for interior (lǐ 裡) disorders; Èrchén tāng 二陳湯 and Liùjūnzǐ tāng 六君子湯 for xūtán 虛痰 (deficient phlegm); Xiǎo’ér niúhuáng wán 小兒牛黃丸 and Xièqīng wán 瀉青丸 for shírè 實熱 (excess heat). The work circulated in Sìchuān and the upper-Yángzǐ region in the late Qīng.
Translations and research
- No substantial English-language scholarship on the Yòukē qièyào located.
- Yòukē qièyào jiàozhù 幼科切要校注 — modern punctuated edition (various imprints).
- Marta Hanson, Speaking of Epidemics in Chinese Medicine (Routledge, 2011) — context for late-Qīng regional medical-pedagogical writing.