自鸦片烟之流入内地，而于水火刀绳砒毒之外顿添一速死之途。且近日之烟实在为害不浅，其死于此者亦较诸物为尤众。殊不知此物但能迷人醉人，并不能死人也。夫烟之害，莫甚于广东。道光七八年间，有三水县人住在省城客店，因贫服生烟而死。店主不能收殁，专人赴三水告其亲属，及亲属赶到，店中死者已先一日活转。其死去三日四夜。又广东老仵作云：凡吃烟死者，棺殓后倘因事开棺检验，从无平正仰卧之尸，非伏即侧。盖烟性既过，其人醒转则必翻腾求出，而棺盖已合，遂至真毙。故凡服烟乍死者，皆非真死也，岂不冤哉？现在广东新刊套板《洗冤录》，内明著救治之方。曰：轻者心中发躁，但用活鸭血或粪汁或酱油或凉水或明矾、雄黄研末灌之，无弗愈者。若服多，毒重身冷气绝，似乎已死，但支体柔软则脏腑经络之气仍是流通，实在未死，速将尸安放阴冷无太阳之地(一经日照即不可救)，撬开牙齿，用箸横在尸口，将金汁或凉水频频灌之。再以冷水在胸前摩擦，仍将头发解散浸在冷水盆内，自然得活。已目击救活数人，凡七日之内身不僵硬者，切勿棺殓云云。《洗冤录》为宫中验用之书，非随口传说者可比。倘肯广为传播，实今世活人第一要事。阅者试思未死活埋之苦，则传播之心不能已矣。又用净银花五钱，生军三钱，胆矾三钱，藜芦三钱，生甘草一西，水煎，蜂蜜五钱冲服。每能戒烟毒。
《医中一得》终
医 医 十 病
本文转自 清阳中医在线
古今名医，卓然议论者代有其人。徐灵胎《诸病源流论》最为脍炙人口。今读清代吴楚天士先生的“医医十病”，其论高妙与灵胎《诸病源流论》在伯仲之间。按吴楚字天士号畹庵，与徐灵胎、张璐玉为同时代人。乃吴昆侄孙，以医名于顺治、康熙年间。今陆续载出，以广我等见闻。
医医十病
序言
人有病，医亦有病。欲医人，先医医。人病不籍医，安能去病？医病不自医，安能医人？夫人病不医，伤在性命；医病不医，伤在阴袭。性命伤，仅一身之害也；阴袭伤，乃子孙之害也。第人之为病，多在百骸；医之为病，止在一心。心存济人，则诸病不起；心专利己，则诸病丛生。约计之，其病有十。大都非冒昧，即妄诞；非残忍，即贪鄙；非陷谀，即奸狡；非卑陋，即恶劣。种种病状，皆根于心，皆根于舍人利己之心。不肖愧无越人术，徒深杞国忧。窃恐膏腴之入深，漫陈攻治之良剂。若不嫌苦口，不畏暝眩，而能细咀其味，猛吞其液，顿令荡涤邪秽，遂而超脱尘凡。亦切广救生灵，定然世受福报。又何必蝇营狗苟，病其心以邀名图利，致造孽无己也哉！
畹庵 吴 楚识
一、医医不学无术之病：
医以生人，亦以杀人。夫医所以生人也，而何以亦杀人？惟学则能生人，不学则适足杀人。盖不学则无以广其识，不学则无以明其理，不学不能得其精，不学则不能通其权、达其变，不学则不能正其讹、去其弊。如是则冒昧从事，其不至杀人也几希矣！甚矣，业医者不可以不学也。或曰：医安有不学者哉？医必有传，或传之于师，或传之于祖若父，皆学也。抑知恃此以为学，其去学也远矣！非谓其传者不足为学，亦以所传之不足尽所学也。彼仅恃其倾耳听受之逸，必不复有心思研究之劳。且既守其一成不易之规，则必昧乎神明变化之理。一若岐伯、越人、仓公历代诸贤圣，皆不如其师、其祖若父之足信从也；一若历代贤圣垂训之书，皆不如其师、其足若父之口语为足凭也。咦！如是而谓之学，其学可知，其医可知矣。故善学者，不论有传无传，总非求得乎古昔圣贤之理不可也；欲深得乎古昔圣贤之理，则非多读书不可也。自《灵》、《素》而下，以及于近代诸书，无不细心探讨。而又参考互订，就其旨归；别其醇疵，辩其得失，弃其糟粕，取其精微，悉其源流，悟其奥义。夫然后识高理透，眼快心灵。凡遇一病，必认得准，拿得定，不为邪说所惑，不为假象所欺，不为俗说所挠；得心应手，实能起死回生，肉人白骨。以此言学，则真学也。学真而术自神矣。岂仅仅得之听受之间，守其一成之规者，遂得谓之学哉？若仅恃此以为学，则必得其偏而失其全，得其浅而失其深，得其皮毛而失其神髓，得其俗套而失其真诠，甚且以讹传讹，终莫知其非者。又且有一味世法，只教人行医，不教人知医者。但授以保名获利之方，而于人之死生置之勿问；或示以不担利害之法，而于病之缓急置而不言。而学医者遂谓道在是矣。及其临症施治，非隔靴搔痒，即傍皮切血，；非画饼充饥，即鸠酒解渴。此术之不精，由学之不足也。此不学无术之病，所宜急医者也。
二、医医脉症罔辩之病：
凡医人用药，须先认症，认症须先审脉。审脉明，斯认症真；认症真，斯用药当。于以疗病也，何难之有？然而难矣？凡有一症，即有一症之寒热虚实。寒与热相反，虚与实相悬。在两人，则彼与此各不相同；即在一人，其前与后亦非一辙。苟不有以辩之，其能不倒行而逆施乎？然其为寒为热、为虚为实，又不令人一望而知也。症之重者，大寒偏似热，大热偏似寒，大虚偏似实，大实偏似虚。若仅就其似者而药之，杀人在反掌间。此症之不可不辩也。于何辩之？即于脉辩之。如伤寒脉浮、洪、数、紧，按之有力者，知其症为阳邪在表也；若沉而急数，重按有力者，知其症为阳邪入里；若浮大满指，按之如丝者，知其症为阴极似阳也。又如咳嗽一症，右寸脉浮数有力者，知其症为肺有实邪也；若浮软或沉小者，知其症为肺气空虚也。诸如此类，宜细心辩之。辩之至精，斯临症无骑墙之见，用药无相左之虞，而医之能事毕矣。其奈近日医家，决不言此，但曰某药可治其病，某病当用某方。至问起所用某药某方之症为寒为热、为虚为实乎？则茫然罔辩也。其不能辨症者，由于不能辩脉也。甚矣，辩脉为尤要矣！奈何著名一世，远近推重之医，常屡告人曰：脉作不得准。呜呼，噫嘻！脉作不得准，更有何者可作得准乎？从来症之疑似难决者，于脉决之。今反云脉作不得准，是全不知脉者也。即不知脉，又何能认症？故无怪其每以竹叶、石膏、治阴症，芩、连、栀子治胃寒。甚至脉以沉迟，尤云是火；脉已将绝，尤云不可补。总缘不知辩脉，遂令流毒至此。虽昔贤亦有从脉不从症，从症不从脉之论。抑知所谓不从者，正深于从也。如沉、细、迟、涩，乃阴寒脉也，而其症却烦躁作渴，面赤身热，若以此为热症而清之则毙矣，惟补之温之。不从其假热之症，正从其真寒之症，而非真谓症有不必从者也。又如狂燥力雄，逾垣上墙，此火热症也，而其脉却沉伏入骨，若以此为阴脉而稳之则危矣，惟清之下之。不从其阴寒沉伏之脉，正从其热极反伏之脉，而非之谓脉有不可从者也。总之，从其真，不从其假。不从者，其外貌；从者，其神髓。医家苟不辩此，未有不颠倒错乱，触手乖张者，一剂之误，命即随之。此脉症罔辩之病，所宜急医者也。
三、医医轻忽人命之病：
谚云：医家有割股之心。若是，则医之爱惜人命也至矣。安得有轻忽人命者哉！然观于今而叹其言之不验，或是古昔之言而于今不符也？如夏谚所云：游豫休助。而孟子叹之曰：今也不然。则所谓医有割股之心，亦尤夫夏时之谚也，今岂其然哉！若观今时之医，不惟无割股之心，若并无援手之意。病家殷勤延医，竭心力，费资财，希冀医能疗疾以安生。而医人若漠不相关，守定故智，以缓不切肤之药，每味与以三、五、七分，否则与清凉反药一剂，便怀利而去。绝不踌躇审顾，以期药之得效，病之得生。迨缓药渐死，或反药立死，又绝无引咎之心，愧悔之意。异日他家延治，又复如是是真以人命为戏也。其残忍惨刻，不较之屠人而尤加烈哉！推其故，皆原于传授之讹，习俗之误，利欲熏心之害。闻名医之传人曰：药性勿厚，药数勿重，气薄剂轻，庶易于解手。是名教人以用药不必中病矣。为之徒者，是忍视起死也，非轻乎人命而何？习俗之弊，尤为可笑。谨遵名医妙决，谓病重切不可为人担利害，只与轻轻数味，仍留原病还他。嗟嗟！延医用药，原为去病。若仍留病，何贵乎医？既留病，则必不能留命。若留一轻病，必渐加重；若留一重病，必渐至死。还他者，听其从容自死之谓也。可以生而必不救之生，本不死而欲坐待其死，其轻乎人命为何如？至于利欲之熏心，不待较而知之也。学医之初，原欲籍此为谋生计耳，岂真是菩萨心，而欲以此救世哉？故见夫享虚名而得厚实者，必尤而效之。彼名医一概用轻微，即学其一概用轻微；名医一概用清降，即学其一概用清降。以为名医之所以致富者在此，吾能学之致富足矣。若必舍此而别求真能活人之法，非愚则迂。所以愈遵轻药易解之师传，共安于留病还人之习尚。一任急来，我惟缓受。所以往往有可生之机，必不用切当之药以相救；明明见相反之药，一惟随声附和以妄投。只恐失一己之名利，遂不顾人之死生。此轻忽人命之病，所宜急医者也。
四、医医遵守时套之病：
天下事，莫便于套，而亦莫害于套。医而涉套，则至便而尤至害也。夫病人之医，犹望岁也。诚能用药切当，起死回生，以赴病家之望，岂非莫大之阴功。奈之何以宽容不切之套应之，使病轻致重，病重致死，宁不杀他人以造己孽乎？无如今之医有不得不从事于套者，何也？有人焉，脱套用药以治人，必相与诽谤之，谗间之，使病人不敢服其药，使其道不得行而后快。若医者果立志救人，不图利己也，则固以道自重，不肯稍自贬屈，思所变计。无如业医者，皆以利己为事也。欲利己，则必效他医利己之法。欲效他医利己之法，自不得不同流合污。从事于众所共习之套，其套维何？其视病在影响之间，其议论为庸众所共之，为妇人、女子所共晓；其用药则不寒不热，不补不泻，又或宁寒无热，宁泻无补，气薄味淡，而又所用无多，不忧暝眩。所以为时俗之所喜，为时流之所尚。斯能合乎时宜，入乎时派，且能趋时而得名，行时而获利，故共推为时套。时哉，套乎！苟不遵而守之，何以享厚实而肥身家乎？如或不尔，即是背时之医。欲认真治病救人，徒为他人争死活，而不能为一己争财利也，岂计之得哉？此医之所以不得不遵守时套也。况时套之学，学也至易。不必费心思之劳，不必多研究之苦，不烦按脉切理，不顾生死利害，不待读书讲求，不待深究药性、详查病情，只学一二最易入俗之语。凡视一病，便云是火。或病人自以为虚，则云虽虚却不可补；或云只宜平补，不可过补；或云只宜清补兼施，不可稳补。只此数语，便以投病人之机，动旁人之听矣。而于药则单择轻飘无力，及清降损真者，共计不上三十余种，便足横行一世。凡治一病，即此三十种中，每种各少许，无论寒热虚实、男妇老幼及轻浅危笃者，悉以此投之。正如戴宽大之帽，不必各合人头。又如咀屠门之肉，何须真充人腹。至若参、芪、归、术等项，稍有益于元气者，概行删去不用。诚恐味厚之药，一有不当，即县弊端，招人指责，以致失名失利。不若轻清之味，微微用之，虽不见功，亦不即为害，而孰知其大害存焉。邪炙不能为之攻，正衰不能为之辅。甚至虚寒已极。尤云有火宜清；危笃已极，尤云平守勿急。由是病人命登鬼录，而医人则病入膏腴矣！此遵守时套之病，所宜急医者也。
五、医医药似对症之病：
自从鸦片烟流入内地，便在火、水、刀、绳、砒毒之外，凭空增添了一条迅速致死的途径。而且近日来的鸦片烟危害极深，死于这种毒品的人数比死于其他各种方式的人还要多。殊不知这种物品只能使人迷乱沉醉，并不能直接致人死亡。
大凡鸦片的危害，没有比广东更严重的了。道光七八年间（1827-1828年），有三水县的人在省城（广州）的客店里居住，因为贫穷吸食生鸦片而死。店主无力收敛尸体，专门派人去三水告知其亲属。等到亲属赶到时，店里的死者已经在前一天复活了。他死去已有三天四夜。又有一位广东老验尸官说：凡是吸食鸦片而死的人，下棺入殓后，如果因事需要开棺检验，从来没有平正仰卧的尸体，不是趴着就是侧卧。这是因为药性过后，人苏醒过来必然会翻腾挣扎想要出来，但棺盖已经合上，于是导致真正死亡。所以凡是刚服食鸦片看似死去的人，都不是真正的死亡，这难道不冤枉吗？现在广东新刊印的套板《洗冤录》中，明确记载了救治的方法。说：病情轻的，心中烦躁，只用活鸭血或粪汁或酱油或凉水或明矾、雄黄研成的粉末灌下去，没有不痊愈的。如果服用量大，毒性重，身体冷气息绝，似乎已经死了，但只要肢体柔软，说明脏腑经络之气仍然流通，实际上是没死。要迅速将尸体放置在阴冷无阳光直射的地方（一旦受到日照就不可救），撬开牙齿，用筷子横在尸口中，用金汁（粪便发酵液）或凉水频频灌入。再用冷水在胸前摩擦，仍将头发解散浸在冷水盆内，自然能够复活。我曾亲眼目睹救活了几个人，凡是七天内身体不僵硬的，千万不要立即下棺入殓，等等。《洗冤录》是宫中验尸使用的书籍，不是随口传说可以相比的。如果肯广泛传播，实在是当今世上救人的第一要务。读者试想未死却被活埋的痛苦，那么传播之心就不能停止了。另外使用净金银花五钱，生大黄三钱，胆矾三钱，藜芦三钱，生甘草一两，水煎煮，蜂蜜五钱冲服。每能戒除鸦片毒瘾。
《医中一得》结束
医 医 十 病
本文转自 清阳中医在线
古今名医，卓越议论者代代都有其人。徐灵胎的《诸病源流论》最为脍炙人口。如今读清代吴楚天士先生的“医医十病”，其论述的高妙与灵胎《诸病源流论》不相上下。按吴楚字天士，号畹庵，与徐灵胎、张璐玉是同时代人。他是吴昆的侄孙，以医术闻名于顺治、康熙年间。现在陆续刊载出来，以拓宽我们的见闻。
医医十病
序言
人有病，医生也有病。想要医治病人，先要医治医生。人的病如果不靠医生，怎么能去除疾病？医生的病如果不自己医治，怎么能医治别人？人的病不医治，伤害的是性命；医生的病不医治，伤害的是子孙后代。性命受伤，只是一身的祸害；子孙后代受伤，乃是家族的灾祸。只是人的生病，多在全身骨骼肢体；医生的生病，只在于一心。心存济世救人，那么各种毛病就不会产生；心里专图私利，那么各种毛病就会丛生。粗略计算，其毛病有十种。大多不是鲁莽冒失，就是荒诞妄为；不是残忍刻薄，就是贪婪卑鄙；不是阿谀奉承，就是奸诈狡猾；不是卑劣浅陋，就是恶劣不堪。种种病症表现，都根源于心，都根源于舍己利己的心。我不才，愧无扁鹊那样的医术，只能深深忧虑国家大事。私下里担心富家子弟病深入膏肓，漫陈攻治疾病的良方。如果不嫌苦口，不畏服药后的瞑眩反应，而能细细咀嚼其味，猛吞其液，顿时荡涤邪秽，从而超脱尘俗。也是切望广救生灵，定然世代受福报。又何必像苍蝇钻营、狗苟且偷生那样，心病缠身以邀名图利，以致造孽无尽呢！
畹庵 吴 楚识
一、医生不学无术的毛病：
医生本是用以救人的，也用以杀人。医生之所以能救人，为什么也会杀人？只有学习才能救人，不学习则恰恰足以杀人。大概不学习就无法广博见识，不学习就无法明白道理，不学习就不能掌握精髓，不学习就不能通晓权变、通达变化，不学习就不能纠正谬误、去除弊端。像这样则鲁莽从事，不至于杀人的情况太少了！严重的是，从事医疗行业的人不可以不学习啊。有人说：医生哪有不学习的呢？医生一定有师传，有的传给老师，有的传给祖先或父亲，这都是学习。却不知道依靠这个作为学习，离真正的学习相差甚远了！不是说传授者的内容不足以作为学问，也是因为所传授的内容不足以涵盖所有的学问。那些人仅仅依靠倾耳听受的安逸，必定不再有心思研究的辛劳。而且既然坚守一成不变的规矩，就必然不明白神明变化的道理。好像岐伯、扁鹊、仓公历代各位圣贤，都不如他们的老师、祖先或父亲值得信任服从；好像历代圣贤留下的训诫之书，都不如他们的老师、祖先或父亲的口头言语值得凭借。咦！像这样还称之为学习，那他的学问可知，他的医术也可知了。所以善于学习的人，不论有无师传，总非求得古昔圣贤的道理不可；想要深得古昔圣贤的道理，就非多读书不可。从《灵枢》、《素问》以下，以及到近代的各种书籍，无不细心探讨。而又参考互订，探究其主旨；辨别其优劣，辩析其得失，抛弃糟粕，吸取精微，弄清源流，领悟奥义。这样之后见识高远、道理透彻，眼力敏锐、心灵手巧。凡是遇到一种病，必定认识准确、把握坚定，不被邪说迷惑，不被假象欺骗，不被世俗言论动摇；得心应手，确实能起死回生，使白骨长肉。以此来说学习，才是真学习。学问真了，技术自然神奇了。岂仅仅是从听受之间得到，坚守一成不变规矩的人，就能称之为学习吗？如果仅依靠这个作为学习，就必定得其偏颇而失去全面，得其浅显而失去深刻，得其皮毛而失去神髓，得其俗套而失去真谛，甚至以讹传讹，最终不知道错误在哪里。又有一种一味迎合世俗的方法，只教人行医，不教人懂医理。只传授保住名声获得利益的方法，而对人的生死置之不问；或者展示不承担利害风险的方法，而对病的缓急置而不谈。而学医者便以为道就在这里了。等到临症施治，不是隔靴搔痒，就是伤皮破血；不是画饼充饥，就是饮鸩止渴。这是技术不精湛，由学习不足造成的。这种不学无术的毛病，是急需医治的。
凡是医生给人用药，必须先认清症状，认清症状必须先审察脉象。审察脉象明了，然后认清症状才真实；认清症状真实，然后用药才恰当。以此来治疗疾病，有什么难的？然而却很难？凡是有一个症状，就有一个症状的寒热虚实。寒与热相反，虚与实相悬。在两个人身上，彼与此各不相同；即使在一个人身上的前后，也不是一个路子。如果不加以辨别，怎么能不倒行逆施呢？然而其为寒为热、为虚为实，又不让人一望而知。症状重的，大寒偏似热，大热偏似寒，大虚偏似实，大实偏似虚。如果仅就那些似是而非的症状来用药，杀人在反掌之间。这就是症状不可不辨别的原因。在哪里辨别呢？就在脉象上辨别。比如伤寒脉浮、洪、数、紧，按之有力者，知道症状是阳邪在表；如果沉而急数，重按有力者，知道症状是阳邪入里；如果浮大满指，按之如丝者，知道症状是阴极似阳。又如咳嗽这一症状，右寸脉浮数有力者，知道症状是肺有实邪；如果浮软或沉小者，知道症状是肺气空虚。诸如此类，应当细心辨别。辨别到极致，那么临症就没有骑墙不定的见解，用药没有相左的虞虑，而医生的能事就完成了。无奈近日的医家，决口不谈这个，只说某药可治其病，某病当用某方。至于问到所用某药某方的症状是寒是热、是虚是实呢？则茫然无法辨别。他们不能辨别症状，是由于不能辨别脉象。严重的是，辨别脉象尤其重要啊！奈何著名一世、远近推崇尊重的医生，常屡次告诉人说：脉象作不得准。呜呼，噫嘻！脉象作不得准，还有什么可作得准的呢？从来症状疑似难决断的，在脉象上决断它。现在反而说脉象作不得准，是完全不懂脉象的人。既然不懂脉象，又怎么能认清症状？所以难怪他们常用竹叶、石膏治疗阴症，用黄芩、黄连、栀子治疗胃寒。甚至脉象沉迟，还说是有火；脉象即将断绝，还说不可补。总缘不知辨别脉象，遂让流毒至此。虽然昔日贤人也有从脉不从症、从症不从脉的论述。却不知道所谓不从，正是深深地从。比如沉、细、迟、涩，是阴寒脉，而其症状却是烦躁作渴，面赤身热，如果以此为热症而清之则会致死，只有补之温之。不从其假热的症状，正是从其真寒的症状，而不是真的认为症状有不必从的。又如狂燥力雄，逾垣上墙，这是火热症，而其脉象却沉伏入骨，如果以此为阴脉而稳之则会危险，只有清之下之。不从其阴寒沉伏的脉象，正是从其热极反伏的脉象，而不是真的认为脉象有不可从的。总之，从其真，不从其假。不从的，是其外貌；从的，是其神髓。医家如果不辨别这个，没有不颠倒错乱，触手乖张的，一剂药的失误，性命随即随之而去。这种脉症无法辨别的毛病，是急需医治的。
三、医生轻忽人命的毛病：
谚语说：医生要有割股之心。如果是这样，那么医生爱惜人命也就到了极点。怎么会有轻忽人命的人呢！然而观察现今，感叹这话不灵验，或许是古昔的话而今不符呢？如同夏朝谚语所说：游豫休助。而孟子感叹说：现在不是这样。那么所谓医生有割股之心，也像夏时的谚语一样，现在难道是那样吗！如果观察现在的医生，不仅没有割股之心，好像并没有援手之意。病家殷勤延请医生，竭尽心力，耗费资财，希望医生能疗疾以安生。而医生却漠不相关，守定故智，用缓慢不切肤的药，每味给三、五、七分，否则给清凉反药一剂，便怀着私利离去。绝不踌躇审视顾盼，以期药物生效，病人得生。等到缓药渐渐致死，或反药立即致死，又绝无引咎之心，惭愧后悔之意。异日别家延请治疗，又重复如是，这真是拿人命当儿戏。其残忍惨刻，不比屠夫更厉害吗！推究其原因，都源于传授的错误，习俗的误导，利欲熏心的危害。听说名医的传人曰：药性勿厚，药量勿重，气薄剂轻，容易下手。这是名义上教人用药不必中病。做徒弟的，忍心看着起死回生的机会丧失，这不是轻乎人命是什么？习俗的弊病，更为可笑。谨遵名医妙诀，谓病重切不可为人担利害，只给轻轻几味药，仍留原病还给病人。唉！延请医生用药，原为去病。如果仍留病，何贵乎医生？既留病，则必不能留命。如果留一轻病，必渐加重；如果留一重病，必渐至死。还给他，听其从容自死的意思。可以生而必不救其生，本不死而想坐待其死，其轻乎人命到了什么地步？至于利欲熏心，不用比较就知道了。学医之初，原想借此谋生计罢了，哪里真是菩萨心肠，想以此救世呢？所以见到享有虚名而得厚实回报的人，一定效仿。那些名医一概用轻微药，就学其一概用轻微药；名医一概用清降药，就学其一概用清降药。以为名医之所以致富在于此，我能学之致富就够了。如果必须舍弃这个而另求真能活人的方法，不是愚蠢就是迂腐。所以越遵从轻药易解的师传，共安于留病还人的习尚。一任急症来临，我只缓缓接受。所以往往有可生的生机，必不用切当之药来相救；明明见相反的药，一惟随声附和以妄投。只恐失一己之名利，遂不顾人之死生。这种轻忽人命的毛病，是急需医治的。
四、医生遵守时套的毛病：
天下事，没有比套子更方便的，也没有比套子更有害的。医学如果涉入套子，则是至便而尤至害。病人的医治，如同盼望丰收。如果能用药切当，起死回生，以满足病家的期望，岂不是莫大的阴德。奈何用什么宽容不切的套子来应付，使病轻致重，病重致死，宁可杀他人以造自己的孽吗？无奈如今的医生有不得不从事于套子的原因，为什么呢？有人，脱离套子用药以治人，必定互相诽谤他，进谗言离间他，使病人不敢服他的药，使他的道不得行而后快。如果医生果立志救人，不图利己，则固以道自重，不肯稍自贬屈，思考变计。无奈从事医疗行业的人，都以利己为事。欲利己，则必效法其他医生利己的方法。欲效法其他医生利己的方法，自然不得不同流合污。从事于众人共同习惯的套子，这套子是什么呢？其视病在影响之间，其议论为庸众所共有，为妇人、女子所共晓；其用药则不寒不热，不补不泻，又或宁寒无热，宁泻无补，气薄味淡，而又所用不多，不怕瞑眩反应。所以为时俗所喜欢，为时流所崇尚。这样才能合乎时宜，入乎时派，且能趋时而得名，行时而获利，所以共同推崇为时套。时哉，套乎！如果不遵守并坚守它，凭什么享受厚实回报而肥壮身家呢？如果不这样，就是背时的医生。欲认真治病救人，徒为他人争死活，而不能为一己争财利，这难道是好的算计吗？这就是医生之所以不得不遵守时套的原因。况且时套之学，学习至极容易。不必费心思的辛劳，不必多研究的痛苦，不烦按脉切理，不顾生死利害，不待读书讲求，不待深究药性、详查病情，只学一二最易入俗的话语。凡是看一种病，便说是火。或者病人自以为虚，则说虽虚却不可补；或者说只宜平补，不可过补；或者说只宜清补兼施，不可稳补。只这几句话，便以投病人之机，动旁人之听了。而对于药则单择轻飘无力，及清降损真者，共计不上三十余种，便足横行一世。凡是治一种病，即在此三十种中，每种各少许，无论寒热虚实、男妇老幼及轻浅危笃者，悉以此投之。正如戴宽大的帽子，不必各合人头。又如咀屠门之肉，何须真充人腹。至于人参、黄芪、当归、白术等项，稍有益于元气者，概行删去不用。诚恐味厚的药，一有不当，即现弊端，招人指责，以致失名失利。不如轻清之味，微微用之，虽不见功，亦不即为害，而谁知道大害存在其中。邪气盛不能为之攻，正气衰不能为之辅。甚至虚寒已极，还说有火宜清；危笃已极，还说平守勿急。由此病人命登鬼录，而医生则病入膏肓了！这种遵守时套的毛病，是急需医治的。
五、医生药似对症的毛病：
Since the influx of opium smoke into the interior regions, a new path to rapid death has been added alongside fire, water, knives, ropes, and arsenic. Moreover, in recent years, the harm caused by opium is profound, and the number of deaths from it exceeds that of all other causes combined. Little do they know that this substance only bewilders and intoxicates people; it does not directly cause death.
Among all places, the harm of opium is most severe in Guangdong. During the 7th and 8th years of the Daoguang reign (1827–1828), a man from Sanshui County was staying in an inn in the provincial capital (Guangzhou). Due to poverty, he consumed raw opium and died. The innkeeper, unable to afford burial expenses, sent a special messenger to Sanshui to inform his relatives. By the time the relatives arrived, the deceased had already revived the day before. He had been dead for three days and four nights. An old coroner in Guangdong stated: "For those who die from smoking opium, if the coffin is opened for inspection after burial, there is never a corpse lying flat on its back; they are either prone or lying on their side." This is because once the drug's effect wears off, the person wakes up and inevitably thrashes about trying to escape, but since the coffin lid is closed, true death ensues. Therefore, anyone who appears to have died immediately after taking opium is not truly dead. Is this not unjust? Currently, the newly printed edition of *Xi Yuan Lu* (Collected Cases of Injustice Rectified) published in Guangdong explicitly records rescue methods. It states: "For mild cases where the patient feels restless in the chest, administering live duck blood, fecal juice, soy sauce, cold water, or a powder made from alum (Mingfan, 明矾) and realgar (Xionghuang, 雄黄) will invariably cure them. If a large dose was taken, toxicity is heavy, the body is cold, breath is absent, and death seems imminent, but if the limbs remain soft, it indicates that the Qi of the Zang-Fu organs and meridians is still circulating, meaning the person is actually alive. Quickly place the corpse in a cool, shaded area away from direct sunlight (once exposed to sun, it cannot be saved), pry open the teeth, place a chopstick horizontally across the mouth, and frequently administer Jin Zhi (Gold Juice, fermented fecal liquid) or cold water. Then rub cold water on the chest, loosen the hair, and immerse the head in a basin of cold water. Naturally, life will return. I have personally witnessed several such rescues. For any case where the body does not stiffen within seven days, do not bury them immediately," etc. *Xi Yuan Lu* is a text used for official forensic examinations in the imperial court, not to be compared with casual rumors. If widely disseminated, it would indeed be the foremost matter for saving lives in the current era. Readers should contemplate the agony of being buried alive; thus, the urge to spread this knowledge is irresistible. Additionally, use 5 qian of purified Honeysuckle Flower (Jinyinhua, 金银花), 3 qian of Raw Rhubarb (Sheng Dahuang, 生大黄), 3 qian of Chalcanthite (Danfan, 胆矾), 3 qian of Veratrum (Lilu, 藜芦), and 1 liang of Raw Licorice Root (Sheng Gancao, 生甘草). Decoct in water, and take with 5 qian of honey dissolved in it. This can effectively treat opium addiction.
The end of *Yi Zhong Yi De* (One Gain in Medicine)
Medical Ten Diseases of Doctors
Transcribed from Qingyang TCM Online
Throughout history, outstanding physicians with profound insights have appeared in every generation. Xu Lingtai’s *Zhu Bing Yuan Liu Lun* (Treatise on the Origins and Flow of Various Diseases) is particularly famous. Reading Mr. Wu Chutianshi’s (Wu Chu) "Ten Diseases of Doctors" from the Qing Dynasty, its sophistication rivals that of Xu Lingtai’s work. Wu Chu, courtesy name Tianshi, pseudonym Wan'an, was a contemporary of Xu Lingtai and Zhang Luyu. He was the great-nephew of Wu Kun and gained fame for his medical skills during the Shunzhi and Kangxi reigns. We publish this series gradually to broaden our horizons.
Ten Diseases of Doctors
Preface
People get sick, and doctors also get sick. To heal patients, one must first heal the doctor. If human illness does not rely on doctors, how can disease be removed? If a doctor's illness is not healed by themselves, how can they heal others? Human illness unhealed harms life and destiny; a doctor's illness unhealed harms descendants. Harm to life affects only one individual; harm to descendants affects the entire lineage. Human illness typically manifests throughout the body; a doctor's illness resides solely in the mind. If the mind harbors compassion to save others, various faults will not arise; if the mind focuses solely on self-interest, various faults will multiply. Roughly estimated, there are ten such diseases. They are mostly either rash or absurd; cruel or greedy; sycophantic or deceitful; base or vile. All these conditions stem from the heart, rooted in the selfish desire to benefit oneself at the expense of others. I, unworthy as I am, lack the skill of Bian Que, yet I deeply worry about national affairs. Fearing that wealthy patients' illnesses penetrate deep into the viscera, I present remedies for treatment. If one does not disdain the bitter taste nor fear the adverse reactions (mingxuan, 瞑眩), but instead carefully savors the meaning and swallows the essence, thereby cleansing evil turbidity and transcending worldly dust, this is a sincere wish to save living beings, surely bringing blessings to generations. Why engage in petty scheming like flies or dogs, letting heart-disease drive one to seek fame and profit, thus accumulating endless sin?
Wan'an Wu Chu acknowledges
I. The Disease of Doctors Lacking Learning and Skill:
Doctors are meant to save lives, yet they also kill. Why do doctors kill when their purpose is to save? Only through learning can one save lives; without learning, one merely kills. Without learning, one cannot broaden knowledge, clarify principles, grasp essentials, master flexibility and adaptation, or correct errors and eliminate弊端. Thus, acting rashly leads almost inevitably to killing. How serious is it that medical practitioners must learn! Some say: "How can doctors not learn? Every doctor has a transmission, either from a teacher or ancestors/fathers; this is learning." But relying on this as learning is far from true learning. It is not that the transmitted content is insufficient, but that what is transmitted cannot cover all knowledge. Those who rely solely on the ease of listening will no longer exert effort in research and study. Furthermore, adhering rigidly to fixed rules means ignoring the principle of divine transformation. It is as if ancient sages like Qibo, Bian Que, and Cang Gong were less trustworthy than their teachers or ancestors; as if ancient texts were less reliable than oral teachings. Oh! If this is called learning, then their learning and medicine are known. Therefore, good learners, regardless of having a teacher, must seek the principles of ancient sages; to deeply understand these principles, one must read extensively. From the *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions) down to modern texts, one must explore meticulously. Cross-reference and revise, grasp the purport, distinguish purity from impurity, debate gains and losses, discard dross, absorb essence, trace sources, and comprehend mysteries. Only then will insight be high, principles clear, vision sharp, and mind agile. When encountering any disease, one must identify it accurately, grasp it firmly, not be confused by heresies, deceived by false appearances, or swayed by popular opinions. With hands and mind in harmony, one can truly revive the dead and make bones grow flesh. This is true learning. With true learning, skill becomes miraculous. Merely receiving instruction and sticking to fixed rules is not learning. Relying on such limited learning leads to partiality over wholeness, superficiality over depth, form over spirit, and clichés over truth, eventually spreading errors unknowingly. There is also a worldly method that teaches practice but not understanding. It only teaches how to preserve reputation and gain profit, ignoring life and death; or shows how to avoid risk, ignoring the urgency of disease. Learners think this is the Way. When treating patients, they either scratch the surface (like scratching an itch through boots) or cause harm; they offer empty promises (like painting cakes to satisfy hunger) or poison (like drinking poison to quench thirst). This lack of skill stems from insufficient learning. This disease of lacking learning and skill needs urgent treatment.
II. The Disease of Doctors Unable to Differentiate Pulse and Symptoms:
When prescribing medication, doctors must first recognize symptoms; recognizing symptoms requires examining the pulse. Clear pulse examination leads to accurate symptom recognition; accurate symptom recognition leads to appropriate prescription. Treating disease then becomes easy. Yet it is difficult! Every symptom has its own cold/heat and deficiency/excess characteristics. Cold and heat are opposite; deficiency and excess are distinct. Between two people, they differ; even in one person, past and present differ. Without differentiation, one acts backwards. However, cold/heat and deficiency/excess are not always obvious. Severe cases may show false heat resembling cold, false cold resembling heat, false excess resembling deficiency, or false deficiency resembling excess. Prescribing based on these similarities kills instantly. Hence, symptoms must be differentiated. Where? In the pulse. For example, in Shanghan (Cold Damage), if the pulse is floating, surging, rapid, or tight, and forceful upon pressure, the syndrome is Yang pathogen in the exterior. If deep, rapid, and forceful upon heavy pressure, the pathogen has entered the interior. If floating and full but thread-like upon pressure, it indicates extreme Yin resembling Yang. For coughing, if the right Cun pulse is floating, rapid, and forceful, it indicates Lung excess pathogen; if floating and soft or deep and small, it indicates Lung Qi deficiency. Such cases require careful differentiation. Precise differentiation prevents hesitation in diagnosis and contradiction in treatment, completing the doctor's duty. Alas, modern doctors rarely discuss this, claiming "Drug X treats Disease Y." When asked whether the syndrome is cold/heat or deficiency/excess, they are baffled. Their inability to differentiate symptoms stems from inability to differentiate pulses. Differentiating pulses is crucial! Yet renowned doctors often claim "Pulses are unreliable." What else is reliable then? Historically, ambiguous symptoms are resolved by pulses. Claiming pulses are unreliable shows ignorance of pulses. Ignoring pulses makes symptom recognition impossible. No wonder they use Zhu Ye (Bamboo Leaf) and Shi Gao (Gypsum) for Yin syndromes, or Huang Qin (Scutellaria), Huang Lian (Coptis), and Zhi Zi (Gardenia) for Stomach cold. Even with deep/slow pulses, they claim Fire; with near-absent pulses, they forbid tonification. This results from failing to differentiate pulses. Ancient sages discussed "following pulse not symptom" or "following symptom not pulse." Understanding this, "not following" actually means "deeply following." For instance, deep, fine, slow, or choppy pulses indicate Yin-Cold, yet symptoms may include restlessness, thirst, red face, and fever. Treating this as Heat and clearing it causes death; one must tonify and warm. Not following the false Heat symptoms follows the true Cold symptoms. Similarly, mania and climbing walls indicate Extreme Heat, yet the pulse may be deep and hidden. Treating this as Yin-Cold and stabilizing it causes danger; one must clear and purge. Not following the hidden pulse follows the pulse of extreme Heat hiding. In short, follow the truth, not the falsehood. Not following is the appearance; following is the essence. Doctors failing to discern this cause chaos and error; a single wrong prescription costs a life. This disease of failing to differentiate pulse and symptom needs urgent treatment.
III. The Disease of Doctors Disregarding Human Life:
The proverb says: "Doctors should have the heart to cut flesh from their own thighs [to feed patients]." If so, doctors would cherish life immensely. How could they disregard it? Observing today, this proverb seems invalid, perhaps applicable only in ancient times. Mencius sighed that customs change. Today's doctors not only lack this heart but seem devoid of any intent to help. Families invite doctors earnestly, spending wealth and effort, hoping for healing. Doctors remain indifferent, using mild, ineffective drugs (3-5-7 fen per herb) or cooling counter-productive prescriptions, then leaving for profit. They do not ponder efficacy or survival. When mild drugs slowly kill or counter-drugs quickly kill, they feel no guilt or remorse. Later, they treat other families similarly. This treats human life as a game. Their cruelty surpasses that of butchers. Reasons include erroneous transmission, bad customs, and greed. Teachers say: "Use light herbs, small doses, weak qi and thin flavor, easy to prescribe." This teaches prescribing without hitting the disease. Apprentices watch lives slip away, disregarding life. Customs are laughable: "Do not take risks for severe cases; give light herbs, leave the disease for the patient." Ah! Medicine aims to remove disease. Leaving disease leaves life at risk. Light disease worsens; severe disease leads to death. "Returning the disease" means letting the patient die calmly. Letting the livable die and waiting for the non-dying to die shows extreme disregard for life. Greed is evident. Learning medicine is for livelihood, not Bodhisattva-like salvation. Seeing successful doctors use light/herbal methods, imitators copy them to gain wealth. Seeking true life-saving methods is deemed foolish. Thus, they stick to light prescriptions and the habit of leaving disease. Urgent cases are met with slow responses. Opportunities for life are missed; contradictory drugs are prescribed blindly. Fear of losing personal fame/profit overrides concern for life/death. This disease of disregarding life needs urgent treatment.
IV. The Disease of Doctors Adhering to Fashionable Conventions:
Nothing is more convenient than conventions, nor more harmful. Medicine involving conventions is extremely convenient yet highly harmful. Healing patients is like hoping for harvest. Proper prescribing saves lives, fulfilling expectations—a great merit. Yet doctors use loose conventions, worsening mild cases and killing severe ones, creating karma. Modern doctors feel compelled to follow conventions. Why? Deviating from conventions invites slander, causing patients to refuse treatment. A doctor determined to save lives, not profit, values the Way and refuses compromise. However, most doctors prioritize profit. To profit, they emulate others' methods, joining the crowd. What are these conventions? Diagnosing vaguely, using common language understood by laypeople and women; prescribing neutral herbs (neither cold/hot, tonifying/purging), preferring cold/purging over hot/tonifying, using light/thin herbs, avoiding adverse reactions. Popular and trendy, this brings fame and profit. Not following this makes one an "out-of-fashion" doctor. Trying to save lives while ignoring personal profit is poor strategy. Hence, doctors adhere to conventions. This learning is easy: no mental effort, no research, no pulse diagnosis, no reading, no deep pharmacological study. Just learn a few clichés. See a disease, call it Fire. If patient claims deficiency, say "cannot tonify"; say "only mild tonification"; say "clear and tonify together." These words please patients and bystanders. Herbs chosen are light, weak, clearing, and damaging to true Qi—less than thirty types suffice to dominate the industry. For any disease, mix small amounts of these thirty types, regardless of cold/heat, deficiency/excess, gender, age, or severity. Like wearing a wide hat that fits no one specifically, or chewing meat at a butcher's shop without eating it. Tonics like Ren Shen (Ginseng), Huang Qi (Astragalus), Dang Gui (Angelica), and Bai Zhu (Atractylodes) are avoided for fear of strong flavors causing adverse effects and criticism. Light/clear herbs are used minimally; though ineffective, they cause no immediate harm, though great harm lies within. They cannot attack pathogens or support deficient Qi. Even in extreme deficiency-cold, they claim Fire and clear; in critical cases, they advise caution. Patients die, doctors become rich. This disease of adhering to conventions needs urgent treatment.
V. The Disease of Doctors Prescribing Apparent Antidotes: