神农氏尝百药以治人病。于是为有医之始。厥后素难诸篇继作。而医乃大备。然上古之治疾。
简略不繁。所用不过一二味而已。自张仲景制伤寒诸方。而后世相承竞撰方书。至有充栋之当。然
或奇峻太过。或泛杂不专。求其一验者盖鲜矣。若东垣李明之。生金源之时。得轩岐之髓。用药处
方。如衡准物。攻补之施。未尝有毫发苟。盖二三百年来。南北所共遵用。而不敢有异议者。此岂
非杰然于其学人哉。罗谦甫氏为东垣高第弟子。卫生宝鉴。则李氏十书之羽翼也。有论有方。跬步
不敢越其师家。法而发明遗蕴。时有裨所未备者。盖今学东垣者之所必由。而世决不可少者也。旧
刻在苏。余因弭节之暇取而览之。则残缺特甚。乃属郡守史侯。订正其讹。且求善本而补焉。呜呼。
济人利物。士君子之急务。而有位者尤甚。若是书不完。则是览者必废。而东垣无辅也。何忍其若
是哉。此固予之心也。倘今既全之后。从此流传或穷乡乏医之处。一有所需。而无遗珠之叹。则前
贤及物之仁。举在是矣。孰谓不收于一补之功乎书成宜志。乃书其后。以为有志泽世者之告。匪直
为医家之言也矣。
弘治七年夏五月既望赐进士出身巡按直隶监察御史汝南刘廷瓒宗敬跋于姑苏之冰玉堂
戊申春。先师东垣老人论春月奉生之道。月令云。是月也。不可以称兵称兵。必天殃。毋杀孩
虫胎夭飞鸟。毋伐。山林。又云。祭先脾。孟春行冬令。则首种不入。行秋令则民大疫。故国有春
分停刑之禁。十二经有取决于胆之戒。仲景云大法、春宜吐。故少阳证禁下。宜小柴胡汤和解之。
少阳用事。万物方生。折之则绝生化之源。此皆奉生之道也。有假者反之。且春初服宣药者。乃伐
天和而损脾胃。非徒无益而又害之。予因演先师之论。着为此论。
世传宣药、以牵牛、大黄之类。或丸或散。自立春后。无病之人服之。辄下数行。云凡人于冬三月
。浓衣暖食。又近于火。致积热于内。春初若不宣泄。必生热疾。又云。解三焦积热。去五脏余毒
。殆无此理。方冬严气凝寒。浓衣暖食近火。所以敌天气之寒也。冬裘夏葛。冬饮汤而夏饮水。皆
自然之道。何积热于内而生疾乎。
且阴阳偏胜则疾。果三焦积热。是阳亢阴绝。岂有得生之理哉。故难经云。腑病易治。脏病
难愈。邪气中脏。病之极矣。今言五脏俱有邪毒。则神将何根据。内经亦曰。春三月此谓发陈。天地
俱生。万物以荣。夜卧早起。广步于庭。被发缓形。以使志生。生而勿杀。予而勿夺。赏而勿罚。
此春气之应。养生之道也。逆之则伤肝。夏
为寒变。奉长者少。又曰。必先岁气。无伐天和。故智者之养生也。必顺四时。适寒温。和喜怒而
安居处。节阴阳而调刚柔。如是则邪僻不至。又曰。苍天之气清净。则志意治。顺之则阳气固。虽
有贼邪。弗能害也。失之则内闭九窍。外壅肌肉。卫气散解。此谓自伤。气之削也。当少阳用事。
万物向荣生发之时。惟当先养脾胃之气。助阳退阴。应乎天道以使之平。今反以北方寒水所化、气
味俱浓、苦寒之剂投之。是行肃杀之令于奉生之月。当升反降。伐脾胃而走津液。使营运之气减削
。其不能输精皮毛经络必矣。奉长之气。从何而生。脏腑何所以禀受。脾胃一衰。何病不起。此诛
罚无过。是谓大惑。无病生之。有病甚之。所谓春服宣药者。自轩岐而下。历代明医。俱无是说。
呜呼。此理明白。非难知也。世多雷同。莫革其弊。深可痛哉。凡有志保生者。但以圣贤之言为准
。则可免疑误之悔。夭折之祸矣。
神农氏亲自品尝各种药物以治疗人类的疾病。从此开启了医学的源头。此后，《黄帝内经》（素问、灵枢）等篇章相继问世，医学体系于是大为完备。然而上古时期治疗疾病的方法，简单而不繁杂。所使用的药物不过一两味而已。自从张仲景制定了治疗伤寒的各种方剂后，后世医家沿袭并竞相编写方书，以至于书籍堆积如山。但是这些方书中，有的药性过于奇险峻烈，有的则泛杂不专一，能够取得一次确切疗效的很少了。像李东垣（名杲，字明之），生活在金元之际，深得轩辕黄帝和岐伯医学精髓，他用药处方，如同秤锤和水平仪一样精准，攻邪与补虚的运用，从未有过丝毫苟且。大概二三百年来，南北各地共同遵从他而使用，不敢有异议，这难道不是他在学术上卓然出众吗？罗谦甫是李东垣的高足弟子，《卫生宝鉴》则是李氏十部著作的辅助羽翼。其中有理论论述，有具体方剂，每一步都不敢超越老师的法度，并通过阐发来揭示其中深奥的内涵，时常补充前人未备之处。这大概是现在学习李东垣学说的人所必须遵循的途径，也是世间决不可缺少的著作。旧刻本在苏州，我趁停驻闲暇之时取来阅览，发现残缺特别严重。于是嘱托郡守史侯，订正其中的错误，并且寻求善本加以补全。唉！救济百姓、利益万物，是士大夫君子的紧急事务，而有地位的人尤其应该重视。如果这本书不完整，那么阅读的人必定会废弃它，而李东垣的学说也就失去了辅助。怎么忍心这样做呢？这确实是我的心意。倘若今后此书完整之后，从此流传开来，或许在穷乡僻壤缺乏医生的地方，一旦有所需求，就不会有遗漏珍珠般的叹息，那么前贤惠及万物的仁爱之心，就都体现在这里了。谁说这不是通过一次补刻就能收效的呢？书成之后应当记录，于是写下这篇后序，以此告知那些有志于恩泽世人的人，不仅仅是为医家而言罢了。
弘治七年夏五月十六日，赐进士出身、巡按直隶监察御史、汝南人刘廷瓒（字宗敬）在姑苏的冰玉堂写下的跋文。
戊申年春天，我的老师李东垣老人论述春季保养生命的原则。《月令》说：这个月，不可以发动战争，发动战争必然招致天灾。不要杀害幼小的昆虫、胎儿和夭折的飞鸟，不要砍伐山林。又说：祭祀祖先时供奉脾脏。如果在孟春时节施行冬季的政策，那么头季种植的作物就不能入仓；如果施行秋季的政策，民众就会发生大瘟疫。所以国家有春分停止刑罚的禁令，十二经脉中也有取决于胆气升发的戒律。张仲景说：大法则是春季适宜用吐法。所以少阳病证禁止使用下法，适宜用小柴胡汤进行和解。少阳当令之时，万物刚刚生长，折断它们就会断绝化生之源。这些都是顺应生机之道。有的人却反其道而行之。况且在初春服用宣通泻下的药物，这是破坏天和之气而损伤脾胃，不仅没有益处，反而有害。我因此推演先师的论述，撰写了这篇论说。
世间流传的宣通药，多用牵牛子、大黄之类，制成丸剂或散剂。从立春之后，让无病之人服用，往往导致腹泻数次。他们说凡人过了冬三个月，穿着厚衣，吃着暖食，又靠近火源，导致体内积聚热邪，初春如果不宣泄，必定产生热性疾病。又说能解除三焦的积热，去除五脏的余毒。这恐怕没有这样的道理。正值冬天严酷寒气凝结，穿厚衣、吃暖食、靠近火源，是为了抵御天气的寒冷。冬天穿皮裘夏天穿葛布，冬天喝热汤夏天喝冷水，都是自然的道理，怎么会因为这样而在体内积聚热邪并生病呢？
况且阴阳偏盛偏衰才会导致疾病。如果真的有三焦积热，那就是阳气亢盛、阴气枯竭，哪里有还能生存的道理呢？所以《难经》说：腑病容易治疗，脏病难以痊愈。邪气侵入脏腑，是病情到了极点。现在说五脏都有邪毒，那么精神将依靠什么呢？《内经》也说：春三个月，这叫作推陈出新。天地生机俱旺，万物繁荣。晚睡早起，在庭院中阔步慢行，披散头发，舒缓形体，以使意志生发。要助长而不要杀戮，给予而不要掠夺，奖赏而不要惩罚。这是顺应春气的养生之道。违背它则会损伤肝脏，到了夏天会发生寒性病变，奉养长养之气的力量就少了。又说：必须顺随岁时的气候，不要破坏天和之气。所以明智的人养生，一定顺应四季，适应寒温变化，调和喜怒情绪，安居处所，调节阴阳以调和刚柔。像这样邪僻之气就不会到来。又说：苍天之气清净，人的志意就安定，顺应它阳气就固密，虽然有贼邪之气，也不能伤害人体。违背它就会导致内部九窍闭塞，外部肌肉壅滞，卫气涣散解怠，这叫做自我伤害，是元气的削弱。正当少阳当令，万物向荣生发的时候，只应当先养护脾胃之气，助长阳气消退阴寒，顺应天道使之平衡。现在反而用北方寒水所化、气味浓厚、苦寒性质的药剂投服，这是在顺应生机的月份施行肃杀的命令，该升发反而下降，损伤脾胃而耗走津液，使营运的气血减损削弱。其不能将精微物质输送到皮毛经络是必然的。奉养长养的生气，从哪里产生？脏腑凭什么禀受营养？脾胃一旦衰弱，什么病不会起来呢？这是惩罚无罪之人，称为极大的迷惑。让无病人生病，让有病的人加重。所谓春季服用宣通泻下药的说法，从轩辕黄帝、岐伯以下，历代名医，都没有这种说法。唉！这个道理明白，并不难知晓。世上大多人盲目附和，不改正这种弊端，真是令人痛心啊。凡是立志保全生命的人，只要以圣贤的话为准绳，就可以避免疑惑误事的后悔和早逝的祸患了。
Shennong tasted hundreds of herbs to treat human diseases. Thus began the origin of medicine. Subsequently, chapters such as those in Huangdi Neijing (Yellow Emperor's Inner Canon) were successively composed, and medical science became greatly complete. However, the treatment of diseases in ancient times was simple and not complicated. The medicines used were merely one or two ingredients. Since Zhang Zhongjing formulated various prescriptions for treating Shanghan (Cold Damage), later generations followed suit and competed to compile prescription books, resulting in stacks of volumes. Yet, some were overly bizarre and峻烈 (harsh/potent), while others were miscellaneous and unfocused; finding even one effective case was rare. Li Dongyuan (Mingzhi), living during the Jin-Yuan period, grasped the essence of Xuanyuan (Yellow Emperor) and Qibo. His use of herbs and formulation of prescriptions were as precise as a balance scale and a level. In his application of attacking pathogenic factors and tonifying deficiency, he never acted negligently. For roughly two hundred to three hundred years, both north and south regions have universally adhered to his methods without dissent. Was he not outstanding among scholars? Luo Qianfu was a senior disciple of Li Dongyuan. Weisheng Baojian (Precious Mirror of Health Preservation) serves as a wing to assist Li’s ten major works. It contains both theoretical discussions and prescriptions, strictly following his master’s teachings without deviation, elucidating profound implications, and often supplementing what was previously incomplete. It is undoubtedly a necessary path for those studying Li Dongyuan’s school today and an indispensable work in the world. An old edition existed in Suzhou. Taking advantage of my leisure time when stopping there, I took it to read and found it particularly damaged. I then entrusted Governor Shi to correct errors and seek good copies for supplementation. Alas! Saving people and benefiting all things is an urgent duty for scholar-officials, especially for those in power. If this book remains incomplete, readers will surely discard it, and Li Dongyuan’s teachings will lack support. How could one bear to do so? This is indeed my intention. If, after completion, this book spreads widely, perhaps in remote villages lacking doctors, whenever needed, there will be no sigh over missed pearls. Then the benevolence of past sages in benefiting all beings will be fully realized here. Who would say that this single act of supplementation yields no merit? Upon completion, it should be recorded. Thus, I wrote this postface to inform those aspiring to benefit the world, not merely for the sake of medical practitioners.
Postface written by Liu Tingzan (Courtesy Name: Zongjing), a Jinshi degree holder granted by imperial examination, Censor patrolling Zhili, from Runan, at Bingyu Hall in Gusu, on the 16th day of the fifth month, summer of the 7th year of Hongzhi.
In the spring of Wushen year, my late master, Elder Dongyuan, discussed the way to nurture life in spring. The Yue Ling (Monthly Ordinances) states: In this month, one must not wage war; waging war invites heavenly disaster. Do not kill young insects, fetuses, or fledgling birds; do not cut down forests. It also states: Offer spleen in sacrifices to ancestors. If winter policies are enacted in early spring, the first planting will fail to enter storage; if autumn policies are enacted, the people will suffer great epidemics. Therefore, the state has prohibitions against executing punishments at the Spring Equinox, and the twelve meridians have warnings regarding their dependence on Gallbladder Qi. Zhang Zhongjing stated: The general principle is that spring is suitable for emesis. Therefore, Shaoyang syndromes prohibit purgation; they are suitable for Xiao Chaihu Tang (Minor Bupleurum Decoction) to harmonize. When Shaoyang governs, all things are just beginning to grow; breaking them cuts off the source of transformation and generation. These are all ways to nurture life. Some fake practitioners do the opposite. Moreover, taking Xuan Yao (purging/dispersing medicines) in early spring damages Heavenly Harmony and harms the Spleen and Stomach. It is not only useless but harmful. I therefore elaborated on my master’s arguments and wrote this treatise.
The Xuan Yao circulated in the world mainly consist of ingredients like Qian Niu Zi (Pharbitis Seed) and Da Huang (Rhubarb Root and Rhizome), made into pills or powders. After Lichun (Start of Spring), healthy people take them, often resulting in several bowel movements. They claim that during the three winter months, people wear thick clothes, eat warm food, and stay near fire, causing heat accumulation internally. If not dispersed in early spring, heat diseases will inevitably arise. They also claim it resolves San Jiao (Triple Burner) accumulated heat and removes residual toxins from the Five Zang Organs. This is likely baseless. During severe winter cold, wearing thick clothes, eating warm food, and staying near fire is to resist the cold weather. Wearing fur in winter and hemp in summer, drinking hot soup in winter and cold water in summer, are all natural ways. How can this cause internal heat accumulation and disease?
Furthermore, illness arises from Yin-Yang imbalance. If there truly were San Jiao accumulated heat, it would mean Yang hyperactivity and Yin exhaustion; how could survival be possible? Thus, Nan Jing (Classic of Difficult Issues) states: Fu organ diseases are easy to treat; Zang organ diseases are difficult to cure. Pathogenic factors invading the Zang organs represent the extreme of disease. Now, saying all five Zang organs have toxic pathogens—where would the Shen (Spirit) rely? Nei Jing also says: The three months of spring are called "Fa Chen" (propagating the new). Heaven and Earth generate together; all things flourish. Sleep late and rise early; walk broadly in the courtyard; let hair hang loose and relax the body, allowing the Yi (Will) to generate. Nurture rather than kill; give rather than take; reward rather than punish. This corresponds to Spring Qi and is the way of health preservation. Violating it injures the Liver, leading to cold transformations in summer, with insufficient energy to nourish growth. It also says: One must follow the seasonal Qi and not damage Heavenly Harmony. Thus, wise people preserve health by conforming to the four seasons, adapting to cold and warmth, harmonizing joy and anger, dwelling peacefully, regulating Yin and Yang to adjust rigidity and softness. In this way, deviant pathogens will not arrive. It also says: The Qi of the Blue Heaven is pure and clear; thus the Yi is regulated. Following it consolidates Wei Qi (Defensive Qi); even if hostile pathogens exist, they cannot harm. Deviating from it causes internal closure of the nine orifices, external stagnation of muscles, and dispersion of Wei Qi. This is self-injury and depletion of Qi. When Shaoyang governs and all things flourish and grow, one should first nourish Spleen and Stomach Qi, assist Yang to retreat Yin, and respond to Heavenly Dao to achieve balance. Now, instead, administering bitter-cold agents derived from Northern Cold Water, with strong flavors and properties, is to issue orders of desolation in a month of nurturing life. Ascending becomes descending; Spleen and Stomach are damaged, and Body Fluids are depleted. The circulating and transforming Qi is reduced. It is inevitable that it cannot transport essence to skin, hair, collaterals, and vessels. From where does the Qi of nurturing growth arise? How do the Zang-Fu receive endowment? Once the Spleen and Stomach decline, what disease will not arise? This is punishing the innocent, called great confusion. Making the healthy sick and worsening the ill. The saying of taking Xuan Yao in spring has no precedent from Xuanyuan and Qibo downwards through famous physicians of all dynasties. Alas! This principle is clear and not difficult to know. The world mostly follows blindly, failing to rectify this malpractice, which is deeply painful. All who aspire to preserve life should take the words of sages as the standard, thereby avoiding regrets of doubt and error, and disasters of premature death.