Shènjí chúyán 慎疾芻言
Humble Words on Caution in Treating Illness by 徐大椿 Xú Dàchūn (Língtāi 靈胎 / Huíxī 洄溪, 1693–1771), the Wújiāng polymath physician.
About the work
A one-juǎn polemical-popularising treatise by Xú Dàchūn, written in the same critical-evidential register as his celebrated Yīxué yuánliú lùn 醫學源流論 (1757) but addressed not to physicians but to the lay reader — bìngjiā (families with patients) who must judge between competing physicians at a household’s deathbed. The text catalogues the major iatrogenic disasters Xú observed in his clinical career under topical heads (nánzǐ láozhài 男子癆瘵, fùrén tāichǎn 婦人胎產, xiǎoér jīngdòu 小兒驚痘 — the three categories of patient he names as most often killed by medical error), and instructs the lay reader on which clinical patterns to suspect, which prescriptions to refuse, and how to identify the yōngyī (incompetent physician). Chúyán in the title is the Confucian-modest “humble words” formula; the actual content is sharp and unforgiving.
Prefaces
The Kanripo source opens with two xù: (i) a printer’s preface by Péng Yǔnzhāng 彭蘊章 (1792–1862; Chángshā 長沙 jìnshì, mid-Qīng statesman), who explains that he encountered the Shènjí chúyán late in life and, regretting that he had not known it sooner, sent a copy back to his hometown to be printed at the Róngchéng 榕城 [Fúzhōu] block-print shop “to give it wider circulation”; the printing was carried out by Xú’s great-grandson Xú Qīn 徐嶔; (ii) Xú’s own yǐn 引 (introduction), in which Xú reconstructs his fifty-year course of medical study: as a young man he had read his family’s medical books, then for ten-plus years he had pursued the LíngSù / HànTáng line of doctrine; he annotated the Nánjīng (=after another decade), the Běncǎo (after another decade), wrote the Yīxué yuánliú lùn (after another decade), wrote the Shānghán lèifāng (five years later); in fifty years he had collated about a thousand juǎn and read about ten thousand. He notes that “a few years ago I composed a Chúyán in one cè to wake the world up, but few were willing to listen” — i.e. the present work is the second, expanded Chúyán.
Abstract
Xú Dàchūn 徐大椿 (1693–1771; CBDB 61225) was the most influential mid-Qīng critical physician, a polymath who wrote also on Lǎozǐ, music theory, and the Yīnfú jīng. The Shènjí chúyán is one of his most popular works, designed as a lay-medical instruction text — a genre also pursued in the late Míng by Lǐ Yánshì 李延是 and others. The text’s internal dating places it shortly before Xú’s two summonings to court (1761, 1771); the conventional dating is 1767 (Qiánlóng 32), supported by the yǐn’s reconstruction of Xú’s writing chronology. The work was printed in Fúzhōu by Xú’s great-grandson Xú Qīn at Péng Yǔnzhāng’s urging — i.e. the surviving recension is the mid-19th-century reprint.
Substantively the work is one of the most-quoted critiques of wēnbǔ (warming-and-tonifying) abuse, of the routine misuse of rénshēn (ginseng), and of contemporary physicians who “abandon the ancient books and invent at random”. The doctrinal critique would be picked up by 李冠仙 in KR3eq084 Zhīyī bìbiàn (1848) and by 王士雄 in the Wēnbìng tradition. The text’s lay-instructional address — bypassing the medical profession to speak directly to the patient’s family — is unusual in the 18th century and anticipates 19th- and 20th-century popular-medical pamphlet literature.
Translations and research
No substantial European-language translation of Shèn-jí chú-yán located. Paul U. Unschuld, Forgotten Traditions of Ancient Chinese Medicine (Paradigm, 1990) is a complete English translation of Xú’s Yī-xué yuán-liú lùn and contains substantial framing material on Xú’s polemical voice that applies equally to the present work. For Xú’s biography and intellectual milieu see also Bridie Andrews, The Making of Modern Chinese Medicine, 1850–1960 (UBC Press, 2014).