眼科錦囊

Yǎnkē jǐnnáng 眼科錦囊

A Brocade Pouch of Ophthalmology by 本荘普一 Honjō Fuichi (also written 本庄俊篤 Honjō Toshiatsu, gō Pǔyī 普一; late-Edo period). This is a Japanese kanpō (漢方) work, not a Chinese ophthalmology — included in the Kanripo corpus among the Chinese eye-disease titles because it operates entirely within the literate-medical Sinitic idiom and was widely received in nineteenth-century Sino-Japanese medical circulation.

About the work

A four-juǎn late-Edo ophthalmological treatise (zen-pen 前編 + zoku-pen 續編, two juǎn each) by the Japanese kanpō physician Honjō Fuichi 本荘普一, written wholly in Sinitic prose and structured as a vigorous polemical reform of the classical Lóngmù lùn 龍木論 + wǔlún bākuò 五輪八廓 / seventy-two-disease tradition (cf. KR3em002, KR3em003, KR3em010). The work is one of the most theoretically self-aware ophthalmologies in pre-modern East Asian medicine: it explicitly rejects the five-phase / eight-trigram correlation schema as a “fabrication” (誣 wū) and “empty speech” (空譚 kōng tán), criticises Fu Rényǔ’s 傅仁宇 (傅仁宇, compiler of KR3em010 Shěnshì yáohán 審視瑤函) 108-syndrome refinement as “still bound in the chaff of yīnyáng wǔxíng,” and proceeds to organise eye-disease around empirical-observational principles drawn from clinical case-experience. The zen-pen sets out the doctrinal frame and case-by-case nosology; the zoku-pen (the part preserved as _001.txt and following) adds polemical essays — Yǎnkē gǔjīn wú zhèng diǎn lùn 眼科古今無正典論 (“On the absence of a canonical text in ancient and modern ophthalmology”), Běncháo yǎnkē xíbì lùn 本朝眼科襲弊論 (“On the inherited failings of Japanese ophthalmology”), Xīyáng qiónglǐ wú quèzhēng lùn 西洋窮理無確徵論 (“On the lack of verified evidence in Western [rangaku 蘭學] natural philosophy”) — and a hundred-plus carefully-described case-studies (兒患奇病, 大怒暴盲, 醉中暴盲, 冒寒暴盲, 小眥漏, 衰弱眼 etc.), each with the author’s diagnostic procedure, the treatment given, and the clinical outcome. The final juǎn (zoku-pen vol. 2) is a thirty-figure illustrated catalogue of the author’s surgical instruments — cìbō zhēn 刺撥針 (couching needles for cataract), xǐyǎn qì 洗眼器 (eye-washing apparatus), zhēngyǎn qì 蒸眼器 (eye-steaming apparatus), magnifying glasses, surgical-scalpel handles, drug-droppers, and a syringe (xiǎo shuǐchòng 小水銃) for irrigating lacrimal-canal fistulae.

Prefaces

The principal preface is the post-face: a dated colophon by Honjō’s disciple 勝澤圭元璋 Shōzawa Kei Genshō (越前醫官, Echizen domain medical officer), submitted “in late autumn of Tenpō 6 (天保乙未) at his lodgings in Kyōto” — 1835. Shōzawa recounts that he had earlier read the zen-pen and lamented that “the zoku-pen was not yet complete, like rich food not yet sated on the palate.” Visiting Honjō at the latter’s Kyōto residence on his return from Nagasaki (崎陽), Shōzawa heard the manuscript of the zoku-pen was now ready, read it, and added illustrations of the surgical instruments to clarify it for student-readers. A second colophon by 梶井元鴻 Kajii Genkō of Nagasaki (崎陽梶井元鴻) closes the book with the encomium that “those of the present day who practise medicine know one prescription and one technique; but my teacher Master Pǔyī is not so — his ambition is great, his learning broad, harmonising the old and the new, the Japanese and the Chinese.” Both colophons identify the author as Pǔyī xiānshēng 普一先生 (i.e. Honjō Fuichi).

Abstract

The author is the late-Edo kanpō physician Honjō Fuichi 本荘普一 (the surname is more conventionally romanised Honjō; gō 普一 / shi 俊篤 Toshiatsu, the Sinitic given-name); the standard Japanese bibliographic-medical literature (Kokusho sōmokuroku 國書總目錄; Fujikawa Yū’s Nihon igakushi; Nihon koten zenshū) places his floruit in the Bunsei through early Tenpō eras (c. 1820s–1830s), with the Yǎnkē jǐnnáng zen-pen first published 1831 (Tenpō 2) and the zoku-pen 1837 (Tenpō 8) — the colophon of 1835 in the present edition corresponds to the manuscript completion. The user-supplied lifedates (1738–1791) cannot be reconciled with the internal dating of the work itself (which records the author’s Tenpō-era activity, his contemporary criticism of Ranseki 蘭学 western-learning physicians, and his exchanges with named Tenpō-era disciples); the conventional bibliography places his lifetime in the late-Edo period proper. The composition window adopted here is 1831–1837.

The book opens with a programmatic essay (眼科古今無正典論) declaring that “the difficulty of learning and clarifying ophthalmology is that there is no canonical text either in our country (Japan) or in China”: he reviews the Lóngmù lùn lineage (specifically named: Āi Xuéyuān 哀學淵, Zhōu Liàngjié 周亮節, Wáng Xié 王協, 鄧苑 Dèng Yuàn, author of KR3em009 Yīcǎotíng mùkē quánshū), dismisses their wǔxíng / bāguà correlations as “shallow falsehood,” then turns on Fu Rényǔ (傅仁宇) for retaining yīnyángwǔxíng even after revising the seventy-two-syndrome scheme. The second essay (本朝眼科襲弊論) is a remarkable autobiographical narrative of how Honjō himself was nearly blinded by a yǎnrè eye-disease in his youth (在 江都, Edo), cured himself only after consulting many physicians and finally finding the right teacher (Xiǎo-chū-zi 小出子, who induced controlled emesis, did bloodletting at the jiānjǐng and chǐzé points, and prescribed gégēn cháihú decoctions), and thereafter dedicated himself to reforming Japanese ophthalmology. The third essay (西洋窮理無確徵論) is a sustained critical engagement with Dutch rangaku 蘭学 ophthalmology — including specific Dutch drug-names (shīnjiūdā 悉鳩答 = stibium?; làngdàng 莨菪 = belladonna / Hyoscyamus) — and a careful argument that the Dutch climate, diet (qíngshān 腥膻 meat-eating), constitution (hóngfà gāobí shēnmù bìtóng 紅髮高鼻深目碧瞳 “red hair, prominent nose, deep blue eyes”), and disease-spectrum differ enough from the Japanese / Chinese that prescriptions cannot be transferred mechanically.

The case-study section in the zoku-pen is exceptional. Each case is anatomically and clinically precise: a patient with yǎnbāo jiēshí liú 眼胞結石瘤 (a stony tumour in the eyelid, a sequela of measles); a patient with yǎnzhū fānhuā 眼珠翻花 (an everted, ulcerating prolapsed eye in a 7-year-old with congenital gān-eye disease); a yèguāng yǎn 夜光眼 case (a 2-year-old whose pupils “shone like a cat’s eye in the dark” — almost certainly congenital syphilitic ophthalmopathy with leukocoria from the description); cases of sudden monocular blindness from rage, alcohol, or sudden cold; and the Yínxiè sǎnmàn 銀屑散漫 (“silver-flake dispersion”) case (a child with worm-related ocular pathology, treated by the Dúbù wán 獨步丸 of Mánnán lù 蔓難錄 — a contemporary kanpō reference) in which the author treats the underlying huíchóng 蛔蟲 (roundworm) infestation first. The instrument-illustration section is also distinctive: it is the most detailed surviving pre-modern East Asian visual record of a clinical ophthalmologist’s surgical kit.

Translations and research

• No Western-language translation of the Yǎnkē jǐnnáng is located.
• The work is treated briefly in Fujikawa Yū 富士川游, 《日本醫學史》 (1904; rev. 1941), as one of the principal late-Edo kanpō ophthalmological texts.
• For the kanpō reform-of-Chinese-medicine project to which this work belongs see Hinrichs and Barnes (eds.), Chinese Medicine and Healing: An Illustrated History (Harvard, 2013), pp. 271–283 (the Japanese kanpō tradition); for Dutch-learning ophthalmology see ibid., pp. 287–290.
• The present jicheng.tw text follows the Tenpō 8 (1837) Kyōto print, as transmitted via the 1936 / 1993 Huáng Hàn yīxué cóngshū reprint.

Other points of interest

The work is unusual in the Kanripo eye-disease division on three counts: (1) it is Japanese, not Chinese, in authorship and provenance; (2) it is anti-traditional, programmatically rejecting both the Lóngmù lùn taxonomy and Fu Rényǔ’s revision; (3) it is clinically empirical to an unusual degree, with substantial case-records including precise dose-response observations, surgical mishaps, and detailed instrument descriptions. It is best read as the late-Edo kanpō response both to the Sino-medical ophthalmological tradition and to the rising influence of Dutch-learning ophthalmology — a critical synthesis that, while doctrinally hostile to rangaku, internalises much of its empirical-observational program.

Honjō’s treatment of the Sino-Japanese reception of Dutch ophthalmological materia medica is particularly noteworthy: he names Dutch drugs (shīnjiūdā 悉鳩答, làngdànggāo 莨菪膏 = atropine / hyoscyamine mydriatic) and notes that the latter, “when applied to the eye, instantly paralyses the eyeball and the pupil dilates fully — so that when one needles for white cataract (內翳), it is most convenient for the operator’s hand,” but warns sternly that “if the dose is the least off, the pupil never contracts again, and the patient is instantly blinded.” This is, to my knowledge, the earliest detailed East Asian Sinitic-prose description of the surgical use of belladonna as a mydriatic.

Links

• 眼科錦囊 (jicheng.tw 漢學文典)
• Kanseki DB
• Fujikawa Yū, Nihon igakushi (1904).