Medical Case Notes

Medical Case Notes is a single fascicle dictated by Shen Zufu (courtesy name Li'an, sobriquet Fengjiang), a Qing-dynasty physician from Wuxi, and recorded by his disciple Zhou Fengru during clinical consultations. Shen first studied the Confucian classics, later abandoned scholarship for medicine, and studied under Ma Peizhi (Ma Wenzhi), a renowned physician of the Menghe school. Firmly grounded in learning and practicing for decades, he achieved therapeutic success in general internal disorders, epidemic and acute diseases, and external sores and ulcers. The book collects nearly one hundred proven cases. Though not numerous, the cases are recorded with concrete details of the four examinations, clear reasoning in pattern differentiation, and balanced, steady prescribing. They cover consumptive exhaustion, latent summerheat and damp-warmth, malaria, cholera with vomiting and diarrhea, mania and phlegm-fire, depression patterns, pregnancy complicated by disease, pediatric summerheat, and external abscesses and sores, many of them difficult and severe conditions that left other physicians helpless. The author's original analyses of pathogenesis appear throughout, such as diagnosing damage to stomach yin from a thick, white, dry tongue coating, and predicting the incipient failure of the zang-fu organs from flies and gnats gathering on the patient's clothes and bedding and around the mouth, nose, and eyes; these reveal his clinical acumen. Appended at the end of the fascicle is a formula called Shengjun Wan (Victorious Army Pill), created after the Jiangsu-Zhejiang War of 1924, for summerfilth cholera with vomiting, diarrhea, and cold limbs, reflecting his desire to benefit the world. The book is preceded by a Summary, prefaces by Zhou Xiaonong and Zhang Shuming, and An Account of Mr. Shen of Liangxi; it is followed by postscripts by Ding Shiyong and Zhou Yuan, which explain how the book came to be and its connection to the Menghe school. The work was originally included in the third collection of the San San Yi Shu (Three-Three Medical Books) compiled by Qiu Qingyuan and published in 1924; the edition now available is in the China Press of Traditional Chinese Medicine's San San Yi Shu series volume Fifteen Secret Medical Case Records, published together with fourteen other case records including A Brief Guide to Medical Practice, A Thousand-Li Medical Case Records, and Ma Peizhi's Medical Case Records.