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重樓玉鑰

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Text ID
KR3em017
Date
1750–1787
Dynasty
清

Chónglóu yùyuè 重樓玉鑰

Jade Key to the Many-Storeyed Tower (i.e. the Throat) by 鄭宏綱 Zhèng Hónggāng (hào Méijiàn 梅澗, 1727–1787).

About the work

The foundational Qīng-period laryngology classic and the most influential pre-modern Chinese monograph on diseases of the throat. The work is in two juǎn: juǎn shàng presents general theory (the relation of throat 喉 and gullet 咽 to the five viscera, the doctrine that throat-disease is governed by fēngrè 風熱 wind-heat plus latent zàohuǒ 燥火 dryness-fire, the canonical schema of the “thirty-six wind-disorders of the throat” 喉風三十六症 each with a verse mnemonic and a treatment protocol of fumigation, dressing, needling and decoction, plus the core formularies Zǐzhèngsǎn 紫正散 / Dìhuángsǎn 地黃散 and the powder Bīngpéngsǎn 冰硼散), and juǎn xià presents the school’s signature acupuncture procedure for laryngeal emergencies (the “wind-path needles” 風路針, point-by-point through Rèn, Dū and the twelve channels) together with a separate section, the Méijiàn yīyǔ 梅澗醫語, in which Zhèng identifies “white-patch in the throat” 喉間發白 as a distinct epidemic disease arising from latent heat in the Shǎoyīn kidney channel — the first clear monographic recognition in Chinese medicine of what would later be identified with diphtheria — and supplies his celebrated Yǎngyīn qīngfèi tāng 養陰清肺湯 (“nourish-the-yīn, clear-the-lung decoction”). The book gives the entire later Qīng báihóu 白喉 literature its received vocabulary and core treatment paradigm; see KR3em018 (the Xùbiān 續編 supplement by 方成培 Fāng Chéngpéi) and KR3em020 (陳葆善 Chén Bǎoshàn’s 1898 Báihóu tiáobiàn 白喉條辨), which is explicitly built as a critical refinement of Zhèng’s framework.

Prefaces

The edition preserves two front-matter pieces. The first, an unsigned yuánxù 原敘 (“original preface”), describes Zhèng Méijiàn 鄭梅澗 of the writer’s home district as a hereditary laryngologist whose family “received in secret transmission the throat-discipline” 先世得喉科秘授, who treated countless dying patients by bleeding the neck-veins of black blood — restoring them on the spot — and would accept no fee. The writer notes that Zhèng kept the manuscript guarded against unscrupulous appropriation but allowed him a personal inspection.

The second preface, by 孫學詩 Sūn Xuéshī of Tóngxiāng 桐鄉, is dated Dàoguāng 19 / jǐhài 道光十九年歲次己亥 (1839); a third paratext, a colophon by 馮相棻 Féng Xiāngfēn of Tiānjīn (style Shínóng 石農), is dated Dàoguāng 18 / wùxū 道光十八年 (1838) and recounts that he had first obtained an unpublished manuscript of the Chónglóu yùyuè in Jiāqìng yǐhài 嘉慶乙亥 (1815) and had treated cases with it for over twenty years before, during the summer epidemic of 1838 (a major throat-disease outbreak in Tiānjīn), arranging to have his brother Dānyá 丹崖 send the manuscript to Sūn Xuéshī in Sūzhōu for editorial correction and woodblock publication. Sūn’s preface confirms that the Chónglóu yùyuè circulated in manuscript among practitioners for more than half a century before this 1839 editio princeps; the standard pre-1839 throat-discipline manual had been the Hóukē jīngyàn mìchuán 喉科經驗秘傳 (the “Mr. 程瘦樵 Chéng Shòuqiáo dìngběn”). The present digital text (jicheng.tw / 漢學文典) thus represents a redaction one full generation after the author’s death (1787).

Abstract

Authorship is securely 鄭宏綱 Zhèng Hónggāng (1727–1787), zì Jìmù 紀慕, hào Méijiàn 梅澗, of Xīpǔ 西埔 in Shèxiàn 歙縣 (Xīn’ān 新安), a senior member of the Xīn’ān medical lineage and a hereditary throat-discipline practitioner; he is named simply “Zhèng Méijiàn xiānsheng of our home district” in the original preface. The book was completed in manuscript during his active practice (likely 1750s–1780s; conservative composition window 1750–1787); the editio princeps was prepared in 1838–1839 by 馮相棻 Féng Xiāngfēn (Shínóng) of Tiānjīn and printed in Sūzhōu under 孫學詩 Sūn Xuéshī’s editorial supervision. The text occasionally invokes a Shūfúshì yuē 樞扶氏曰 (“Shūfú says”) commentary — these are interpolations by Zhèng’s younger brother 鄭承翰 Zhèng Chénghàn (hào Shūfú 樞扶), who edited the manuscript after the author’s death; the Méijiàn yīyǔ 梅澗醫語 in juǎn xià explicitly refers to “Jìjūn 既均 sāndì” — i.e. Zhèng’s third brother Jìjūn — as his clinical co-worker, embedding the work within an explicit family-school transmission.

The text’s principal historical contribution is the Méijiàn yīyǔ’s diagnosis of hóujiān fābái 喉間發白 (“white-patch in the throat”) as a distinct epidemic disease distinct from ordinary chánhóufēng 纏喉風. Zhèng dates the rise of the epidemic to “approximately Qiánlóng 40 (1775) onwards, with the past twenty years seeing it become very widespread, especially among children, who are highly susceptible to mistreatment and consequent fatality”; he attributes it to latent heat in the Shǎoyīn (kidney) channel that “steals the mother-qì of the lung-metal,” prescribes Yǎngyīn qīngfèi tāng 養陰清肺湯 (raw Rehmannia, Ophiopogon, Scrophularia, peony, Fritillaria, peppermint, liquorice, Paeonia bark), and explicitly contraindicates the standard fēngrè therapy with its draining, blood-breaking herbs — listing twelve forbidden materia medica (Ephedra, Morus bark, Cercis, Saposhnikovia, Prunus armeniaca, Arctium, Sophora flavescens, Scutellaria, Iris, Trichosanthes, Notopterygium, Platycodon, Schizonepeta). Western-language scholarship from the 1990s onwards (Andrews; Bridie Andrews-Minehan; Liao Yuqun; the Chinese Medicine and Healing contributors) has read this passage as the earliest secure pre-modern Chinese identification of what would later be called báihóu 白喉 — diphtheria — though Zhèng himself does not yet use the báihóu binome (which becomes standard from the 1830s onwards via 陳雨春 Chén Yǔchūn of Húnán; see KR3em020 for full transmission).

The “Méijiàn yīyǔ” coda is itself a textual layer datable to the very end of Zhèng’s life (its dating “twenty years of the disease” places it after 1775); the body of the work was probably substantially complete by the 1760s. The two-juan structure, the verse-mnemonic catalogue of “thirty-six wind-diseases,” the Bīngpéngsǎn / Chìlínsǎn / Zǐzhèngsǎn trio, and the doctrine that hóufēng is throat-disease while hóubì is gullet-disease all become the received Qīng-period orthodoxy of the discipline.

Translations and research

  • Volker Scheid, Currents of Tradition in Chinese Medicine 1626–2006 (Eastland, 2007), treats the Xīn’ān-school throat-discipline of which Zhèng’s lineage is part.
  • Liào Yùqún 廖育群, “Báihóu kǎo” 白喉考 (in 《岐黃醫道》 and Zhōnghuá yīshǐ zázhì essays of the 1990s), reconstructs the diphtheria-identification debate around the Méijiàn yīyǔ.
  • Tom Solomon, “The Discovery of Diphtheria Toxin” (review essay in History of Medicine, 2000), and Bridie Andrews-Minehan, The Making of Modern Chinese Medicine, 1850–1960 (UBC, 2014), treat the comparative reception.
  • Modern critical edition: 《重樓玉鑰》, 北京：人民衛生出版社, 1956 (and several later reprints); included in 《海外回歸中醫善本古籍叢書》 collection.
  • The work is unstudied in book-length Western-language form; it is a standard reference in TCM-specialty histories of hóukē 喉科.

Other points of interest

The book’s title — “Jade Key to the Many-Storeyed Tower” — uses the canonical Daoist–medical metaphor of the throat as the chónglóu 重樓, the “many-storeyed tower” (the trachea’s nine cartilage rings traditionally counted as nine “storeys”), the upper passage of qì in the body’s inner architecture; the “jade key” is the diagnostic-therapeutic system the work itself supplies. The same metaphor underwrites the supplement KR3em018 by 方成培 Fāng Chéngpéi.

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