Xusun Qiwie: A Subtle Exposition of Consumptive Disorders

Xusun Qiwie is a monograph on the diagnosis and treatment of consumptive disorders (xulao) by the Qing dynasty physician Hong Ji'an. It was completed and published in the xinsi year of the Qianlong reign (1761) and consists of two volumes. The author, Hong Ji'an, whose given name was Wei and who also used the courtesy name Xiacheng, was a native of Yuyao, Zhejiang. Having contracted tuberculosis himself, he abandoned the civil examinations and devoted himself to medicine, developing particular expertise in consumptive disorders. The book is grounded in the theories of the Huangdi Neijing and also draws on Zhang Zhongjing's pattern differentiation, Zhu Danxi's approach of nourishing yin, and Zhang Jiebin's theories of supplementing yin and yang, combined with the author's own clinical experience. Later generations have regarded it as one of the more important monographs in the field of consumptive disorders. The upper volume begins with the classical doctrines, explaining the principles of regulating daily life and nurturing the original spirit to prevent deficiency from progressing to consumption; it then discusses the causes of deficiency and consumption, pointing out that excessive drinking, drunken sexual indulgence, overeating, emotional excess, and internal damage from the seven emotions can all lead to deficiency. The book takes yin and yang as the guiding framework for differentiation and treatment: yin deficiency typically presents with fever, restlessness, flushed face, dry lips, and hemoptysis or epistaxis; yang deficiency typically presents with aversion to cold, emaciation, shortness of breath, fatigue, dizziness, poor appetite, abdominal pain, and diarrhea. It then separately sets out the causes, patterns, and treatments for cough, loss of blood, bone-steaming, seminal emission, and amenorrhea in women, and discusses consumptive exhaustion, its transmission and transformation, the five strains, seven damages, and six extremes, differentiation of deficient fire, pulse diagnosis, nail diagnosis, sneeze diagnosis, critical signs of deficiency and consumption, and how to distinguish conditions that resemble consumption but are not. The lower volume contains seventy-two formulas, such as Liuwei Dihuang Wan, Bawei Wan, Dabuyuan Jian, Zuogui Yin, Yougui Yin, and Guipi Tang, each noting its indicated patterns and modifications. The book is meticulous in pattern differentiation and pairs formulas with discussion, making it an important document for the study of the traditional Chinese medicine theory of consumptive disorders.