医之为道至矣。故周官有疾医,视万民四时之病,春之 首,夏之痒疥,秋之疟寒,冬之咳
嗽上气,皆分而治之,验其状而制其禄,甚为不轻也。后世官 失职,故于其术每择之不精。有
人于此,能合于古者之道,岂不犹空谷足音之可喜者乎?如吾同县戴原礼氏是已。原礼生儒家,
习闻诗礼之训, 有志于泽物。乃徒步至乌伤,从朱先生彦修学医。先生见其颖悟倍常,倾心
援之。原礼自是识日广,学日笃,出而治疾,往
往多奇验。予请得而详道之。
原礼从叔仲章,六月患大热,面赤,口谵语,身发红斑。他医投以大承气汤,而热愈极。原
礼脉之曰∶左右手皆浮虚无力,非真热也。张子和云∶当解表而勿攻里,此证似之,法当汗。遂
用附子、干姜、人参、白术为剂,烹液冷冻饮料之,大汗而愈。
诸暨方氏子妇,疟后多汗,呼媵人易
衣,不至,怒形于色,遂昏厥若死状。灌以苏合香丸而苏。自后闻人步之重,鸡犬之声,辄厥逆
如初。原礼曰∶脉虚甚,重取则散,是谓汗多亡阳,正合经意。以黄芩、人参日补之,其惊渐减,
至浃旬而安。
松江朱仲文,长夏畏寒,身常挟重续,食饮必热如火方下咽,微温则呕。他医授以胡椒煮伏
雌之法,日啖鸡者三,病愈亟。原礼曰∶脉数而大且不弱。刘守真云∶火极似水,此之谓矣。椒
发阴经之火,鸡能助痰,只以益其病尔。以大承气汤下之,昼夜行二十余,顿减纩之半。复以黄
连导痰汤益竹沥饮之,竟瘳。
姑苏朱子明之妇,病长号,数十声暂止,复如前。人以为厉所凭,莫能疗。原礼曰∶此郁病
也。痰闭于上,火郁于下,故长号则气少舒。经云∶火郁则发之是已。遂用重剂涌之,吐痰如胶
者无算,乃复初。
乐原忠妻,亦苏人,因免乳后病惊,身翩翩然如升浮云之上,举目则重屋旋运,持身弗定。
他医饮以补虚治惊,皆不验。原礼曰∶左脉虽芤且涩,神色不动,是因惊致心包络积污血耳,法
宜下之。下积血如漆者一斗,即愈。
留守卫吏陆仲容之内子病热,妄见神鬼,手足 动。他医用黄连清心汤不中。原礼视之曰∶
形瘦而色不泽,乃虚热耳,法当以李杲甘温除大热之法为治,即经所谓损者温之者也。服参 而安。
他若此者甚众。予备闻贤士大夫恒言之,今不能悉数也。呜呼!有人于此,可不谓之合于古道者乎?夫
医之为道,本于《素问》、《内经》,其学一坏于开元,再坏于大观。习俗相仍,绝不知究其微指,
唯执一定之方,类刻舟而求剑者。人訾之,则曰∶我之用此,不翅足矣,又何事《内经》为?宋
之钱仲阳独得其秘于遗经而扩充之。金之张、刘、李诸家又从而衍绎之。于是《内经》之学大明。
刘之学,朱彦修得之最深。大江以南医之道本于《内经》,实自朱发之。原礼乃其高弟,其用心
也笃,故造理为特精。其传授有要,故察证无不中,亦可谓贤也已矣。近来京师缙绅家无不敬爱
之,服其剂沉 豁然如洗。或欲荐为医官,辞不就,道赋诗以钱其东还,且请余为序。昔者司马
迁作《仓公传》,载其应诏所对,凡廿有三,书治病之状甚具。予仿此义,稍陈原礼疗疾奇中者,
系之首简,并告周官疾医四时治证之概。世之知言君子必有所择焉。(《宋学士集》)
医学这一道术,真是至高无上啊。所以《周礼》中设有疾医一职,负责诊治万民四季的疾病:春季多为首部疾病,夏季多为瘙痒疥疮,秋季多为疟疾寒热,冬季多为咳嗽气逆,都分别进行治疗,根据病情轻重来核定俸禄,可见其职责之重要。后世官员失职,因此在选拔医生时往往不够严谨精当。如果有这样的人,能够契合古代医道的精髓,难道不是如同空谷足音般令人欣喜的吗?像我们同县的戴原礼先生就是这样的人。
戴原礼出身于儒家家庭,熟读诗书礼仪的教诲,有志于造福万物。于是他徒步前往乌伤,拜朱彦修先生门下学习医学。先生见他聪慧悟性远超常人,便倾心教导他。从此以后,戴原礼见识日益广博,学问日益深厚,出诊治病,往往有奇特的疗效。请允许我详细叙述他的事迹。
戴原礼的堂叔戴仲章,在六月患大热病,面色赤红,口中说胡话,身上发出红斑。其他医生给他服用大承气汤(峻下热结的方剂),结果热势更加严重。戴原礼诊察他的脉象说:“左右手脉象都浮虚无力,这不是真正的实热。”张子和曾说:“应当解表而不要攻里”,这个病症与此相似,治法应当发汗。于是用附子、干姜、人参、白术组成药方,将药液煮好后放冷饮用,患者大汗淋漓后痊愈。
诸暨方氏的儿媳,患疟疾后出汗很多,呼唤侍女换衣服,侍女没及时到,她脸上露出怒色,随即昏厥,状如死亡。灌服苏合香丸(开窍醒神剂)后苏醒。此后只要听到人脚步重的声音或鸡犬叫声,就会再次昏厥如前。戴原礼说:“脉象非常虚弱,重按则散乱,这是所说的‘汗多亡阳’,正符合经典的意思。”于是用黄芩、人参每天补益,她的惊恐逐渐减轻,过了十天就安稳了。
松江朱仲文,盛夏时节怕冷,身体常常感觉沉重,饮食必须滚烫如火才能咽下,稍微温热就会呕吐。其他医生传授他用胡椒煮雌鸡的方法,他每天吃三只鸡,病情反而更加急迫。戴原礼说:“脉象数而且大,并不弱。”刘守真曾说:“火极似水”,说的就是这种情况。胡椒会激发阴经之火,鸡肉能助长痰湿,只会增加他的病痛罢了。于是用大承气汤泻下他,昼夜排便二十多次,病情顿时减轻了一半。随后又用黄连导痰汤配合竹沥水饮用,最终痊愈。
姑苏朱子明的妻子,患病时长时间大声呼叫,几十声暂时停止,然后又像之前一样。人们认为是厉鬼附身,无法治疗。戴原礼说:“这是郁证。”痰浊闭塞于上焦,火邪郁结于下焦,所以大声呼叫时气机稍微舒畅。经典说:“火郁则发之”,就是这个道理。于是用重剂催吐,吐出像胶一样的痰液无数,身体才恢复如初。
乐原忠的妻子,也是苏州人,因难产后患惊悸症,身体飘飘然如同升在浮云之上,睁眼看到房屋旋转运动,站立不稳。其他医生给她服用补虚治惊的药物,都没有效果。戴原礼说:“左脉虽然芤且涩,但神色没有变动,这是因为惊吓导致心包络积聚污血,治法应当攻下。”排出如漆般的积血一斗,立即痊愈。
留守卫吏陆仲容的妻子患热病,胡言乱语看见神鬼,手足抽搐。其他医生用黄连清心汤治疗无效。戴原礼观察她说:“形体消瘦且面色无光泽,这是虚热,治法应当采用李杲‘甘温除大热’的方法,也就是经典所说的‘损者温之’。”服用参类药材后安宁。
像这样的情况还有很多。我详尽地听贤士大夫们经常谈论,现在不能全部列举出来。唉!如果有这样的人,难道不可以说是契合古代医道的人吗?医学之道,本源在于《素问》和《内经》,其学问在开元年间第一次败坏,在大观年间第二次败坏。习俗沿袭,完全不知道探究其中的精微旨意,只执着于固定的方子,就像刻舟求剑一样。被人指责时,却说:“我用这个方子,已经足够了,何必去研究《内经》呢?”宋代的钱乙(钱仲阳)独自在遗经中得其秘奥并加以扩充。金代的张元素、刘完素、李杲等各家又进而演绎发挥。于是《内经》的学问得以大明。刘完素的学问,朱彦修学得最深。大江以南的医学之道本于《内经》,实际上是从朱彦修开始发扬的。戴原礼是他的得意高徒,用心笃实,所以对医理造诣特别精深。他传授医术抓住要领,所以辨证没有不准确的,也可以说是贤能的人了。近来京城的官员世家无不敬爱他,服用他的药剂后豁然开朗,如洗去污垢一般。有人想推荐他做医官,他推辞不接受,作诗赋送他东归,并且请求我为此书写序。昔日司马迁撰写《仓公传》,记载了他应诏回答的问题,共二十三个,详细记录了治病的情况。我仿照这个义例,稍微陈述戴原礼治疗疾病奇特精准的案例,附在卷首,并告知《周礼》疾医四季诊治疾病的概况。世上懂理的君子必定会有所选择。(出自《宋学士集》)
The Way of Medicine is indeed supreme. Thus, the *Rites of Zhou* established the office of Physician for Diseases (Ji Yi), responsible for examining and treating the illnesses of the myriad people across the four seasons: in spring, diseases of the head; in summer, itching and scabies; in autumn, malaria and chills; in winter, cough and rebellious Qi. These were treated separately, and salaries were determined based on the severity of the condition, indicating that the responsibility was not trivial. In later generations, officials neglected their duties, so the selection of practitioners was often imprecise. If there were individuals here who could align with the ancient Dao of medicine, would they not be as welcome as footprints in an empty valley? Such is our fellow townsman, Mr. Dai Yuanli.
Mr. Yuanli was born into a Confucian family, familiar with the teachings of Poetry and Rites, and had the ambition to benefit all living things. He walked to Wushang to study medicine under Master Zhu Yanxiu. The Master saw his exceptional intelligence and wit, far surpassing ordinary people, and taught him with dedication. From then on, Mr. Yuanli’s knowledge broadened daily, and his learning deepened. When he practiced medicine, his treatments often yielded miraculous results. Allow me to recount these details.
Mr. Yuanli’s cousin, Dai Zhongzhang, suffered from severe heat in June, with a red face, delirious speech, and red rashes on the body. Other physicians administered Da Chengqi Tang (Major Orderly Release Decoction), but the heat intensified. Mr. Yuanli palpated the pulse and said, "Both left and right pulses are floating, deficient, and weak; this is not true excess-heat." Zhang Zihe stated, "One should release the exterior rather than attack the interior." This case resembles that principle; the method should involve inducing sweating. Thus, he prescribed a formula of Fuzi (Prepared Aconite Root), Ganjiang (Dried Ginger), Renshen (Ginseng Root), and Baizhu (Atractylodes Rhizome). The decoction was cooled and given to drink, resulting in profuse sweating and recovery.
The wife of Fang from Zhuji suffered from excessive sweating after malaria. When she called her maid to change clothes and the maid did not arrive promptly, anger appeared on her face, leading to syncope resembling death. She was revived by administering Suhexiang Wan (Styrax Pill). Thereafter, hearing heavy footsteps or the sounds of chickens and dogs triggered syncope identical to before. Mr. Yuanli said, "The pulse is extremely deficient; upon heavy pressure, it scatters. This is what is meant by 'profuse sweating leads to loss of Yang,' which perfectly aligns with the classic meaning." He used Huangqin (Scutellaria Root) and Renshen (Ginseng Root) for daily tonification. Her fright gradually decreased, and she stabilized within ten days.
Zhu Zhongwen from Songjiang feared cold during midsummer, felt constant heaviness in his body, and required food and drink to be boiling hot to swallow; if slightly warm, he vomited. Other physicians advised him to eat three boiled female chickens daily with pepper, but his condition worsened urgently. Mr. Yuanli said, "The pulse is rapid, large, and not weak." Liu Shouzhen said, "Extreme fire resembles water," which applies here. Pepper stimulates fire in the Yin meridians, and chicken promotes phlegm; these only exacerbate the disease. He used Da Chengqi Tang (Major Orderly Release Decoction) to purge him. He defecated more than twenty times day and night, and the illness suddenly reduced by half. Subsequently, he was treated with Huanglian Daotan Tang (Coptis Phlegm-Guiding Decoction) mixed with Zhuli (Bamboo Sap), leading to complete recovery.
The wife of Zhu Ziming from Gusu suffered from prolonged screaming, pausing briefly after dozens of cries, then resuming. People believed she was possessed by a malevolent spirit and could not be cured. Mr. Yuanli said, "This is a Stagnation Syndrome (Yu Bing)." Phlegm obstructs the upper Jiao, and Fire stagnates in the lower Jiao, so screaming allows Qi to relax slightly. The Classic states, "When Fire is stagnant, it must be dispersed." Thus, he used a heavy emetic agent. He expectorated countless amounts of glue-like phlegm, and she returned to health.
The wife of Le Yuanchong, also from Suzhou, developed fright after difficult childbirth. Her body floated as if ascending above clouds; when she opened her eyes, houses seemed to rotate, and she could not stand steadily. Other physicians administered tonics for deficiency and treatments for fright, all without effect. Mr. Yuanli said, "Although the left pulse is hollow and choppy, her spirit and color remain unchanged. This is due to fright causing accumulated turbid blood in the Pericardium Collateral. The method should be purgation." He purged one dou of dark, lacquer-like accumulated blood, and she recovered immediately.
The wife of Lu Zhongrong, an official in the Guard of the Palace, suffered from heat, hallucinating spirits and ghosts, with convulsions of the hands and feet. Other physicians used Huanglian Qingxin Tang (Coptis Heart-Clearing Decoction) without success. Mr. Yuanli observed, "Her form is thin and complexion lusterless; this is deficiency-heat. The method should follow Li Gao’s principle of using sweet-warm herbs to eliminate great heat," which corresponds to the Classic saying, "Those who are depleted should be warmed." After taking Ginseng, she became calm.
There are many such cases. I have heard scholars and officials discuss them frequently, but cannot list them all now. Alas! If there is such a person, can we not say he aligns with the ancient Dao? The Way of Medicine originates from the *Suwen* and *Neijing*. Its scholarship was first corrupted in the Kaiyuan era and again in the Daguan era. Customs persisted, and no one sought to explore its subtle meanings, clinging rigidly to fixed prescriptions like carving a mark on a boat to find a sword. When criticized, they claimed, "Using this prescription is sufficient enough; why bother with the *Neijing*?" Qian Boyuan (Qian Zhongyang) of the Song Dynasty alone discovered secrets in the surviving classics and expanded upon them. Scholars of the Jin Dynasty, such as Zhang Yuansu, Liu Wansu, and Li Gao, further elaborated on them. Thus, the study of the *Neijing* became clearly illuminated. Liu Wansu’s scholarship was deeply mastered by Zhu Yanxiu. South of the Great River, the medical tradition based on the *Neijing* truly began with Zhu. Mr. Yuanli was his distinguished disciple. His devotion was sincere, so his understanding of medical principles was particularly refined. His teaching methods were essential, so his diagnosis of syndromes was invariably accurate. He can indeed be called virtuous. Recently, officials in the capital revered him; after taking his prescriptions, patients felt instantly relieved, as if cleansed. Some wished to recommend him as an Imperial Physician, but he declined, composing poetry to send him eastward, and requested I write a preface. Sima Qian once wrote the *Biography of Cang Gong*, recording twenty-three cases he answered to imperial inquiries, detailing treatment conditions thoroughly. I imitate this intent, briefly presenting Mr. Yuanli’s miraculous cures, attaching them to the beginning of this volume, and summarizing the seasonal diagnoses of the *Zhou Li* Physicians. Gentlemen of insight among the world will surely make their choices. (From *Song Xueshi Ji*)