Lìyáng jīyào 癘瘍機要
Crucial Essentials of Leprous Ulcers by 薛己 (Xuē Jǐ, zì Xīnfǔ 新甫; hào Lìzhāi 立齋, 1487–1559)
About the work
A focused three-juǎn Míng monograph on lìyáng 癘瘍 — the family of chronic skin-and-nerve diseases (including dà fēng 大風, lài 癩, and zǐbái diàn fēng 紫白癜風) treated more broadly under fēng / lài nomenclature in the Míng corpus. Self-dated by the preface of Shěn Qǐyuán 沈啟原 to Jiājìng suì jiǎyín zhōngqiū (mid-autumn of jiǎyín = autumn 1554). Together with KR3ek035 Jiěwéi yuánsǒu of Shěn Zhīwèn (Jiā-jìng-period), one of the two principal Míng monographs on leprosy, and the central source for Angela Leung’s reconstruction of the Míng wēnbǔ school’s contribution to leprosy management.
Abstract
The single front-matter preface is by Xiùzhōu 秀州 Shěn Qǐyuán 沈啟原 (zì Dàoqīngfǔ 道卿甫), dated 1554. Shěn defends surgery (yángyī 瘍醫) as a legitimate branch of medicine via a long political metaphor: military force is to administrative regulation as yángyī is to internal medicine — both deal with emergencies after the failure of normal regulation. He praises Xuē Jǐ as one who treats wàikē on the basis of Nèijīng / Sùwèn principles, refusing the dichotomy between internal and external medicine. Xuē’s method is zhì běn 治本 (treat the root); to favour tiáobǔ 調補 (regulation-and-tonification) as a strategy of “complete defences”; and to use jiělì 解利 (resolution-and-discharge) only as expedient attack. The book is presented as a record of Xuē’s clinical cases edited by his friend Shěn Zǐ 沈梓.
The work’s distinctive contribution is to apply Xuē Jǐ’s characteristic píwèi + míngmén (脾胃 + 命門) dual-foundation theory and his core internal-medicine formulae — bǔzhōng yìqì tāng 補中益氣湯, liùjūnzǐ tāng 六君子湯, guīpí tāng 歸脾湯, jiājiǎn bāwèi wán 加減八味丸 — to leprosy management, integrating it with internal medicine rather than dismissing it to specialist external practitioners. The therapeutic register is wēnbǔ (warming-tonifying) throughout, in line with Xuē’s broader Sūzhōu programme. The work makes heavy use of yīàn 醫案 (medical-case records) as didactic vehicle.
The work documents Xuē’s late-period intellectual position on the management of lì: leprosy, like other surgical disorders, must be analysed through the standard internal-medicine apparatus of qìxuè and zàngfǔ deficiency, not by specialist topical-only protocols. This wēnbǔ extension of leprosy management is discussed prominently in Leung’s Leprosy in China (2009) as evidence for the Míng reconceptualisation of lài / máfēng.
Translations and research
- 薛立齋醫學全書, 中國中醫藥出版社 — collected modern edition.
- Leung, Angela Ki Che. Leprosy in China: A History. Columbia University Press, 2009 — extensive treatment.
- 三三醫書 collection — early reprint.
- Xuē Jǐ shēng-píng kǎo-zhèng (Sinomed 2024) — modern Chinese-language biographical study.
- 中華醫史雜誌 articles on the Míng wēn-bǔ school.
Other points of interest
Compare KR3ek035 Jiěwéi yuánsǒu of Shěn Zhīwèn (also Jiā-jìng-period), which takes a different methodological tack — building a 36-fēng taxonomy by viscera channel — to address the same disease cluster. The pairing of Lìyáng jīyào and Jiěwéi yuánsǒu documents the two main mid-Míng intellectual approaches to leprosy.