读书宜识字，顾名即思义，人事尽如斯，少弊自多利。
今医者满天下矣，试问以医字作何解说，莫不张口茫然，如坠烟雾。字且不识，而欲其
技之良、道之精，得乎？
医之字义从匚从矢从 从酉。匚受物之器，受矢于器为医。《说文》训为“盛弓弩短矢
器”，加 于右上， 亦兵器，下复从酉，酉，古酒字，古为毒物，故大禹绝之（石顽谓为从古
服药多以酒助，非也）。神农尝毒，经谓药多为毒物，凡治某病皆谓以某药毒之，《内经》亦多
如此，即以毒攻毒之义，可见医之为用尽伤人之具矣。病者既积矢 、毒酒之属于一身，其
危已可想见，医者如再不慎之又慎，不更危乎其危乎？黄帝以治兵之余治病，于是医字下笔
从医，国语兵不解医本此所谓用药如用兵也，凡欲为医者，可不知所从事哉？
古之医者，人皆神圣而又贵为天子，富有四海，或为大臣，如歧伯、伊芳尹是，或为达官，
如长沙太守仲景是。大臣达官虽富贵不逮天子，而身家皆自优裕，得以专一于医，而无别
虑萦扰，且复药皆自尝自备（今之西医、东医亦自备药，颇合吾国古法，此其一得），一遇病
者，无不应手奏效。盖先于经络脏腑，洞见 结，更于气化传变，预为防制，非若今之西医，
必待其人死后，购而剖解，始知其病之所在，自以为实验，人亦莫不以为然，然究不知其病
之所在也。人唯有生气，方有气化传变，既死
则气已绝而无迹可寻。如咳嗽病，有因外感，有因内伤，有因外感而变成内伤，或只关本
脏，或为火刑金，或为子累母，或为母累子，或不能胜其所胜而转使胜其所不胜。《内经》所
云∶五脏皆令人咳，甚则移传六脏。此皆古圣神人明气化传变之理，传之至今，历历不爽者
也。西医则剖解后见肺叶焦枯，或且溃烂，遂只名之曰肺炎。凡遇咳嗽，概以肺炎治之，无
论寒热有异，即只以肺炎论，亦不知其炎之由于心，由于肾，由于脾胃与肝胆，徒执一本位
为治。无怪其多不效，而转以为本不治，是皆由于不明五运六气以及脉息之确有可凭，故
虽至死亦不知病之所以然。今之重视西医、从学西医者，直与西医同梦，吾所以为医者立自
医之方，并欲以开通西医者，以其一也。类乎此者，不知凡几。
又如寻常疟疾，寒热来往，作止有时，一证既有，来往之名必有来往之处，来从何作？
往从何止？医者昧昧，漫不加察，虽中古以后之名大家亦皆不知其病之所在，稍贤明者，不
过能分十二经络，或阴或阳，于邪来时，所注重之经界，经界既正，则药力专到，不致累及
无辜。然必既专且久，邪始渐衰而退，非能直指病之来源也。下此则皆囫囵乱治，抄撮本证
数方投之，或以止截为功，或当邪衰自愈，以故病疟者无不经年累月受害。西医亦只知以
金鸡纳霜截之，然亦有效有不效（阴虚者，则多不效，且不宜服）。即使收效一时，后必再
发，更或变生他证而不可救，吾见不可殚述。岂知凡病皆不离经络、脏腑，唯此病若不在经
络、脏腑而别有所寄发作时，始由经络而脏
腑，退止时又由脏腑而经络而止其所休焉。以时来往者，则又胃气为之也。胃于五行属土，
于五德属信，故有信若潮，如人饥则思食，皆胃之日信，与妇女之月信同。然此虽予一人之
私言，然物理验有得，圣人复起不易吾言矣。《内经》阴阳疟论，歧伯曰∶疟之将来也，阴阳
之且移也，必从四末始也，坚束其处而决去之。只此四语，贼情，贼踪，贼窟，治法无不毕
具。如法为之，无论何疟，莫不霍然，所谓捣其老巢，老贼净尽，非圣人而能若是乎？非真洞
见脏腑经络而能若是乎？又何须效西医之剖解而始为实验耶！恐虽剖解，亦莫名其妙也。
今特为医者揭之，以为自医医人最便宜方，更以开通西医，使知吾国古圣人之法，不事剖
解，向能洞见经络脏腑之神（此证唯张子和、喻嘉言见及经旨，惜皆不能笃守圣法而杂出
多方）。
今之医者，大率下愚者多，其较古之圣神不知几千万里。且又皆读书不成，别业不就，
无聊之极，思始遁于医之一途。于是圣神与天地参之道，遂变为至愚无聊者之逋逃薮，况当
世界，苟且轻贱之积习牢不可破，其欲以为利者亦未矣。或别有会心者藉此以夤缘入官，遇
上官病，或其家属病，不俟延请，行同毛遂，时运一至，偶然幸中，美差优缺，纷至踏来，上官
亦最乐，此所谓惠而不费也。富贵逼人，亦常有事，是则不必问其道之若何矣。若其不善夤
缘，又无真实本领，不过聊为糊口计，且有时并口亦不能糊，徒见轻鄙于世界，且并贻讥于
外人，以为吾国医者如是，任意推测古圣之道，亦不过如是言。念及此，吾又不愿人之再
业此，如果有发愤而欲为此者，则请相率而进吾之方，毋虑其愚也，以学愈之，毋虑其贫也，
以勤俭愈之，毋虑其糊口不能也。以夷齐首阳之日孔子在陈之时较之，虽饿死事小也，能如
是天下何事不可为乎？则再请进吾之多方更以自医。
医道务从正心博学为体，而以继往开来为用，其间息邪说，距 行贯治道功夫，亦万
不可少。若徒以日诊数人，月好数病，年活多人为毕能事，而于国家元气，天下 毫无所
裨，人虽视我甚重，自待未免尚轻，良医良相之说，非虚语也。燮理阴阳，且足以弥天地之
灾，于人事更无论矣，相位不可必期，道理要归一致，出位之思君子，当不禁此，且不必
问朝廷世界对待医者何如，而只裕吾胞与之怀时，切饥溺之思尤于贫贱，富贵不易其心，
所谓宁可人负我，不可我负人，此正心之说也，即自医之第一方也。
博学人于识字读书之始即以《灵》、《素》、《内经》、《难经》、《伤寒论》、《金匮玉函经》、《甲乙
经》、《活人书》、合《四子》、《五经》、《尔雅》先后并读，更于性理经济书多读，然后再读《神农本
草经》、《长沙方》，经唐、宋、金、元、明代、国朝各大名家着述，以及欧亚之《儒门事亲》，西医
五种广学汇编，英国产科诸书择其大要者，次第阅之。其余如《千金》、《外台》、《圣济总录》、《证
治准绳》、《古今医统》、《名医类案》、《三因方》之类，不过为医家之大类书，略为涉猎，以备参
考可耳，至若邪说 行，有乖圣道古法而误世者，则概从阁置，或直以从火，只读时须精考
古书之简脱，与后儒之参附者，勿使为其蒙蔽而贻误，尤须于经史子集中不明言医而于医
道有合者，心领而神会之，所谓无字句间之医也。此博学而又须善学人也，自医之第二方也。
学医最忌先看本草与各方书，一经寓目，即可略识药品，聊记汤头，凑杂成方，于天地
阴阳五运六气，全无理会，于人身经络脏腑、病机脉情，毫无觉察。一遇病者，遂觉技痒，为
之延医，偶然幸中，自鸣得意。人有见之，亦谓知医，于是误尽苍生，终无入道之日。今之医
者大都如是。况所阅本草，既非《神农本经》所见，方书又非古圣经方，不过坊间所刊俗本，
如《本草备要》、《医方集解》、《验方新编》、《三指禅》、《笔花医镜》、《万病回春》、《冯氏锦囊》、《东医
宝鉴》、《医宗必读》之类，此种最易误人之书，却最盛行于今之世，几于家置一编，以为医道
尽于此矣。况且并此种类，亦未尽读熟读，凡有病家必为彼辈先试其手，及至辗转贻误，始
思一延名医，而时所谓名医者，又不过薛立斋、赵养葵、张景岳、李士材、陈修园之徒。然
其自命亦颇不凡，意谓较多读书，总属儒医，其实于医道仍是隔靴搔痒，不知取法乎上，仅
得其中，取法乎中，品斯下矣。又况等而下之耶，有志医道，其唯从吾息邪说距 行而直入
于圣人之室。
学医尤忌误解《伤寒论》，案仲景自序云∶作《伤寒杂病论》合十六卷，原为万病立法，所
谓法者，即六经气化传变，而方药随之而变之法也。以六经提纲者，使医者必先明六经经
界，则万病不外乎六经。唐宋以来，致力于《伤寒论》者无虑百数十家，究其所作，不出二义。
一则因本文为之注疏，犹公谷之说春秋，一则引本文而为立论，犹韩婴说诗。外传非多，以
辞害义，即失断章取义。自王叔和编次伤寒、杂病分为两书，于本论削去杂病而论中杂病
又存，而未去者尚多，且参以私意，紊乱仲景原文，改头换面不少，以致世之读《伤寒论》者
谓能治伤寒即能治杂病，遂多以杂病当伤寒，以伤寒概杂病而混治之。不知天下之病杂病
多而伤寒少，如地当西北，时当严寒，或多伤寒，外此则皆杂病矣。若地当东南，则杂病温
病为多，实时当严寒亦不过感寒冒寒而已。医者不明六经之法是统伤寒杂病而论，只以治
伤寒之方药概治杂病，而不知以六经之法分治杂病，此皆叔和阶之厉也。叔和序例所引
《内经》，莫不增句易字，况仲景耶！欲识真仲景者，当于原书本论逐条察其笔法，知考工记
自不合于周官，褚先生大不侔于太史，世皆以《金匮要略》为仲景《杂病论》，有若似圣人唯
曾子以为不可耳。柯韵伯《伤寒论翼》辨之最精且详，吾敢附于柯曰∶王叔和者，岐伯、仲景
之罪人，而后世医道之蝥贼也。虽《金匮》由叔和而始彰，其功亦不可没，然究功不掩罪，有
志医道者，不得仲景《伤寒杂病论》原本十六卷而读之，慎勿以伤寒之药治杂病而误尽苍
生，幸甚幸甚。
学医必须讲究气化传变，欲知气化传变又必先明阴阳，切忌混论阴阳，不分六经经
界。脏腑固分阴阳，而一脏又各有阴阳，一腑亦各有阴阳，俱宜逐脏逐腑一一厘清，气化传
变始能分晓。此在古名大家已少概见，今世中外业此者更无。徒梦见人身只阴阳两端，一病
则千头万绪，非能先正经界，鲜不堕入迷途，差之毫厘，谬以千里，世之学人既不曾闻大
道，又不力追上乘，只以苟且从事，因陋就简，谬以袭谬，歧之又歧，全不知气化为何事，何
能梦岐景耶！不能窥见岐景，又何能与论医道耶！君子之道，辟如行远必自迩，辟如登高必
自卑，所谓下学而上达也。若夫医道，则必上学而旁达，笃守古圣之法，然后旁通四达，以
斯推展博大而收土壤细流之助，仍不出古圣范围，方为医学正宗。
学医更须知凡病是随脏腑之气而变，又随药气而变。如太阳恶寒，非必伤寒始恶寒
也，无论风寒湿暑燥火，邪气一入太阳，无不恶寒。盖以太阳本寒水经，邪入触动寒水之
气，遂自恶寒。阳明发热，非必中热即发热也，阳明为南方火部，无论何邪，一入阳明，未有
不发热也。如入少阳，少阳为太阳阳明转枢，在半表半里之间，故又有寒热往来之势。或又
随药气而变使然。不然，何以伤寒在太阳有桂枝麻黄等方，一入阳明、少阳又有葛根、白虎、
承气、大小柴胡等方，是一经界中已有在经在脏在腑之别。若邪未入阳明，尚在太阳，一用
葛根未有不入阳明也。尚在太阳或在阳明，一用柴胡未有不入少阳也。是皆脏腑气化传变
与药气传变之故也。不独伤寒为然，杂病亦莫不然。不独三阳为然，即六阳六阴亦莫不然。
仲景《伤寒杂病论》先以六经提纲者，亦此之故，虽未条分缕晰，善学人，要当善悟而三反
也。世之混论阴阳，只论寒热虚实者，何能语于医道？而况乎能辨寒热虚实者亦寡矣，学人
可不知所务乎？西医不亦闻所未闻乎！
用药如用兵，兵法之要在明地势，用药之要在明经界。凡治病必先明六经之界，始知贼
邪所从来，知某方是某府来路，某方是某郡去路。来路如边关三阳是也，去路如内境三阴是
也。六经来路各不同，太阳是大路，少阳是僻路，阳明是直路，太阴近路也。少阴后路也，厥
阴斜路也。客邪多从三阳来，主邪多由三阴起。犹外寇自边关至，乱民自内地生也。明六
经地形，始得握万病之枢机；详六经来路，乃能操治病之规则。如伤寒，大寇也，病从外来；
中风，流寇也，病因旁及；杂病、内病，乱民也，病由中起，既认为何等之贼，又知为何地所
起，发于其境，便御之本境，移祸邻郡，即两路来攻，如邪入太阳地面，即汗而散之，犹陈利
兵于要害，乘其未定而击之也。邪之轻者在卫，重者在营，尤重者在胸膈。犹寇之浅者在
关外，其深者在关上，尤深者在关内也。是麻黄为关外之师，桂枝为关上之师，大小青龙为
关内之师矣。凡外寇不靖，内地盗贼必起而应之，因立两解法，故又有大小青龙及桂枝麻黄
加减诸方。如前军无纪，致内乱蜂起，当重内轻外，因有五苓、十枣、陷胸、抵当等汤也。邪
入少阳地面，宜杂用表里寒热攻补之品，为防御和解之法，如偏僻小路利于短兵，不利于矛
戟，利于守备，不利于战争也。邪之轻者入腠理，重者入募原，尤重者入脾胃，小柴胡腠理
之剂也，大柴胡募原之剂也，小建中、半夏泻心、黄芩、黄连四汤少阳脾剂也，柴胡加芒硝
读书应当先认识汉字，看到名称就要思考其含义，处理人事也应当如此，这样弊端自然减少，利益自然增多。
如今医生遍布天下，试着问他们“医”字作何解释，没有不张口结舌、茫然无知的，就像掉进烟雾里一样。连字都不认识，却想让他们医术精良、道行精深，可能吗？
“医”字的字义由匚（fāng）、矢、幵（jiān，此处原文似有缺漏或异体，结合下文兵器之意，指兵器）和酉组成。匚是盛放物品的器具，在器具中接受箭矢称为“医”。《说文解字》解释为“盛弓弩短箭的器具”，在右上方加上幵，幵也是兵器，下方再从酉，酉是古时的“酒”字，古代酒被视为毒物，所以大禹禁止饮酒（石顽认为古人服药多以酒送服，这是不对的）。神农尝百草发现毒性，《内经》说药物大多有毒性，凡是治疗某种疾病都说用某种药物的毒性来克制它，《内经》中也有很多这样的说法，这就是以毒攻毒的意思，由此可见，“医”的作用完全是伤害人的工具。病人身上已经积聚了箭矢、毒药和酒这类属于身体的危害，其危险程度已经可以想象，如果医生再不小心谨慎，不是更加危险吗？黄帝在治理军队之余治疗疾病，于是“医”字下面从“医”（此处原文表述较为晦涩，意指医与兵同源），《国语》中说军事与医学本源相同，这就是所谓的用药如用兵。凡是要做医生的人，怎么能不知道从事的方向呢？
古代的医生，人们都称他们为神圣之人，有的尊贵如天子，富有四海；有的身为大臣，如岐伯、伊尹；有的身为高官，如长沙太守张仲景。大臣和高官虽然富贵不如天子，但自身和家庭都非常优裕，能够专心于医学，没有其他杂念困扰，而且药材都是自己品尝、自己准备（现在的西医、东医也自备药材，很符合我国古法，这是他们的一个优点），一遇到病人，没有不立刻见效的。这是因为他们在经络脏腑方面洞察秋毫，对于气化的传变规律，预先进行防范和控制，不像现在的西医，一定要等人死后，购买尸体解剖，才知道病在哪里，自以为这是实验，人们也都认为是对的，然而终究还是不知道病的确切所在。人只有活着，才有气化的传变，一旦死亡，气就断绝了，没有痕迹可寻。比如咳嗽病，有因外感引起的，有因内伤引起的，有因外感变成内伤的，或者只关乎本脏，或者是火克金，或者是子病累母，或者是母病累子，或者是不能胜其所胜而反而被所不胜者克制。《内经》所说：五脏都能让人咳嗽，严重时甚至会传变到六腑。这些都是古代圣人神明之人阐明气化传变道理，流传至今，清晰准确无误的。西医则是解剖后看到肺叶焦枯，或者溃烂，就只命名为肺炎。凡是遇到咳嗽，一概按肺炎治疗，不管寒热有什么不同，即使只按肺炎论治，也不知道炎症是由于心、肾、脾胃还是肝胆引起的，只是固执地从一个部位进行治疗。难怪他们大多无效，反而认为是这个病无法治愈，这都是因为不明白五运六气以及脉象确实有凭据可依，所以直到死也不知道病的根本原因。现在重视西医、学习西医的人，简直和西医用的是同一个梦，所以我替医生制定自医的方子，并想要开通西医的思想，就是因为这一点。类似这种情况的，不知有多少。
又比如寻常的疟疾，寒热往来，发作和停止都有时间，既然有这个证候，往来的名字必然有往来的地方，从哪里来？到哪里去停止？医生糊涂，随意不加考察，即使是中古以后的名医大家也不知道病在哪里，稍微贤明一点的，不过能分辨十二经络，或是阴经或是阳经，在邪气来的时候，注重所在的经络界限，经络界限既已端正，那么药力就能专一地到达，不至于牵连无辜。但是必须既专一又持久，邪气才会逐渐衰退退去，并不能直接指出病的来源。更差一些的，都是糊里糊涂乱治，抄录几个治疗本证的方子投药，有的以截断疟疾为功效，有的等邪气衰退自愈，所以患疟疾的人没有不经过长年累月受害的。西医也只是知道用金鸡纳霜来截断它，但也有效有不效（阴虚的人，大多无效，而且不宜服用）。即使暂时收到效果，以后必定复发，或者变生其他病症而无法救治，我见到的不可尽述。哪里知道所有的病都不离开经络、脏腑，只有这个病如果不在经络、脏腑，而是别处寄居，发作时，才由经络传到脏腑，退止时，又由脏腑回到经络，停在它休息的地方。按时往来的，是因为胃气的作用。胃在五行中属土，在五德中属信，所以有信用像潮水一样准时，比如人饿了就想吃饭，都是胃的日信，与妇女的月经（月信）相同。但这虽然是我个人的私言，然而物理验证确有心得，即使圣人复活也不会改变我的话。《内经》阴阳疟论中，岐伯说：疟疾将要来临的时候，阴阳之气将要转移，一定从四肢末端开始，紧紧束缚那个部位然后决破去除它。只有这四句话，贼情、贼踪、贼窟、治法无不具备。按照这个方法去做，无论什么疟疾，没有不霍然痊愈的，所谓捣毁老巢，老贼净尽，如果不是圣人谁能做到这样呢？如果不是真正洞察脏腑经络谁能做到这样呢？又何必效仿西医解剖才开始实验呢！恐怕即使解剖，也是一头雾水。
现在特意为医生揭示这些，作为自医医人最便宜的方子，同时也用来开通西医，使他们知道我国古代圣人的方法，不从事解剖，向来就能洞察经络脏腑的神妙（这个观点只有张子和、喻嘉言触及到了经旨，可惜都不能严格遵守圣法而混杂出多方）。
如今的医生，大多是下愚之人，比起古代的圣神之人不知相差几千万里。而且他们都读书不成，别的职业也不成就，无聊到了极点，才想到遁入医学这一条路。于是神圣与天地参道的学问，就变成了至愚无聊者的逃避之所，何况在当今世界，苟且轻贱的积习牢不可破，那些想借此谋利的人也没有指望。或者有另有心思的人借此攀附权贵进入官场，遇到上官生病，或其家属生病，不等邀请，就像毛遂自荐一样，时运一到，偶然侥幸成功，美差优缺纷至沓来，上官也很高兴，这就是所谓的惠而不费。富贵逼人，也常有这种事，这就没必要问他的道术如何了。如果不善于攀附权贵，又没有真本事，不过是聊以糊口，有时甚至连口都糊不住，徒然被世人轻视鄙夷，并且招致外人讥笑，认为我国的医生就是这样，任意推测古圣之道，也不过是这样说说罢了。想到这些，我不愿意别人再从事这行了，如果有发愤图强想要从事这行的，那就请一起来接受我的方子，不要担心他愚笨，通过学习治好它；不要担心他贫穷，通过勤俭治好它；不要担心他不能糊口。拿伯夷、叔齐在首阳山的日子和孔子在陈国的时候相比，虽然饿死是小事情，如果能做到这样，天下有什么事做不成呢？那么就再请接受我的多方子来自医吧。
医道务必以正心博学为体，以继往开来为用，其中排斥邪说、抵制邪行、贯通治道的功夫，也万万不可少。如果只是每天诊治几个人，每月治好几个病，每年救活多个人作为毕生能事，而对国家元气、天下毫无裨益，虽然别人看我很重，自我对待未免还太轻，良医良相的说法，不是虚语。调理阴阳，足以弥补天下的灾难，对于人事就更不用说了，相位不一定能求得，道理最终是一致的，越位思考的君子，应当不禁受这种考验，而且不必问朝廷和世界如何对待医生，只要扩充我爱惜同胞的情怀，时刻想着救济饥溺之苦，尤其是对贫贱之人，富贵也不能改变他的心，所谓宁可人辜负我，不可我辜负人，这正是正心的说法，也就是自医的第一方。
博学的人从识字读书开始，就把《灵枢》、《素问》、《内经》、《难经》、《伤寒论》、《金匮玉函经》、《甲乙经》、《活人书》，合上《四子》、《五经》、《尔雅》先后并读，更多关于性理经济的书要多读，然后再读《神农本草经》、《长沙方》，经过唐、宋、金、元、明代、清朝各大名家的著作，以及欧洲的《儒门事亲》、西医五种广学汇编，英国产科诸书选择其中大要的，依次阅读。其余如《千金方》、《外台秘要》、《圣济总录》、《证治准绳》、《古今医统》、《名医类案》、《三因方》之类，不过是医家的大类书，略微涉猎，以备参考即可，至于那些邪说邪行，违背圣道古法而误世的书，则一概搁置，或者直接烧掉，只是在阅读时必须精心考证古书的简牍脱漏，以及后世儒者的参附之处，不要被它们蒙蔽而贻误，尤其要在经史子集中那些不明言医学但与医道契合的内容，心领神会，这就是所谓无字句间的医学。这就是博学而又善于学习，是自医的第二方。
学医最忌讳先看本草和各方的书籍，一旦看了，就可以大致识别药品，勉强记住汤头，凑杂成方，对天地阴阳五运六气，完全没有理会，对人体经络脏腑、病机脉情，毫无觉察。一遇到病人，就觉得技痒，为他延请医生，偶然侥幸成功，自我得意洋洋。别人看见，也说懂医，于是误尽苍生，始终没有入门的一天。现在的医生大都如此。况且所看的本草，又不是《神农本草经》所见到的，方书也不是古圣经方，不过是坊间刊印的俗本，如《本草备要》、《医方集解》、《验方新编》、《三指禅》、《笔花医镜》、《万病回春》、《冯氏锦囊》、《东医宝鉴》、《医宗必读》之类，这种最容易误导人的书，却在当今世界最盛行，几乎家家有一本，以为医道就在这里了。况且连这种种类的书，也没有全部读熟读透，凡是家里有病人的，必定先让这些人试手，等到辗转误人之后，才想到延请名医，而当时所谓的名医，也不过是薛立斋、赵养葵、张景岳、李士材、陈修园之流。然而他们自命不凡，意思是自己读了较多书，总是儒医，其实对于医道仍然是隔靴搔痒，不知道取法乎上，仅得其中，取法乎中，品级就低了，更何况比这更低呢？有志于医道的人，唯有从我这里排斥邪说、抵制邪行，直接进入圣人的殿堂。
学医尤其忌讳误解《伤寒论》，根据张仲景自序说：写作《伤寒杂病论》共十六卷，原本是为万病立法，所谓的法，就是六经气化传变，而方药随之变化的法则。用六经提纲，是为了让医生必须先明白六经的界限，那么万病就不外乎六经。唐宋以来，致力于《伤寒论》的不下百数十家，究其所作，不出两种意义。一种是本文为之作注疏，就像公羊谷梁解说春秋；一种是引用本文而立论，就像韩婴说诗。外传不多，以辞害义，就是失去断章取义。自从王叔和编次伤寒、杂病分为两本书，在本论中删去了杂病，而论中杂病又存在，而未去掉的还有很多，并且掺杂了他的私意，扰乱了张仲景的原文，改头换面不少，导致世上读《伤寒论》的人认为能治伤寒就能治杂病，于是多以杂病当作伤寒，以伤寒概括杂病而混治之。不知道天下的病杂病多而伤寒少，比如地处西北，时令严寒，或多伤寒，除此之外都是杂病了。如果地处东南，则杂病温病居多，即使时令严寒也不过是感寒冒寒而已。医生不明白六经之法是统括伤寒杂病而论，只用治伤寒的方药概括治疗杂病，而不知道用六经之法分治杂病，这都是王叔和造成的祸害。王叔和序例所引用的《内经》，无不增句易字，何况张仲景呢！想要认识真正的张仲景，应当在原书本论中逐条观察其笔法，知道《考工记》本身就不合于《周礼》，褚先生的文章大大不同于太史公，世人都把《金匮要略》当作张仲景的《杂病论》，好像只有曾子认为不可以一样。柯韵伯的《伤寒论翼》辨析得非常精详，我敢附和柯曰：王叔和是岐伯、张仲景的罪人，而后世医道的害虫。虽然《金匮》由王叔和才开始彰显，他的功劳也不可抹杀，然而终究功不掩罪，有志于医道的人，得不到张仲景《伤寒杂病论》原本的十六卷而阅读，千万不要用治伤寒的药去治杂病而误尽苍生，幸甚幸甚。
学医必须讲究气化传变，想要知道气化传变又必须先明白阴阳，切忌混淆谈论阴阳，不分六经界限。脏腑固然分阴阳，而一脏又各有阴阳，一腑也各有阴阳，都应当逐脏逐腑一一厘清，气化传变才能分晓。这在古代名医大家中已经很少见到，当今世界中外从事这行的人更没有。只是梦见人身只有阴阳两端，一病则千头万绪，不能先端正界限，很少有不堕入迷途的，差之毫厘，谬以千里，世上的学人既不曾听闻大道，又不努力追求上乘，只是苟且从事，因陋就简，错误地沿袭错误，错上加错，完全不知道气化是什么事，怎么能梦见岐伯和张仲景呢！不能窥见岐伯和张仲景的境界，又怎么能与他们谈论医道呢！君子的道路，譬如走远路一定从近处开始，譬如登高山一定从低处开始，这就是所谓下学而上达。至于医道，则必须上学而旁通，严格遵守古圣的方法，然后旁通四达，以此推展博大而收土壤细流之助，仍然不出古圣的范围，这才是医学正宗。
学医还必须知道所有的病都是随着脏腑之气而变化，又随着药气而变化。比如太阳病恶寒，不一定是伤寒才恶寒，无论风寒湿暑燥火，邪气一入太阳，无不恶寒。因为太阳本是寒水经，邪气侵入触动寒水之气，自然就恶寒。阳明病发热，不一定是中热才发热，阳明是南方火部，无论什么邪气，一入阳明，没有不发热的。如果入少阳，少阳是太阳阳明转枢，在半表半里之间，所以又有寒热往来的趋势。或者又随着药气变化使然。不然，为什么伤寒在太阳有桂枝麻黄等方，一入阳明、少阳又有葛根、白虎、承气、大小柴胡等方，是一个经界中已经有在经、在脏、在腑的区别。如果邪气未入阳明，还在太阳，一用葛根没有不入阳明的。还在太阳或在阳明，一用柴胡没有不入少阳的。这都是脏腑气化传变与药气传变的缘故。不只是伤寒如此，杂病也没有不这样的。不只是三阳如此，就是六阳六阴也没有不这样的。张仲景《伤寒杂病论》先用六经提纲，也是这个缘故，虽然没有条分缕析，善于学习的人，应当善于领悟而反复思考。世上混淆谈论阴阳，只论寒热虚实的人，怎么能谈论医道？更何况能辨别寒热虚实的人也少了，学人难道不知道所务之急吗？西医不也是闻所未闻吗！
用药如用兵，兵法的关键在于明确地势，用药的关键在于明确经界。凡是治病必须先明确六经的界限，才知道贼邪从哪里来，知道某方是哪里的来路，某方是哪里的去路。来路如同边关三阳，去路如同内境三阴。六经来路各不相同，太阳是大路，少阳是僻路，阳明是直路，太阴是近路。少阴是后路，厥阴是斜路。客邪多从三阳来，主邪多由三阴起。就像外寇从边关来到，乱民从内地产生。明白六经地形，才能掌握万病的枢机；详细六经来路，才能操持治病的规则。比如伤寒，是大寇，病从外来；中风，是流寇，病因旁及；杂病、内病，是乱民，病由中起，既然认定为哪种贼寇，又知道是从哪里产生的，发于其境，就在本境抵御，移祸邻郡，就从两路来攻，比如邪气进入太阳地面，就发汗解散它，犹如在要害处陈列精兵，趁其未定而攻击它。邪气轻的在卫分，重的在营分，特别重的在胸膈。犹如寇敌浅的在关外，深的在关上，特别深的在关内。所以麻黄是关外的军队，桂枝是关上的军队，大小青龙是关内的军队。凡是外寇不安定，内地盗贼必定起来响应，因此设立两解法，所以又有大小青龙及桂枝麻黄加减诸方。如果前军无纪律，导致内乱蜂起，应当重内轻外，因此有五苓、十枣、陷胸、抵当等汤。邪气进入少阳地面，宜杂用表里寒热攻补的药物，作为防御和解的方法，如同偏僻小路利于短兵，不利于矛戟，利于守备，不利于战争。邪气轻的进入腠理，重的进入募原，特别重的进入脾胃，小柴胡是腠理的药剂，大柴胡是募原的药剂，小建中、半夏泻心、黄芩、黄连四汤是少阳脾的药剂，柴胡加芒硝
Reading requires recognizing characters; upon seeing a name, one should ponder its meaning. Human affairs are no different from this: if done so, drawbacks will naturally decrease and benefits increase.
Today, doctors are everywhere. If we ask them to explain the character "Yi" (Medicine), none can answer without gaping in confusion, as if lost in smoke. If they cannot even recognize the character, how can they be expected to possess excellent skills and profound Dao?
The etymology of the character "Yi" consists of *fang* (匚, a container), *shi* (矢, arrow), *jian* (幵, weapons), and *you* (酉, wine). *Fang* is a vessel for holding objects; receiving arrows within the vessel constitutes "Yi". *Shuowen Jiezi* defines it as "a vessel for holding short bows and arrows." Adding *jian* (also a weapon) to the upper right, and *you* below, where *you* is the ancient character for wine, which was considered toxic in antiquity, hence Yu the Great prohibited it (Shiwan incorrectly believed that ancients used wine to assist in taking medicine). Shennong tasted toxins; the *Neijing* states that medicines are mostly toxic substances. Treating a certain disease by saying "use the toxicity of substance X to cure it" appears frequently in the *Neijing*. This illustrates the principle of using toxicity to combat toxicity. Thus, the function of "Yi" is entirely a tool for harming people. Patients already accumulate arrows, toxic wines, and other hazards within their bodies; their danger is evident. If doctors are not extremely cautious, will they not be even more dangerous? The Yellow Emperor treated diseases after managing military affairs. Thus, the character "Yi" incorporates elements related to warfare. The *Guoyu* states that military strategy and medicine share the same origin. This is what is meant by "using medicine like using troops." Anyone wishing to become a doctor must know their direction of endeavor.
Ancient doctors were regarded as sacred and divine. Some were as noble as emperors, possessing the four seas; others were high ministers, such as Qibo and Yi Yin; or high officials, such as Zhang Zhongjing, Governor of Changsha. Although ministers and officials were not as wealthy as emperors, their personal and family lives were comfortable enough to allow them to focus exclusively on medicine without distraction. Moreover, they tasted and prepared their own herbs (modern Western and Eastern doctors also prepare their own medicines, aligning with ancient Chinese methods, which is one advantage). When encountering patients, they achieved immediate effects. This is because they had clear insight into meridians and zang-fu organs, and could anticipate and prevent the transmission of Qi transformation. Unlike modern Western medicine, which waits for death to purchase corpses for dissection to locate disease—claiming this as experimentation, which people accept but ultimately fails to identify the true source of disease. Only when alive does Qi transformation occur; after death, Qi ceases, leaving no trace. For example, coughing may result from external pathogens, internal injury, or external pathogens transforming into internal injury. It may affect only the primary organ, or involve Fire insulting Metal, Child affecting Mother, Mother affecting Child, or failure to overcome what it normally controls, leading to being controlled by what it cannot overcome. The *Neijing* states: "All five Zang organs can cause coughing, and severe cases may transmit to the six Fu organs." These principles of Qi transmission, elucidated by ancient sages, remain accurate to this day. Western medicine, however, observes scorched or ulcerated lung lobes post-dissection and names it pneumonia. All coughs are treated as pneumonia, regardless of cold or heat differentiation. Even limiting diagnosis to pneumonia, they fail to recognize whether inflammation stems from the Heart, Kidney, Spleen/Stomach, or Liver/Gallbladder. They stubbornly treat from a single anatomical site. No wonder efficacy is low, and they attribute failure to incurability. This stems from ignorance of the Five Movements and Six Qi and reliable pulse diagnosis. Thus, they die without understanding the root cause. Those who value and study Western medicine today dream the same dream as Westerners. Therefore, I prescribe self-medication formulas for doctors and aim to enlighten Western medicine, for this very reason. Countless similar cases exist.
Take common malaria, characterized by alternating chills and fever at specific times. Since there is a pattern of coming and going, there must be a place of origin and cessation. Where does it come from? Where does it stop? Doctors are ignorant and fail to investigate. Even famous masters since ancient times did not know the disease's location. The slightly wiser could distinguish the twelve meridians, yin or yang, focusing on the meridian boundaries during pathogen arrival. Once boundaries are correct, medicinal power reaches specifically without harming the innocent. However, treatment must be consistent and prolonged for pathogens to gradually decline; it does not directly target the disease source. Inferior practitioners treat indiscriminately, copying several prescriptions for the syndrome, aiming to intercept malaria or waiting for spontaneous recovery upon pathogen decline. Consequently, malaria patients suffer for years. Western medicine uses Cinchona bark powder to intercept, but efficacy varies (ineffective and unsuitable for Yin deficiency). Even if temporary relief occurs, relapse is inevitable, potentially leading to untreatable complications. I have witnessed countless such cases. Do they not know that all diseases relate to meridians and zang-fu organs? Only when this disease resides elsewhere, transmitting via meridians to zang-fu during onset, and returning from zang-fu to meridians during remission, does it follow this pattern. Timely alternation is governed by Stomach Qi. The Stomach corresponds to Earth in the Five Elements and Trustworthiness in the Five Virtues, hence its regularity resembles tides, just as hunger prompts eating (daily trust) and menstruation (monthly trust). Though this is my personal view, physical verification supports it; even if sages rose again, they would not change my words. In the *Neijing*'s discussion on Yin-Yang Malaria, Qibo stated: "When malaria is about to arrive, Yin and Yang are shifting, starting from the four extremities. Bind firmly at these points and rupture them to expel it." These four sentences cover pathology, symptoms, location, and treatment perfectly. Following this method, any malaria resolves instantly, destroying the nest and eliminating the thief. Only a sage could achieve this. Only one with profound insight into zang-fu and meridians could do so. Why emulate Western dissection for experimentation? Even dissection would yield confusion.
I reveal this now as the most economical prescription for doctors to heal themselves and others, and to enlighten Western medicine regarding ancient Chinese methods that洞察 (insight into) meridians and zang-fu without dissection (Only Zhang Zihe and Yu Jiayan touched upon this essence, but failed to strictly adhere to sage methods, mixing multiple approaches).
Modern doctors are largely foolish, far inferior to ancient sages. Having failed in studies and other professions, driven by extreme boredom, they flee into medicine. Thus, the sacred Dao of participating with Heaven and Earth becomes a refuge for the foolish and bored. Given the current world, where superficiality and contempt are entrenched, those seeking profit find little hope. Some use this to climb social ladders; encountering illness in superiors or their families, they volunteer uninvited like Mao Sui. With luck, they succeed, gaining lucrative positions. Superiors are pleased, achieving benefit without cost. Wealth and status may force themselves upon them, rendering their medical ethics irrelevant. Those unable to flatter and lacking real skill merely struggle to survive, often failing even that, facing scorn from society and ridicule from foreigners who assume all Chinese doctors are incompetent guessers. Reflecting on this, I discourage others from entering this field. However, for those determined to pursue it, come receive my prescriptions. Do not fear stupidity; learning cures it. Do not fear poverty; diligence cures it. Do not fear starvation. Compared to Boyi and Shuqi starving on Mount Shouyang or Confucius stranded in Chen, starvation is minor. If one can endure this, what task cannot be accomplished? Then accept my multiple prescriptions for self-healing.
Medical practice must take Righteous Mind and Broad Learning as its foundation, and inheriting the past while opening the future as its application. Efforts to reject false doctrines and resist evil practices to integrate therapeutic paths are indispensable. Merely treating a few patients daily, curing a few monthly, and saving many annually as one's life's work, contributing nothing to national vitality or the world, shows that although others value me highly, I undervalue myself. The saying "Good Doctor, Good Minister" is not empty talk. Regulating Yin and Yang can remedy heavenly disasters, let alone human affairs. While political office is uncertain, the underlying principles are consistent. A gentleman contemplating duties beyond his station should reflect on this. Regardless of how the court or world treats doctors, one should expand compassion, constantly thinking of relieving hunger and drowning, especially for the poor and lowly, maintaining heart unchanged by wealth or status. "Better that others wrong me than I wrong others." This is the doctrine of Righteous Mind, the first prescription for self-healing.
For broad learning, start reading *Ling Shu*, *Su Wen*, *Neijing*, *Nanjing*, *Shanghan Lun*, *Jingui Yufan Jing*, *Jiayi Jing*, *Huo Ren Shu*, along with the *Four Books*, *Five Classics*, and *Erya*. Read extensively on moral philosophy and statecraft. Then study *Shennong Bencao Jing* and *Changsha Fang*. Proceed through major works of Tang, Song, Jin, Yuan, Ming, and Qing dynasties, European texts like *Rumen Shiqin*, compilations of Western medicine, and key British obstetrics books. Miscellaneous encyclopedic works like *Qianjin Fang*, *Waitai Miyao*, *Shengji Zonglu*, *Zhengzhi Zhunsheng*, *Gujin Yitong*, *Mingyi Leian*, and *Sanyin Fang* are merely reference materials; skim them. Discard false doctrines and harmful texts violating sage methods, even burning them. Carefully verify ancient texts for missing bamboo slips and later Confucian interpolations to avoid deception. Especially, comprehend medical principles hidden within historical and philosophical classics—the "medicine between the lines." This is broad yet wise learning, the second prescription for self-healing.
The greatest taboo in learning medicine is studying Materia Medica and formula books first. Doing so allows superficial recognition of herbs and memorization of decoctions, leading to haphazard prescription composition. Ignorance of Heaven-Earth Yin-Yang, Five Movements, and Six Qi; lack of awareness of meridians, zang-fu, pathology, and pulse conditions. Upon encountering patients, one feels eager to demonstrate skills. Accidental success breeds arrogance. Others perceive this as medical knowledge, leading to mass harm and never entering the true Dao. Modern doctors are mostly like this. Moreover, the Materia Medica studied is rarely the authentic *Shennong Bencao Jing*, and formula books are not ancient classics but popular commercial editions like *Bencao Beiyao*, *Yifang Jijie*, *Yanfang Xinbian*, *Sanzhi Chan*, *Bihua Yijing*, *Wanbing Huichun*, *Fengshi Jinnang*, *Dongyi Baojian*, and *Yizong Bidu*. These misleading books are prevalent, found in almost every home, mistaken for the entirety of medical knowledge. Furthermore, even these are not thoroughly mastered. Families try these practitioners first; only after repeated errors do they seek famous doctors. But "famous doctors" are often followers of Xue Lizhai, Zhao Yangkui, Zhang Jingyue, Li Shicai, and Chen Xiuyuan. Though proud of being scholar-doctors, they scratch the surface of medicine, failing to aim high. Aiming high yields medium results; aiming medium yields low results. How much worse is aiming lower? Those aspiring to the medical Dao must reject false doctrines and enter the Sage's chamber directly.
The greatest error in learning medicine is misunderstanding the *Shanghan Lun*. According to Zhang Zhongjing's preface, he wrote *Shanghan Zabing Lun* in sixteen volumes, establishing laws for all diseases. These laws refer to the Six Channels' Qi transformation and corresponding formula variations. Using Six Channel outlines ensures doctors understand channel boundaries, encompassing all diseases within the Six Channels. Since Tang and Song, over a hundred scholars have commented on the *Shanghan Lun*. Their works fall into two categories: annotations akin to Gongyang and Guliang commentaries on the *Spring and Autumn Annals*, or theoretical expansions akin to Han Ying's commentary on the *Book of Songs*. Deviating from the text harms the meaning. Wang Shuhe separated Shanghan and Zabing into two books, removing Zabing from the main text but retaining scattered references, altering Zhongjing's original text with personal biases. This led readers to believe treating Shanghan equates to treating Zabing, causing confusion. In reality, Zabing is more common than Shanghan, except in northwest regions during extreme cold. In southeast regions, Zabing and warm diseases dominate; even cold weather causes mild cold exposure. Doctors ignoring Six Channel laws treat all diseases with Shanghan formulas, failing to differentiate Zabing by Six Channels. This disaster stems from Wang Shuhe. His preface altered *Neijing* quotes; imagine his handling of Zhongjing! To know true Zhongjing, examine the original text's style. Just as *Kaogong Ji* differs from *Zhou Li*, and Chu Sheng's writings differ from Sima Qian's, the world mistakes *Jingui Yaolue* for Zhongjing's *Zabing Lun*, a view contested by Zengzi. Ke Yunbo's *Shanghan Lun Yi* analyzes this precisely. I agree: Wang Shuhe is the enemy of Qibo and Zhongjing, and a pest of later medical Dao. Although *Jingui* gained prominence through him, his merit does not outweigh his fault. Those aspiring to the medical Dao must read the original sixteen volumes of *Shanghan Zabing Lun*. Do not use Shanghan formulas for Zabing and harm the people.
Learning medicine requires understanding Qi transformation. To know Qi transformation, one must first understand Yin-Yang, avoiding confusion and distinguishing Six Channel boundaries. Zang-Fu have Yin-Yang, and each Zang/Fu has its own Yin-Yang, requiring clear distinction to understand Qi transmission. Ancient masters rarely saw this; modern practitioners worldwide lack it. Dreaming of only Yin-Yang leads to complexity in disease. Without correcting boundaries, one falls astray. A slight error leads to huge mistakes. Scholars unaware of the Great Way, seeking neither high levels nor rigorous study, settle for mediocrity, compounding errors. Ignorant of Qi transformation, how can they dream of Qibo and Zhongjing? Without glimpsing their realm, how can they discuss medical Dao? The gentleman's path is like traveling far from near, climbing high from low—learning basics to reach higher truths. Medical Dao requires foundational learning and broad extension, strictly adhering to sage methods, then expanding widely within the sage's scope, constituting orthodox medicine.
One must know diseases change with Zang-Fu Qi and medicinal Qi. Taiyang aversion to cold is not exclusive to cold damage; any pathogen entering Taiyang causes aversion because Taiyang is a Cold-Water channel, and pathogens disturb Cold-Water Qi. Yangming fever is not exclusive to heat damage; Yangming is the Southern Fire region; any pathogen entering causes fever. Shaoyang, the pivot between Taiyang and Yangming, located between exterior and interior, causes alternating chills and fever. Medicinal Qi also induces changes. Hence, Taiyang Shanghan uses Guizhi and Mahuang formulas; Yangming/Shaoyang uses Gegen, Baitu, Chengqi, and Chaihu formulas. Within one channel boundary, distinctions exist between channel, Zang, and Fu. Using Gegen while pathogen is still in Taiyang drives it to Yangming. Using Chaihu in Taiyang/Yangming drives it to Shaoyang. These are results of Zang-Fu Qi transmission and medicinal Qi transmission. This applies to Zabing and all Six Yin/Yang channels. Zhongjing's Six Channel outlines serve this purpose. Learners must悟 (comprehend) and reflect. Those confusing Yin-Yang and discussing only cold/heat/deficiency/excess cannot discuss medical Dao, let alone distinguish these patterns. Can Western medicine hear of this?
Using medicine is like using troops; military strategy emphasizes terrain, medicine emphasizes channel boundaries. Treat diseases by defining Six Channel boundaries to identify pathogen origin. Incoming paths resemble border Three Yang channels; outgoing paths resemble inner Three Yin channels. Taiyang is the main road, Shaoyang the remote path, Yangming the direct route, Taiyin the close path, Shaoyin the rear path, Jueyin the diagonal path. External pathogens usually enter via Three Yang; internal pathogens originate from Three Yin. Like invaders from borders or rebels from interior. Understanding Six Channel terrain grasps the pivot of all diseases; detailing incoming paths dictates treatment rules. Shanghan is a major invasion from outside; Fengzhong is a roaming bandit spreading from sides; Zabing/internal disease is internal rebellion arising from within. Identifying the type of "thief" and its origin allows defense in the originating territory. If threat spreads to neighboring territories, attack from both routes. If pathogen enters Taiyang, induce sweating to disperse it, like deploying elite troops at strategic points to strike before consolidation. Light pathogens are in Wei (Defensive) level, heavy in Ying (Nutritive) level, critical in Chest/Diaphragm. Like enemies outside, inside, or deep within the pass. Mahuang is the army outside the pass, Guizhi at the pass, Da/Xiao Qinglong inside. Unrest outside invites internal rebellion; thus, dual-resolution formulas like Da/Xiao Qinglong and modified Guizhi/Mahuang are used. If front-line discipline fails causing internal chaos, prioritize internal over external, using Wuling, Shizao, Xianxiong, Didang decoctions. Pathogens entering Shaoyang territory require mixed exterior-interior, cold-heat, attack-tonification strategies for defense and reconciliation, like narrow paths favoring short weapons over spears, defense over offense. Light pathogens enter Couli (Pores), heavy enter Muyuan (Membrane Source), critical enter Spleen/Stomach. Xiao Chaihu treats Couli, Da Chaihu treats Muyuan. Xiao Jianzhong, Banxia Xiexin, Huangqin, Huanglian treat Shaoyang-Spleen. Chaihu plus Mangxiao...