Medical Practice in Twelfth Century China A Translation of Xu Shuwei S Ninety Discussions Cases On Cold Damage Disorders Asaf Goldschmidt

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Archimedes 54 New Studies in the History and Philosophy
of Science and Technology
Asaf Goldschmidt
Medical Practice in
Twelfth-century China –
A Translation of Xu Shuwei’s
Ninety Discussions [Cases]
on Cold Damage Disorders
Archimedes
NEW STUDIES IN THE HISTORY AND PHILOSOPHY
OF SCIENCE AND TECHNOLOGY
VOLUME 54
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More information about this series at http://www.springer.com/series/5644

Asaf Goldschmidt
Medical Practice
in Twelfth-century China –
A Translation of Xu
Shuwei’s Ninety Discussions
[Cases] on Cold Damage
Disorders
Asaf Goldschmidt
Department of East Asian Studies
Tel Aviv University
Tel Aviv, Israel
Visiting Professor
Renmin University of China
Beijing, China
ISSN 1385-0180 ISSN 2215-0064 (electronic)

Archimedes
ISBN 978-3-030-06102-9 ISBN 978-3-030-06103-6 (eBook)
https://doi.org/10.1007/978-3-030-06103-6
Library of Congress Control Number: 2018965241
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Preface
The medical encounter, in which a physician diagnoses and treats a patient, is the
epicenter of medicine. It is during these brief moments that years of preparation and
training culminate in what the therapist hopes will be a cure for the patient’s disease.
Even the slightest mistake can cause deterioration in the patient’s condition or even
a fatal consequence. Given the importance of the medical encounter, it is quite sur-
prising how little we know about it in Chinese medicine before the twentieth cen-
tury. We do not know where the medical encounter took place nor who participated
in it. We do not know how Chinese physicians diagnosed their patients, whether
they relied primarily on the pulse, the patient’s appearance, or dialogue with the
patient. We do not know how physicians treated their patients, whether they fol-
lowed the procedures recorded in the grand medical formularies of China or chose
alternatives. Nor do we know whether they prepared medications themselves or
merely wrote out a prescription, leaving patients to find the ingredients and prepare
the medicine on their own. All these questions are essential if we want to understand
medicine as it was practiced, not only as it was imagined in doctrinal and practical
texts. There is likely to have been a great disparity between what texts dictated and
what was actually done. The case records translated in this book highlight some of
these disparities and demonstrate how Xu Shuwei 許叔微 (1080–1154), the author
of this book, coped with them. These cases also bring to the fore the complicated
scene of the medical encounter, which included other participants besides the patient
and the doctor and often included controversies.
Historians of medicine in China have generally argued that medical practice
was based on a handful of well-known medical canons that incorporate a theoreti-
cal structure of great abstraction and sophistication.1 These medical classics pro-
vide an ideal depiction of physiology and pathology based on a paradigm or
cosmology of microcosmos and macrocosmos of the body, the state, and the exter-
nal universe.2 The macrocosm-microcosm relationships were explained by termi-
1
See Unschuld 1985 and 1986, Sivin 1987, Kuriyama 1999, Furth 1999, and Lu and Needham
2002.
2
Sivin 1995b.
v
vi Preface
nology based predominantly, but not exclusively, on qi 氣, yin-yang, and Five

Phases (wuxing 五行).3 This cosmology originated from the Han dynasty (206
BCE–220 CE) but kept its influence throughout history when physicians used it to
explain the normal functions of the body and when they go awry, i.e., the phenom-
ena of disease or disorder. Disease was thus one outcome of the struggle between
pathogenic qi (xie qi 邪氣) entering the body from the outside and proper or ortho-
pathic qi (zheng qi 正氣) defending the body from within. Pathogen (xie 邪)
referred to agents of disorder or qi other than that of the body, which disrupted its
balance. Some of the canons propose an ideal strategy for treatment but rarely
provide specific details on how to apply it or how to modify it according to the
patient’s response. Physicians throughout history rarely encountered these ideal
circumstances, for the sick must have manifested patterns varying slightly or dra-
matically from classical norms. In other words, it is unclear to what extent Chinese
physicians could and did apply the canonical, idealized medical procedures in their
everyday clinical practice.
Surprisingly, scholars have paid little attention to the thousands of other surviv-
ing medical documents in China—especially manuals, textbooks of diagnosis and
therapy, and collections of case records.4 Even less attention has been devoted to
exploring depictions of the medical encounter in nonmedical sources, such as nov-
els, local gazetteers, and miscellaneous jottings.5 In recent years, new studies con-
cerning specific diseases, epidemics and their impact, public health, medical policy,
popular medicine, and similar topics have begun to extend the purview of “Chinese
medicine” beyond the scope of formal doctrines and theories.6 Research on physi-
cians—as individuals or as an occupational group—and on the clinical encounter
between patients, their families, healers, and physicians, however, remains cursory.7
Consequently, it is still unclear how physicians acquired and practiced their craft,
how their individual perceptions of medicine differed, how they and their skills
varied geographically and socially, and, as noted above, to what extent their actual
clinical practice mirrored the methods of the medical canons.
3
Qi is a term that is untranslatable into languages that draw their metaphysics from Western tradi-
tions. Depending on the context, it can mean “stuff that makes things happen” or “stuff in which
things happen” and “what makes things happen in stuff” (Sivin 1987, pp. 46–53). In other words,
qi is what is most vital to our well-being—what keeps us alive and vitality itself. When appearing
out of order, it is also a harmful vitality. In Chinese cosmology, the polarity of yin-yang and the
division of Five Phases represented a division of the world into either complementary types of qi
or five relational aspects of qi. For further discussion on yin-yang and Five Phases, see Sivin 1987,
pp. 59–80.
4
A partial list of those who have discussed some of these texts includes Harper 2001, Grant 2003,
Furth, Zeitlin, and Hsiung 2007, and Hsu 2010.
5
Cullen 1993 and Schonebaum 2016 are examples of works that studied the medical encounter in
Chinese novels.
6
See Scheid 2007, Leung 2009, and Hanson 2011.
7
Grant 2003, Chao 2009, and Hsu 2010 are the exception.
Preface vii
This translation of Xu Shuwei’s Ninety Discussions8 on Cold Damage Disorders

(Shanghan jiushi lun 傷寒九十論, ca. after 1149) begins filling this lacuna. It makes
accessible the first extant collection of medical case records compiled by a Chinese
physician. Reading original case records in translation is one of the best ways for
nonspecialists to learn about the clinical encounter from the physicians’ perspec-
tive. In them, they recorded what they considered most important to transmit to
posterity. This translation of 90 cases begins with a brief introductory survey of Xu
Shuwei’s life and work, the historical context of Xu’s era, a brief overview of
changes in medicine during this period, and a concise history of the genre of case
studies in China.
As China’s first published collection of a physician’s own medical case records,
Xu’s book stands as one of the most innovative Chinese medical treatises. From
historical perspective, the influence of this innovative book was limited, since it was
about 300 years before other physicians followed Xu’s initiative and compiled col-
lections of their cases, establishing the genre of case histories (yi’an 醫案).9
Moreover, odd as it may seem, the earliest surviving copy of this book was not
printed until 1853. Xu’s book faithfully describes the interaction between a physi-
cian and his patients from the former’s perspective. It provides the reader with
invaluable details about the social status of Xu’s patients, the roles of family mem-
bers and bystanders in the medical encounter, and how he diagnosed and treated
disorders. It also provides us with the author’s corpus of therapy for one type of
disorder—Cold Damage (shanghan)—which, at its rudimentary meaning, was
taken as a generic term for any acute, potentially epidemic, rapid-onset febrile
diseases.10
Since Xu Shuwei 許叔微 (1180–1154) was the first Chinese physician to com-
pile and publish a collection consisting only of his medical case records, and since
he does not explain his decision to publish this collection, we are left to ponder what
motivated him to do so. Early Chinese doctors refrained from publishing case
records to a general readership, since doing so would have revealed their accumu-
lated clinical knowledge, a physician’s most precious asset. Instead, they shared
these cases, usually verbally but sometimes in written form, only with family mem-
bers or with their most devoted disciples. Advances in print technology in conjunc-
tion with government sponsorship of printing projects from the eleventh century on,
8
It is important to note that Xu Shuwei uses the character lun 論, which means “discussions,” not
an案 in his title. Regardless, I consider this book to be a collection of what we would define as case
histories even though he does not use the character an案, which later, during the Ming dynasty
(1368–1644), became the common word for medical case histories.
9
See Goldschmidt 2015.
10
As evident from the cases translated below, for Xu Shuwei, Cold Damage had a much broader
meaning. This disorder was caused by invasion of external cold pathogen most often during the
winter. This cold pathogen initially affected the external part of the body with heat sensations as its
primary symptom. The affects of cold pathogen were sometimes delayed, leading to eruptions of
disorders during other seasons as the warmer weather transformed cold pathogen into heat patho-
gen with severe heat sensations. After its initial manifestation, the cold pathogens penetrated
deeper into the body, causing a variety of different symptoms with or without heat sensations.
viii Preface
however, led to the spread of medical canons, materia medica literature, and enor-
mous formularies, thus expanding and complicating traditional ways of circulating
medical knowledge.
Throughout Chinese history, most physicians wrote books in order to transmit
medical knowledge, doctrines, and practices to their successors, although some
aimed to enhance their reputations among their peers.11 Transmission is a compli-
cated process, especially in the case of clinical know-how such as palpating the
pulse and diagnosing a disorder from different and often conflicting array of symp-
toms. Doing so in writing is a tall order. How to transmit hands-on knowledge to the
next generation concerned Chinese thinkers from early times, as can be seen in the
Daoist classic Zhuangzi. In one anecdote, the two characters—Duke Huan and a
wheelwright—discussed different ways to transmit knowledge:
Duke Huan was reading a book at the top of the hall, wheelwright [Bian] was chipping a
wheel at the bottom of the hall. He put aside his mallet and chisel, and went up to ask Duke
Huan
“May I ask what words my lord is reading?”
“The words of a sage.”
“Is the sage alive?”
“He is dead.”
“In that case what my lord is reading is the dregs of the men of old, isn’t it?”
“What business is it of a wheelwright to criticize what I read? If you can explain your-
self, well and good; if not, you die.”
“Speaking for myself, I see it in terms of my own work. If I chip at a wheel too slowly,
the chisel slides and does not grip; if too fast, it jams and catches in the wood. Not too slow,
not too fast; I feel it in the hand and respond from the heart, the mouth cannot put it into
words, there is a knack in it somewhere which I cannot convey to my son and which my son
cannot learn from me. This is how through my seventy years I have grown old chipping at
wheels. The men of old and their untransmittable message are dead. Then what my lord is
reading is the dregs of men of old, isn’t it?”12
Zhuangzi challenges written records of ancient sages as a means of transmitting the

knowledge needed to manage state and society. The story’s point is that text is use-
less for transmitting practical know-how.
The greatest problem in medical training is teaching the practical knowledge that
one can acquire only through experience. Physicians are no better equipped than
wheelwrights to accomplish this daunting task. Medical case histories or case
records13 could have solved this problem in China as they did so in Europe. The
authors of the book of Epidemics in the Hippocratic Corpus used cases to set the
norms and rules of medical practice based on their direct experience, since they had
no established medical canon to draw on. Galen, however, rejected this form of
medical writing since they were too informal. Cases, although not forming a genre,
11
For further discussion on the transmission of medical knowledge in China, see Hsu 1999,
pp. 1–2, and Wilms 2005.
12
Graham 1981, 139–140, I kept the paragraph organization of Graham’s original translation
intact. See also Yearley 1996.
13
For discussion concerning the changing definition of medical case histories in the Chinese con-
text, see Furth, Zeitlin, and Hsiung 2007, pp. 129–130.
Preface ix
were used among the Empiricists who saw themselves as the faithful interpreters of
the Hippocratic legacy. Cases regained prominence and became an epistemic genre
in Europe during the sixteenth century, as shown by Gianna Pomata, mirroring simi-
lar change in China.14
Xu’s collection of cases uniquely sets out examples of twelfth-century medical
practice, including diagnosis, reasoning about syndromes, and treatment. Xu’s
accounts also depict interactions between patients, members of their families, phy-
sicians, and other healers. Thus the book translated here reveals not just medical
history but also rarely accessible social history. It also clarifies, for one physician
and one group of diseases, the phases of the medical encounter, namely, diagnosis,
differentiation of the disorder, selection of a treatment strategy, and the application
of a treatment regimen.
Xu Shuwei’s 90 cases provide a direct glimpse into the clinical scene during the
first half of the twelfth century. They also enable us to see what the physician con-
sidered important through the details he included for posterity in his documentation.
It is likely that Xu modified his accounts for certain purposes, but the many non-
clinical details included in the cases enable us to reconstruct the context of the
medical encounter.15 For example, in some cases (such as Case Number 3), Xu
Shuwei provides us with ample data about the circumstances in which the patients
contracted the disorders. He often details the name, gender, social status, and even
the rank and occupation of the patients―particularly prestigious ones. His approach
makes his cases realistic, showing that these were real people he was treating.
Tel Aviv, Israel Asaf Goldschmidt
14
See Pomata 2010, 2011, and especially 2014, and Hanson and Pomata 2017.
15
For example, Xu may have altered some details in his cases to better fit his goal of exemplifying
and clarifying the diagnosis and treatment procedures of Cold Damage disorders.
Note on the Translation
Translation is inherently limited in conveying the original message and concepts in a

given text. What one translator considers equivalent, someone else may well see as a
failure to get the point. In translating Chinese medical texts into English, the clinical
terms, which often are without parallel in Western languages, pose the biggest prob-
lem in conveying the Chinese author’s intention while, at the same time, keeping the
translation comprehensible. There is no comprehensive dictionary in any Western
European language for classical Chinese medical terms. The usefulness of such a
dictionary would, in any case, be limited by the numerous unresolved terminological
debates that pervade the contemporary literature. The main reason for this incom-
mensurability is the underlying divergence in basic concepts of the body between the
Chinese and Western traditions. The Chinese terminology mainly describes func-
tions and processes, whereas Western nomenclature largely concentrates on struc-
tures and materiality, or what Kuriyama terms the “anatomical gaze.”1 This Western
perception of the body, which originated in Greek civilization, led to a focus on
muscles and the location of lesions; Chinese physicians paid attention to color as a
manifestation of the body’s harmonious or disharmonious function. This leads to a
frequent debate about approaches to translating Chinese medical writings.
One of the most familiar examples in the history of Chinese medicine is the prob-
lem of whether or not to translate the pair of the fundamental terms Qi 氣 and Xue血.2
1
See Kuriyama 1999 (esp. Chapter 3, p. 127, for the “anatomical gaze”), Sivin and Lloyd 2002,
and Sivin 1987.
2
In Chinese medicine, qi is what makes the body function (see Note 3 above). Chinese doctors
differentiated between the yang aspect of general bodily qi, naming it Qi, and the yin aspect, nam-
ing it Xue (blood). The combination of both, namely, “qi and xue [blood]” (qi xue) was how they
referred to what animated and nurtured the body. Xue [blood], being the yin counterpart of qi,
encompasses not only the red liquid flowing in arteries and veins but bodily fluids in general. Xue
is often translated as “blood.” However, this translation reduces the meaning of the word to the
Western modern meaning, ignoring other aspects of the word which are unique to Chinese medi-
cine. In classical medical discourse, which emphasized functions over materials and structures, xue
meant the yin vitalities of the body more often than the familiar fluid that flows red from wounds.
I therefore leave this term untranslated, as I do with qi.
xi
xii Note on the Translation
Until about two decades ago, it was common to translate qi in various ways, drawing
on ancient Greek, Latin, and modern science to render it as pneuma, air, energy, vital
energy, influence, or, more recently, circulating life force. None of these translations
conveys the original scope of the Chinese word. Lately, it has become the norm to
refrain from translation, romanizing qi instead. In contrast, the majority of scholars
translate xue as blood, its modern biomedical meaning, and in doing so making the
reader, unconsciously, to assume that this modern or Western definition holds failing
to understand the Chinese author’s intention.3 I translate xue as “blood” when the
Chinese author refers to the red fluid that flows in the veins and arteries or, alterna-
tively, the red fluid that gushes out of a deep cut or a severe injury to the body. This
also exists in Xu Shuwei’s book in a number of cases, for example, in discussing
blood coming out of the navel (Case Number 9) or a case of nosebleed (Case Number
63). In other cases, I choose to leave xue refraining from translating it. For example,
in one of his cases, Xu Shuwei discusses coldness or heat entering the xue, causing
congelation. By not translating it here, I keep Xu’s allusion to the xue as the yin
counterpart of qi that flows in the various circulation tracts along the body and sus-
tains health.4
Consequently, I have decided to leave a few key terms in their original form―qi,
xue, zang 臟, and fu 腑5 among others―to avoid such a misunderstanding. As for
the myriad of other clinical terms, I have tried to provide the clearest possible trans-
lations, linked when possible to excellent scholarship. Nevertheless, my translation
of Xu’s 90 cases will not be a benchmark for translating this clinical language. I
merely strive to provide the reader with a legitimate interpretation of the clinical
scene that Xu describes. I provide the Chinese text at the end of each section for
readers prepared to explore the Chinese terminology further.
Another issue concerning translation has to do with the Song dynasty context.
The Song government launched a number of projects to print and promulgate
authoritative versions of medical books, both contemporary and ancient canons,
enabling easy access to medical knowledge. The government also set up an educa-
tion system to teach medicine and even set up an examination system to test the
medical students, thus standardizing medical knowledge and terminology.6 These
3
Sivin is one of the few who claims that his should not be translated if we choose not to translate
qi; see Sivin 1987, pp. xxvi, 51–52.
4
It is important to note that these tracts do not correspond to arteries, veins, nerves, or even lymph
ducts.
5
Zang and Fu refer to the body’s internal organs that Chinese doctors perceived as simultaneously
structural and functional entities. In Chinese medical throughout history, authors focused on what
these entities do in health and sickness rather on what the viscera are. In order to differentiate
between the functional approach of the Chinese and the organs that bear the same names in modern
medicine, I follow Sivin and translate these two terms as zang and fu “visceral systems of func-
tions” (Sivin 1987, pp. 121, 124–133). There are six yin or zang visceral systems of functions—the
heart, lungs, liver, spleen, kidneys, and cardiac envelop. There are six yang or fu visceral systems
of functions—the small intestines, large intestines, gall bladder, stomach, urinary bladder, and san
jiao (三焦 triple jiao).
6
Goldschmidt 2009, chapters 1–2
Note on the Translation xiii
changes affected doctors’ discussions and writings. During the Song, we rarely find
doctors debating the meaning of basic medical terminology, as we do earlier. They
struggled, however, with the newly available canons, such as the republication of
the Treatise on Cold Damage and Miscellaneous Disorders, or the greatly expanded
variety of available drugs detailed in the newly published materia medica collec-
tions.7 I have discussed these changes elsewhere, but more work is required to fully
realize the impact of these changes on doctors. In this translation, I have limited my
comments about changes in medical terminology, except when they are pertinent to
Xu Shuwei’s discussions.
All too often, translations from classical Chinese into English are overly literal,
as some translators concentrate on accounting for every word in the original, even
when this interferes with conveying the overall meaning of the text.8 Such transla-
tions tend to be stiff and unnatural. This fails to convey the clear and straightforward
style of medical case histories.
In view of the many limitations in our understanding of premodern Chinese med-
ical practice, I have sought a readability that conveys some of the tone of the origi-
nal while preserving, where possible, characteristic Chinese terms and concepts. I
feel this approach will best reveal Xu’s experiences to modern readers, especially to
nonspecialists.
7
Goldschmidt 2009, chapter 3.
8
I follow Sivin’s example (2009, pp. 5–6).
Acknowledgments
This book came about as a product of a much larger project, namely, the reconstruc-
tion of the medical clinical encounter or the clinical scene in Song dynasty China
(960–1276). I read Xu Shuwei’s books as part of an earlier project focusing on Cold
Damage Disorders, but the significance of the case records in his collection of 90
cases dawned on me only while working on my current project in recent years. It
was then that I decided that the best way to convey the clinical encounter to readers
in the West would be to enable them to read the earliest collection of cases compiled
by a physician themselves, hence the translation.
I am happy to acknowledge the support this project received from a number of
institutions. This research was supported by the Israel Science Foundation (Grant
No. 1199/16). It was during my stay at the Institute for Advanced Study (IAS) as a
member of the School of Historical Studies that this translation began. I am grateful
for the hospitality of IAS hosting me and my family for a year (September 2014 to
July 2015) and especially to the librarians of the IAS, who tirelessly fulfilled my
requests for various rare editions of Xu Shuwei’s books. I would also like to extend
my gratitude to Dagmar Schäfer the head of Department III at the Max Planck
Institute for the History of Science (MPIWG) in Berlin for hosting me for three
summers while working on this project.
I would like to thank Nathan Sivin for reading the full manuscript and providing,
as always, valuable comments and criticism. I also want to thank Marta Hanson and
Yi-li Wu with whom I discussed various aspects of this project. I would also like to
thank Gilly Nadel who edited the introduction to the translation. Lastly, I want to
thank my family for their patience with me and my ongoing research and especially
during the course of this demanding project.
xv
Contents
Part I
Introduction�� 3
Setting the Stage: Demographic, Economic, and Social Changes
During the Late Northern Song and Early Southern
Song Dynasties�� 3
Medicine During the Northern Song Dynasty �� 7
Xu’s Surviving Books: His Trilogy on Cold Damage
Disorders and His Formulary�� 19
A Brief History of Medical Cases Records in China�� 22
The General Pattern or Structure of Xu Shuwei’s Case Records �� 25
Part II Translation of Cases

Case Number 1 �� 29
Case #1: Clarifying the Debate Concerning the Usage of Chinese
Herbaceous Peony Root in the Cassia Twig Decoction Manifestation
Type 辯桂枝湯用芍藥證�� 30
Case #2: Manifestation Type [Requiring Treatment with] Prepared
Aconite Root Added to Cassia Twig Decoction 桂枝加附子湯證�� 33
Case #3: Manifestation Type [Requiring Treatment with] Magnolia
Officinalis and Apricot Added to Cassia Twig
Decoction 桂枝加濃樸杏子湯證�� 35
Case #4: Manifestation Type of Ephedra Decoction 麻黃湯證�� 38
xvii
xviii Contents

Case #5: Manifestation Type of Great Green Dragon
Decoction 大青龍湯證�� 42
Case #6: Yang Brightness Syndrome in Which Draining Downward
Is Permissible 陽明可下證�� 44
Case #7: Manifestation Type of Yang Brightness [Treated by]
Honey Enema 陽明蜜兌證�� 48
Case #8: Kidney Deficiency and Yang Desertion Manifestation
Type 腎虛陽脫證�� 52
Case #9: Manifestation Type of Blood [xue] Coming Out
of the Navel 臍中出血證�� 56
Case #10: Manifestation Type of Subsiding/Latent Yang Within
the Yin 陰中伏陽證 �� 60
Case #11: Manifestation Type of Violent Death Due
to Cold Damage 傷寒暴死證�� 64
Case #12: Manifestation Type of Not Being Able to Sleep
at Night 夜間不眠證�� 67
Case #13: Manifestation Type of Major Bupleurum
Decoction 大柴胡湯證�� 70
Case #14: Manifestation Type of Urgently Draining Downward
the Yang Brightness [Tract] 陽明急下證�� 74
Case #15: Manifestation Type of Self Resolving/Healing Cold
Damage [Disorder] 傷寒自解證�� 78
Case #16: Manifestation Type of Heat Entering the Blood
Chamber 熱入血室證�� 82
Case #17: Manifestation Type Jerking Sinews and Twitching
Flesh 筋惕肉瞤證�� 86
Contents xix

Case #18: Manifestation Type in Which the Yang Brightness
Tract Must Be Drained Downwards 陽明當下證�� 90
Case #19: Manifestation Type of Cassia Twig Decoction Plus
Kudzu Root 桂枝加葛根湯證 �� 94
Case #20: Manifestation Type of Kudzu Decoction 葛根湯證 �� 95
Case #21: Manifestation Type of Hard Convulsive
Disorder 剛痓證�� 98
Case #22: Manifestation Type of the Attenuated Yin
[Stage/Circulation Tract] 厥陰證�� 101
Case #23: Manifestation Type of Mature Yin
[Stage/Circulation Tract] 太陰證�� 106
Case #24: Manifestation Type of Mature Yang
Sunstroke 太陽中暍證�� 109
Case #25: Manifestation Type of Black or Gray
Fingernails 指甲黑青證�� 111
Case #26: Manifestation Type of Eyes Staring
Forward 瞪目直視證�� 113
Case #27: Manifestation Type of the Tongue Curled Back
and the Scrotum Retracted 舌卷囊縮證�� 115
Case #28: Manifestation Type of Uncontrollably Twisting
Cloth and Groping Bed Cloth 循衣摸床證 �� 117
Case #29: Manifestation Type of Pathogenic [Qi] Entering
the Major Circulation Tracts 邪入大經證 �� 119
Case #30: Manifestation Type of Mature Yang Cassia Twig
[Decoction] 太陽桂枝證 �� 121
xx Contents

Case #31: Manifestation Type of Cassia Twig Decoction 桂枝證�� 128
Case #32: Manifestation Type of the Immature Yin
[Stage/Circulation Tract] 少陰證�� 129
Case #33: Manifestation Type of the Immature Yang
[Stage/Circulation Tract] 少陽證�� 131
Case #34: Manifestation Type of Dual Contraction
[Cold Damage] 兩感證�� 133
Case #35: Manifestation Type of Combining Disorder
of the Three Yang 三陽合病證�� 135
Case #36: Manifestation Type of White Tiger Plus Ginseng
Decoction 白虎加人參湯證�� 137
Case #37: Manifestation Type of Heat Sensations
and Aversion to Cold 發熱惡寒證�� 141
Case #38: Manifestation Type of Chest Bind That Can
Be Drained Downwards 結胸可下證�� 143
Case #39: Manifestation Type of Chest Bind That
Can Be Treated with Moxibustion 結胸可灸證�� 146
Case #40: Manifestation Type of Hiccups Following
Sweating [Treatment] 汗後吃逆證�� 147
Case #41: Manifestation Type of Leaking Wind 漏風證�� 149
Case #42: Manifestation Type of Blood in the Urine 小便出血證 �� 151
Case #43: Manifestation Type of Cold Damage and Swollen
Legs during Pregnancy 妊娠傷寒腳腫證�� 154
Case #44: Manifestation Type of Warm Wind 風溫證�� 158
Contents xxi

Case #45: Fox-Creeper Manifestation Type 狐惑證 �� 162
Case #46: Manifestation Type of Eruption of Yellow Color 發黃證�� 166
Case #47: Manifestation Type of Eruption of Yellow Color
in a Patient with a Tendency Toward Dampness 濕家發黃證�� 167
Case #48: Manifestation Type of Yellow Entering and Clearing
the Way [Dao] 黃入清道證 �� 169
Case #49: Manifestation Type of First Sweating Then Draining
Downward 先汗後下證�� 171
Case #50: Manifestation Type of Blood Stasis in the Mature Yang
[Tract] 太陽瘀血證�� 176
Case #51: Manifestation Type of Yin Disorder with Yang
Pulse 陰病陽脈證�� 179
Case #52: Manifestation Type of Differentiating Immature
Yin and Tense Pulses 辯少陰脈緊證�� 183
Case #53: Manifestation Type of Drawing [Prominent] Blue
Veins 青筋牽引證�� 188
Case #54: Manifestation Type of Purulent Xue [Blood] Draining
Downward 下膿血證�� 191
Case #55: Manifestation Type of Needling the Yang Brightness
[Tract] 刺陽明證�� 193
Case #56: Manifestation Type of Yin-Yang Merging 陰陽交證�� 195
Case #57: Manifestation Type of Yin-yang Exchange 陰陽易證�� 198
Case #58: Manifestation Type of Crossing the Hands over
the Chest 叉手冒心證�� 199
xxii Contents

Case #59: Manifestation Type of Cold Damage with
Deafness 傷寒耳聾證�� 201
Case #60: Manifestation Type of Flailing of Arms
and Legs 揚手躑足證�� 203
Case #61: Manifestation Type of Urinary Incontinence 遺尿證 �� 206
Case #62: Manifestation Type of Slippery Moss on the
Tongue 舌上滑苔證�� 207
Case #63: Manifestation Type of Nosebleed 衄血證�� 209
Case History #64: Manifestation Type of Cold Damage Pain
in the Rib-Sides 傷寒脅痛證�� 211
Case History #65: Manifestation Type of Cold Damage
by Warm Ague 傷寒溫瘧證�� 214
Case History #66: Manifestation Type of Developing
Macules 發斑證 �� 217
Case #67 – Manifestation Type of Visceral Bind 臟結證�� 221
Case #68 – Manifestation Type of Yang Bind 陽結證�� 224
Case #69 – Manifestation Type of Cold Damage
and Complex-Heat Diarrhea 傷寒協熱利證 �� 227
Case #70 – Manifestation Type of Stomach Heat
and Vomiting 胃熱嘔吐證 �� 229
Case #71 – Manifestation Type of Sudden Turmoil Disorder
and Muscle Cramps 霍亂轉筋證�� 231
Case #72 – Manifestation Type of Counter-Flow Cold in the Two
Shins 兩脛逆冷證�� 233
Contents xxiii

Case #73 – Manifestation Type of Relapsing Taxation Following
Sweating 汗後勞復證�� 236
Case #74 – Manifestation Type of Sweating Followed
by Sores 汗後瘡瘍證�� 240
Case #75: Manifestation Type of Dusty Facial Complexion
and Aversion to Cold 面垢惡寒證�� 243
and Diarrhea 傷寒下利證�� 245
with Closed Eyes 傷寒閉目證�� 249
Case History #78: Cold Damage Due to External
Repletion 傷寒表實證 �� 252
Case History #79: Manifestation Type of the Counterflow
Cold in the Arms and Legs 手足逆冷證�� 256
Case #80: Cold Damage Manifestation Type of the Category
of [Alternating] Cold and Heat 寒熱類傷寒證 �� 260
Case History #81: Manifestation Type of Loss of Sweat
and Nosebleed 失汗衄血證�� 264
Case History #82: Manifestation Type of Straitened
Spleen 脾約證�� 268
Case #83: Manifestation Type of Repulsing Yang and Blocking
Yin 格陽關陰證�� 272
Case #84: Manifestation Type of Mature Yang and Yang
Brightness Combination Disorder 太陽陽明合病證�� 275
Case #85: Manifestation Type of Vexation
and Depression 懊怫郁證�� 280
xxiv Contents

Case #86: Manifestation Type of Two Arms Groping
in the Air 兩手撮空證 �� 283
Case #87: Manifestation Type of Ingesting Qi-Ordering Decoction
for Dysentery 下利服承氣湯證�� 287
Case #88: Manifestation Type of Warm Dampness 濕溫證�� 291
Case #89: Manifestation Type of Xue (Blood) Congelation
in the Chest 血結胸證 �� 296
Case # 90: Manifestation Type of Exhaustion of all Six Yang
Circulation Tracts 六陽俱絕證�� 299
Bibliography �� 301
Index�� 315
Part I
Introduction
This introduction will provide the reader with an account of Xu Shuwei’s life, as
well as its historical, cultural, and medical context, details concerning Xu’s writings
and their historical significance, a brief history of medical case histories in China,
and Xu’s contribution to clinical Chinese medicine.
etting the Stage: Demographic, Economic, and Social

S
Changes During the Late Northern Song and Early Southern
Song Dynasties
Xu Shuwei, the author of Ninety Discussions on Cold Damage Disorders, lived dur-
ing an exciting yet turbulent era, characterized on the one hand by rapid changes
and innovations in many aspects of life and on the other hand by geopolitical weak-
ness. It was a watershed period, hence the division of the dynasty into the Northern
Song (960–1127) and the Southern Song (1127–1276). Jacques Gernet, in his mon-
umental history of China, describes the Song dynasty as a time of unprecedented
changes:
There is not a single sector of political, social, or economic life in the eleventh to thirteenth
centuries which does not show evidence of radical change in comparison with earlier ages.
It is not simply a matter of a change in scale (increase in population, general expansion of
production, development of internal and external trade) but of a change of character.
Political habits, society, the relations between classes, the armies, the relations between
town and country, and economic patterns are quite different from what they had been in the
aristocratic, still half-medieval Tang Empire. A new world had been born whose basic char-
acteristics are already those of the China of modern times.1
1
Gernet 1985, p. 300.
© Springer Nature Switzerland AG 2019 3

A. Goldschmidt, Medical Practice in Twelfth-century China – A Translation
of Xu Shuwei’s Ninety Discussions [Cases] on Cold Damage Disorders,
Archimedes 54, https://doi.org/10.1007/978-3-030-06103-6_1
4 Introduction
Dieter Kuhn, in a more recent monograph, devoted to the history of the Song
dynasty, goes even further in his estimation of the Song as transformational:
The tenth-century transition from the late Tang to the early Song empire marks the most
decisive rupture in the history of imperial China. The “old world” of the northern hereditary
aristocratic families, with genealogies going back hundreds of years, finally vanished in the
turmoil and civil wars between 880 and 960, and with their fall the old statecraft was forgot-
ten or lost. A newly emerging class of scholar-officials, trained in Confucian doctrine and
graduated in a competitive civil service examination system, was willing and well-prepared
to take on responsibility for reshaping Chinese tradition. Their political, ideological, philo-
sophical, cultural, literary, artistic, technological, and scientific achievements, combined
with powerful economic forces that reconfigured daily life, have come to define our under-
standing of the Song as a transformative dynasty. Few periods in Chinese history are as
rewarding as this in demonstrating the willingness of the Chinese to restructure and reform
their society as a whole. Some historians have gone so far as to call the Song transformation
a Chinese “renaissance” that heralded the dawn of modernity.2
One of the definitive features of Song China was the sharp increase in population
and its dispersion throughout the territory of the Song Empire. Between the eighth
and twelfth centuries, China’s population nearly doubled. The population early in
the twelfth century stood at over 100 million people, a sharp increase from a peak
of approximately 50 to 60 million around the mid-eighth century.3 During the
Northern Song, the center of China’s population shifted from the north – the tradi-
tional heartland of Chinese civilization – to the South, where, by the end of the
Northern Song period, approximately 65% of the population lived.4 In other words,
by the early twelfth century, the number of Chinese people residing south of the
Yangzi River was probably greater than the total population of the Tang dynasty
(618–907). This southern population was no longer concentrated along the river
basins and the eastern coast, but was widely distributed.
This population shift to the South necessitated a sharp increase in food produc-
tion, mainly of rice, a high-yield southern crop. A trade network emerged to enable
the distribution of food to and from new regions previously not part of the Chinese
economy. The population shift to the South catalyzed many technological innova-
tions in rice agriculture, centered on adapting vast areas to rice cultivation – includ-
ing multiple cropping, introduction of new and especially early-ripening rice, and
expansion of large-scale irrigation. The cycle of expanding rice production and
population growth slowed down during the first half of the thirteenth century and
finally stagnated during the Ming dynasty (1368–1644), when the availability of
uncultivated lands dwindled and technology no longer provided the edge for increas-
ing production.5
2
Kuhn 2009, p. 1.
3
Ho, Ping-ti 1967, pp. 33–53 and Deng 2004. The increase in population resulted from advances
in agriculture technology and the introduction of new strains of rice, the Champa rice imported
from Vietnam being the most prominent one.
4
See Kuhn 2009, pp. 71–75; Elvin 1973, pp. 204–209; Bielenstein 1987; and Hartwell 1982,
pp. 365–442.
5
Needham 1986; Bray 1984, 1986; McDermott and Shiba 2015; and Golas 2015. Elvin (1973)
claims that the Song dynasty was the only period in Chinese history in which there was real per
Setting the Stage: Demographic, Economic, and Social Changes During the Late… 5
The dispersion of China’s population separated the empire’s economic and polit-
ical centers. The capital remained in the North at Kaifeng, on the banks of the
Yellow River, until 1127, and it had to be fed. Consequently, the Southward shift
and the increased production of rice stimulated the establishment of large-scale
long-distance trade, leading, in turn, to the establishment, for the first time in
Chinese history, of large-scale cities as commercial, not political, hubs.6 Smaller
market centers proliferated throughout the countryside. G. W. Skinner has argued
that the unprecedented level of urbanization reached in the Song was most likely not
exceeded until the late nineteenth or early twentieth century.7 The growing network
of cities, countryside markets, and food production centers, enabled secondary
industries, predominantly specialized, to spring up or to grow enormously to serve
the urban and rural markets.
The new ecological niche for China’s population, one that for centuries prior to
the Song had been thought of as an uncultivated wilderness where the local people
lived like wild animals,8 opened a new epidemiological frontier as the increasing
(and increasingly southern) population encountered new pathogens. The upgraded
distribution and market system with its facilitated the transmission of these patho-
gens faster than ever before. Traveling with traders and taking root in the growing
cities, pathogens transformed the previously rather stable epidemiological frontier.
This, in turn, created a renewed interest in an almost forgotten third-century medical
book that focused on southern contagious diseases and especially on epidemics –
the Treatise on Cold Damage and Miscellaneous Disorders (Shanghan zabing lun
傷寒雜病論, better known as the Treatise on Cold Damage Disorders, in short
Treatise) by Zhang Ji 張機 (ca. 150–219 CE, also known as Zhang Zhongjing 張仲
景).
Concurrent with the demographic and economic changes of the Song was the
emergence of one of the most distinctive features of Chinese civilization, the
scholar-official class certified through competitive literary examinations, a merito-
cratic elite unlike that of any other major civilization before the nineteenth century.9
The meritocratic Song elite differed from its Tang-dynasty predecessor in several
regards. The examination system, used only on a small scale in the Sui (589–618)
and Tang (618–907) dynasties, played a central role in fashioning this new elite. The
early Song emperors’ primary concern was to prevent the government from being
dominated by the military men and civil officials of the old aristocratic class, as had
been the case during the Tang. They greatly expanded the civil service examinations
and the government school system to form the major route into the civil service.10
capita growth in the Chinese economy. During the Ming there was great economic growth, but
when the substantial growth in population is factored in, there was not growth per capita.
6
Hartwell 1982, pp. 365–442, Golas 2015, Hymes 2015.
7
Skinner 1977, pp. 3–26.
8
See Ebrey 1993, pp. 109–111. The original is from Fan Xiangyong, Loyang jie lan ji jiaozhu.
9
Hymes 2015.
10
Worthy 1975, especially his Introduction and chap. 1.
6 Introduction
The number of those passing the highest examinations soon averaged four to five
times the number during the Tang dynasty and continued to grow steadily as the
Song dynasty progressed. The material covered in the generalist examinations con-
sisted mostly of the Confucian classics. However, the Song emperors’ desire to
create official meritocratic elite to counterbalance the old military aristocracy kin-
dled a renaissance-like approach to all knowledge, from philosophy to the sciences
and medicine, leading to a revision and rethinking of the classics.
Advances in printing techniques during the Song dynasty, including the small-
scale introduction of movable type, enabled knowledge to spread, as books could be
published in greater quantities. At first, most publications were government-
sponsored reproductions of classical texts. The government, by means of the Bureau
for Revising Medical Books, even printed cheaper small-print editions of some
medical books to further their dissemination and availability to the readers. During
the Southern Song dynasty (1127–1276), we see, for the first time, the emergence of
a true book-publishing industry including private publishers, which sold books on a
great variety of topics, including medicine, agriculture, astronomy, divination, and
geography.11
While Song China experienced an unprecedented level of economic develop-
ment, its relations with its neighbors were fraught, resulting in an internal crisis
regarding to the role of the emperor and the bureaucracy. The period from 1067 to
the fall of the Northern Song in 1127 was one of the most politically and socially
turbulent eras in the history of imperial China. In response to the humiliations
inflicted on the Song by its neighboring northern empires, the Khitan Liao Empire
(907–1125) and the Tangut Xi Xia Empire (1038–1227), and to the enormous sums
the Song had to pay them to keep the peace after the altercations of the 1040s, the
young Emperor Shenzong (r. 1067–1085) appointed a new prime minister, Wang
Anshi 王安石 (1021–1086), to reform the government and the administration.
Wang implemented an economic and social program of reforms titled the “New
Policies.” This program included among other things low-interest government loans
to peasants, new land surveys that reformed the tax system, establishment of gov-
ernment monopolies on various commercial products to regulate prices of goods,
and even training of local militia groups. All these reforms affected every tier of
society including the economy, the military, and the education and civil service
recruitment systems. These reforms also created unrest among officials who saw
them unfit and detrimental to the empire. The outcome was a kind of civil war
within the bureaucracy, as every decade or so one faction took power and purged the
ranks of the civil service, greatly weakening of the government.12
During the early twelfth century, a new player became prominent in the Inner
Asian geopolitical scene – the newly established Jin dynasty (1115–1234), which
conquered Kaifeng and North China in 1127 and captured the entire Song imperial
11
See Goodrich 1963, pp. 36–43; Ji Shaofu 1991; Cherniack 1994, pp. 5–125; Chia 1996,
pp. 10–48; Chia 2002, pp. 65–99; Hilde De Weerdt 2007; Lucille Chia and Hilde De Weerdt 2011;
and Hymes 2015.
12
See Liu 1959, Smith 2009, Levine 2009, and Drechsler 2015.
Medicine During the Northern Song Dynasty 7
family. Only one of the emperor’s sons escaped, and he reestablished the dynasty –
later called the Southern Song – south of the Yangzi River, with its capital in
Hangzhou. The region that suffered the most during these decades of military con-
frontation was the area between the Huai and the Yangzi rivers, which was where
Xu Shuwei lived.
Medicine During the Northern Song Dynasty
The radical transformations of the Song dynasty – in society, in commerce, and in

government – defined the context in which medicine developed during this period.
Medicine at the beginning of the Southern Song dynasty was strikingly different
from what it had been a mere century and a half earlier. A profound shift had
reshaped medical theory, practice, and training. The number of medicinal ingredi-
ents available in the markets increased dramatically, and the number drugs recorded
in materia medica collections (bencao 本草) more than doubled.13 The ingredients,
dosages, and functions of each component of the medicinal formulas on record
changed, as well.14 Probably the most important change was the number and variety
of medical books printed during this time, mostly published by the Song govern-
ment. These included contemporary compilations as well as ancient canons that had
not previously been accessible to a majority of physicians. These changes and many
more transformed the medical environment of physicians and hence medical prac-
tice after the eleventh century.15
Before the Song dynasty, medicine was not considered a worthy occupation for the
scholarly elite, let alone nobles. Physicians, often called “time-saving doctors”
or “hereditary physicians” (shiyi 世醫), were often associated with sorcerers or fortu-
netellers.16 These physicians predominantly studied their trade from an older member
of the family or from a master they served for years or decades before treating patients
independently. We do not know the literacy level of these physicians, although they
were literate to some extent; part of the initiation process was to copy the manuscripts
of their teacher.17 However, the social status of such physicians was generally low.
Sons of the elite almost never showed interest in earning a living by therapy.
13
Okanishi 1974, p. 285 reproduced by Shang Zhijun et al. 1989, p. 219.
14
Miyashita 1976, 1977, 1979, 1980.
15
Goldschmidt 2005, 2009.
16
For discussion concerning the names see case 23 below. Some examples appear in Tang dynasty
sources such as Han Yu’s Shi shuo 師說 (558.5645–6), the New Official History of the Tang
Dynasty (Xin Tang shu, 204:5797), and in Sun Simiao’s Essential Prescriptions Worth a Thousand,
for Urgent Need (Beiji qianjin yao fang備急千金方)in Okanishi 1969, p. 16. For discussions about
the status of physicians during the Song dynasty see Hymes 1987, pp. 9–11, 61–66; Needham et al.
2000, pp. 38–42; Chao Yuan-ling 2000, pp. 66–70; Goldschmidt 2009, pp. 19–20; and Yu Gengzhe
2011.
17
See Sivin 1995a.
8 Introduction
During the Song dynasty, however, for the first time in history, the government
set out to upgrade the status of medicine and to attract members of the literati elite
to become physicians.18 A new cohort of physicians became prominent – ones who,
in addition to practicing medicine, had passed the civil service examinations and
served in a government office. Later writers sometimes refer to these doctors as the
Literati Doctors (ruyi 儒醫).19 During this time, emperors and high-ranking scholar-
officials, including ministers and prime ministers, regularly showed interest in and
practiced medicine, or at the very least collected medical books and materials such
as drugs.20 For example, the official history of the Song records no fewer than five
Northern Song emperors as practicing medicine, collecting medications, or spon-
soring or even authoring medical books.21
This imperial interest in medicine, along with the change in the examination
systems and the declining influence of the aristocratic families, fueled officials’
interest in medicine. Three prime examples are Su Shi (1037–1101), Shen Kuo
(1031–1095), and Fan Zhongyan (989–1052). The medical writings of Su, a high-
ranking official and a leading literary figure, and Shen, his peer in the civil service
and probably the greatest polymath of his time, were combined in a formulary that
became one of the most widely cited texts in Chinese medicine. Fan, who at the
height of his career served as assistant prime minister, established the Imperial
Medical School. According to a story dating to the Southern Song, he consulted an
oracle about his future and learned that he would become neither a prime minister
nor a good physician. He sighed and said, “To be unable to aid the living can hardly
fit the life’s ambition of a magnanimous man!” This led to a saying later attributed
to him: “If you cannot be a good prime minister, at least you can be a good
physician.”22
The Song government initiated numerous projects aimed at promoting medical
education and practice and set up institutions that reshaped and reformed medicine.
In the tenth and eleventh centuries, the government established projects to collect
medical books, to compare surviving editions and correct errors, to revise their con-
tents when needed, to print them, and finally to distribute copies to the localities.
The first such project of collecting and printing medical books took place from the
970s to the 990s, when the government printed mostly formularies and books of
18
Goldschmidt 2009, chaps. 1, 2, and 4.
19
It is important to note that, although this term was coined during the early twelfth century to refer
to doctors who passed the imperial medical examinations, it was not frequently used by Song-
dynasty authors. See also Chen Yuan-ping 1997, pp. 116–127, and Goldschmidt 2009, pp. 56–57.
20
Goldschmidt 2009, chaps. 1, 2, and 4.
21
Records show that Emperors Taizu and Renzong performed acupuncture and moxibustion, and
Emperor Zhenzong prescribed medicine to an official. Records also indicate that Emperors Taizu
and Taizong collected information concerning drugs and formulas from various localities. Lastly,
Emperor Huizong ordered a compilation of the Medical Encyclopedia, and may actually have writ-
ten the Canon of Sagely Benefaction. See Goldschmidt 2006 and 2009 (chapter 1).
22
The original story appears in Neng gaizhai man lu 能改齋漫錄, juan13, pp. 5b–6a. See Sivin
2015, pp. 78–79. It should be noted that this story does not appear in Fan’s collected works. Many
later sources quote this saying (不為良相,則為良醫) with some variations, all attributing it to Fan.
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le persone colte stomacavansi d’un assolutismo non palliato dalla
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Re Vittorio Emanuele, si dicesse pur raggirato dalla moglie, dal
confessore, dal confidente, palesava però intenzioni benevole;
lasciava poc’a poco sottentrare le nuove idee e nuove persone; e
dopo gli odiati Cerutti e Borgarelli, chiamò al ministero il conte
Prospero Balbo, onorato per mente e per liberalità secondo i tempi e
il ceto, che impacciato da tutto l’organamento burocratico, sperò alle
urgenti riforme supplire con palliativi. Secondando la moda, si diè
voce che stava in lavoro una costituzione, e se non veniva agli
effetti, imputavasene l’Austria, la cui vicinanza impacciava
l’indipendenza del regno; l’Austria, potenza preponderante in Italia,
spauracchio universale, su cui i governanti versavano anche le colpe
proprie. Rimedio unico, infallibile a tutti gli abusi acclamavasi la
costituzione: questa al Piemonte attirerebbe l’attenzione e i voti di
chiunque aspira al meglio nazionale, e d’un soffio diroccherebbe
l’Austria, reggentesi solo sul despotismo: gli impazienti
raddoppiavano d’attività nelle combriccole dei Carbonari, degli
Adelfi, de’ Maestri sublimi; e quando scoppiò la rivoluzione di Napoli,
più sorrise il desiderio d’emancipare il Piemonte dalla tutela
austriaca, e metterlo a capo dell’Italia redenta.
Allora le società secrete abbracciarono moltissimi soldati, più
avvocati e professori, e gl’impiegati fin nelle somme magistrature, e
non pochi del clero, e tutti gli studenti; poi propagate nelle provincie
compresero sindaci e parroci, legarono intelligenze colle lombarde e
romagnole. L’antica lealtà savojarda repugnava dalle congiure; l’onor
militare rifuggiva dal calpestare il giuramento di fedeltà; ma si fece
intendere che non trattavasi di ribellarsi al re, bensì di salvarlo dalla
congiura dei preti e dei nobili e dalla servitù, dell’Austria, che si
spargeva volesse obbligare a ricevere guarnigione tedesca, e
concorrere alla spedizione contro di Napoli; anzi, essa pensasse
trarre in un arciduca il Piemonte, a danno di Carlalberto principe di
Savoja Carignano.
Questo giovane rampollo del ramo cadetto reale, educato
popolarmente a Parigi, erasi mescolato d’amicizie, di studj, di
godimenti, d’intelligenze colla gioventù coeva; e poichè de’ quattro
fratelli della Casa regnante nessuno lasciava figliuoli maschi,
trovossi vicino al trono, e fu messo granmastro d’artiglieria. In
quest’arma molti aderivano a’ Carbonari, ed essi gli posero indosso
la febbre di divenire illiberatore d’Italia. Il conte Santorre Santarosa
spingeva a venire ai fatti, mentre sollevata Napoli, incalorite le menti
dalla rivoluzione greca e dalla spagnuola, imbarazzate le Potenze;
Francia commossa parlava di vessillo tricolore, di costituzione del
1791; la Germania, reciso il nervo austriaco, volea rialzare il
liberalismo; Italia esser matura; leverebbesi come un uomo solo per
acquistare la libertà, l’unità, l’indipendenza. Quando poi gli Austriaci
mossero verso Napoli, certo (diceasi) gli eroi popolari terranno testa
lungamente (1821); i monti sono le barriere della libertà, nè i briganti
furono mai domabili: intanto l’insurrezione in Piemonte si compirà
senza ostacoli, Milano seconderà, Romagna e i piccoli Stati non
tarderanno, e tutta l’Italia superiore si troverà costituita prima che
gl’Imperiali tornino a reprimerla; Francia, se anche non favorisse,
non permetterà mai che l’Austria entri armata in paese che confina
con essa.
Si cominciò al solito dalla stampa clandestina, e girò un reclamo, in
cui pretendeasi strappare al re la benda postagli da’ suoi cortigiani,
rivelandogli esausto l’erario, il denaro stillato dalla fronte del popolo
è prodigato a impinguare le più alte e inutili persone dello Stato; gli
uomini a cui è affidata l’economia pubblica sagrificano all’egoismo
personale gl’interessi della patria. — Maestà, se invece di cumulare i
poteri in una classe sola, aveste chiamato il consiglio di tutta la
nazione, i lumi generali avrebbero riparato a questi mali, nè voi
avreste il rimorso d’aver condotto a rovina lo Stato. Il vostro Governo
avversò sempre la dottrina; l’istruzione primaria è abbandonata
all’ignoranza e all’impotenza dei Comuni; l’educazione media è
tiranneggiata dai Gesuiti; gli studj filosofici involti nella ruggine
monacale; i legali, disordinati per mancanza di legislazione;
l’Università condotta da uomini o inetti o stupidi o maligni, gl’ingegni
migliori vanno a cercare un pane altrove, o vivono sprezzati. I favoriti
hanno il monopolio dei diritti e dei privilegi, pesando sulla classe
industriosa della società. Le provincie dai governatori delle divisioni
sono rette come paese di nemici. Le amministrazioni civiche e
comunali cascano in disordine per l’indolenza, l’incapacità, la
discordia dei capi. La religione, in mano dei Gesuiti, è strumento
d’ambiziose voglie e di tenebrosi raggiri. La legislazione civile ha
l’arbitrio per base, la criminale il carnefice per sostegno. Uno strano
ed informe accozzamento di leggi romane, di statuti locali, di
costituzioni patrie, di editti regj, di sentenze senatorie, di
consuetudini municipali, hanno tolto la bilancia alla giustizia, e
lasciata la strada al despotismo dei tribuni. L’esercito non ha forza
morale, perchè composto di elementi contrarj, di corpi privilegiati, di
brigate varie tra loro di dottrine, di lingua, di diritti, comandati da capi
promossi non per merito ma per favore. Dei militari una parte è
avvilita, perchè si vede preclusa la strada ai gradi maggiori; tutti
indignati ai maneggi del vostro Governo, il quale medita di trafficare
la loro vita col gabinetto d’Austria. No: il nome de’ soldati piemontesi
non si confonderà mai col tedesco; essi sono e saranno italiani».
L’11 gennajo 1821 alquanti studenti dell’Università comparvero al
teatro d’Angennes con berretti rossi alla greca. Arrestati, in onta del
privilegio che li sottoponeva al magistrato degli studj, furono messi in
fortezza: i condiscepoli irritati si asserragliano nell’Università, a gran
voce domandando la scarcerazione de’ colleghi: il reggimento
Guardie mandato a calmarli trova resistenza, e fa sangue. Tali
manifestazioni sogliono chiamarci primizie di martiri; e ne rimase una
cupa irritazione. Se n’incaloriva la faccenda delle società secrete;
ma quale costituzione adottare? la francese, la spagnuola, o
l’inglese? perocchè sempre si stava all’imitare, anzichè fondarsi sulle
basi storiche e nazionali. Per risolvere si mandano tre deputati alla
vendita suprema di Parigi, alla quale faceano centro i Liberali di
Spagna, i Radicali d’Inghilterra, gli Eterj di Grecia, i nostri Carbonari;
e vien data la preferenza alla costituzione spagnuola, come scevra
d’elementi aristocratici e tutta popolare. Ma il Governo, istruitone
forse dalla Polizia francese, intercettate le lettere del principe La
Cisterna e del marchese Priero, conobbe partecipi gl’impiegati e i
militari, cioè quelli che doveano opporsi, onde non sapeva o non
poteva impedire. Il conte Moffa di Lisio e il marchese Sanmarzano,
uffiziali sospetti, invitati a partire da Torino, ricusano, e con Giacinto
Collegno, ajutante di Carlalberto, con Santarosa, Morozzo, Ansaldi,
Bianco, Baronis, Asinari ed altri uffiziali prendono concerto di
rivoltare l’esercito, sorprendere Alessandria, acclamare Vittorio re
costituzionale dell’alta Italia.
I cospiratori non si erano intesi co’ Napoletani, onde non fu nè
contemporaneo il sollevarsi, nè uniforme l’intento; poi i preparativi
erano impacciati dal tentennare del principe di Carignano fra la gloria
e la fedeltà. Ma la rivolta scoppia fra i militari a Fossano ed
Alessandria (9 marzo), costituendo una giunta della Federazione
italiana; fra il restante esercito corre il grido d’Italia, di francare
dall’Austria il re, sicchè possa seguire i moti del suo cuore italiano, di
porre il popolo nell’onesta libertà di manifestare i proprj voti al trono,
come i figli a un padre; e scritto sui vessilli, Regno d’Italia,
Indipendenza italiana; e gridando, Viva la costituzione, Morte agli
Alemanni, i sollevati s’accostano a Torino. Quivi gli studenti e
alquanti militari col capitano Ferrero attruppatisi a San Salvario, che
allora giaceva un pezzo fuor di città, gridano la costituzione; altri
uccidono il colonnello Raimondi che li richiama al dovere; ma non
secondati dal popolo, con disastrosa marcia sfilano come vinti verso
Alessandria, il cui comandante fu ucciso [184].
Il re non osa ricorrere alla forza, ma espone lealmente la
dichiarazione fatta dai re a Troppau contro ogni novità, mostrando
come ne resterebbe pericolata l’indipendenza; e non volendo nè
promettere quel che non è disposto a mantenere, nè autorizzare atti
che agli stranieri diano pretesto d’invadere il suo paese, depone una
corona (13 marzo) ch’egli non potea conservare se non colla guerra
civile.
Il Carignano, da lui nominato reggente, esitava a palesare le sue
intenzioni, sicchè schiamazzi, poi armi. Dalla cittadella sorpresa
gl’insorgenti minacciano far fuoco sulla città: molti soldati lasciano le
bandiere, considerandosi come sciolti dal giuramento dato al re;
l’anarchia sottentra; quando il Carignano proclama la costituzione
spagnuola, gli applausi vanno al cielo, e al nome di Carlalberto si
accoppia quello di re d’Italia.
In Lombardia avea preso piede la setta della Federazione italiana, e
da un pezzo tramava nelle sale del marchese Gattinara di
Breme [185] e del conte Federico Confalonieri, mascherata sotto il
velo d’imprese benefiche o progressive, come una distilleria d’aceto
a Lezzeno, un battello a vapore sul lago di Pusiano e sul Po,
l’illuminazione a gas, il mutuo insegnamento, un bazar, il giornale del
Conciliatore, apostolo del romanticismo. L’Austria, avutone fumo,
arrestò Silvio Pellico, giovane saluzzese educatore in casa Porro, la
cui Francesca da Rimini avea fatto sperare all’Italia un secondo
Alfieri. Allo scoppiar della rivoluzione piemontese si rinserrarono le
file in mano del conte Confalonieri, principale nella sciagurata
insurrezione del 1814, poi nei suoi viaggi legatosi co’ primarj liberali,
e che si mise attorno Demester e Arese antichi uffiziali napoleonici,
Giuseppe Pecchio economista, Pietro Borsieri letterato, i marchesi
Giorgio Parravicini e Arconati, Benigno Bossi, i fratelli Ugoni di
Brescia, il cavaliere Pisani di Pavia, il conte Giovanni Arrivabene di
Mantova, l’avvocato Vismara novarese, Castiglia, altri ed altri. Essi
aveano già disposta sulla carta una guardia nazionale, una giunta di
Governo; neppur l’inno mancava, opera d’un sommo poeta; e
appena l’esercito piemontese varcasse il Ticino, insorgerebbero
Milano, Brescia, le valli, le campagne, occupando le casse e le
fortezze di Peschiera e Rôcca d’Anfo.
I Lombardi spedirono al Sanmarzano, generale degli insorgenti
piemontesi, con numerose firme esortandolo a venire. — Cominciate
ad insorgere voi», ci diceano i ministri piemontesi; e noi
rispondevamo: — Da soli non bastiamo a vincere; ma senza noi, voi
non bastate a difendervi». Il vero è che Sanmarzano contava
appena ducento dragoni e trecento fanti; ma poichè coll’audacia
dominansi le rivoluzioni, risolvea ritentar l’impresa, massime che gli
Austriaci, collo sgomento di chi accampa in terra nemica, aveano
ritirato ogni truppa dal Ticino, e il vicerè lasciavasi vedere a incassar
mobili e vendere vasellame. Ma il ministro piemontese Villamarina
disapprovò quella temerità; e il reggente che, come dice il Santarosa
«voleva e non voleva», mandò quel reggimento ad Alessandria. Così
la rapidità degli avvenimenti, la inconcepibile mancanza di concerti,
la titubanza dei capi, la paura che Torino cessasse d’essere capitale
del Regno, elisero il moto della Lombardia, donde sol pochi giovani
corsero in Piemonte ad aggregarsi al battaglione di Minerva.
Binder ambasciatore austriaco, insultato fin nel suo palazzo, parte
lasciando una nota minacciosa. Il duca del Genevese che, per la
rinunzia del fratello, diventava re col nome di Carlo Felice, da
Modena dichiara ribellione ogni attenuamento della piena autorità
reale, e punibile chi non torni all’ubbidienza; ed ordina le truppe si
concentrino a Novara sotto il generale La Torre. Carlalberto, anche
dopo giurata la costituzione, non si era risoluto a convocare i collegi
elettorali, bandir guerra all’Austria, entrare in Lombardia. Udita poi la
dichiarazione del nuovo re, e che questo avea invocato l’Austria,
dicendo minacciata la propria vita, e sè incapace di padroneggiare la
rivoluzione, fugge all’esercito regio a Novara, e di là pubblica che
«altro ambir non saprebbe che di mostrarsi il primo sulla strada
dell’onore, e dar così l’esempio della più rispettosa obbedienza ai
sovrani voleri».
Era il 23 marzo, il giorno stesso d’un altro proclama ventisette anni
dopo.
Quella fuga toglieva agl’insorgenti ogni apparenza di legalità: ma
risoluti di non cedere, creano una giunta provvisoria [186]; sparigliano
proclami e bugie. Intanto ogni cosa va sossopra; la Savoja si
chiarisce pel re; la brigata che porta quel nome, ricusa disertare,
onde fu dovuta rimandare in patria; i carabinieri in arme si recano
all’esercito regio; a Genova il governatore Des Geneys, che
annunziò la defezione di Carlalberto, è assalito, trascinato per le vie,
e a fatica salvato dai generosi che non voleano contaminare con
violenze la rivoluzione; i Liberali medesimi discordano, quali
caldeggiando la Camera unica, quali la duplice, quali unitarj, quali
federalisti. Santarosa, fatto ministro della guerra, cerca destare il
coraggio colle speranze, e collo spargere che gli Austriaci furono
disfatti dai Napoletani, e le valli Bresciane insorsero furibonde; ma
ecco giungere certezza della disfatta degli Abruzzi, e che centomila
Russi sono in mancia; poi addosso ai Liberali muovono i Realisti col
generale La Torre e gli Austriaci col generale Bubna (9 aprile), che in
Lombardia aveva, se non alle trame, partecipato alle speranze de’
Carbonari; presso Novara succede un’affrontata, e la rivoluzione
piemontese è finita.
Carlalberto ricoveratosi a Milano, è dal generale austriaco
beffardamente presentato come re d’Italia: Carlo Felice a Modena lo
tratta come uno scapato, e la lettera di lui getta in viso al suo
scudiere: egli si ritira a Firenze a digerire l’obbrobrio, confessare i
suoi torti e farne scusa, solo appoggiato dall’ambasciatore francese
per rispetto alla legittimità [187].
La società de’ Maestri Sublimi, raffinamento della Massoneria, e che
professava il regicidio, fu dalla Francia trapiantata a Ginevra dal
fiorentino Michelangelo Buonarroti, antico adepto di Babœuf, che
v’istituì un congresso italiano per diffonderne i dogmi nel nostro
paese. Alessandro Adryane, che n’era diacono straordinario, fu
spedito qui per rannodare le rotte fila; ma a Milano lasciossi cogliere
con tutte le carte, le quali diedero a conoscere la trama, senza
bisogno che la rivelasse Carlalberto, come si ciancia. Da nove mesi
era finito il parapiglia di Piemonte quando si cominciarono i processi
contro i Lombardi, parte a Milano, parte a Venezia [188], da una
commissione speciale, alla cui testa il tirolese Salvotti. In quelli
l’imputato si trovava all’arbitrio d’un giudice, senza difensori,
senz’avere sott’occhio le sue e le altrui deposizioni; durava interi
mesi di solitudine nel carcere fra un esame e l’altro; e qualche volta
l’inquirente, fattosi mansueto, gli diceva: — Ecco, ella è interamente
nelle mie mani. Qui non siamo in paese di pubblicità
compromettente. Confessa ella quel che del resto noi sappiamo?
l’imperatore le fa grazia, ella torna a casa sua onorato. Persiste al
niego? sta in me il diffamarla, e spargere che ha tutto rinvesciato,
che tradì i compagni, e così torle quel ch’ella mostra valutare tanto,
la pubblica opinione».
Ad arti di simil genere, piuttosto che a torture fisiche, non tutti
resistettero; vi fu uno che, per generosità di salvare un amico, corse
a denunciare se stesso, poi accortosi dell’errore si finse pazzo, e per
mesi sostenne la straziante simulazione; altri credette scagionarsi
col provare che aveva dissuaso i Piemontesi dall’invadere la
Lombardia; altri ammise di quelle tenui concessioni che conducono
ad altre; tanto che si potè raccogliere onde condannare
Confalonieri [189], Adryane, Castiglia, Parravicini, Tonelli, Borsieri,
Arese e molt’altri a Milano, dove furono esposti sulla gogna il 24
gennajo 1824. E già a Venezia, la vigilia di Natale, giorno di
gratulazioni e feste ecclesiastiche e civili, erasi letta la sentenza di
Pellico, Maroncelli, Solera, Villa, Oroboni, Foresti, Fortini ed altri e,
cosa insolita in quella stagione, l’accompagnarono tuoni e ruggito del
mare sotto un insistente scirocco, onde al domani la città fu invasa
dall’acqua, e tutto il litorale ne patì fin alla Spezia e a Genova.
Furono portati allo Spielberg, ove alcuni soccombettero, quali il
conte Oroboni, il veterano Morelli, il Villa; Maroncelli perdette una
gamba; altri poterono dopo molti anni uscire ancora a narrare i proprj
patimenti [190]. E mentre alcuni li esagerarono, o posero in evidenza
se stessi, o denigrarono altrui, Silvio Pellico li raccontò senza
rancori, senz’arte; e tutto il mondo lesse le sue Prigioni, e la pietà
per quei sofferenti partorì esecrazione a colui che così facea soffrire:
e che pure non avea mai lasciato che l’applicazione dell’estremo
supplizio gli togliesse di esercitare il diritto più prezioso pei re, il
ripiego più nobile pell’uomo, la grazia e la riparazione.
Gioja, Romagnosi, Trechi, Mompiani, Visconti e altri fur on rilasciati
senza condanna [191]. I quali poi restavano in condizione tristissima,
chè, mentre la Polizia perseverava nell’adocchiarli e vessarli, quasi a
giustificarsi dell’averli perseguitati, il pubblico (troppo solito complice
degli oppressori) dubitava di loro perchè non condannati, e
accogliendo le sinistre insinuazioni sparse d’alto luogo, finiva per
temere e odiare quelli ch’erano temuti e odiati dal Governo.
In Piemonte si fecero 92 sentenze di morte, 432 di lunga o perpetua
prigionia [192], ma tutti in contumacia, essendosi lasciato partire chi
volle; il notajo Garelli e il sottotenente Laneri furono messi a morte, e
in effigie La Cisterna, Caraglio, Collegno, Lisio, Morozzo, Regis,
Santarosa; di seicennovantaquattro uffiziali inquisiti, dugenventi
furono destituiti, e così molti impiegati civili.
Anche negli Stati Pontifizj i cospiratori abbondavano: e il Puccini,
direttore della Polizia toscana, scriveva al Corsini plenipotenziario al
congresso di Lubiana: «Nelle Marche e nelle Legazioni sono assai
numerose le sêtte, e grandi mezzi adoprano per diffondere l’odio
contro i Governi monarchici, e sperano nei torbidi d’Italia, comunque
arrivino. L’odio di questi partiti si sfoga colle maniere dei tempi del
duca Valentino. Molte uccisioni vennero commesse negli anni scorsi
sopra ecclesiastici ed impiegati pubblici a Forlì, Ravenna, Faenza;
altre in maggior numero modernamente, certo per odio di parte».
Istantemente aveano chiesto che le truppe sarde si avvicinassero al
confine, ma non ne fu nulla; e quel Governo, ripigliata forza,
cominciò gli arresti; di quattrocento processati, molti, principalmente
per opera del Rusconi legato di Ravenna e del Sanseverino di Forlì,
condannò alla pena capitale, che il papa commutò nella reclusione. Il
granduca non credette necessarj i processi perchè non ebbe paura.
Maria Luigia li lasciò fare, e vi furono involti Ferdinando Maestri e
Jacopo Sanvitali professori; ma commutò le pene in esiglio. A
Modena nel 1817 erasi formata una società della Spilla nera per
rassicurare i Napoleonidi: e al tempo stesso i Massoni, gli Adelfi, le
Chiese dei sublimi maestri perfetti aveano adepti, e s’erano ascritti i
dottori Carlo e Giuseppe Fattori di Reggio, nella cui casa teneansi le
adunanze, il capitano Farioli di Guida, il dottore Pirondi, Prospero
Rezzio e molti ebrei [193]. Tutte le Società aveano statuti proprj, ed
alcune v’univano l’obbligo di farsi vicendevoli correzioni e di non
vagheggiare la moglie dell’amico: comune era quello di uccidere chi
fosse condannato o avesse rivelato il segreto: pagare una certa
somma, manifestare a tutta la società le operazioni del Governo.
Sconfitti su tutti i punti, i Liberali rifuggono in Ispagna a fiancheggiare
una causa che sentiano dover soccombere, ma che era la loro; e a
mostrare, colle generose morti, che non erano colpevoli delle fughe
di Rieti e di Novara. Altri crociaronsi in ajuto della Grecia, dove a
Sfacteria perì il Santarosa, eroe all’antica.
Gli alleati, all’udire l’inaspettato successo, esclamano «doverlo
attribuire non tanto ad uomini che mal comparvero nel giorno della
battaglia, quanto al terrore onde la Provvidenza colpì le ree
coscienze»; e protestando di lor giustizia e disinteresse, annunziano
all’Europa d’aver occupato il Piemonte e Napoli, e nella lora unione
«una sicurezza contro i tentativi de’ perturbatori». Insieme
partecipano ai loro ministri presso le Corti «essere principio e fine di
loro politica il conservare ciò che fu legalmente costituito, contro una
setta che pretende ridurre tutto a una chimerica eguaglianza»;
annunziano altamente che «i cambiamenti utili o necessarj nelle
leggi o nella amministrazione degli Stati, non devono emanare che
dalla libera volontà di quelli che Dio rese responsali del potere [194].
Così essi erigonsi custodi e dispensieri unici della verità, della
giustizia, delle franchigie: e i Liberali ebbero servito agl’interessi
dell’Austria, dandole occasione di estendere l’alta vigilanza e quasi
l’impero su tutta la penisola, da lei sottratta ai tumulti o al progresso.
Poi a Verona (1822) s’adunarono a congresso i re di tutta Europa
colla grandezza loro e cogli avanzi di loro miserie: e i diplomatici più
vantati dichiararono che «resistere alla rivoluzione, prevenire i
disordini, i delitti, le calamità, assodar l’ordine o la pace, dare ai
Governi legittimi gli ajuti che aveano diritto di chiedere, fu l’unico
oggetto degli sforzi dei sovrani; ottenutolo, ritirano i soccorsi che la
sola necessità avea potuto provocare e giustificare, felici di lasciare
ai principi il vegliare alla sicurezza e tranquillità del popolo: e di
togliere al mal talento fin l’ultimo pretesto di cui possa valersi per
ispargere dubbj sull’indipendenza dei sovrani d’Italia». In fatto
l’Austria si persuase a sgombrare il Piemonte e abbreviare
l’occupazione del Napoletano; della Grecia non si ascoltarono
tampoco i deputati, benchè il papa gli avesse accolti ad Ancona e
raccomandati; si convenne dei casi in cui i re si dovrebbero sussidj
reciproci; si stabilì soffocare la rivoluzione anche in Ispagna, e
l’incarico ne fu commesso all’esercito francese, che tra le grida di
Muoja la costituzione, Viva il re assoluto, procedette senza ostacolo
fino a Siviglia. Carlalberto, combattendo al Trocadero, aveva in
faccia ai re lavato la macchia dell’essersi lasciato salutare re
d’Italia [195].
La facile caduta di rivolte militari o di popolari sommosse, fecero
persuasi i re d’essere sicuri, e che niuna reale efficacia possedesse
lo spirito liberale, che amavano confondere col rivoluzionario;
bastasse affrontarlo per vincerlo; e pesarono sull’Italia con una
taciturna oppressione non ricreata da verun lampo di speranza.
CAPITOLO CLXXXIV.
La media Italia. Rivoluzioni del 1830.
Nei Liberali questo momentaneo agitarsi sotto le bajonette de’

padroni lasciò scontentezza, ma non sconforto: e poichè, invece di
studiar le vere cause della ruina, la spiegavano colla plateale
ragione del tradimento, altra lezione non se ne traeva se non
d’esecrare i traditori, e non isperare nei principi.
Tanti profughi ond’erano piene non solo Francia, Inghilterra e
Svizzera, ma Barberia e Turchia, rodendo il pane dell’esiglio
rinnovavano que’ tempi del medioevo quando le trame dei fuorusciti
decideano le sorti della patria, e co’ loro scritti mantenevano
l’irrequietudine, eccitando sdegni che pareano speranze. Giuseppe
Pecchio descrisse i proprj viaggi e la vita di Foscolo e la storia
dell’amministrazione finanziera del regno d’Italia e quella
dell’economia politica nel nostro paese, adulandoci: Giovanni
Arrivabene applicavasi all’economia e alla beneficenza pubblica:
Camillo Ugoni continuava la critica letteraria, come il Salò:
Santarosa ed altri raccontavano la rivoluzione di Piemonte, mentre
Pepe e Carascosa duellavano su quella di Napoli: il capitano Bianco
insegnava la guerra per bande: Giannone ordiva un poema l’Esule: il
conte Alerino Palma sedeva nell’areopago della risorta Grecia, e in
quella lingua scriveva delle viti e del vino: le romanze di Giovanni
Berchet milanese rendevano popolare l’esecrazione contro l’Austria
e contro Carlalberto. I libri che si faceano leggere, erano proscritti o
di proscritto; le opere statistiche del Gioja, le giuridiche del
Romagnosi, le mediche del Rasori, le filologiche del Giordani e del
Foscolo, le storiche del Troya, del Colletta, del Sismondi, le poetiche
del Pellico e del Rossetti, le filosofiche del Borelli, prediligeansi
perchè d’autori perseguitati; voleano vedersi allusioni e condanne
contro l’autorità che le proibiva, e il divieto aguzzava le voglie, e
toglieva il criterio di sceverare il vero dal falso. Così crebbe la
smania del leggere e scrivere, del ragionare e ragionacchiare di
politica e d’economia; e si moltiplicarono i giornali.
Era anche questa un’imitazione di Francia, dove i Carbonari, non
avendo potuto insorgere nel 1821, si erano diretti a preparare
l’opinione sia alla tribuna, sia colle gazzette, lanciandosi in una
politica avventurosa, com’è sempre quella che non ha il riscontro
della realtà, ed esercitando quell’opposizione negativa, ch’è
facilissima perchè ha bisogno solo di collocarsi in un punto di vista
differente da quello del Governo, ed è insufflata dalle passioni
invidiose e malevole. Di là quei giornali arrivavano in Italia: i Governi
che ne capivano la potenza a segno di proibirli, non riuscivano ad
opporvene alcuno, il quale alla savia moderazione che concilia
anzichè irritare unisse la prudente franchezza che fa rispettare la
ragione anche quando contraria, e all’elogio dà valore e dignità col
saper disapprovare. Intanto sui Francesi formavasi quel poco di
spirito pubblico, creando bisogni e affetti che non erano i nostri;
lodando una beneficenza che storpia l’uomo per avere il vanto di
dargli le stampelle; erudendosi a una storia tessuta con luoghi
comuni e paradossi; allucinandosi ad un liberalismo che abbaja
contro ciò che s’ha a distruggere, non ragiona sopra ciò che bisogna
sostituire, e vagheggia una democrazia che sconoscendo le parti più
vitali delle nazioni e degli individui, condanna ad abdicare ogni
valore proprio ed inabissarsi nella così detta opinione pubblica, cioè
volgare.
Quest’indeclinabile imitazione de’ Francesi, della loro scienza
incompleta, della filosofia eclettica, della letteratura improvvisata,
della politica rischiosa fu sempre una delle più funeste endemie
degl’Italiani. Intanto i principi nostri credevano che i mali si
rimediassero col negarli, e se la compressione materiale ristabilì
l’ordine esterno, non si provvide all’interna agitazione, cresciuta anzi
ne’ paesi dove non s’era dianzi sfogata, e dei quali or ci avanza a
parlare.
Il papa era stato rintegrato ne’ suoi possessi, eccetto Avignone e il
contado Venesino che Francia si tenne, e le fortezze di Comacchio e
Ferrara a cavallo del Po, volute dall’Austria ad onta delle proteste
pontifizie.
Roma aveva esultato nel ricuperare il Laocoonte, l’Apollo, la Corte,
le solennità, l’aurifera affluenza dei forestieri. Pio VII, tornando
ingloriato dal martirio, non ricercò alcuno per l’operato durante il
Governo francese o nell’invasione di Murat; anzi il generale
austriaco Stefanini, col fare qualche persecuzione, scemò la
propensione che non piccola v’era per gli Austriaci. Col consiglio del
cardinale Consalvi e del Bartolucci, il papa con motuproprio (1816 6
luglio) sistemò l’amministrazione pubblica in aspetto di legge
generale che tenesse dell’antico senza ripudiare tutto il nuovo,
tenendo all’unità e uniformità collo sbandire quelle amministrazioni
molteplici, e ridurre a un centro le giurisdizioni. Lo Stato fu diviso in
diciannove provincie, oltre la metropoli colla comarca; ogni
delegazione in distretti ch’erano quarantaquattro: questi in
seicenventisei Comuni sotto delegati prelatizj. Le Comunità
regolavansi da un consiglio che deliberava, da una magistratura che
amministrava, scegliendone i membri fra il clero, i possessori, i
letterati, i negozianti, salva la conferma del delegato. Roma ebbe un
senatore e conservatori; e così Bologna.
Ai fidecommessi poteasi rinunziare: abolite le servitù e le riserve;
abolite le giurisdizioni baronali, eccetto quelle del cardinale decano
in Ostia e Velletri, e del maggiordomo papale in Castelgandolfo;
aboliti gli statuti municipali, se non in quanto concerne l’agricoltura.
Si sistemò l’imposta, alleggerendola d’un quarto, e doveasi erigere il
rendiconto annuo, compilare un catasto regolare, un registro di tutto
il debito pubblico fruttante il cinque per cento, con una cassa di
redenzione.
Abolito il codice civile e il criminale francese, le commissioni, i giudizj
privati, si accentravano le giurisdizioni, determinando i tribunali
collegiali e le loro gradazioni, con appelli a Bologna, Macerata e
Roma, e una cassazione detta Segnatura; le cause trattate in
italiano, motivate le sentenze criminali, difeso il reo e confrontato coi
testimonj, abolita ogni guisa di tortura; indipendente l’autorità
giudiziale, responsali i magistrati. Ma regolamenti soggiunti
smentirono i preamboli, nè i codici promessi comparvero mai: i fôri
vescovili impacciavano col trarre a sè ogni lite ove fosse implicato un
ecclesiastico: rinacquero i vecchi tribunali della fabbrica di San
Pietro che conosce di qualunque eredità a suffragio delle anime, e
della congregazione de’ chierici di camera per le cause demaniali: la
Segnatura non giudicava definitivamente, ma rimetteva alla sacra
Rota, la quale cogli opinamenti (del resto opportuni a raggiungere la
verità) poteva eternare le cause, ripetendo l’audiatur invece dello
exequatur.
Alla francese continuarono l’ordinamento delle finanze, le ipoteche, il
bollo, il registro: ma il commercio era incagliato da privative e
protezioni; arbitraria la Polizia, diretta dal governatore di Roma, e
che applicava fino la pena del cavalletto. I soldati raccoglievansi per
ingaggio: privilegio dei chierici la istruzione e la censura, come a soli
prelati la diplomazia, e le supreme magistrature amministrative e
giuridiche, e fino il governo delle armi. Il papa ripristinò le accademie
della Religione cattolica, d’Archeologia, di San Luca; malgrado le
indomabili paure dei re, concesse ospitalità alla famiglia Buonaparte;
rielesse cardinali; colle antiche cerimonie canonizzò molti santi, fra
cui gl’italiani Andrea da Peschiera, Costante da Fabiano, Antonio da
San Germano vercellese, Ranieri da San Sepolcro, Francesco
Caracciolo, e le beate Angela da Desenzano, Caterina da Racconigi,
Giacinta Marescotti, Bartolomea Bagnesi fiorentina.
Alla basilica di San Paolo, fondata da Costantino, arricchita
dagl’imperatori e dai pontefici con quadri, musaici, porte di bronzo,
cimelj, marmi, s’apprese il fuoco accidentalmente, e que’ tesori
d’arte e di devozione e ventiquattro colonne di marmo frigio ne
rimasero distrutte. Parve preludere alla fine del pontefice, il quale
allora appunto cascando in camera, si ruppe l’osso del femore, e
soccombette (1823 20 luglio). Eroe da che la prigionia pose fine alle
sue debolezze, nè gradi nè ricchezze attribuì ai parenti; non
commise crudeltà, ma non impedì le malversazioni; e inetto al
governo, abbandonava il paese più povero, disordinato e bollente di
ire. Gli fu dato successore Annibale Della Genga (28 7bre), col nome
di Leone XII; il quale congedò il Consalvi, che lascerà buon nome fra
i ministri di Stato per lo spirito conciliativo ed opportuna fermezza, e
che poco dopo morendo, i molti donativi diplomatici destinò ad
erigere una statua al pontefice, di cui era stato sostegno.
Leone XII, reputato per moralità non meno che per l’accorgimento
politico mostrato come nunzio in Francia, proseguì le cure pastorali
contro «l’irruente empietà, e contro la meticolosa politica, invasata
dalla paura dei forti ed affettante alterigia coi deboli»; comprò la ricca
biblioteca artistica del Cicognara, che l’imperator d’Austria avea
ricusata; fece da giureconsulti esaminare il motuproprio del suo
predecessore; nominò anche una congregazione di Stato, ma subito
la risolse in mera assemblea consultiva. Parve anzi condiscendere ai
retrivi col lasciar vivere gli arbitrj di ciascun dicastero: vennero estesi
i diritti delle comunità; ma se ne’ consigli entravano tutte le classi,
rimaneva separata la nobiltà, con le primogeniture e fedecommessi,
credendo «influisca al decoro del principato»: volevasi anche
ripristinare le giurisdizioni baronali «come l’unico mezzo di ridonare il
lustro alla nobiltà romana», se il concistoro non si fosse opposto. Le
femmine dotate furono escluse dalla successione; rimessi i giudizj a
singoli, invece de’ collegi; aboliti i tribunali di distretto; introdotto di
nuovo il latino ne’ giudizj, e nelle più grandi Università e nelle cinque
minori; ad ecclesiastici affidato il condurre anche il processo dei laici;
attribuito ai Gesuiti il collegio romano, il museo, e l’osservatorio, con
dodicimila scudi di rendita sul tesoro pontifizio; ripristinato il
Sant’Uffizio; estesi i privilegi della manomorta.
Forza era dunque dar torto al papa di prima o al presente, e
facilmente si dava torto ad entrambi, cioè si perdea la fede
nell’autorità. Commissioni di preti ed uffiziali sgomentarono le
Legazioni, solcate da società segrete, che manifestavansi ad ora ad
ora con assassinj di pretesto politico, e contro avversarj che
denunciavansi per Sanfedisti: e un tentativo d’insurrezione nel 1825
in occasione del giubileo, costò la testa a un Targhini. Il cardinale
Rivarola nella legazione di Ravenna in una sola volta, udito il parere
de’ giudici, condannò (1825) cinquecentotto persone; poi ad un tratto
perdonò a tutte, assegnò pensioni ai loro parenti, e cercò
rappattumare Sanfedisti e Carbonari per via di matrimonj, che
riuscirono come Dio vel dica. Essendosi poi attentato alla vita del
legato, egli istituì una commissione severissima, moltiplicò le spie,
lasciò andare alla forca sette omicidi (1828), che il pubblico
compassionò come vittime politiche. Del resto, allorchè si promise
perdono a chi spontaneo venisse a far dichiarazioni, a centinaja vi
accorsero. Tali erano i governati, tali i governanti.
Leone XII aveva divisato di riformare le regole ed il vestire dei frati,
riducendoli a tre soli Ordini: uno di regolari, poveri, di scienza
discreta e gran cuore, che servissero al popolo sussidiando i parroci
e prestandosi agli spedali. Il secondo, tutto all’educazione e
istruzione della gioventù, e a sostenere gl’interessi della religione e
del buon costume. Il terzo di contemplativi, che salmeggiassero,
predicassero, e cercassero l’evangelica perfezione.
Non mancavano i Barbareschi di molestare le coste; ma peggior
vitupero allo Stato Pontifizio veniva dai briganti. L’antico paese dei
Volsci, fra gli Appennini, le paludi Pontine e i monti d’Albano e
Tuscolo, fino al 1809 appartenne alla famiglia Colonna, che all’armi
addestrava quelle popolazioni per ajutarsene nelle sue emulazioni
cogli Orsini e coi papi. E i papi non vi poteano nulla; se non che, alle
persone probe dando un brevetto di cherico, le sottraevano alla
giurisdizione territoriale. I Francesi abbatterono questa feudalità; ma
gli eccessi della coscrizione del 1813 tornarono in armi la
popolazione, e bande di politici vi si formarono in opposizione di re
Gioachino. Sotto il debole Governo sottentrato crebbero di baldanza:
obbedienti a capi quali De Cesaris e Gasparone nelle provincie
romane, Furia e Vandarelli nelle napoletane confinanti, e carichi
d’armi e di reliquie, a torme fin di cento scorrazzavano la campagna
spopolata, e rendeano pericolosissimo il tragitto da Roma al
Napoletano; assalirono e taglieggiarono un collegio alle porte di
Terracina, i Camaldolesi presso Tuscolo; molte famiglie ridussero sul
lastrico; guastarono i commerci, l’agricoltura, la pastorizia. Chi
avrebbe osato negare ricovero e vitto a questi formidabili? Assai
volte il Governo dovette scendere a patto con essi, pure beato
quando qualcuno tornasse a penitenza, e venisse a sospendere a
una Madonna il coltello insanguinato. Il Consalvi, fisso di sterminarli,
s’accontò col Governo napoletano acciocchè non li ricoverasse nel
suo territorio, arse le capanne e i villaggi ove annidavano, e potè
consacrare una festa a commemorazione d’averli distrutti. Ma non lo
erano così, che molto non restasse a fare. Leone XII spedì il
cardinale Pallotti legato a latere con un editto, ove, cessata ogni
misericordia o transazione, intimavasi morte immediata ai briganti
côlti; pena cinquecento scudi ai Comuni ove succedesse un loro
latroneccio. Di fatto si trovarono ridotti aventi, che a Sonnino
capitolarono: ed essi furono mandati nelle fortezze, il paese distrutto.
Lo Stato romano si estendeva fra il 41 e il 45º parallelo per
centrentadue miglia da Ancona a Civitavecchia e ducenquaranta dal
Po a Terracina, con due milioni e settecensettantaduemila abitanti, e
con fama di sterilità a terreni calcari e vulcanici, che sarebbero
ubertosissimi. Il pendìo dell’Appennino che scende al Mediterreneo
presenta vaste pianure, esercitate colla coltivazione grande; verso
l’Adriatico le varietà della piccola trovansi nelle Legazioni, nelle
Marche, nelle valli dell’Appennino. Le Legazioni partecipano della
fertilità della Lombardia; e una popolazione intelligente e laboriosa
prospera la coltura della seta, del frumento, del riso, del vino, della
canapa. Altrettanta è la fecondità delle Marche, ma i possessori
meno ricchi s’accontentano delle produzioni meno costose, quali il
vino e la seta: il colono è a mezzerìa, non affittajuolo. Lo Stato
guadagna assai dalle saline di Cervia e di Comacchio.
L’inameno Appennino verso settentrione vestesi di foreste; ma di
sotto di Roma restò ignudo, dacchè Sisto V le fece distruggere per
togliere il nido ai masnadieri: da quelle che sopravanzano verso il
lago di Bolsena e le fonti del Tevere si taglia eccellente legname
anche da navi. Le valli interposte si lavorano a piccola coltura, e
bellissime quelle della Nera e del Velino: la scabra dell’Anio è atta
appena all’ulivo: verso il Napoletano si allargano i piani di Sacco. Le
rive del Tevere mostrano la piccola coltivazione fino al monte
Soratte, ove comincia l’Agro romano, vastità di ducencinquantamila
ettari ubertosissimi, ma che accumulati in possessioni non minori di
trecento ettari, e fino di cinquecentomila, spesso con una sola casa
rustica, la più parte rimane soda, o soltanto lavorata a lunghissimi
intervalli.
Nel medioevo le famiglie romane viveano alla campagna e de’
prodotti di questa, e se le guerre private vi recavano guasti,
adoperavasi però ogni cura a farle fruttare come unica ricchezza.
Quando i papi cominciarono a impinguare i nipoti, questi comprarono
i beni de’ piccoli proprietarj, che volentieri li cambiavano contro
luoghi di monte, oggi diremo azioni di banca, molto fruttuosi. Nel
1470 Sisto IV permise a qualunque avventiccio di seminare per
proprio conto un terzo del terreno che fosse rimasto sodo: tale idea
avevasi allora della proprietà! Sisto V nel 1585 con un milione di
scudi stabilì una cassa di credito agricola a favore de’ proprietarj
dell’Agro romano; ma ben poco vantaggiò. Intanto i Borghesi vi
comprarono da ottantamila terre, e Paolo V le decretava immuni da
confisca: i Barberini altrettanto, impiegandovi, si disse, cento milioni
di scudi. Così sparve la proprietà suddivisa, e molte famiglie di
Parma, Firenze, Urbino lasciavano le proprie terre per venire a
Roma a goder le rendite dei Monti; ma non tardarono ad accorgersi
d’aver ceduto il certo per l’incerto. Alessandro VII cominciò le
riduzioni d’interessi: onde il credito ebbe una scossa tanto maggiore
perchè la cosa era inusata, i capitali si ascosero o sparvero, e così la
terra appartenne a proprietarj cui mancavano i capitali da utilizzarla.
Scemata la produzione, si dovette assicurare il vivere alle
popolazioni col proibire l’asportazione; laonde l’agricoltura si
restrinse a produrre soltanto quant’era necessario per l’interno.
Oggimai quell’ampiezza era posseduta da centredici famiglie e
sessantaquattro congregazioni: i Borghesi davano a fitto
ventiduemila ettare, i Chigi cinquemila seicento, i Cesarini Sforza
undicimila, e così via, cavandone da otto a diciotto franchi l’ettare: e i
grandi fittajuoli sopperivano alle spese cui non basterebbero i
proprietarj. Nella stagione che l’aria è men micidiale, si fa ressa ad
ottenere le ricchezze del suolo; centinaja d’aratri, a quattro, a sei, a
otto paja di bufali di fronte lo solcano; quella che credevi una
sodaglia incolta, in pochi giorni trovasi arata e sementata; poi si
dimentica fino all’ora della messe, quando un nugolo di montanari
scende alla mietitura; e dove parea un mare di biade ondeggianti, in
pochi giorni non rimane spiga in piede, e sottentra aspetto di
deserto. La gente degli Abruzzi, compiuta l’opera, riporta a’ suoi
monti pochi denari e le febbri. Il resto si abbandona alla pastorizia
che frutta senza spese nè pericolo, ed offre un cibo sano e nutritivo
alla città: ma neppur le mandre si pensa a moltiplicare, o introdurvi
migliori specie di montoni e di cavalli, in modo da farne lontane
asportazioni. Un pastore sceso dalla montagna, a cavallo addirizza i
numerosissimi armenti, trafiggendo con un lancione il puledro o la
bufala che scompigli il branco; e pochi bastano a migliaja d’animali.
Di cui in tutto lo Stato contansi oggi quattro milioni ducentomila capi,
dove seicentosessantatremila sono bovini, quindicimila muli ed asini,
due milioni e mezzo di pecore, trecentoventimila capre,
settecentomila majali. Ecco perchè delle 4,166,297 ettare dello Stato
Pontifizio, 1,046,861 tengonsi a prati.
Le alture d’Albano che fanno cornice all’Agro romano, nutrono una
popolazione robusta, e d’uva e frutti provvedono la capitale: ma
neppur qui abbastanza si cerca migliorare le produzioni, e il vino e
l’olio.
Di là da Velletri cominciano le paludi Pontine su quarantadue
chilometri di lunghezza per diciotto di larghezza. Pio VI vi sanò
ottomila ettare, che furono distribuite in enfiteusi coll’obbligo di
coltivarle e mantenere i canali secondarj, ma non che adoprarvi tutta
la cura, è assai se s’adempiono i contratti. Principali concessionarj
sono le famiglie Massimo, Fiano, Gaetani, e la fabbrica di San
Pietro, alla quale appartiene il Campo Morto di ottomila cinquecento
ettare, dove, fra gli altri allettativi per attirar gente, i malfattori sono
tenuti immuni dalla giustizia purchè subiscano la disciplina
prescrittavi. Quel podere alla semenza di mille ettolitri di frumento e
quattrocentoventi d’altre granaglie risponde l’annuo ricolto di
quindicimila trecento ettolitri; quattrocento giornalieri lavorando alla

Medical Practice in Twelfth Century China A Translation of Xu Shuwei S Ninety Discussions Cases On Cold Damage Disorders Asaf Goldschmidt

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Medical Practice in Twelfth Century China A Translation of Xu Shuwei S Ninety Discussions Cases On Cold Damage Disorders Asaf Goldschmidt

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Medical Practice in Twelfth century

China A Translation of Xu Shuwei s

Dialogues on the Theory and Practice of Literary

Clinical Cases in Disorders of Melanocytes Sunil

Modern Selfhood in Translation A Study of Progressive

Long Cases in Clinical Medicine Concerned With Long

Emery and Rimoin s Principles and Practice of Medical

Pleural Diseases: Clinical Cases and Real-World

The Book of Cold Cases 1st Edition St James Simone

A Carnival of Losses Notes Nearing Ninety Donald Hall

ASSOCIATE EDITORS FOR MATHEMATICS AND PHYSICAL SCIENCES

ASSOCIATE EDITORS FOR BIOLOGICAL SCIENCES

ADVISORY BOARD FOR MATHEMATICS, PHYSICAL SCIENCES AND TECHNOLOGY

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nology based predominantly, but not exclusively, on qi 氣, yin-yang, and Five

This translation of Xu Shuwei’s Ninety Discussions8 on Cold Damage Disorders

Zhuangzi challenges written records of ancient sages as a means of transmitting the

Tel Aviv, Israel Asaf Goldschmidt

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Part II Translation of Cases

 etting the Stage: Demographic, Economic, and Social

© Springer Nature Switzerland AG 2019 3

Medicine During the Northern Song Dynasty

The radical transformations of the Song dynasty – in society, in commerce, and in

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