伤寒一证,仲景论中立三百九十七法,一百一十三方,神明变化,可谓既详且尽矣。其
治杂证也,则有《金匮要略》,分门别类,包举该括,无非示人以规矩准绳,欲其触类傍
通,以应变于无穷也。但其辞旨古奥,义蕴幽深。条目繁多,未易领会,人多苦之。兹
特撮其要旨,编为歌诀,俾学人便于熟读默记,融会贯通,然后再玩味全书,则易读易
解,有会心之乐,而无望洋之叹矣。由此登堂入室,将见二千年来大法微言,昭如日月,
不致尘封,庶几于斯道不无小补云尔。
六经为病尽伤寒,气同病异岂期然,推其形脏原非一,因从类化故多端。明诸水火
相胜义,化寒变热理何难,漫言变化千般状,不外阴阳表里间。
【注】六经,谓太阳、阳明、少阳,太阴、少阴、厥阴也。为病尽伤寒,谓六经为病,尽
伤寒之变化也。气同,为天之六气,感人为病同也。病异,谓人受六气生病异也。岂期
然,谓不能预先期其必然之寒热也。推其形脏原非一,谓推原其人形之浓薄,脏之虚实
非一也。因从类化故多端,谓人感受邪气虽一,因其形脏不同,或从寒化,或从热化,或
从虚化,或从实化,故多端不齐也。明诸水火相胜义,谓水胜则火灭,火胜则水干也。化
寒变热理何难,谓邪至其经,或从阴化为寒,或从阳变为热,即水火相胜从化之理,何难
明也。漫言变化千般状二句,谓伤寒变化千般、总不外乎阴阳表里间也。
伤寒这一病证,张仲景在著作中论述了三百九十七种治法,列出了一百一十三首方剂,其变化之神妙,可以说已经详尽无遗了。他治疗杂病时,则有《金匮要略》一书,分门别类,全面概括,无非是向人们展示规矩准绳,希望学者能够触类旁通,以应对无穷无尽的变化。但是,《金匮要略》的文辞古奥,义理深幽,条目繁多,不容易领会,许多人对此感到苦恼。因此,我特意摘录其核心要旨,编成歌诀,使学习者便于熟读默记,融会贯通,然后再研读全书,就会觉得容易读懂和理解,既有领悟心得的乐趣,又不会有面对浩瀚书海而叹息的无奈。由此登堂入室,将会看到两千年来中医的大法和精微言论,像日月一样光明清晰,不至于被尘封埋没,希望对这门学问不无小小的补益。
六经所患的疾病都是伤寒,虽然感受的天之气相同,但发病表现各异,这难道是必然的吗?推究其形体和脏腑原本就不一致,因为邪气随体质不同而发生转化,所以症状表现多种多样。明白了水火相互克制的道理,理解寒热转化的原理并不难,不要说变化有千般形态,总不出阴阳、表里的范畴。
【注】六经,指的是太阳经、阳明经、少阳经、太阴经、少阴经、厥阴经。为病尽伤寒,意思是六经所患的疾病,都是伤寒病的各种变化。气同,指天之六气(风、寒、暑、湿、燥、火)感人致病,感受的外因是相同的。病异,指人受六气侵袭后生病的表现各不相同。岂期然,指不能预先预料其必然表现为寒证或热证。推其形脏原非一,指推究每个人的形体肥瘦厚薄、脏腑虚实状况原本就不一致。因从类化故多端,指人感受的邪气虽然相同,但因为每个人的形体和脏腑不同,有的从寒化,有的从热化,有的从虚化,有的从实化,所以病情表现多种多样。明诸水火相胜义,指水盛则火灭,火盛则水干。化寒变热理何难,指邪气传入经络后,有的从阴经转化为寒证,有的从阳经转化为热证,这就是水火相胜、随体而从化的道理,理解起来有什么困难呢?漫言变化千般状二句,指伤寒的变化虽然有千般形态,但总不出阴阳、表里的范围。
The syndrome of Shanghan (Cold Damage) was discussed by Zhang Zhongjing, who established 397 treatment methods and 113 formulas in his work. The divine changes were so detailed and comprehensive that they could be considered exhaustive. When treating miscellaneous diseases, he wrote *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), categorizing them systematically and comprehensively, providing rules and standards to guide practitioners to apply knowledge analogously and respond to infinite variations. However, its language is archaic and profound, its meanings are deep and obscure, and its categories are numerous, making it difficult to comprehend; many people find it burdensome. Therefore, I have extracted its core principles and compiled them into rhythmic verses (ge jue), enabling students to memorize them easily, integrate the knowledge thoroughly, and then study the complete text with ease and understanding, experiencing the joy of insight without feeling overwhelmed by the vastness of the material. By ascending from the hall to the inner chamber, one will see the great laws and subtle words of two thousand years illuminated like the sun and moon, preventing them from being buried in dust, hopefully offering a small contribution to this path of medicine.
Diseases of the Six Channels all fall under Shanghan; though the pathogenic Qi is the same, the manifestations differ—is this inevitable? Tracing back, the physical constitutions and Zang-Fu organs are not uniform; because pathogens transform according to their nature, the outcomes are manifold. Understanding the principle of mutual overcoming between Water and Fire makes it easy to grasp the logic of transforming into Cold or Heat. Do not claim that there are thousands of varied transformations; they all lie within Yin-Yang and Exterior-Interior.
[Note] "Six Channels" refers to Taiyang (Greater Yang), Yangming (Bright Yang), Shaoyang (Lesser Yang), Taiyin (Greater Yin), Shaoyin (Lesser Yin), and Jueyin (Terminal Yin). "Diseases of the Six Channels all fall under Shanghan" means that diseases occurring in the Six Channels are all variations of Shanghan. "Qi is the same" refers to the Heaven's Six Qi (Wind, Cold, Summerheat, Dampness, Dryness, Fire) affecting humans similarly as external causes. "Disease differs" means that after contracting these Six Qi, the resulting illnesses manifest differently in individuals. "Is this inevitable?" implies that one cannot predetermine whether the outcome will be Cold or Heat. "Tracing back, the physical constitutions and Zang-Fu organs are not uniform" means investigating that people's body structures (thick/thin) and Zang-Fu states (deficiency/excess) vary originally. "Because pathogens transform according to their nature, the outcomes are manifold" means that although the contracted pathogen is the same, due to differences in constitution and organ status, it may transform into Cold, Heat, Deficiency, or Excess, leading to diverse presentations. "Understanding the principle of mutual overcoming between Water and Fire" refers to the concept that when Water prevails, Fire is extinguished; when Fire prevails, Water dries up. "It is easy to grasp the logic of transforming into Cold or Heat" means that once the pathogen enters the channels, whether it transforms into Cold via Yin or Heat via Yang follows the logic of Water-Fire interaction and transformation, which is not hard to understand. The last two lines mean that although Shanghan presents in thousands of forms, it ultimately does not exceed the scope of Yin-Yang and Exterior-Interior.