凡治病必明天道地理,人之强弱,必问起居饮食、暴乐暴苦。病从内而之外者,先治其内,
后治其外;病从外而之内者,先治其外,后治其内。内外不相及,则治主病,急则治其标,缓则
治其本。先其所因而后其所主,补上治下制以缓,补下治上制以急。大毒治病十去其六,中毒治
病十去其七,小毒治病十去其八,无毒治病十去其九。必养必和,俟其来复。此皆《素问》之文,
而医家之所当知也。不能尽录,姑摄其要,以示其概云。(《柏斋三书》)
夫医之道大矣。自神农黄帝岐伯雷公而下,无非圣哲开其源,贤智导其流,故能拯黎元之疾
苦,赞天地之生育。世道既降,士大夫以此为技艺,不屑为之而界之凡流。是以至精至微之理,
而出于至卑至贱之思,其不能起人之疾,反以夭其命者多矣。此范文正公所以自谓不为良相,则
为良医。伊芳川先生有云∶治病而委之庸医,比之不慈不孝。自昔卓然名家者,如和、缓、扁鹊、
淳于意、张仲景、孙真人等,其论医也,莫不以保养为先,药石为辅。至于察形诊脉,必致辨于
毫芒疑似之末。而深痛夫世之医者,苟简虚 ,顾乃以医之伐病,如将之伐敌,当用背水阵以决
胜。是徒见夫华佗之说,时出其间,至于剖腹续筋之法,乃别术所得,非神农本草经方条理药性
常道尔。今惟仲景一书,为众方之祖,学人当取法云。(《医说》序)
凡是治病,必须通晓天道与地理环境,了解患者体质的强弱,并详细询问其日常生活起居和饮食习惯,以及是否经历过突然的喜乐或痛苦。疾病由内而发影响外部的,先治疗内部病因,后治疗外部症状;疾病由外侵入影响内部的,先治疗外部邪气,后调理内部脏腑。如果内外病机互不关联,则针对主要病症进行治疗;病情紧急时先治其标症,病情缓和时先治其本因。应先消除致病原因,再治疗主要病症;补益上部、治疗下部时,药制宜缓;补益下部、治疗上部时,药制宜急。使用大毒药物治病,病去十分之六即止;使用中毒药物治病,病去十分之七即止;使用小毒药物治病,病去十分之八即止;使用无毒药物治病,病去十分之九即止。治疗后必须注重调养,使身体平和,等待正气恢复。这些都是《素问》中的原文,是医生应当知晓的道理。因篇幅所限不能全部收录,姑且摘录其要点,以展示大概情况。(出自《柏斋三书》)
医学之道非常宏大。自从神农、黄帝、岐伯、雷公以来,无非是圣哲开启源头,贤能智慧引导流派,因此能够拯救百姓的痛苦,辅助天地的化育之功。世道衰微之后,士大夫将医学视为技艺,不屑于亲自从事,而将其交给平庸之辈。因此,极其精微深奥的道理,却出自卑贱浅陋的思考,不仅不能治愈人的疾病,反而导致许多人早逝的情况很多了。这就是范仲淹自称如果不做良相,就做良医的原因。伊芳川先生曾说:治病而委托给庸医,比之不慈不孝更为严重。自古以来卓越成名的医家,如秦越人(号和)、医缓、扁鹊、淳于意、张仲景、孙思邈等人,他们论述医学,无不把保养身体放在首位,药物治疗作为辅助。至于观察形体、诊察脉象,必定要在毫厘之间、疑似之处进行细致辨析。然而他们深深痛恨当时的医者,苟且简慢、虚伪空疏,竟然把医生对抗疾病比作将领对抗敌人,应当使用“背水阵”这样的绝境战术来决一胜负。这仅仅是看到了华佗的说法偶尔出现其中,至于剖腹续筋等高超技法,乃是其他特殊技艺所得,并非《神农本草经》中关于方剂条理和药性常道的内容。如今只有张仲景的一本书,被众方之祖推崇,学习的人应当效法它。(出自《医说》序)
In treating any disease, one must understand the principles of Heaven and Earth (Tian Dao Di Li), assess the patient's physical strength, inquire about daily routines and diet, and ask about sudden experiences of joy or suffering. If a disease originates internally and manifests externally, treat the interior first, then the exterior; if a disease invades from the exterior and affects the interior, treat the exterior first, then the interior. If the interior and exterior are not interconnected, treat the primary disease: in acute cases, treat the branch (Biao, symptomatic manifestation); in chronic or mild cases, treat the root (Ben, underlying cause). Address the etiology first, then the primary symptoms. When tonifying the upper body to treat lower body issues, the preparation should be gentle/slow; when tonifying the lower body to treat upper body issues, the preparation should be urgent/fast. When using highly toxic herbs to treat disease, stop when 60% of the disease is resolved; when using moderately toxic herbs, stop at 70%; when using slightly toxic herbs, stop at 80%; when using non-toxic herbs, stop at 90%. Post-treatment requires nourishment and harmony, waiting for the recovery of Zheng Qi (Vital Qi). These are texts from the *Su Wen* (Basic Questions), which physicians must know. Due to space constraints, not all can be recorded; here, only the essentials are excerpted to show the general outline. (From *Bai Zhai San Shu*)
The Way of Medicine is profound. Since Shennong, Huangdi, Qibo, and Leigong, sages have opened its source, and the wise have guided its flow, thereby saving the people from suffering and assisting the creative power of Heaven and Earth. As the world declined, scholars regarded medicine as a mere craft, disdaining to practice it themselves and leaving it to commoners. Consequently, extremely subtle and profound principles were handled by shallow and lowly minds, often failing to cure diseases and instead causing premature death. This is why Fan Zhongyan said that if he could not serve as a good minister, he would serve as a good physician. Mr. Yifangchuan stated: entrusting treatment to mediocre doctors is worse than being unfilial and unkind. Since ancient times, renowned masters such as He Huan, Bian Que, Chunyu Yi, Zhang Zhongjing, and Sun Simiao have always prioritized health preservation, regarding herbal medicine as secondary. Regarding observation of form and pulse diagnosis, they insisted on distinguishing minute details and ambiguous signs. They deeply lamented contemporary physicians who were negligent, superficial, and hypocritical, comparing the doctor's battle against disease to a general's battle against an enemy, suggesting the use of a "back-to-the-river formation" to decide victory. This merely reflects occasional references to Hua Tuo's methods; techniques like abdominal surgery and tendon repair belong to specialized arts, not the standard principles of formulas and herb properties found in the *Shennong Bencao Jing*. Today, only Zhang Zhongjing's book serves as the ancestor of all formulas, and students should take it as their model. (Preface to *Yi Shuo*)