Wàikē jīngyì 外科精義
Essentials of External Medicine by 齊德之 (Qí Dézhī, fl. late Yuán) — Medical Erudite, External-Medicine Imperial Physician of the Imperial Pharmacy (醫學博士充御藥院外科太醫).
About the work
A two-juǎn treatise compiled in the late Yuán by Qí Dézhī, an imperial-medical-bureau official-physician with the title Yīxué bóshì chōng Yùyào yuàn wàikē Tàiyī 醫學博士充御藥院外科太醫. The work is the principal Yuán surgical monograph and the first to systematically import classical pulse-diagnosis (màizhěn 脈診) into external medicine — Qí’s polemical thesis being that surgeons who treat lesions without taking the pulse “act like the blind.” Misattributed in Míng commercial editions to the Dōngyuán shí shū 東垣十書 (Ten Works of Lǐ Dōngyuán); the Sìkù tíyào explicitly corrects this misattribution.
Abstract
The work’s date is fixed by the absence of references to Lǐ Gǎo 李杲 (Dōngyuán), with whom Qí is sometimes wrongly grouped: the Sìkù editors observe that “throughout the book there is not one character touching on Lǐ Gǎo” (書中無一字涉及李杲), confirming that the Wàikē jīngyì circulated independently and was only later editorially appended to the Dōngyuán shí shū compilation by Míng booksellers. The composition is conventionally dated to the mid-fourteenth century (within the bracket 1330–1335 adopted here on the basis of Qí’s known imperial-pharmacy tenure). The work was admitted to the Sìkù under the Yī jiā lèi.
The upper juǎn opens with diagnostics: a Lùn chuāngzhǒng zhěnhòu rùshì fǎ 論瘡腫診候入式法 essay that programmatically grounds chuāngyáng 瘡瘍 diagnosis in pulse-reading, followed by differentials of xūshí 虛實, depth, and prognostic shàn / è 善惡 signs. The clinical-methods inventory includes biānlián 砭鐮 (lancet-and-sickle), tiēxié 貼熁 (medicated plaster), tàzì 溻漬 (medicated soak), zhēnluò 針烙 (needle-and-cautery), jiǔ fǎ 灸法 (moxibustion), nèixiāo 內消 (internal dispersion), zhuīshí 追蝕 (corrosion of necrotic flesh), tuō lǐ 託裡 (interior supporting), and zhǐtòng 止痛 (analgesic) methods. The lower juǎn gathers monographs on the wǔ fā jū 五發疽, yōngjū 癰疽, fùgǔ jū 附骨疽, yīnchuāng 陰瘡, shí dú 時毒, zhū chuāng 諸瘡, dīng chuāng 疔瘡, luǒlì 瘰癧, and zhì lòu 痔瘻, drawing systematically on the Sùwèn, Língshū, Nànjīng, on the Hàn–Táng masters Wáng Shūhé 王叔和 and Zhāng Zhòngjǐng 張仲景, and on the Táng–Sòng formularies Qiānjīn, Wàitái, Shènghuì, and Shèngjì zǒnglù.
The work’s most consequential methodological contribution is its nèiwài jiānzhì 內外兼治 (combined internal-and-external treatment) and gōngbǔ jiānshī 攻補兼施 (combined attack-and-tonification) doctrine — a polemical break with the topically focused practice of ordinary chuāngyī 瘡醫. The Sìkù tíyào praises the work for this systematic-internal-medicine framing of surgery. The text was subsequently mis-cited by Sūn Yīkuí 孫一奎 in his Chìshuǐ yuánzhū 赤水元珠 as “Lǐ Dōngyuán’s Wàikē jīngyì” — a serious philological error.
Translations and research
- Included in the Míng Dōng-yuán shí shū commercial editions (misattributed); separately re-edited in modern punctuated collections by 中醫古籍出版社 and 人民衛生出版社.
- No standalone Western-language translation located.
Other points of interest
The Sìkù tíyào notes a textual oddity: its opening line gives the work as “1 juǎn”, but the body of the text and all standard recensions present 2 juǎn. This appears to be a Sìkù copyist’s slip; the catalog and the present recension are both 2 juǎn.