Sānyīn jíyī bìngzhèng fānglùn 三因極一病證方論
Discourses on Formulae and Disease-Patterns Unified Through the Three Causes by 陳言 Chén Yán (zì Wúzé 無擇, fl. 1174, Qīngtián 青田 / Lìshuǐ, Zhèjiāng).
About the work
The foundational Southern-Sòng medical-theoretical treatise that systematised the Three Causes (sān yīn 三因) doctrine of disease aetiology. The 18-juǎn recension comprises 180 disease-headings (門) and slightly more than 1,050 formulae (方一千五十餘道), organised throughout under Chén’s tripartite aetiological scheme:
- Nèi yīn 內因 — internal causes: the seven emotions (qīqíng 七情) arising from the zàngfǔ 臟腑 and manifesting in the limbs;
- Wài yīn 外因 — external causes: the six excesses (liù yín 六淫) of seasonal qì, arising from the channels and lodging in the zàngfǔ;
- Bùnèiwài yīn 不內外因 — neither internal nor external: dietary, traumatic, sexual, and accidental causes.
Chén’s pulse-diagnostic doctrine — the guān qián yī fēn 關前一分 (first division before the guān pulse-point) reading, in which the rényíng 人迎 (left wrist) registers external causes and the qìkǒu 氣口 (right wrist) registers internal causes — provides a method for assigning every disease to its proper aetiological class. The work is the doctrinal hinge at which Sòng medicine moved from a primarily formulary-based to an aetiology-based clinical reasoning, anticipating and providing the framework for the JīnYuán medical revolution. Yán Yònghé 嚴用和’s Jìshēng fāng 濟生方 builds directly on Chén Yán’s tripartite scheme.
This entry (KR3er055) is the hǎiwài huíliú 海外回流 (overseas-repatriated) recension of the work; the WYG (Wényuān gé Sìkù) recension is catalogued separately at KR3e0041.
Prefaces
The hxwd _000.txt preserves the author’s own preface, dated indirectly to 1174 by reference to two earlier dates: (i) Shàoxīng xīnsì 紹興辛巳 = 1161, when Chén compiled an earlier six-juǎn work, the Yīyuán zhǐzhì 依源指治, for his cousin Yè Jué 葉桷 (zì Bócái 伯材), who carried it to the xíngcháo 行朝 (the Southern-Sòng court at Línān) intending to have it printed under noble patronage but died before this could be done; and (ii) Chúnxī jiǎwǔ 淳熙甲午 = 1174, when Chén, in conversation with his friends Tāng Zhìdé 湯致德遠 and Qìng Défū 慶德夫, was urged to expand and resystematise his earlier work — producing the present Sānyīn jíyī bìngzhèng fānglùn with its 180 mén and ~1,050 formulae. Chén signs as “Qīngtián Hèxī Chén Yán Wúzé” (青田鶴溪陳言無擇), giving his locality, lineage-residence, name and zì.
Abstract
The date is internally secured at Chúnxī 1 / 1174. The work was repeatedly reprinted in the Sòng, Yuán, Míng, and Qīng, and was included in the SKQS (where it appears under the alternative title Sānyīn fāng 三因方). The KRP catalog meta entry’s “fl. 1500–1540” for Chén Yán reflects a corrupt source and should be disregarded; the present work’s own preface, the SKQS bibliographic notice, and CBDB (id 10017) all support the 1174 date.
The transmission history is complex. The work circulated under several titles — Sānyīn fāng 三因方, Sānyīn jíyī fāng 三因極一方, Sānyīn jíyī bìngyuán lùncuì 三因極一病源論粹 (Chén’s own pre-publication title, per his preface) — and in recensions of varying juǎn-count (the Sòngshǐ yìwénzhì records an 18-juǎn version, but a 6-juǎn abridgement also circulated). The Japanese-preserved recension on which the hxwd text rests preserves a slightly different mén sequence in juǎn 12–18 from the SKQS recension.
Translations and research
The work figures prominently in standard accounts of Sòng medicine: see Asaf Goldschmidt, The Evolution of Chinese Medicine: Song Dynasty, 960–1200 (Routledge, 2009), ch. 6, for a sustained treatment of Chén Yán and the Sān-yīn doctrine; Paul Unschuld, Medicine in China: A History of Ideas (California, 1985); TJ Hinrichs and Linda Barnes (eds.), Chinese Medicine and Healing (Harvard, 2013), ch. 5 (Goldschmidt on Sòng medicine).