The Perception and Treatment of People about Abscesses in the Song Period: Focus on Hongmai Yijianzhi.

During the Song period, abscesses were a disease that could affect anyone regardless of their class. This study examines how people at that time explained the cause of abscesses and their efforts to treat them, focusing on the experiences of those who suffered from abscesses and their families. Previous research on disease history during the Song period primarily focused on ailments like colds and infectious diseases , or plagues prevalent in the southern regions of China. On the other hand, examining abscesses as a common everyday illness that could affect anyone and considering them from the perspective of patients' experiences has remained unexplored in previous studies. To reconstruct the experiences of Song period patients, this study analyzes over sixty anecdotes related to abscesses found in Yi Jian Zhi written by Hong Mai. These cases span across the mid to late 12th century, with a majority of the patients being from the literati () class or connected to the literati. These anecdotes exhibit two distinct trends. One focuses on narratives surrounding the onset of abscesses, attributing their cause primarily to the patients' lifestyle. When the cause of the abscesses was unknown, people metaphorically attributed its onset to perceived blasphemy against God, an act of killing, negligence in duties, or other wrongdoings. This trend is evident among the literati class in particular, where abscesses were often linked to factors such as excessive legal executions or exploitation, and even acts of killing people. Except for those cases, in explaining the cause of abscesses in commoners, there were instances caused by a pediculus infestation, while in case of literati, Dansha () poisoning was a common cause. It is interesting to note that the narrative tradition, prevalent in official history biographies, which attributes the onset of abscesses to worries and resentment, was not evident in written records such as Yi Jian Zhi. Furthermore, the detailed description of external similarities, portraying abscesses as traces of punishment from the underground realm, is a narrative characteristic that solidified such stereotypical perceptions. The literati's notion that they should alert people through these related anecdotes contributed to the spread of this perception. Another trend in these anecdotes was centered around narratives of abscess treatment, where the focus shifted primarily to seeking "doctors," unlike the metaphorical explanations of abscess onset causes and processes. When afflicted with abscesses, people generally sought out those renowned surgeons, known as Yang-yi , and those famous for treating abscesses. In local communities, individuals who had "received the divine secrets of abscesses," those possessing their own mysterious abscesses cures, and those famous for generations for treating abscesses by using stone acupuncture were active. Such information about them was shared within the local societies. Their treatment predominantly consisted of surgical procedures to lance abscesses and drain pus, which often led patients to endure significant pain during the treatment process. In many cases, such patients sought treatment from well-known local surgeons and abscess specialists who surgically treated them. The literati, who are said to have influenced the development of pulse-centered medical and academic medicine in China, also sought out surgeons for abscess treatment. Medical formularies compiled by the court as well as privately published ones rarely mentioned surgical methods utilizing tools. The fact that surgical techniques were utilized in local regions at that time indicates a disparity between the official medical practices documented in texts and the practical methods employed in local communities. An analysis of approximately sixty anecdotes related to abscesses shows that abscesses were characterized by unknown causes and excruciating pain. Their onset was often attributed to the patient's lifestyle and wrongdoings, and they were also perceived as punishment for one's wrongdoings. However, as it was a disease where treatment effects could be relatively easily observed through surgical procedures, there was a proactive utilization of the locally formed treatment environment, preferring surgical interventions over relying on religious powers. Contrary to the medical trends and methods outlined in medical literature, surgical treatments were prevalent as the chosen method of treatment among the population in local communities. It appears that the realities experienced, reasoned, and shared by people in the Song period regarding the perception and response to abscesses did not necessarily align with those of mainstream medical practices. Moreover, despite attributing the onset of abscesses to one's wrongdoing, there was a preference for seeking surgeons or Yang-yi over religious methods in their treatment, reflecting a characteristic of the local medical culture surrounding abscesses during the Song period.

Another Tradition of Chinese Medical Knowledge Dissemination: The Characteristics and Significance of the 'Zhiguai Medical Cases' of the Song Period.

During the explanation of the origin of 'prescription,' an interesting phenomena in the accumulation and diffusion of medical knowledge in the Song Period is that many prescriptions contain narratives with bizarre elements, such as those given by God through dreams, received from 'strange people,' or from animals appearing in these dreams. This study features an anecdote called 'zhiguai Medical Cases,' which contains bizarre elements in the dissemination process of prescription, narrative of the treatment experience, and specific content of prescription, called a 'zhiguai prescription.' In previous research, such prescriptions were often called a 'God-delivered prescription.' However, a 'zhiguai prescription' appears adequate because it includes a number of factors beyond the 'God-delivered prescription.' This study examines the background of the intensive emergence of massive zhiguai medical cases in the Song Period, reviews the characteristics and significance of the zhiguai prescriptions in the context of postwar medical history, and finally investigates the influence of the bizarre narrative by tracing the dissemination of related prescriptions. This study found that the zhiguai prescription experiences were different from the so-called 'academic' that was formed in the Song Period, and it was 'another' method of medical knowledge dissemination based on their narratives. The emergence of many zhiguai medical cases in the Song Period, especially in the Southern Song period, is related to the activities of the literati official. The literati officials of the Song Period frequently witnessed strange or anomalous phenomena in their daily life. They relied on them to relieve the powerlessness of reality and left records. In addition, unlike the authors of the zhiguai genre of the previous era, they maintained an attitude faithful to the facts when recording them. The massive appearance of the zhiguai medical cases in the Song Period was the result of the combination of the intention of the literati official who valued medicine their medical knowledge to spread the awareness, their reliance on the strange or anomalous phenomena, and their attitude that emphasized a realistic narrative. The significance of the zhiguai prescription of the Song Period can be found in the supplementation and diffusion of existing medical knowledge. In previous research, these were collectively described as 'public experienced methods'; however, various characteristics were found by analyzing the nineteen cases of zhiguai medical cases in Yijianzhi by comparing them with the related contents of the herbal medicine and prescription books of the time. In the use of herbal medicines for specific diseases, there are cases that are unusual or meaningful when compared with existing herbal medicine or prescription books, and thus, this became a decisive basis for the expansion of herbal knowledge in the later period. Moreover, new treatment methods that were not often seen in medical books at the time were introduced, and they have been continuously transmitted to the medical and herbal medicine books since then. Additionally, this study also found cases that were focused on promoting medical knowledge that was not well-known, and the knowledge that must be known, although they were recorded in the existing medical and herbal medicine books. The record of the zhiguai medical cases evidently had its meanings in supplementing and disseminating existing medical knowledge. Prescriptions in the record of the zhiguai medical cases of the Song Period were subsequently recorded in various medical and herbal medicine books, and they handed down until the Ming and Qing period. Later, when a zhiguai prescription was described in a medical book, its bizarre narrative was not omitted, leaving a trace in the name of the prescription. It can be seen that this bizarre narrative served as a decisive opportunity for the prescription to be transmitted later, considering that existing medical books mentioned the related narratives in Yijianzhi as the source for these subsequent transmissions. When discussing the characteristics of the Song Period in Chinese medical history, many studies state that a strong academic medical trend was centered on the pulse and internal medicine, referring to the development of printing technology, the literati official's interest in medicine, and the compilation of medical books. The contents and dissemination of the zhiguai medical cases of the Southern Song confirm 'another' tradition of medical knowledge transmission that relied on the bizarre phenomena and its narratives in Chinese medical history. Its transmission to the Ming and Qing period signifies the continuation of this tradition into later times. The fact that the zhiguai medical cases were later recorded in medical books in the Ming and Qing period clearly shows the dynamism of how knowledge of the 'case' affects the knowledge expansion of medicine, thereby revealing the power of 'another' tradition called the 'zhiguai' narratives.

Knowledge Transmission of Medical Prescription and the Role of the Literati Officials from the Song Dynasty: Focusing on Huadupainongneibusan.

This paper attempts to examine the spread of medical prescription knowledge during the Song dynasty and the role played by the literati officials through a reconstruction of the transmission of Painongneibusan, a prescription to treat abscesses. An examination of the origins of Painongneibusan shows that after being confirmed in the Qianjinyaofang, it was passed down through Waitaimiyao, Taipingshenghuifang, Shengjizonglu, and Taipinghuiminhejijufang. In particular, in the records from Taipinghuiminhejijufang, which was revised and enlarged during the Shaoxing period (1131-1162) unlike transmissions that were almost identical to those from previous periods, we can find a clear increase in the knowledge regarding medicinal effects, medicinal ingredients, administration methods, precautions and so on. However, if we examine the same prescription record included in Hongshijiyanfang published by Hong Jun in 1170, we can see that the contents are almost exactly the same as those in Taipinghuiminhejijufang and that Hongshijiyanfang had even more content. Through this study, we can deduce that the prescription recorded in these two books were from the same original text. In addition, we can conclude that the original text is likely to be sourced from the knowledge of folk medicine. According to the records, Hu Quan received this prescription from an "outsider," and Hu Quan gave this to Hong Kuo, who wrote an introduction and published it as a stone carving in Huizhou. After this, knowledge about this prescription became known far and wide. While Chen Yan criticized the abuse of this prescription, Hong Jun still included it in Hongshijiyanfang, and Hong Mai included it in Yijianzhi, leading to it becoming even more widespread. Due to this spread of the prescription, the transmission of the description that is connected from "Outsider - Ho Quan - Three Hong Brothers" continued to appear in many medical anthologies by literati officials. Whenever this prescription was mentioned, they referred to Three Hong Brothers, and it went as far as to cause the practice to sometimes be called "Hongshineibusan." Chen Ziming continued the criticism of Chen Yan in Waikejingyao; while the prescription made famous by Hong Kuo had the same contents as prescription in Taipinghuiminhejijufang, the fact that criticism was only directed at Hong Kuo is a proof of his influence in the spread of related knowledge. In conclusion, this happened during an active time of accumulation, exchange, and competition in the knowledge of prescription, as can be observed in various sources from the Song Period. There were various communications and exchanges between officials, locals, and literati officials, and tensions could also sometimes be found. We can say that the role of the literati officials was to collect, record, publish, and spread the knowledge of medicine taken from various sources. In addition, in relation to the spread of the knowledge of medicine, the influence of the literati officials exceeded Taipinghuiminhejijufang, which was the official text at that time.