《左传》云∶三折肱知为良医也。从未有人注及三折肱之意。予谓∶古之医者，自备药
笼至
病家延医后，向笼取药，或君臣未配，或轻重失宜，取而复置，置而复取，总以郑重为事，
此为三折肱也。又《礼记》云∶医不三世，不服其药。后注者，多以世业之谓，非也。医必
父而子，子而孙，如是其业则精，始服其药。若传至曾元，更为名医矣！其间贤者不待言，
其不肖者若何？因其世业，而安心服其药。设为所误，生死攸关，虽愚者不为也。况医道可
通仙道，远数十百年，偶出一豪杰之士，聪明好学，贯微彻幽。然而上世并非医者，舍是人
而必求所谓三世者，有是理乎？凡医者必读上古《神农本草》、黄帝《素问》、《灵枢经》
，及仲景《伤寒论》三世之书，方为有本之学，从而服药，庶无误人。三世者，三世之书也
。汉儒谓∶《神农本草》、黄帝《素问》、元女《脉诀》，为三世之书。聊记以质博学之君
子。
扁鹊兄弟三人皆善医。魏文侯问曰∶子兄弟三人孰最善？对曰∶长兄视色，故名不出家
；仲
兄视毫毛，故名不出门；如鹊针人血脉，投人药饵，故名闻诸侯。然扁鹊见齐桓侯，知疾在
腠理，疾在血脉，疾在肠胃，亦未尝非能视色知人之疾也。若彼之兄弟，后世安有如是之神
哉！夫脉之难明，古今所病也。至虚有盛候，而大实有羸状，疑似之间。便有生死之异。士
大夫多秘所患以求延医，验医之能否，使索病于冥漠之中，辨虚实寒热于疑似之间。医不幸
而失，终不肯自谓失也。巧饰遂非，以全其名；间有审密者，虽惑主人之言，亦参以己见，
两存而杂治，亦云难矣。不如东坡之言∶凡医之工拙，先验于平时，有疾求疗，尽告以所患
，使医了然知患之所在，然后参之以脉，虚实寒热，洞然胸中。故虽中医，治吾疾常愈，吾
求疾愈而已，岂以困医为事哉？如此则岂非智耶？
《左传》中说：“一个人三次折断手臂，就能成为良医。”从来没有人注解过“三折肱”的真正含义。我认为：古代的医生，自己备有药笼。被病人请去诊治后，从药笼中取药，有时君臣（主辅）配伍不当，或者剂量轻重不合适，取了又放回去，放了又再取，总是以谨慎郑重为行事准则，这就是所谓的“三折肱”。
另外，《礼记》中说：“如果不是传承三世的家传医生，就不服用他的药。”后来的注释者，大多将其解释为世代行医的意思，这是不对的。医生必须是父亲传给儿子，儿子传给孙子，这样医术才能精湛，才值得让人服药。如果传到曾孙、玄孙那一辈，更是名医了！其中贤能的不必说，那些不肖子孙又怎么样呢？仅仅因为是家传世业，就安心服用他的药。万一被误治，关乎生死，即使是愚笨的人也不会这样做。况且医道可以通晓仙道，相隔几百年甚至上千年，偶尔出现一位豪杰之士，聪明好学，洞察幽微深奥的道理。然而他祖上并非医者，如果舍弃这样的人而一定要追求所谓“三世”家传的人，有这样的道理吗？凡是医生必须研读上古的《神农本草经》、黄帝《素问》、《灵枢经》，以及张仲景的《伤寒论》这三部经典著作，这才是有根基的学问，然后据此服药，才不至于误人。所谓的“三世”，指的是这三部经典著作。汉代儒生认为：《神农本草经》、黄帝《素问》、元女《脉诀》，就是所谓的“三世之书”。我姑且记录下来，以此向博学的君子请教。
扁鹊兄弟三人都擅长医术。魏文侯问他说：“你们兄弟三人，谁最擅长？”扁鹊回答说：“大哥通过观察面色诊断，所以名声不出家门；二哥通过观察毫毛细微变化诊断，所以名声不出巷门；像我扁鹊，是用针刺入人的血脉，给人投喂药物，所以名声闻名于诸侯国。”然而扁鹊见到齐桓侯时，知道疾病在腠理（皮肤与肌肉之间），在血脉，在肠胃，这也未尝不是通过观察面色来知晓他人疾病的方法。像他那两个兄弟，后世哪里还有如此神奇的人呢！脉诊难以明了，是古今都困扰医生的问题。极度虚弱的病症可能表现出盛实的征候，极度实邪的病症可能表现出羸弱的症状，在疑似之间，就会产生生死的差异。士大夫阶层多隐瞒自己的病情以求延请医生，以此检验医生的能力高低，让医生在模糊不清的状态下索求病因，在疑似难辨的情况下辨别虚实寒热。医生不幸判断失误，最终也不肯承认自己失误。于是巧言掩饰错误，以保全自己的名声；间或有审慎细密者，虽然困惑于主人的言辞，但也参以自己的见解，两种方法并存杂用治疗，这也算是很难了。不如苏东坡所说的：凡是医生技艺的高下，先在平时验证。有病求医时，把患病情况全部告诉医生，使医生清楚地知道病在哪里，然后再结合脉象，对虚实寒热了然于胸。所以即使是中等水平的医生，也能治好我的病，我只是追求病愈罢了，哪里会把难为医生当作事情来做呢？像这样难道不是明智的吗？
The *Zuo Zhuan* states: "One who has fractured their arm three times knows how to be a good physician." No one has ever annotated the true meaning of "three fractures of the arm" (San Zhe Gong). I propose that: In ancient times, physicians kept their own medicine chests. After being summoned to a patient's home, they would retrieve herbs from the chest. Sometimes the Jun-Chen (Monarch-Minister) compatibility was improper, or the dosage weights were unsuitable; they would take them out and put them back, put them back and take them out again, always acting with utmost caution and seriousness. This is what is meant by "three fractures of the arm."
Furthermore, the *Book of Rites* (Liji) states: "Do not take the medicine of a physician whose lineage does not extend for three generations." Later annotators mostly interpreted this as referring to hereditary medical practice, which is incorrect. A physician must be a father passing down to a son, and a son to a grandson, so that their skills become refined before one dares to take their medicine. If it passes to great-grandsons and beyond, they would certainly be famous doctors! Among them, the virtuous need not be mentioned, but what of the unworthy? To calmly accept their medicine solely because of hereditary status... if mistaken in treatment, life and death are at stake; even a fool would not do this. Moreover, the Way of Medicine can connect to the Way of Immortality. Separated by hundreds or thousands of years, occasionally a heroic figure emerges—intelligent, fond of learning, penetrating into subtle and profound truths. Yet their ancestors were not physicians. To discard such a person and insist on seeking someone from a "three-generation" lineage, is there any logic in this? Any physician must study the ancient *Shennong Bencao Jing* (Divine Farmer's Materia Medica), the Yellow Emperor's *Suwen* (Basic Questions), the *Lingshu Jing* (Spiritual Pivot), and Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage)—these three classic texts—to possess a foundational scholarship. Only then should one take medicine based on them, lest one mislead others. The term "three generations" here refers to these three classic texts. Han Confucians considered the *Shennong Bencao Jing*, the Yellow Emperor's *Suwen*, and Yuannü's *Maijue* (Pulse Instructions) to be the "three generations of books." I record this briefly to inquire about it from learned gentlemen.
Bian Que and his two brothers were all skilled in medicine. Marquis Wen of Wei asked him, "Among your three brothers, who is the most skilled?" He replied, "My eldest brother diagnoses by observing facial complexion, hence his fame does not leave the household; my second brother diagnoses by observing fine hairs, hence his fame does not leave the neighborhood; as for me, Bian Que, I use needles to penetrate blood vessels and administer herbal decoctions, hence my fame is known among the feudal lords." However, when Bian Que saw Duke Huan of Qi, he knew the disease was in the Couli (skin and muscle interstices), in the blood vessels, and in the stomach and intestines. This was also a method of knowing another's disease through observation. How could later generations produce such miraculous figures like his brothers? The difficulty of understanding pulse diagnosis has been a concern since ancient times. Extreme deficiency may present with excess symptoms, while extreme excess may present with deficient signs; between these similarities and differences lies the distinction between life and death. Scholars often conceal their ailments to invite physicians, testing the physician's ability, forcing the doctor to seek the cause in obscurity and distinguish deficiency/excess and cold/heat amidst ambiguity. If the physician unfortunately errs, they are ultimately unwilling to admit fault. They skillfully disguise their mistakes to preserve their reputation; occasionally, those who are meticulous, though confused by the patient's words, still incorporate their own views, employing both methods simultaneously for mixed treatment. This is indeed difficult. It is better to follow Su Dongpo's words: The proficiency or clumsiness of a physician is first verified during normal times. When seeking treatment for illness, tell the physician everything about your condition, allowing the physician to clearly understand where the disease lies, and then combine this with pulse diagnosis, having a clear mind regarding deficiency/excess and cold/heat. Thus, even an average physician can cure my illness. I only seek recovery; I do not make it my business to hinder the physician. Is this not wise?