Yùyì cǎo 寓意草
Random Notes on My Intentions by 喻昌 Yú Chāng 喻昌 (zì Jiāyán 嘉言, hào Xīchāng 西昌, 1585–1664), of Xīchāng 西昌 (Jiāngxī), one of the three great Míng-Qīng transitional medical authorities.
About the work
A single-juǎn anthology of approximately sixty extended case-narratives composed by Yú Jiāyán in his late life, framed not as a yīàn 醫案 (“medical case-record”) proper but as a series of lǐlùn 理論 (theoretical) cases — long, prose-essay-like discussions of difficult clinical presentations, each beginning from a difficult-case in Yú’s own practice and expanding it into a meditation on the underlying principles of pulse-theory, treatment-method, and the relationship of medical practice to Confucian gézhìchéngyì 格致誠意 (investigation of things, sincerity of intention) doctrine. The work is one of the most philosophically dense of all the casebook-genre texts and stands as the principal source for Yú Jiāyán’s clinical thought.
Prefaces
The hxwd _000.txt opens with a long programmatic author’s preface — one of the most famous Qīng-period medical-philosophical statements. It opens: “I have heard that the physician’s yī is yì 意 (medicine is intention). When a single illness is before one, first one regulates it with intention, only afterwards working it out with method and weaving it through with prescription. The Nèijīng says, ‘The subtle and the marvellous reside in intention’ — this is its meaning. Which physician has no intention? Yet the shallow and the deep derive from it; the chisel-mortise fit derives from it; the path-of-a-thousand-leagues derives from it; the security or peril of the disease-mechanism, its lurking and its rising — none of these does not derive from it. The congealing and the loosening of intention, the splitting and the wildness, do they not court danger?” The preface then aligns medical-clinical intention with the Confucian Dàxué 大學’s chéngyì 誠意 — sincerity of intention — and the precise distinction Yú insists on is between qī 欺 (self-deception) and qiè 慊 (self-satisfaction): the physician’s intention is the very same Confucian moral discipline. “The Great Learning’s accomplishment of sincere intention rests on the investigation-of-things and arrival-at-knowledge, and its discriminations are particularly strict on the two paths of self-deception and self-satisfaction. The killing mechanism follows on the hidden and shadowed; the life mechanism is wrapped in the pure-and-white. The earlier Ru’s discrimination of the gate between human and ghost is fine — I, Chāng, say that the self-deception and self-satisfaction within medical practice are the very gate of human and ghost for the multitude.” The preface continues with a long lament for the vulgar attainment of medicine, naming only Chángshā [Zhāng Zhòngjǐng 張仲景] as truly exceeding the common run and contrasting the xiānshì (Daoist transcendents and Buddhist liberators) for whom philosophical maturity is more common than for the rúyī 儒醫 lineage. This is a key text in the late-Míng / early-Qīng rúyī discourse.
Abstract
Yú Jiāyán 喻昌 (Yú Chāng 喻昌, hào Xīchāng 西昌, 1585–1664, CBDB 89867 / 438028) was a Jiāngxī literatus-physician who began life as a zhūshēng 諸生 candidate, accompanied the future Sòng Yìngxīng 宋應星 brothers on the road, took ordination as a Chán monk after the fall of the Míng, and resumed lay practice as a physician in the Chángshú region of Jiāngsū in his later decades. He is one of the three great physicians of the Míng-Qīng transition (together with Zhāng Lù 張璐 張璐 and Wú Yǒuxìng 吳有性 = 吳有性, the founder of wēnyì 溫疫 epidemic theory). His three principal works are the Yùyì cǎo 寓意草, the Yīmén fǎlǜ 醫門法律 (KR3e0027 / KR3e0048-area), and the Shànglùn piān 尚論篇 (a major commentary on the Shānghán lùn 傷寒論).
The Yùyì cǎo was completed in 1643 (Chóngzhēn 16, the last full year of the Míng) and first printed shortly thereafter; the composition window 1643–1664 reflects this with Yú’s death year as upper bound. The work was extensively reprinted across the Qīng. Its title — yùyì cǎo “draft on lodged intentions” — programmatically signals its essayistic character: cases not as case-precedents but as occasions for the lodging of philosophical and clinical yì (intention/meaning), in implicit pun on his zì Jiāyán 嘉言 (“praising words”).
The casebook contains some of the most famous extended case-narratives in Chinese medical history, including the case of a patient with deep yáng depletion treated successfully with high-dose rénshēn 人參, the case of a young man with severe summer-heat damage rescued by aggressive qīngyíng therapy, and a long set of paediatric cases. It is the principal source for the late-Míng yīzhě yì yě 醫者意也 (“medicine is intention”) clinical-philosophical tradition.
Translations and research
Hinrichs and Barnes 2013, ch. 6 (Míng-Qīng transitional medicine). For Yú Jiāyán’s place in the Míng-Qīng rú-yī tradition see Pierce Salguero, “From Rú-yī to Medical Reformer: Yu Chang’s Yùyì cǎo”, in Journal of the History of Medicine and Allied Sciences 67.4 (2012) — check title; the Yù-yì cǎo is also briefly discussed in Hanson 2011.
Links
- ctext.org has the Yùyì cǎo in full.
- Kanseki DB
- 寓意草