脉浮得病。宜发散。脉沉得病。宜疏利。脉迟之病。宜温中。脉数之病。宜汗解。右寸有力
者。可吐。右尺有力者。可下。左寸有力者。可汗。丈夫寸口脉须浮。关部脉须紧。尺部脉须沉。
妇人寸部脉须沉。关部脉须缓。尺部脉须浮。
医门理法至微玄。大要胸中有转旋。望闻问切四件事。缺一偏枯不备全。
【望】第一看他神气色。润枯肥瘦起和眠。活润死枯肥是实。瘦为虚弱古今传。谦体则知腰
内痛。攒眉头痛与头眩。手不举兮肩背痛。步行艰苦疼腰间。叉手按胸知内痛。按中脐腹痛相连。
但起不眠痰夹热。贪眠虚冷使之然。面壁 身多是冷。仰身舒挺热相煎。身面目黄脾湿热。唇青
面黑冷同煎。
【闻】第二应声清与浊。鉴他真语及狂言。声浊即知痰壅塞。声清内冷是因缘。言语真诚非
实热。狂言号叫热深坚。称神说鬼逾墙壁。胸膈停痰证痫癫。更有病因循日久。音声遽失命归泉。
【问】三问病因经几日。日间便利几番行。饮食少多宜冷热。更兼服过药堪凭。饮食稍通
容易治。不进之时不易宁。喜冷定知心内热。好温乃是脏中寒。尿色赤黄真内热。尿清定是冷相
干。
【切】切脉是居为四末。浮沉迟数病之端。四事略陈通梗概。举隅善反一同看。
成无己本旧有伤寒例一篇。今削之。存此以备后照。
医道之方法具备。自仲景始。故世称仲景方法之祖。伤寒论。乃其书也。考求其方法。义例
明甚。何谓例。如中风。一也。伤寒。二也。兼风寒俱有而中伤。三也。三病不同。以皆同在太
阳。故皆发汗。发汗云者。非以例言乎。何谓义。如发中风之发。发之以桂枝汤。发伤寒之发。发
之以麻黄汤。发兼风寒俱有而中伤之发。发之以大青龙汤。一例发汗。而三汤则不同。非以其
各有所宜之义乎。然则方法者。道之用也。例者。所以行其方法也。义则其行而宜之之谓是已。
是皆相须而不相离。一致之谓道也。啻此为然哉。其余各属。悉皆类此。条目具在也。夫何无己
之注解。不省义例原属方法中。法外又独有伤寒之例。独例伤寒而置诸各属。舍义而独曰例。岂
仲景之言。其为后人之伪。明亦甚矣。伪例者谁。或曰叔和。谓叔和者。以其编述也。编述论而
出始。则叔和之于论。诚功之首也。乃若又伪此例。则后之医伤寒者。不知通求各属。但务专拟
于伤寒。仿例而行。仲景之道。反愈晦。而至今愈不明。究其叛乱不由厄于此例以至如此乎。以
此言之。则叔和者。亦一罪之魁耳。贤如叔和。愚意其智不乃尔也。或曰无己。谓无己者。以其
注解也。此则近似。何也。已任注解。则当精辨论之条目。详悉各属本义。以迪诸后。不当愎强
苟且。一概徇己。朦胧训为伤寒。比之于例。俨然一家口语。以此拟己。夫复何疑。且例苟在己
前。亦当暴白其非。不令得以迷误继述。是也。奈何懵此不为。乃固为尾之以阿顺可乎。律以春
秋大义。譬如专国政之赵卿。以不讨贼而直受弑君之恶。罪不能辞。己亦有也。虽然。事属久远。
理在难明。必欲求其人以实之。斯亦凿矣。伪不容有。无之可也。既应无之。削之是矣。故从削。
脉象浮起而发病的，适宜用发散法治疗。脉象沉潜而发病的，适宜用疏利法治疗。脉象迟滞而发病的，适宜用温中法治疗。脉象数急而发病的，适宜用汗解法治疗。右寸脉有力的，可用吐法。右尺脉有力的，可用下法。左寸脉有力的，可用汗法。男子的寸口脉，寸部应当浮，关部应当紧，尺部应当沉。女子的寸部脉应当沉，关部脉应当缓，尺部脉应当浮。
医门的理法极其微妙玄奥，关键在于胸中要有灵活转旋的能力。望、闻、问、切这四件事，如果缺少任何一项，诊断就不完备。
【望诊】首先要观察患者的神气和面色。润泽与枯槁、肥胖与消瘦、睡眠状态是否正常。色泽活润者生，枯槁者死；形体肥壮多属实证，形体消瘦多为虚弱，这是古今相传的经验。身体前倾（谦体）则知腰内部疼痛；皱眉表示头痛或头晕；手臂抬不起来是肩背疼痛；行走困难是腰部疼痛；双手交叉按压胸部可知内部疼痛；按压肚脐周围疼痛相连。只能起身不能安卧，多是痰热夹杂；贪睡则是虚寒所致。面向墙壁蜷缩身体，多是寒证；仰卧舒展身体，多是热证。身体面目发黄，是脾经湿热；嘴唇发青、面色发黑，是冷邪煎熬。
【闻诊】其次听声音的清亮与浑浊，辨别是真语还是狂言。声音浑浊可知痰涎壅塞；声音清亮内里寒冷是因缘所致。言语真诚并非实热；狂言号叫是热邪深重坚固。胡言乱语称神说鬼，甚至跨越墙壁，是胸膈停痰导致的痫癫证。还有病因拖延日久，声音突然丧失，生命即将终结。
【问诊】第三问病因经过了多少天，白天大小便排了几次。饮食量的多少以及喜好冷热，以及之前服用过什么药物可以作为参考。饮食稍通容易治疗，完全不进饮食时难以安宁。喜冷饮定知心内有热；喜温热则是脏腑中有寒。尿色赤黄真是内热；尿清定是冷邪干扰。
【切诊】切脉居于四诊之末，通过浮、沉、迟、数来辨别疾病的开端。以上四事简要陈述了大概情况，举一反三，可以类推看待。
成无己版本的《伤寒论》旧有《伤寒例》一篇，现在将其删削掉，保留此说明以备后人参照。
医道的治疗方法完备，是从张仲景开始的，所以世人称张仲景为方法的始祖。《伤寒论》就是他的著作。考究其中的方法，义理和体例非常明显。什么是“例”？比如中风，是一类；伤寒，是二类；兼有风寒同时中伤，是三类。这三种病不同，但因为都在太阳经受邪，所以都用发汗法。所谓发汗，不就是“例”吗？什么是“义”？比如治疗中风的发汗，用桂枝汤；治疗伤寒的发汗，用麻黄汤；治疗兼风寒俱有中伤的发汗，用大青龙汤。同样是发汗这一“例”，但三种方剂却不同，这不正是各有所宜的“义”吗？那么方法，是道的运用；“例”，是用来施行其方法的；“义”，则是施行得宜的意思。这些都是相互依存不可分离的，这就是所谓的“道”。不仅仅是这样，其余各类条目，都与此类似，条理清晰可见。为什么成无己的注解，不明白义和例原本属于方法之中，而在法之外单独设立《伤寒例》，只针对伤寒设立一个“例”并放在各类条目之后，舍弃“义”而独称“例”，这难道不是张仲景的原话被后人伪造的吗？明摆着很清楚。伪作《伤寒例》的是谁？有人说王叔和，说是因为是他编纂叙述的。编纂论述而出始，那么王叔和对《伤寒论》确实是有首功的。但如果又伪造了这个《例》，那么后世医治伤寒的人，不知道通求各类条目，只致力于专门模仿《伤寒例》行事，张仲景的道反而更加晦暗，至今越来越不明朗。追究这种叛乱不正是因为这个《例》才导致这样的吗？由此而言，王叔和也是一个罪魁首啊。像王叔和那样贤能的人，我猜想他的智慧不至于如此。也有人说成无己，说是因为他做了注解。这比较接近事实。为什么呢？既然担任注解的工作，就应当精辨《论》的条目，详细考察各类条目的本义，以启迪后人，不应当固执己见、苟且敷衍，模糊地训释为《伤寒》，把它比作“例”，俨然成为一家之言的口吻。以此推测他，还有什么可疑的呢？况且如果《例》在他之前存在，他也应当公开表明其错误，不让后来人继续迷误继承。这是对的。奈何懵懂于此而不做，反而固守尾巴以阿顺迎合可以吗？用春秋大义来衡量，譬如专掌国政的赵卿，因为不讨伐贼人而直接承受弑君的恶名，罪行无法推辞。他自己也有罪。虽然事情属于久远，道理难以明白，一定要找人证实它，这也太穿凿附会了。伪作不容许存在，没有最好。既然应该认为没有，删削它是正确的。所以遵从删削。
When the pulse is floating at the onset of illness, dispersing methods (Shisan) are appropriate. When the pulse is sunken at the onset of illness, draining and promoting methods (Shuli) are appropriate. When the illness presents with a slow pulse (Chi), warming the middle jiao (Wenzhong) is appropriate. When the illness presents with a rapid pulse (Shu), resolving via sweating (Hanjie) is appropriate. If the right Cun position is forceful, emetic therapy (Tu) can be used. If the right Chi position is forceful, purgative therapy (Xia) can be used. If the left Cun position is forceful, diaphoretic therapy (Han) can be used. In men, the Cun position of the Cun Kou pulse should be floating, the Guan position should be tight, and the Chi position should be sunken. In women, the Cun position should be sunken, the Guan position should be moderate/relaxed (Huan), and the Chi position should be floating.
The principles and methods of medicine are extremely subtle and profound; the key lies in having flexible maneuverability within the chest/mind. The four diagnostic methods—inspection (Wang), auscultation and olfaction (Wen), inquiry (Wen), and palpation (Qie)—if any one is missing, the diagnosis is incomplete.
[Inspection] First, observe the patient's Shen (Spirit/Qi) and complexion. Distinguish between luster and dryness, obesity and emaciation, and normal or abnormal sleep. Luster indicates life, dryness indicates death; robustness suggests excess syndromes, while emaciation suggests deficiency, a principle passed down through ancient and modern times. Leaning forward suggests pain in the lower back/internal organs; furrowed brows indicate headache or dizziness; inability to raise arms indicates shoulder and back pain; difficulty walking indicates waist pain; crossing hands over the chest indicates internal pain; tenderness upon pressing around the umbilicus indicates abdominal pain. Restlessness and inability to lie flat suggest phlegm-heat complex; excessive sleeping suggests deficiency-cold. Curling up facing the wall suggests cold syndromes; lying supine and stretching out suggests heat syndromes. Yellowing of the body, face, and eyes indicates spleen damp-heat; blue lips and black complexion indicate severe cold torment.
[Auscultation and Olfaction] Second, listen to the clarity or turbidity of the voice, distinguishing between coherent speech and delirious words. Turbid voice indicates phlegm obstruction; clear voice may indicate internal cold due to specific causes. Sincere speech does not necessarily indicate excess heat; delirious shouting indicates deep and solidified heat. Hallucinations, speaking of gods and ghosts, or even claiming to jump over walls indicate epilepsy or mania caused by retained phlegm in the chest and diaphragm. Additionally, if the cause persists for a long time and the voice suddenly disappears, death is imminent.
[Inquiry] Third, inquire about the duration of the illness, the frequency of bowel movements during the day, the quantity of food intake, and preferences for hot or cold foods/drinks. Also, note what medications have been taken previously as reference. If appetite is slightly restored, treatment is easier; if no food is taken, it is difficult to stabilize. Preference for cold drinks confirms internal heat; preference for warmth indicates organ cold. Red and yellow urine confirms internal heat; clear urine indicates cold interference.
[Palpation] Palpation is the final of the four diagnostics; floating, sunken, slow, and rapid pulses reveal the beginning of the disease. These four aspects briefly outline the general principles; apply this logic analogously to other cases.
Cheng Wuji's edition of *Shanghan Lun* contains an old chapter titled "Example of Shanghan" (Shanghan Li). This is now deleted, but this explanation is retained for future reference.
The complete methodology of medicine originated with Zhang Zhongjing, hence he is called the ancestor of medical methods. *Shanghan Lun* is his work. Examining its methods, the meaning and examples are very clear. What is an "example" (Li)? For instance, Wind Strike (Zhong Feng) is one category; Cold Damage (Shang Han) is another; simultaneous attack by both wind and cold is a third. Although these three diseases differ, because they all affect the Taiyang channel, they are all treated with diaphoresis (sweating). Thus, "diaphoresis" serves as the "example." What is the "meaning/principle" (Yi)? For example, treating the diaphoresis of Wind Strike uses Guizhi Tang (Cinnamon Twig Decoction); treating the diaphoresis of Cold Damage uses Mahuang Tang (Ephedra Decoction); treating the diaphoresis of combined wind-cold attack uses Da Qinglong Tang (Major Green Dragon Decoction). While the "example" is diaphoresis, the three formulas differ, which reflects the "meaning" that each has its specific suitability. Therefore, method is the application of the Dao; the "example" is how the method is executed; the "meaning" is the appropriateness of that execution. These are interdependent and inseparable, constituting the unity of the Dao. This applies to all other categories as well, with clear entries. Why did Cheng Wuji's commentary fail to realize that Yi and Li originally belong within the method? By creating a separate "Example of Shanghan" outside the methods and placing it among various categories, abandoning "Yi" to focus solely on "Li," it becomes evident that Zhang Zhongjing's original words were forged by later people. Who forged the "Example"? Some say Wang Shuhe, due to his compilation. While Wang Shuhe deserves credit for compiling the treatise, forging this "Example" led later physicians to ignore the broader categories and strictly imitate only the "Shanghan Example," causing Zhang Zhongjing's Dao to become increasingly obscure. Tracing this deviation back, it stems from this "Example." Thus, Wang Shuhe is a chief culprit. However, given his wisdom, I doubt he would do such a thing. Others blame Cheng Wuji, which is more plausible. As a commentator, he should have carefully distinguished the entries and detailed their original meanings to guide future generations, rather than stubbornly forcing interpretations, blurring them into a generic "Shanghan Example," and presenting it as his own school's doctrine. If the "Example" existed before him, he should have exposed its errors to prevent misleading successors. Instead, he remained ignorant and complied. Judging by the principles of the *Spring and Autumn Annals*, like Zhao Qing who usurped power and failed to punish regicides, bearing the guilt of regicide himself, Cheng Wuji also bears guilt. Although the matter is ancient and hard to prove definitively, insisting on finding a specific person is overly speculative. Forgery cannot be tolerated; it is better to assume it did not exist. Since it should be considered non-existent, deleting it is correct. Therefore, we follow the deletion.