雍曰。世医论斑瘾疹。不甚详明。虽庞朱二氏亦然。朱氏曰。初
春病患肌肉斑烂瘾疹如锦文者。温毒也。庞氏之言亦然。朱氏曰。发
斑有二症。有热病发斑。温毒发斑。温毒如上所言是也。热病发斑
者。朱氏曰。或未发汗。或已经汗下。而热毒不散。所以发斑疮瘾疹
如锦文。俗云麸疮。素问谓之胗。此误也。雍谓斑与疮 及瘾疹。实
是三种。伤寒热病发斑。谓之斑。其形如丹砂小点。终不成疮。退即
消尽。不复有疮。温毒斑即成疮。古人谓毒热疮也。舍是又安得别有
热毒一疮。后人谓豌豆疮。以其形似之也。温毒疮数种。豌豆疮则其
毒之最者。其次水泡麻子是也。又其次麸疮子是也。如麸片。不成
疮。但退皮耳。以其不成疮。故俗谓之麸疮。又与瘾疹不同。瘾疹者。
皮肤发痒。搔之则瘾疹垄起。相连而出。终不成疮。不结脓水。亦不
退皮。忽尔而生。复忽尔而消。亦名风尸也。世人呼麸疮。或曰麸疹即是。
洵自幼即喜读灵素家言。以习举业。未暇及也。匡居善病。退而学医。乃得从澹安师游。师年虽高。好学
弥笃。其治病皆有法度。知名震医林为不虚。日者手一编示洵曰。此予旧藏郭氏伤寒补亡论
也。在元明时。已缺一卷。今锓板久无。抄本亦鲜。以其亡而补之。且将并其补者而亡之。予所不忍。其为予
校雠。将付梓焉。受书卒读。错句讹字。所在多有。兢兢惧不胜任。重负委托。悉心研求。晨夕辨
难。订正者有之。阙疑者有之。割爱者有之。仍不敢稍失其真面目。以副吾师绍述之怀。庶无湮乎先贤之遗。
而有补于斯道之用云尔。
宝山门人范洵谨跋
郭雍说:世间的医生论述斑、瘾疹,不够详细明确。即使是庞安时、朱肱两位医家也是如此。朱肱说:初春时节,患者肌肉出现斑烂、瘾疹,纹理像锦缎一样,这是温毒病。庞安时的观点也是这样。朱肱又说:发斑有两种证候,一种是热病发斑,一种是温毒发斑。所谓温毒发斑,就是上面所说的那种情况。至于热病发斑,朱肱说:或者是因为没有发汗,或者是已经经过发汗、攻下治疗,但热毒仍然没有消散,所以导致皮肤出现斑疮、瘾疹,纹理如锦缎一般。民间称之为“麸疮”。《素问》称之为“胗”,这是错误的。我认为斑、疮以及瘾疹,实际上是三种不同的病症。伤寒热病引起的发斑,称为“斑”,其形态像丹砂的小点,最终不会变成疮疡,消退后就会完全消失,不会再留下疮痕。温毒引起的斑则会形成疮疡,古人称之为毒热疮。除了这些,哪里还有所谓的另一种“热毒疮”呢?后人称之为“豌豆疮”,是因为它的形状相似。温毒疮有好几种,其中毒性最重的是豌豆疮,其次是水泡和麻子(天花),再次是麸疮子。麸疮像麦麸片一样,并不形成真正的疮疡,只是消退时脱皮而已。因为不形成疮疡,所以民间称之为“麸疮”。这又与瘾疹不同。瘾疹表现为皮肤瘙痒,抓挠后会出现隆起的瘾疹,连成一片而出,最终也不形成疮疡,不结脓水,也不脱皮,突然产生,又突然消退,也被称为“风尸”。世人所说的“麸疮”,有的认为就是“麸疹”。
范洵自幼就喜欢阅读《灵枢》、《素问》等医家著作,用来准备科举考试,当时没有闲暇顾及这些。我闲居在家时身体多病,退而学习医学,才得以跟随澹安老师游学。老师虽然年事已高,但好学之心更加坚定。他治病都有法度,在医学界闻名并非虚名。有一天,老师拿着一本书给我看,说:“这是我以前收藏的郭雍所著的《伤寒补亡论》。”这本书在元朝和明朝时期,就已经缺少了一卷。现在刻印版早已失传,抄本也很少见。因为它有散佚部分需要补充,而且恐怕连后来补充的部分也会散佚,我不忍心看到这种情况发生。于是请老师校勘此书,打算将其刻印出版。我接受书籍并读完,发现错句和讹误的字很多,心中兢兢业业,害怕不能胜任,辜负了老师的委托。于是我悉心研究探求,早晚辨析疑难,对原文进行了订正,也有存疑未决的地方,还有割爱舍弃的内容。但我始终不敢稍微失去它原本的面貌,以符合老师传承先贤遗志的情怀,希望不至于让先贤的遗留被埋没,并对这门学问有所补益罢了。
宝山门人范洵谨跋
Guo Yong stated: Physicians of the world discuss macules (macula) and urticaria (urticaria) with insufficient detail and clarity. This applies even to the works of Pang Anshi and Zhu Gong. Zhu Gong said: In early spring, if patients present with maceration of the skin, macules, and urticaria resembling brocade patterns, this is a Warm-Toxin disease (Warm toxin). Pang Anshi's view was similar. Zhu Gong further stated that there are two types of macule eruptions: one caused by Heat diseases (Heat pathogen), and the other by Warm-Toxin. The Warm-Toxin type refers to the condition described above. Regarding macules caused by Heat diseases, Zhu Gong said: Whether due to failure to induce sweating, or after sweating and purging treatments have been applied but the Heat-toxin remains unresolved, macules, sores, and urticaria appear on the skin with patterns like brocade. Commonly called "bran sores" (bran-like rash), the *Suwen* (Plain Questions) refers to it as "Zhen," which is an error. I hold that macules (macula), sores (ulcer/lesion), and urticaria are actually three distinct conditions. Macules resulting from Cold Damage (Shanghan) Heat diseases are termed "Ban" (macules); their appearance resembles small points of cinnabar, and they ultimately do not form sores. Upon subsiding, they disappear completely without leaving any sore traces. Macules caused by Warm-Toxin will form sores; the ancients referred to these as toxic-heat sores. Aside from these, where would another category of "Heat-toxin sores" come from? Later generations called them "pea sores" because of their morphological similarity. There are several types of Warm-Toxin sores; the most severe in toxicity is the pea sore (smallpox/variolae verae), followed by vesicular and pustular forms (variola vaccinae/vaccinia), and then the bran-like sores. Bran-like sores resemble wheat bran flakes and do not constitute true sores; they merely shed skin upon resolution. Because they do not form sores, they are commonly called "bran sores." This differs from urticaria. Urticaria manifests as itching of the skin; scratching causes raised wheals (urticarial plaques) to emerge continuously. They do not form sores, do not produce pus, do not shed skin, arise suddenly, and vanish just as suddenly. It is also known as "Wind-Corpse" (Feng Shi). Among the populace, what is called "bran sores" is sometimes identified as "bran urticaria."
Fan Xun has loved reading medical texts such as the *Ling Shu* (Spiritual Pivot) and *Su Wen* (Plain Questions) since childhood, primarily to prepare for the imperial examinations, and thus had no leisure to attend to them at that time. Living in seclusion and suffering from frequent illnesses, I turned to studying medicine and thereby had the opportunity to study under Master Tan'an. Although advanced in age, Master Tan'an remained deeply committed to learning. His methods of treating diseases were always principled and systematic, earning him widespread renown in the medical community, which was well-deserved. One day, he showed me a book and said, "This is my old copy of Guo Yong's *Supplemental Lost Chapters on Cold Damage* (Zhongzhang Shanghan Buwang Lun)." By the Yuan and Ming dynasties, one volume was already missing. The printed blocks have long been lost, and manuscript copies are rare. Since parts are lost and need supplementation, and fearing that even the supplemented parts might be lost, I could not bear to let this happen. Therefore, I asked him to collate the text, intending to have it printed. Having accepted the book and read it through, I found numerous erroneous sentences and characters. Fearing I was unequal to the task and might fail to live up to the trust placed in me, I studied it diligently, debating doubts morning and night. Some passages were corrected, some questions left open, and some content omitted. Nevertheless, I dared not deviate slightly from its original essence, hoping to fulfill my master's intention of continuing the legacy, so that the remnants of the sages would not be obscured, and this discipline might benefit from these contributions.
Respectfully inscribed by Fan Xun, disciple of Baoshan