书以载道。载而不醇则反害。书乎哉。医家之书。自本草素灵难经以至伤寒论。方法具而体
用备。书少而义精。道之原也。末流纷纷。汗牛充栋。多遂横。少遂塞。以横之牵矫蹈附。猎名
媒利。适所以成绳蠹 氛。而言之。醇乎哉。盖不过徒为凿凿扰扰。道愈昏而世愈惑。虽多亦奚
以为。医道与儒道通。夫何读儒家书。三年则必有魁天下而名世之儒出。读医书。虽经世计。未
便见有医之能良者出于其间。为何如人焉。儒难邪医难邪。世固有小视夫医而以易易言者。盖亦
未之思而云然尔。愚于儒。且惮不能。今乃医。何也。天既 然以医之道勉我。我虽不敏。不敢
不勉也。苟欲勉。则凡在为道。皆不可不勉。而后庶乎可以能勉言。是故。痉有道。帝伯仲景道
之矣。后人不道也。而又反以惊风之妄谬害之。祸世厄道不为不久矣。此其医之所以难也欤。诚
有所不能忍见者。故敢申明其道而复书之。以与知我者同从事于勉焉。痉书之谓也。
万历己亥正月人日九龙山人方有执自跋
伤寒论者。仲景氏辨伤寒而论之之谓也。伤寒何为而辨论也。乱伤寒者中风。并中风寒。杂
伤寒者温病。风温。霍乱。本气自病。与凡痉湿 。皆与伤寒相涉于疑。故一一条辨而例论之。
然后各皆始得分晓而不惑。此伤寒论之所以作也。然诸病之所以有待于条辨例论。而后各皆始得分
晓而不惑者。以皆统于六经也。六经各一经络脏腑。惟太阳独多始病荣卫之两途。诸病论经。论
经者。经辨而病明也。伤寒与中风。则于论经之中。吃紧关系。严辨又在太阳之荣卫。盖风则病
卫。寒则病荣。风寒俱有。则荣卫皆受而俱病。太阳一也。荣卫二。而病则三焉。此太阳所以分
当严辨。而与余经不同也。过太阳。阳明以下。辨论乃得各归于经。所以自微而着。自少而多。
剩徒法而以方法具备者计之。筹其条目。法则迤逦已三百九十七。方则因仍已一百一十三。然而
法中乃有一则曰。知犯何逆。随证治之之条。二则曰。知犯何逆。以法治之之目。法言若是。岂
非以其丝辨缕论。积多若是。犹不足以尽风寒之所欲论之谓邪。噫。仲景氏所以作论之心。于此
可以想见其万一于言国文本之外矣。曾谓非辨非论。顾可以清杂乱。而正伤寒之名实乎。不能
也。是故伤寒不可以作经。而但可以作论者。其意不在此欤。名虽曰论。实则经也。说者谓医家
之有此书。犹儒家之有语孟。盖以其浑融该博。曲尽精微。恢恢乎足以股肱素难。而为斯道之日
星。信矣。然其举纲振目。经纶阖辟。首尾条贯。脉络分明。近则可以言仿佛学庸。远则可以议
属比春秋。而法象乎易。说者遗之。似亦未可以言其全知此书之纯粹也。嗟惟文本。去古未远。
辞简义奥。读而道其道者。要皆不过模形
范影。踪迹汤丸。错择名利。以求凿柄于盲瞽之余。譬之乐师。习○ HT 以治钟 琴瑟。节奏
虽工。求其所谓正六律。谐五音。通八风。而能与天地同和者。难言也。叔和类集而编次之。各
为一篇。独于太阳。分而为三。一一以辨。标其篇目。夫既以辨标其篇目。则论归重于辨。叔和
已得之矣。既分太阳为三篇。则太阳一经归重于三辨。叔和已明之矣。自今观之。各篇之中。不合
于辨者。历历可指也。而太阳三篇。尤溷溷然无辨于三也。似此编次。徒赖叔和之名存。岂复叔
和之实在哉。必由后之轻浮。有如类证之辈者。不谙论义。不会辨意。骋以卑陋。计图剽窃。务
为欺炫。纷更错乱。颠倒变易。法则断股离肢。方则裒多益寡。将谓不如此。不足以动众。惟徇
私己。罔解误人。然冠履倒置。望者必骇。薰莸同 。嗅者必憎。或出重辑亦未可知。是以匡郭
纵完。而体骨终失。遂使晚见狐疑。卒致非全书之谬。虽专医之门。咸置之而不读。夫以此书为
非仲景氏之全书置而不读。彼业不在医。无足怪也。以业既在医。亦视为非全书而不读。则其为
医也。可得谓之全医乎。何不思之甚也。于是斯文湮没。至道蓁芜。民膺斯疾。幸邪不邪。不敢
必也。窃谓此惧。跋履山川。冒蒙荆棘。崎岖南北。东抵齐鲁。西涉川陕。委志从正。以趣明师。
期还叔和之故。以通仲景之源。风霜二十余年。颜霉鬓雪。神其默迪。一旦豁然。征之道途。足
成小试。倦老思休。归田闭 。考众本之殊同。反离异而订正。一师友之授传。窃僭负为此集。八
经寒暑。稿脱七誊。深惭蛙吹。玷荷骥附。虽不足以合叔和之雅调。而宣仲景氏之遗音。至于溯
流穷源。欲伸长○ HT 而拟望六律正。五音谐。八风通。天地和同。底民物于康阜。以上际唐
虞之盛之心。所以延颈企踵于任斯道之君子者。未尝有一息之不然。此其所以
宁负僭窃而不敢逃避也。谨书揭简。以告同志云。
辛卯冬日长至歙灵山方有执书于溪南无逸所
书籍是用来承载大道的。如果承载的内容不纯正，反而会带来危害。书啊！医家的著作，从《本草》、《素问》、《灵枢》、《难经》直到《伤寒论》，治疗方法完备，体用兼备。书籍虽少而义理精微，这是道的本源。到了后世末流，著作纷纷出现，堆积如山，大多变得杂乱无章，少数则显得闭塞不通。因为杂乱，就牵强附会、矫揉造作；因为闭塞，就固步自封。那些凭借杂乱之说来猎取名声、谋取利益的人，恰恰成为了蛀虫和污秽之气。至于谈论这些著作，还算纯正吗？大概不过是徒劳地造成混乱和喧嚣，使得道更加昏暗，世人更加迷惑，虽然书多又有什么用呢？
医学之道与儒家之道是相通的。为什么读儒家的书，三年后一定会有能统领天下、闻名于世的儒者出现？而读医书，即使经过世代计算，却未见有良医从中产生。这是为什么呢？是儒学难还是医学难？世上本来就有轻视医学，认为它很容易的人，这大概是没有深思熟虑才这样说罢了。我对于儒学，尚且害怕自己不能胜任，如今却从事医学，为什么呢？上天既然以医学之道勉励我，我虽然不聪敏，也不敢不努力。如果想要努力，那么凡是在道上的事情，都不可以不努力，然后才可以称得上是能够谈论“努力”。所以，《痉书》是有道的，黄帝、伯高、仲景已经阐述了道。后人却不遵循道，反而用“惊风”这种荒谬的理论来害它，祸害世间、困厄大道的时间不算短了。这就是医学之所以难的原因吧。我实在不忍心看到这种情况，所以敢于申明这个道并再次写下这本书，以此来与了解我的人一起致力于努力。这就是所谓的《痉书》。
万历己亥年正月人日（正月初七），九龙山人方有执自跋。
《伤寒论》，是张仲景氏辨别伤寒并进行论述的意思。为什么要辨别和论述伤寒呢？扰乱伤寒概念的是中风，以及将中风与寒混为一谈；混杂伤寒概念的是温病、风温、霍乱、本气自病，以及各种痉、湿、暍（中暑）等，这些都与伤寒在疑惑中相互牵连。所以要一一进行条辨和例论，然后各自才能开始清晰明了而不被迷惑。这就是《伤寒论》之所以创作的原因。然而，各种疾病之所以有待于条辨和例论，然后才能各自清晰明了而不被迷惑，是因为它们都统摄于六经之中。六经各包含经络和脏腑，只有太阳经最初发病时涉及营卫两条途径。诸病论述经络，论述经络，经络辨析清楚，病症也就明确了。伤寒与中风，则在论述经络之中有着紧密的关系，严格的辨析又在太阳经的营卫之间。大概风邪致病伤及卫气，寒邪致病伤及营血。风寒都有，则营卫都受邪而共同发病。太阳经是一个，营卫是两个，而病症则有三个。这就是太阳经之所以应当严格辨析，而与其他经脉不同的原因。过了太阳经，阳明经以下，辨析论述才能各自归于本经。所以是从微弱到显著，从少到多。仅仅通过方法来具备所有方法，计算其条目，法则蜿蜒已有三百九十七条，方剂因袭已有第一百一十三首。然而在法则中却有两条说：“知道犯了什么逆证，随着证候治疗”的条款；两条说：“知道犯了什么逆证，按照法治疗”的项目。法则说到如此地步，难道不是因为它像梳理丝线一样细致辨析论述，积累这么多，还不足以穷尽风寒想要论述的全部内容吗？唉！张仲景氏创作这部论著的心意，从这里可以想象出万一，而在言语文字之外了。谁说这不是辨析和论述，怎么能澄清杂乱，端正伤寒的名实呢？是不能的。所以《伤寒论》不可以当作经书，而只能当作论著，其用意不就在这里吗？名义上虽然叫“论”，实际上就是“经”。评论者说医家有这本书，就像儒家有《论语》和《孟子》，大概是因为它浑融广博，曲尽精微，宽绰有余足以辅助《素问》和《难经》，成为这条大道的日月星辰，确实是这样。然而它举纲振目，经纬开合，首尾连贯，脉络分明，近则可以比作《大学》、《中庸》，远则可以类比《春秋》，效法《易经》。评论者忽略这一点，似乎也不能说是完全了解这本书的纯粹性。唉！文本离古代不远，辞句简练而义理深奥，读它并践行其道的人，大体不过只是模仿外形，追随汤丸的痕迹，错杂地选择名利，以求在盲瞽之余得到一点凿柄般的契合。譬如乐师，学习某种技艺来治理钟琴瑟，节奏虽然工整，但要寻求所谓正六律、谐五音、通八风，并能与天地同和的境界，就很难说了。王叔和分类集录并编次它，各成一篇，唯独对太阳经，分为三篇，一一进行辨析，标出篇目。既然以辨析为标题，那么论述的重点在于辨析，王叔和已经掌握了这一点。既然将太阳经分为三篇，那么太阳一经的重点归于三种辨析，王叔和已经阐明了这一点。从现在来看，各篇之中，不符合辨析精神的，历历可数。而太阳三篇，尤其混淆不清，没有体现出三种辨析的区别。像这样的编次，仅仅依靠王叔和的名声得以保存，哪里还有王叔和的实际内容呢？必定是由于后世的轻浮之人，像类证之辈那样，不懂论义，不理解辨析之意，凭借卑陋之见，企图剽窃，务必做到欺骗炫耀，频繁更改，错乱颠倒，使法则支离破碎，方剂增损不当。他们以为不这样做，不足以打动众人，只是顺从私欲，不解误人。然而冠履倒置，观望的人一定会惊骇；香草臭草放在一起，闻的人一定会厌恶。或许有人出来重新编辑也未可知。因此，虽然外框完整，但体制骨骼最终丧失，致使后来者见到狐疑，最终导致这不是全书的谬误。即使是专门的医家，也都把它放在一边不读。把这本书当作不是张仲景氏的全书而放置不读，那些业不在医学的人，不足为怪。既然业已在医学，也视为非全书而不读，那么他作为医生，可以称为全医吗？怎么不想想呢？于是斯文湮没，大道荒芜，百姓遭受疾病，幸还是不幸，不敢肯定。我私下里担忧这种情况，跋山涉水，冒着荆棘，崎岖于南北，东抵齐鲁，西涉川陕，立志归正，去追求明师，期望恢复王叔和的原貌，以通达张仲景的源头。风霜二十多年，容颜变黑鬓发如雪，神灵默默启迪，一旦豁然开朗，验证于路途，脚力足以小试。疲倦年老想休息，归田闭门，考察众本的异同，反离异而订正，请教师友传授，私自僭越承担为此集注。历经八个寒暑，稿子脱手七次誊写，深深惭愧如蛙鸣般浅薄，玷辱地依附于骏马之后。虽然不足以符合王叔和的雅调，而宣扬张仲景氏的遗音，至于追溯源头，想要伸长脖子仰望六律正、五音谐、八风通、天地和同，使百姓万物安康，以上追唐虞盛世之心，所以伸长脖子踮起脚尖期待承担此道的君子，未曾有一刻不这样。这就是为什么宁愿背负僭越窃取之名而不敢逃避的原因。谨以此书揭示于简册，以此告知志同道合的人。
辛卯年冬日冬至，歙县灵山方有执书写于溪南无逸所。
Books serve to carry the Dao (the Way). If what is carried is not pure, it will instead cause harm. Ah, books! Medical works, ranging from *Bencao* (Materia Medica), *Suwen* (Basic Questions), *Lingshu* (Spiritual Pivot), *Nanjing* (Classic of Difficult Issues) up to *Shanghan Lun* (Treatise on Cold Pathogenic Diseases), possess complete methods and fully prepared substance and function. The books are few yet the principles are refined; this is the origin of the Dao. In later generations, however, works have proliferated, filling ox-carts and lining buildings like dust. Most have become chaotic and sprawling, while a few have become blocked and stagnant. Due to chaos, one resorts to forced connections and arbitrary attachments; due to stagnation, one becomes narrow-minded. Those who hunt for fame and profit through such chaotic assertions merely become bookworms and foul air. As for discussing these works, are they pure? They are likely nothing more than futilely creating confusion and disturbance, making the Dao even dimmer and the world more bewildered. What use is there in having many?
The Way of Medicine is connected with the Way of Confucianism. Why is it that after reading Confucian books for three years, there inevitably emerge Confucians who can lead the world and gain fame? Yet, when reading medical books, even over generations, no truly capable physicians seem to emerge among them. Why is this? Is Confucianism difficult or is Medicine difficult? There are indeed those in the world who look down upon medicine, considering it easy and speaking of it lightly. This is likely said without deep reflection. I, regarding Confucianism, am already afraid that I cannot achieve it; why then do I now engage in medicine? Heaven has used the Way of Medicine to encourage me. Although I am not intelligent, I dare not fail to strive. If one wishes to strive, then everything related to the Dao must be strived for, so that one may eventually speak of "striving." Therefore, the *Jing Shu* (Book on Stiffness/Spasm) possesses the Dao; the Yellow Emperor, Bo Gao, and Zhang Zhongjing have expounded upon it. Later people did not follow the Dao but instead harmed it with the absurdity of "Wind Shock" (Jing Feng). The disaster to the world and the obstruction of the Dao have lasted long enough. This is perhaps why Medicine is difficult. I truly cannot bear to see this situation, so I dare to clarify this Dao and write this book again, to engage in striving together with those who understand me. This is what is meant by the *Jing Shu*.
Postscript by Fang Youzhi, Mountaineer of Jiulong, on the Human Day (7th day) of the first month of the Jihai year of the Wanli era.
*Shanghan Lun* refers to Zhang Zhongjing's differentiation and discussion of cold pathogenic diseases. Why differentiate and discuss cold pathogenic diseases? Because "Zhongfeng" (Wind Strike) confuses the concept of Shanghan, conflating wind strike with cold; and "Wenbing" (Warm Diseases), Fengwen (Wind-Warmth), Huoluan (Cholera-like disorder), Benqi Zibing (Diseases originating from internal Qi imbalance), as well various Jing (Stiffness/Spasm), Shi (Dampness), and He (Heatstroke) conditions all intermingle with Shanghan amidst doubt. Therefore, each must be differentiated and discussed by category, so that each can begin to be clear and free from confusion. This is the reason for the creation of *Shanghan Lun*. However, the reason why various diseases require differentiation and categorical discussion to become clear and free from confusion is that they are all unified under the Six Channels (Liu Jing). Each of the Six Channels involves meridians and zang-fu organs. Only the Taiyang (Greater Yang) channel initially involves both Ying (Nutritive) and Wei (Defensive) pathways. Discussing diseases by channels means that once the channels are differentiated, the diseases become clear. Between Shanghan and Zhongfeng, within the discussion of channels, lies a critical relationship: strict differentiation focuses on the Ying and Wei of the Taiyang channel. Generally, wind pathogens affect the Wei, while cold pathogens affect the Ying. If both wind and cold are present, both Ying and Wei are affected and both become diseased. The Taiyang channel is one, Ying and Wei are two, but the diseases are three. This is why the Taiyang channel requires strict differentiation, differing from other channels. Beyond the Taiyang, for Yangming and subsequent channels, differentiation and discussion allow each to return to its respective channel. Thus, it proceeds from subtle to manifest, from few to many. Merely counting the methods to cover all possibilities, the items of law extend to 397, and the formulas inherited number 113. Yet within these laws, there are clauses stating: "Know what deviation has occurred, and treat according to the syndrome," and items stating: "Know what deviation has occurred, and apply the appropriate method." Laws stated thus, does it not imply that because the differentiation is as detailed as sorting silk threads, accumulating so much, it still is insufficient to exhaust all that needs to be discussed regarding wind and cold? Alas! From this, one can imagine one ten-thousandth of Zhang Zhongjing's intention in writing this treatise, beyond mere words and text. Who would say that this is not differentiation and discussion, and how else could chaos be cleared and the name and reality of Shanghan be rectified? It cannot be done otherwise. Therefore, *Shanghan Lun* should not be treated as a Classic (Jing) but only as a Treatise (Lun); is not its intent here? Although nominally called a "Treatise," in essence it is a "Classic." Commentators say that for medical practitioners, having this book is like Confucians having the *Analects* and *Mencius*, largely because it is holistic and comprehensive, capturing subtleties with precision, broad enough to support *Suwen* and *Nanjing*, serving as the sun and moon of this Dao. Truly so. It grasps the key points and details, manages the opening and closing of meridians, maintains coherence from beginning to end, and clarifies the network. Closely, it resembles *Daxue* (Great Learning) and *Zhongyong* (Doctrine of the Mean); distantly, it can be compared to *Chunqiu* (Spring and Autumn Annals) and modeled after *Yijing* (Book of Changes). Commentators who overlook this seem unable to claim full knowledge of the purity of this book. Alas! The text is not far removed from antiquity; its language is concise and its meaning profound. Those who read it and practice its way generally only imitate forms and shadows, trace the footsteps of decoctions and pills, mistakenly choose fame and profit, seeking a fit in the remnants of blindness. It is like a music master learning techniques to tune bells, qin, and se; although the rhythm is skillful, to seek the so-called correct Six Pitch-pipes, harmonious Five Tones, communication of Eight Winds, and harmony with Heaven and Earth is hard to achieve. Wang Shuhe classified, collected, and arranged them into separate chapters. He divided the Taiyang chapter into three parts, differentiating each one and labeling the titles. Since he labeled them by differentiation, the focus of the treatise lies in differentiation; Wang Shuhe had grasped this. Since he divided Taiyang into three chapters, the focus of the Taiyang channel lies in three differentiations; Wang Shuhe had clarified this. Viewing it from today, within each chapter, those that do not conform to differentiation are clearly identifiable. Especially in the three Taiyang chapters, they are particularly confused, lacking distinction among the three. Such arrangement relies merely on Wang Shuhe's name for preservation; where is the actual content of Wang Shuhe? It must be that frivolous later generations, like those compiling case classifications, ignorant of the treatise's meaning and the intent of differentiation, relying on their own pettiness, attempting plagiarism, aiming for deception and display, frequently altering, causing chaos and inversion, breaking apart the laws and modifying the formulas arbitrarily. They believed that without doing so, they could not attract attention, catering only to selfish desires and misunderstanding, leading others astray. However, putting caps on feet and shoes on heads will surely shock observers; mixing fragrant herbs with foul ones will surely disgust sniffers. Perhaps someone might come out to re-edit it. Thus, although the outer frame remains intact, the structure and bones are ultimately lost, causing later readers to doubt and eventually concluding it is not the complete work. Even specialists in medicine place it aside unread. To consider this book not the complete work of Zhang Zhongjing and leave it unread is understandable for those not engaged in medicine. But for those engaged in medicine, viewing it as incomplete and refusing to read it—can such a person be called a complete physician? How thoughtless. Thus, this literature was obscured, the Great Dao overgrown, and people suffered from diseases. Whether luck or misfortune, it is uncertain. I privately feared this state, traversed mountains and rivers, braved thorns, traveled north and south, reaching Qilu in the east and Sichuan-Shaanxi in the west, dedicating myself to the right path, seeking enlightened masters, hoping to restore Wang Shuhe's original order and connect to Zhang Zhongjing's source. Through twenty years of wind and frost, my face darkened and hair turned white, spirits silently guided me, until one day I suddenly understood. Testing this on my journey, my strength sufficed for a small trial. Tired and old, thinking of rest, I returned to the fields, closed the door, examined differences among various editions, corrected deviations, consulted friends and teachers, and presumptuously undertook this compilation. Over eight winters and summers, the manuscript was rewritten seven times. Deeply ashamed of my shallow contributions like a frog's croak, yet honored to attach myself to the steed. Although insufficient to match Wang Shuhe's elegant tone or proclaim Zhang Zhongjing's legacy, tracing the stream to its source, stretching my neck to gaze at the correction of Six Pitch-pipes, harmony of Five Tones, passage of Eight Winds, and unity of Heaven and Earth, aiming for the health of people and things, aspiring to the prosperity of Tang and Yu, I have never ceased longing for gentlemen who bear this Dao. This is why I dare not escape, even if accused of presumption. I respectfully record this on bamboo slips to inform my comrades.
Written by Fang Youzhi of Lingshan, She County, at Wuyi Studio in Xinan, on the Winter Solstice day of the Xinmao winter.