中醫經典古籍電子叢書系列
伤寒恒论上
清·鄭欽安
闡釋·唐步祺
民間中醫網恭校
伤寒恒论上
伤寒恒论下
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伤寒恒论
電子版序
中華民族文化博大精深、源遠流長,中醫更是中華民族的瑰寶,幾千年來一直維護著中華民族的健康。繼承和發揚中醫,本是我們與生俱來的使命。可是由於種種原因,中醫的許多典籍,目前仍然藏在深閨。二十一世紀的人類歷史,已經進入資訊時代。為了充分利用現代電子科技發揚祖國傳統醫學、弘揚祖國優秀文化,我們民間中醫網的網友們自發地組織起來,啟動了“中醫經典古籍電子叢書”的編制工作。
鄭欽安的《傷寒恒論》是我們繼《醫理真傳》和《醫法圓通》之後完成的第三部電子版書籍。本書以巴蜀書社1996年1月出版的《鄭欽安醫書闡釋》中的《傷寒恒論》為底本,校對過程中儘量保持原版原貌,修正了原書的印刷排版錯誤,並重新繪製了插圖。參與本書校對工作的網友有lihua2006、lizlopez、putaojia、tengel、qiqi、wesleybb、wyjk、yinxing3m、白芍、常觀無我、常精進、澄空助理、大灰狼、古月、念佛、月亮心事、緣醫求道、圓周率、漢服等,全書由漢服統稿並排版。在整理過程中同時得到了三七生先生和劉文澄先生的支持與幫助,在此一併表示感謝。
“中醫經典古籍電子叢書”發佈於“民間中醫-理論方法”論壇。我們力圖提供正確無誤的電子版,但限於能力,自知錯誤在所不免。因此我們希望所有閱讀本系列電子書的朋友能夠將發現的錯誤在論壇上告知我們,我們會根據實際情況不定期地更新。從其他地方獲得本書的網友,也請及時到此處查詢,獲得最新的圖書版本,以免有錯誤的版本流散無窮。我們仍在製作其他一些優秀的中醫圖書的電子版,也希望並歡迎更多的志願者加入到我們的隊伍中來。
民間中醫網中醫經典古籍電子叢書志願編撰組
公元二○○六年三月
鄭欽安原序
《傷寒》一書,相傳千餘年,俱雲仲景原文,名賢迭出,注家亦多,不勝枚舉。余閱原文,頗有領悟。茲將原文逐條一一剖析,不敢與前賢並駕,但就鄙見所及,逐條發明,雖不敢雲高出手眼,此亦救世之本心,聊以補名賢之不逮,亦大快事也,高明諒之,是為序。
一、此書即遵舒馳遠先生分列上、中、下篇,挨次發明,而他書則前後原文不一。總之論其原文,發明聖意,即前後錯亂,而原文終在也。學者亦不必論短、論長則得矣。
二、太陽篇條內有稱中風字句,當是太陽受風,而中字不當,何也?中者如矢之中靶,人何能當?況書有稱中經中風中髒之別,而條內所稱中風,全不似中風面目,學者察之。
大清光緒二十年孟冬月上浣臨邛鄭壽全欽安序
張仲景原序(校補)
論曰:餘每覽越人入虢之診,望齊侯之色,未嘗不慨然歎其才秀也。怪當今居世之士,曾不留神醫藥,精究方術,上以療君親之疾,下以救貧賤之厄,中以保身長全,以養其生,但競逐榮勢,企踵權豪,孜孜汲汲,惟名利是務,崇飾其末,忽棄其本,華其外而悴其內,皮之不存,毛將安附焉!卒然遭邪風之氣,嬰非常之疾,患及禍至,而方震栗,降志屈節,欽望巫祝,告窮歸天,束手受敗,齎百年之壽命,持至貴之重器,委付凡醫,恣其所措。咄嗟嗚呼!厥身已斃,神明消滅,變為異物;幽潛重泉,徒為啼泣。痛夫舉世昏迷,莫能覺悟;不惜其命,若是輕生,彼何榮勢之雲哉!而進不能愛人知人,退不能愛身知己,遇災值禍,身居厄地;蒙蒙昧昧,蠢若遊魂。哀乎!趨世之士,馳競浮華,不固根本,忘軀徇物,危若冰穀,至於是也。
余宗族素多,向餘二百;建安紀年以來,猶未十稔,其死亡者,三分有二,傷寒十居其七。感往昔之淪喪,傷橫夭之莫救。乃勤求古訓,博采眾方,撰用素問九卷,八十一難,陰陽大論,胎臚藥錄,並平脈辨證,為傷寒雜病論合十六卷,雖未能盡愈諸病,庶可以見病知源,若能尋餘所集,思過半矣。
夫天布五行,以運萬類;人稟五常,以有五臟,經絡府俞,陰陽會通;玄冥幽微,變化難極。自非才高識妙,豈能探其理致哉!上古有神農、黃帝、歧伯、伯高、雷公、少俞、少師、仲文,中世有長桑,扁鵲,漢有公乘陽慶及倉公,下此以往,未之聞也。觀今之醫,不念思求經旨,以演其所知,各承家技,始終順舊;省疾問病,務在口給;相對斯須,便處湯藥;按寸不及尺,握手不及足,人迎趺陽,三部不參;動數發息,不滿五十,短期未知決診,九候曾無仿佛;明堂闕庭,盡不見察,所謂窺管而已,夫欲視死別生,實為難矣。孔子雲:“生而知之者上,學則亞之,多聞博識,知之次也”。余宿尚方術,請事斯語。
前言
《傷寒論》係張仲景總結漢代以前醫學成果,參合其臨床經驗撰著的第一部理、法、方、藥俱備的醫典,從而形成我國醫學獨有的“辨證論治”理論體系。自金·成無己《注解傷寒論》問世後,千百年來注釋者無慮數百家。(包括日本漢醫)因其文字古奧,敘證簡略,大都從文字角度闡述,而少有論及如何具體運用其方。於其內涵亦見仁見智,學術多歧,各不相侔,但都推崇備至,譽其為“方書之祖”。
名醫家張令韶特別指出《傷寒論》是治百病的全書。他說:“書雖論傷寒,而臟腑經絡,營衛氣血,陰陽水火,寒熱虛實,靡不畢備,神而明之,千般疢難,如指諸掌。故古人雲:能醫傷寒,即能醫雜證,信非誣也。”柯韻伯亦強調:“仲景之六經,為百病立法,傷寒雜病,治無二理,鹹歸六經節制。”但真能全面應用《傷寒論》理、法、方、藥來治療各種病症者,實屬罕見。
鄭欽安緊緊掌握《傷寒論》之精髓,於臨證中廣泛運用其方藥於各種病症之治療,卓有成效。著《醫理真傳》、《醫法圓通》、《傷寒恒論》三書,互相發明,渾然一體,不可分割,全是臨證經驗的總結,貫穿以陰陽為總綱,萬病不出六經宗旨,不出一元真氣的學術思想。
特重陽虛陰盛之闡發,達到登峰造極。善用大劑量姜、桂、附以回陽救逆,拯人于危。其于陽虛辨治所積累之獨到經驗,實發前人之所未發,乃祖國醫學之瑰寶,千古一人而已!
餘深服其理,運用亦多效驗。惜年代稍久,原書已少流傳,乃決心就平日學習所得及臨床經驗,對三書加以點校,並為之闡釋。《醫理真傳闡釋》、《醫法圓通闡釋》二書已先後問世。出版後,日本漢醫界亦來函讚譽,如東洋醫學綜合研究所所長矢數道明將此書收入《漢方臨床叢書》,東洋醫學會副會長伊藤良譽為“填補了日本研究漢醫史缺清代傷寒學派的空白”,並對其採用書中方劑治病取得療效而感謝。德國真仁堂康復中心去歲邀請前往講學。臺灣、香港學者,亦累函索書。國內識與不識者,承紛紛賜信或見訪,各方鞭策,時切於心。
國務院前古籍整理領導小組組長李老一氓,備加鼓勵,叮囑務必完成三書闡釋,俾鄭氏三書成一完璧。因年事已高,且預為《傷寒恒論》題簽。殷殷期許,不敢稍忘。三年來,未遑寢息,反復考訂、修改,現已付梓,庶可稍慰李老在天之靈。
《傷寒恒論》(光緒二十年,即西元1894年刊行)鄭氏自序雲:“余閱原文,頗有領悟。茲將原文逐條一一剖析,不敢與前賢並駕,但就鄙見所及,逐條發明,雖不敢雲高出手眼,此亦救世之本心,聊以補名賢之不逮。”通觀全書,不因襲陳說,能獨抒己見,對原文疑似之處,加以糾正,而無曲解臆斷之嫌。其最大特點是將條文緊密扣合臨床實際,切實說理,將理論與臨床密切結合起來,指導辨證、治療。如太陽中篇13條:“咽喉乾燥者,不可發汗。”鄭氏說:“凡咽喉乾燥之人,津液已傷,豈可再行發汗以重奪其液乎?有因下元坎中真氣衰微,不能啟真水上升而致者,法宜扶陽;有因邪火灼其津液而致者,法宜清潤;有因寒水逆於中,阻其胃中升騰之氣而致者,法宜行水……”他分析了各種不同情況,並示人在臨證中細心察之。又說“若此等證皆非發汗所宜。”這樣從臨症實際情況來論證,對治病多所啟迪,于古醫學家中未多見也。又如少陰後篇13條:“少陰病,四逆,其人或咳、或悸、或小便不利、或泄利下重者,四逆散主之。”
鄭氏認為:“按少陰病而至四逆,陽微陰盛也,其中或咳、或悸者,水氣上幹也;小便不利者,陽不化陰也;腹痛下重,陰寒之極也。法宜大劑回陽為是,而此以四逆散主之,吾甚不解。”足見鄭氏不限於前人所說,敢獨抒己見,對原文疑誤之處進行辯證,並提出治法,更補仲景之所未及。
惜《傷寒恒論》文筆既簡,脫落亦多,臨應活用,尚待發明;且未列方藥、方解,檢閱亦多不便。今加以點校、闡釋,補明方藥,並將藥性及其應用範圍逐一講明,並參以五十年來臨證經驗以印證之。旨在古為今用,推陳出新,且欲保存原書全貌使之廣泛流傳,於其所不知者,則付缺如,以俟後之醫者研究。加之學殖荒疏,錯謬之處,在所難免,尚乞海內方家,不吝指正。
我與巴蜀書社人士素不相識,但他們不隨俗風,不計經濟損失,高瞻遠矚,以宏揚中華民族優秀傳統文化為己任,精心編輯審核,前幾年已將我闡釋的《醫理真傳》、《醫法圓通》先後付梓版行。今《傷寒恒論》闡釋甫殺青定稿,即由責任編輯接手編輯,以期早日問世。並在適當時候擬將三書結集合訂為一冊擴版精印以饗廣大讀者,這種舉措,感佩固不僅作者一人而已也。
這套書編寫過程中,承蒙原中國中醫學會副會長、北京中醫學院教授任應秋諄諄囑余整理發揚鄭氏醫學;原全國政協委員廖老沫沙題簽;知名學者老友王利器教授為鄭欽安撰傳;原西北大學校長老同學郭琦教授,以及成都中醫學院原副院長、研究員侯占元,成都中醫學院教授郭子光、戴佛延,老友余行達教授,四川華西中醫藥研究所吳傳先所長的關懷和支持,謹此表示衷心感謝。
鄭氏三書之闡釋,前後歷時十五年,本書亦屢易其稿。余妻張賜金長期從事中學語文教學,每一稿成,必先與之探討修訂,深得啟迪裨益;小兒高龍、高驤參與收集、抄寫,亦多進益,當勉其潛心學習,以承家學。
唐步祺于成都槐樹齋1993年11月30日
凡例
一、本書根據鄭欽安所著《傷寒恒論》原文,逐條闡釋,以繼承和發揚為原則,旨在為臨床者之實用。
二、鄭書編列次第,其條文係遵舒馳遠《再重訂傷寒集注》(舒氏篇目悉按喻嘉言《尚論篇》,故是書篇目,一一遵之而未易)。惟條文錯亂,多與《傷寒論》原書不符,現據1959年中醫研究院所編《傷寒論語譯》本校對,將鄭書每條正文結尾“原文”二字後,以阿拉伯數字序號表示出該條文在《傷寒論》原著中次序,以便讀者對照檢索。
三、《傷寒論語譯》本有《辨霍亂病脈證並治篇》及其它條文,但舒馳遠、鄭欽安之書俱無,本書為鄭書闡釋,故亦不例,但在書末依次錄出,以供參考。
四、原書條文後,未列方劑,筆者為之補出,作了方解及應用範圍,並附畢生經驗,以資驗證。
五、對原書詞義未清之處,專立注釋一目,生僻字給出中文拼音及直音。為便閱讀,採用頁末注方式。
六、校勘一般不出校語,以“()”標明錯文、脫文、或衍文,校改後之正字或補入者,則用“〔〕”標出。
七、原書有少許眉批,不便橫排,改寫在原文之後,闡釋之前。
又各方煮服法“右幾味”的“右”字,亦因橫排,改作“上”字。
傷寒恒論卷一
太陽上篇
凡風傷衛之證,列於此篇,計五十三法(據舒本校增)
一、太陽為之病,脈浮①,頭項強痛而惡寒②原文1(序號為《傷寒論》398條原次序,全書同)。
①脈浮:浮象淺表,輕按即得,指邪初入也。
②頭項強(jiàng匠)痛:即頭痛項強之意,謂頸部有牽強不適之感。項指頸之後部。惡(wù務)寒:畏寒怕冷。
鄭論:按太陽本氣主寒水,太陽統周身皮膚,毛竅、營衛、百脈,經絡,為一身綱領。毛竅乃太陽寒水氣化出路㈠,一切外邪之來,必由毛竅而始入內,出入兩字,乃邪正機關,萬病繩墨。脈浮者,指邪初入也;頭項強痛者,指邪犯太陽地面經絡也;惡寒者,指太陽本氣受病也。惡寒二字,乃太陽提綱,認證眼目,知得惡寒二字,無論一年四季為病,只要見得病人現有頭、項、腰、背強痛,惡寒、發熱,即按太陽法治之,毋得拘於時令,而有失經旨也。
㈠氣化二字有兩說:從毛竅而出者,輕清之露也;從下而出者,重濁之汁也。故太陽有傳經、傳腑,皆在這氣化上探求(頂批)。
中医经典古籍电子丛书系列
伤寒恒论上
清·郑钦安 著
阐释·唐步祺
民间中医网 恭校
伤寒恒论上
伤寒恒论下
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伤寒恒论
电子版序
中华文化博大精深、源远流长,中医更是中华民族的瑰宝,几千年来一直维护着中华民族的健康。继承和发扬中医,本是我们与生俱来的使命。可是由于种种原因,中医的许多典籍,目前仍然藏在深闺。二十一世纪的人类历史,已经进入信息时代。为了充分利用现代电子科技发扬祖国传统医学、弘扬祖国优秀文化,我们民间中医网的网友们自发地组织起来,启动了“中医经典古籍电子丛书”的编制工作。
郑钦安的《伤寒恒论》是我们继《医理真传》和《医法圆通》之后完成的第三部电子版书籍。本书以巴蜀书社1996年1月出版的《郑钦安医书阐释》中的《伤寒恒论》为底本,校对过程中尽量保持原版原貌,修正了原书的印刷排版错误,并重新绘制了插图。参与本书校对工作的网友有lihua2006、lizlopez、putaojia、tengel、qiqi、wesleybb、wyjk、yinxing3m、白芍、常观无我、常精进、澄空助理、大灰狼、古月、念佛、月亮心事、缘医求道、圆周率、汉服等,全书由汉服统稿并排版。在整理过程中同时得到了三七生先生和刘文澄先生的支持与帮助,在此一并表示感谢。
“中医经典古籍电子丛书”发布于“民间中医-理论方法”论坛。我们力图提供正确无误的电子版,但限于能力,自知错误在所难免。因此我们希望所有阅读本系列电子书的朋友能够将发现的错误在论坛上告知我们,我们会根据实际情况不定期地更新。从其他地方获得本书的网友,也请及时到此处查询,获得最新的图书版本,以免有错误的版本流散无穷。我们仍在制作其他一些优秀的中医图书的电子版,也希望并欢迎更多的志愿者加入到我们的队伍中来。
民间中医网中医经典古籍电子丛书志愿编撰组
公元二〇〇六年三月
郑钦安原序
《伤寒》一书,相传千余年,俱云仲景原文,名贤迭出,注家亦多,不胜枚举。余阅原文,颇有领悟。兹将原文逐条一一剖析,不敢与前贤并驾,但就鄙见所及,逐条发明,虽不敢云高出手眼,此亦救世之本心,聊以补名贤之不逮,亦大快事也,高明谅之,是为序。
一、此书即遵舒驰远先生分列上、中、下篇,挨次发明,而他书则前后原文不一。总之论其原文,发明圣意,即前后错乱,而原文终在也。学者亦不必论短、论长得矣。
二、太阳篇条内有称中风字句,当是太阳受风,而中字不当,何也?中者如矢之中靶,人何能当?况书有称中经中风中脏之别,而条内所称中风,全不似中风面目,学者察之。
大清光绪二十年孟冬月上浣临邛郑寿全钦安序
张仲景原序(校补)
论曰:余每览越人入虢之诊,望齐侯之色,未尝不慨然叹其才秀也。怪当今居世之士,曾不留神医药,精究方术,上以疗君亲之疾,下以救贫贱之厄,中以保身长全,以养其生,但竞逐荣势,企踵权豪,孜孜汲汲,惟名利是务,崇饰其末,忽弃其本,华其外而悴其内,皮之不存,毛将安附焉!卒然遭邪风之气,婴非常之疾,患及祸至,而方震栗,降志屈节,钦望巫祝,告穷归天,束手受败,赍百年之寿命,持至贵之重器,委付凡医,恣其所措。咄嗟呜呼!厥身已毙,神明消灭,变为异物;幽潜重泉,徒为啼泣。痛夫举世昏迷,莫能觉悟;不惜其命,若是轻生,彼何荣势之云哉!而进不能爱人知人,退不能爱身知己,遇灾值祸,身居厄地;蒙蒙昧昧,蠢若游魂。哀乎!趋世之士,驰竞浮华,不固根本,忘躯徇物,危若冰谷,至于是也。
余宗族素多,向余二百;建安纪年以来,犹未十稔,其死亡者,三分有二,伤寒十居其七。感往昔之沦丧,伤横夭之莫救。乃勤求古训,博采众方,撰用素问九卷,八十一难,阴阳大论,胎臚药录,并平脉辨证,为伤寒杂病论合十六卷,虽未能尽愈诸病,庶可以见病知源,若能寻余所集,思过半矣。
夫天布五行,以运万类;人禀五常,以有五藏,经络府俞,阴阳会通;玄冥幽微,变化难极。自非才高识妙,岂能探其理致哉!上古有神农、黄帝、歧伯、伯高、雷公、少俞、少师、仲文,中世有长桑,扁鹊,汉有公乘阳庆及仓公,下此以往,未之闻也。观今之医,不念思求经旨,以演其所知,各承家技,始终顺旧;省疾问病,务在口给;相对斯须,便处汤药;按寸不及尺,握手不及足,人迎趺阳,三部不参;动数发息,不满五十,短期未知决诊,九候曾无仿佛;明堂阙庭,尽不见察,所谓窥管而已,夫欲视死别生,实为难矣。孔子云:“生而知之者上,学则亚之,多闻博识,知之次也”。余宿尚方术,请事斯语。
前言
《伤寒论》系张仲景总结汉代以前医学成果,参合其临床经验撰著的第一部理、法、方、药俱备的医典,从而形成我国医学独有的“辨证论治”理论体系。自金·成无己《注解伤寒论》问世后,千百年来注释者无虑数百家。(包括日本汉医)因其文字古奥,叙证简略,大都从文字角度阐述,而少有论及如何具体运用其方。于其内涵亦见仁见智,学术多歧,各不相侔,但都推崇备至,誉其为“方书之祖”。
名医家张令韶特别指出《伤寒论》是治百病的全书。他说:“书虽论伤寒,而脏腑经络,营卫气血,阴阳水火,寒热虚实,靡不毕备,神而明之,千般疢难,如指诸掌。故古人云:能医伤寒,即能医杂证,信非诬也。”柯韵伯亦强调:“仲景之六经,为百病立法,伤寒杂病,治无二理,咸归六经节制。”但真能全面应用《伤寒论》理、法、方、药来治疗各种病症者,实属罕见。
郑钦安紧紧掌握《伤寒论》之精髓,于临证中广泛运用其方药于各种病症之治疗,卓有成效。著《医理真传》、《医法圆通》、《伤寒恒论》三书,互相发明,浑然一体,不可分割,全是临床经验的总结,贯穿以阴阳为总纲,万病不出六经宗旨,不出一元真气的学术思想。
特重阳虚阴盛之阐发,达到登峰造极。善用大剂量姜、桂、附以回阳救逆,拯人于危。其于阳虚辨治所积累之独到经验,实发前人之所未发,乃祖国医学之瑰宝,千古一人而已!
余深服其理,运用亦多效验。惜年代稍久,原书已少流传,乃决心就平日学习所得及临床经验,对三书加以点校,并为之阐释。《医理真传阐释》、《医法圆通阐释》二书已先后问世。出版后,日本汉医界亦来函赞誉,如东洋医学综合研究所所长矢数道明将此书收入《汉方临床丛书》,东洋医学会副会长伊藤良誉为“填补了日本研究汉医史缺清代伤寒学派的空白”,并对其采用书中方剂治病取得疗效而感谢。德国真仁堂康复中心去岁邀请前往讲学。台湾、香港学者,亦累函索书。国内识与不识者,承纷纷赐信或见访,各方鞭策,时切于心。
国务院前古籍整理领导小组组长李老一氓,备加鼓励,叮嘱务必完成三书阐释,俾郑氏三书成一完璧。因年事已高,且预为《伤寒恒论》题签。殷殷期许,不敢稍忘。三年来,未遑寝息,反复考订、修改,现已付梓,庶可稍慰李老在天之灵。
《伤寒恒论》(光绪二十年,即西元1894年刊行)郑氏自序云:“余阅原文,颇有领悟。兹将原文逐条一一剖析,不敢与前贤并驾,但就鄙见所及,逐条发明,虽不敢云高出手眼,此亦救世之本心,聊以补名贤之不逮。”通观全书,不因袭陈说,能独抒己见,对原文疑似之处,加以纠正,而无曲解臆断之嫌。其最大特点是将条文紧密扣合临床实际,切实说理,将理论与临床密切结合起来,指导辨证、治疗。如太阳中篇13条:“咽喉干燥者,不可发汗。”郑氏说:“凡咽喉干燥之人,津液已伤,岂可再行发汗以重夺其液乎?有因下元坎中真气衰微,不能启真水上升而致者,法宜扶阳;有因邪火灼其津液而致者,法宜清润;有因寒水逆于中,阻其胃中升腾之气而致者,法宜行水……”他分析了各种不同情况,并示人在临证中细心察之。又说“若此等证皆非发汗所宜。”这样从临症实际情况来论证,对治病多所启迪,于古医家中未多见也。又如少阴后篇13条:“少阴病,四逆,其人或咳、或悸、或小便不利、或泄利下重者,四逆散主之。”
郑氏认为:“按少阴病而至四逆,阳微阴盛也,其中或咳、或悸者,水气上干也;小便不利者,阳不化阴也;腹痛下重,阴寒之极也。法宜大剂回阳为是,而此以四逆散主之,吾甚不解。”足见郑氏不限于前人所说,敢独抒己见,对原文疑误之处进行辩证,并提出治法,更补仲景之所未及。
惜《伤寒恒论》文笔既简,脱落亦多,临应活用,尚待发明;且未列方药、方解,检阅亦多不便。今加以点校、阐释,补明方药,并将药性及其应用范围逐一讲明,并参以五十年来临证经验以印证之。旨在古为今用,推陈出新,且欲保存原书全貌使之广泛流传,于其所不知者,则付缺如,以俟后之医者研究。加之学殖荒疏,错谬之处,在所难免,尚乞海内方家,不吝指正。
我与巴蜀书社人士素不相识,但他们不随俗风,不计经济损失,高瞻远瞩,以宏扬中华民族优秀传统文化为己任,精心编辑审核,前几年已将我阐释的《医理真传》、《医法圆通》先后付梓版行。今《伤寒恒论》阐释甫杀青定稿,即由责任编辑接手编辑,以期早日问世。并在适当时候拟将三书结集合订为一册扩版精印以飨广大读者,这种举措,感佩固不仅作者一人而已也。
这套书编写过程中,承蒙原中国中医学会副会长、北京中医学院教授任应秋谆谆嘱余整理发扬郑氏医学;原全国政协委员廖老沫沙题签;知名学者老友王利器教授为郑钦安撰传;原西北大学校长老同学郭琦教授,以及成都中医学院原副院长、研究员侯占元,成都中医学院教授郭子光、戴佛延,老友余行达教授,四川华西中医药研究所吴传先所长的关怀和支持,谨此表示衷心感谢。
郑氏三书之阐释,前后历时十五年,本书亦屡易其稿。余妻张赐金长期从事中学语文教学,每一稿成,必先与之探讨修订,深得启迪裨益;小儿高龙、高骧参与收集、抄写,亦多进益,当勉其潜心学习,以承家学。
唐步祺于成都槐树斋1993年11月30日
凡例
一、本书根据郑钦安所著《伤寒恒论》原文,逐条阐释,以继承和发扬为原则,旨在为临床者之实用。
二、郑书编列次第,其条文係遵舒驰远《再重订伤寒集注》(舒氏篇目悉按喻嘉言《尚论篇》,故是书篇目,一一遵之而未易)。惟条文错乱,多与《伤寒论》原书不符,现据1959年中医研究院所编《伤寒论语译》本校对,将郑书每条正文结尾“原文”二字后,以阿拉伯数字序号表示出该条文在《伤寒论》原著中次序,以便读者对照检索。
三、《伤寒论语译》本有《辨霍乱病脉证并治篇》及其它条文,但舒驰远、郑钦安之书俱无,本书为郑书阐释,故亦不例,但在书末依次录出,以供参考。
四、原书条文后,未列方剂,笔者为之补出,作了方解及应用范围,并附毕生经验,以资验证。
五、对原书词义未清之处,专立注释一目,生僻字给出中文拼音及直音。为便阅读,采用页末注方式。
六、校勘一般不出校语,以“()”标明错文、脱文、或衍文,校改后之正字或补入者,则用“〔〕”标出。
七、原书有少许眉批,不便横排,改写在原文之后,阐释之前。
又各方煮服法“右几味”的“右”字,亦因横排,改作“上”字。
伤寒恒论卷一
太阳上篇
凡风伤卫之证,列于此篇,计五十三法(据舒本校增)
一、太阳为之病,脉浮①,头项强痛而恶寒②原文1(序号为《伤寒论》398条原次序,全书同)。
①脉浮:浮象浅表,轻按即得,指邪初入也。
②头项强(jiàng匠)痛:即头痛项强之意,谓颈部有牵强不适之感。项指颈之后部。恶(wù务)寒:畏寒怕冷。
郑论:按太阳本气主寒水,太阳统周身皮肤,毛窍、营卫、百脉,经络,为一身纲领。毛窍乃太阳寒水气化出路㈠,一切外邪之来,必由毛窍而始入内,出入两字,乃邪正机关,万病绳墨。脉浮者,指邪初入也;头项强痛者,指邪犯太阳地面经络也;恶寒者,指太阳本气受病也。恶寒二字,乃太阳提纲,认证眼目,知得恶寒二字,无论一年四季为病,只要见得病人现有头、项、腰、背强痛,恶寒、发热,即按太阳法治之,毋得拘于时令,而有失经旨也。
㈠气化二字有两说:从毛窍而出者,轻清之露也;从下而出者,重浊之汁也。故太阳有传经、传腑,皆在这气化上探求(顶批)。
Traditional Chinese Medicine Classic Ancient Books Electronic Series
Shanghan Henglun (Constant Commentary on Cold Damage), Upper Volume
Qing Dynasty · Zheng Qin'an (Author)
Interpretation · Tang Buqi
Proofread by Minjian Traditional Chinese Medicine Network
Shanghan Henglun, Upper Volume
Shanghan Henglun, Lower Volume
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Shanghan Henglun
Electronic Edition Preface
Chinese culture is profound and extensive, with a long history. Traditional Chinese Medicine (TCM) is a treasure of the Chinese nation, having safeguarded the health of the Chinese people for thousands of years. Inheriting and promoting TCM is our innate mission. However, due to various reasons, many TCM classics remain hidden away today. Human history in the 21st century has entered the information age. To fully utilize modern electronic technology to promote our country's traditional medicine and excellent culture, netizens of the Minjian Traditional Chinese Medicine Network spontaneously organized themselves to launch the compilation work of the "Traditional Chinese Medicine Classic Ancient Books Electronic Series."
Zheng Qin'an's *Shanghan Henglun* is the third electronic book completed after our previous works, *Yili Zhuan* (True Transmission of Medical Principles) and *Yifa Yuantong* (Comprehensive Understanding of Medical Methods). This book uses the *Shanghan Henglun* contained in *Zheng Qin'an Yishu Chanshi* (Interpretation of Zheng Qin'an's Medical Books), published by Bashu Book Society in January 1996, as its base text. During the proofreading process, we strove to maintain the original appearance of the edition, corrected printing and layout errors of the original book, and redrew the illustrations. Netizens who participated in the proofreading include lihua2006, lizlopez, putaojia, tengel, qiqi, wesleybb, wyjk, yinxing3m, Baishao, Changguan Wwo, Chang Jingjin, Chengkong Assistant, Dahui Lang, Guyue, Nianfo, Yue Liang Xin Shi, Yuan Yi Qiudao, Yuanzhoulv, Hanfu, etc. The entire book was compiled and laid out by Hanfu. During the organization process, we also received support and assistance from Mr. Sanqisheng and Mr. Liu Wencheng, for which we express our gratitude here.
The "Traditional Chinese Medicine Classic Ancient Books Electronic Series" was published on the "Minjian TCM - Theory and Methods" forum. We strive to provide an error-free electronic version, but limited by our capabilities, we acknowledge that errors are inevitable. Therefore, we hope that all friends reading this series of e-books will inform us of any errors found on the forum, and we will update irregularly based on actual situations. Netizens who obtained this book from other places should also check here promptly to obtain the latest version, to prevent erroneous versions from circulating indefinitely. We are still producing electronic versions of other excellent TCM books and hope and welcome more volunteers to join our team.
Volunteer Compilation Group of the Traditional Chinese Medicine Classic Ancient Books Electronic Series, Minjian Traditional Chinese Medicine Network
March 2006 AD
Original Preface by Zheng Qin'an
The book *Shanghan Lun* (Treatise on Cold Damage) has been passed down for over a thousand years, said to be the original text of Zhang Zhongjing. Many distinguished scholars have emerged, and there are numerous commentators, too many to enumerate. Having read the original text, I have gained considerable understanding. Here, I analyze the original text item by item. I dare not compete with former sages, but merely expound upon my humble insights item by item. Although I do not claim superior insight, this is the fundamental intention of saving the world, merely attempting to make up for the shortcomings of famous sages. It is also a great joy. I trust that the learned will understand. This serves as the preface.
1. This book follows Mr. Shu Chi Yuan's division into upper, middle, and lower sections, expounding sequentially. Other books have inconsistent ordering of the original text. In summary, discussing the original text and elucidating the sage's intent means that even if the order is confused, the original text remains. Scholars need only focus on the content without debating shortfalls or merits.
2. In the Taiyang Chapter, there are phrases mentioning "Zhong Feng" (Wind Strike/Stroke). These likely refer to the Taiyang channel being affected by wind, but the character "Zhong" (Strike/Hit) is inappropriate. Why? "Zhong" implies hitting a target like an arrow; how can a person withstand such force? Moreover, the texts distinguish between striking the channels, wind strike, and striking the viscera. The "wind strike" mentioned in these clauses does not resemble the clinical presentation of stroke at all. Scholars should observe this carefully.
Preface by Zheng Shouquan (Zhen'an) of Linqiong, Early Winter of the 20th Year of Guangxu, Qing Dynasty
Original Preface by Zhang Zhongjing (Corrected and Supplemented)
Discussion: Whenever I read about Bian Que's diagnosis in Guo and his observation of the color of the Duke of Qi, I cannot help but sigh at their outstanding talent. I am puzzled by the scholars of today who do not pay attention to medicine and pharmacology, nor meticulously study medical arts. They fail to treat the illnesses of rulers and parents above, save the poor and lowly below, or preserve their own bodies and lives in the middle. Instead, they compete for glory and power, grovel before the wealthy and powerful, diligently pursuing only fame and profit. They adorn the superficial while neglecting the root, beautifying the exterior while exhausting the interior. If the skin does not exist, where will the hair attach? Suddenly encountering pathogenic wind qi, suffering from unusual diseases, when disasters and calamities arrive, they tremble in fear. They lower their ambitions and submit, hoping in vain for shamans and diviners. When all avenues are exhausted, they resign themselves to death, surrendering to defeat. They entrust their hundred-year lifespan and precious body to mediocre physicians, allowing them to act arbitrarily. Alas! Their bodies perish, their spirit vanishes, turning into strange entities; buried deep in the underworld, they become objects of tears. It is painful that the whole world is confused and unaware; they do not cherish their lives, treating them so lightly. What glory or power could possibly justify this? Advancing, they cannot love or understand others; retreating, they cannot love or know themselves. Encountering disaster and calamity, they find themselves in desperate situations, ignorant and dim-witted, foolish as wandering souls. How sorrowful! Those who pursue worldly affairs gallop after vanity and splendor, failing to solidify their roots, forgetting their bodies to serve external things, precarious as ice and valleys, reaching this state.
My clan was originally large, numbering over two hundred. Since the Jian'an era, less than ten years have passed, yet two-thirds of them have perished. Seven out of ten deaths were due to Shanghan (Cold Damage). Grieving the loss of the past and mourning the untimely deaths that could not be saved, I diligently sought ancient teachings, extensively collected prescriptions, utilized the *Suwen* (Basic Questions), *Nanjing* (Classic of Difficult Issues), *Yin Yang Da Lun* (Great Treatise on Yin and Yang), *Tailu Yaolu* (Records of Fetal Development and Pharmacology), along with pulse assessment and syndrome differentiation, compiling them into the *Shanghan Zabing Lun* (Treatise on Cold Damage and Miscellaneous Diseases) in sixteen volumes. Although unable to cure all diseases completely, it allows one to see the disease and know its source. If one can follow what I have compiled, one will have grasped more than half of medical knowledge.
Heaven distributes the Five Elements to operate all categories; humans receive the Five Constants to possess five Zang organs. Meridians, collaterals, fu organs, and shu points connect yin and yang. Profound and subtle, changes are difficult to fathom. Unless one possesses high talent and profound insight, how can one explore its principles and implications? In ancient times, there were Shennong, Huangdi, Qibo, Bogao, Leigong, Shaoyu, Laoshi, and Zhongwen. In the middle ages, there were Changsang and Bianque. In the Han dynasty, there were Gongcheng Yangqing and Cangong. Below these, nothing has been heard of. Observing doctors of today, they do not reflect on seeking the essence of classics to expand their knowledge. Each inherits family skills, adhering strictly to old traditions. When examining illnesses and asking about diseases, they rely solely on eloquence. After a brief conversation, they immediately prescribe decoctions. Checking the cun pulse does not extend to chi; holding the wrist does not reach the foot. Renying and Duyang pulses are not compared among the three positions. Counting breaths during rapid pulses takes less than fifty beats. For short-term prognosis, diagnosis is undecided; the nine pulses show no resemblance. The Mingtang (forehead) and Yueting (nose bridge) are not observed at all. This is merely peeking through a tube. To distinguish between life and death truly is indeed difficult. Confucius said: "Those who know from birth are superior; those who learn are next; those who hear much and know widely are inferior." I have long valued medical arts. Please allow me to act upon these words.
Foreword
The *Shanghan Lun* is the first medical classic authored by Zhang Zhongjing, summarizing medical achievements prior to the Han Dynasty and integrating his clinical experience. It possesses complete theory, methods, formulas, and herbs, thereby forming China's unique theoretical system of "Syndrome Differentiation and Treatment." Since the publication of Cheng Wuji's *Annotated Shanghan Lun* in the Jin Dynasty, hundreds of commentators have emerged over thousands of years (including Japanese Kampo physicians). Due to its archaic language and concise symptom descriptions, most commentaries explain from a textual perspective, rarely discussing how to specifically apply its formulas. Interpretations of its connotations vary, leading to academic diversity and disagreement, yet all highly praise it, honoring it as the "Ancestor of Formula Books."
Famous physician Zhanglingshao particularly pointed out that the *Shanghan Lun* is a comprehensive book for treating all diseases. He said: "Although the book discusses Shanghan, it covers viscera, meridians, Ying and Wei, Qi and Blood, Yin and Yang, Water and Fire, Cold and Heat, Deficiency and Excess without exception. If understood spiritually and clearly, thousands of difficulties are like looking at one's palm. Thus, ancients said: 'One who can treat Shanghan can treat miscellaneous syndromes.' This is certainly not false." Ke Yunbo also emphasized: "Zhongjing's Six Channels establish laws for all diseases. Shanghan and miscellaneous diseases share no different principles; all fall under the regulation of the Six Channels." However, those who can comprehensively apply the theory, methods, formulas, and herbs of the *Shanghan Lun* to treat various conditions are rare.
Zheng Qin'an closely grasped the essence of the *Shanghan Lun*, widely applying its formulas and herbs to treat various conditions clinically with remarkable effectiveness. He wrote three books: *Yili Zhuan*, *Yifa Yuantong*, and *Shanghan Henglun*. These mutually illuminate each other, forming an inseparable whole, all summaries of clinical experience. They are permeated by the academic thought that Yin and Yang are the general outline, all diseases do not exceed the principle of the Six Channels, and none depart from the Primordial Qi.
He particularly emphasized the elaboration of Yang deficiency and Yin excess, reaching the pinnacle. He skillfully used large doses of Ginger, Cinnamon Twig, and Aconite Root to restore Yang and rescue from collapse, saving people from danger. His unique experiences accumulated in diagnosing and treating Yang deficiency truly uncovered what predecessors had not revealed. It is a treasure of national medicine, unique in millennia!
I deeply admire his theories and have found them effective in practice. Regrettably, due to the passage of time, the original books have become scarce. I resolved to punctuate, proofread, and interpret these three books based on my daily learning and clinical experience. The interpretations of *Yili Zhuan* and *Yifa Yuantong* have already been published. After publication, the Japanese Kampo community also sent letters of praise. For instance, Director Yabu Kazumasa of the Institute of Oriental Medical Comprehensive Research included this book in the *Kampo Clinical Series*, and Vice President Ito Ryo of the Oriental Medical Association praised it as "filling the gap in Japanese research on Kampo history regarding the Qing Dynasty Shanghan School," expressing gratitude for its therapeutic efficacy using formulas from the book. The Zhenrentang Rehabilitation Center in Germany invited me to lecture last year. Scholars from Taiwan and Hong Kong also repeatedly requested copies. Domestic acquaintances and strangers alike sent letters or visited. The encouragement from all sides stays constantly in my heart.
Mr. Li Yimang, former head of the State Council's Ancient Books Compilation Leading Group, offered strong encouragement, urging me to complete the interpretation of the three books so that Zheng's three works would form a perfect whole. Due to his advanced age, he also provided the title calligraphy for *Shanghan Henglun*. His earnest expectations I dare not forget. For three years, I have had no rest, repeatedly verifying and modifying. Now it is ready for print, slightly comforting Mr. Li's spirit in heaven.
In his self-preface to *Shanghan Henglun* (published in the 20th Year of Guangxu, i.e., 1894 AD), Zheng stated: "Having read the original text, I gained considerable understanding. Here, I analyze the original text item by item. I dare not compete with former sages, but merely expound upon my humble insights item by item. Although I do not claim superior insight, this is the fundamental intention of saving the world, merely attempting to make up for the shortcomings of famous sages." Reviewing the entire book, it does not follow stale views but expresses independent opinions. It corrects doubtful parts of the original text without suspicion of distortion or arbitrary judgment. Its greatest feature is tightly linking clauses to clinical reality, explaining principles concretely, and closely combining theory with clinical practice to guide syndrome differentiation and treatment. For example, Clause 13 of the Middle Taiyang Chapter states: "Those with dry throat should not undergo sweating therapy." Zheng said: "For anyone with a dry throat, body fluids are already damaged. How can one induce sweating again to further deplete fluids? Some cases result from the decline of True Qi in the Lower Burner Kan center, failing to initiate the ascent of True Water; the method should support Yang. Some result from pathogenic fire scorching body fluids; the method should clear and moisten. Some result from cold water reversing in the middle, obstructing the ascending Qi of the Stomach; the method should move water..." He analyzed various situations and indicated careful observation in clinical practice. He also said, "If these syndromes are present, sweating therapy is unsuitable." Arguing from actual clinical situations provides much enlightenment for treating diseases, which is rare among ancient physicians. Another example is Clause 13 of the Later Shaoyin Chapter: "Shaoyin disease, with cold extremities, where the patient may have cough, palpitations, difficulty urinating, or diarrhea with a sensation of heaviness below, is primarily treated with Sini San (Four Counterflow Powder)."
Zheng believed: "Regarding Shaoyin disease progressing to cold extremities, this indicates weak Yang and flourishing Yin. Cough or palpitations indicate Water Qi interfering upwards. Difficulty urinating indicates Yang failing to transform Yin. Abdominal pain and heaviness below indicate extreme Yin Cold. The method should use large doses to restore Yang. Yet this clause prescribes Sini San, which I greatly do not understand." This shows Zheng was not limited to previous explanations, dared to express independent opinions, dialectically examined doubtful errors in the original text, proposed treatment methods, and supplemented what Zhongjing omitted.
Regrettably, the writing of *Shanghan Henglun* is concise, with many omissions. Flexible application in clinical settings awaits further elucidation; furthermore, it lacks listed formulas and formula explanations, making reference inconvenient. Now, adding punctuation, proofreading, and interpretation, supplementing clear formulas, explaining herb properties and application scopes one by one, and verifying with fifty years of clinical experience aims to use the past for the present, eliminate the old to bring forth the new, and preserve the original book's full appearance for widespread dissemination. For what is unknown, I leave it blank, awaiting future researchers. Given my sparse scholarship, errors are inevitable. I beg experts within and beyond the seas not to withhold corrections.
I have never known the people at Bashu Book Society, but they do not follow vulgar trends, disregard economic losses, look far ahead, and take promoting excellent traditional Chinese culture as their responsibility. They carefully edited and reviewed, publishing my interpreted *Yili Zhuan* and *Yifa Yuantong* in recent years. Now that the interpretation of *Shanghan Henglun* has just been finalized, the responsible editor took over editing to ensure early publication. At an appropriate time, it is planned to bind the three books together into one volume for expanded, fine printing to enjoy broad readership. Such measures deserve admiration not only from the author.
During the compilation of this set, I received earnest advice from Ren Yingqiu, former Vice President of the China Association of Chinese Medicine and Professor at Beijing College of Traditional Chinese Medicine, to organize and promote Zheng's medicine; calligraphy by Liao Moshan, former member of the National Committee of the Chinese People's Political Consultative Conference; biography of Zheng Qin'an written by renowned scholar and old friend Professor Wang Liqi; care and support from Guo Qi, professor and old classmate, former president of Northwest University; Hou Zhanyuan, former vice president and researcher of Chengdu College of Traditional Chinese Medicine; Professors Guo Ziguang and Dai Fuyan of Chengdu College of Traditional Chinese Medicine; old friend Professor Yu Xingda; and Wu Chuanxian, director of the Sichuan West China Institute of Traditional Chinese Medicine. I sincerely express my gratitude.
The interpretation of Zheng's three books took fifteen years, and this book underwent multiple drafts. My wife, Zhang Cijin, who has long engaged in middle school Chinese teaching, discussed and revised every draft with me, providing deep inspiration and benefit. My sons, Gao Long and Gao Xiang, participated in collection and copying, bringing much progress. I shall encourage them to study diligently to inherit the family learning.
Tang Buqi at Huaishu Studio, Chengdu, November 30, 1993
General Rules
1. This book interprets the original text of Zheng Qin'an's *Shanghan Henglun* item by item, adhering to the principles of inheritance and promotion, aiming for practical use by clinicians.
2. Zheng's book arrangement follows Shu Chi Yuan's *Re-revised Shanghan Jizhu* (Shu's chapter titles follow Yu Jiayan's *Shanglun Pian*, thus this book's chapters follow them exactly without change). However, the clauses are disordered and often inconsistent with the original *Shanghan Lun*. Now, based on the *Shanghan Lun Yu Yi* (Verbatim Translation of Shanghan Lun) compiled by the Academy of Traditional Chinese Medicine in 1959, we proofread against this edition. After the word "Original Text" at the end of each clause in Zheng's book, Arabic numerals indicate the sequence number of that clause in the original *Shanghan Lun*, facilitating reader comparison and retrieval.
3. The *Shanghan Lun Yu Yi* edition includes the "Chapter on Differentiating Huoluan Disease Pulse, Syndromes, and Treatment" and other clauses, but neither Shu Chi Yuan's nor Zheng Qin'an's books contain them. As this book is an interpretation of Zheng's work, we do not include them in the main text, but list them sequentially at the end of the book for reference.
4. The original book did not list formulas after the clauses. The author supplements them, providing formula explanations and application scopes, attaching lifelong experience for verification.
5. For unclear meanings in the original text, a specific annotation section is established, providing Chinese pinyin and direct pronunciation for obscure characters. For ease of reading, end-of-page notes are adopted.
6. Collation generally does not produce collation notes. Wrong characters, missing characters, or superfluous characters are marked with "( )". Corrected characters or inserted ones are marked with "[ ]".
7. The original book has some marginal comments inconvenient for horizontal typesetting. These are rewritten after the original text and before the interpretation.
Also, in the cooking and administration instructions for various formulas, the character "You" (Right/Previous) meaning "the aforementioned [number] ingredients" is changed to "Shang" (Up/Above) due to horizontal typesetting.
Shanghan Henglun, Volume One
Taiyang Upper Chapter
All syndromes where Wind injures Wei (Defensive Qi) are listed in this chapter, totaling fifty-three methods (added according to Shu's edition).
1. Taiyang disease presents with floating pulse①, stiffness and pain in the head and neck, and aversion to cold② Original Text 1 (Sequence number refers to the original order of Clause 398 in *Shanghan Lun*, same throughout the book).
① Floating Pulse: The floating image is superficial, obtained with light pressure, indicating pathogenic factors have just entered.
② Head and Neck Stiffness and Pain: Means headache and stiff neck, referring to a feeling of pulling and discomfort in the neck. "Neck" refers to the posterior part of the neck. Aversion to Cold: Fear of cold and chilliness.
Zheng's Commentary: According to Taiyang, its native Qi governs Cold Water. Taiyang controls the skin, hair follicles, Ying and Wei, all vessels, and meridians of the whole body, serving as the guideline for the entire body. Hair follicles are the exit route for the transformation of Taiyang Cold Water Qi㈠. All incoming external pathogens must enter internally starting from the hair follicles. The characters "enter" and "exit" are the mechanism of pathogen and righteous Qi, the standard for all diseases. A floating pulse indicates pathogenic factors have just entered; head and neck stiffness and pain indicate pathogens invading the Taiyang territory meridians; aversion to cold indicates the Taiyang native Qi is diseased. The two characters "aversion to cold" are the outline of Taiyang, the key to identifying syndromes. Knowing these two characters, regardless of the season causing illness, as long as the patient currently exhibits head, neck, waist, back stiffness and pain, aversion to cold, and fever, one should treat according to Taiyang methods. Do not be constrained by seasonal timing, lest one lose the essence of the classics.
㈠ There are two interpretations of "Qi Transformation": That which exits through hair follicles is light and clear dew; that which exits downward is heavy and turbid fluid. Thus, Taiyang transmission via channels or transmission to fu organs are all explored through this Qi transformation (Top Comment).