医道之晦久矣。明人有四大家之说，指张仲景、刘河间、李东垣、朱丹溪四人，谓为千
古医
宗。此真无知妄谈也。夫仲景先生，乃千古集大成之圣人，犹儒这孔子。河间、东垣，乃一
偏之家。丹溪不过斟酌诸家之言，而调停去取，以开学人便易之门。此乃世俗之所谓名医也
。三子之于仲景，未能望见万一，乃跻而与之并称，岂非绝倒？如扁鹊、仓公、王叔和、孙
思邈辈，则实有师承，各操绝技，然亦仅成一家之言，如儒家汉唐诸子之流，亦断断不可与
也子并列，况三人哉？至三人之高下，刘则专崇《内经》，而实不能得其精义；朱则平易浅
近，未睹本原；至于东垣执专理脾胃之说，纯用升提香燥，意见偏而方法乱，贻误后人，与
仲景正相反。后世颇宗其说，皆由世人之于医理全未梦见，所以为所惑也。更可骇者，以仲
景有《伤寒论》一书，则以为专明伤寒，《金匮要略》则以为不可根据以治病，其说荒唐更甚
。吾非故欲轻三子也。盖此说行则天下惟知三子之绪余，而不深求仲景之学，则仲景延续先
圣之法，从此日衰。而天下万世，夭扎载途，其害不少，故当亟正之也。
医之高不齐，此不可勉强者也。然果能智竭谋，小心谨慎，犹不人。更加以诈伪万端
害不可穷矣。或立奇方以取异；或用僻药以惑众；或用参茸补热之药，以媚富贵之人；或假
托仙佛之方，以欺愚鲁之辈；或立高谈怪论，惊世盗名；或造假经伪说，瞒人骇俗；或明知
此病易晓伪说彼病以示奇。如冬月伤寒，强加香薷于伤寒方内而愈，以为此暑病也，不知香
薷乃其惑人之法也。如本系热症，强加干姜于凉药之内而愈，以为此真寒也，不知彼之干姜
，乃泡过百次而无味者也。于外科则多用现成之药，尤不可辨，其立心尤险。先使其疮极大
，令人惊惶而后治之，并有能发不能收，以至毙者。又有偶得一方，或五灰膏、三品一条枪
之灰，罔顾人之极痛，一概用之，哀号欲死，全无怜悯之心。此等之人，不过欲欺人图利，
即使能知一二，亦为私欲所汨没，安能奏功？故医者能正其心术，虽学不足，犹不至于害人
。况果能虚心笃学，则学日进；学日进，则每治必愈，而声名日起，自然求之者众，而利亦
随之。若专于求利，则名利秘两失，医者何苦舍此而蹈彼也？
中医之道被遮蔽已经很久了。明代人有“四大家”的说法，指张仲景、刘河间、李东垣、朱丹溪这四人，称他们为千古医宗。这真是无知妄谈。张仲景先生，是千古集大成的圣人，就像儒家的孔子一样。刘河间、李东垣，只是一偏之见的医家。朱丹溪不过是斟酌各家之言，调和取舍，以此开启方便之门给初学者。这是世俗所谓的名医。这三人与张仲景相比，连万分之一都赶不上，却将他们并列并称，岂不令人绝倒？像扁鹊、仓公、王叔和、孙思邈这些人，确实有师承渊源，各操绝技，但也仅能自成一家之言，如同儒家汉唐诸子之类，也绝对不可以与孔子并列，何况这三个人呢？至于这三人的高下：刘河间专门推崇《黄帝内经》，但实际上未能得其精义；朱丹溪平易浅近，未窥见本源；至于李东垣执着于专门调理脾胃的说法，纯用升提香燥的药物，见解偏颇而方法混乱，贻误后人，这与张仲景（的学术思想）正好相反。后世很尊崇他的学说，都是因为世人对医理完全未曾梦见，所以被迷惑。更令人骇异的是，因为张仲景有《伤寒论》一书，就认为他专门阐明伤寒，《金匮要略》则被认为不可依据来治病，这种说法比之前更加荒唐。我并不是故意要轻视这三个人。大概是因为这种说法流行，天下人只知道这三人的余绪，而不深入探求张仲景的学问，那么张仲景延续先圣的方法，从此日益衰微。而天下万世，夭折的人遍布道路，其危害不少，所以应当急切地纠正它。
医术的高低不齐，这是不能勉强强求的。然而如果真能智谋竭尽，小心谨慎，还不至于害人。再加上欺诈虚伪手段万千，害处就不可穷尽了。有的立奇方以取怪异之名；有的用偏僻药物以迷惑大众；有的用人参、鹿茸等补热之药，以讨好富贵之人；有的假托仙佛之方，以欺骗愚鲁之辈；有的立高谈怪论，惊世盗名；有的造假经伪说，瞒人骇俗；有的明知此病容易辨识，却伪说彼病以示奇特。比如冬天月伤寒，强行在伤寒方中加入香薷而痊愈，就认为是暑病，不知道香薷只是他迷惑人的手法。比如本系热症，强行在凉药中加入干姜而痊愈，就认为是真寒证，不知道那干姜是经过水泡百次而无味道的。在外科方面多用现成之药，尤其难以辨别，其用心尤为险恶。先使疮疡极大，令人惊惶而后治疗，甚至有只能发散不能收敛，以致死亡的。又有偶然得到一方，或五灰膏、三品一条枪的灰烬，不顾病人极度疼痛，一概使用，哀号欲死，全无怜悯之心。这种人，不过想欺人图利，即使知道一二，也被私欲所淹没，怎能奏效？所以医者若能端正心术，虽然学问不足，还不至于害人。况且如果真能虚心笃学，学问就会日益进步；学问日益进步，那么每次治疗必愈，声名自然兴起，求治者众多，利益也随之而来。如果专于求利，则名利两失，医者何必舍此而蹈彼呢？
The Way of Medicine has been obscured for a long time. The Ming dynasty scholars proposed the theory of "Four Great Masters," referring to Zhang Zhongjing, Liu Hejian, Li Dongyuan, and Zhu Danxi, claiming them to be the eternal patriarchs of medicine. This is truly ignorant nonsense. Mr. Zhang Zhongjing is the sage who synthesized all achievements throughout history, just as Confucius is for Confucianism. Liu Hejian and Li Dongyuan are merely specialists with one-sided views. Zhu Danxi merely weighed the words of various schools, harmonized and selected them, thereby opening a convenient door for beginners. These are what the secular world calls famous doctors. Compared to Zhang Zhongjing, these three could not reach even one ten-thousandth of his level, yet they are ranked equally with him; is this not absurd? As for Bian Que, Cang Gong, Wang Shuhe, Sun Simiao, and others, they indeed had lineage inheritances and mastered unique skills, but they only formed their own schools of thought, similar to the various philosophers of the Han and Tang dynasties in Confucianism. They absolutely cannot be ranked alongside Confucius, let alone these three. Regarding the hierarchy among these three: Liu Hejian exclusively revered the *Huangdi Neijing* (Yellow Emperor's Inner Canon), yet failed to grasp its essential meaning; Zhu Danxi was plain and superficial, failing to perceive the root origin; as for Li Dongyuan, he adhered strictly to the theory of regulating the Spleen and Stomach, using purely ascending, aromatic, and drying methods. His opinions were biased and his methods chaotic, misleading future generations, which is exactly opposite to Zhang Zhongjing. Later generations greatly respected his theories because people of the world had never even dreamed of medical principles, thus being confused by them. What is more shocking is that because Zhang Zhongjing wrote the *Shanghan Lun* (Treatise on Cold Damage), people believed he specialized only in cold damage, and because of the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), they considered it unreliable for treating diseases. Such statements are even more absurd. I do not intend to lightly disparage these three men. It is simply that once this theory spreads, the world will only know the remnants of these three and will not deeply seek the learning of Zhang Zhongjing. Consequently, the method passed down from the ancient sages by Zhang Zhongjing will decline day by day. Then, in the world and for all generations, premature deaths will litter the roads, causing considerable harm. Therefore, it must be urgently corrected.
The disparity in medical skill is uneven, and this cannot be forced. However, if one can exhaust one's wisdom and planning, and be careful and cautious, one will still not harm people. But if added to this are myriad forms of deceit and hypocrisy, the harm becomes inexhaustible. Some establish miraculous prescriptions to gain notoriety; some use obscure herbs to confuse the public; some use warming tonics like Ginseng Radix et Rhizoma (Renshen) and Deer Antler Cornu (Lurong) to flatter the wealthy; some falsely attribute prescriptions to immortals or Buddhas to deceive the ignorant; some make grandiose and bizarre claims to shock the world and steal fame; some forge classic texts and false theories to deceive people and startle society; some knowing a disease is easy to identify, falsely claim another disease to show off. For example, in winter, when contracting Cold Damage (Shanghan), forcibly adding Moslae Herba (Xiangru) to a Cold Damage prescription leads to recovery, so they claim it was Summerheat Disease (Shubing), unaware that Xiangru was merely a trick to bewitch people. If it was originally a Heat Syndrome (Rezheng), forcibly adding Zingiberis Rhizoma (Ganjiang) to cooling medicines leads to recovery, so they claim it was True Cold (Zhenhan), unaware that the Ganjiang used had been soaked in water a hundred times until flavorless. In surgery, they mostly use ready-made medicines, which are especially hard to distinguish, and their intentions are particularly sinister. They first allow the sore to become extremely large, frightening people, and then treat it. There are even cases where they can induce discharge but not heal the wound, leading to death. Others, having accidentally obtained a formula, such as Wuhui Gao (Five Ashes Plaster) or Sanpin Yitiao Qiang (Three Species Single-Specie Gun) ash, disregard the patient's extreme pain and apply it indiscriminately. The patients wail in agony, desiring death, showing no compassion whatsoever. Such people merely wish to deceive others for profit. Even if they know a little, they are submerged by selfish desires, how can they achieve success? Therefore, if a physician can rectify their mindset, even if their learning is insufficient, they will at least not harm people. Moreover, if they can study with humility and sincerity, their learning will advance daily; as learning advances, every treatment will succeed, their reputation will rise naturally, seekers will increase, and profits will follow. If one focuses solely on seeking profit, both fame and profit will be lost. Why would a physician abandon this path to tread upon that?