余友薛文煌，字朗斋，通州人，素知医。道光十年二月，因赴山东，来舍辞行。闲谈言
及古
宗。血是精汁入血府所化，心乃是出入气之道路，其中无血。朗斋曰∶吾兄所言不实，诸物
心皆有血，何独人心无血？余曰∶弟指何物心有血？曰∶古方有遂心丹治癫狂，用甘遂末，
以猪心血和为丸，岂不是猪心有血之凭据？余曰∶此古人之错，非心内之血，因刀刺破其心
，腔子内血流入于心，看不刺破之心，内并无血，余见多多。试看杀羊者，割其颈项，不刺
心，心内亦无血。又曰∶不刺心，何死之速？余曰∶满腔血从刀口流，所以先流者速，继而
周身血退还腔子，所以后流者迟，血尽气散，故死之速。如人斗殴破伤，流血过多，气散血
亡，渐至抽风，古人立名曰破伤风，用散风药治死受伤者，凶手拟抵，治一个，即是死两个
。若明白气散血亡之义，即用黄 半斤，党
余不论三焦者，无其事也。在外分头面四肢，周身血管；在内分膈膜上、下两段，膈膜
以上
瘀之症；立血府逐瘀汤，治胸中血府血瘀之症；立膈下逐瘀汤，治肚腹血瘀之症。病有千状
万态，不可以余为全书。查证有王肯堂《证治准绳》，查方有周定王朱 《普济方》，查药
有李时珍《本草纲目》，三书可谓医学之渊源。可读可记，有国朝之《医宗金鉴》，理足方
效，有吴又可《瘟疫论》。其余名家，虽未见脏腑，而攻发补泻之方，效者不少。余何敢云
着书，不过因着《医林改错·脏腑图记》后，将平素所治气虚、血瘀之症，记数条示人以规
矩，并非全书。不善读者，以余之书为全书，非余误人，是误余也。
我的朋友薛文煌，字朗斋，是通州人，向来精通医术。道光十年二月，因为他要前往山东，来我住处辞行。闲聊时谈及古代医家关于脏腑的论述。我认为：血是由精汁进入“血府”后化生而成的；心只是气体出入的道路，其中并没有血。朗斋说：“您所说的不符合事实，各种动物的心脏都有血，为什么唯独人心没有血？”我说：“你指的是哪种动物的心脏有血？”他说：“古方中有用‘遂心丹’治疗癫狂病的，使用甘遂末，以猪心血调和做成丸药，这难道不是证明猪心有血的依据吗？”我说：“这是古人的错误，并非心脏内部本身有血。是因为用刀刺破猪心时，胸腔内的血液流入心脏中，看起来像是心内有血；如果不刺破心脏，里面其实并没有血，我见过很多这样的例子。你看杀羊的人，割断羊的脖颈，并不刺破心脏，羊心内也没有血。”他又问：“不刺破心脏，为什么死得这么快？”我说：“因为满腔的血液从刀口流出，所以先流出的速度快；随后全身的血液退回胸腔，所以后流出的速度慢。当血液流尽、气机散失，所以死亡迅速。就像人斗殴受重伤，流血过多，气散血亡，逐渐出现抽搐症状，古人将此病命名为‘破伤风’，用祛风药物治疗导致受伤者死亡。按律凶手应抵命，但这样治一个病人，就等于害死了两个。如果明白‘气散血亡’的道理，就使用黄芪半斤，党参……”
我不承认三焦的存在，因为没有这个实体。在体表分为头面四肢和周身血管；在体内分为膈膜上、下两段。膈膜以上为瘀血之症；创立“血府逐瘀汤”，治疗胸中血府瘀血之症；创立“膈下逐瘀汤”，治疗肚腹瘀血之症。疾病表现千姿百态，不能把我的书当作医学全书。查证理论可参考王肯堂的《证治准绳》，查证方剂可参考周定王朱橚的《普济方》，查证药物可参考李时珍的《本草纲目》，这三本书可以说是医学的渊源。值得阅读和记忆的还有本朝的《医宗金鉴》，其理据充分、方药有效；还有吴又可的《瘟疫论》。其余名家，虽然未能看清脏腑结构，但其攻邪、发表、补虚、泻实的方法，有效的也不少。我怎敢声称自己著书立说？不过是在写完《医林改错·脏腑图记》之后，将平时治疗的“气虚”、“血瘀”病症记录几条，作为展示给人们的规矩（范例），并不是完整的医学全书。不善读书的人，把我的书当作全书，这不是我误导别人，而是他们误解了我。
My friend Xue Wenhuang, courtesy name Langzhai, was from Tongzhou and had long been knowledgeable in medicine. In the second month of the 10th year of the Daoguang era, he came to my residence to bid farewell as he was about to travel to Shandong. During our casual conversation, we discussed ancient theories regarding the Zang-Fu organs. I stated that blood is transformed from essence fluids entering the "Blood Mansion" (Xue Fu); the Heart is merely the pathway for the entry and exit of Qi, and contains no blood within it. Langzhai said, "What you say is not factual; the hearts of all creatures contain blood, why should the human heart be an exception?" I asked, "Which creature's heart do you refer to as containing blood?" He replied, "In ancient prescriptions, there is 'Suixin Dan' used to treat mania and epilepsy, made by mixing Kansui powder with pig heart blood into pills. Is this not proof that the pig heart contains blood?" I said, "This is an error by ancients; it is not blood originally inside the heart. When the heart is pierced by a knife, blood from the chest cavity flows into the heart, creating the illusion that the heart itself holds blood. If one does not pierce the heart, there is actually no blood inside. I have observed this many times. Observe those who slaughter sheep: when they sever the neck without piercing the heart, the heart inside remains devoid of blood." He then asked, "If the heart is not pierced, why does death occur so rapidly?" I explained, "Because the entire volume of blood flows out through the incision, the initial flow is rapid; subsequently, blood from the rest of the body retreats into the chest cavity, making the later flow slower. When blood is exhausted and Qi dissipates, death occurs swiftly. Similarly, if a person suffers severe trauma from a fight, excessive bleeding leads to dissipation of Qi and loss of Blood, gradually resulting in convulsions. The ancients named this condition 'Po Shang Feng' (Broken Injury Wind) and treated it with wind-dispelling herbs, which caused the injured patient to die. According to law, the attacker should face capital punishment, but such treatment effectively kills two people for every one attempted to be saved. If one understands the principle of 'Qi dissipation and Blood loss,' one would use Astragali Radix (Huangqi) half a jin, Codonopsis Radix (Dangshen)..."
I deny the existence of the Sanjiao (Triple Burner) because it lacks physical reality. Externally, it corresponds to the head, face, limbs, and systemic blood vessels; internally, it is divided into upper and lower segments by the diaphragm. Stasis above the diaphragm constitutes stasis in the chest region; therefore, I formulated Xuefu Zhuyu Tang (Blood Mansion Stasis-Expelling Decoction) to treat blood stasis in the chest Blood Mansion; and Gexia Zhuyu Tang (Below Diaphragm Stasis-Expelling Decoction) to treat abdominal blood stasis. Diseases manifest in thousands of forms; my book cannot be regarded as a comprehensive medical text. For theoretical verification, one may consult Wang Kentang's Zhengzhi Zhunsheng (Standardized Diagnosis and Treatment); for formula verification, Zhu Su's Puji Fang (Universal Effective Prescriptions); and for materia medica verification, Li Shizhen's Bencao Gangmu (Compendium of Materia Medica). These three works are indeed the sources of medicine. Also worthy of study are the Yizong Jinjian (Golden Mirror of Medicine) of our dynasty, which possesses sound principles and effective formulas, and Wu Youke's Wenyi Lun (Treatise on Pestilential Diseases). Other renowned physicians, although they failed to correctly identify the Zang-Fu anatomy, employed methods of attacking pathogens, releasing the exterior, tonifying deficiency, and draining excess, many of which proved effective. How dare I claim to have authored a definitive medical work? I merely recorded several cases of Qi deficiency and blood stasis that I commonly treated, following the completion of the "Zang-Fu Diagram Record" in *Yilin Gaicuo*, to provide guidelines for others. It is not a complete medical encyclopedia. Those who fail to read properly and mistake my book for a comprehensive medical text are not misled by me, but rather misinterpret my intent.