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Text ID
KR3em028
Date
1860–1890
Dynasty
清

Hóukē jíyè 喉科集腋

Gleanings on Laryngology by 沈青芝 Shěn Qīngzhī (late-Qīng physician of Lìyáng 溧陽).

About the work

A two-juǎn late-Qīng laryngology compendium — shàngjuǎn covering theory, needling technique, and the diagnostic typology of severe and acute throat conditions, xiàjuǎn covering the prescriptions. The author’s stated aim is the practical preservation of life in the face of epidemic báihóu fēng 白喉風 outbreaks, supplemented with a comprehensive review of the inherited laryngology corpus. The text combines orthodox doctrinal teaching (the yānhóu anatomical division, the zhēnfǎ 針法 at the standard hand- and face-acupoints — shǎoshāng 少商, shāngyáng 商陽, zhōngchōng 中衝, guānchōng 關衝, shǎochōng 少衝, jiáchē 頰車, qūchí 曲池, hégǔ 合谷 — with a zhúrì xuèshén 逐日血神 daily-prohibition calendar restricting the use of each acupoint), the typology of severe conditions (hóubì 喉痹, hóufēng 喉風, chánhóu fēng 纏喉風, báihóu fēng 白喉風, lànhóu shā 爛喉痧, yīnxū hóulóng 陰虛喉嚨), and a detailed discussion of the 19th-century báihóu epidemics.

Prefaces

The work is prefaced by a xiǎoxù 小序 by 方燕昭 Fāng Yànzhāo (zì Bóróng 伯融, of Dìngyuǎn 定遠), the author’s friend of ten years’ standing, dated Guāngxù 7 xīnsì 辛巳, first month of autumn (1881), written “at the Wēncuì xuān 溫翠軒 of his temporary residence at Hánshàng” 邗上 (Yángzhōu 揚州). Fāng records that he had repeatedly asked Shěn for his laryngology methods without success until Shěn, declaring himself aged, finally entrusted him with the volume saying “the heart’s-blood of my entire life is in this.” A subsequent self-preface (zì xù 自序) by Shěn Qīngzhī himself, dated Guāngxù gēngyín 庚寅 (1890) mid-winter, signed “from the Jújǐng Shānfáng 橘井山房 at Guǎnglíng 廣陵”, recounts the Qiánlóng 54 (1789) outbreak of báihóu fēng in the north, the Xiánfēng 6 (1856) outbreak that swept both north and south, and the catastrophic Guāngxù gēngyín (1890) outbreak in the Yángzhōu region in which “of every ten or twenty cases, only two or three survived.” Shěn reports having declined an offer of payment from Fāng for the publication of the work, electing to release it freely to the world.

Abstract

Hóukē jíyè is one of the major late-Qīng laryngology compendia, and — alongside KR3em027 Báihóu quánshēng jí of 李紀方 (1882) — one of the principal indigenous-medical responses to the diphtheria epidemics that swept south China in the 1880s and 1890s. Shěn Qīngzhī’s etiological theory is distinctive in late-imperial laryngology: he argues that báihóu fēng arises when the “lung — which belongs to metal and whose colour is white — falls under conditions of summer drought combined with secondary yīn-damp infection, like dry wood that grows mushrooms after long time”; hence “wind-drying drugs do not save, only cooling-moistening prescriptions can preserve life.” He explicitly criticizes the use of shēngtí xīnwēn fēngzào suānsè 升提辛溫風燥酸澀 (uplifting/pungent-warm/wind-drying/sour-astringent) classes of drug in báihóu, and grounds his own prescribing in the transformations of the lóngdǎn xiègān tāng 龍膽瀉肝湯, báihǔ tāng 白虎湯, pǔjì xiāodú yǐn 普濟消毒飲, xījiǎo dìhuáng tāng 犀角地黃湯, and huánglián jiědú tāng 黃連解毒湯, modified to exclude exactly those four prohibited drug-classes.

Shěn Qīngzhī is not recorded in CBDB and his life-dates are not securely fixed. He was a senior physician of Lìyáng 溧陽 (Jiāngsū) practising in the Zhènjiāng / Yángzhōu region; his self-preface implies a working life of “several decades” reaching from the 1850s through the 1890 epidemic. The composition window is therefore set at 1860 (a defensible terminus a quo for sustained adult practice) – 1890 (the date of his self-preface, the latest stratum in the received text). The preface by Fāng Yànzhāo gives a terminus ante quem of 1881 for an earlier draft of the work, but the integrated shàngxià 上下 two-juǎn recension carrying the 1890 gēngyín preface is what survives in the present witness.

Translations and research

  • No standalone Western-language translation located.
  • For the historical context of the 19th-century diphtheria epidemics in China see Hinrichs and Barnes (eds.), Chinese Medicine and Healing: An Illustrated History (Harvard, 2013), pp. 343–345.
  • Modern reprint via the Hǎiwài huíliú zhōngyī shànběn gǔjí cóngshū 海外回流中醫善本古籍叢書.
  • The work is briefly discussed in 耿鑒庭, Zhōngguó zhōngyī hóukē fāzhǎn shǐ 中國中醫喉科發展史.

Other points of interest

The text’s “shínán 十難 [ten difficulties]” discussion — listing ten clinical problems in differential diagnosis of báihóu — is cited approvingly as “a method that may stand as the model for later students.” Shěn’s pointed dating of the three major báihóu epidemics he had heard of or lived through (1789, 1856, 1890) is among the more precise epidemic-chronicling passages in the late-Qīng medical corpus.

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