Shāngkē dàchéng 傷科大成
Compendium of Traumatology by 趙濂 Zhào Lián (zì Zhúquán 竹泉, 清).
About the work
A single-juǎn late-Qīng traumatology synthesis by 趙濂 Zhào Lián (zì Zhúquán 竹泉), a Jiāngsū practitioner of Dāntú 丹徒 who devoted decades of clinical practice to shāngkē. The text was completed in Guāngxù 17 (1891) — the first printed edition is the Guāngxù 17 woodblock — and went through multiple lead-type reprints between 1929 and 1955 before being collected in the modern Hǎiwài huíliú zhōngyī shànběn gǔjí cóngshū (漢學文典). It is the most systematic single-volume late-Qīng traumatology, organising the discipline into a head-to-foot prognostic atlas of the “fatal acupoints” (xuédào jíxiōng 穴道吉凶), a battery of five physical-examination signs (kànshāng jíxiōng 看傷吉凶), and a comprehensive prescription-formulary covering haemostasis, blood-quickening, bone-setting, internal-medicine support, and special-condition protocols.
Prefaces
The _000.txt source file as transmitted in 漢學文典 opens directly with the Xiānkàn xuédào jíxiōng 先看穴道吉凶 chapter and contains no preface, postscript, or compiler signature. The 1891 Guāngxù printed edition is reported to have carried a brief author’s preface, but it is not preserved in the recension reproduced here.
Abstract
Internal evidence places the work in the late nineteenth century. The cataloging meta gives the author as Zhào Lián, dynasty 清; modern reference works (Baidu Baike, Chinese medical-bibliographic catalogues) date completion to Guāngxù dīngmǎo / Guāngxù 17 (1891), with the editio princeps the same year. The composition window adopted here is therefore the single year 1891.
The text is structured in twelve thematic blocks, with no juan division:
- Diagnosis of the “fatal acupoints” (Xiānkàn xuédào jíxiōng). A head-to-foot atlas of points whose injury is fatal: xìnmén 囟門 (anterior fontanelle), jiéliáng 節梁 (nasal bridge), tàiyáng 太陽, tūgǔ 突骨 (laryngeal prominence), sāigǔ 塞骨 (subglottic notch), xīnwō 心窩 (xiphoid notch / lóngtánxué 龍潭穴), dāntián 丹田, luǎnzǐ 卵子 (testes), bǎiláo 百勞, tiānzhù 天柱, the two shènxué 腎穴 in the back, wěibāgǔ 尾巴骨 (coccyx), hǎidǐxué 海底穴 (perineum), ruǎngǔ 軟骨 (below the breasts), qìmén 氣門 (left precordium), xuèhǎi 血海 (right precordium), and the two breasts.
- Five examination signs (Kànshāng jíxiōng). Inspect the eyes (white-eye blood-filaments indicate the volume of internal extravasation); inspect the fingernails (nail-bed refill test, two centuries before its formalisation in modern emergency medicine); inspect the genitals (testicular or breast retraction is grave); inspect the toenails; inspect the soles (red-pink is favourable, yellow is bad). Three or more bad signs is fatal.
- Triage of the unconscious patient. Detailed protocols for resuscitation using yázào 牙皂 (soap-bean powder) blown into the nostrils to provoke sneezing, followed by jiǔcàibái 韭菜白 (chive-stalk) juice with boy’s urine.
- The doctrine of xíngqì xuè 行氣血 (channelled qi-and-blood) by which different acupoint injuries produce stereotyped clinical syndromes.
- Drug-channel routing — guide-medicines (yǐnjīngyào 引經藥) for each body region: chuānxiōng 川芎 for upper body, guìzhī 桂枝 for arms, báizhǐ 白芷 / gǎoběn 藁本 for the back, báisháo 白芍 for chest/abdomen, qīngpí 青皮 for left ribs, cháihú 柴胡 for right ribs, dùzhòng 杜仲 for hip, mùguā 木瓜 for legs, niúxī 牛膝 for lower body. 6–12. Site-by-site treatment protocols and formulary, with named compound prescriptions (over 100): Héshāng wán 和傷丸, Jílì sǎn 吉利散, Sǔnshāng gāo 損傷膏, Hùxīn yǎngyuán tāng 護心養元湯, Fēilóng duómìng tāng 飛龍奪命湯, Háihún tāng 還魂湯, Shōuzhū sǎn 收珠散, Tiěshàn sǎn 鐵扇散 (“Iron-Fan Powder,” for staunching haemorrhage), Bǔshèn yǎngxuè tāng 補腎養血湯, and many others. Of particular note are the explicit blood-quickening “channel-guide” formulations that integrate 王清任 Wáng Qīngrèn’s (1768–1831) early-nineteenth-century blood-stasis doctrine into traumatology.
The work is by far the most cited single late-Qīng shāngkē manual in the modern PRC TCM curriculum on traumatology, and it remains in print today. It is also the source of much of the standard contemporary Chinese-medicine acute-trauma protocol.
Translations and research
- No standalone Western-language monographic study located.
- Modern critical edition: 趙濂 《傷科大成》, in 《中國醫學大成續集》, 上海科學技術出版社 reprint; punctuated edition in 《海外回歸中醫善本古籍叢書》.
- 韋以宗 《中國骨傷科學辭典》 / 《中國骨傷科學史》 (北京：中國醫藥科技出版社) — the standard modern history of Chinese traumatology — treats Zhào Lián and the Shāngkē dàchéng as marking the late-Qīng consolidation of the shāngkē discipline.
Other points of interest
The fingernail-bed-refill test described under “Examination Sign Two” — press the patient’s fingernail, release, and observe how quickly the original colour returns — is one of the earliest formally codified Chinese-medicine attestations of what modern emergency medicine calls the capillary refill test.