A CHINESE OPINION ON LEPROSY,

BEINGA TPANSLATIONOF A CHAPTERFROM THE MEDICALSTANDARD-WORK

Imperial edition of the Golden Mirror for the medical class1)

BY

B. A. J. VAN WETTUM.

' LEPROSY.

Leprosy always takes its origin from pestilential miasms. Its causes are three in number, and five injurious forms are distinguished. Also five forms with mortification of some part, which make it a most loathsome disease. By self-restraint in the first stage of his illness, the patient may perhaps preserve his

COMMENTARY.

The ancient name of this disease was - (pestilential "wind") This", JI, means "wind with poison in it".

1) First chapter of the 87tb volume. It was published in the 7th year of the reign of K'ien-Lung,A.D. 1742. According to Wylie, it is one of the best works of moderntimes for general medicalinformation. (A Wylie, Notes on Chineseliterature, pag. 82). It bas a 2) The. above forms the text of the essay. the shape of $ (rhyme) and consistsof four lines each of seven words. In the arrangementof these, not much care is taken with to and regard 2fi: fà (rhytm) flfi (rhyme). 3) The true meaningof the character as occurringin the present essay,is not 257

The Canon 4) says: "this If. means that the blood and the vital ' ' fluid are hot and spoiled". The vital fluid is no longer pure. That is the reason why the nosebone gets injured, the color of the face destroyed and the skin is covered with boils and sores. A poisonous wind has stationed itself in the veins and does not go away. This is why the disease was named "pestilential-wind". Now-a-days people call it jfl (great-numbness-wind). One of its causes is the influence of the wind and the ground. In the Middle Kingdom, the disease is rarely met with; only in the miasmatic regions 5) many cases occur. Another cause is contagion and infection. The former by contact with a person who has leprosy, - f. i. father and mother, man and wife and the inmates of a same house transmitting it to each other. - The latter from carelessness with regard to one's surroundings, f. i. when the privy, the dwelling-house, the bed and bedding, and the clothes are unclean.

Still another cause is want of self-restraint, - f. i. when sitting in a draught after bathing, only thinking of what is pleasant; when sleeping in the dew and catching cold; or when sleeping on damp ground. In all these cases a poisonous "wind" steals into one's veins.

Though three different causes are distinguished, they all proceed - easily circumscribed.Originally, of course, it means "wind" which translation I have maintainedthroughout these lines for the sake of evidence.But in the differentplaces, the significationvaries between: wind, vapour, air, breath, influence- and also: inflammation, eruption, scrofula,leprosy, etc. 4) Probably the Canon of Medicinejm 41 ; vide Wylie, op. cit., pag. 77 and 80. 5) As such the provinceof Kwang-Tungis known in the first place, and in a much less degree also Fuh-KIenand the other provincesof South-.In the Ypt the of 00 (chapter h' and others), provinces Kwang-Tung,Kwang-Si, Yun-Nan and Kwei-Cheuare named as miasmaticregions, transportation to which is the highest degree of the punishmentof perpetual banishment. 258 from this chief one that, unaware, the body is affected by pestilential ' ... vapours from heaven and earth. Before showing themselves, they accumulate for a long time and then the disease breaks out. The whole body grows numb and after that white marks and red spots appear on the skin, which spread about like (a sort of eruption) 1). The skin is in appear- ance like that of a snake and falls off in pieces. If after breaking out, the disease spreads in the direction from head to foot, the symptoms are favorable; if from below upwards, ' they are fatal. When coming on gradually, the malady may be cured; but when it shows itself suddenly, it is incurable. The poison of the "wind" penetrates the body and gets trans- formed into worms. These worms eat away the five viscera') and therefore cause the disease to appear in five injurious forms, viz: , if the lungs are affected, first the hairs of the eyebrows fall off, if the liver is affected, purple blisters are formed, if the kidneys are affected, first the soles of the feet get perforated, if the stomach is affected, the whole body becomes scurfy, if the heart is affected, first the eyes are injured. These are the dangerous forms of the disease. Besides these, there are five forms with mortification of some part of the body, namely:

is not mentioned in Wells or Giles' dictionaries. 6) The character B Williams' K'ang-Hi's has it defined as follows : B :H with "'1'ien-fung",whole pieces of the skin are coveredwith spots, it occurs in two forms either with purple or with white spots. In the present medical work rA 1-+,l iss separately treated of in the 5th chapter of the same 87th volume,where we find f. i.: The name is "sweat etc. ff fx popular blotches", [Aledburst translates this definition ofK'ang-Hi, as the scalesof leprous subjects,of which there are two kinds, the red and white. Note of the redaction.] 7) being the heart, the liver, the stomach, the lungs and kidneys. 259

If the body is so numb as to be quite senseless, the skin is dead.

If when cut with a kuife, there is no feeling of pain, the flesh is dead.

If the hands and feet drop off, the sinews are dead. If the ridge of the nose falls in, the edges of the eye-lids are cut in, the lips turn outwards and the voice gets hoarse, the bones are dead.

When one of these modes of these mortifications has entered, the disease is fatal and not to be cured.

When the disease is first perceptible, immediately: (prescription A; see here after) must be used in order to produce sweat.

After that, the following medicines must be taken in succession: (prescriptions B, C and D).

If the gums bleed, the mouth must be rinsed with a decoction of equal parts of: " ' Ji roots of Coptis teeta

Lomaria nipponica. Franchet and externally smeared with Ü JAI (prescription E) as an ointment. At the same time baths must be taken of riverwater in which two each of

8) The names of medicinesare determinedwith the aid of the followingbooks: a) E. Bretschneider,Botanicon Sinicum. b) F. Porter Smith, Contributionstowards the Materia Medica and natural . c) E. Bretschneider,Notes on some Botanical questions connectedwith the Export trade of China. d) A. G. Vorderman,The Chinesetreatment of Diphtheritis; 7"OMM?lao, vol. I, etc. The works mentionedsub b) and c) I was enabledto peruse by the kindnessof 1)r. A. G. Vorderman,author of the treatise named sub d). 260

. ' root bark of Lycium chinense Salvia Plebeia .

root of Sophora angustifolia root of Heterotropa Asaroides ' have been decocted.

When having to deal with the injurious or fatal forms of the if disease, the upper part of the body is affected, fi? -lo- (prescription F) must be taken, and if the lower part, then take (prescription G). When the ridge of the nose has fallen in, (prescription H) must be taken. If the patient shows slight signs of consumption, forthwith let him use (prescription I) and at the same time

drink fin (prescription J). When he can keep his heart free from cares with few desires, and can be careful of his diet, by an early treatment, he may per- haps preserve his life. When, however, he cannot limit his taste to plain food and cannot . extinguish all lustful desires, even when convalescent, the patient in- dispensably will relapse again and at the end is beyond deliverance.

(Prescription B).

JI. 1ft, Divinely efficacious powder for removing "wind".

salted scorpion ...... one JLh root of Angelica anomala .... , id. ! root of Panax Ginseng, ...... id.

9) The Chineseweights are: Fr 0 o 0 0 " The JT () is equal by Treaty to 604,5j grammes, the $5j (tael), or sixteenthof a catty, is 37,783 grammes, the or tenth of a tael, is 3,778 grammes, the (candaxeen),or tenth of a , is 0,378 grammes, the or tenth of a is _ fjJt (), , 0,038 grammes. 261

The above, reduced to a fine powder, must be used in doses of two mace. The day before, do not take supper. Next morning, having empty stomach, swallow it along with warm wine If after that the body feels a little strengthened, the medicine has been effective. ' Prescription-rhyme 11).

The divinely efficacious powder for removing "wind" use against leprosy. The body is numb, white marks arise and red spots. Scorpions, Orris-root and Ginseng each one tael, With au empty stomach take it along with wine; and the numb- ness is better.

(Prescription C). _

Powder for driving away "wind".

i?* figured rhubarb ...... 6 tael. golden turmeric from Sz'-Chuen, parched . 1,8 id.

JpL fi pods and spines of Gleditschia chinensis . 1,5 id.

The above must be ground together to fine powder. Each dose ' ' ' is of five mace. Add:

* it j&, extract of Gynocardia odorata... 1,5 mace. sulphate of soda...... 1 id.

At five o'clock in the morning, having an empty stomach, take it along with warm wine. Then wait till nine, and take the same physic again after having added some prepared honey to remove the bad taste. Take much care not to lie down and sleep.

The wines of China are crude almost unrefined, 10) spirituous liquors, alltogether ' being distilledfrom rice, millet, barley and all sorts of fermentedgrain (P. each a of it is inserted the Smith).of a 11) fly p . After recipe resume having shape p which serves to aid the memory of the physician.Like the text, it consistsof four lines each of seven words,arranged without much regard to rhytm and rhyme. 262

It after a while there is a loose motion several times, that does not matter, and can be remedied by eating very thin-boiled rice.

When, on the first day, fi§ J% fl§ (prescription B) has been taken, the next day then use this medicine, and on the third day take

0 )a Jt (prescription D). After that begin again and go on in the same succession.

If the patient is lean and thin, the present recipe may be taken only once in ten days. Old and weak people must not use it at all. Rhyme, etc. 12)

(Prescription D).

? it 1t Pills for crushing "wind".

?? ? ? , Siegesbeckia Orientalis ...... 1 tael. - T, seeds of Arctium Lappa: parched... , id. , stalks of Ephedra Flava ..... , id. leaves of Xanthium Strumarium.... id.

, root of Heterotropa Asaroides .... id. , Tormentilla (?) from Sz'-Chuen .... icl. , root of Angelica Polymorpha..... id. , Salvia Plebeia ...... id.

#@ fruit of Vitex trifolia ...... id. , root of Ligusticum vulgare..... id. 100 seeds of Plantago Major ...... id. Ii 1lit, Rubia sp...... id. , Gastrodia elata ...... id. IbT root of Apocynum Juventus ..... id. j£ '?', dried root of an Angelica species .... id. y id. of Angelica japonica. A. Gray... id.

12) The prescription-rhymecontaining nothing new, and its peculiaritybeing lost by transliteration, this one and those followinghave been omitted. 263

The above is ground to fine powder and made to pills, with wheaten flour kneaded tao paste together with wine, of the size of the seeds of 4ff-L :HPJ,Sterculia platanifolia. Each dose is of sixty to seventy pills, which are swallowed down along with warm wine. Daily two doses are to be taken. , Rhyme, etc. ° . (Prescription E).

, Powder for, all at once, expelling "wind". sulphur...... 2 tael. calcareous spar...... id. burnt alum...... id.

.J{ ¿R' Lomariaomana nipponicanipponica ...... id. id. tt 1* T, fruits of Cnidiunl-Monnieri ..... I tael. sulphate of soda ...... 5 mace.

The above is ground to fine powder and, together with pork-fat - of the sacrificial month 13), poun.ded fine in a mortar and applied as an ointment.

Rhyme etc.

(Prescription F). Intoxicated-genius-elixir. seeds of Arctium tael. 1t T, Lappa; parched .. , I ?' linseed...... id. ? flJ , fruits of Lycium Chinense ..... id. fll , fruit of Vitex trifolia ...... id. root of Sophora angustifolia..... 5 mace. fruit of Tribulus Terrestris ... , id.

rw root of Ligusticum vulgare .... id. root of Trichosanthes cucumerina ... id.

13) the twelfth month, being in winter; the meaningof the expression probablyis : firm pork-fat. , 14) Bretschneider,Bot. Sin. III, no. 129, p. 228, says that P. Smith is wrongin his identification;it is perhaps a sort of Vicia? G. S. ". 264

The above is ground to fine powder. Each dose is of one mace. Add 1,2 candareen of ? ' ? - calomel - and rub till equally mixed. Take it at morning-, noon- and night-time along with tea from used tea-leaves. After some five or seven days, a stinking yellow mucus is produced in the interstices between the teeth and the whole body aches and feels uncomfortable as when intoxicated. Afterwards blood and matter are passed, all very filthy and stinking. The root of the disease has then been taken away. Rhyme etc.

. ' (Prescription G). ' N Heavenly-recreating-powder.

rhubarb; roasted ...... , 1 tael.

pods and spines of Gleditschia Chinensis . 1 ,5 tael. golden turmeric from Sz'-Chuen 5 mace. the white seeded Pharbitis nil; with both ends, one half raw, and the other half parched . 6 mace.

The above is rubbed together to fine powder. Each dose is of two mace or three mace. It is taken along with some mellow wine at early morning, the body meanwhile facing towards the east. If on the same day a filthy discharge is passed with either matter or . worms, the medicine has been efficacious. Rhyme etc. " . (Prescription H).

4,q ia Powder for renewing the body. kind of black snake ..... 1 tael.

S 1£ tt, white spotted snake ...... id. common earth worms, cleaned... id. root of Heterotropa Asaroides .... 3,5 mace.

seed of Muricia Cochinchinense ... id. 265

8 1E, root of Angelica anomala .... , 3,5 mace. 1 Gastrodia elata, with the stalk.... , id.

)-I root of Paconia Rubra, ..... id. fruit of Vitex trifolia ...... id.

root of Angelica polymorpha .... id. id. jfi) 1F ears of' Salvia Plebeia..... , id. camomile ...... id. ll< §Ml flg , Asbestus ...... id. Polygonum bistorta ...... id. root of Sophora angustifolia .... id. root of Adenaphora Polymorpha ... id. root of Apocynum Juventus .... id. 7i 1!f¡ rootlets of Acorus Gramilleus.... id. Equisetum Hiemale ...... id. dried tubers of Asparagus Japonicus, without the heart...... id.

Angelica refracta from Sz'-Chuen ... id. fruit of Tribulus Terrestris. See note 14 . id.

Liquorice-root, clried ...... id. Linseed ..... , ... id. jf Tjtt root of Atractylis ovata, soaked in water in which rice has been scoured; and then parched id. 1f/i Jtffl, tuberous roots of Aconitum chinense seu Fischeri, infused in warm water and barked id.

This is ground together to fine powder. Each dose is of five mace. It is taken along with some warm wine : the more wine, the better. Without Polygonum bistorta and asbestus, will do as well. Rhyme etc. 266

(Prescription I).

it Lotion for strengthening and purging the system.

? fruit of Forsythia Suspensa, without the inner part ...... 6 candareen. root-stock of Thalictrum Rubellum .. id.

,p root of Platycodon Graudiflorum .. 5 candareen. root of Scutellaria macrantha... 4 candareen. root of Rehmannia lutea .... id.

it roots of Coptis teeta .... 3 candareen. ?! ' common earth-worms, cleaned, soaked in . wine and parched ...... id. root of Angelica polymorpha... id. root of Astragalus sinicus .... id. wood of Caesalpinia Sappan ... id. dried scorpions ...... id. ginseng ...... 2 candareen. seeds of Anloulunl. Crdanlonlum .. , id.

Liquorice-root, fresh , ... , 1 candareen.

This is boiled with two cup-fuls of water and one of wine till the volume is one cup-ful. The refuse is thrown away. Also take:

¥Jae, resin from Populus Euphratica ... 1 eandareen. t horse-leech, parched ..... 3 pieces. , gadfly, parched...... 3 pieces. musk ...... 5 cash.

kernel of the bitter peach, ground fine. 3 pieces. and rub this together to fine powder. Put it into the decoctum and boil again till seven tenth of its original volume. The lotion is used after mealtime.

Rhyme, etc. 267

(Prescription J).

Wine of Dogbane.

1iif it root of Apocynum Juventus..... 4 tael. root of Angelica polymorpha, the thicker part 1 tael. id., the id.

j# flj Efl, skales of the Pangolin (Manis Javanica), roasted id. if, root of Rehmannia lutea, raw.... id. Jt, id., prepared ...... , id. dried toads...... id.

£ , leaves of Juniperus chinensis .... 4 mace. pine-needles ...... id.

1£ jJp It, bark of the root of Aralia pentaphylla .. id. JJ[ tuberous roots of Aconitum sp., boiled in water and barked...... id.

tuberous roots of other Aconitum sp., infused in boiling water and barked.... id.

These drugs are put into a bag made of grass-cloth 15), the mouth of which is tied together. Take twenty catty of yellow wine 16) and put it together with the bag with medicine into a jar and close it firmly. Put the jar into much boiling water for the time that three incense-sticks burn 17), and then store it away in a cellar for seven days. Open the jar and use the wine. Drink regularly till drunk and perspiring. Take care to avoid the draught. Rhyme, etc.

grass-cloth, manufacturedfrom the fibres of the BoehmeriaNivea (China-grass). 16) a light table wine made from glutinousrice. 17) about two hours. ; . , 268

(Prescription A).

All-efficacious-elixir, vide the chapter on tumors and ulcers

L1I root of Atractylis ovata from Mas-San . 8 tael. I)WL, stenzs of Ephedra Flava ..... I tael. , dried root of Angelica sp..... id. , Salvia Plebeia ...... id. rYJ it, root of Ligusticum vulgare.... id. , root of Heterotropa Asaroides.... id. Ht , tuberous root of Aconitum sp. infused in boiling water and barked..... id. tuberous root of another Aconitum infused ' in boiling water and barked .... id.

, Angelica refracta...... id. , Dendrobium nobile ...... id. , salted scorpions ...... id. m6 I root of Angelica polymorpha .... id. it -+I:- Liquorice-root ...... id. id. , Gastrodia elata ...... id. jQf it root of Apocynum Juventus .... id. /4[E , realgar...... id.

The above sixteen drugs, after being rubbed fine, are prepared with honey and made into pills weighing three mace each. They are coated with cinnabar and ought to be preserved in a small earthen- ware jar.

18) the last paragraph of chapt. 1st, vol. 76th of the present work.