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喉科指掌

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Text ID
KR3em024
Date
1700–1757
Dynasty
清

Hóukē zhǐzhǎng 喉科指掌

Pointing-the-Palm Manual of Laryngology by 張宗良 Zhāng Zōngliáng (zì Liúxiān 留仙, mid-Qīng physician of Sūzhōu).

About the work

A six-juǎn mid-Qīng laryngology treatise — one of the principal organized monographs of the Qīng hóukē corpus, and the foundational text of the so-called “Zhāng-clan” lineage of laryngology. Juǎn 1 lays out the general theoretical framework — the yānhóu dàgāng 咽喉大綱論 division of throat into yān 咽 (left, wèi 胃, “swallowing-gate”) and hóu 喉 (right, fèi 肺, “breathing-gate”), the diagnostic schema of pulse-channels (yòushǒu tú 右手圖 / zuǒshǒu tú 左手圖), the liùwèi tāng 六味湯 (six-flavour decoction) which the author makes the base prescription for nearly all conditions, the shíbāwèi shényào 十八味神藥 (eighteen-flavour spirit-drug), the catalogue of sixteen and four “fatal-sign” conditions, the manipulation of insufflation tubes and lancets, and the standard acupoints (頰車, 少商, 商陽, 中衝, 關衝, 少衝). The remaining five juǎn are a head-to-tail clinical typology of named conditions: single, double, and rosary-string rǔé 乳蛾, chánhóu fēng 纏喉風, zǒumǎ hóufēng 走馬喉風, suǒhóu fēng 鎖喉風, hóuyōng 喉癰, hóujūn 喉菌, hóuxuǎn 喉癬, chóngshé 重舌, fēiyáng hóu 飛揚喉, and so on, each with its prescriptions and chuīyào 吹藥 powders.

Prefaces

The preface — by 彭啟豐 Péng Qǐfēng (1701–1784), Sūzhōu native and Yōngzhèng 5 (1727) jìnshì zhuàngyuán 進士狀元, in office at the time as zǔo shìláng 左侍郎 of the Ministry of Works and 浙江提督學院 — declares medicine “the most varied of the arts and the hardest of the Ways; and within medicine, the laryngology art is the hardest of the hard.” Péng frames the work in the orthodox doctrinal terms: “swallowing accepts food, breathing accepts air; swallowing-tract joins the spleen, breathing-tract joins the heart; metal is dry, its disorder is sè 澀, hence the breathing-tract’s disorder is bì 痹; earth is wet, its disorder is mud, hence the swallowing-tract’s disorder is swelling.” He then commends his fellow-Sūzhōu Mr. Zhāng “Liúxiān” 留仙 for having “long and deeply applied his mind to the laryngology art” and having “collected and edited established prescriptions, supplemented them with his own clinical insights, set out the typology in detail, and assembled the volume.” The preface is dated Qiánlóng 22 dīngchǒu 丁丑, chūnwáng èryuè 春王二月 (1757 spring, 2nd month).

Abstract

Hóukē zhǐzhǎng is the most widely circulated and frequently reprinted Qīng laryngology monograph, and along with KR3em023 Jiāoshì hóukē zhěnmì and the Yóu-clan corpus (KR3em021, KR3em022) it formed the canonical core of late-imperial throat-medicine. Its central therapeutic innovation is the systematic generalization of the liùwèi tāng (six-flavour decoction; not to be confused with the liùwèi dìhuáng wán 六味地黃丸) as the universal base prescription, modulated by add-ons for individual conditions and routes. The author Zhāng Zōngliáng, zì Liúxiān 留仙, was a Sūzhōu physician of the early-mid Qīng who, on the evidence of Péng Qǐfēng’s preface, was already established as an experienced laryngology specialist by 1757; he is not recorded in CBDB and his lifedates are not securely fixed in the standard references. The work was compiled over the years preceding the 1757 publication; the composition window is therefore set to c. 1700 (a conservative terminus a quo given Zhāng’s working biography) – 1757 (preface and probable first printing).

The catalog meta of KR3em026 咽喉秘集 records its author as 張宋良, which the present cataloging takes — following standard Chinese specialist scholarship — to be a typographic slip for the present 張宗良; the variant is preserved in KR3em026’s frontmatter and flagged there.

Translations and research

  • No standalone Western-language translation located.
  • The text is treated in 耿鑒庭 et al., Zhōngguó zhōngyī hóukē fāzhǎn shǐ 中國中醫喉科發展史; in standard Chinese-medical-history textbook coverage of Qīng external-clinical specialities; and in Zhōngyī dà-cí-diǎn 中醫大辭典 s.v. Hóu-kē zhǐ-zhǎng and 張宗良.
  • Modern critical editions: in Zhōngyī gǔjí zhěnběn cóngkān and individual collated reprints by 人民衛生出版社 from the 1950s onwards; the present jicheng.tw recension is one of several extant Qīng witnesses.

Other points of interest

The title Zhǐzhǎng 指掌 (literally “pointing-the-palm”) is a stock idiom of late-imperial popular pedagogy: the matter is “as clear as the lines on one’s palm.” The book’s reputation is captured in Péng Qǐfēng’s preface metaphor: “as a lamp seizes a shadow, in a hundred [cases] not one is missed.”

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