一伤寒头绪最繁。予尽削去。独举大纲。晓畅厥义。而条贯自达。
一伤寒向重表里。而虚实为尤要。先哲已代明之。兹编特委曲详尽。欲临症者慎焉。
一是书专论伤寒。每引他症以相较。盖他症既明。则不混于伤寒。而无妄治之失矣。
一凡先哲要旨。间取一二。以备参阅。盖不敢私秘。欲公好于吾党也。
一医案仅举一二。就正有道。匪敢矜其所得。效步邯郸。务期有裨于大义而已。
一是集坦易简直。然历二十余载。揣摩经验。凡几易稿始就。俟有识者采择焉。
一杂症另附。取其明备。约于至当。不出先贤围范。而亦不囿于围范。有取
之左右逢源之乐。故并载之。
一妇人科。凡调经胎前产后。最费调摄。得其指归。仍易拾芥。兹编独约而
该。简而明。参阅之自悉。
一原方备载。以便参考。有可遵守者。有宜变通者。在临时裁酌。断不应胶
执以违病机。反致遗害也。
一医学与他艺不同。毋论贵贱。为性命所倚托。非小可事也。必立心贵谨。
处行欲方见闻期博。体验惟精。庶足无愧。故并致篇末以告同志云。
经曰。人之伤于寒也。则为病热。余始读而疑之。谓既伤于寒。何以反病热
乎。盖寒者天之阴气也。热者人之阳气也。天以阴气侵人。则拘急而畏寒。
人以阳气被郁。则蒸冒而发热。然邪气既盛。正气不能拒之而出。须以辛
温之药助之。使邪从汗解而愈。此发表之所由设也。重则麻黄。次则羌活。
又次则紫苏。皆当因其轻重而施之。中病即止。毋使过剂。过则邪气既去。
正气反虚。种种变迁。不易枚举。盖汗者身之液也。始由寒闭腠理。无从发
越。故藉汗以疏通。令气和平斯已。今发之太过。则人身之津液既耗于外。
必竭于内。无论汗多亡阳。而胃腑燥竭。肾阴消亡。烦渴秘结等症。总由一
汗所致。诸谓其可泛视乎。故余尝谓治伤寒法。不可不汗。不可轻汗。不可
大汗。不可再汗。不可误汗。明乎此者。庶入仲景之室而免文伯之恐也。
一太阳受冬月严寒。头疼壮热。畏寒拘急。脉紧盛而无汗者。仲景用麻黄
二钱。桂枝一钱。甘草五分。杏仁八粒。生姜三片。枣一枚。水煎。名麻黄汤。
治冬月正伤寒。此不可不汗也。
一前症虽具。或感非时暴寒。不可与麻黄汤用羌活紫苏防风荆芥葛根
广皮川芎甘草等。量症加减。此不可大汗也。
一前症虽具。或元气素弱。或向有杂病。及产后。痘后。失血后。兼劳倦内伤。
并犯房欲者。果又冒寒。方与荆防苏葛甘草陈皮。随症加减。微解其表。
若不因寒而发热者。只治其本。此不可轻汗也。
一前症虽具。曾经发表出汗。不可复用发散。盖邪既却矣。而又汗之。能不
伤正气乎。此不可再汗也。
一凡恶寒发热。杂症皆有。即一疮一疖亦复如是。岂可不审何证所致概
用发散。如余治一妇恶寒发热。脉得洪数。询之乃左乳肿痛。余竟治其
乳。肿痛顿消。寒热亦止。举一可例其余。此不可误汗也。
余观近时风尚。凡病家。医士。及旁观者一发寒热。动以伤寒首戒。每必
曰曾汗否。曾下否。使汗之下之而毙。纵无憾也。如不汗不下而痊。犹未
惬志焉。此生民之厄运。未俗之波靡也。失哲代起而痛发之。相沿不觉。
可胜悼哉。余习见劳倦阴虚杂症。胎前产后暑病等。妄发汗而死者。不
可胜计。不得不深致焉。
一、伤寒病的头绪最为繁杂。我将其全部删削，只保留大纲要点，使义理清晰通达，条理自然分明。
一、伤寒历来重视表证与里证的区分，而虚实辨证更为关键。先贤已经对此阐明得很透彻了。本编特别详尽细致地论述，旨在让临证医生谨慎对待。
一、本书专门论述伤寒，每处都引用其他病症进行对比。因为其他病症既然明确了，就不会与伤寒混淆，从而避免误治的错误。
一、凡是先贤的重要主旨，偶尔选取一二条，以备参考查阅。这是因为不敢私自秘藏，希望与同道中人共同分享。
一、医案仅列举一两例，以求教于有道之士，并非敢夸耀自己的所得，而是效仿邯郸学步（意指谦卑学习），务必期求对大义有所裨益罢了。
一、这部文集坦率平易、简明扼要，然而历经二十多年，揣摩并积累经验，经过多次修改稿子才最终定稿。等待有识之士采纳选择。
一、杂病另行附录，取其明白完备，简约而恰当，既不出先贤的规范范围，也不局限于先贤的规范范围，有着左右逢源的乐处，所以一并记载。
一、妇科方面，凡调经、胎前、产后，最费调养摄生。得其要领，便如拾取小草般容易。本编唯独简约而全面，简明而清晰，参阅者自然能知晓。
一、原方完整记载，以便参考。其中有可以遵守的，有适宜变通的，在于临时斟酌裁度，绝不应拘泥固执而违背病机，反而导致遗害。
一、医学与其他技艺不同，不论贵贱，都是性命所寄托的，不是小事。必须立心贵在谨慎，行事欲方正，见闻期望广博，体验力求精微，这样才能无愧于心。所以写在篇末以告诫志同道合的人。
经文说：“人受寒邪侵袭，就会发生热病。”我开始读到这里时感到疑惑，认为既然受了寒邪，为什么反而生病发热呢？大概寒是天地的阴气，热是人的阳气。天地的阴气侵犯人体，就会导致身体拘急而畏寒；人的阳气被郁遏，就会蒸腾冒热而发热。然而邪气既已强盛，正气不能将其驱逐出去，需要用辛温的药物来辅助，使邪气随汗液排出而痊愈。这就是发表法设立的缘由。病情重的用麻黄，次之的用羌活，再次之的用紫苏，都应当根据病情的轻重来施用。药中病即止，不要使剂量过大。过量则邪气虽去，正气反而虚弱，种种变化，不易一一列举。大概汗是身体的津液，起初由寒邪闭塞腠理，无从发散，所以借助发汗来疏通，使气机平和就可以了。现在发汗太过，那么人体的津液既在外耗散，在内也必然枯竭。无论是因为汗多亡阳，还是胃腑干燥枯竭，肾阴消亡，烦渴、便秘等症状，总归是由一次过汗所致。各位难道可以轻视看待吗？所以我曾经说治疗伤寒的方法，不可不发汗，不可轻率发汗，不可大汗，不可再次发汗，不可误发汗。明白这些道理的人，差不多就能进入张仲景的堂奥，而免除文伯那样的恐惧了。
一、太阳经受冬月严寒，出现头痛、高热、畏寒、身体拘急、脉象紧盛且无汗的症状，张仲景使用麻黄二钱、桂枝一钱、甘草五分、杏仁八粒、生姜三片、大枣一枚，水煎服，名为麻黄汤。治疗冬月正伤寒，这是不可不发汗的情况。
一、前面的症状虽然具备，但如果是感受非时节的暴寒，不可以用麻黄汤，而应用羌活、紫苏、防风、荆芥、葛根、广皮（陈皮）、川芎、甘草等，根据症状加减。这是不可大汗的情况。
一、前面的症状虽然具备，但如果元气素来虚弱，或者向来有杂病，以及产后、痘疹后、失血后，兼有劳倦内伤，并且犯房事者，如果又冒受寒邪，才给予荆芥、防风、紫苏、葛根、甘草、陈皮，随症加减，轻微解其表邪。如果不是因寒而发热，只治疗其根本。这是不可轻率发汗的情况。
一、前面的症状虽然具备，但曾经发表出汗，不可再复用发散药物。因为邪气既然退却，而又发汗，能不损伤正气吗？这是不可再次发汗的情况。
一、凡是恶寒发热，杂病都有，即使是一个疮疡或疖肿也是如此。难道可以不审察是什么证候所致，就一概使用发散药物吗？比如我治疗一位妇女恶寒发热，脉象洪数，询问得知是左侧乳房肿痛。我竟然只治疗她的乳房，肿痛顿时消除，寒热也随之停止。举一例可推知其余。这是不可误发汗的情况。
我观察近时的风尚，凡是病人家属、医生及旁观者，一见寒热发作，动不动就以伤寒为首要禁忌。每个人都一定问：“曾发汗了吗？曾攻下过了吗？”使得因为发汗或攻下而死的人，纵然没有遗憾。如果不发汗不攻下而痊愈，心里仍然不满意。这是百姓的厄运，世俗的风气败坏啊。失去哲人起来痛切地揭露它，相沿成习不觉悟，怎能不胜悲伤呢？我常见到因劳倦、阴虚杂病、胎前产后暑病等，被妄自发汗而死的，不可胜数。不得不深切地感叹于此。
One: The complexities of Shanghan (Cold Damage) are most numerous. I have eliminated all the intricate details, retaining only the general outline, so that its principles become clear and coherent, allowing the logical connections to naturally emerge.
One: In the study of Shanghan, emphasis has traditionally been placed on the differentiation between exterior (Biao) and interior (Li) syndromes, with deficiency and excess (Xu-Shi) being particularly crucial. This point has already been clearly elucidated by ancient masters. This compilation discusses these matters in particular detail, aiming to urge clinicians to exercise caution.
One: This book focuses exclusively on Shanghan, citing other diseases for comparison in each instance. Since other diseases are clarified, they will not be confused with Shanghan, thereby avoiding errors in treatment.
One: Occasionally, one or two key points from ancient masters are selected for reference. This is done because I dare not keep them secret, but wish to share them publicly with my colleagues.
One: Medical cases are cited sparingly, just one or two, to seek correction from those knowledgeable in the Dao. I do not dare to boast of my achievements; rather, like learning steps in Handan (a metaphor for humble learning), I strive merely to contribute to the greater principles.
One: This collection is straightforward and concise. However, after more than twenty years of contemplation and clinical experience, it underwent multiple revisions before completion. It awaits the selection of discerning readers.
One: Miscellaneous diseases are appended separately, chosen for their clarity and comprehensiveness, simplicity and appropriateness. They neither exceed nor are confined by the norms of sages, offering the joy of versatility. Therefore, they are included.
One: Regarding gynecology, regulating menstruation, prenatal care, and postpartum recovery require careful nursing. Once the guiding principles are grasped, it becomes as easy as picking up a blade of grass. This compilation is uniquely concise yet comprehensive, simple yet clear; readers will understand upon consultation.
One: Original prescriptions are fully recorded for reference. Some may be followed strictly, while others should be adapted flexibly, depending on temporary judgment. One must never adhere rigidly to formulas against the pathogenesis, which would cause harm.
One: Medicine differs from other arts. Regardless of status, it entrusts life and death; it is no trivial matter. One must establish a mindset of utmost caution, act with integrity, broaden one's knowledge and experience, and refine one's practical understanding, thus remaining without shame. These words are written at the end to admonish fellow practitioners.
The Classic states: "When humans are injured by cold, they develop febrile diseases." When I first read this, I doubted it, asking how injury by cold could result in heat. Cold is the Yin Qi of Heaven; heat is the Yang Qi of humanity. When Heaven's Yin Qi invades the human body, it causes stiffness and aversion to cold. When human Yang Qi is constrained and depressed, it steams and rises, causing fever. However, when pathogenic factors are strong and righteous Qi cannot expel them, acrid-warm herbs must be used to assist, allowing pathogens to resolve through sweating. This is the rationale for establishing exterior-releasing methods. For severe cases, Ephedrae Herba (Mahuang) is used; for moderate cases, Notopterygii Rhizoma et Radix (Qianghuo); for mild cases, Perillae Folium (Zisu). Dosage should be adjusted according to severity. Stop when the disease is addressed; do not overdose. Overdosing depletes righteous Qi even after pathogens are gone, leading to various complications difficult to enumerate. Sweat is body fluid. Initially, cold closes the pores, preventing release, so sweating is used to unblock and harmonize Qi. Excessive sweating consumes fluids externally and exhausts them internally. Whether due to sweat-induced loss of Yang, dryness of the Stomach Fu, or depletion of Kidney Yin, symptoms such as irritability, thirst, and constipation stem from excessive sweating. Can this be ignored? Thus, I have said: treating Shanghan requires sweating, but not lightly, not heavily, not repeatedly, and not erroneously. Understanding this allows one to enter Zhang Zhongjing's inner chamber and avoid the fears associated with Wenbo.
One: When the Taiyang channel suffers winter cold, presenting with headache, high fever, aversion to cold, stiffness, tight and full pulse, and anhidrosis, Zhang Zhongjing prescribed Mahuang Tang (Ephedra Decoction): Ephedrae Herba (Mahuang) 2 qian, Cinnamomi Ramulus (Guizhi) 1 qian, Glycyrrhizae Radix et Rhizoma (Gancao) 0.5 qian, Armeniacae Semen Amarum (Xingren) 8 grains, Zingiberis Rhizoma Recens (Shengjiang) 3 slices, Jujubae Fructus (Dazao) 1 piece, decocted in water. This treats true Shanghan in winter, where sweating is indispensable.
One: Although previous symptoms are present, if exposed to sudden cold out of season, Mahuang Tang should not be used. Instead, use Notopterygii Rhizoma et Radix (Qianghuo), Perillae Folium (Zisu), Saposhnikoviae Radix (Fangfeng), Schizonepetae Spica (Jingjie), Puerariae Radix (Gegen), Citri Reticulatae Pericarpium (Guangpi), Ligustici Chuanxiong Rhizoma (Chuanxiong), and Glycyrrhizae Radix et Rhizoma (Gancao), modified according to symptoms. This represents the principle of not sweating excessively.
One: Although previous symptoms are present, if the patient has inherent Qi deficiency, chronic miscellaneous diseases, or is postpartum, recovering from smallpox/variolae, post-hemorrhagic, suffering from fatigue-induced internal injury, or having engaged in sexual activity, and subsequently catches cold, then use Schizonepetae Spica (Jingjie), Saposhnikoviae Radix (Fangfeng), Perillae Folium (Zisu), Puerariae Radix (Gegen), Glycyrrhizae Radix et Rhizoma (Gancao), and Citri Reticulatae Pericarpium (Guangpi), modified slightly to release the exterior gently. If fever is not caused by cold, treat the root cause. This illustrates the principle of not sweating lightly.
One: Although previous symptoms are present, if exterior release and sweating have already occurred, do not repeat dispersing methods. Since pathogens have retreated, sweating again will damage righteous Qi. This illustrates the principle of not sweating repeatedly.
One: Aversion to cold and fever occur in many miscellaneous diseases, even in single carbuncles or boils. One must not indiscriminately use dispersing methods without diagnosing the specific syndrome. For example, I treated a woman with aversion to cold and fever, whose pulse was flooding and rapid. Upon inquiry, she had painful swelling in her left breast. I treated only the breast swelling, which resolved immediately, along with the chills and fever. This example applies to others. This illustrates the principle of not sweating erroneously.
Observing contemporary trends, whenever patients, doctors, or bystanders see chills and fever, they immediately suspect Shanghan and ask, "Has sweating been induced? Has purgation been performed?" Deaths resulting from improper sweating or purgation are accepted without regret, while recovery without these treatments leaves people dissatisfied. This is the misfortune of the people and the decline of vulgar customs. If wise men were to arise and expose this, yet the practice continues unnoticed, how sorrowful it is! I have seen countless deaths caused by erroneous sweating in cases of fatigue, Yin deficiency, miscellaneous diseases, prenatal/postpartum conditions, and summerheat. I cannot help but deeply lament this.