Xiǎo’ér dòuzhěn fānglùn 小兒痘疹方論
Discourse on Recipes for Children’s Smallpox and Eruptive Fever by 陳文中 Chén Wénzhòng (撰)
About the work
A single-juǎn Southern-Sòng paediatric monograph on dòuzhěn 痘疹 (smallpox and eruptive fever) by Chén Wénzhòng 陳文中 (fl. 1169–1184 per CBDB), Héānláng 和安郎 official-rank physician, pàn Tàiyījú jiān Hànlín liángyī 判太醫局兼翰林良醫 (Judge of the Imperial Medical Bureau concurrently Liángyī of the Hànlín Academy) — the central-court paediatric authority of the Southern-Sòng late twelfth century. The work is the foundational text of the warm-supplementation (wēnbǔ 溫補) tradition in Chinese paediatric smallpox medicine and is canonically paired in opposition to Qián Yǐ 錢乙’s earlier cooling-purging (qīngxiè 涼瀉) paediatric tradition. The standard formulation in later MíngQīng paediatric literature is Qián shì zhǔ liáng, Chén shì zhǔ wēn 錢氏主涼，陳氏主溫 — Qián is for cooling, Chén is for warming. This is the same text as KR3ej056 Chén shì xiǎo’ér dòuzhěn fānglùn 陳氏小兒痘疹方論 (the Chénshì-prefixed title); the hxwd recension of KR3ej053 is the more commonly cited form.
Prefaces
Chén Wénzhòng’s self-preface lays out his motivation: paediatric smallpox is among the gravest of childhood diseases, ill-suited to indiscriminate self-medication, and many children die from physician error rather than disease severity. The preface continues with the doctrine of sānhuìyèdú 三穢液毒 (Three Foul-Liquid Poisons) — fetal poisons of the five zàng / six fǔ, of the membranes and flesh, and of qì-blood and bone-marrow — as the three layered sources of the smallpox / eruption sequence. He demands that mother and infant abstain from cōng 蔥, jiǔ 韭, xiè 薤, suàn 蒜, cù 醋, jiǔ 酒, yán 鹽, jiàng 醬, zhāng 獐, tù 兔, jī 雞, quǎn 犬, yúxīng 魚腥 (onion, leek, garlic, vinegar, wine, salt, jiàng, antelope, hare, chicken, dog, fishy foods).
Abstract
The Xiǎo’ér dòuzhěn fānglùn is structured as a treatise paired with an extensive formulary. The lùn 論 sections lay out Chén’s diagnostic-therapeutic doctrine: smallpox is a biǎolǐ 表裡 / xūshí 虛實 problem requiring careful four-way classification (biǎolǐ jùshí 表裡俱實 — both surface and interior replete; biǎolǐ jùxū 表裡俱虛 — both vacuous; biǎoshí lǐxū — surface replete, interior vacuous; biǎoxū lǐshí — surface vacuous, interior replete). The classification governs prognosis (replete-on-both presentations resolve smoothly; vacuous-on-both presentations are gravest) and treatment (shí 實 — replete — calls for cooling-purging à la Qián Yǐ; xū 虛 — vacuous — calls for warming-supplementation, Chén’s distinctive prescription). The signature formulas of the wēnbǔ tradition are introduced here: shíyīwèi mùxiāng sǎn 十一味木香散 (Eleven-Ingredient Mùxiāng Powder), shíèrwèi yìgōng sǎn 十二味異功散 (Twelve-Ingredient Yìgōng Powder), shēnqí nèituō sǎn 參耆內托散 (Ginseng-Astragalus Inner-Drawing-Out Powder), and ròudòukòu wán 肉豆蔻丸 (Nutmeg Pill).
The text is enriched throughout by yú àn 愚按 (“my note”) interpolations attributed to Xuē Jǐ 薛己 (1487–1559), the Míng paediatrician of the Bǎoyīng cuōyào 保嬰撮要 (KR3ej015) lineage, who edited Chén’s text and added his own clinical commentary. The Xuēshì yú àn layer transforms the original Sòng work into a Míng-recensioned reading that integrates Chén’s wēnbǔ method with Xuē’s later bǔtǔ 補土 (earth-supplementation) school. Many later MíngQīng smallpox treatises cite ChénXuē together as the canonical warm-supplementation lineage.
The work’s date is fixed by Chén’s office pàn Tàiyījú in the Southern Sòng; CBDB records his flourishing years as 1169–1184, so the composition window is the late twelfth century. The catalog assigns the work to NánSòng 南宋. The Sìkù quánshū zǒngmù tíyào placed Chén Wénzhòng among the most authoritative Sòng paediatric authors. Sòngshǐ Yìwénzhì 《宋史·藝文志》 records the work. The text is one of the few Sòng paediatric monographs preserved in continuous transmission.
Translations and research
- T. J. Hinrichs and Linda L. Barnes (eds), Chinese Medicine and Healing: An Illustrated History. Belknap, 2013 — Sòng paediatrics chapter, treating Qián Yǐ and Chén Wén-zhòng as the foundational opposed schools.
- Joanna Grant, A Chinese Physician: Wang Ji and the “Stone Mountain Medical Case Histories”. RoutledgeCurzon, 2003 — Míng reception of Sòng paediatric doctrine.
- Marta Hanson, Speaking of Epidemics in Chinese Medicine. Routledge, 2011 — Míng-Qīng reception of the wēn-bǔ / qīng-xiè paediatric dichotomy.
- Chinese-language scholarship: studies of Chén Wén-zhòng in the Zhōng-yī ér-kē xué-shǐ 《中醫兒科學史》 historiographic tradition treat this work as foundational; see for example Sū Lǐ-xīn 蘇禮新 et al., Zhōng-guó ér-kē yī-xué fā-zhǎn-shǐ 《中國兒科醫學發展史》 (Beijing: People’s Medical Publishing, multiple editions).
Other points of interest
The Xiǎo’ér dòuzhěn fānglùn is the canonical Sòng counterweight to Qián Yǐ’s KR3ej020 Xiǎo’ér yàozhèng zhíjué 小兒藥證直訣. Together they establish the cooling-purging / warming-supplementation polarity that organizes the entire subsequent history of Chinese paediatric smallpox medicine for the next 500 years. Wàn Quán 萬全 (the Míng author of KR3ej066 Dòuzhěn xīnfǎ) and Xuē Jǐ 薛己 (the editor of KR3ej015 Bǎoyīng cuōyào) both explicitly position themselves as mediating between Qián and Chén.
The catalog assignment to NánSòng is correct; the hxwd parallel entry KR3ej056 (assigned simply to Sòng 宋) is the same text under the variant Chénshì-prefixed title, and the two should be read together.