Línzhèng zhǐnán yīàn 臨證指南醫案
Clinical Compass — Medical Case Records by 葉桂 Yè Guì 葉桂 (zì Tiānshì 天士, hào Xiāngyán 香岩, 1666–1745).
About the work
Ten juǎn of clinical case records of Yè Tiānshì, posthumously compiled by his disciples Huá Xiùyún 華岫雲 et al. from the master’s case-notes and first printed in 1766. The casebook is organised by syndrome (89 syndrome-categories in the standard edition: fēng 風, shǔ 暑, shī 濕, zào 燥, huǒ 火, zhōngfēng 中風, gānfēng 肝風, xūláo 虛勞, fèiwěi 肺痿, etc.) with multiple cases under each, and supplemented by Huá Xiùyún’s didactic commentary Lùn àn 論按 — itself an important secondary stratum of the work. The compilation is universally regarded as the foundational document of mature Qīng warm-disease (wēnbìng 溫病) clinical theory and is one of the most influential medical books of the Qīng period.
This text appears as KR3ep010 in the present catalog. It is also catalogued separately as KR3e0042 in the main KR3e division, where the same work is held under a different recension. The hxwd _000.txt of KR3ep010 opens with the appended formulary of all prescriptions cited in the cases — a feature added to the printed editions as a study aid.
Prefaces
The hxwd _000.txt of this recension does not begin with the customary preface but with the Fùlù 附錄 (“Appendix”): the comprehensive prescription-list (“Anciliary record of all prescriptions used in the cases, listed below, for the convenience of beginners in consultation”) — Guìzhī tāng 桂枝湯, Guìzhī jiā fùzǐ tāng 桂枝加附子湯, Língguìzhúgān tāng 苓桂朮甘湯, Xiǎo jiànzhōng tāng 小建中湯, etc., proceeding through the entire Shānghán lùn / Jīnguì yàolüè repertoire as deployed in Yè’s casebook. The standard editorial preface by Huá Xiùyún 華岫雲 (often dated to 1766) is preserved in the other recensions but does not appear in the front of this manuscript.
Abstract
Yè Guì 葉桂 (1666–1745) is fully treated in the person note 葉桂. The Línzhèng zhǐnán yīàn was compiled by Huá Xiùyún 華岫雲 — Yè’s senior disciple — from clinical records kept by the master and the disciples in the years c. 1720–1745, and was first printed in Sūzhōu in 1766 (Qiánlóng 31). The composition window 1745–1766 reflects the death of the master and the first publication of the compilation respectively, with the case material itself drawn from the preceding twenty-five years. Subsequent imprints proliferated through the late eighteenth century and across the nineteenth, with the work becoming the principal clinical textbook of the Sūzhōu medical world.
The casebook is the principal documentary record of the mature Yè Tiānshì clinical synthesis: the systematic deployment of wèiqìyíngxuè biànzhèng 衛氣營血辨證 (the four-stage warm-disease differentiation that Yè had earlier expounded in his Wēnrè lùn 溫熱論), the routine use of light dispersing prescriptions for early-stage seasonal epidemics, the heavy reliance on the gānfēng nèidòng 肝風內動 (internal stirring of liver-wind) framework for stroke-like presentations, and the characteristic Sūzhōu attention to jīnyè 津液 (body fluids) preservation. The casebook also contains the most extended Qīng treatment of women’s disorders and paediatric cases by a single physician and was the principal source for the Republican-period reconstruction of Yè’s clinical legacy.
The proliferation of “Yè-school” simplifying handbooks in the late eighteenth and early nineteenth centuries — denounced explicitly by 吳塘 Wú Jūtōng KR3ep003 in his preface to the Wēnbìng tiáobiàn and by Zhāng Yùqīng’s disciples KR3ep006 — is also a feature of this casebook’s reception history: as the preface to KR3ep006 observes, it became the zhǎngzhōng zhū 掌中珠 of mediocre practitioners, with the simplifying excesses of “the Yè school” eventually drawing reformist criticism from the late-Qīng Ménghé tradition.
Translations and research
Hanson, Marta. 2011. Speaking of Epidemics in Chinese Medicine: Disease and the Geographic Imagination in Late Imperial China. Routledge — sustained treatment of Yè Tiānshì and the Lín-zhèng zhǐ-nán tradition. Hinrichs, T. J., and Linda L. Barnes, eds. 2013. Chinese Medicine and Healing: An Illustrated History. Harvard / Belknap — see esp. pp. 196–203 on Yè. Scheid, Volker. 2007. Currents of Tradition in Chinese Medicine 1626–2006. Eastland Press.