一、医之志。须发慈悲恻隐之心,誓救大地含灵之苦。视众生之病,不论亲疏
贵贱,贤愚贫富,皆当恫 乃身,尽力殚力,曲为拯理。
二、医之学。须上通天道,使五运六气,变化郁复之理,无一不精。中察人身,
使十四经络,内而五脏六腑之渊涵,外而四肢百骸之贯串,无一不彻。下明物理,
使昆虫草木之性情气味,无一不畅。然后可以识病而用药。
三、医之识。医之用药,如将之用兵。纵横合变,呼吸异宜。非识见之高,不
能神会而独断也。然此识非可袭取,非可商量。全在方寸中,虚明活泼。须涤除嗜
欲,恬 无为,则虚空自然生白也。
四、医之慎。医为人之司命,生死系之。用药之际,须兢兢业业,不可好奇而
妄投一药,不可轻人命而擅试一方,不可骋聪明而遽违古法。倘或稍误,明有人非,
幽有鬼责,可惧也。
五、医之善。君子之游艺,与据德根据仁,皆为实学。故古人技艺之工,都从善
养中得来。若承蜩,若养鸡,皆是法也。医虽小道,实具甚深三昧。须收摄心体,
涵泳性灵,动中习存,忙中习定。外则四体常和,内则元神常寂。然后望色闻声,
问病切脉。自然得其精,而施治得宜也。
六、医之术。医非徒仁术,亦仙术也。谚云∶古来医道通仙道,此岂无稽之言
哉。凡欲学医,须将玄门之旨,留神讲究。玄牝之门,生身之户,守中养气之诀,
观窍观妙之理,务求明师指示,亲造其藩而闯其室。此处看得明白,则病候之生灭,
身中之造化,已洞悉矣。以之治疾,岂不易易。况人之疾,有草木金石所不能治者,
则教之根据法用功,无不立愈。天台智者禅师,谓一日一夜调息之功,可以已二十余
年之痼疾。盖天之阳气一回,则万物生色。人之元气一复,则百体皆和。宿疾普消,特其余事耳。
七、医之量。书云∶必有忍,其乃有济。有容德乃大。医者术业既高,则同类
不能无忌。识见出众,则庸庶不能无疑。疑与忌合,而诽谤指摘,无所不至矣。须
容之于不校,付之于无心,而但尽力于所事。间有排挤殴詈,形之辞色者,亦须以
孟子三自反之法应之。彼以逆来,我以顺受。处之超然,待之有礼,勿使病家动念可也。
八、医之言。仲尼大圣屡以慎言为训。而医者之言,尤当慎者,不可夸己之长,
不可谈人之短,不可浮诞而骇惑病患,不可轻躁而诋诽同类。病情之来历,用药之
权衡,皆当据实晓告,使之安心调理。不可诬轻为重,不可诳重为轻。即有不讳,
亦须委曲明谕。病未剧,则宽以慰之,使安心调理;病既剧,则示以全归之道,使
心意泰然。宁默毋哗,宁慎毋躁。
九、医之行。语曰∶以身教之从,以言教之讼。故慎吾之言,不若端吾之行。
道高天下,守之以谦。智绝人群,处之以晦。敦孝弟,重伦理,而于礼、义、廉、
耻四字,则秉之如蓍龟,遵之如柱石。久而勿失,自然起敬起信,而医道易行也。
十、医之守。医虽为养家,尤须以不贪为本。凡有病患在,即举家不宁。当此
时而勒人酬谢。家稍不足,则百计营求,艰难更倍。即充足之家,亦于满堂懊恼之
中,而受其咨诅痛苦之惠,亦非心之所安也。故我生平于病患所馈,不敢纤毫轻受。
有不给者,或更多方周给之。非以市恩,吾尽吾心而已矣。子孙习医而能根据此十事,古之圣贤,何以加此。
一、医者的志向。必须发起慈悲恻隐之心,发誓要拯救天下众生的疾苦。看待众生的疾病,不论亲疏、贵贱、贤愚、贫富,都应当感同身受,竭尽全力,委婉周全地予以救治。
二、医者的学问。必须上通天道,使五运六气(指自然界气候变化的规律)、变化郁复(指气机郁结与恢复)的道理,无一不精通。中察人体,使十四经络(连接脏腑肢节的通道),内而五脏六腑(心、肝、脾、肺、肾、胃、胆、小肠、大肠、膀胱、三焦)的深奥内涵,外而四肢百骸(全身骨骼肌肉)的贯通联系,无一不透彻。下明物理,使昆虫草木的性情气味,无一不明了。然后才可以辨识疾病并用药。
三、医者的见识。医者用药,如同将领用兵。纵横捭阖、灵活变通,时机适宜与否至关重要。如果不是见识高超,就不能神妙领会并独自决断。然而这种见识不是可以抄袭获取的,也不是可以随意商量的。全在于内心,虚空明亮、活泼灵动。必须涤除嗜好欲望,恬淡无为,那么虚灵自然产生智慧。
四、医者的谨慎。医生是人的命运主宰,生死系于一身。用药之际,必须兢兢业业,不可好奇而妄投一药,不可轻视人命而擅自试用一方,不可炫耀聪明而轻易违背古法。倘若稍有失误,明处有人指责,暗处有鬼神责罚,这是令人恐惧的。
五、医者的善良。君子研习技艺,与依据道德仁义一样,都是实学。所以古人技艺的精巧,都从善心的修养中得来。像承蜩(粘蝉)、养鸡那样专注,都是法则。医学虽然是小道,实则具备极深的奥妙。必须收敛心神,涵养性灵,在动中练习存养,在忙中练习定力。外在则四肢常和顺,内在则元神常寂静。然后望色闻声,问病切脉(中医诊法之一,通过触摸脉搏诊断病情)。自然能得其精髓,而施治得当。
六、医者的术数。医学不仅仅是仁爱之术,也是仙家之术。谚语说:古来医道通仙道,这难道是毫无根据的话吗?凡是想要学医,必须将玄门(道家)的宗旨,留心讲究。玄牝之门(道家术语,指生命本源)、生身之户,守中养气(在身体中部保养元气)的秘诀,观窍观妙(观察体内窍穴与微妙变化)的道理,务必寻求明师指示,亲自进入其门径并深入其堂奥。这里看得明白,那么病候的生灭,身体中的造化,已经洞察无余了。用它来治疗疾病,难道不容易吗?况且人的疾病,有草木金石所不能治疗的,就教导他们依据方法用功,没有不立刻痊愈的。天台智者禅师,说一日一夜调息(调节呼吸)的功夫,可以治愈二十多年的痼疾。大概天的阳气一回旋,万物就生出颜色。人的元气一旦恢复,百体都调和。宿疾普遍消除,只是其余的事罢了。
七、医者的度量。书说:必定有忍耐,才能有所成就。有包容德行才伟大。医者技术学业既然高深,那么同行不能不嫉妒。见识出众,那么平庸之辈不能不怀疑。怀疑与嫉妒结合,诽谤指摘,无所不用其极了。必须在不被计较中包容,付之于无心,而只尽力于所从事的工作。间或有排挤殴打辱骂,表现在言辞脸色上的,也必须用孟子“三自反”(自我反省)的方法应对。别人以逆耳之言来,我以顺受的态度对待。处理得超然,对待有礼节,不让病患起念头(产生误解或恶意)就可以了。
八、医者的言语。孔子大圣多次以慎言为训诫。而医者的言语,尤其应当谨慎,不可夸耀自己的长处,不可谈论别人的短处,不可浮夸荒诞而惊骇迷惑病患,不可轻率浮躁而诋毁同类。病情的来历,用药的权衡,都应当据实告知,使他们安心调理。不可把轻症说成重症,不可把重症说成轻症。即使有不测,也必须委婉明确地告知。病未严重,则宽慰他,使他安心调理;病已严重,则示以善终之道,使他心意泰然。宁可沉默不要喧哗,宁可谨慎不要急躁。
九、医者的品行。俗话说:以身教人,人们服从;以言教人,人们争辩。所以谨慎我的言语,不如端正我的行为。道德高于天下,以谦虚坚守。智慧绝出人群,以晦涩低调处之。敦厚孝悌,重视伦理,而对于礼、义、廉、耻四个字,则像占卜用的蓍草龟甲一样秉持,像柱石一样遵守。长久不丢失,自然引起人们的尊敬信任,而医道容易推行。
十、医者的操守。医学虽然是养家糊口的职业,尤其必须以不贪为本。凡是有病患在,全家都不安宁。在这个时候索取酬谢。家境稍不足,则百计营求,艰难加倍。即使是充足之家,也在满堂懊恼之中,承受他们的咨嗟诅咒痛苦的恩惠,也不是心里安适的。所以我生平对于病患所馈赠,不敢丝毫轻受。有不给的,或者更多方周济他们。不是为了买好,我只是尽我的心意罢了。子孙习医如果能依据这十件事,古代的圣贤,怎么能超过这个呢。
1. The Physician's Aspiration. One must arouse a heart of compassion and pity, vowing to save all sentient beings from suffering. When viewing the illnesses of sentient beings, regardless of kinship or distance, nobility or baseness, wisdom or foolishness, wealth or poverty, one should feel their pain as one's own, exert utmost effort, and provide gentle and comprehensive care.
2. The Physician's Learning. One must understand the Heavenly Dao above, mastering the principles of Five Movements and Six Qi (the laws governing natural climatic changes) and the mechanisms of stagnation and recovery without omission. In the middle, one must examine the human body, thoroughly understanding the Fourteen Meridians (channels connecting organs and limbs), the profound connotations of the Zang-Fu Organs (Heart, Liver, Spleen, Lung, Kidney, Stomach, Gallbladder, Small Intestine, Large Intestine, Bladder, Sanjiao) internally, and the interconnection of the four limbs and bones externally. Below, one must comprehend physical principles, knowing the nature and flavors of insects and plants without exception. Only then can one identify diseases and prescribe medication.
3. The Physician's Insight. A physician's use of herbs is like a general's use of troops. It requires flexibility and adaptation to timing. Without high insight, one cannot achieve divine comprehension and independent judgment. However, this insight cannot be copied or discussed casually. It resides entirely within the mind, which must be empty, bright, and lively. One must cleanse desires and maintain tranquility and non-action, so that emptiness naturally generates clarity.
4. The Physician's Caution. Physicians are the arbiters of life and death for others. When prescribing, one must be diligent and cautious, not throwing drugs whimsically out of curiosity, not risking lives by arbitrarily testing prescriptions, nor displaying cleverness by hastily violating ancient methods. If even a slight error occurs, one faces criticism in the human realm and retribution from spirits in the unseen world; this is terrifying.
5. The Physician's Benevolence. The gentleman's engagement in arts, along with relying on Virtue and Ren (Benevolence), constitutes practical learning. Thus, the skill of ancients came from cultivating goodness. Whether catching cicadas or raising chickens, these are methods. Medicine, though considered a minor art, possesses profound mysteries. One must gather the mind, nourish the spirit, practice preservation amidst movement, and cultivate stillness amidst busyness. Externally, the four limbs remain harmonious; internally, the Yuan Shen (Original Spirit) remains tranquil. Then, through observing complexion and listening to sounds, asking about illness, and taking the pulse (a TCM diagnostic method involving palpating the radial artery), one naturally grasps the essence and applies treatment appropriately.
6. The Physician's Art. Medicine is not merely an art of benevolence but also an art of immortality. The proverb says: "Since ancient times, the medical path has connected with the immortal path." Is this baseless? Those wishing to study medicine must pay attention to the principles of the Xuanmen (Taoist School). Regarding the Gate of Xuanpin (a Taoist term for the source of life), the door of birth, the secret of guarding the center and nourishing Qi (vital energy), and the principles of observing apertures and subtleties, one must seek guidance from enlightened masters and personally enter their gates and chambers. Once understood clearly, the emergence and cessation of symptoms and the transformations within the body are fully comprehended. Using this to treat disease is easy. Moreover, some diseases cannot be cured by herbs, minerals, or metals; teaching patients to follow specific practices leads to immediate recovery. Zen Master Zhiye of Tiantai said that one day and night of breathing regulation could cure chronic ailments lasting over twenty years. When Heaven's Yang Qi returns, all things gain color. When a person's Yuan Qi recovers, the whole body harmonizes. The elimination of old diseases is merely a secondary matter.
7. The Physician's Magnanimity. The Book of Documents states: "Only with endurance can there be success. With tolerance, virtue becomes great." When a physician's skills are superior, peers may feel jealous. When insights stand out, ordinary people may doubt. Doubt combined with jealousy leads to slander and criticism. One must tolerate without contention, act without attachment, and focus only on one's duties. If faced with exclusion, beating, cursing, or hostile expressions, one should respond using Mencius' method of self-reflection. Accept hostility with compliance, handle situations with detachment, treat others with courtesy, and avoid causing distress to the patient.
8. The Physician's Speech. Confucius, the Great Sage, frequently advised caution in speech. A physician's words require particular caution: do not boast of your strengths, do not discuss others' weaknesses, do not speak extravagantly to frighten or confuse patients, and do not speak rashly to disparage peers. The origin of the condition and the rationale for medication must be explained truthfully to ensure patient peace and proper management. Do not exaggerate mild conditions as severe, nor downplay severe ones as mild. Even if death is inevitable, explain it tactfully and clearly. For mild illness, offer comfort to ensure peace; for severe illness, guide towards a dignified passing to ensure mental calm. Prefer silence to noise, caution to rashness.
9. The Physician's Conduct. It is said: "Teaching by example leads to obedience; teaching by words leads to argument." Therefore, guarding one's speech is less important than rectifying one's conduct. Maintain humility despite high morality, and obscurity despite superior wisdom. Uphold filial piety and fraternal duty, value ethics, and hold Ritual, Righteousness, Integrity, and Shame as sacred as divination tools, adhering to them steadfastly. Over time, this naturally inspires respect and trust, making the practice of medicine easier.
10. The Physician's Integrity. Although medicine sustains families, one must base it on non-greed. When patients are present, families are anxious. Demanding payment at such times is inappropriate. If the family is poor, seeking compensation causes hardship. Even for wealthy families, accepting gifts amidst their grief and curses brings no peace of mind. Therefore, throughout my life, I have never lightly accepted any gift from patients. If unable to pay, I often provide additional remedies to help. This is not to buy favor, but simply to fulfill my conscience. If descendants study medicine based on these ten points, how could ancient sages surpass this?