医之为学先须熟谙内经并张李刘朱四家之说以知病源次观本草以知药性而处方次晓素难
及叔和脉诀以知切脉而定虚实必宗斯三者以为提纲又考诸历代名医之正法庶使病机明而不惑
于学也
医之源流自黄帝歧伯秦越人东汉张仲景西晋王叔和隋之巢元方五代陈日华宋陈文忠严用
和金之陈无己刘守真张元素元李明之王好古朱彦修辈悉皆医门名流正派大可学人也故多收录
其法至于近代明医若吴中罗益沧州吕复皆承东垣之余绪咸有着述未易枚举嗟乎自内经以来医
书一百九十九家其间量为择取各随所宜以为定见
病源之说专以内经为主复采先贤群经定论但去其繁就其简以便观览
形证之设谓人有病于脏腑经络必有证见于皮毛颜色之间且人心肝脾肺肾在人身中藏而不
可见若夫口鼻耳目则露而共见者也五脏受病患马能知之盖有诸中形诸外古云脏病形乃应所谓
外证以证内病若不识外证岂能明内病耶今病下略具形证以便审察
脉理之妙有七表八里九道六极合为三十样之分呼吸之际识病情决生死岂不难哉人未尝会
得脉理之妙但值病者徒张切脉之名岂知脉理之机妙今于病下考定应有之脉及挟病之脉大略有
所凭据
从事医学这门学问,首先必须熟练掌握《黄帝内经》以及张仲景、李东垣、刘完素、朱丹溪这四家的学说,以此来了解疾病的根源;其次要研读《本草》,以知晓药物的性质,从而制定处方;再次要通晓《素问》、《难经》以及王叔和的《脉诀》,以掌握切脉技巧并判断病证的虚实。必须将这三者作为学习的纲领,同时考证历代名医的正统法则,这样在学术上才能明了病机而不产生困惑。
医学的源流传承,始于黄帝与岐伯,经过秦越人(扁鹊)、东汉张仲景、西晋王叔和、隋朝巢元方、五代陈日华、宋朝陈文忠和严用和、金代陈无己、刘守真、张元素、元代李明之、王好古、朱彦修等人,他们都是医界的正统名流,非常值得学习。因此书中收录了他们的治疗方法。至于近代的明医,如吴中的罗益、沧州的吕复,都承袭了李东垣的学术余绪,都有著作传世,难以一一列举。唉!自从《黄帝内经》以来,医书有一百九十九家,这里只是略微加以选择选取,各自依据适宜的内容确立为定论。
关于疾病根源的论述,专门以《黄帝内经》为主,兼采先贤各经典的定论,但去除了繁杂的内容,保留简明的部分,以便于阅读查阅。
关于形体症状的设置,认为人如果在脏腑经络患病,必然会在皮毛颜色之间表现出证候。而且人心、肝、脾、肺、肾在人体内部隐藏不可见,而口、鼻、耳、目则是显露且共同可见的。五脏受到病患影响,马(此处疑为“焉”或泛指)能知道它吗?大概是因为内在有病,外在就会显现。古人说内脏的疾病会反映在形体上,所谓通过外在证候来诊断内在疾病,如果不认识外在证候,怎么能明白内在疾病呢?现在在各病之下略具形体症状,以便审查观察。
脉理的奥妙有七表、八里、九道、六极,合起来分为三十种类型。在呼吸之间识别病情,决断生死,难道不难吗?人们未曾领会脉理的奥妙,遇到病人时只是徒然摆出切脉的名头。哪里知道脉理的精妙机理呢?现在在各病之下考证确定应有的脉象及伴随疾病的脉象,大略有凭据可循。
治疗疾病的方法,是在面对疾病时辨别病源,明确脉证,分类收集古代现成的方剂和法则,以及发表、攻里、调和等各方剂,适宜攻伐还是适宜固守,正治法还是反治法,缓治还是急治,使医生能够顺利下手施治。
The study of medicine requires first becoming proficient in the *Huangdi Neijing* (Yellow Emperor's Inner Canon) and the theories of Zhang Zhongjing, Li Dongyuan, Liu Wansu, and Zhu Danxi to understand the origin of diseases. Secondly, one must study the *Bencao* (Materia Medica) to know the properties of herbs and thereby formulate prescriptions. Thirdly, one must be familiar with the *Suwen*, *Nanjing*, and Wang Shuhe's *Maijue* (Classic of Pulse Diagnosis) to master pulse palpation and determine deficiency or excess. These three aspects must serve as the outline for learning. Furthermore, by examining the orthodox methods of famous physicians throughout history, one can clarify the pathogenesis and avoid confusion in one's studies.
The lineage of medicine originated from Huangdi and Qibo, followed by Qin Yueren (Bian Que), Zhang Zhongjing of the Eastern Han Dynasty, Wang Shuhe of the Western Jin Dynasty, Chao Yuanfang of the Sui Dynasty, Chen Rihua of the Five Dynasties period, Chen Wenzhong and Yan Yonghe of the Song Dynasty, Chen Wuji, Liu Shouzhen, and Zhang Yuansu of the Jin Dynasty, and Li Mingzhi, Wang Haogu, and Zhu Yanxiu of the Yuan Dynasty. All these figures are distinguished mainstream figures in the medical field and are worthy of study. Therefore, their methods have been extensively collected. As for modern enlightened physicians, such as Luo Yi from Wuzhong and Lv Fu from Cangzhou, they all inherited the academic legacy of Li Dongyuan and produced works that are too numerous to list. Alas! Since the *Huangdi Neijing*, there have been 199 medical texts. Here, only a selection has been made according to appropriateness to establish definitive views.
The discussion on disease origins focuses primarily on the *Huangdi Neijing*, incorporating the established conclusions from various classics by sages of old. Complicated content is removed while concise content is retained to facilitate reading and reference.
The categorization of physical signs posits that if a person suffers from disease in the Zang-Fu organs or meridians, symptoms will inevitably manifest in the skin, hair, and complexion. The Heart, Liver, Spleen, Lungs, and Kidneys are hidden within the body and invisible; whereas the mouth, nose, ears, and eyes are exposed and visible to all. When the five Zang organs are affected by pathology, how can it not be known? This is because internal conditions manifest externally. As the ancients said, internal organ diseases reflect in the physical form. Thus, external signs diagnose internal diseases. If one does not recognize external signs, how can one understand internal diseases? Now, under each disease, physical signs are briefly outlined to facilitate examination.
The subtlety of pulse theory encompasses Seven Exterior, Eight Interior, Nine Distinctive, and Six Extremes pulses, totaling thirty types. Distinguishing disease conditions and determining life or death amidst breaths is indeed difficult. People often fail to grasp the subtlety of pulse theory; when encountering patients, they merely pretend to palpate pulses without understanding the mechanism and wonder of pulse diagnosis. Now, under each disease, the appropriate pulses and accompanying pathological pulses are examined and determined, providing a basis for reference.
The methods of treating diseases involve distinguishing disease origins and clarifying pulse signs when facing illness. One should collect ancient established formulas and methods, including those for releasing the exterior, purging the interior, and harmonizing. Depending on whether attack or consolidation is suitable, and whether orthodox or counter-treatment is applied, along with slow or rapid methods, the physician may proceed effectively.