余谓初学医者，先熟药性，次明经络，再识病名，然后讲解脉理，以证其所生病。证脉相同，
药无不应。病家云发热恶寒，头项痛，腰脊强，则知病在太阳经也。身热目痛，鼻干不得眠，则知
病在阳明经也。胸胁痛，耳聋，口苦舌干，往来寒热而呕，则知病在少阳经也。腹满咽干，手足自
温，或自利不渴，或腹满时痛，则知病在太阴经也。引衣蜷卧，恶寒，或舌干口燥，则知病在少阴
经也。烦满囊缩，则知病在厥阴经也。潮热自汗，谵语发渴，不恶寒反恶热，揭去衣被，扬手掷足，
或发斑黄，狂乱，五六日不大便，则知病在正阳明，胃腑病也。设若脉证不明，误用麻黄，令人汗
多亡阳；误用承气，令人大便不禁；误用姜、附，令人失血发狂。正
为寒凉耗其胃气，辛热损其汗液，燥热助其邪热。庸医杀人，莫此为甚。伤寒之邪，实无定体，或
入阳经气分，则太阳为首，其脉必浮，轻手便得。或入阴经血分，则少阴为先，其脉必沉，重手方
得。浮而有力无力，是知表之虚实。沉而有力无力，是知里之寒热。中而有力无力，是知表里缓急。
脉有浮沉虚实，证乃传变不常。治之之法，先分表里寒热、阴阳虚实、标本。先病为本，次病为标，
先以治其急者，此为上工。问证以知其外，察脉以知其内，全在活法二字，不可拘于日数。但见太
阳证在，直攻太阳。但见少阴证在，直攻少阴。但见真寒，直救真寒。但见三证具，便作主张，不
必悉具，当如何处治，此为活法。若同而异者，明之。似是而非者，辩之。在表者，汗之、散之。
在里者，利之、下之。在上者，因而越之。下陷者，升而举之。从乎中者，和解之。直中阴经者，
温补之。若解表不开，不可攻里，日数虽多，但有表证而脉浮者，尚宜发散。此事不明，攻之为逆。
经云∶一逆尚引日，再逆促命期。若表证解而里证具者，不可攻表，日数虽少，但有里热证而脉沉
实者，急当下之。此事不明，祸如反掌。经云∶邪热未除，复加燥热，抱薪救火矣。
如直中阴经真寒证，然无热，恶寒不渴，急宜温补，切禁寒凉。此事不明，杀人甚速。经云∶非徒
无益，而反害之。阴证似阳者，温之。阳证似阴者，下之。阳毒者，分轻重下之。阴毒者，分缓急
温之。阳狂者，下之。阴厥者，温之。湿热发黄者，利之、下之。血证发黄者，清之、下之。发斑
者，清之、下之。谵语者，下之、温之。痞满者，消之、泻之。结胸者，解之、下之。太阳证似少
阴者，温之。少阴证似太阳者，汗之。衄血者，解之、止之。发喘者，汗之、下之。咳嗽者，利之、
解之。正伤寒者，大汗之、大下之。感冒暴寒者，微汗之、微下之。劳力感寒者，温散之。温极病
者，微解之、大下之。此经常之大法也。有病一经，已用热药，而又用寒药，如少阴证用白虎汤、四
逆散寒药者，少阴证用四逆汤、真武汤热药者，庸俗狐疑，讵能措手哉！呜呼，能察伤寒之证名，
而得伤寒之方脉如此亲切，乃为良医。是知寒药治少阴，乃传经热证也。是知热药治少阴，乃直中
阴经之寒证也。辩名定经，明脉识证，验证用药。真知在表而汗，真知在里而下，真知直中阴经而
温。如此而汗，如彼而下，又如彼而温。辛热之剂，投之不差，寒凉之药，用之必当，病奚逃乎？
须分轻重缓急，老少虚实，久病新发，妇人胎产，室女经水。大凡有胎
产而伤寒者，不与男子伤寒同治法。无胎产者，治相同。妇女经水适断、适来，寒热似疟者，即是
热入血室，但当和解表里。久病者，过经不解，坏证也。新发者，始病也。老者，血气衰。少者，
血气壮。缓者，病之轻。急者，病之重。寒药热服，热药凉服，其中和之剂，温而服之。战汗分为
四证，要知邪正盛衰。类伤寒四证，照常法则治之。虽云发蒙，实登仲景之梯阶也。余虽专伤寒科，
必出乎庸俗夸诞之医万万。且余一生所蓄肺腑家秘，语句方法，俱已备载发挥。窥我门墙者，虽有
多人，然片言不繁之要，不得再四经自讲明，故述启蒙、捷法、脉要、贯珠数，一一开注，明白所
示。自宜谨慎深密，勿授受于非人，毋轻泄于浇薄，莫负我之用心耳。
我认为初学中医的人，首先要熟记药性，其次要明白经络，再认识病名，然后讲解脉理，以此来验证疾病所引发的症状。当证候与脉象相符时，用药没有不奏效的。病人说发热、恶寒（怕冷）、头项痛、腰脊强直，就知道病在太阳经。身体发热、眼睛痛、鼻子干、无法安睡，就知道病在阳明经。胸胁部疼痛、耳聋、口苦舌干、忽冷忽热且呕吐，就知道病在少阳经。腹部胀满、咽干、手足自然温暖，或者自发性腹泻且不口渴，或者腹部胀满且时而疼痛，就知道病在太阴经。拉着衣服蜷缩而卧、怕冷，或者舌干口燥，就知道病在少阴经。心烦腹胀、阴囊收缩，就知道病在厥阴经。潮热、自汗、说胡话、口渴、不怕冷反而怕热、掀开衣被、扬手掷足，或者出现发斑发黄、狂乱、五六天不大便，就知道病在正阳明，即胃腑的病。如果脉证不明确，误用麻黄汤（Mahuang Tang, Ephedra Decoction），会导致出汗过多而亡阳；误用承气汤（Chengqi Tang, Purging Decoction），会导致大便失禁；误用干姜、附子等辛热药物，会导致出血、发狂。这是因为寒凉药耗损胃气，辛热药损伤汗液，燥热药助长邪热。庸医杀人，没有比这更严重的了。伤寒的邪气，确实没有固定的形态，有的进入阳经的气分，则以太阳经为首，其脉象必定浮，轻按即可触及。有的进入阴经的血分，则以少阴经为先，其脉象必定沉，重按才能触及。脉象浮而有力或无力，可知表证的虚实。脉象沉而有力或无力，可知里证的寒热。脉象中取而有力或无力，可知表里证的缓急。脉象有浮沉虚实的变化，证候也就传变无常。治疗的方法，先要分清表里、寒热、阴阳、虚实、标本。先发生的病为本，后发生的病为标，先治疗紧急的情况，这才是高明的医生。通过问诊了解外在表现，通过切脉了解内在情况，全在于灵活运用这两个字，不可拘泥于发病的天数。只要见到太阳证存在，就直接治疗太阳经。只要见到少阴证存在，就直接治疗少阴经。只要见到真寒证，就直接救治真寒。只要见到这三种证候具备，就做出主张，不必所有症状都齐全，应当如何处置，这就是灵活的方法。对于相同而不同的，要阐明它；对于相似而实质不同的，要辨析它。病在表的，用发汗法、疏散法。病在里的，用利尿法、攻下法。病在上部的，因势利导使其涌吐。病在下陷的，提升并举起它。病在中焦的，用和解法。邪气直中阴经的，用温补法。如果解表不开，不可攻里，即使天数很多，只要有表证且脉浮，仍然适宜发散。如果不明白这个道理，强行攻里就是逆治。经书说：一次误治还能拖延时日，再次误治就会加速死亡。如果表证已解而里证具备，不可攻表，即使天数很少，只要有里热证且脉沉实，就必须急下之。如果不明白这个道理，祸患如反掌之间发生。经书说：邪热未除，又加上燥热，如同抱薪救火。
如果是直中阴经的真寒证，没有发热，怕冷且不渴，急需温补，严禁使用寒凉药。如果不明白这个道理，杀人速度极快。经书说：不仅无益，反而有害。阴证似阳的，用温法。阳证似阴的，用下法。阳毒证，根据轻重程度攻下。阴毒证，根据缓急程度温补。阳狂证，用下法。阴厥证，用温法。湿热导致的发黄，用利尿、攻下法。血证导致的发黄，用清热、攻下法。发斑的，用清热、攻下法。说胡话的，用攻下或温法。痞满的，用消导、泻下法。结胸的，用解表、攻下法。太阳证似少阴的，用温法。少阴证似太阳的，用汗法。流鼻血的，用解表、止血法。喘息的，用汗法或下法。咳嗽的，用利尿或解表法。正伤寒，用大汗法、大下法。感冒暴寒，用微汗法、微下法。劳力感寒，用温散法。温热极盛病，用微解法、大下法。这是常规的大法。有一种情况是一经病，已经用了热药，又用寒药，比如少阴证用白虎汤（Baihu Tang, White Tiger Decoction）、四逆散（Sini San, Inverse Cold Powder）等寒药，或者少阴证用四逆汤（Sini Tang, Four Reversal Decoction）、真武汤（Zhenwu Tang, True Warrior Decoction）等热药，庸俗之人狐疑不定，怎么能下手呢！唉，能察知伤寒的证名，并获得如此亲切准确的伤寒方脉知识，才是良医。由此可知，寒药治少阴，是传经热证。由此可知，热药治少阴，是直中阴经的寒证。辨别名称确定经脉，明察脉象识别证候，验证后用药。真正知道在表而用汗法，真正知道在里而用下法，真正知道直中阴经而用温法。像这样发汗，像那样攻下，又像那样温补。辛热药剂，投用不差；寒凉药物，使用得当，疾病怎能逃脱？必须分清轻重缓急、老少虚实、久病新发、妇人胎产、处女月经。大凡有胎产而患伤寒的，不与男子伤寒同治法。无胎产的，治疗方法相同。妇女月经刚断或刚来，寒热似疟疾的，就是热入血室（Heat entering the Blood Chamber），只应当和解表里。久病的，过经不解，是坏证。新发的，是始病。年老的人，气血衰。年轻的人，气血壮。缓者，病轻。急者，病重。寒药热服，热药凉服，其中的平和药剂，温服。战汗分为四种证候，要知道邪正盛衰。类伤寒四种证候，照常法则治疗。虽然名为启蒙，实际上是登上张仲景医学阶梯的台阶。我虽然专攻伤寒科，但一定超出庸俗夸诞的医生万万倍。况且我一生所积蓄的肺腑家秘，语句方法，都已详细记载发挥。窥探我门墙的人，虽然有众多，然而片言不繁的要旨，不能不再次亲自讲明，所以叙述启蒙、捷法、脉要、贯珠数，一一加注，明白所示。自己应当谨慎深密，不要传授给非人，不要轻泄给浅薄之人，不要辜负我的用心罢了。
I believe that for medical students, one must first become familiar with the properties of herbs, then understand the meridians, next recognize disease names, and subsequently explain pulse principles to verify the symptoms caused by diseases. When the syndrome and pulse correspond, there is no medicine that will not be effective. If a patient reports fever (Fever), aversion to cold (Aversion to Cold), headache in the head and neck, and stiffness in the waist and spine, one knows the disease is in the Taiyang Meridian (Taiyang Channel). If the body is hot, eyes hurt, nose is dry, and sleep is impossible, one knows the disease is in the Yangming Meridian (Yangming Channel). If there is pain in the chest and hypochondrium, deafness, bitter taste in the mouth, dry tongue, alternating chills and fever, and vomiting, one knows the disease is in the Shaoyang Meridian (Shaoyang Channel). If there is abdominal fullness, dry throat, naturally warm hands and feet, or spontaneous diarrhea without thirst, or abdominal fullness with intermittent pain, one knows the disease is in the Taiyin Meridian (Taiyin Channel). If one pulls clothes to curl up and lie down, fears cold, or has a dry tongue and mouth, one knows the disease is in the Shaoyin Meridian (Shaoyin Channel). If there is irritability and abdominal fullness, and contraction of the scrotum, one knows the disease is in the Jueyin Meridian (Jueyin Channel). If there is tidal fever, spontaneous sweating, delirium, thirst, aversion to heat rather than cold, throwing off clothes and blankets, waving hands and kicking feet, or appearance of macules and jaundice, mania, or constipation for five to six days, one knows the disease is in the Zheng Yangming, specifically the Stomach Fu organ. If the pulse and syndrome are unclear, and Mahuang Tang (Ephedra Decoction) is mistakenly used, it causes excessive sweating and loss of Yang; if Chengqi Tang (Purging Decoction) is mistakenly used, it causes fecal incontinence; if dried ginger (Ganjiang, Rhizoma Zingiberis Preparatum) and prepared aconite (Fuzi, Radix Aconiti Lateralis Preparata) are mistakenly used, it causes bleeding and mania. This is because cold medicines consume stomach Qi, acrid-hot medicines damage sweat fluids, and dry-heat medicines assist pathogenic heat. The killing of people by quack doctors is most severe in this regard. The pathogen of Shanghan (Cold Damage) indeed has no fixed form. If it enters the Qi level of the Yang meridians, Taiyang is primary, and its pulse must be floating (Floating Pulse), detectable with light pressure. If it enters the Blood level of the Yin meridians, Shaoyin is primary, and its pulse must be deep (Deep Pulse), detectable only with heavy pressure. Whether the floating pulse is forceful or feeble indicates the deficiency or excess of the exterior. Whether the deep pulse is forceful or feeble indicates the cold or heat of the interior. Whether the middle pulse is forceful or feeble indicates the urgency of the exterior and interior. Pulses vary in floating, deep, deficient, and excess states, so syndromes change unpredictably. The method of treatment is to first distinguish between exterior/interior, cold/heat, Yin/Yang, deficiency/excess, and root/branch. The initial disease is the root, the subsequent disease is the branch; treating the urgent condition first is the method of a superior physician. Ask questions to know the exterior, examine the pulse to know the interior; all lies in flexibility ("living methods"), and one must not be bound by the number of days. If Taiyang syndrome persists, directly treat Taiyang. If Shaoyin syndrome persists, directly treat Shaoyin. If true cold exists, directly rescue true cold. If these three conditions are present, make a decision; it is not necessary for all symptoms to be complete. One should determine how to treat based on the situation; this is flexibility. For things that are similar but different, clarify them. For things that appear similar but are not, differentiate them. For those at the exterior, use sweating (Diaphoresis) and dispersing methods. For those at the interior, use purgation (Purgative Method) and draining methods. For those above, induce vomiting according to their position. For those sinking, lift and raise them. For those in the middle, use harmonizing methods. For direct invasion of Yin meridians, use warming and tonifying methods. If the exterior cannot be resolved, do not attack the interior; even if many days have passed, if there is an exterior syndrome and a floating pulse, dispersion is still appropriate. Failure to understand this leads to counterproductive attacks. The Classics say: "One mistake may prolong life, two mistakes hasten death." If the exterior syndrome is resolved and interior symptoms appear, do not attack the exterior; even if few days have passed, if there are interior heat symptoms and a deep, solid pulse, urgent purgation is required. Failure to understand this leads to disaster as quick as turning a hand. The Classics say: "If pathogenic heat is not removed, adding dry-heat is like carrying firewood to save a fire."
For true cold syndromes from direct invasion of Yin meridians, where there is no fever, aversion to cold, and no thirst, urgent warming and tonification are needed, strictly forbidding cold medicines. Failure to understand this kills quickly. The Classics say: "It is not only useless but also harmful." For Yin syndromes resembling Yang, use warming. For Yang syndromes resembling Yin, use purgation. For Yang toxicity, purge according to severity. For Yin toxicity, warm according to urgency. For Yang mania, purge. For Yin collapse, warm. For jaundice due to damp-heat, drain and purge. For jaundice due to blood disorders, clear heat and purge. For macules, clear heat and purge. For delirium, purge or warm. For epigastric fullness and obstruction, dissipate and purge. For chest binding, resolve and purge. For Taiyang syndrome resembling Shaoyin, warm. For Shaoyin syndrome resembling Taiyang, sweat. For nasal bleeding, resolve and stop bleeding. For asthma/wheezing, sweat or purge. For cough, drain or resolve. For proper Shanghan, use heavy sweating and heavy purgation. For sudden cold exposure, use mild sweating and mild purgation. For cold contracted through labor, use warming dispersion. For extreme heat diseases, use mild resolution and heavy purgation. These are the general principles of the classics. There are cases where one meridian disease uses hot medicine and then cold medicine, such as using Baihu Tang (White Tiger Decoction) or Sini San (Inverted Cold Powder) for Shaoyin syndrome, or using Sini Tang (Four Reversal Decoction) or Zhenwu Tang (True Warrior Decoction) for Shaoyin syndrome. Quacks hesitate and doubt, unable to act! Alas, one who can observe Shanghan syndrome names and obtain Shanghan formulas and pulses with such precision is a good physician. Thus, we know that cold medicines treat Shaoyin when it is a transmitted heat syndrome. We know that hot medicines treat Shaoyin when it is a direct invasion cold syndrome of the Yin meridians. Differentiate names, determine meridians, clarify pulses, identify syndromes, verify before prescribing. Truly know to sweat when at the exterior, truly know to purge when at the interior, truly know to warm when invading Yin meridians directly. Sweat like this, purge like that, warm like another. Acrid-hot agents will not fail; cold-cool medicines will be appropriate. How can the disease escape? One must distinguish severity, urgency, age, constitution, chronic vs. acute onset, women's pregnancy/birth, and maidens' menstruation. Generally, women with pregnancy/birth contracting Shanghan are treated differently from men. Those without pregnancy/birth are treated similarly. When women's menstruation has just stopped or just started, and chills/fever resemble malaria, it is Heat Entering the Blood Chamber (Re Ru Xue Shi); only harmonize exterior and interior are needed. Chronic illness means passing through meridians without resolution, a damaged syndrome. Acute onset means initial illness. The elderly have declining Qi and Blood. The young have robust Qi and Blood. Slow indicates mild disease. Urgent indicates severe disease. Cold medicines taken hot, hot medicines taken cool, neutral medicines taken warm. Chills and sweating are divided into four syndromes; one must know the balance of pathogen and healthy Qi. Similar-to-Shanghan syndromes are treated according to standard rules. Although called "Enlightenment," it is actually the ladder to Zhang Zhongjing's medical achievements. Although I specialize in Shanghan, I certainly surpass quack doctors by far. Moreover, my lifelong accumulated family secrets and methods are fully recorded and elaborated. Those peering into my school, though numerous, require repeated explanation of concise essentials. Therefore, I describe Enlightenment, Quick Methods, Pulse Essentials, and Beaded Pearls, annotating each clearly. One should be cautious and secret, not teach non-appropriate persons, nor leak to frivolous people, lest you betray my intention.