Gǔjīn yīàn àn 古今醫案按
Critical Commentary on Ancient and Modern Medical Cases by 俞震 Yú Zhèn (Dōngfú 東扶, c. 1709–1793), of Jiāshàn 嘉善.
About the work
A ten-juǎn critical anthology of Chinese medical case-records from antiquity through the early Qīng, organised by syndrome / disease category, with the compiler’s own ànyǔ (按語, “critical commentary”) appended to each case. This is the founding text of the yīàn àn (commented case-record) sub-genre and the single most influential mid-Qīng medical-historiographical work.
Prefaces
The _000.txt opens with the zìxù by Yú Zhèn, who develops a sustained Mèngzǐ-grounded epistemological argument: as Mencius distinguished guījǔ 規矩 (rules and squares) from qiǎo 巧 (skilled judgement), so the medical canon provides the guījǔ but only clinical wisdom provides the qiǎo. “Famous physicians can investigate the transformations of a single disease and of several diseases-in-one-body, bending themselves to follow each transformation; operating within the guījǔ but illuminating themselves beyond the guījǔ, nothing fails to come to hand. Then one realises that the rules have a limit, but the skilled use of rules has no limit.”
Abstract
Yú Zhèn’s project was to retrieve from the existing case-record corpus those specimens that exemplified qiǎo — the skilled judgement that operated within but transcended the rules. The preface explicitly states that “case-records circulated are mixed in quality, both fine and faulty are received together” 醇疵互收, and that his editorial selection was meant to qùqǔ 去取 (“set aside or accept”) on a discriminating basis. To each selected case he appends ànyǔ (按語) that “discriminates between real and false, distinguishes right from wrong, untangles same-from-different in apparent identity, marks blue-rising-from-indigo (the disciple surpassing the master), or by summing several events in a few words encapsulates the import, or by gathering old-and-new theories supplements what the cases fail to reach.”
The work was completed in Qiánlóng wùxū (1778) per the conventional dating, with a Qiánlóng-period printing. Modern reprintings continue. Yú Zhèn’s ànyǔ established the methodological precedent for later critical-anthology works: 魏之琇 Wèi Zhīxiù’s Xù míngyī lèiàn 續名醫類案 (KR3ep017, KR3ep018) consciously continues Yú’s project; 王士雄 Wáng Shìxióng (Mèngyīng) produced an abbreviated selection (KR3ep072 Gǔjīn yīàn àn xuǎn) of Yú’s casebook in the mid-nineteenth century.
The composition is therefore dated 1778. The casebook is arranged in ten juǎn by major disease category (傷寒, 中風, 虛勞, etc.), each containing multiple cases with critical commentary.
Translations and research
Hinrichs and Barnes 2013, pp. 199–202 — substantial coverage of Yú Zhèn’s Gǔjīn yīàn àn as the founding work of the Qīng commented-case-record sub-genre. Furth, Charlotte. 2007. “Producing Medical Knowledge through Cases: History, Evidence, and Action,” in Thinking with Cases: Specialist Knowledge in Chinese Cultural History, ed. Charlotte Furth, Judith T. Zeitlin, and Ping-chen Hsiung. University of Hawai’i Press — analyses Yú Zhèn’s case-record methodology.
Other points of interest
The text is exceptionally well-edited and produces an “instant canon” — by selecting from the Hàn through Qīng casebooks Yú Zhèn effectively defined the early-modern Chinese medical-case-record canon. Modern Chinese-medical educators continue to use Gǔjīn yīàn àn as a teaching text.