仲景伤寒论。本散亡之余。王叔和编辑成帙。观其序例云。搜采旧论。录其对病真方。拟防
世急。此非仲景原本可知矣。然则仲景之书。赖叔和而传。叔和之名。亦赖仲景而传。后之
编次伤寒者不下数十家。徒相争于篇次之间。纷如聚讼。究之吾辈读书。苟能深明其义理。
奚必相争于篇目。独其序例诚有可訾。前明方中行仅从削去。至国朝喻嘉言程郊倩始痛加贬
驳。虽立言未免过激。然以余平心而论。叔和传书之功。诚不可没。其序例之可议者。内如
所陈温热异气。拉杂不清。至如以时论病。以日分经。与夫先汗后下之法。实与本论多相矛
盾。反将仲景之圆机活法。说成呆相。予非敢轻诋前贤。乃沿此说者。其祸至今而未有已。
故不得不为之辨。辨在后篇。
天有四时以布五运而分六气。人身应之。则有六经以分主五行。人在气交之中果能奉若天道
。御气调神。则寒暑温凉。亦自循乎天地自然之令气。何至于病。惟逆之而病生焉。则言病
当穷乎人事之变。故仲景但就人身表里腑脏上审其所犯者何证。即知六气中之病属何气。六
经中之病在何经。因其证之异同而病名斯定焉。其辨证之法。如同一太阳病而以证之有汗无
汗。脉之浮缓浮紧。分别风与寒。又以口之渴与不渴。分别风寒与温,同一渴而又以恶寒不
恶寒。分别温与热。至于传变之后。或出表。或入里。剖晰毫芒。随证通变。又施种种误治
救逆之法。何等精细。何等圆活。今乃谓冬月中而即发者。名为正伤寒。春为温。夏为热。
不惟仲景论中并无此语。且如执是说。则冬月中岂无患太阳病发热而渴者乎。夏月中岂无患
太阳
病恶寒无汗者乎。将安所适从乎。岂一时之中。只许人生此一病。不许更生他病乎。此说实
倡自叔和之序例。而疑团至今未破。故予亟打破此机关。为千百年来一扫魔障。
张仲景的《伤寒论》,本是散佚残存之余本。王叔和将其编辑成册。看他的序例中说:“搜集采集旧有的医论,记录其中针对病症的真实方剂,以防世人急用。”这就可以知道,这并非张仲景的原著了。既然如此,那么张仲景的书,依靠王叔和才得以流传;王叔和的名声,也依靠张仲景得以传世。后世编次《伤寒论》的人不下几十家,只是在篇章次序上互相争论,像众多诉讼一样纷乱。究其根本,我们读书人,如果能够深刻明白其中的义理,又何必在篇目名称上互相争执?只是他的序例确实有值得指责的地方。前明代的方中行仅仅将其删去,到了本朝(清代)的喻嘉言、程郊倩才开始严厉地贬低驳斥。虽然他们的言论未免过于激进,但凭我平心而论,王叔和传播书籍的功劳,确实不可抹杀。他序例中可议之处,内部如所陈述的温热异气,杂乱不清;至于以季节论病、按日子划分经络,以及先发汗后攻下的治法,实在与《伤寒论》正文多有矛盾,反而将张仲景灵活圆通的医术,说成了僵死呆板的教条。我不敢轻易诋毁前代贤人,而是那些沿袭这种说法的人,其祸害至今仍未停止。所以不得不为它辩驳,辩驳的内容在后一篇。
天有四时以布列五运并分主六气,人身与之相应,则有六经来分别主管五行。人在天地气交之中,如果能顺奉天道,驾驭气机、调摄精神,那么寒暑温凉,自然也会遵循天地自然的时令之气,怎么会生病呢?只有违背了它才产生疾病,那么谈论疾病应当穷尽人事的变化。所以张仲景只就人身表里脏腑之上,审察其所犯的是什么证候,就知道六气中的病属于哪一气,六经中的病在哪一经。根据证候的异同,病名就确定了。他辨证的方法,如同同样是太阳病(太阳经受邪所致的病证),却根据证候有汗无汗、脉象浮缓或浮紧,来分别风邪与寒邪;又根据口是否口渴,来分别风寒与温病;同样是口渴,又根据是否恶寒,来区分温病与热病。至于传变之后,或出表,或入里,剖析得毫厘不差,随证候灵活变通,又施用种种误治后的救逆之法,何等精细,何等圆活。现在却说冬天月份中立即发作的,名为正伤寒;春季为温病,夏季为热病。这不仅张仲景的论中没有这样的话,而且如果坚持这种说法,那么冬天月份里难道没有患太阳病发热而口渴的吗?夏天月份里难道没有患太阳病恶寒无汗的吗?这将听从哪一种说法呢?难道一个季节之中,只允许人生这一种病,不允许再生其他病吗?这种说法实际上是由王叔和的序例倡导的,而疑团至今未破。所以我急切地打破这个机关,为千百年来扫除魔障。
Zhang Zhongjing's *Treatise on Cold Damage* (*Shanghan Lun*) was originally a remnant of scattered and lost texts. Wang Shuhe edited it into a volume. In his preface, he stated: "I collected old theories and recorded their authentic prescriptions for specific conditions, to prevent urgency in the world." This indicates that this is not Zhang Zhongjing's original work. Nevertheless, Zhang Zhongjing's book was transmitted thanks to Wang Shuhe, and Wang Shuhe's fame was also transmitted through Zhang Zhongjing. There were dozens of later editors who arranged *Cold Damage*, engaging in futile disputes over chapter sequences, chaotic as litigation. Ultimately, for us readers, if we can deeply understand its principles, why must we argue over chapter titles? However, his preface indeed has points worthy of criticism. Fang Zhongxing of the late Ming Dynasty merely deleted it, while Yu Jiayan and Cheng Jiaoqian of the Qing Dynasty began to severely denounce and refute it. Although their statements may have been overly radical, in my impartial opinion, Wang Shuhe's merit in transmitting the book cannot be denied. The debatable aspects of his preface include: internally, the description of "warm-heat heterogenous qi" (*Wenre Yiqi*) is messy and unclear; furthermore, diagnosing diseases by season, dividing meridians by days, and the method of sweating first then purging later, actually contradict much of the main text. This turns Zhang Zhongjing's flexible and dynamic medical methods into rigid dogma. I do not dare lightly disparage former sages, but those who follow this theory have caused harm that persists to this day. Therefore, I must refute it; the refutation follows in the next section.
Heaven has four seasons to distribute the Five Movements (*Wuyun*) and divide the Six Qi (*Liuqi*). The human body corresponds to this, possessing the Six Meridians (*Liujing*) to respectively govern the Five Elements. Humans exist within the intersection of qi; if one can obey the Way of Heaven, manage qi, and regulate spirit, then cold, heat, warmth, and coolness will naturally follow the commands of heaven and earth. How could illness arise? Illness only arises when one violates these natural laws. Thus, discussing disease requires exhausting the changes in human affairs. Therefore, Zhang Zhongjing only examined the exterior-interior and zang-fu organs of the human body to determine what syndrome was contracted, thereby knowing which of the Six Qi the disease belonged to and which of the Six Meridians it affected. Based on the similarities and differences of syndromes, the disease names were established. His method of syndrome differentiation was precise: for example, in cases of Taiyang Disease (disease resulting from pathogenic invasion of the Taiyang channel), he distinguished Wind from Cold based on the presence or absence of sweating and whether the pulse was floating-slow (*Fuhuan*) or floating-tight (*Fujin*). He distinguished Wind-Cold from Warm diseases based on thirst. Even among those with thirst, he distinguished Warm diseases from Heat diseases based on aversion to cold. After transmission and transformation, whether exiting the exterior or entering the interior, he analyzed nuances meticulously, adapting flexibly to syndromes, and employed various methods to correct iatrogenic errors. How refined! How dynamic! Yet now it is claimed that immediate onset in winter is called "True Cold Damage" (*Zheng Shanghan*), spring is Warm disease, and summer is Heat disease. Not only does Zhang Zhongjing's treatise contain no such words, but if one adhered to this view, would there be no cases of Taiyang Disease with fever and thirst in winter? Would there be no cases of Taiyang Disease with aversion to cold and no sweating in summer? Which view should one follow? Does a single season allow only one type of disease, prohibiting others? This theory was actually initiated by Wang Shuhe's preface, and the doubt remains unresolved to this day. Therefore, I urgently break through this barrier, sweeping away demonic obstacles for thousands of years.