识以用药。世人不知。而过听之。其夭害生灵也。不可胜计。世之腐儒。率其浅见以着书。世人不察。而误用
之。其夭害生灵也。又不可胜计。夫使儿童夭折。弗遂长年。登非举世之大患。而仁者之深忧乎。先大人专心理
学。而旁通于医。予少时尝闻其训。曰。事亲者不可不知医。慈幼者不可不知医。于是每乘暇日。博览方书。精
察病情。而于活幼治痘。尤精心焉。盖因其术之独难也。是以用心独苦也。阅历之多。精思之久。天启其衷。豁
然深悟其妙理。每用之家族。用之姻友。随试辄效。有可自信者。不惟庸医腐儒之浅陋。得以洞察其弊而救正之。
凡前哲之方论。皆得参酌裁决。无有能出吾范围者。于是写吾心之所独悟。而发前人之所未发。取其长。弃其短。
矫其偏。救其失。其辨证也简而明。其立方也精而切。着为一编。命之曰活幼心法。谓以吾之心悟为后法。而可
以回生起死也。又附问辨医案于其后。以志吾言之非无惩。吾法之果可用也。嗟乎。一书成名。君子所耻。而况
于技乎。予岂以此自表见乎。然而始之苦心于此。聊以自为。不虞其技之精妙。一至于此。可以救生灵之夭折也。
是以不忍自私。而必以公之天下后世也。江右清江聂尚恒识。
朱纯嘏曰。清江久吾聂氏名尚恒。生于隆庆末年。万历
年间以乡进士。出知福建汀州府宁化县事。卓有政声。惜当时以儒臣显。不列名于医林。故其姓字。不传于今世
岐黄之口。即着有活幼心法一书。亦不传于今世岐黄之家。要知天地气化生聂氏于豫章之清江。非为此一隅之幼
儿女起见。将令普天之下。后世之人。提撕警觉。救斯世之赤子。而令安全于襁褓中也。今独知久吾聂氏集痘疹
之大成。开幼科之法眼。议论精辩证确。用药当不偏于寒凉。亦不偏于温补。深得中和之理。合宜之用。无过不
及之差。嘏生也晚。不获亲炙门墙。恭承面谕。幸得活幼心法而熟读之。沈潜玩味。裘葛三更。一旦恍然。若有
心领神会。顿将前此之旧闻。洗涤净尽。心胸之茅塞。剪锄豁开。又恐天下之大。万方之众。不能周知。岁久年
深。终成湮没。今特表而出之。凡业幼科者。必当熟读活幼心法。反复究竟。自然得心应手乎。（疡医大全引痘
疹定论）
〔亡名氏痘疹慈幼津筏〕二卷 存
〔朱氏（一麟）治痘大成集〕四卷 存
小引曰。余闵家少多未度此关。故读书外。偶习此业。以为救度。浪得其名。不能谢郡邑之车骑。昔年已写蘧
庐游戏二编。识浅见俚。有论无方。宜高明吐之耳。二十余年。何长安射覆。不遇而归。乃坐岩洞内。觇涉黄岐
灵素。及华扁张成以下。昭代名公蠹简残篇。忽栩栩觉。而于痘事。十千百中一二。聊寓言为大成集。顾瞻旧业。
又若爽然失矣。然而都非余心也。漆园则任呼牛呼马。余则任呼儒呼书。朱一麟应我识。
〔徐氏（君盛）鳌头活幼小儿痘疹全书〕五卷 存
〔胡氏（阙名）痘疹〕医藏目录一卷 未见
〔 章懒文子痘疹玉髓〕医藏目录一卷 未见
〔 谷痘疹〕医藏目录一卷 未见
〔汪氏（阙名）痘疹〕医藏目录卷阙 未见
〔汪氏（秋鹤）痘疹）医藏目录卷阙 未见
〔亡名氏余毒治法条例〕医藏目录一卷 未见
〔痘疹正觉草〕医藏目录一卷 未见
〔倪氏（有美）痘疹解疑〕医藏目录卷阙 未见
〔九江宋氏（阙名）痘科异治〕医藏目录一卷 未见
〔赵氏（承易）痧痘集〕未见
按上见于嘉定县志。
〔高氏（士）痘疹论〕未见
〔沈氏（好问）痘疹启微〕未见
按上二种。见于浙江通志。
钱塘县志曰。沈好问。字裕生。少孤力学。世业小儿医。至好问益精。视小儿病。必洞见脏腑。尤善治痘证。
沈勤云义女年十岁。幼子痘。女抱儿出诊。好问曰。儿无伤。女出恶痘矣。若呼头及骨痛。宜服粪清。如其言而
愈。闵家女阿观年八岁。出痘甚恶。好问曰。诸医云何。对曰。死证不必药矣。好问曰。儿一身死痘。然有一生
痘尚可生。令取五年抱雏母鸡。用药入鸡腹。外以糯蒸鸡。令食尽。视之右手寸关脉痘二粒。明艳如珠。女果生。
江鲁陶子一岁。痘止三颗。见额上耳后唇傍。好问曰。儿痘部心肾脾三经。逆传土克水。水克火。宜攻不宜补。
攻则毒散。补则脏腑相戕。治至十四日。痘明润将成矣。好问曰。以石膏治之。恐胃土伤肾水。俗医怜儿小。谬
投以参。好问见之惊曰。服参耶。不能过二十一日矣。儿卒死。许季明幼子痘。好问曰。顺证
也。不必补。小儿纯阳。阳盛必克阴。许不从。痘愈。讥好问为妄。好问曰。儿且死。许益不悦。至十二日。儿
熟睡。视之绝矣。好问为杭小儿医。所全活甚众。
〔万氏（邦孚）痘疹方论〕五卷 未见
〔黄氏（一麟）痘疹遗书〕未见
〔赵氏（贞观）痘疹论〕未见
〔顾氏（行）治 全书〕二卷 未见
按上四种。见于浙江通志。
〔冯氏（国镇）痘疹规要〕未见
按上见于河南府志。
〔黄氏（良佑）麻痘秘法〕未见
〔吴氏（邦宁）痘疹心法〕未见
按上见于休宁县志。
〔许氏（学文）痘疹约言〕未见
按上见于合肥县志。
聂尚恒认识到用药的重要性。世人对此不了解，却轻易听信他人，导致无数生灵夭折受害，数量不可胜数。世间的迂腐儒生，往往凭借浅薄的见识撰写医书，世人不加考察而误用这些书籍，致使生灵夭折受害，其数量又不可胜数。让儿童夭折、不能长寿，这难道不是举世的大患，以及仁人君子深深的忧虑吗？
我的父亲专心研究理学，并旁通医学。我年少时曾听到他的教诲说：“侍奉父母的人不能不懂医，慈爱幼儿的人不能不懂医。”因此，我每逢闲暇之日，便博览方书，精心察辨病情，而在救治幼儿和治疗痘疹方面，尤为用心。大概是因为这项医术特别难以掌握，所以我用心最为刻苦。经过大量的临床阅历和长久的精思，上天启发我的心智，让我豁然开朗，深刻领悟其中的奥妙。我将此法应用于家族成员和姻亲朋友，每次尝试都立即见效，这让我有了自信。这不仅让我能够洞察庸医和腐儒的浅陋弊端并加以纠正，而且对于前人的方论，我也能参酌裁决，没有谁能超出我的范围。于是，我写下心中独自领悟的内容，阐发前人未曾发表的观点，取其长处，弃其短处，矫正偏颇，补救失误。我的辨证简明清晰，立方精准切中病机。将这些内容汇编成一册，命名为《活幼心法》，意为以我的心悟作为后世的法则，从而可以起死回生。又在书后附上问答辨析和医案，以表明我的话并非无凭无据，我的方法确实可用。唉！靠一本书成名，是君子所羞耻的，何况是依靠技艺呢？我难道是想以此自我炫耀吗？然而，起初我在此处苦心钻研，只是为了自娱，没想到技艺竟精妙到这种地步，足以拯救生灵免于夭折。因此，我不忍心私自占有，而一定要将其公之于天下后世。江右清江聂尚恒记述。
朱纯嘏评论道：清江人久吾聂氏名尚恒，生于隆庆末年，万历年间以乡进士的身份出任福建汀州府宁化县知县，政绩卓著，声誉很好。可惜当时他以儒臣身份显赫，未列入医林名录，所以他的姓名未能流传于当今中医界。即使他著有《活幼心法》一书，也未能在当今中医家中流传。要知道，天地气化在豫章清江孕育了聂氏，并非仅仅为了这一隅地方的幼儿着想，而是为了让普天之下、后世之人提起警觉，拯救世间婴儿，让他们在襁褓中平安成长。如今人们只知道久吾聂氏集痘疹之大成，开启儿科的法眼，议论精辟，辨证准确，用药既不偏于寒凉，也不偏于温补，深得中和之理，使用得当，没有过与不及的偏差。我出生较晚，未能亲自拜入门墙接受当面教诲，有幸得到《活幼心法》并熟读它。我潜心玩味，无论冬夏（裘葛代指冬夏衣物，此处指日夜研读），三更时分仍沉浸其中，忽然有一天恍然醒悟，仿佛心领神会，将此前所有的旧闻洗涤干净，心胸中的茅塞被剪锄豁开。我又担心天下广大，万方众多，不能普遍知晓，岁月长久，终将湮没无闻。现在特意表彰并刊印此书，凡是从事儿科者，必定应当熟读《活幼心法》，反复探究到底，自然就能得心应手。（引自《疡医大全》所引《痘疹定论》）
〔无名氏《痘疹慈幼津筏》〕二卷 存世
〔朱一麟《治痘大成集》〕四卷 存世
小引曰：我怜悯家中晚辈多未度过痘疹这一关，所以在读书之外，偶尔研习这门技艺，以为救人渡难。但这只是浪得虚名，并不能谢绝郡邑官员的车马拜访（意指不愿以此谋取名利）。昔年我已写过《蘧庐游戏》两编，见识浅陋鄙俗，只有理论没有方剂，应该被高明之士摒弃。二十多年来，我在长安像猜谜一样到处碰壁，不得而归。于是坐在岩洞内，深入研读黄帝岐伯的《灵枢》、《素问》，以及华佗、扁鹊、张仲景等历代名医的残篇断简。忽然间觉得生动有趣，对痘疹之事，十千百中能有百分之一的把握。姑且借此写成《大成集》。回顾旧业，又若有所失。然而这些都非我心之所向。庄子（漆园吏）任人呼牛呼马，我则任人呼儒呼书。朱一麟顺应我的识见。
〔徐君盛《鳌头活幼小儿痘疹全书》〕五卷 存世
〔胡氏（无名）《痘疹》〕医藏目录一卷 未见
〔章懒文子《痘疹玉髓》〕医藏目录一卷 未见
〔谷氏《痘疹》〕医藏目录一卷 未见
〔汪氏（无名）《痘疹》〕医藏目录卷阙 未见
〔汪秋鹤《痘疹》〕医藏目录卷阙 未见
〔无名氏《余毒治法条例》〕医藏目录一卷 未见
〔《痘疹正觉草》〕医藏目录一卷 未见
〔倪有美《痘疹解疑》〕医藏目录卷阙 未见
〔九江宋氏（无名）《痘科异治》〕医藏目录一卷 未见
〔赵承易《痧痘集》〕未见
以上见于《嘉定县志》。
以上两种见于《浙江通志》。
《钱塘县志》记载：沈好问，字裕生，少年丧父，勤奋学习，世代从事小儿医，到了沈好问更加精通。诊治小儿疾病，必能洞见脏腑情况，尤其擅长治疗痘证。
沈勤云的义女十岁，她的幼子出痘，女儿抱着孩子出来求诊。沈好问说：“孩子没有受伤，是女孩出了恶痘。”如果呼叫头部及骨头痛，适宜服用粪清（人尿或猪尿等，此处特指人中白或类似物，古籍中常指人中黄或清液，视具体语境，此处直译粪清/尿清）。照他的话做，果然痊愈。
闵家的女儿阿观八岁，出痘非常严重。沈好问问：“其他医生怎么说？”回答说：“这是死证，不必用药了。”沈好问说：“孩子全身都是死痘，但还有一颗活痘，还可以救活。”命令取五年抱雏的母鸡，将药放入鸡腹，外面用糯米蒸鸡，让孩子吃尽鸡肉。观察发现，女孩的右手寸关脉出现两粒痘疹，明亮鲜艳如珍珠，女孩果然存活。
江鲁陶的儿子一岁，只出了三颗痘，出现在额头、耳后、嘴唇旁边。沈好问说：“孩子的痘分布在心、肾、脾三经，属于逆传，土克水，水克火，适宜攻伐而不适宜补益。攻伐则毒散，补益则脏腑相互伤害。”治疗到第十四天，痘疹明润将要结痂。沈好问说：“如果用石膏治疗，恐怕会伤胃土、损肾水。世俗医生怜惜孩子小，错误地投以人参。”沈好问看到后惊讶地说：“服用人参了吗？不能超过二十一天了。”孩子最终死亡。
许季明的幼子出痘，沈好问说：“这是顺证，不必补益。小儿纯阳，阳气盛必然克制阴气。”许季明不听从，痘疹痊愈后，讥笑沈好问胡说。沈好问说：“孩子快要死了。”许季明更加不高兴。到了第十二天，孩子熟睡，查看已经断气。
沈好问是杭州的小儿医，保全活命的人很多。
〔万邦孚《痘疹方论》〕五卷 未见
〔黄一麟《痘疹遗书》〕未见
〔赵贞观《痘疹论》〕未见
〔顾行《治痘全书》〕二卷 未见
以上四种见于《浙江通志》。
以上见于《河南府志》。
以上见于《休宁县志》。
以上见于《合肥县志》。
Nie Shangheng recognized the importance of medication. The common people, unaware of this, easily listened to others, resulting in an uncountable number of lives being lost or harmed. Pedantic scholars of the world, relying on their shallow insights to write medical books, led the public to misuse them without scrutiny, causing another uncountable number of casualties. Is it not a major calamity for the world and a deep concern for benevolent people that children die prematurely and fail to reach old age?
My father devoted himself to Neo-Confucian studies (Lixue) while also gaining proficiency in medicine. In my youth, I heard his instruction: "One who serves parents must know medicine; one who shows compassion to children must know medicine." Therefore, during every spare day, I extensively read medical formularies and carefully examined pathological conditions, paying particular attention to pediatric care and smallpox treatment. This was likely because the art was uniquely difficult, requiring my utmost effort. Through extensive clinical experience and prolonged profound thinking, heaven inspired my mind, leading to a sudden and deep comprehension of its subtle principles. When applied to family members and relatives, each attempt yielded immediate results, giving me confidence. This allowed me not only to discern and correct the shortcomings of quacks and pedants but also to evaluate and adjudicate the formulas and theories of past sages, finding none that exceeded my scope. Thus, I recorded my unique insights and expounded upon points previously unexpressed by predecessors, adopting strengths, discarding weaknesses, correcting biases, and remedying errors. My syndrome differentiation was simple and clear; my formula construction was precise and pertinent. Compiling these into a volume, I named it *Huoyou Xinfa* (Heart Method for Preserving Children), implying that my mental comprehension could serve as a standard for posterity, capable of reviving the dead. I appended questions, answers, and medical cases to demonstrate that my words were not baseless and my methods were indeed effective. Alas! Achieving fame through a single book is something gentlemen should be ashamed of, let alone relying on technical skills. Did I intend to display myself thereby? However, my initial painstaking study was merely for self-cultivation; I did not anticipate that my skill would become so exquisite as to save lives from premature death. Therefore, I could not bear to keep it private and resolved to make it public to the world and future generations. Recorded by Nie Shangheng of Qingjiang, Jiangyou.
Zhu Chonggu commented: Nie Shangheng, courtesy name Jiuwu, was from Qingjiang. He was born at the end of the Longqing era and served as the Magistrate of Ninghua County, Tingzhou Prefecture, Fujian Province, during the Wanli era as a Xiangjin (provincial graduate). He had an outstanding political reputation. Regrettably, he was prominent as a Confucian official at the time and was not listed among medical professionals, so his name did not pass down to contemporary practitioners of Qi-Huang (traditional Chinese medicine). Even his work *Huoyou Xinfa* has not circulated among modern TCM circles. It must be understood that the cosmic qi generated Nie in Qingjiang, Yuzhang, not merely for the infants of that corner, but to awaken all under heaven and future generations to save the infants of this world, ensuring their safety in infancy. Today, people only know that Jiuwu Nie synthesized the knowledge of smallpox and opened the eye of pediatric methodology. His discussions were refined, and his syndrome differentiation accurate. His medication was neither biased towards cold-cooling nor towards warming-tonifying, deeply grasping the principle of harmony and appropriateness, avoiding excess and deficiency. I was born late and could not personally receive instruction at his door. Fortunately, I obtained and studied *Huoyou Xinfa*. Immersing myself in its meaning, reading day and night regardless of season, suddenly one day I felt enlightened, as if understanding intuitively. All previous hearsay was washed away, and the blockage in my mind was cleared. Fearing that the vast world and numerous people might not know of it, and that it might eventually be lost to time, I have specially highlighted and published it. All those practicing pediatrics must diligently study *Huoyou Xinfa*, exploring it thoroughly, so that they may naturally achieve mastery. (Quoted from *Yangyi Daquan* citing *Douzhen Dinglun*)
*[Wuming Shi Douzhen Ciyou Jinfa]* (Anonymous: *The Ferry of Compassion for Children in Smallpox*), 2 volumes. Extant.
*[Zhu Shi (Yilin) Zhidou Dacheng Ji]* (Zhu Yilin: *Great Collection for Treating Smallpox*), 4 volumes. Extant.
Preface: I pitied that many young people in my family failed to survive the hurdle of smallpox. Therefore, besides studying books, I occasionally practiced this profession to save lives. However, I gained only a false reputation and could not decline the visits of local officials. Years ago, I wrote two volumes of *Qulu Youxi* (Playthings in a Temporary Hut), which contained shallow views and vulgar language, offering theory but no formulas, suitable only to be discarded by the learned. For over twenty years, I wandered in Chang'an like guessing hidden objects, meeting with failure and returning home. So, I sat in a cave, delving into the *Lingshu* and *Suwen* of Huangdi and Qibo, as well as fragmented texts of Hua Tuo, Bian Que, Zhang Zhongjing, and other famous doctors of the enlightened age. Suddenly, I felt vividly awakened, gaining a fraction of understanding regarding smallpox matters. I casually composed the *Dacheng Ji* (Great Collection). Looking back at my old pursuits, I felt a sense of loss. Yet, none of this was truly my heart's desire. Zhuangzi (the Lacquer Garden Official) allowed others to call him ox or horse; I allow others to call me Confucian or scholar. Zhu Yilin accommodates my insight.
*[Xu Shi (Junsheng) Aotou Huoyou Xia'er Douzhen Quanshu]* (Xu Junsheng: *Complete Book of Aotou Pediatric Smallpox*), 5 volumes. Extant.
*[Hu Shi (Wuming) Douzhen]* (Hu Family [Anonymous]: *Smallpox*), Medical Treasury Catalog, 1 volume. Not seen.
*[Zhang Lanwenzi Douzhen Yusu]* (Zhang Lanwenzi: *Jade Marrow of Smallpox*), Medical Treasury Catalog, 1 volume. Not seen.
*[Gu Shi Douzhen]* (Gu Family: *Smallpox*), Medical Treasury Catalog, 1 volume. Not seen.
*[Wang Shi (Wuming) Douzhen]* (Wang Family [Anonymous]: *Smallpox*), Medical Treasury Catalog, volume missing. Not seen.
*[Wang Shi (Qiuhe) Douzhen]* (Wang Qiuhe: *Smallpox*), Medical Treasury Catalog, volume missing. Not seen.
*[Wuming Shi Yuduzhifa Tiaoli]* (Anonymous: *Regulations for Treating Residual Toxins*), Medical Treasury Catalog, 1 volume. Not seen.
*[Douzhen Zhengjue Cao]* (*Grass Drafts of Smallpox Enlightenment*), Medical Treasury Catalog, 1 volume. Not seen.
*[Ni Shi (Youmei) Douzhen Jieyi]* (Ni Youmei: *Resolving Doubts on Smallpox*), Medical Treasury Catalog, volume missing. Not seen.
*[Jiujiang Song Shi (Wuming) Daoke Yizhi]* (Song Family of Jiujiang [Anonymous]: *Different Treatments for Smallpox*), Medical Treasury Catalog, 1 volume. Not seen.
*[Zhao Shi (Chengyi) Shadou Ji]* (Zhao Chengyi: *Collection of Sha and Smallpox*). Not seen.
The above are recorded in the *Jiading County Gazetteer*.
*[Gao Shi (Shi) Douzhen Lun]* (Gao Shi: *Discourse on Smallpox*). Not seen.
*[Shen Shi (Haowen) Douzhen Qiwei]* (Shen Haowen: *Awakening the Subtleties of Smallpox*). Not seen.
The above two are recorded in the *Zhejiang Tongzhi* (General History of Zhejiang).
The *Qiantang County Gazetteer* states: Shen Haowen, courtesy name Yusheng, was orphaned in childhood and studied hard. His family had been engaged in pediatrics for generations. Shen Haowen became even more proficient. In treating pediatric diseases, he could clearly perceive the internal organs, especially excelling in treating smallpox.
Shen Qinyun's adopted daughter was ten years old. Her younger brother developed smallpox. The girl brought the child out for consultation. Shen Haowen said, "The child is unharmed; it is the girl who has severe smallpox." If she complains of head and bone pain, she should take urine/clear fluid (Fenqing). Following his advice, she recovered.
Min family's daughter Aguan was eight years old and suffered from severe smallpox. Shen Haowen asked, "What do other doctors say?" She replied, "It is a fatal case; no medicine is needed." Shen Haowen said, "Although the child has many 'dead' pox, there is one 'living' pox, so she can still be saved." He ordered taking a hen that had hatched chicks five years prior, placing medicine inside the chicken, steaming it with glutinous rice outside, and having the girl eat it all. Upon inspection, two bright, pearl-like pox appeared on the Cun and Guan pulses of her right hand. The girl indeed survived.
Jiang Lutao's son was one year old, with only three pox appearing on the forehead, behind the ears, and beside the lips. Shen Haowen said, "The pox locations involve the Heart, Kidney, and Spleen meridians, indicating a reverse transmission where Earth overcomes Water, and Water overcomes Fire. Attack is indicated, not tonification. Attacking disperses the toxin; tonifying harms the internal organs." Treatment continued until the fourteenth day, when the pox became bright and moist, nearing resolution. Shen Haowen said, "Using Gypsum (Shigao) might damage Stomach Earth and Kidney Water. Vulgar physicians, pitying the child's small size, mistakenly administered Ginseng (Renshen)." Seeing this, Shen Haowen exclaimed in shock, "She took Ginseng? She will not survive beyond the twenty-first day." The child died.
Xu Jiming's young son developed smallpox. Shen Haowen said, "This is a favorable progression; no tonification is needed. Children are purely Yang; excessive Yang inevitably overcomes Yin." Xu did not obey. The smallpox healed, and Xu mocked Shen Haowen as reckless. Shen Haowen said, "The child is about to die." Xu was displeased. On the twelfth day, the child fell into a deep sleep and was found dead.
Shen Haowen was a pediatrician in Hangzhou who saved many lives.
*[Wan Shi (Bangfu) Douzhen Fanglun]* (Wan Bangfu: *Formula Discourse on Smallpox*), 5 volumes. Not seen.
*[Huang Shi (Yilin) Douzhen Yishu]* (Huang Yilin: *Lost Writings on Smallpox*). Not seen.
*[Zhao Shi (Zhenguan) Douzhen Lun]* (Zhao Zhenguan: *Discourse on Smallpox*). Not seen.
*[Gu Shi (Xing) Zhi... Quanshu]* (Gu Xing: *Complete Book of Treatment...* [Title incomplete]), 2 volumes. Not seen.
The above four are recorded in the *Zhejiang Tongzhi*.
*[Feng Shi (Guozhen) Douzhen Guiyao]* (Feng Guozhen: *Essentials of Smallpox Rules*). Not seen.
The above is recorded in the *Henan Fu Zhi*.
*[Huang Shi (Liangyou) Madou Mifa]* (Huang Liangyou: *Secret Methods for Measles and Smallpox*). Not seen.
*[Wu Shi (Bangning) Douzhen Xinfa]* (Wu Bangning: *Heart Method of Smallpox*). Not seen.
The above are recorded in the *Xiuning County Gazetteer*.
*[Xu Shi (Xuewen) Douzhen Yueyan]* (Xu Xuewen: *Brief Words on Smallpox*). Not seen.
The above is recorded in the *Hefei County Gazetteer*.