Mázhěn bèiyào fānglùn 麻疹備要方論
Essential Formulary and Discourse on Measles by 吳硯丞 Wú Yànchéng (撰); preface by 吳與九 Wú Yǔjiǔ (1853)
About the work
A single-juǎn mid-Qīng measles-specialty (mázhěn 麻疹) treatise by Wú Yànchéng 吳硯丞, dated by the printed preface Xiánfēng sān nián guǐchǒu zhòngxià 咸豐三年歲次癸丑仲夏 = mid-summer 1853. The preface, by Shuāngxī Wú Yǔjiǔ 雙溪吳與九 (a relative who arranged for the printing), explicitly contrasts the abundance of dòu (smallpox) literature with the relative scarcity of má (measles) literature, attributing many má-related child deaths to physician underestimation: fán dà cūn xiǎo luò, xiǎoér wǎngzhé zhě, bù zhī fán jǐ 凡大村小落，小兒枉折者，不知凡幾 (in village after village, the count of children prematurely lost is unknowable). The work was printed as a companion volume to the Shénjiǔ jīnglún 《神灸經綸》 acupuncture-moxibustion work that Wú Yǔjiǔ’s father (Wú Yànchéng) had previously edited.
Prefaces
The 1853 preface by Wú Yǔjiǔ 吳與九 frames the work’s distinctive doctrine: má chū liùfǔ, yǔ dòu chū wǔzàng zhě bù tóng 麻出六腑，與痘出五臟者不同 (measles emerges from the six fǔ, smallpox from the five zàng; their treatments are correspondingly different); zhì dé qí fǎ, kě yǐ piān yán jū yào 治得其法，可以片言居要 (if one finds the right method, a few key principles suffice). The principal complaint is against careless physicians who, holding measles to be easier than smallpox, dispense superficial prescriptions and thereby cǎo jiān rén mìng 草菅人命 (treat human life as no better than weeds).
Abstract
The work opens with Yuánshǐ lùn 原始論 (Discourse on Origins): like smallpox, measles is a tāidú 胎毒 (fetal poison) released by encounter with seasonal lìqì 沴戾之氣 (perverse epidemic qì). The defining doctrinal distinction is that dòu chū wǔzàng shǔ yīn, yīn zhǔ xuè, gù yǒu xíng yǒu jiāng 痘出五臟屬陰，陰主血，故有形有漿 (smallpox emerges from the yīn five zàng, which govern blood, so smallpox has both form and pus); whereas zhěn chū liùfǔ shǔ yáng, yáng zhǔ qì, gù yǒu xíng wú jiāng, qí zhèng duō shí, yǒu rè ér wú hán 疹出六腑屬陽，陽主氣，故有形無漿，其症多實，有熱而無寒 (measles emerges from the yáng six fǔ, which govern qì, so measles has form but no pus; its presentation is replete-heat, never cold). From this single classification follows the work’s entire therapeutic programme.
The treatise is then organised through sequenced clinical phases: zhěnmài 疹脈 (measles pulse — emphatically, the yòu cùn 右寸 — right cùn — Lung pulse should be hóngdà yǒulì 洪大有力, since Lung governs the surface and carries the eruption out; sunken-weak cùn is alarming because it signals yáng zhèng with yīn pulse); biànzhèng 辨症 (differential diagnosis against measles-imitating febrile illnesses); chūrè 初熱 (the initial fever phase); zhěn zhì hé shí 疹治合時 (treatment according to phase); jiànxíng lùn zhì 見形論治 (treatment once eruption is visible); shōumò lùn zhì 收沒論治 (treatment during fade); a thematic section on individual measles-associated complications (fever, body-cold, cough, dyspnoea, vomiting, vomiting of roundworms, thirst-irritability, delirium, convulsions, food intake, eye disorders, nose disorders, mouth-tongue-tooth-throat disorders, sweating, abdominal pain, diarrhoea, dysentery, urinary-faecal retention, somnolence, mágān 麻疳 measles emaciation, pregnancy-with-measles, gàidòu zhěn 蓋痘疹 covering-smallpox eruption, yǐnzhěn 癮疹 hidden eruption, and dietary prohibitions). The work concludes with a formulary section listing the principal prescriptions: Xuāndú fābiǎo tāng 宣毒發表湯, Shēngmá gégēn tāng 升麻葛根湯, Fángfēng jiědú tāng 防風解毒湯, Jiāwèi huánglián jiědú tāng 加味黃連解毒湯, etc.
The signature therapeutic doctrine: a strict three-phase protocol of biǎotuō 表托 (surface-expression) at outset, qīnglì 清利 (cooling-draining) once eruption is complete, and yǎngxuè 養血 (blood-nourishing) for the post-fade phase, with the explicit prohibition: wù zhíní yú qīnglì 勿執泥於清利 (do not become fixated on cooling-draining once eruption has resolved). This middle-phase reversal — from cooling-purging in the active phase to blood-nourishing in the recovery phase — is the work’s principal contribution and was widely cited in late-Qīng measles literature.
Date 1853 is firm from the printed preface. Wú Yànchéng 吳硯丞 is otherwise poorly attested; CBDB has no entry. He appears to have been a mid-Qīng Jiāngnán physician active in the same intellectual circle as the Shénjiǔ jīnglún author.
Translations and research
- No substantial Western-language scholarship on the Mázhěn bèiyào fānglùn located.
- Marta Hanson, Speaking of Epidemics in Chinese Medicine: Disease and the Geographic Imagination in Late Imperial China. Routledge, 2011 — Jiāng-nán epidemic medicine in the mid-19th century.
Other points of interest
The work’s nosological frame — measles as a yáng / liùfǔ / qì disease in radical contrast to smallpox as a yīn / wǔzàng / xuè disease — represents the high-Qīng systematic-correlative formulation of the má / dòu distinction. This explicit yīnyáng / zàngfǔ / qìxuè mapping is the most concise and influential late-Qīng statement of the doctrine.