Qīngxiá yīàn 青霞醫案
Medical Case Records of Qīngxiá [Shěn Dēngjiē] by 沈登階 Shěn Dēngjiē 沈登階 (hào Qīngxiá 青霞, mid-to-late Qīng physician).
About the work
A single-juǎn casebook of mid-to-late Qīng cases organised primarily around a single extended treatment-narrative documented at the head of the work: a 1857 case (dīngchǒu 丁丑, ninth month) treating the son of Fāng Zǐyán 方子嚴, a guāncháshǐ 觀察使 (provincial-circuit intendant), stationed at the Fèngyáng 鳳陽 examination quarters, whose son Zhònghóu 仲侯 was severely ill. The case is presented as a month-by-month, pulse-by-pulse log: arrived at Fèngyáng on the twenty-sixth day, treated continuously for a month, finally got the patient to a sitting position. The case is then recorded in full clinical detail through the subsequent files. This single-case-focus is characteristic of certain mid-Qīng casebook formats in which an exemplary difficult case takes up the bulk of the work.
Prefaces
The hxwd _000.txt opens directly with the case material in the dated mode: “In the ninth month of dīngchǒu 丁丑 [1857], the son of the guānchá Fāng Zǐyán, named Zhònghóu, at the Fèngyáng test quarters was severely ill. At the time I [Shěn Dēngjiē] was sojourning in Hànshàng 邗上 [Yángzhōu]; the guānchá invited me to come and treat him. On the twenty-second of the month I set out; on the twenty-sixth I arrived at Fèng [-yáng], and with Zhònghóu morning and night I diagnosed and treated; in the course of one month, he finally got up to sit. I now record the whole sequence below. Ninth month, twenty-sixth day, I diagnosed: the pulse came like xián 弦 (wiry), with burning heat and no sweat, more severe in the afternoon, the face puffily swollen, of qīng-yellow colour, the nose dark, mouth bitter and thirsty, periodic coughing with sputum of grey-white colour, foam like pearls, drool running from the inside of the mouth, tongue-coating slippery-and-greasy, the front half white, the back half ash-black, lips and mouth scorched-and-cracked, mood-spirit foggy-and-sunken, day and night awake and not able to sleep. This was an interior-lurking autumn-dryness qì, exteriorly receiving the chill of cold dew; the illness had passed twenty days, the dryness-qì had transformed into heat, the exterior and interior had not been able to communicate-and-reach, the perverse qì had entered deeply, the burning heat had increased day by day, the yīn fluids preserved few, gradually leading to interior collapse — the syndrome belonged to…”
The case is one of the most fully-documented seasonal-epidemic cases in the late-Qīng casebook literature and presents Shěn Dēngjiē’s mature qiūzào 秋燥 (autumn-dryness) clinical reasoning at length.
Abstract
Shěn Dēngjiē 沈登階 (hào Qīngxiá 青霞) — mid-to-late Qīng physician of the Jiāngnán region, associated with the Yángzhōu (Yángzhōu / Hànshàng) area as suggested by the case-internal evidence. The internal-evidence dating (1857) anchors his floruit to the late-Xiánfēng / Tóngzhì era. The composition window 1857–1900 reflects this. CBDB has no entry; biographical data are limited to what can be reconstructed from the casebook itself.
The work is one of several late-Qīng qiūzào 秋燥 (autumn-dryness) casebooks of the post-喻昌-吳塘 tradition (autumn-dryness was systematised as a distinct seasonal-epidemic category by Yú Jiāyán 喻昌 in the seventeenth century and developed further by Wú Jūtōng 吳塘 in the Wēnbìng tiáobiàn). The Fèngyáng case is its principal clinical example.
Translations and research
For the qiū-zào doctrine see Hanson 2011 and Hinrichs and Barnes 2013, ch. 7.
Links
- For the qiūzào tradition: see also 喻昌 Yīmén fǎlǜ and 吳塘 Wēnbìng tiáobiàn.
- Kanseki DB
- 青霞醫案