张幼年失估,慈帏严课,苦读儒业。继以疾病时多,且力绵艰于治生,爰有习医之
举,从师访道,悬刺十有春秋,博及群书,始知大道无秘,尽在先圣贤数卷书中耳,
乃奋然将古哲图经诸书,按门类纂《内经》、大小杂证、药性痘疹、女科、外科、脉诀
计共二十余篇,既而临证,以书验证,以证合方,针线相对,毫发不爽,窃喜先圣贤
之遗书方论不谬也。逮至阅历愈久,更有得乎心而应乎手者,似难以言语间形容,乃
益信无方可用之语更不谬,复于寤寐中以求其真元之至理,究竟只在我身生来之所得,
之愈信无书可读之语尤不谬也。若是,则诸方诸论可以不载不垂矣。虽然,古哲之论
也、方也,犹居之有门户也、庭径也,苟不由此,何能登堂入室以达安身憩息之所耶?
故余牢落风尘,半生牛马,虽爱憎由人,而真诚自矢,不揣固陋,誓成此集。知我者
其惟是乎?罪我者其惟是乎?
甲戌六月既望后学冯兆张载白
一、医学肇自轩岐,《素问》垂训千古,天地阴阳之造化,人身疾病之安危,阐发
殆尽,虽历代名医高论叠出,总无能出其范围矣。但卷数繁多,难以统读,谨将至要,
纂列首篇,使学人开卷便得圣贤至理,不难一贯以通及诸书也。
一、天有生长收藏之候,人有少壮老弱之常,然其间修短不同,盛衰迥别者,由乎
阴阳失调,水火为害,或根于先天,或因于后天也,故次详水火立命之基,阴阳强弱
之用,先天后天之分,使开卷即得《内经》之至理,复明保命之真元,俾贤愚共可却
病以长生,老少并堪养生于勿药,此张之鄙愿也。
一、次论阴阳失调而为病也。天有六淫之太过,人有百病之变常,自初诞诸胎症,
及头、目、耳、鼻、口唇、胸胁、肩背、腰腹腿足诸疾,乃及风、寒、暑、湿、燥、
火,惊疳、吐泻、伤寒、疟疾、风痨、鼓膈各门诸症,后附外科、女科及四言脉诀,
自天及人,自少及老,自上及下,自内及外,自男及女,启形及脉,悉挨次序,不敢紊乱。
一、天人阴阳一理,故诸疾病,每与运气相符。至于婴儿,离先天不远,神气未
固,感触尤易,故出痘者,必多于子午卯酉年,而病症多应于天符岁值所属,是以内
集五运六气于中,幸毋迂视。
一、考古哲幼科证论,仅讲先天,即所论吐泻惊疳诸症,理浅言略,及至年大而涉
后天,虚实盛衰之变,并未讲及。其方脉症论,仅讲后天得失,而先天禀赋浓薄,并
不究其由来,竟将一人分为两截,况孩子每多因后天致病,大人亦有因先天受 ,可
两不推详,以究其原耶。故是书每症以幼科证治讲完,随将方脉证治继后,先后之情
并明,浅深之理悉见。
一、治小儿疾病,较之男子妇人,其难尤甚。但小儿易怒伤肝,恣食伤脾;大人穷
欲伤肾,多思伤心,郁思伤脾,恼怒伤肝,悲哀伤肺。故书治小儿之法,犹浣衣之去
垢者居多,以其所犯,多属标症也。治大人之法,犹植树之培根者居多,以其所犯,
多属本症也。然小儿亦有因先天怯弱致疾;大人亦有因倍食伤胃抱 。小儿而犯不足,
大人而犯有余,于此并可互参。况气血有偏而成病,病则怪变百端。大人而犯小儿之
病,小儿而犯大人之病,病即雷同,治何可执?故张先以小儿多犯标症者,列之于前;
次以大人之多犯本症者合之于后。且得天地生长之义,顺而不逆,类治法泻补之方,
循而有常,按门独论,已得虚实之妙,合参共究,尤深变化之机。
一、考古哲幼科证论,理甚浅而言多略,则何以明病源?故业幼科者,凡治伤食、
伤风,易能凑效。如遇年大,而一干七情六郁,及先天阴阳不足,变化难明之症,暨
女人年当二七,有经行、经闭、太过、不及之愆,略涉疑难,便尔束手。况今非太古,
气禀即已浇漓,性成复难淳朴,男子不及二八,女子不及二七,便多情欲致疾者乎,
焉可以纯阳例论,执一为治!且至痘疹时行,每多男子、女人、孕妇患痘,此尤宜熟
诸方脉,始能调治。盖元神固泄有殊,而脏腑阴阳气血则一,况理由深而得浅易,由
浅而究深难。故凡诚心活幼者,必先既行细究幼科诸书,还须以男子方论参看,则遇
疑难症候,一目了然,故张汇纂是杂症,以幼科各症本论、本方,列之于前,随以方
书同症异论、异方者,继之于后,以便参看,以广识见。况用药如用兵,纪律稍乖,
吉凶立判。古今方药,各有所长,谨将众腋,用集一裘。《经》所谓∶小而大,言一而
知百病之害;浅而博,可以言一而知百也。
一、张才疏学浅,词句不工,然亦求达而已矣。不敢过尚虚文,以害实理。
一、凡有方论,皆出之于古哲。但内有相传既久,不无鲁鱼之讹。今张考订,缺者
全之,略者充之,舛者革之,隐者明之,必取发明,不敢因袭。
一、立论必取王道中平,故饮食万类,独重五谷,以其得天地之正气也。因人治病
而立论,亦必取中正和平,切于病症,切于治法为要。凡内有纯以五行相生相克,穷
义吐词,词虽近理,实系虚浮,于病症、于治法,茫然不合者,又焉可宗之?谨将附
之于本论之末,勿敢纂列于前,以讹识见,亦勿敢尽行删去,以寡我闻。
一、是书自胎中至初生,以及长成,俱曲论殆尽,庶使百凡疑难,皆可考订,临症不致束手。
一、治症须分明经络,故张细为疏详脏腑、阴阳、生克、形色善恶,庶治者易得其
原,犹锁之得钥,不致妄揣,以悖生生之道。是以医家之识经络,犹舟子之识道途,
否则,何以行之。
一、大人百病虽殊,要不出乎六气所因;小儿杂症虽繁,惊疳吐泻尤重。故张于六
气诸论,及惊疳吐泻数门,集论大方既毕,便以本门虚实寒热之病候,分为数条,赘
以补泻温平之药味,列为数类,使后人一览可知,随病采药,不泥于成方之拘执矣。
盖古人之立方,为仿法也。罗氏谓之以今病而仿古方,犹拆旧料而改新房。今张既列
古方于前,以为成法,复具活法于后,以为变通,则所向皆宜,何必更为之拆旧料哉!
但昔人勤俭淡薄,故衣食得克,慎行守已,故心安神静,是以中气不伤。偶有疾病,
多从外来,故用调治,宜散、宜宣。今人懒惰奢华,故衣食难克,越理妄作,故心劳
神耗,是以中气有伤。凡有疾病,多从内起,故用调治,宜滋、宜补。此古今时候有
殊,而用药因异之大意也。
张仲景(此处指作者冯兆张自称或泛指医家,原文“张”指作者冯兆张)幼年丧父,母亲严格督促,刻苦攻读儒家学业。后来因为疾病频繁,且体力微薄难以维持生计,于是有了学习医学的念头,跟随老师访求医道,悬壶行医已有十余年,广泛涉猎各类书籍,这才知道大道没有秘密,全都在古代圣贤的几卷书中罢了,于是奋发地将古代哲人的图经等书,按照门类编纂《内经》、大小杂证、药性痘疹、妇科、外科、脉诀,共计二十余篇。随后进行临床实践,用书本知识验证病症,用病症来契合方剂,针法与线法相对照,毫发不差,暗自欣喜于古代圣贤遗留的书方论述没有错误。等到阅历越久,更有心得于心而应合于手的情况,似乎难以用言语形容,于是更加相信“无方可用”的话更不谬误,又在睡梦中寻求其真元的至理,究竟只在于我身体生来所具备的,于是更加相信“无书可读”的话尤其不谬误。像这样,那么诸方诸论可以不记载不流传了吗?虽然如此,古代哲人的论述和方剂,就像居住有门户、庭院和小路一样,如果不通过这些,怎么能登堂入室到达安身休息的地方呢?所以我漂泊风尘,半生劳碌,虽然爱憎由人,但真诚自誓,不顾自己固陋,发誓完成这部文集。了解我的大概只有这些人吧?怪罪我的大概也只有这些人吧?
一、医学起源于黄帝岐伯,《素问》流传训诫千古,天地阴阳的造化,人身疾病的安危,阐述得极其详尽,虽然历代名医高论叠出,总没有能超出这个范围的。只是卷数繁多,难以通读,我将最重要的内容,编纂列为首篇,使学习者开卷就能得到圣贤的至理,不难一贯地贯通其他书籍。
一、天有生长收藏的节候,人有少壮老弱的常态,然而其中寿命长短不同,盛衰迥然不同的原因,是由于阴阳失调,水火为害,有的根源于先天,有的由于后天造成的,所以接着详细论述水火立命的根基,阴阳强弱的作用,先天后天的区分,使开卷就能得到《内经》的至理,又明白保命真元的重要性,使贤愚都可以祛病长生,老少都能在不吃药的情况下养生,这是冯兆张的卑微愿望。
一、接着论述阴阳失调而致病。天有六淫(风、寒、暑、湿、燥、火六种外感病邪)太过,人有百病的变常,从初生时的胎症,以及头、目、耳、鼻、口唇、胸胁、肩背、腰腹腿足各种疾病,以及风、寒、暑、湿、燥、火,惊疳(小儿因惊恐或饮食积滞引起的疳积)、吐泻、伤寒、疟疾、风痨(消耗性肺病)、鼓膈(腹部胀大如鼓,胸膈阻塞)各门各种症状,后面附上外科、妇科及四言脉诀,从天到人,从少到老,从上到下,从内到外,从男到女,从形体到脉象,都按次序排列,不敢紊乱。
一、天人阴阳是一个道理,所以各种疾病,往往与运气相符。至于婴儿,离先天不远,神气未固,感触尤其容易,所以出痘的人,一定多于子午卯酉年,而病症多对应于天符岁值所属,因此在内部汇集五运六气在中部,希望不要视为迂阔而轻视。
一、考察古代哲人的儿科证论,只讲先天,即使所论述的吐泻惊疳等症状,理论浅显言辞简略,到了年纪大涉及后天,虚实盛衰的变化,并没有讲到。其方脉症论,只讲后天得失,而先天禀赋浓薄,并不探究其由来,竟然将一个人分为两截,何况孩子多因后天致病,大人也有因先天受累,可以两者都不推详以探究根源吗?所以这本书每个症状先以儿科证治讲完,随后将方脉证治继后,先后的情况并明,深浅的道理悉见。
一、治疗小儿疾病,比之男子妇人,困难尤其甚。但是小儿易怒伤肝,恣食伤脾;大人穷欲伤肾,多思伤心,郁思伤脾,恼怒伤肝,悲哀伤肺。所以书里治疗小儿的方法,就像洗衣服去垢者居多,因为他们所犯的,多属于标症(表象症状)。治疗大人的方法,就像植树培根者居多,因为他们所犯的,多属于本症(根本症状)。然而小儿也有因先天怯弱致病的;大人也有因暴饮暴食伤胃抱病的。小儿犯不足之病,大人犯有余之病,在此并可互相参考。何况气血有偏而成病,病了则怪变百端。大人犯小儿的病,小儿犯大人的病,病即雷同,治疗怎么可固执不变?所以冯兆张先以小儿多犯标症者,列之于前;次以大人之多犯本症者合之于后。并且得到天地生长的意义,顺而不逆,类治法泻补的方剂,循而有常,按门独论,已得虚实的妙处,合参共究,尤深变化之机。
一、考察古代哲人的儿科证论,理论很浅而言辞多简略,那么如何明确病源?所以从事儿科的人,凡是治疗伤食、伤风,容易凑效。如果遇到年纪大,而一系列七情六郁,以及先天阴阳不足,变化难明的症状,以及女人年龄当二七(14岁),有经行、经闭、太过、不及的过失,稍微涉及疑难,便束手无策。何况现在不是太古时代,气禀已经浇漓,性格形成又难淳朴,男子不到二八(16岁),女子不到二七(14岁),便多情欲致病的吗,怎么可以用纯阳的例子来论述,执一为治!而且到了痘疹时行,每多男子、女人、孕妇患痘,这尤其应该熟悉诸方脉,才能调治。盖元神固泄有殊,而脏腑阴阳气血则一,何况理由深而得浅易,由浅而究深难。所以凡诚心活幼者,必须先既行细究幼科诸书,还须以男子方论参看,则遇疑难症候,一目了然,所以冯兆张汇纂是杂症,以儿科各症本论、本方,列之于前,随以方书同症异论、异方者,继之于后,以便参看,以广识见。何况用药如用兵,纪律稍乖,吉凶立判。古今方药,各有所长,谨将众腋,用集一裘。《经》所谓:小而大,言一而知百病之害;浅而博,可以言一而知百也。
一、冯兆张才疏学浅,词句不工,但也只求通达而已。不敢过尚虚文,以害实理。
一、凡有方论,皆出于古代哲人。但内有相传既久,不无鲁鱼之讹(文字传抄错误)。现在冯兆张考订,缺者全之,略者充之,舛者革之,隐者明之,必取发明,不敢因袭。
一、立论必取王道中平,所以饮食万类,独重五谷,因为它们得天地之正气也。因人治病而立论,也必取中正和平,切于病症,切于治法为要。凡内有纯以五行相生相克,穷义吐词,词虽近理,实系虚浮,于病症、于治法,茫然不合者,又焉可宗之?谨将附之于本论之末,勿敢纂列于前,以讹识见,亦勿敢尽行删去,以寡我闻。
一、这本书从胎中至初生,以及长成,都曲论殆尽,庶使百凡疑难,皆可考订,临症不致束手。
一、治症须分明经络,所以冯兆张细为疏详脏腑、阴阳、生克、形色善恶,庶治者易得其原,犹锁之得钥,不致妄揣,以悖生生之道。是以医家之识经络,犹舟子之识道途,否则,何以行之。
一、大人百病虽殊,要不出乎六气所因;小儿杂症虽繁,惊疳吐泻尤重。所以冯兆张于六气诸论,及惊疳吐泻数门,集论大方既毕,便以本门虚实寒热之病候,分为数条,赘以补泻温平之药味,列为数类,使后人一览可知,随病采药,不泥于成方之拘执矣。盖古人之立方,为仿法也。罗氏谓之以今病而仿古方,犹拆旧料而改新房。现在冯兆张既列古方于前,以为成法,复具活法于后,以为变通,则所向皆宜,何必更为之拆旧料哉!但昔人勤俭淡薄,故衣食得克,慎行守已,故心安神静,是以中气不伤。偶有疾病,多从外来,故用调治,宜散、宜宣。今人懒惰奢华,故衣食难克,越理妄作,故心劳神耗,是以中气有伤。凡有疾病,多从内起,故用调治,宜滋、宜补。此古今时候有殊,而用药因异之大意也。
Zhang (referring to the author Feng Zhaozhang) lost his father in childhood. His mother strictly supervised him, and he studied Confucian classics bitterly. Later, due to frequent illnesses and his weak physical strength making it difficult to sustain a livelihood, he decided to study medicine. He followed teachers to seek medical wisdom, practiced medicine for over ten years, and extensively read various books. Only then did he realize that the Great Dao holds no secrets; everything is contained within the volumes of ancient sages. Thus, he energetically compiled works such as the *Neijing* (Inner Canon), major and minor miscellaneous diseases, medicinal properties, smallpox and rashes, gynecology, surgery, and pulse diagnosis manuals into twenty-plus categories. Subsequently, through clinical practice, he verified diseases with book knowledge and matched prescriptions to symptoms. Acupuncture and needling techniques corresponded precisely, without the slightest error. He secretly rejoiced that the prescriptions and theories left by ancient sages were not erroneous. As his experience grew, he gained insights that resonated from heart to hand, which seemed difficult to describe in words. Consequently, he came to believe even more firmly that the saying "no fixed prescription is applicable" is not wrong. He sought the ultimate truth of primordial essence even in his dreams, realizing it ultimately resides in what one is born with. Thus, he believed even more strongly that "there are no books worth reading" is also not wrong. If this is the case, should all prescriptions and theories be unrecorded and untransmitted? Nevertheless, the discussions and prescriptions of ancient sages are like doors, courtyards, and paths in a house. Without passing through them, how can one enter the hall and room to reach a place of rest? Therefore, though I have wandered in the dusty world and labored like an ox or horse for half my life, while others may love or hate me, I vow sincerity. Not disregarding my own limitations, I swear to complete this collection. Those who understand me will likely be these few; those who blame me will likely be these few too.
On the 16th day of the sixth month of the Jiaxu year, the humble student Feng Zhaozhang records.
1. Medicine originated with Huangdi (Yellow Emperor) and Qibo. The *Suwen* (Basic Questions) has transmitted its teachings for millennia, elucidating thoroughly the creation of heaven and earth's yin and yang, and the safety or peril of human diseases. Although famous doctors of successive dynasties have produced lofty theories, none could exceed this scope. However, due to the numerous volumes, it is difficult to read them all comprehensively. I have compiled the most essential points into the first chapter, enabling students to grasp the sages' ultimate truths upon opening the book, facilitating a consistent understanding across other texts.
2. Heaven has seasons of growth, flourishing, harvesting, and storage; humans have normal stages of youth, vigor, old age, and frailty. Differences in lifespan and distinct variations in prosperity and decline arise from yin-yang imbalance and harm caused by water and fire, rooted either in congenital factors or acquired later in life. Therefore, the following sections detail the foundation of life established by water and fire, the function of yin-yang strength and weakness, and the distinction between congenital and acquired factors. This allows readers to grasp the ultimate truths of the *Neijing* immediately, understand the true essence of preserving life, and enables both the wise and the foolish to eliminate disease and prolong life, allowing people of all ages to maintain health without medication. This is Feng Zhaozhang's humble wish.
3. Next, we discuss diseases caused by yin-yang imbalance. Heaven experiences excesses of the Six Excesses (Wind, Cold, Summer-heat, Dampness, Dryness, Fire); humans experience variations among hundreds of diseases. From congenital conditions present at birth to ailments of the head, eyes, ears, nose, lips, chest, hypochondrium, shoulders, back, waist, abdomen, legs, and feet, as well as conditions caused by Wind, Cold, Summer-heat, Dampness, Dryness, Fire, fright, infantile malnutrition (Jing Gan), vomiting and diarrhea, Cold Damage (Shanghan), malaria, wind consumption, and abdominal distension/chest obstruction, each category is covered. Surgery, gynecology, and four-character pulse diagnosis formulas are appended at the end. Arranged from heaven to humanity, youth to old age, top to bottom, inside to outside, male to female, form to pulse, everything follows a strict order without disorder.
4. Since heaven and humanity share the same yin-yang principles, various diseases often correspond with climatic cycles. Infants, being close to their congenital state, have unstable spirit and qi, making them particularly susceptible to external influences. Therefore, smallpox outbreaks occur more frequently in years corresponding to Zi, Wu, Mao, and You, and symptoms often align with the annual heavenly stems and earthly branches. Thus, the Five Movements and Six Qi are integrated herein; do not dismiss this as pedantic.
5. Ancient pediatric theories focused solely on congenital factors. Even when discussing vomiting, diarrhea, fright, and malnutrition, the theories were shallow and brief. They failed to address changes in deficiency/excess and prosperity/decline associated with acquired factors in adulthood. Conversely, adult medical theories focused only on acquired factors, ignoring the thickness or thinness of congenital endowment. This artificially splits a person into two parts. Moreover, children often fall ill due to acquired factors, while adults may suffer from congenital weaknesses. How can we neglect investigating the root causes? Therefore, this book discusses pediatric treatment first, followed by adult pulse and syndrome treatment, clarifying both sequences and depths of theory.
6. Treating pediatric diseases is more difficult than treating adults or women. Children easily injure the Liver through anger and the Spleen through excessive eating. Adults injure the Kidneys through excessive desires, the Heart through overthinking, the Spleen through stagnant thoughts, the Liver through irritation, and the Lungs through grief. Thus, pediatric treatment methods resemble washing clothes to remove dirt, addressing mostly superficial symptoms (Biao). Adult treatment methods resemble nurturing tree roots, addressing fundamental symptoms (Ben). However, some children get sick due to congenital weakness, and some adults due to overeating damaging the Stomach. Children suffering from deficiency and adults suffering from excess can be cross-referenced. Furthermore, qi and blood imbalances cause diverse manifestations. When adults contract pediatric diseases or vice versa, treatments cannot be rigidly applied. Hence, this book lists pediatric cases (mostly Biao symptoms) first, followed by adult cases (mostly Ben symptoms). This aligns with the natural order of growth, ensuring therapies follow regular patterns of purging and tonifying. By studying each category independently yet comparatively, one grasps the subtleties of deficiency and excess, deepening the understanding of dynamic changes.
7. Ancient pediatric theories were shallow and brief, failing to clarify disease origins. Pediatricians could easily treat food stagnation or wind-cold but struggled with complex cases involving seven emotions, six depressions, congenital yin-yang deficiency, or menstrual irregularities in women around age fourteen (two sevens). In modern times, unlike antiquity, people's constitutions are weaker, and natures less pure. Men under sixteen and women under fourteen often develop diseases due to sexual desire. One cannot simply apply the "pure yang" theory rigidly. Additionally, during epidemic smallpox, men, women, and pregnant women are affected, requiring mastery of various prescriptions and pulses. Although spiritual essence varies, organ systems, yin-yang, qi, and blood remain consistent. Deep reasons are hard to grasp from shallow ones. Therefore, sincere pediatricians must study pediatric texts thoroughly and consult adult medical theories. This compilation places pediatric original theories and prescriptions first, followed by alternative theories and prescriptions from other texts for comparison, broadening knowledge. Medication is like warfare; slight disciplinary errors lead to immediate victory or defeat. Ancient and modern prescriptions have their strengths; I have gathered them like patches to make a coat. As the Classic states: "Small yet great, knowing one thing reveals the harm of a hundred diseases; shallow yet extensive, knowing one thing reveals a hundred."
8. My talent is limited and learning shallow; my language is not elegant, but I strive for clarity. I dare not indulge in empty rhetoric that harms practical truth.
9. All prescriptions and theories are derived from ancient sages. However, long-standing transmission may contain copying errors. I have corrected them: filling gaps, expanding summaries, correcting errors, and clarifying obscurities. I aim for innovation, avoiding mere imitation.
10. Theories must adhere to the "Kingly Way" of moderation. Among foods, grains are prioritized as they embody the righteous qi of heaven and earth. Medical theories must be balanced, relevant to symptoms, and effective in treatment. Purely theoretical discussions based on Five Elements generation and restriction, however logical sounding, are often vacuous and irrelevant to actual treatment. These are appended at the end to avoid misleading beginners, yet retained to preserve knowledge.
11. This book covers conditions from conception to infancy and adulthood comprehensively, resolving doubts and preventing helplessness during clinical practice.
12. Treatment requires clear understanding of meridians. I have detailed organs, yin-yang, generation/restriction cycles, and physical signs to help practitioners find the root cause, like finding a key for a lock, avoiding speculation that violates the way of life. Understanding meridians is as crucial to a doctor as knowing the path is to a boatman.
13. Although adult diseases vary, they stem from the Six Qi. Pediatric miscellaneous diseases are numerous, but fright, malnutrition, vomiting, and diarrhea are critical. After discussing the Six Qi and key pediatric conditions, I categorize deficiency/excess and cold/heat syndromes, adding appropriate tonifying, purging, warming, and neutral herbs. This allows future practitioners to select medicines flexibly rather than relying rigidly on fixed formulas. Ancient formula creation was methodological. Luo Shi said using ancient formulas for modern diseases is like dismantling old materials to build new houses. I present ancient formulas as standard methods and living methods for adaptation, ensuring suitability without needing to dismantle old structures. Ancients were frugal and cautious, protecting their Middle Qi from external pathogens, thus requiring dispersing and ventilating treatments. Modern people are lazy and extravagant, damaging their Middle Qi internally through stress and excess, thus requiring nourishing and tonifying treatments. This difference in era explains the variation in medication strategies.