余读勋臣先生《医林改错》一书，而叹天下事，有人力为之者，有天意成之者。先生是
书，
之一游也。此岂非天假之缘，而使数千载之误，由先生而正之哉！帷膈膜一事，留心三十年
，
哉！至先生立方医疾，大抵皆以约治博。上卷着五十种血瘀之症，以三方治之。下卷论半身
不遂，以一方治之，并审出未病以前四十种气虚之形症，非细心何能至此。论吐泻转筋，治
分攻补两途，方由试验中来；论小儿抽风非中风，以大补元气一方治之，以不能言之儿，查
出二十种气虚之形症，平素细心不问可知；论痘非胎毒，痘浆非血化，以六方治古人不治之
六十种逆痘，颇有效者。先生之书，大抵补前人之未及，而在气虚血瘀之症为多，今特揭诸
篇首。
知非子书
余着《医林改错》一书，非治病全书，乃记脏腑之书也。其中当尚有不实不尽之处，后
人倘
外感内伤，伤人何物，有余不足，是何形状。至篇中文义多粗浅者，因业医者学问有深浅也
。前后语句多复重者，恐心粗者前后不互证也。如半身不遂内有四十种气亏之症，小儿抽风
门有二十种气虚之症，如遇杂症，必于六十种内互考参观，庶免谬误。望阅是书者，须详审
焉。
玉田王清任书
古人曰∶既不能为良相，愿为良医。以良医易而良相难。余曰∶不然。治国良相，世代
皆有
本先失。病本既失，纵有绣虎雕龙之笔，裁云补月之能，病情与脏腑，绝不相符。此医道无
全人之由来也。
夫业医诊病，当先明脏腑。尝阅古人脏腑论及所绘之图，立言处处自相矛盾。如古人论
脾胃
磨胃化食，脾不动则食不化？论脾之动静，其错误如是。其论肺，虚如蜂窠，下无透窍，吸
之则满，呼之则虚。既云下无透窍，何得又云肺中有二十四孔，行列分布，以行诸脏之气？
论肺之孔窍，其错误又如是。其论肾有两枚，即腰子，两肾为肾，中间动气为命门。既云中
间动气为命门，何得又云左肾为肾，右肾为命门，两肾一体，如何两立其名，有何凭据？若
以中间动气为命门，藏动气者，又何物也？其论肾错误又如是。其论肝，左右有两经，即血
管，从两胁肋起，上贯头目，下由少腹环绕阴器，至足大趾而止。既云肝左右有两经，何得
又云肝居于左，左胁属肝？论肝分左右，其错误又如是。其论心，为君主之官，神明出焉，
意藏于心，意是心之机，意之所专曰志，志之动变曰思，以思谋远曰虑，用虑处物曰智，五
者皆藏于心。既藏于心，何得又云脾藏意智，肾主伎巧，肝主谋虑，胆主决断？据所论，处
处皆有灵机，究竟未帮助生灵机者何物，藏灵机者何所，若用灵机，外有何神情，其论心如
此
门上输于脾肺，宣播于诸脉。此段议论，无情无理。胃下口名曰幽门，即小肠上口。其论小
肠
自肛门出，水归膀胱为尿。如此论，尿从粪中渗出，其气当臭，尝用童子小便，并问及自饮小便
之人，只言味咸，其气不臭。再者，食与水合化为粪，粪必稀溏作泻，在鸡鸭无小便则可，在
马牛有小便则不可，何况乎人？看“小肠化食，水自阑门出”一节，真是千古笑谈。其论心包
络，细筋如丝，与心肺相连者，心包络也。又云心外黄脂是心包络。又云心下横膜之上，竖膜
之下，黄脂是心包络。又云膻中有名无形者，乃心包络也。既云有名无形，何得又云手中指之
经，乃是手厥阴心包络之经也？论心包络竟有如许之多，究竟心包络是何物，何能有如许之
多耶？其论三焦，更为可笑。《灵枢》曰∶手少阴三焦主乎上，足太阳三焦主乎下，已是两三
焦矣。《难经·三十一难》论三焦∶上焦在胃之上，主内而不出；中焦在胃中脘，主腐熟水谷
；下焦在脐下，主分别清浊。又云∶三焦者，水谷之道路。此论三焦是有形之物。又云∶两肾
中间动气，是三焦之本。此论三焦是无形之气。在《难经》一有形、一无形，又是两三焦。王
叔和所谓有名无状之三焦者，盖由此也。至陈无择以脐下脂膜为三焦，袁淳甫以人身着内一层
，形色最赤者为三焦，虞天民指空腔子为三焦，金一龙有前三焦、后三焦之论。论三焦者，不
可以指屈，有形无形，诸公尚无定准，何得云手无名指之经，是手少阳三焦之经也？其中有自
相矛盾者，有
余尝有更正之心，而无脏腑可见，自恨着书不明脏腑，岂不是痴人说梦，治病不明脏腑
，何
，四月初旬，游于滦州之稻地镇，其时彼处小儿正染瘟疹痢症，十死八九，无力之家多半用
代席裹埋。代席者，代棺之席也。彼处乡风，更不深埋，意在犬食，利于下胎不死，故各义
冢中，破腹露脏之儿，日有百余。余每日压马过其地，初未尝不掩鼻，后因念及古人所以错
论脏腑，皆由未尝亲见，遂不避污秽，每日清晨，赴其义 ，就群儿之露脏者细视之，犬食
之余，大约有肠胃者多，有心肝者少，互相参看，十人之内，看全不过三人，连视十日，大
约看全不下三十余人，始知医书中所绘脏腑形图，与人之脏腑全不相合，即件数多寡亦不相
符。惟胸中膈膜一片，其薄如纸，最关紧要，及余看时皆以破坏，未能验明在心下心上、是
斜是正，最为遗憾。至嘉庆四年六月，余在奉天府，有辽阳州一妇，年二十六岁，因疯疾打
死其夫与翁，解省拟剐。跟至西关，忽然醒悟，以彼非男子，不忍近前。片刻，行刑者提其
心与肝肺从面前过，细看与前次所看相同。后余在京，时嘉庆庚辰年，有打死其母之剐犯，
行刑于崇文门外吊桥之南，却得近前，及至其处，虽见脏腑，膈膜已破，仍未得见。道光八
年五月十四日，剐逆犯张格尔，及至其处，不能近前。自思一篑未成，不能终止。不意道光
九年十二月十三日夜间，有安定门大街板厂胡同恒宅请余看症，因谈及膈膜一事，留心四十
年，未能审验明确。内有江宁布政司恒敬公，言伊芳曾镇守哈密，领兵于喀什噶尔，所见诛戮
逆尸最多，于膈膜一事，知之最悉。余闻言喜出望外，即拜叩而问之，恒公鉴余苦衷，细细
帮助形状。余于脏腑一事，访验四十二年，方得的确，绘成全图。意欲刊行于世，惟恐后人
未见脏腑，议余故叛经文。欲不刊行，复虑后世业医受祸，相沿又不知几千百年。细思黄帝
虑生民疾苦，平素以《灵枢》之言下问岐伯、鬼臾区，故名《素问》。二公如知之的确，可
对君言，知之不确，须待参考，何得不知妄对，遗祸后世。继而秦越人着《难经》，张世贤
割裂《河图洛书》为之图注，谓心肝肺以分两计之，每件重几许，大小肠以尺丈计之，每件
长若干，胃大几许，容谷几斗几升。其言仿佛是真，其实脏腑未见，以无凭之谈，作欺人之
事，利己不过虚名，损人却属实祸。窃财犹谓之盗，偷名岂不为贼。千百年后，岂无知者？
今余刻此图，并非独出己见，评论古人之短长，非欲后人知我，亦不避后人罪我，惟愿医林
中人，一见此图，胸中雪亮，眼底光明，临症有所遵循，不致南辕北辙，出言含混，病或少
失，是吾之浓望，幸仁人君子鉴而谅之。
时道光庚寅孟冬直隶玉田县王清任书于京邸知一堂
我阅读了勋臣先生所著的《医林改错》一书，不禁感叹世间之事，有靠人力完成的，也有靠天意成就的。先生的这本书，正是上天借由机缘，让数千年来医学上的谬误，通过先生得以纠正啊！尤其是关于膈膜这一部位的研究，先生留心观察长达三十年，真是令人敬佩啊！至于先生制定方剂治疗疾病，大抵都是运用简约的方法治理复杂的病症。上卷记载了五十种血瘀的病症，用三个方剂来治疗；下卷论述半身不遂，用一个方剂来治疗，并且审察出发病前四十种气虚的症状和体征，如果不是细心钻研，怎么能达到这种程度呢？论及吐泻转筋，治疗方法分为攻邪和补虚两条途径，方剂都是从临床实践中得来的；论及小儿抽风并非中风，用大补元气的方剂来治疗，对于无法言语表达的小儿，能查出二十种气虚的症状和体征，这平时若不细心观察是看不出来的；论及痘疹并非胎毒，痘浆并非血液化生，用六个方剂治疗古人认为无法治疗的六十种逆痘，颇有疗效。先生的书，大体上是补充前人未涉及的内容，而在气虚血瘀的病症方面尤为突出，现在特别将这些篇章揭示在卷首。
知非子 题写
我撰写《医林改错》一书，并非专门论述治病的书籍，而是记录脏腑形态的书籍。其中可能还有不实和不详尽的地方，后人如果……（原文此处似有缺漏或语意未完，依文意译为：后人若发现不当之处）……外感与内伤，伤害人体的是什么物质，有余和不足时，呈现什么形状。至于文中有些文义比较粗浅，是因为从业医生的学问有深有浅。前后语句多有重复，是担心粗心的人前后不能互相印证。例如半身不遂中有四十种气亏的病症，小儿抽风门中有二十种气虚的病症，如果遇到其他杂症，必须在六十种情况中互相参考对照，以免出现谬误。希望阅读此书的人，必须详细审慎地考察。
玉田王清任 书写
古人说：“如果不能做良相，那就愿做良医。”因为良医容易做而良相难做。我说：不是这样。治理国家的良相，代代都有。但如果治病不明脏腑，就像治国失去了根本。病本既然错误，即使有绣虎雕龙般的文笔，裁云补月般的才能，病情与脏腑也绝不相符。这就是医道中没有完美之人的由来。
从事医学诊断疾病，应当先明白脏腑。曾经阅读古人关于脏腑的论述以及所绘制的图谱，立论处处自相矛盾。例如古人论述脾胃，胃负责磨碎食物消化，脾不动则食物不消化？论述脾的动静，其错误就是这样。论述肺，说肺像蜂巢一样空虚，下面没有透气的孔窍，吸气就满，呼气就虚。既然说下面没有透气的孔窍，为什么又说肺中有二十四孔，行列分布，以运行各脏的气？论述肺的孔窍，其错误又是这样。论述肾有两个，就是腰子，两肾称为肾，中间的动气称为命门。既然说中间的动气是命门，为什么又说左肾为肾，右肾为命门，两肾是一体，如何能建立两个名字，有什么依据？如果把中间的动气作为命门，那么藏纳动气的又是什么东西呢？论述肾的错误又是这样。论述肝，左右有两根经脉，就是血管，从两胁肋起，向上贯穿头目，向下经过少腹环绕阴器，到大脚趾结束。既然说肝左右有两根经脉，为什么又说肝居于左边，左胁属于肝？论述肝分左右，其错误又是这样。论述心，是君主之官，神明由此产生，意藏于心，意是心的机制，意之所专称为志，志的变动称为思，用思谋虑长远称为虑，用虑处理事物称为智，这五种都藏于心。既然都藏于心，为什么又说脾藏意智，肾主技巧，肝主谋虑，胆主决断？根据所论述的，处处都有灵机，究竟是谁帮助产生了灵机，灵机藏在哪里，如果使用灵机，外在有什么神情表现？论述心就是这样。
……（中间段落因原文排版断裂，依上下文逻辑补全大意）……胃的上口输于脾肺，宣播于诸脉。这段议论，无情无理。胃的下口名叫幽门，即小肠的上口。其论述小肠……（原文此处断裂，推测为讨论小肠功能）……从肛门排出，水液归入膀胱成为尿液。如此论述，尿液从粪便中渗出，气味应当发臭，我曾试用童子小便，并询问自己喝小便的人，只说味道咸，气味不臭。再者，食物与水混合化为粪便，粪便必然稀溏导致腹泻，在鸡鸭身上没有小便是可以的，在马牛身上有小便是不可以的，何况是人呢？看“小肠化食，水自阑门出”这一节，真是千古笑谈。论述心包络，细筋如丝，与心肺相连的是心包络。又说心外面的黄脂是心包络。又说心下横膜之上，竖膜之下，黄脂是心包络。又说膻中有名无形的，乃是心包络。既然说有名无形，为什么又说手中指的经脉，是手厥阴心包络的经脉？论述心包络竟然有这么多说法，究竟心包络是什么东西，怎么会有这么多说法呢？论述三焦，更为可笑。《灵枢》说：手少阴三焦主乎上，足太阳三焦主乎下，已经是两个三焦了。《难经·三十一难》论述三焦：上焦在胃之上，主纳而不出的；中焦在胃中脘，主腐熟水谷；下焦在脐下，主分别清浊。又说：三焦者，是水谷的道路。此论述三焦是有形之物。又说：两肾中间的动气，是三焦的根本。此论述三焦是无形的元气。在《难经》中一有形一无形，又是两个三焦。王叔和所说的有名无状的三焦，大概由此而来。到了陈无择以脐下的脂膜为三焦，袁淳甫以人身内部一层、颜色最红的为三焦，虞天民指空腔子为三焦，金一龙有前三焦、后三焦的论述。论述三焦的人，数不胜数，有形无形，各位专家尚无定准，怎么能说手无名指的经脉，是手少阳三焦的经脉呢？其中有的自相矛盾，有的……（原文此处似有缺漏）……
我曾经有更正之心，但没有脏腑可见，自恨著书却不明白脏腑，岂不是痴人说梦，治病不明白脏腑，怎么会……（原文此处似有缺漏）……四月初旬，我在滦州的稻地镇游历，当时那里的小孩正感染瘟疹痢症，十死八九，无力家庭多半用代棺的席子包裹埋葬。代席，就是代替棺材的席子。当地的风俗，不深埋，意在让狗吃，利于下胎不死，所以各个义冢中，破腹露脏的小孩，每天有百余具。我每天骑马经过那里，起初也不掩鼻，后来想到古人之所以错误论述脏腑，都是因为未曾亲眼所见，于是我不避污秽，每天清晨，去那些义冢，对着群儿暴露的脏腑仔细观看，被狗吃剩下的，大约有肠胃的多，有心肝的少，互相参看，十个人里面，看完整的不过三人，连续看了十天，大约看完整的不下三十多人，才知道医书中绘制的脏腑形图，与人的脏腑完全不相符合，即使件数多少也不相符。只有胸中的膈膜一片，薄如纸张，最为紧要，等到我看的时候都已经破坏，未能验明是在心下还是心上，是斜还是正，最为遗憾。到了嘉庆四年六月，我在奉天府，有个辽阳州的女子，二十六岁，因疯疾打死了丈夫和公公，解送省城判处凌迟。跟随到西关，忽然醒悟，因为她不是男子，不忍心靠近。片刻后，行刑者提着心和肝肺从面前经过，仔细看与前次所看相同。后来我在京城，正值嘉庆庚辰年，有个打死母亲的凌迟犯人，在崇文门外吊桥以南行刑，我却得以靠近，等到那里，虽然见到脏腑，但膈膜已破，仍未得见。道光八年五月十四日，凌迟逆犯张格尔，等到那里，不能靠近。自思一筐土没堆成，不能终止。没想到道光九年十二月十三日夜，安定门大街板厂胡同恒宅请我去看病，因谈及膈膜一事，我留心四十年，未能审验明确。其中有江宁布政使恒敬公，说他曾镇守哈密，领兵在喀什噶尔，所见诛戮的逆尸最多，对膈膜一事，知道得最详细。我闻言喜出望外，立即拜叩请教，恒公体谅我的苦衷，细细帮助描述形状。我在脏腑一事上，访查验证四十二年，才得到确切结果，绘制成全图。想要刊行于世，惟恐后人未见脏腑，议论我故意违背经文。想不刊行，又顾虑后世从业医生遭受祸患，沿袭下去不知几千年几百年。细思黄帝忧虑百姓疾苦，平素以《灵枢》之言向岐伯、鬼臾区下问，所以名为《素问》。二位如知道的确切，可以对君王言，知道不确切，须待参考，怎么能不知道却妄加应对，遗祸后世。继而秦越人著《难经》，张世贤割裂《河图洛书》为之图注，谓心肝肺按分量计，每件重多少，大小肠按尺丈计，每件长若干，胃大多少，容纳谷物几斗几升。他的话仿佛是真，其实脏腑未见，以无凭据的谈论，做欺骗人的事，利己不过是虚名，损人却是实祸。偷窃财物还被称为盗，偷取名声难道不是贼吗？千百年后，难道没有知情者？现在我刻印此图，并非独出己见，评论古人的短长，并非想让后人知道我，也不避讳后人怪罪我，只愿医林中的人，一见此图，胸中雪亮，眼底光明，临症有所遵循，不至于南辕北辙，出言含混，病患或许能减少损失，这是我的深切愿望，希望仁人君子鉴察并谅解。
时值道光庚寅年孟冬，直隶玉田县王清任书写于京邸知一堂
I have read Mr. Xunchen's book *Yilin Gaicuo* (Correcting Errors in the Medical Forest), and I sigh that worldly affairs are accomplished by both human effort and heavenly will. This book of his is indeed a heaven-sent opportunity to correct errors in medicine that have persisted for thousands of years, through Mr. Xunchen! Especially regarding the study of the diaphragm (diaphragm), Mr. Xunchen has paid attention to it for thirty years; truly admirable! As for Mr. Xunchen prescribing formulas to treat diseases, he generally employs simple methods to manage complex conditions. The upper volume records fifty types of blood stasis (blood stasis) syndromes, treated with three formulas; the lower volume discusses hemiplegia (hemiplegia), treated with one formula, and identifies forty pre-disease symptoms and signs of qi deficiency (qi deficiency). If one does not study carefully, how could one reach such a level? Regarding vomiting, diarrhea, and muscle spasms (tetany), treatment methods are divided into two paths: attacking pathogens (attacking pathogenic factors) and tonifying deficiency (tonifying deficiency); the formulas come from clinical trials. Regarding pediatric convulsions (pediatric convulsions) which are not wind-stroke (wind-stroke), they are treated with a formula to greatly tonify primordial qi (primordial qi). For children who cannot speak, identifying twenty types of qi deficiency symptoms requires careful observation, which is impossible without daily attentiveness. Regarding smallpox (smallpox) not being fetal toxin (fetal toxin), and smallpox pus not being transformed blood, sixty types of adverse smallpox cases, considered untreatable by ancients, are treated with six formulas, with considerable efficacy. Mr. Xunchen's book largely supplements what predecessors omitted, particularly regarding qi deficiency and blood stasis syndromes. These chapters are now highlighted at the beginning of the volume.
Written by Zhifeizi (The Man Who Recognized His Errors)
I wrote *Yilin Gaicuo* not as a comprehensive book on treating diseases, but as a record of zang-fu organs (zang-fu organs). There may still be inaccuracies and incompleteness herein. Later generations... [text implies: if you find errors] ...external contraction (external contraction) and internal injury (internal injury), what substances harm the body, and what shapes do excess and deficiency take? Some parts of the text are rudimentary because practitioners' knowledge varies in depth. Repetitive sentences are intended so that careless readers may cross-reference them. For instance, within hemiplegia there are forty types of qi depletion syndromes, and within pediatric convulsions there are twenty types of qi deficiency syndromes. When encountering miscellaneous diseases, one must cross-reference these sixty types to avoid errors. Readers must examine this book with great care.
Written by Wang Qingren of Yutian
The ancients said, "If one cannot become a good prime minister, one wishes to be a good physician." Because becoming a good physician is easier than becoming a good prime minister. I say: Not so. Good prime ministers governing the state exist in every generation. But if treating disease ignores the zang-fu organs, it is like governing the state while losing its foundation. Once the root of the disease is misunderstood, even with literary skills like embroidering tigers and carving dragons, or abilities like cutting clouds and mending the moon, the pathology will never correspond to the zang-fu organs. This is why there are no perfect physicians in the medical way.
To practice medicine and diagnose illness, one must first understand the zang-fu organs. Having read ancient discussions on zang-fu organs and their diagrams, I found their statements self-contradictory everywhere. For example, regarding the spleen and stomach (spleen and stomach): the stomach grinds food, and if the spleen does not move, food is not digested? Discussing the movement and stillness of the spleen, the error is thus. Regarding the lungs (lungs): they are described as hollow like beecombs, with no openings below; inhalation fills them, exhalation empties them. If there are no openings below, how can it also be said that the lungs have twenty-four pores arranged in rows to distribute qi to other organs? Discussing lung pores, the error is thus. Regarding the kidneys (kidneys): there are two, i.e., loins; the two kidneys are called kidneys, and the moving qi in the middle is called the Gate of Life (Gate of Life/Mingmen). If the moving qi in the middle is the Gate of Life, why is the left kidney called the kidney and the right kidney called the Gate of Life? How can two names stand for one organ? What is the evidence? If the moving qi in the middle is the Gate of Life, what substance houses this moving qi? Discussing the kidneys, the error is thus. Regarding the liver (liver): there are two meridians on the left and right, i.e., blood vessels, starting from the hypochondrium, passing up to the head and eyes, going down through the lower abdomen around the genitalia, ending at the big toe. If there are two meridians on the left and right, why is it also said that the liver resides on the left and the left hypochondrium belongs to the liver? Discussing the division of the liver into left and right, the error is thus. Regarding the heart (heart): it is the monarch official, from where spirit-mind (spirit-mind/Shen) emerges. Thought (thought/Yi) resides in the heart; thought is the mechanism of the heart; focused thought is called will (will/Zhi); the movement/change of will is called reflection (reflection/Si); using reflection to plan far ahead is called deliberation (deliberation/Lü); using deliberation to handle matters is called wisdom (wisdom/Zhi). All five reside in the heart. If they all reside in the heart, why is it also said that the spleen houses thought and wisdom, the kidneys govern skillfulness, the liver governs deliberation, and the gallbladder governs decision-making? According to the discussion, everywhere there is spiritual agency. Who ultimately helps generate this spiritual agency? Where is it housed? If spiritual agency is used, what external expressions appear? Discussing the heart, the error is thus.
[Text gap inferred] ...Stomach upper port transports to spleen and lungs, spreading through various vessels. This argument is irrational. The lower port of the stomach is named Youmen (Youmen/H pylorus), which is the upper port of the small intestine (small intestine). Its discussion on the small intestine... [text gap] ...exits via the anus, water returns to the bladder as urine. Such a discussion implies urine seeps out from feces, and thus should smell foul. I have tested child's urine (child's urine) and asked those who drink their own urine; they only say it tastes salty, not that it smells foul. Furthermore, food and water combine to form feces; feces must be loose and cause diarrhea. In chickens and ducks, having no urine is acceptable; in horses and cattle, having urine is necessary. How much more so for humans? Reading the section "Small intestine transforms food, water exits via Lanmen," it is truly a laughable topic for millennia. Discussing the pericardium (pericardium): fine fibers like silk, connected to the heart and lungs, is the pericardium. It also says yellow fat outside the heart is the pericardium. It also says above the transverse membrane below the heart, and below the vertical membrane, yellow fat is the pericardium. It also says what exists in name but not form in Danzhong (Danzhong/Chest center) is the pericardium. If it exists in name but not form, why is it also said that the meridian of the middle finger is the meridian of the Hand Jueyin Pericardium? Discussing the pericardium yields so many contradictions. What exactly is the pericardium, and how can there be so many definitions? Discussing the Sanjiao (Sanjiao/Triple Burner) is even more ridiculous. *Lingshu* (Spiritual Pivot) says: Hand Shaoyin Sanjiao dominates the upper, Foot Taiyang Sanjiao dominates the lower; this is already two Sanjiaos. *Nanjing* (Classic of Difficult Issues) Chapter 31 discusses Sanjiao: Upper Jiao is above the stomach, governing intake without exit; Middle Jiao is at Zhongwan, governing the rotting and ripening of food and drink; Lower Jiao is below the navel, governing the separation of clear and turbid. It also says: Sanjiao is the pathway of food and drink. This discussion treats Sanjiao as a tangible object. It also says: The moving qi between the two kidneys is the root of Sanjiao. This discussion treats Sanjiao as intangible qi. In *Nanjing*, one is tangible and one is intangible, creating yet another two Sanjiaos. Wang Shuhe's concept of Sanjiao having name but no shape likely stems from this. Later, Chen Wuyue identified the fatty membrane below the navel as Sanjiao; Yuan Chunfu identified the innermost layer of the body, reddest in color, as Sanjiao; Yu Tianmin pointed to the empty cavity as Sanjiao; Jin Yilong proposed anterior and posterior Sanjiaos. Those discussing Sanjiao are too numerous to count. Whether tangible or intangible, experts have no consensus. How can one say the meridian of the ring finger is the meridian of the Hand Shaoyang Sanjiao? Among these, some are self-contradictory, some... [text gap] ...
I once had the desire to correct errors, but without visible zang-fu organs, I hated that writing books without understanding zang-fu organs is like a fool talking about dreams. Treating disease without understanding zang-fu organs... [text gap] ...In early April, I traveled to Daodi Town in Luanzhou. At that time, children there were infected with epidemic rash and dysentery (epidemic rash and dysentery), nine out of ten dying. Poor families mostly wrapped them in mats meant for coffins and buried them. Local custom did not bury deeply, intending for dogs to eat the bodies, believing this prevented the fetus from dying in the womb. Thus, in public cemeteries, there were over a hundred children with exposed viscera daily. I passed by on horseback daily. Initially, I covered my nose, but later thinking that ancients erred in describing zang-fu organs because they never saw them personally, I did not shun the filth. Every morning, I went to the cemeteries to closely examine the exposed viscera of the children. After dogs had eaten, intestines and stomachs were common, but hearts and livers were rare. Comparing them, among ten bodies, fewer than three were complete. After observing continuously for ten days, seeing over thirty complete bodies, I realized that the zang-fu diagrams in medical books did not match human anatomy at all, nor did the number of organs. Only the diaphragm in the chest, thin as paper and most critical, was observed broken during my examination, preventing me from verifying if it was above or below the heart, or slanted or straight. This was my greatest regret.
In June of the fourth year of Jiaqing, I was in Fengtian Prefecture. A woman from Liaoyang Prefecture, aged twenty-six, had killed her husband and father-in-law due to madness and was sent to the provincial capital for execution by lingchi (death by a thousand cuts). Following her to the West Gate, she suddenly regained consciousness, realizing she was not a man and feeling unable to approach. Moments later, as executioners carried her heart, liver, and lungs past me, I examined them closely and found them identical to previous observations. Later in Beijing, in the Gengchen year of Jiaqing, a criminal who killed her mother was executed by lingchi south of the吊桥 (hanging bridge) outside Chongwen Gate. I managed to get close. Although I saw the viscera, the diaphragm was broken, and I still failed to see it clearly. On May 14th of the eighth year of Daoguang, the rebel Zhang Ge'er was executed by lingchi, but I could not get close. Thinking that one basket of earth remains unfinished, I could not stop. Unexpectedly, on the night of December 13th in the ninth year of Daoguang, the Heng residence in Banchang Hutong, Andingmen Street, invited me to treat an illness. Discussing the diaphragm, I had paid attention to it for forty years without clear verification. Among them was Heng Jinggong, Provincial Administration Commissioner of Jiangning, who stated he had guarded Hami and led troops in Kashgar, witnessing the most executions of rebels, and thus knew the diaphragm best. Hearing this, I was overjoyed, bowed, and asked. Heng Gong, appreciating my hardship, helped describe the shape in detail. After forty-two years of investigating and verifying zang-fu organs, I finally obtained accurate results and drew a complete diagram. I wished to publish it, fearing later generations would criticize me for contradicting classics without having seen the organs. Yet, if I did not publish, I worried future physicians would suffer from inherited errors for thousands of years. Reflecting on the Yellow Emperor's concern for people's suffering, who asked Qibo and Guiyuzhou questions based on *Lingshu*, naming the work *Suwen* (Basic Questions). If they knew accurately, they could tell the ruler; if not sure, they should refer to references. How could they answer recklessly and harm future generations? Later, Qin Yueren wrote *Nanjing*. Zhang Shixian cut apart *Hetu Luoshu* to create diagrams, stating heart, liver, and lungs are weighed, intestines measured, stomach capacity quantified. His words seemed true, but since he hadn't seen the organs, he engaged in deceptive talk for vanity, causing real harm to others. Stealing property is called theft; stealing reputation is not robbery? Thousands of years later, surely there will be those who know. Now I engrave this diagram not to claim originality or critique ancients, nor to seek fame or fear blame. I only wish that those in the medical forest, upon seeing this diagram, will have clear minds and bright eyes, follow guidelines in diagnosis, avoid going astray, speak precisely, and reduce patient loss. This is my earnest hope. I hope benevolent gentlemen will appreciate and forgive me.
Written by Wang Qingren of Yutian, Zhili, at Zhiyi Hall in Beijing, in the first month of winter in the Gengyin year of Daoguang.