醫斷與斥醫斷

Yī duàn yǔ Chì yī duàn 醫斷與斥醫斷

Medical Pronouncements, with The Rebuttal of the Medical Pronouncements by 鶴沖元逸 (撰) and 吉益爲則 (述, the doctrinal source)

About the work

The Yī duàn yǔ Chì yī duàn 醫斷與斥醫斷 (Japanese Idan to Sekidan) is a composite volume containing the doctrinal manifesto of the Edo Kohōha 古方派 (Ancient-Formula School) — Yī duàn 醫斷 (“Medical Pronouncements”), composed by 鶴沖元逸 Tsuruoki Genitsu 鶴沖元逸 from the spoken lectures of 吉益爲則 Yoshimasu Tōdō 吉益爲則 (1702–1773) — together with its principal early rebuttal, Chì yī duàn 斥醫斷 (“A Rebuttal of the Medical Pronouncements”), composed by an opponent of the Kohōha and printed here as a paired counter-document. The work is independently catalogued in the hxwd series as KR3eq054 in the present knowledgebase.

Abstract

The Yī duàn. The doctrinal core of the volume. The senior preface, by Taki Kakudai 瀧長愷 (彌八父 Yahachi-fu), of Nagato 長門 province, is undated but is the standard 1759 preface to the printed edition; Tsuruoki’s own preface is dated Enkyō 4 / 10 = winter 1747 (延享丁卯冬十月, signed 西肥鶴沖元逸書於洛西僑居 — “Tsuruoki Genitsu of Saihi [Hizen, in western Kyūshū], at his Kyoto western-quarter temporary residence”). The autobiography in the author’s preface: Tsuruoki spent ten years studying medicine, repeatedly frustrated by the doctrinal contradictions among the major Kyoto schools; he travelled to Kyoto in autumn 1745 (乙丑之秋) to investigate at first hand; through the disciple Kitaoku Kōtaku 北奧孔澤 he was introduced to Yoshimasu Tōdō; he converted to Tōdō’s doctrine and wrote out the present record of Tōdō’s teaching in 1747.

The architecture of the Yī duàn is a series of brief, polemically titled essays each demolishing a piece of the received SòngYuánMíng medical consensus. The major chapter-essays:

• 司命 (Sī mìng, “Master of Lives”): rejection of the convention of calling physicians “masters of lives.” Death and life are decreed by Heaven (天命); the physician administers disease, not life.
• 元氣 (Yuán qì, “Primary qì”): the term yuánqì “primary qì” is not in the six classics; it was invented by Hàn-Confucian commentators and amplified in TángSòng to dominate medical discourse. Yuánqì cannot decline (it is Heaven-bestowed) and therefore cannot be “tonified.” What the SòngYuánMíng tradition called “yuánqì deficiency” is, in fact, the suppression of constitutional vigour by underlying poison (dú 毒); remove the poison and the vigour returns spontaneously.
• 脈候 (Mài hòu, “Pulse-examination”): pulses vary as faces do; the canonical 27-type pulse taxonomy is illusory; Biǎn Què’s Shǐjì biography explicitly states that he diagnosed “without waiting for pulse-cutting”; the master’s teaching prioritises symptom first, then abdomen, then pulse.
• 腹候 (Fù hòu, “Abdominal examination”): the abdomen is the diagnostic primary in Tōdō’s clinical method. (This is the signature Kohōha doctrine of fùzhèng 腹證.)
• 臟腑 (Zàngfǔ): the Zhōu lǐ mentions “nine viscera” without distinguishing organs and bowels; Zhāng Zhòngjǐng makes no use of the zàngfǔ scheme; the Shānghán lùn references that do appear are post-Hàn interpolations by Wáng Shūhé. The Han-and-later five-phase-correspondence reasoning (xiāngkè mutual conquest, the doubled-kidney, the mìngmén, the xīnbāo, the sānjiāo) is dismissed as useless to therapy.
• 經絡 (Jīngluò, “Channels and connectors”): the meridian theory is unconnected to therapy and is to be ignored. Acupuncture and moxa points are also rejected: “there is no point that cannot be moxa’d, and no channel that cannot be needled” — the so-called jǐngyíngshūjīnghé sequence-of-five is “wild theorising” (妄說).
• 引經報使 (Yǐnjīng bàoshǐ, “Channel-targeted drug action”): the doctrine that specific drugs target specific channels (Lǐ Dōngyuán’s signature pharmacology) is rejected.
• 本草 (Běncǎo, “Materia medica”): the Shénnóng běncǎo substance-by-substance therapeutic claims are to be filtered against actual Zhāng Zhòngjǐng usage; what cannot be derived from the Shānghán / Jīnguì clinical record is rejected.

The cumulative effect is the systematic dismantling of the entire post-Hàn theoretical apparatus of Chinese medicine and the relocation of all medical reasoning into the Shānghán / Jīnguì canon — the doctrinal core of the Kohōha programme.

The Chì yī duàn. The rebuttal, printed in this composite volume as a paired counter-document, was composed by an opponent of the Kohōha (the source-file does not preserve the rebuttal’s signature in the jc base-edition fragment I have inspected). The work answers Tsuruoki’s chapters point-by-point, defending the standard SòngYuánMíng zàngfǔ / jīngluò / yuánqì doctrine. Its existence and circulation document the public polemical controversy generated by the Yī duàn in mid-18th-century Kyoto medical circles.

The work is securely dated: the Yī duàn manuscript is 1747 (Tsuruoki preface), printed 1759 (Taki Kakudai’s senior preface; the Yī duàn was the first published statement of the Kohōha programme, three years before the Lèijù fāng and twelve years before the Yào zhēng). The Chì yī duàn rebuttal appeared shortly after the 1759 Yī duàn publication.

The work was transmitted to China and entered the Shanghai HuángHàn yīxué cóngshū 皇漢醫學叢書 (Shanghai: Shìjiè Shūjú, 1936), ed. Chén Cúnrén 陳存仁 — the immediate vector for the hxwd-series text. In China the Yī duàn became the principal vehicle by which late-Qīng / Republican Chinese jīngfāngpài 經方派 (classical-formula-school) revivalists encountered the Edo Kohōha’s doctrinal programme.

Translations and research

• Trambaiolo, Daniel. 2013. “Native and Foreign in Tokugawa Medicine.” Journal of Japanese Studies 39 (2): 299–324 — substantial treatment of the Idan / Kohōha polemics.
• Trambaiolo, Daniel. 2014. “Ancient Texts and New Medical Ideas in Eighteenth-Century Japan.” Asian Medicine 9 (1–2): 78–104.
• Marushima Eisuke 丸島英祐. Multiple Japanese studies of Yoshimasu Tōdō and the Kohōha.
• Sakai Shizu 酒井シヅ. 1998. Edo no naka no Kanpō 江戸の中の漢方. Tokyo: NHK Books.
• Otsuka Yasuo 大塚敬節. 1989. Kanpō ishi no negaikoto 漢方医師の願いごと. Tokyo: Misuzu Shobō.

Other points of interest

The Yī duàn is the most influential single Japanese statement on the philosophical foundations of medicine produced in the 18th century. Its doctrinal radicalism — the complete rejection of all post-Hàn theoretical apparatus — established the methodological framework within which subsequent Edo kanpō developed, and via late-Qīng / Republican reception became one of the principal Japanese intellectual influences on modern East Asian classical-formula practice. The pairing with the Chì yī duàn rebuttal in this 1936 hxwd recension is unusual and historically valuable, since the Chì yī duàn is much less frequently reprinted; the pairing preserves the dialogic structure of the original controversy rather than presenting Tōdō / Tsuruoki’s manifesto in isolation.

Links

• Compiler-author: 鶴沖元逸.
• Doctrinal source: 吉益爲則 / Yoshimasu Tōdō.
• Intermediary: Kitaoku Kōtaku 北奧孔澤 (Yoshimasu pupil through whom Tsuruoki met Tōdō; no separate person note).
• Senior preface: Taki Kakudai 瀧長愷 of Nagato (Confucian scholar friend, no separate person note).
• Companion works in Kohōha canon: KR3eu063 Lèijù fāng (1762), KR3eu065 Jiāshú fāng yǔ Fāng jí (1755–1780), KR3eu072 Yào zhēng (1771).
• Parallel listing: KR3eq054.
• Series: HuángHàn yīxué cóngshū 皇漢醫學叢書 (Shanghai: Shìjiè Shūjú, 1936), ed. 陳存仁.