予始识怀子抱奇时。方治帖括。自后天下苦兵革。生齿半疮痍。予愧出而
为吏。未能苏疾苦。振穷厄。及退居乡曲。知怀子隐于医以自全。生活人无
算。嗟乎。不为相则为医。士君子利物济民。有志者当如是矣。然而周官之
于医也。岁有考。月有稽。以其治疗之多验与否。定上中下之目。非如后世
之人。自以为长桑而漫无准量者也。夫古今方伎匪一。惟医则属之。修短
之数。利害攸寄。有人曰。我善用兵。兵不必孙吴。而胜之数少。败之数多矣。
有人曰。我善用药。药不必卢扁。而生之徒三。死之徒七矣。轩皇涿鹿之战。
开兵法之祖。乃素问一书。实为千古万年续命之经。天道好生而恶杀。圣
人以药济兵之穷。愚者乃姑妄试之。而刀圭竟为不祥之器。学医人费。可
不为寒心哉。语云。习方三年。无可医之病。医病三年。无可用之方。此言良
医别有慧悟。非必局于纸上陈言也。怀子则曰长沙易水诸大家。着书立
言。发所未发以诏后人。皆大医王慈照软语。方不可执。法亦不可废。第其
中若者从。若者违。争在丝发之间。必能直追所见。自言其所当然。庶免史
公疾多道少之讥。而治者称至繁变莫伤寒若。故往往难之。怀子则出之
以易。管令人约而可循。迄于杂症女科。爰悉举其平昔已试之法。剀切详
尽。着为医彻。吾知其于生人之道。真可告无罪于天下。譬之为民牧者。确
有治谱可传。称为众母无愧耳。
嘉庆戊辰季春青浦述庵王昶题
我初次结识怀远先生抱奇时,他正在研习科举应试的文章。此后天下战乱频仍,百姓伤亡惨重,半数人口遭受创伤。我惭愧自己出仕为官,未能解除百姓的疾病痛苦,救济贫困危难之人。等到退隐乡间,才知道怀远先生隐居行医以保全自身,救活的人不计其数。唉!不做宰相就做医生,君子造福万物、救济民众,有志之士应当如此。
然而,《周礼》对于医生的管理,每年有考核,每月有稽查,根据治疗效果的多少与是否有效,评定上、中、下等级。不像后世那些人,自认为是扁鹊(长桑君弟子)再世而漫无标准衡量。古往今来方术众多,只有医学关乎人的寿命长短,利害攸关。有人说:“我善于用兵。”但即使不是孙武、吴起那样的名将,胜算少而败算多。有人说:“我善于用药。”但即使不是卢医、扁鹊那样的神医,救活三人而死七人。轩辕黄帝在涿鹿之战中,开启了兵法的源头;而《素问》一书,实为千古万年延续生命的经典。天道喜好生命而厌恶杀戮,圣人用药物来弥补军事手段的局限。愚昧之人却姑且尝试,使得药石竟然成了不祥之器。学习医学的费用和代价,怎能不让人寒心呢?
俗话说:“学习方剂三年,没有可治的病;行医三年,没有可用的方子。”这话说明良医另有独特的领悟,不一定局限于纸上的陈旧言论。怀远先生说:长沙(张仲景)、易水(张元素等)各位大家,著书立说,阐发前人未发之旨以教导后人,都是大医王慈悲柔和的教诲。方剂不可固执死守,法则也不可以废弃。只是其中哪些该遵循、哪些该违背,差别就在毫厘之间,必须能直接追溯所见到的道理,陈述其所以然,以免受到司马迁批评“医术多而医理少”的讥讽。而且治疗变化繁复,没有比伤寒更复杂的了,所以往往被认为很难。怀远先生却将其化繁为简,使人简约而可遵循。直到杂症和妇科,都全面列举了他平日已经验证过的方法,恳切详尽,著成《医彻》一书。我知道他在救人之道上,真可以向天下人宣告无愧。这就像为民父母的地方官,确实有治理的法谱可以传承,称为众人的母亲也当之无愧。
嘉庆戊辰年(1808年)春季三月,青浦述庵王昶题写
When I first met Mr. Huaiyuan (Baoqi), he was studying for the imperial examinations. Afterwards, warfare plagued the world, and half of the population suffered from wounds and injuries. I felt ashamed that, having entered officialdom, I failed to alleviate the people's suffering from disease or relieve their poverty and distress. Later, upon retiring to my hometown, I learned that Mr. Huaiyuan had hidden himself in medicine to preserve his life, saving countless people. Alas! One may either serve as a Grand Councilor or become a physician. A gentleman who benefits all things and aids the people should aspire to this.
However, according to the *Rites of Zhou* (*Zhou Li*), physicians were subject to annual assessments and monthly inspections, with grades of upper, middle, and lower determined by the efficacy and frequency of their treatments. This differs from later generations who, considering themselves reincarnations of Changsang Jun (a legendary healer), lack any standard measure. Throughout history, there have been many arts and skills, but only medicine concerns matters of life and death, where benefits and harms are critical. Some say, "I am skilled in military strategy." Yet, even without being Sun Wu or Wu Qi, victories are few and defeats numerous. Others say, "I am skilled in pharmacology." Yet, even without being Lu Qian or Bian Que, three out of ten patients survive while seven die. The Yellow Emperor's battle at Zhuolu initiated the origins of military strategy, yet the *Suwen* (*Basic Questions*) is truly the eternal scripture for sustaining life across millennia. The Way of Heaven favors life and abhors killing; sages used medicine to compensate for the limitations of military force. Fools, however, experiment recklessly, turning medicinal tools into instruments of ill omen. The cost and risk of learning medicine should indeed be chilling.
It is said, "Study formulas for three years, and you find no diseases to treat; practice medicine for three years, and you find no formulas to use." This implies that excellent physicians possess unique insights, not merely adhering to stale theories on paper. Mr. Huaiyuan states: The great masters of Changsha (referring to Zhang Zhongjing) and Yishui (referring to Zhang Yuansu and his school) wrote books and established doctrines, expounding upon previously unarticulated principles to instruct future generations. These are like the compassionate words of a Great Physician King. Formulas should not be rigidly adhered to, nor methods discarded. The distinction between what to follow and what to deviate lies in the finest details; one must directly trace the underlying principles and explain their rationale, thereby avoiding Sima Qian's criticism of "much technique but little theory." Furthermore, among complex conditions, none are more difficult to manage than Cold Damage (*Shanghan*). Thus, it is often considered arduous. Mr. Huaiyuan, however, simplifies these complexities, making them concise and accessible. Regarding miscellaneous diseases and gynecology, he comprehensively lists methods he has previously verified, presenting them earnestly and in detail in his work *Yi Che* (*Thorough Understanding of Medicine*). I believe that in the way of preserving life, he can truly declare himself blameless before the world. It is akin to a local governor who possesses a reliable manual for governance, deserving the title of "Mother of the People" without shame.
Inscribed by Wang Chang of Qingpu, Shu'an, in the third month of the Wuchen year of the Jiaqing reign.