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醫宗金鑑·眼科心法要訣

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Text ID
KR3em007
Date
1742–1749
Dynasty
清

Yīzōng jīnjiàn · Yǎnkē xīnfǎ yàojué 醫宗金鑑·眼科心法要訣

Essential Verses on Ophthalmological Method (from the Golden Mirror of the Medical Tradition) edited by imperial commission under the direction of 吳謙 Wú Qiān (zì Liùjí 六吉, Tàiyīyuàn yuànpàn 太醫院院判).

About the work

The ophthalmological section (眼科心法要訣) of the imperial Qīng medical compendium 《醫宗金鑑》 Yīzōng jīnjiàn 醫宗金鑑 — formally KR3e0090 Yùzuǎn yīzōng jīnjiàn 御纂醫宗金鑑 (90 juǎn, completed Qiánlóng 14 = 1749). The full Yīzōng jīnjiàn was compiled by imperial commission under the chief editorship of 吳謙 Wú Qiān and co-editor 劉裕鐸 Liú Yùduó of the Imperial Medical Academy; the ophthalmological section corresponds to juǎn 77–78 of the parent work and forms the official Qīng curriculum text for ophthalmology. The text is structured entirely in mnemonic seven-character verse (gē 歌, yàojué 要訣), each verse followed by an explanatory prose commentary (zhù 注) and the matched prescription. The arrangement is encyclopaedic-orderly: anatomical foundations (the eye as the meeting-place of the five viscera and six bowels’ essences); the wǔlún 五輪 and bākuò 八廓 schemata (with a notable editorial revision — “the inner cataracts are causally due to the seven emotions damaging the viscera; the outer obstructions are due to the six excesses entering from outside”); twenty-four named inner-cataract syndromes (黃風, 綠風, 黑風, 烏風, 青風, 圓翳, 冰翳, 滑翳, 澀翳, 浮翳, 沉翳, 橫翳, 散翳, 偃月翳, 白翳黃心, 黑水凝翳, 棗花翳, 雷頭風, 驚振, 瞳仁幹缺, 雀目, 高風, 胎患, etc.); the parallel outer-obstruction catalogue; and supplementary topics (能遠怯近 / 能近怯遠 hyperopia and myopia, 瞳神散大 / 瞳神縮小 mydriasis and miosis, 乾澀昏花 dry-eye, 白眼痛, 女子逆經, 行經目痛, 妊娠目病, 產後病目). The verse-and-prescription pairing makes the work the most efficient mnemonic ophthalmological textbook in the Chinese tradition.

Prefaces

The front matter preserves a 補遺 “supplementary” section rather than a separate preface (the imperial preface to the Yīzōng jīnjiàn as a whole is in KR3e0090). The eye-medicine section opens in medias res with the Mùjīng yuánshǐ gē 目睛原始歌 (“Verse on the Origin of the Eye-Pupil”) and its commentary, framed in the standard Nèijīng idiom: “Heaven has the sun and moon, the essences of yīn and yáng; man has two eyes, the essences of the five viscera and six bowels” (天有日月陰陽精，人有二目臟腑精). The editorial àn 按 (“Editor’s note”) after the eight-quadrant exposition makes the work’s distinctive doctrinal contribution: “Eye-medicine practitioners all assign the five wheels to the viscera, correlated with the five phases; and the eight quadrants to viscera, correlated with the eight trigrams — and so cause viscera and bowels to be confused, with no clear scheme of application. But if the five wheels belong to the viscera, then the eight quadrants ought naturally to belong to the bowels. We have now revised this, so that the student, looking at the positions of the wheels and quadrants, will immediately see whether the disease lies in the viscera or in the bowels.” This editorial reform — splitting lún and kuò between zàng (viscera) and fǔ (bowels) respectively — is the imperial-court’s official answer to the centuries-long confusion in the wǔlún bākuò tradition, and it stuck: virtually all post-1749 Chinese ophthalmologies follow the Jīnjiàn assignment.

Abstract

The work is the eye-medicine section of the imperial Qīng medical compendium Yīzōng jīnjiàn (90 juǎn total), compiled under imperial commission between 1740 and 1742 and printed in 1742 (some sources 1749 for the final corrected printing) under the title 御纂醫宗金鑑 Yùzuǎn Yīzōng jīnjiàn. The chief editor was 吳謙 Wú Qiān (zì Liùjí 六吉, fl. Qiánlóng early period), with co-editor 劉裕鐸 Liú Yùduó — both Imperial Medical Academy officers. The full text became the official Qīng-period medical curriculum (kept in every Imperial Medical Academy and required reading for the medical examination) and is the principal vehicle through which MíngQīng medical orthodoxy was transmitted into the modern PRC medical-school tradition. The dating bracket here (1742–1749) reflects the printing of the parent work; the ophthalmological section was likely drafted earlier (1740–1742) along with the rest of the Jīnjiàn.

The eye-medicine section is structurally a synthesis of the Lóngmù lùn 龍木論 family (cf. KR3em002, KR3em003) and the Jīn–Yuán aetiological model of 李杲 Lǐ Dōngyuán and 朱震亨 Zhū Dānxī as mediated through KR3em001 Yuánjī qǐwēi. The twenty-four inner-cataract syndromes are taken directly from the Lóngmù lùn tradition; the prescriptions are largely drawn from Yuánjī qǐwēi; and the doctrinal framework — particularly the wǔlún / bākuò split — is the imperial editors’ own innovation. The eye-medicine section’s most influential single prescription is the Háijīng wán / Tōngmíng bǔshèn wán 還睛丸 / 通明補腎丸 (for inner-cataract deficiency syndromes), which became the standard Qīng-period internal-medical treatment for early cataract.

The work also incorporates a substantial fù wàizhì fāng 附外治方 (appended external-treatment formulary) at the end: medicated dressings, eye-drops, and topical preparations including the Yīnzhǒnggāo 焮腫膏, Zǐjīngāo 紫金膏 (a calamine-based mineral ointment of remarkable complexity — eighteen ingredients), Shíyàndān 石燕丹 (with several variant compositions for different translucent-membrane conditions), Mófēnggāo 摩風膏, and the famous Wǔdǎngāo 五膽膏 (a “five-galls” preparation — pig, ox, sheep, carp, and bear gall, with honey and copper-coated Coptis). These are the standard Qīng-period topical preparations and are repeatedly reprinted (often without acknowledgement) in late-imperial popular ophthalmologies.

Translations and research

  • No complete Western-language translation. A partial English summary is available in: Paul U. Unschuld, Medicine in China: A History of Pharmaceutics (University of California Press, 1986), §§ on the Yīzōng jīnjiàn; and a description in Unschuld and Zheng Jinsheng, Chinese Traditional Healing: The Berlin Collections of Manuscript Volumes (Brill, 2012), 2:1183 ff.
  • For the parent work see Hinrichs and Barnes (eds.), Chinese Medicine and Healing: An Illustrated History (Harvard, 2013), p. 173 (the imperial-compendium genre of Qīng medicine), p. 196 (Qīng ophthalmology and the Indo-Buddhist couching tradition).
  • Modern Chinese critical edition: 《醫宗金鑑》, ed. 鄭金生 et al., reprinted many times (北京：人民衛生出版社, 1957, 1963, 1973, 1995, 2006). The eye-medicine section is independently reprinted in 《眼科心法要訣》 (北京: 人民衛生出版社, 1958, 1985).

Other points of interest

The Yǎnkē xīnfǎ yàojué is one of the most accessible pre-modern Chinese ophthalmologies for the contemporary reader, precisely because its verse-and-prescription mnemonic structure makes the underlying clinical taxonomy directly legible: each named syndrome appears as a gē 歌, with the diagnostic verse, the prose explanation, and the prescription, all on a single page. It is the natural starting-point for anyone studying Qīng ophthalmology, and the corpus through which all subsequent Chinese ophthalmologists trained until the modern era.

Note also the imperial-curricular split of the wǔlún / bākuò between zàng and fǔ — the Jīnjiàn’s most consequential single editorial intervention in the ophthalmological tradition. The Jīnjiàn compilers’ programmatic note (“we have now revised this”) is among the very few places in the work where the imperial editorial voice is fully audible.

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