《原机启微》一书，敕山老人所着也。敕山吴人，生胜国时，卒于洪武初，少受书碧山
汤公，得其疏通知远之旨，好积坟素，多至五千卷，为重屋栖之。恣其探讨，以才博闻，或
劝之仕，则曰富贵有命，不可强也。时元季崩剥，意不欲仕乱世，故谩应云，晚置别墅于敕
山，逍遥物外，自称敕山老人，人亦随称之。敕山尝读《黄帝内经》，慨然叹曰∶穷而在下
，可以济人利物者，其惟医乎。乃益发古今方书，研究而会通之。不数年，尽能工其术。其
治人，无问贵贱男女，内外大小，凡所治咸效，专以慈仁为意，未尝邀报谢，故施惠博而道
益尊。浙河之西，其声 然震也。是书载治眼一科，书凡二卷。上卷论病疾之原，下卷
论方剂之宜，以及君臣佐使、从逆反正之义。其说甚明，使人可按疾而治。治罔不奇效者，
敕山之用心如此，可谓仁矣。他所着方书，并行于世，不特专是科也。今之为医者，大抵守
师说，如伤寒、内伤、带下、小儿，各专门自高，殊不能相通，此岂可与论玄命之奥哉。治
眼绝无古传方，虽张仲景、李明之诸公，论医之详，庶几神妙，而于是犹略略也。后之学人
无所师，故目疾为最难治。夫医者，意也，非其心明乎天人之际，察乎古今之变，卓然有所
见焉，乌可以易言哉。是书析理精明，法制具备，文词尔雅，成一家言，殆有超乎方术之外
者，虽达之为政可也。敕山之学，其能以涯 窥乎。予旧藏写本，顾多讹谬，不敢轻以
试人。南京太医院院判薛公新甫见之曰∶此书予求之久矣，今幸见之先生所，请梓焉以广其
传，仍撰次己所见闻为一卷附于后。薛公亦吴人，以医显，生平着述甚富，藏之尚方，副在
家集，能行其学人也。此书之传绝，且百余年，至新甫而复行，后之人日蒙利焉，新甫可谓
同敕山之用心矣。敕山姓倪氏，名维德，其行事具宋太史墓铭，予但序是书之始末云。
嘉靖壬辰春南京礼部祠祭司主事长洲王庭书
《原机启微》这本书，是由敕山老人所撰写的。敕山是吴地人，生活在元朝（胜国），去世于明洪武初年。他年轻时在碧山跟随汤公读书，领悟了通达事理、见识深远的宗旨。他喜好收集古代典籍，多达五千卷，为此专门建造了多层楼阁来存放这些书籍。他尽情地进行探讨研究，凭借才学广博、见闻丰富，有人劝他出仕做官，他却说富贵由天命决定，不可强求。当时正值元朝末年社会动荡崩解，他本意不愿在乱世中做官，所以便敷衍回答说：晚年我在敕山置办了别墅，逍遥于世俗之外，自称为敕山老人，人们也就随之这样称呼他。
敕山曾经阅读《黄帝内经》，感慨叹息道：身处穷困卑微的地位，却能够救济世人、造福万物的，大概只有医学了吧。于是更加广泛地发掘古今医方书籍，深入研究并融会贯通它们。没过几年，他就完全精通了医术。他治疗病人，不分贵贱男女、老少内外，凡是他治疗的都取得了疗效。他专心以慈悲仁爱为念，从未索取报酬或感谢，因此施予的恩惠广泛，而他的医德也愈发受到尊崇。浙河以西地区，他的名声显著震动。
这本书记载了眼科一科的治疗内容，全书共两卷。上卷论述眼疾产生的原因，下卷论述方剂的适宜用法，以及君臣佐使、顺从与逆治、纠正偏差等义理。他的学说非常明晰，使人能够依据病症进行治疗。治疗没有不取得奇特疗效的，这体现了敕山用心的精深，可以说是仁爱的了。他所撰写的其他医方书籍，也在世间并行流传，并不只专注于这一科。
当今行医的人，大多墨守师承之说，如伤寒、内伤、带下病、儿科等，各自标榜专门之学而自高自大，殊不能相互贯通，这哪里能与之讨论玄妙生命之奥义呢？治疗眼疾的古传方剂极少，虽然张仲景、李东垣（李明之）诸位先生，论医详尽，几乎达到了神妙的境界，但对于眼科方面仍然略显简略。后世的学医者没有老师传授，所以眼疾被认为是最难治疗的。
所谓医者，就是意念与心法，如果不是内心明了天人之间的关系，洞察古今的变化，卓越地有所见解，怎么可以轻易谈论呢？这本书剖析道理精明，法制完备，文辞典雅，自成一家之言，大概有超越一般医术之外的境界，即使将其用于治理政事也是可以的。敕山的学问，岂是浅薄之人所能窥测的呢？
我旧时收藏有手抄本，但其中多有讹误错乱，不敢轻易拿给人看。南京太医院院判薛新甫见到后说：“这本书我寻求很久了，现在有幸在先生这里见到，请刻印它以广泛流传，并且撰写我自己所见所闻的一卷附在后面。”薛公也是吴地人，以医术显名，生平著述非常丰富，有的藏在皇家图书馆，有的附在家集中，能够推行他的学术给后人。这本书的流传断绝，已经一百多年了，直到薛新甫手中才得以重新流行，后代的人日日蒙受其利，薛新甫可以说是与敕山有着同样的用心了。
敕山姓倪，名维德，他的生平事迹记载在宋太史的墓志铭中，我只是为这本书的前后始末作序罢了。
嘉靖壬辰年春季，南京礼部祠祭司主事、长洲人王庭 书写
*Yuanji Qiwei* (Origin of the Machine, Revealing the Subtle) is a work authored by the Old Man of Chishan. The Old Man was from Wu, lived during the Yuan Dynasty (referred to as "Shengguo" or the previous dynasty), and died in the early Hongwu period of the Ming Dynasty. In his youth, he studied under Master Tang at Bishan, grasping the essence of being open-minded, knowledgeable, and far-sighted. He had a fondness for accumulating ancient texts, collecting up to five thousand volumes, which he stored in multi-storied pavilions built specifically for this purpose. He indulged in exploration and study, relying on his broad talent and extensive learning. When advised to enter official service, he would say that wealth and honor are determined by destiny and cannot be forced. At that time, the late Yuan Dynasty was collapsing into chaos; having no desire to serve in such a turbulent era, he casually replied that in his later years he had established a villa at Chishan, where he wandered freely beyond worldly affairs, calling himself the Old Man of Chishan, and people accordingly followed suit in addressing him.
The Old Man once read the *Huangdi Neijing* (Yellow Emperor's Inner Canon) and sighed with emotion, saying: "To be in a humble and obscure position yet able to benefit humanity and aid all living things—this can only be achieved through medicine." Consequently, he further explored ancient and modern medical formularies, studying them deeply and integrating their principles. Within a few years, he had fully mastered the art. In treating patients, he distinguished neither between noble and lowly, male and female, nor between internal and external conditions, nor between the young and old; all whom he treated were cured. He focused entirely on compassion and benevolence, never seeking reward or gratitude; thus, his beneficence was widespread, and his Dao (Way) became increasingly revered. His reputation resonated powerfully west of the Zhe River.
This book records treatments for ophthalmology, comprising two volumes. The upper volume discusses the origins of ocular diseases, while the lower volume elaborates on the appropriateness of formulas, including the principles of Jun-Chen-Zuo-Shi (Sovereign, Minister, Assistant, Courier herbs), following versus opposing treatments, and correcting deviations. His theories are very clear, allowing practitioners to treat diseases according to specific indications. His treatments invariably yielded remarkable efficacy, demonstrating the profound intentionality of the Old Man, which can be termed benevolent. Other medical formularies he authored are also circulating in the world, not limited solely to this specialty.
Contemporary physicians generally adhere strictly to their masters' teachings. Fields such as Shanghan (Cold Damage), Neishang (Internal Injury), Daixia (Leukorrhea), and pediatric diseases each claim exclusive expertise and pride themselves independently, failing to achieve mutual integration. How can such individuals discuss the profound mysteries of life? Ancient transmitted formulas for treating eye diseases are extremely rare. Although figures like Zhang Zhongjing and Li Mingzhi (Li Dongyuan) provided detailed discussions on medicine, approaching divine subtlety, their treatment of ophthalmology remained relatively brief. Later generations of learners lacked proper teachers, making eye diseases the most difficult to treat. Medicine is essentially an art of the mind; unless one’s heart clearly comprehends the relationship between Heaven and Humanity, observes the changes of past and present, and possesses outstanding insights, how can one lightly speak of it? This book analyzes principles with precision, establishes complete methods, employs elegant language, and forms a unique school of thought. It likely transcends mere technical skills, being suitable even for governance. The scholarship of the Old Man is certainly beyond the ken of superficial observers.
I previously possessed a handwritten copy, but it contained many errors and corruptions, so I dared not lend it to others. Xue Xinpu, Vice Director of the Nanjing Imperial Medical Academy, saw it and said, "I have sought this book for a long time. Now that I have seen it in your possession, please have it printed to spread its transmission. Additionally, compile a volume of your own observations and append it to the end." Lord Xue was also from Wu, renowned for his medical skill. He produced abundant writings in his lifetime, some stored in the imperial archives and others included in his family collections, capable of propagating his learning to future generations. The transmission of this book had been cut off for over a hundred years until it was revived by Xinpu. Future generations will daily benefit from it; Xinpu can be said to share the same intention as the Old Man.
The Old Man’s surname was Ni, given name Weide. His life events are detailed in the epitaph written by Grand Historian Song. I merely write this preface to record the beginning and end of this book.
Written in the Spring of the Renchen Year of Jiajing by Wang Ting, Director of the Sacrificial Bureau of the Ministry of Rites, Nanjing, from Changzhou.