(柯本。卒。作杂。宜从。详见于综概。方氏以降诸本。并无集字。)
论曰。（程本。删论曰二字。锡志柯同。）余每览越人入虢之诊。望齐侯之色。（二事。见史记扁鹊传。）
未尝不慨然叹其才秀也。（慨。 通。说文。 。叹也。诗王风。 其叹。又曹风。忾我寤叹。忾。即慨字。
案晋潘岳间居赋序。岳尝读汲黯传。至司马安四至九卿。而良史书之。以巧宦之目。未尝不慨然废书而叹文法
略同。并原于史孟轲列传。）怪当今居世之士。曾不留神医药。精究方术。（史秦始皇纪。召文学方术之士。
汉平帝纪。方术本草。）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。（汉萧望之传。天下之士。延颈企踵。争愿自效。）孜孜汲汲。（博雅。孜孜汲汲。剧也。）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。（左传。僖十四年文。）卒然遭邪风之气。
婴非常之疾。（婴疾。又见后汉李膺传。）患及祸至。而方震栗。降志屈节。（论语微子。不降其志。不辱其
身。家语。宰予进于孔子曰。夫子之于司寇也。日少而屈节数矣。不可以已乎。）钦望巫祝。（尔雅。钦。敬
也。楚语。在男曰觋。在女曰巫。说文。祝。祭主赞词者也。）告穷归天。束手受败。（束手。见后汉光武纪。）
百年之寿命。（ 。当作 。 。 同。千金方作 。 。亦持也。左传僖三十二年注。上寿百二十岁。中
寿百岁。下寿八十。庄子盗跖篇。人上寿百岁。中寿八十。下寿六十。）持至贵之重器。委付凡医。恣其所措。
咄嗟呜呼。（何休公羊注曰。噫。咄嗟也。）厥身已毙。神明消灭。变为异物。（贾谊鹏鸟赋。化为异物兮。
又何足患。）幽潜重泉。（江淹述哀诗。美人归重泉。李善注。引潘岳悼亡诗。之子归穷泉。重壤永幽隔。）
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。（案从当今居世之士至此。
千金方序论。引张仲景曰。文与此少异。）而进不能爱人知人。退不能爱身知己。遇
灾值祸。身居厄地。（厄。何本作死。）蒙蒙昧昧。 若游魂。（ 。千金作戆。柯本作蠢。礼哀公问。寡人
愚冥烦。易系辞。游魂为变。皇甫谧甲乙经序曰。夫受先人之体。有八尺之躯。而不知医事 此所谓游魂耳。
盖此义也。）哀乎趋世之士。驰竞浮华。不固根本。忘躯徇物。（庄子让王篇。今世俗之君子。危身弃生以徇
物。）危若冰谷。（潘岳寡妇赋。若履冰而临谷。李善注。毛诗曰。惴惴小心。如临于谷。又曰。战战兢兢。
如履薄冰。北史周武帝纪。诏曰。每一念及。若临冰谷。）至于是也。余宗族素多。向余二百。建安纪年（案
纪年。纪元之年也。汉书武帝纪。元狩元年。冬十月。祠五 。获一角兽。以燎。始以天瑞纪元。）以来。犹
未十稔。（左传襄二十七年。不及五稔。注。稔。年也。熟也。谷一熟。为一年。）其死亡者。三分有二。（案
此乃当今居世之士。委付凡医。故如是尔。）伤寒十居其七。感往昔之沦丧。（书微子篇。今殷其沦丧。博雅。
沦。没也。）伤横夭之莫救。乃勤求古训。（书毕命。不由古训。于何其训。）博采众方。撰用素问。九卷。
八十一难。（志云。素问九卷者。素问八十一篇。内有遗阙。故举其卷。灵枢君臣问答八十一篇。毫无遗阙。
故举其篇。案九卷。即灵枢。八十一难即难经也。志聪注太谬妄。）阴阳大论（案林亿等。以素问运气七篇。
为阴阳大论。然无明据焉。）胎胪药录。（志云。胎胪药录者。如神农本经。长桑阳庆禁方之类。胎胪者。罗
列之谓。案此说未有所据。）并平脉辨证。（柯云。仲景言平脉辩证。为伤寒杂病论。是脉与证。未尝两分也。
案平脉辨证。亦似书名。然史志未着录。今无所考。）为伤寒杂病论合十六卷。虽未能尽愈诸病。庶可以见病
知源。若寻余所集。思过半矣。（易下系辞。知者观其彖辞。则思过半矣。王弼云。过半之益。不亦宜乎。孔
颖达云。聪明知达之士。观彖辞。则能思虑有益。以过半矣。）夫天布五行。以运万类。人禀五常。以有五脏。
（白虎通曰。五常者何。谓仁义礼知信也。五脏。肝仁。肺义。心礼。肾知。脾信也。）经络腑 。（气腑。
穴。）阴阳会通。（易上系辞。观其会通。以行其典礼。）玄冥幽微。变化难极。自非才高识妙。岂能探其
理致哉。（案才高。与首段才秀应。）上古有神农黄帝岐伯伯高雷公少俞少师仲文。（案仲文。史书医传等。
无考。）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。（即前段所谓凡医。）不念思求经旨。以演其所知。各承家技。终始顺旧。省疾问病。务在口给。
（论语。御人以口给。何晏注。佞人口辞捷给。）相对斯须。（斯须。犹须臾。礼乐记。礼乐不可斯须去身。）
便处汤药。按寸不及尺。（寸谓寸口。尺谓尺肤。）握手不及足。人迎趺阳。三部不参。（十便良方。引王贶
脉诀曰。说脉之法。其要有三。一曰人迎。在结喉两旁。法天。二曰三部。谓寸关尺。在于腕上侧。法人。三
曰趺阳。在足面系鞋之所。法地。三者皆气之出入要会。所以能决吉凶死生。凡三处。大小迟速。相应齐等。
则为无病之人。故曰。人迎趺阳。三部不参。动数发息。不满五十。未知生死。所以三者决死生之要也。）动
数发息。不满五十。（灵枢根结篇曰。脉。不满五十动。而一止者。一脏无气。故须候五十动。）短期未知（陆
机叹逝赋。嗟人生之短期。李善注。素问。雷公曰。请问短期。）决诊。九候（见素问三部九候论。）曾无仿
佛。（说文曰。仿。相似也。佛。见不审也。）明堂阙庭。尽不见察。（灵枢五色篇曰。明堂。鼻也。阙者。
眉间也。庭者。颜也。）所谓窥管而已（庄子曰。魏牟谓公孙龙曰。乃规规而求之以察。索之以辨。是直用管窥
天。用锥指地。不亦小乎。）夫欲视死别生。实为难矣。（案齐侯犹生。而视其死。虢太子已死。而别其生。
首以越人之才秀起。故结以此二句。○夫天以下。止难矣。千金方。载治病略例首。文与此少异。）孔子云。
生而知之者上。学则亚之。多闻博识。知之次也。（论语季氏篇曰。孔子曰。生而知之者上也。学而知之者次
也。困而学之又其次也。文异义近。）余宿尚方术。请事斯语。（论语颜渊篇。雍虽不敏。请事斯语○案生而
知之者。乃前段所谓其才之秀者也。学与多闻博识。乃前段所谓勤求古训。博采众方之类是也。盖生而知之者。
天之所赋。不可企而及。学与多闻博识。人之所能。皆可勤而至矣。当今居世之士。不留神医药。精究方术。
独仲景宿尚之。然无越人之才之秀 唯欲多闻博识。以精究之。故诵孔子语。以服膺之而已。此盖仲景之谦辞。）
汉长沙守南阳张机着。
程应旄曰。案古人作书大旨。多从序中提出。故善读书者。未读古人书。先读古人序。从序法中。读及全
书。则微言大义。宛然在目。余读伤寒论仲景之自序。竟是一篇悲天悯人文本。从此处作论。盖即孔子惧作春
秋之微旨也。
林亿等校定序曰。张仲景汉书无传。见名医录。云。南阳人。名机。仲景乃其字也。举孝廉。官至长沙太
守。始受术于同郡张伯祖。时人言。识用精微过其师。（太平御览。引仲景方序论。文同）按皇甫谧甲乙经序
云汉有华佗张仲景。仲景见侍中王仲宣。时年二十余。谓曰。君有病。四十当眉落。眉落半年而死。令服五石
汤可免。仲宣嫌其言忤。受汤勿服。居三日。见仲景。谓曰。服汤否。仲宣曰。已服。仲景曰。色候固非服汤
之诊。君何轻命也。仲宣犹不言。后二十年果眉落。后一百八十七日而死。终如其言。此事。虽扁鹊仓公。无
以加也。（太平御览。引何 别传。文同。）又晋书皇甫谧传。仲景垂妙于定方。抱朴子。仲景开胸纳赤饼。
（出初学记。及素问王冰注。今抱朴子无所考。）晋去汉未远。其见称于当时如何。仲景虽于汉书无传。其为
汉末人无疑矣。（后汉书刘表传。建安三年。长沙太守张羡。率零陵桂阳三郡畔表。表遣兵攻围。破羡平之。
注。英雄记曰。张羡南阳人。盖仲景。羡之族。岂表破羡之后。使仲景代之乎。）
（柯本将“卒”字改为“杂”字，应当遵从原文。详见于综概部分。方氏以来的各种版本，都没有“集”字。）
论述说：我每次阅读越人（指扁鹊）进入虢国诊视太子病情、以及观察齐侯面色这两件事（这两件事记载在《史记·扁鹊传》中），未曾不感慨叹息他的才华出众。（“慨”通“忾”，《说文解字》解释为叹息。《诗经·王风》中有“其叹”，《曹风》中有“忾我寤叹”，“忾”即“慨”字。案：晋代潘岳《闲居赋序》中说，潘岳曾读《汲黯传》，读到司马安四次升迁至九卿，而良史将其记录下来，以“巧宦”称呼他，潘岳未曾不感慨地放下书卷叹息。文法大致相同，都源于《史记·孟轲列传》。）
我奇怪当今的士人，竟然不留心医药，不精心研究医术方技。（《史记·秦始皇本纪》提到召见文学方术之士，《汉书·平帝纪》提到方术本草。）对上不能治疗君主和父母的疾病，对下不能拯救贫贱者的困厄，对内不能保全自身长久健康，以养护生命。只是竞相追逐荣耀权势，踮起脚跟仰慕权贵豪门。（《汉书·萧望之传》说：“天下的士人，伸长脖子踮起脚跟，争着愿意效力。”）他们勤勉急切地追求名利，只致力于名利的经营，崇尚修饰细枝末节，忽视抛弃根本，外表华丽而内部憔悴。皮都不存在了，毛将依附在哪里呢？（语出《左传·僖公十四年》。）突然遭受邪风的侵袭，患上突如其来的重病。（“婴疾”一词也见于《后汉书·李膺传》。）祸患降临，才感到震惊恐惧，降低志向，屈从气节。（《论语·微子》说：“不降低自己的志向，不辱没自己的身体。”《孔子家语》中宰予对孔子说：“夫子对于司寇一职，日子短了却多次屈节，难道可以停止吗？”）恭敬地盼望巫祝祈祷。（《尔雅》说：“钦”是恭敬的意思。《国语》说：“男称觋，女称巫。”《说文解字》说：“祝”是祭祀时主持赞词的人。）告穷无门，归咎于天，束手待毙，接受失败。（“束手”一词见于《后汉书·光武帝纪》。）百年的寿命（“ ”当作“寿”，“寿”与“ ”同义，《千金方》作“ ”，“ ”也是持守的意思。《左传·僖公三十二年》注解说：上寿一百二十岁，中寿一百岁，下寿八十岁。《庄子·盗跖篇》说：人上寿百岁，中寿八十，下寿六十。）拿着最珍贵的身体，交给平庸的医生，任凭他们处置。唉声叹气！（何休在《公羊传》注中说：“噫，咄嗟，都是叹息声。”）身体已经死亡，精神魂魄消灭，变成异物。（贾谊《鹏鸟赋》说：“化为异物啊，又有什么可担忧的。”）灵魂深潜于黄泉之下。（江淹《述哀诗》说：“美人归于重泉。”李善注引用潘岳《悼亡诗》：“之子归穷泉，重壤永幽隔。”）只能让亲人徒劳地哭泣悲痛。可叹的是，举世之人昏迷不悟，没有人能觉悟，不爱惜自己的生命，像这样轻视生命，还谈什么荣华权势呢？（案：从“当今居世之士”到此处，孙思邈《千金方序论》引用张仲景的话，文字与此略有不同。）进不能爱人知人，退不能爱身知己，遭遇灾难祸患，身处困境之中。（“厄”字，何本作“死”。）糊里糊涂，昏昏沉沉，如同游荡的灵魂。（“ ”字，《千金方》作“戆”，柯本作“蠢”。《礼记·哀公问》说：“寡人愚冥烦。”《易经·系辞》说：“游魂为变。”皇甫谧《甲乙经序》说：“承受先人的形体，有八尺高的身躯，却不知道医事，这就是所谓的游魂罢了。大概就是这个意思。”）可悲啊，趋炎附势的士人，奔驰竞争于浮华，不巩固根本，忘却身体去追逐外物。（《庄子·让王篇》说：“当今世俗的君子，危害身体、放弃生命去追逐外物。”）危险得如同站在冰面上、临近深渊一样。（潘岳《寡妇赋》说：“如同踩着冰面对着山谷。”李善注引用《毛诗》说：“惴惴小心，如临于谷。”又说：“战战兢兢，如履薄冰。”《北史·周武帝纪》诏书说：“每念及此，如同面临冰谷。”）竟然到了这种地步。
我的宗族一向人口众多，从前有一百多人。自建安纪年以来，还不到十年。（案：“纪年”即纪元之年。《汉书·武帝纪》记载：元狩元年冬十月，祭祀五 ，捕获一只一角兽，用它燎祭，开始用天瑞来纪元。）其中死亡的，有三分之二。（案：这是因为当今的士人把生命交给平庸医生，所以才这样。）其中因伤寒病死的占十分之七。感伤往昔的亲族沦丧，痛心横死夭折者无法挽救，于是勤奋探求古代训诫，广泛采集各方药方，撰写使用《素问》、《九卷》、《八十一难》、《阴阳大论》、《胎胪药录》，并结合平脉辨证的方法，写成《伤寒杂病论》共十六卷。虽然不能完全治愈所有疾病，但或许可以见到病症就知道根源。如果研读我所编纂的书，思考就能收获大半了。（《易经·下系辞》说：“聪明的人观看彖辞，就能思虑获益过半。”王弼说：“过半的益处，不也很适宜吗？”孔颖达说：“聪明通达的人，观看彖辞，就能思虑有益，认为收获过半了。”）
上天分布五行，用来运转万物；人禀受五常，从而拥有五脏。（《白虎通》说：什么是五常？就是仁、义、礼、智、信。五脏对应为：肝主仁，肺主义，心主礼，肾主智，脾主信。）经络腑穴，阴阳会通。（《易经·上系辞》说：“观察它们的会通，以推行礼仪典章。”）玄妙幽微，变化难以穷尽。如果不是才识高超、见识精妙的人，怎么能探究其中的道理呢？（案：“才高”与开头的“才秀”相应。）上古时代有神农、黄帝、岐伯、伯高、雷公、少俞、少师、仲文。（案：“仲文”在史书医传等中没有考证。）中古时代有长桑君、扁鹊，汉代有公乘阳庆和仓公。在此之后的，就没有听说了。
观察现在的医生（就是前段所说的庸医），不想着思考寻求经典旨意，以推演他们所知道的技艺，各自继承家族的技术，始终沿袭旧法。诊治疾病，务求口齿伶俐。（《论语》说：“用口齿伶俐来应付别人。”何晏注说：“佞人口辞敏捷。”）相对片刻之间（“斯须”即须臾、一会儿。《礼记·乐记》说：“礼乐不可片刻离开身体。”），就开处方用药。按寸口脉搏不到尺肤，握手部不到足部，人迎、趺阳、三部脉搏不互相参照。（《十便良方》引用王贶《脉诀》说：“说脉法，要点有三。一是人迎，在喉结两旁，法天；二是三部，指寸关尺，在手腕侧面，法人；三是趺阳，在足面系鞋的地方，法地。这三处都是气出入的要会，所以能决定吉凶生死。凡三处，大小迟速，相应齐等，就是无病的人。所以说：‘人迎、趺阳、三部不参，动数发息，不满五十，未知生死。’所以这三处是决断生死的关键。”）脉搏跳动急促，呼吸不足五十次。（《灵枢·根结篇》说：“脉搏不满五十次跳动而有一次停顿的，是一脏无气，所以需要候满五十动。”）短期寿命未知，诊断决断，对于九候脉法（见《素问·三部九候论》）曾经没有相似的了解。（《说文解字》说：“仿”是相似，“佛”是看不清楚。）明堂、阙庭的面色，完全没有观察到。（《灵枢·五色篇》说：“明堂”是鼻子，“阙”是眉间，“庭”是颜面。）这叫做管中窥豹而已（《庄子》说：魏牟对公孙龙说：“你规规矩矩地寻求观察，索求辨析，这简直是用管子看天，用锥子指地，不也很渺小吗？”）想要区分死生，确实很难了。（案：齐侯还活着，而观察他的死兆；虢太子已经死了，而辨别他的生机。开头以越人的才华出众起笔，所以结尾用这两句话收束。○从“夫天布五行”以下，直到“实为难矣”，《千金方》载《治病略例》首，文字与此略有不同。）
孔子说：“生来就知道的人是上等的，学习然后知道的人是次一等的，多闻博学，是再次一等的。”（《论语·季氏篇》说：孔子说：“生而知之者上也，学而知之者次也，困而学之又其次也。”文字不同，意义相近。）我向来崇尚方术，请践行这句话。（《论语·颜渊篇》：冉雍说：“雍虽不敏，请事斯语。”○案：“生而知之者”就是前段所说的“其才之秀者也”。“学与多闻博识”，就是前段所说的“勤求古训，博采众方”之类。大概“生而知之者”是天所赋予的，不可企及；而“学与多闻博识”是人所能做到的，都可以勤奋达到。当今的士人，不留心医药，不精心研究方术，只有仲景向来崇尚它。然而没有越人那样的才华出众，只想通过多闻博识来精心研究，所以诵读孔子的话，以此铭记在心。这大概是仲景的谦辞。）
汉长沙太守南阳人张机撰写。
程应旄说：案古人著书的宗旨，大多从序言中提出。所以善于读书的人，在未读古人书之前，先读古人的序。从序的法度中，读懂全书，那么微言大义，就在眼前了。我读《伤寒论》仲景的自序，竟是一篇悲天悯人的文章。从此处开始论述，大概就是孔子畏惧乱世而作《春秋》的微旨。
林亿等人校定序说：张仲景在《汉书》中没有传记，见于《名医录》。说他是南阳人，名机，仲景是他的字。被举荐为孝廉，官至长沙太守。起初向同郡的张伯祖学习医术，当时的人说，他识别运用医术的精微之处超过他的老师。（《太平御览》引用仲景《方序论》，文字相同。）按皇甫谧《甲乙经序》说：汉代有华佗、张仲景。仲景看见侍中王仲宣，当时二十多岁，对他说：“你有病，四十岁时眉毛会脱落，眉毛脱落后半年就会死。让你服用五石汤可以避免。”仲宣嫌他的话冒犯，接受了汤药却没有服用。过了三天，又见到仲景，问他：“服汤药了吗？”仲宣说：“已服。”仲景说：“气色确实不是服汤药的诊断表现，你为什么轻视生命呢？”仲宣还是不说话。二十年后果然眉毛脱落，后又过一百八十七天而死，最终像他预言的那样。这件事，即使是扁鹊、仓公，也无法超越。（《太平御览》引用何劭《别传》，文字相同。）又据《晋书·皇甫谧传》，仲景在定方方面垂示奥妙，《抱朴子》说仲景开胸纳赤饼（出自《初学记》及《素问》王冰注，现在《抱朴子》中无所考证）。晋代距离汉代不远，他在当时受到称赞的情况如何？仲景虽然在《汉书》中没有传记，但他无疑是汉末人。（《后汉书·刘表传》记载：建安三年，长沙太守张羡率领零陵、桂阳三郡背叛刘表，刘表派兵攻打包围，击败并平定了张羡。注引《英雄记》说：张羡是南阳人，大概是仲景的同族。难道是刘表攻破张羡之后，让仲景代替了他吗？）
(Ke's edition changes "Zu" (sudden) to "Za" (miscellaneous), which should be followed. See details in the General Overview. Versions from Fang Shi onwards do not have the character "Ji" (Collection).)
The Treatise states: Whenever I read about Yue Ren (referring to Bian Que) diagnosing the Crown Prince of Guo and observing the complexion of the Duke of Qi (these two events are recorded in *Records of the Grand Historian: Biography of Bian Que*), I cannot help but sigh with admiration for his outstanding talent. ("Kai" is interchangeable with "Kai"; *Shuowen Jiezi* explains it as a sigh. *Book of Songs: Wang Feng* mentions "his sigh," and *Cao Feng* mentions "I sigh awake, Kai," where "Kai" is the same as "Kai." Note: In Jin Dynasty Pan Yue's *Preface to Leisurely Living*, Pan Yue reads the *Biography of Ji An*. Upon reaching Sima An's four promotions to the Nine Ministers, recorded by good historians under the label of "clever official," Pan Yue could not help but sigh and put down his book. The legal structure is similar, both originating from *Records of the Grand Historian: Biography of Mencius*.)
I am surprised that scholars of today do not pay attention to medicine or carefully study medical arts. (See *Records of the Grand Historian: Annals of Qin Shi Huang* regarding the summoning of literary and technical experts, and *Annals of Emperor Ping of Han* regarding technical arts and materia medica.) They fail to treat the illnesses of rulers and parents above, rescue the poor and lowly below, nor preserve their own bodies for longevity to nourish life. Instead, they compete for glory and power, stretching their necks and standing on tiptoes to admire powerful nobles. (*Han Shu: Biography of Xiao Wangzhi* states: "Scholars of the world stretch their necks and stand on tiptoes, competing to offer their services.") They strive diligently and anxiously, devoted only to fame and profit, honoring superficialities while neglecting the root, appearing splendid on the outside but emaciated within. If the skin does not exist, where will the hair attach? (From *Zuo Zhuan*, 14th year of Duke Xi.) Suddenly encountering pathogenic wind, they suffer from unusual diseases. ("Ying Ji" also appears in *Hou Han Shu: Biography of Li Ying*.) When disaster strikes, they tremble in fear, lowering their ambitions and compromising their integrity. (*Analects: Wei Zi*: "Do not lower your ambition, do not humiliate your body." *Kongzi Jiayu*: Zai Yu said to Confucius, "For the Master regarding the position of Siko, though the time was short, he compromised his integrity many times. Can this stop?" ) They respectfully hope for shamans and diviners. (*Erya*: "Qin" means respectful. *Guoyu*: "Male is Xi, female is Wu." *Shuowen Jiezi*: "Zhu" refers to the one who recites prayers during sacrifices.) Finding no recourse, they blame Heaven, surrendering themselves to defeat. ("Shu Shou" appears in *Hou Han Shu: Annals of Guangwu*.) A lifespan of a hundred years (The character should be "Shou" (longevity); "Shou" and the original character are synonymous; *Qianjin Fang* uses another variant, meaning to hold/keep. *Zuo Zhuan* commentary on 32nd year of Duke Xi: Upper longevity is 120 years, middle is 100, lower is 80. *Zhuangzi: Robber Zhi*: Human upper longevity is 100, middle 80, lower 60.) entrust this precious vessel (the body) to mediocre physicians, allowing them to act arbitrarily. Alas! (He Xiu's commentary on *Gongyang Zhuan*: "Yi, duojie are sounds of sighing.") The body perishes, spirit and consciousness vanish, transforming into a strange object. (Jia Yi's *Owl Fu*: "Transformed into a strange object, why worry?") The soul sinks deep into the underworld. (Jiang Yan's *Lament*: "The beauty returns to the heavy spring." Li Shan's commentary cites Pan Yue's *Mourning for the Dead*: "This person returns to the dark spring, separated forever by layers of earth.") Only leaving relatives to weep in vain. Alas, the whole world is confused and unaware, failing to realize the truth, disregarding their lives, treating life so lightly—what talk of glory and power is there then? (Note: From "scholars of today" to here, Sun Simiao's *Preface to Qianjin Fang* quotes Zhang Zhongjing, with slight textual differences.) Advancing, they cannot love or understand others; retreating, they cannot love or understand themselves. Encountering disaster, they find themselves in dire straits. ("E" is written as "Si" (death) in He's version.) Muddled and ignorant, like a wandering soul. (In *Qianjin Fang* it is written as "Zhang," in Ke's edition as "Chun." *Book of Rites: Ai Gong Wen*: "I am foolish and dark." *Book of Changes: Xi Ci Xia*: "Wandering souls undergo change." Huangfu Mi's *Preface to Jiayi Jing*: "Receiving the body of ancestors, having an eight-foot stature, yet not knowing medical affairs—this is called a wandering soul. This is the meaning.") How sorrowful for those scholars pursuing worldly trends, racing in vanity, not securing the root, sacrificing their bodies for external things. (*Zhuangzi: Rang Wang*: "Current secular gentlemen endanger their bodies and abandon life to pursue external objects.") Dangerous as if walking on ice near a valley. (Pan Yue's *Widow's Lament*: "Like treading on ice facing a valley." Li Shan's commentary cites *Mao Shi*: "Trembling with care, like facing a valley." Also: "Trembling and cautious, like treading on thin ice." *History of Northern Dynasties: Annals of Emperor Wu of Zhou*: Edict says, "Whenever I think of it, it is like facing ice and valleys.") To this extent.
My clan has always been large, formerly numbering over two hundred. Since the Jian'an era, less than ten years have passed. (Note: "Jinian" refers to the year of the era. *Han Shu: Annals of Wu Di*: Yuan Shou 1st year, winter October, sacrificed to the Five Spirits, captured a one-horned beast, used it for sacrifice, and began using heavenly omens to name the era.) Among them, two-thirds have died. (Note: This is because contemporary scholars entrust their lives to mediocre physicians, hence such results.) Seven out of ten deaths were due to Cold Damage (Shanghan). Grieving the loss of the past, pained by the untimely deaths that could not be saved, I diligently sought ancient teachings, extensively collected various prescriptions, utilized the *Suwen* (Plain Questions), *Jiujuan* (Nine Volumes), *Bayishinan* (Eighty-One Difficulties), *Yinyang Dalun* (Great Treatise on Yin and Yang), *Tailu Yaolu* (Record of Fetal Structure and Drugs), and combined pulse diagnosis and syndrome differentiation to compile the *Shanghan Zabing Lun* (Treatise on Cold Damage and Miscellaneous Diseases) in sixteen volumes. Although unable to cure all diseases completely, it may allow one to see the disease and know its source. If you study my compilation, you will gain more than half the benefit. (*Book of Changes: Xi Ci Xia*: "The wise observe the Tuan Commentary and gain more than half the benefit." Wang Bi says: "Is it not appropriate to gain more than half?" Kong Yingda says: "Intelligent and aware persons, observing the Tuan Commentary, can gain beneficial thoughts, considering it more than half complete.")
Heaven distributes the Five Elements to operate all categories; humans receive the Five Constants to possess the Five Zang Organs. (*Baihu Tong*: What are the Five Constants? Benevolence, Righteousness, Propriety, Wisdom, and Trustworthiness. Five Zang correspondences: Liver-Benevolence, Lung-Righteousness, Heart-Propriety, Kidney-Wisdom, Spleen-Trustworthiness.) Meridians and Fu organs, Yin and Yang connect and communicate. (*Book of Changes: Xi Ci Shang*: "Observe their convergence and communication to practice rituals and institutions.") Profound and subtle, changes are hard to exhaust. Unless one has high talent and profound insight, how can one explore its principles? (Note: "High talent" corresponds to "outstanding talent" in the first paragraph.) In ancient times, there were Shennong, Yellow Emperor, Qibo, Bo Gao, Leigong, Shaoyu, Shaoshi, and Zhongwen. (Note: "Zhongwen" is not found in historical medical biographies.) In the middle ages, there were Changsang Jun and Bian Que; in the Han Dynasty, there were Gongcheng Yangqing and Cang Gong. Since then, nothing has been heard of.
Observing current physicians (those referred to as mediocre physicians in the previous section), they do not reflect on seeking the essence of classics to expand their knowledge. Each inherits family skills, continuously following old methods. When examining illnesses, they rely on glib speech. (*Analects*: "Deceive people with glib speech." He Yan's commentary: "Flatterers speak quickly and cleverly.") Facing each other for a moment ("Sisu" means a brief instant. *Book of Rites: Yue Ji*: "Rituals and music cannot be absent for even a moment."), they immediately prescribe decoctions. Palpating the Cun (inch) position without reaching the Chi (cubit) position; holding the hand without reaching the foot; Renying, Duyang, and the three positions are not cross-referenced. (*Shibian Liangfang* cites Wang Kuang's *Pulse Classic*: "The method of discussing pulses has three essentials. One is Renying, beside the larynx, corresponding to Heaven. Two are the Three Positions, Cun-Guan-Chi, on the wrist, corresponding to Man. Three is Duyang, on the top of the foot where shoes are tied, corresponding to Earth. These three are the vital points of Qi entry and exit, thus determining fortune and misfortune, life and death. If the size, speed, and rhythm at these three places correspond equally, it indicates a healthy person. Thus it is said: 'If Renying, Duyang, and the three positions are not cross-referenced, and the pulse moves rapidly with breaths fewer than fifty, one cannot know life or death.' Therefore, these three are key to deciding life and death.") If the pulse moves rapidly and breaths are fewer than fifty... (*Ling Shu: Gen Jie*: "If the pulse does not move fifty times before stopping, one Zang lacks Qi, so one must wait for fifty movements.") Short-term lifespan is unknown, diagnostic decisions are made, yet there is no resemblance to the Nine Pulse Positions (see *Suwen: Sanbu Jiuhou Lun*). There is no semblance of understanding. (*Shuowen Jiezi*: "Fang" means similar, "Fo" means unclear observation.) The Ming Tang (nose), Que (between eyebrows), and Ting (forehead) are not observed. (*Ling Shu: Se Se Pian*: "Ming Tang" is the nose, "Que" is between the eyebrows, "Ting" is the forehead.) This is merely looking through a tube. (*Zhuangzi*: Wei Mou told Gongsun Long: "You seek observation rigidly and analyze辨析, this is simply using a tube to view heaven and a cone to point at earth, is it not small?") To distinguish death from life is truly difficult. (Note: Duke Qi was still alive, yet his impending death was observed; the Crown Prince of Guo was already dead, yet his life was distinguished. Starting with Bian Que's talent, ending with these two sentences. ○ From "Heaven distributes Five Elements" to "truly difficult," *Qianjin Fang* *General Examples for Treating Disease* preface has slightly different text.) Confucius said: "Those who know from birth are superior; those who learn are next best; those who hear much and know widely are next after that." (*Analects: Ji Shi*: Confucius said: "Those born with knowledge are superior; those who acquire knowledge through learning are next; those who learn when troubled are next again." Text differs, meaning is close.) I have long esteemed medical arts; please let me practice these words. (*Analects: Yan Yuan*: Yong says, "Though I am not quick-witted, please let me practice these words." ○ Note: "Those born with knowledge" refers to "outstanding talent" mentioned earlier. "Learning and broad knowledge" refers to "diligently seeking ancient teachings and extensively collecting prescriptions." Being born with knowledge is heaven-endowed and unattainable; learning and broad knowledge are human capabilities achievable through diligence. Contemporary scholars neglect medicine and fail to study arts carefully; only Zhongjing has long esteemed them. Lacking Bian Que's talent, he seeks to refine through broad knowledge, hence quoting Confucius to keep it in mind. This is likely Zhongjing's modesty.)
Written by Zhang Ji, Courtesy Name Zhongjing, Administrator of Changsha, Han Dynasty, from Nanyang.
Cheng Yingmao says: Note that the main intent of ancient books is often raised in the preface. Therefore, good readers read the preface before the book. By reading the whole book through the preface's method, the subtle words and great meanings appear clearly. Reading Zhang Zhongjing's self-preface to the *Shanghan Lun*, it is essentially a text mourning the world and pitying people. Starting the treatise from here embodies the subtle intent of Confucius fearing chaos and writing the *Spring and Autumn Annals*.
Preface by Lin Yi et al., editors: Zhang Zhongjing has no biography in the *Han Shu*, but is seen in *Famous Doctors Record*. It says he was from Nanyang, named Ji, with Zhongjing as his courtesy name. Recommended as Xiaolian, he rose to the office of Taishou (Administrator) of Changsha. He initially received his art from his fellow townsman Zhang Bozu. People of the time said his precision and subtlety in application exceeded his teacher. (*Taiping Yulan* cites Zhongjing's *Prescription Preface*, text is the same.) According to Huangfu Mi's *Preface to Jiayi Jing*: In the Han Dynasty, there were Hua Tuo and Zhang Zhongjing. Zhongjing saw Attendant Wang Woxuan, who was over twenty years old, and said, "You have an illness. Your eyebrows will fall out at forty, and six months after they fall, you will die. Taking Wushi Tang could prevent this." Woxuan disliked his blunt words, accepted the prescription but did not take it. Three days later, Zhongjing saw him again and asked, "Did you take the medicine?" Woxuan said, "Yes." Zhongjing said, "Your complexion certainly does not match the diagnosis of taking the medicine. Why do you disregard your life?" Woxuan remained silent. Twenty years later, his eyebrows indeed fell out, and he died 187 days later, exactly as predicted. Even Bian Que and Cang Gong could not surpass this. (*Taiping Yulan* cites He Bie's *Biography*, text is the same.) Also, *Jin Shu: Biography of Huangfu Mi* states Zhongjing's subtlety lay in fixed prescriptions. *Baopuzi* mentions Zhongjing prescribing a chest-opening red pill (found in *Chuxue Ji* and Wang Bing's commentary on *Suwen*, but not in extant *Baopuzi*). The Jin dynasty was not far removed from the Han; how highly he was regarded at the time is evident. Although Zhongjing has no biography in the *Han Shu*, he is undoubtedly a late Han figure. (*Hou Han Shu: Biography of Liu Biao*: Jian'an 3rd year, Zhang Xian, Taishou of Changsha, led Lingling and Guiyang commanderies to rebel against Liu Biao. Liu Biao sent troops to besiege and defeated Xian. Commentary citing *Yingxiong Ji*: Zhang Xian was from Nanyang, likely a clansman of Zhongjing. Was Zhongjing appointed to replace him after Liu Biao defeated Xian?)