Shāzhěn jíyào 痧疹輯要
Compiled Essentials on Scarlet-Type Eruptive Fevers by 葉霖 Yè Lín (撰); preface by 李振霆 Lǐ Zhèntíng (1890)
About the work
A four-juǎn late-Qīng specialty treatise on shāzhěn 痧疹 (scarlet-type eruptive fevers — what modern medicine identifies principally as scarlet fever from Streptococcus pyogenes, distinct from mázhěn 麻疹 measles and yǐnzhěn 隱疹 urticaria) by 葉霖 Yè Lín (zì Zǐyǔ 子雨, hào Shílín jūshì 石林居士) of Yángzhōu 揚州 (Jiāngsū), one of the principal late-Qīng kǎojù medical philologists. The work was completed in Wùzǐ zhī dōng 戊子之冬 = winter of 1888 and published in 1890 with a preface by 李振霆 Lǐ Zhèntíng of Sìmíng (Níngbō) at Běitíng 北亭. It is Yè Lín’s principal paediatric specialty work, complementing his better-known Nánjīng zhèngyì 難經正義 (KR3ea058, 1895) and other classical-canonical medical commentaries.
Prefaces
Preface by 李振霆 Lǐ Zhèntíng of Sìmíng Běitíng 四明北亭, dated Guāngxù gēngyín mùchūn zhī chū 光緒庚寅暮春之初 = early third lunar month of 1890. Lǐ frames the work in classical-canonical idiom: the Zhōulǐ records that medicine in antiquity was the responsibility of shàngshì 上士 (senior officers), reflecting its serious moral status; modern yīguān 醫官 (medical officials) and provincial physicians have largely failed to maintain this standard. Lǐ characterises his friend Yè Zǐyǔ (= Yè Lín) as mǐn ér hào xué 敏而好學 (quick and fond of learning), having in middle age repeatedly cuō wù yú yōnggōng zhī shǒu 多誤於庸工之手 (had his own family misled by mediocre practitioners), and having therefore kǎirán yǒu jìshì zhī zhì 慨然有濟世之志 (decided with moral indignation to dedicate himself to medical salvation). Yè had spent ten years (bìhù shí nián 閉戶十年) in closed study and produced multiple substantial medical works. The present Shāzhěn jíyào — Lǐ writes — biànzhèng lùnyīn, zhézhōng zhōngwài 辨證論因，折衷中外 (its biànzhèng and etiological discussion are balanced between Chinese and Western medicine), with the sānjiāo 三焦 (triple-burner) and tóngshēn qǔcùn 同身取寸 (taking the cùn measurement from the patient’s own body) discussions fā qiánrén suǒ wèi fā 發前人所未發 (illuminating what predecessors had not articulated) and chāoyì gǔjīn 超軼古今 (surpassing the ancient-and-modern tradition). Lǐ commends the work as jìshì zhī shū, chuánshì zhī shū 濟世之書，傳世之書 (a book for saving the world, a book for transmission to posterity). Author’s self-preface: Yè explains that shāzhěn 痧疹 (scarlet-eruption) — as distinct from measles and urticaria — has no extant canonical treatment in the Hàn-Wèi jīngfāng 經方 (canonical-prescription) literature, was only sparingly addressed in Táng-Sòng works, and was first systematically treated by 萬全 Wàn Quán of Luótián in the Míng — shāoshāo chǎnmíng qí yì, ér yǔ yān bùxiáng 稍稍闡明其義，而語焉不詳 (slightly elucidated, but not in detail). Late-Qīng jiā paediatric authorities have jiān yǒu jīng lùn 間有精論 (occasionally refined discussions), but these are mostly scattered at the end of smallpox treatises and frequently confused with yǐnzhěn and shí má 時麻; the biànzhèng is unclear and the treatment-methods duō chuǎn 多舛 (often mistaken). In the cold winter of wùzǐ (1888), Yè therefore compiled the present specialty work gōu wǎngzhé zhī jīnghuá, jué xiānxián zhī àozhǐ 鉤往哲之精華，抉先賢之奧旨 (drawing the essence from past sages, extracting the deep ideas from earlier worthies) into a single volume.
Abstract
The Shāzhěn jíyào is one of the principal late-Qīng specialty treatises on shāzhěn (scarlet eruptive fever), a category that in modern epidemiology corresponds principally to scarlet fever and related Streptococcus-induced exanthems. Its four juǎn are organised around the differential diagnosis of shāzhěn from related disorders (mázhěn 麻疹 measles, yǐnzhěn 隱疹 urticaria, shímá 時麻 seasonal measles, fēngzhěn 風疹 rubella), the etiology (Yè integrates Chinese-medical fēngrè 風熱 doctrine with explicit consideration of zhōngwài 中外 (Chinese and Western) sources — a notable feature for a late-Qīng paediatric work), the staged clinical course, and the prescription corpus. The work’s distinctive theoretical contributions are: (1) the systematic differentiation of shāzhěn from related eruptive fevers, with explicit biāozhì (signs) for each; (2) the original sānjiāo 三焦 doctrine, applying the triple-burner classification system to eruptive-fever physiology; (3) the tóngshēn qǔcùn 同身取寸 (patient-body cùn-measurement) doctrine, applying the Língshū anthropometric measurement standard to paediatric pulse-diagnosis. The 1888 composition and 1890 publication dates place the work at the end of the Qīng paediatric specialty tradition, on the eve of the introduction of Western medical bacteriology to China.
Translations and research
- Yè Zǐyǔ yīxué quánshū 葉子雨醫學全書 — modern collected edition of Yè Lín’s medical writings.
- 熊秉真 Xióng Bǐngzhēn (Hsiung Ping-chen), A Tender Voyage. Stanford UP, 2005 — late-Qīng paediatric specialty context.
- Marta Hanson, Speaking of Epidemics in Chinese Medicine. Routledge, 2011 — late-Qīng epidemic medicine.
- Shāzhěn jíyào jiàozhù 痧疹輯要校注 — modern punctuated edition.
- No substantial English translation located.
Other points of interest
The work’s explicit engagement with zhōngwài (Chinese and Western) medical literature is a marker of the late-Guāngxù medical-cultural moment, when treaty-port hospitals had begun to introduce Western medical literature into Chinese physician circles. Yè Lín — though a kǎojù classical-medicine specialist — is one of several late-Qīng physicians who attempted to integrate Western-medical pathology with Chinese-medical biànzhèng doctrine, anticipating the early-Republican TCM modernisation movement.