Shànqì zhèngzhì lùn 疝氣證治論
A Treatise on the Diagnosis and Treatment of Hernia-Qi (Japanese: Sankì shōchi ron) by 大橋尚因 (Ōhashi Shōin / 玄竹 Genchiku, zì Hǎixī 海西, 18th c., 江戶) — Edo-period Japanese physician of Owari domain (張藩).
About the work
A specialist Edo monograph on shànqì 疝氣 (lower-abdominal pain syndromes, including hernia complex) by Ōhashi Shōin, a long-practising Owari-domain physician trained in Kyōto under a court Koma 御醫 lineage. Postfaced by Tō Iin 滕惟寅 (Fuji no Korenobu) in Anei 7 / 1778. The work is a representative document of Edo Koihō 古方派 / Han’igaku clinical reasoning — privileging direct Zhāng Zhòngjǐng-style formulae (Guìzhī jiā fùzǐ tāng 桂枝加附子湯, Dàhuáng fùzǐ tāng 大黃附子湯, Hòupò qīwù tāng 厚朴七物湯) and rejecting SòngJīnYuán polypharmacy. The work was subsequently reissued in expanded form as KR3ek050 Shànzhèng jījù.
Abstract
The principal paratext is the postface by Tō Iin 滕惟寅 (Fuji no Korenobu, a 張藩 / Owari-domain physician), dated Anei 7 lóngjí wùxū xià wǔ yuè = Anei 7 (1778), summer fifth month. Tō Iin praises Ōhashi as a long-practising provincial doctor (over forty years of practice; specialist in shànqì / shàn jiǎ 疝瘕), notes that his pupil Gen-setsu 玄節 brought the manuscript to Tō Iin for blessing before publication, and defends the unpolished diction with a memorable image: “the prose is rustic yet shows insight; whereas elegant modern formularies are like jade in a famine year — beautiful but inedible — this book is grain in a year of abundance — not prized, but indispensable.” There is no authorial preface in this file.
The work attacks the existing classification (the various 古七疝 / 五疝 / 諸疝 — water, sinew, fox, corpse, stone, cold, plate, vessel, qì, male, blood shàn, etc.) as nominal, and grounds shàn instead in two paired organs (肝 + 腎) plus an aetiology of hán xié 寒邪 + jié qì 結氣 (cold-pathogen + stagnant qì). Diagnoses are made by palpating ràoqí dòngqì 繞臍動氣 (peri-umbilical pulsation) and cháng míng 腸鳴 like frogs (wā míng 蛙鳴); shàn is recognised as the hidden cause of “wrong-name” diseases (fǎnwèi 反胃, wěibì 痿痹, láozhài 勞瘵, gǔzhàng 鼓脹, xīntòng 心痛, yāotòng 腰痛). Therapeutics privilege wūtóu 烏頭 / fùzǐ 附子 + zhīzǐ 梔子 over the conventional xíngqì 行氣 sweetening drugs (bīngláng 檳榔, mùxiāng 木香, wūyào 烏藥, xiāngfù 香附…) which Ōhashi denounces as inert for zhēn hán shàn 真寒疝.
The work has an extensive medical-case section (zhìyàn 治驗). Main formulae include: Guìzhī jiā fùzǐ tāng 桂枝加附子湯 (the master formula); Bǔshèn tāng 補腎湯 (家方); Língzhú qiāngfù tāng 苓朮羌附湯; Gāncǎo gānjiāng tāng 甘草乾薑湯; Fúlíng tāng 茯苓湯; Shēngjiāng bànxià tāng 生薑半夏湯; Gǔzhīfù tāng 古梔附湯; Wūjiāo tāng 烏椒湯; Wūtóu tāng 烏頭湯; Shǔjiāo tāng 蜀椒湯; Fúlíng guìgān tāng 茯苓桂甘湯; Sìwèi huíxiāng sǎn 四味茴香散; Sānbái tāng 三白湯; Hòupò qīwù tāng 厚朴七物湯; Dàhuáng fùzǐ tāng 大黃附子湯; Liángjiāng tāng 良薑湯; modified Bēntún tāng 奔豚湯; Liúlì wán 硫荔丸; Shǒunián sǎn 手拈散; Shénbǎo wán 神保丸; Wūtóu jiān 烏頭煎; Dǐdāng wūtóu guìzhī tāng 抵當烏頭桂枝湯.
Ōhashi Shōin was native of Owari and trained in Kyōto under a Koma 駒御醫 (Koma court physician — possibly Koma Hōsetsu). By 1778 Tō Iin describes him as about seventy, so birth c. 1708. CBDB does not cover Japanese physicians.
Translations and research
- No substantial Western secondary literature located. Brief Japanese kanpō notices (e.g. 大塚敬節 Ōtsuka Keisetsu references in his Edo-period bibliographies); 富士川游 Nihon igakushi covers the Owari Koihō lineage. Discussed obliquely in Daniel Trambaiolo’s work on Edo kanpō.
Other points of interest
The work is one of the clearest Edo-period documents of the Koihō 古方派 (Ancient-Formula school) clinical method as it applied to shàn 疝, and Ōhashi’s bold reclassification of shàn as a master category subsuming many “false” diagnoses is distinctive within the Edo kanpō literature. The parallel recension KR3ek050 Shànzhèng jījù gives essentially the same content under a different title.
Links
- 富士川游 《日本醫學史》 (1904)
- Kanseki DB
- 疝氣證治論