医学肇于《灵》、《素》，犹儒家之有六经，乃众理之总汇，证治之极则，所谓不废江
河万
古流也。长沙张仲景出，实有以绍轩岐之传，广汤液之用，于医门推为至圣，洵不诬已。魏
晋以降，医术流为方技，士大夫耻习其业，坠绪茫茫，不绝者如缕。宋和政间，开和剂、惠
民等局，以疗民病，令太医院试其通于《灵》、《素》之理者，授之以官，始令为医，于是医
学稍稍振兴。刘李朱张各家，崛起金元间，而或论温热，或主脾胃，或专滋阴，或任攻伐，
家各为说，人持一是。正如汉儒说经，各承家法，靡所折衷。明代王损庵等诸贤辈出，拾遣
补阙，阐发经旨，斯道昌明，于斯为盛。其中矫然特出，独立门户者，则如张凤逵之论暑，
吴又可之论疫，喻西昌之补秋燥，张介宾之辨阳虚，皆能于此道中开径自行，不为旧说所蒙
。然或嫌其略，或失之粗，或辨焉而过于刻深，或论焉而涉于肤浅，亦犹宋儒钻研性理，疏
说经义，非不各有心得，可以扶翼圣道，而各得一偏，要未能悉归至当，则甚矣。斯理之精
深，而不可无以衡之，以衷于壹是也。我朝医学昌明，名流迭出。吾吴叶天士先生，以颖敏
之才，探灵兰之奥，一时活人之名，震乎宇内，惜乎求治者多，其生平精力，殚于治病，未
遑有所着述。世传医案数种，亦非其所手定，其中真赝相参，瑜瑕不掩，读者病焉。外如《
景岳发挥》一书，虽有阐发而言多愤激，似非著作体裁。又有《本草经注》，《本事方释义
》两种，类以五行五脏配合敷衍，绝少精意，似亦非先生手笔，或者先生名重当时，门弟子
窃其绪论，着为成书，遂托其名于先生欤。《惟温热论》一卷，虽篇帙无多，而其中发明证
治，补前贤之遗阙，示后学以指归，言皆精要，语不游移，洵可法可传之作。而温邪犯肺逆
传心包一语，犹为后人指摘，则信乎着述之难，而医理之不可不衡以壹是也审矣。甲午长夏
，晤缪君少初于石梅精舍，纵谭医理，缪君不以诒为固陋，出先生所着《医衡》一书见示，
而索序焉。诒受而读之，其书虽采自前人，而纲罗宏富，抉择精严，其不惬于理者，又经改
定，间附论说，以裨阙漏。所谓衡之以理，而衷于壹是者，此书其庶几乎？缪君以贤宰官乞
退，辟精庐于湖山佳处，怡情松菊，寄傲烟霞，盖有古人之高致者，而 于是书。刊以行
世，盖以极斯人之疾苦而登之仁寿，其犹是贤宰官爱人无已之心也夫。缪君深于斯理，而不
屑以医名，爰书此以质之，或者其有以教我乎，即幸甚。
光绪二十年甲午中秋前二日江阴后学柳宝诒书于琴川舟次
医学起源于《黄帝内经》中的《灵枢》和《素问》，这就像儒家有六经一样，是各种道理的总汇，是辨证治疗的最高准则，正如所说的那样，像江河万古长流一样不可废弃。长沙人张仲景出现后，确实继承了轩辕、岐伯的传承，扩大了汤液（中药方剂）的应用，在医门中被推崇为至圣，这确实是不虚假的。魏晋以后，医术沦为方技，士大夫以学习这门职业为耻，学术传统断绝茫茫，仅存的线索如游丝般微弱。宋神宗熙宁年间，开设和剂局、惠民局等机构，用来治疗百姓的疾病，命令太医院中那些通晓《灵枢》、《素问》道理的人参加考试，授予他们官职，这才使得医学稍稍振兴。刘完素、李东垣、朱丹溪、张从正各家，在金元时期崛起，有的论述温热病，有的主张调理脾胃，有的专门滋阴，有的任用攻伐之法，各家各持一说，人人坚持自己的观点。正如汉代儒生解说经典，各自继承家法，没有统一的折衷标准。明代王肯堂等贤才辈出，拾遗补缺，阐发经典旨意，这一道术昌盛光明，在此时达到极盛。其中卓越突出，独立门户的，比如张凤逵论述暑病，吴又可论述瘟疫，喻昌（字西昌）补充秋燥的理论，张介宾辨析阳虚，都能在这条道路上开辟新路自行其是，不被旧说所蒙蔽。然而有的被嫌略简，有的失之粗疏，有的辨析过于苛刻深刻，有的论述涉于肤浅，也就像宋儒钻研性理，疏解经义，并非没有各自的心得，可以辅助圣道，但各执一端，终究未能完全归于恰当，这就说明了这个医理的精深，以及不能不用“衡”（衡量标准）来加以评判，以归于统一正确的结论。本朝医学昌盛光明，名流不断涌现。我们吴地的叶天士先生，凭借聪颖敏捷的才华，探求医奥深意，当时救人的名声震动天下，可惜求治的人多，他一生的精力都耗费在治疗疾病上，无暇著书立说。世间流传的几种医案，也不是他亲手定稿的，其中真假混杂，优点缺点并存，读者对此感到困扰。另外像《景岳发挥》一书，虽然有阐发之意但言辞多愤激，似乎不符合著作的体裁。又有《本草经注》、《本事方释义》两种，大抵是用五行五脏配合敷衍，极少精妙立意，似乎也不是先生的手笔，或许是先生名重当时，门弟子窃取他的绪论，写成成书，于是假托他的名字罢了。《温热论》一卷，虽然篇幅不多，但其中发明证治，弥补前贤的遗缺，给后学指明方向，言语皆精要，态度不游移，确实是值得效法流传的作品。而“温邪犯肺逆传心包”这句话，还被后人指摘，这确实证明了著述之难，以及医理不可不用统一标准来衡量的道理是很清楚的。甲午年长夏，我在石梅精舍与缪少初君相遇，纵谈医理，缪君不认为我固陋，拿出先生所著的《医衡》一书给我看，并索求序言。我接受并阅读了它，这本书虽然采自前人，但纲罗宏富，抉择精严，其中不合情理的地方，又经过改定，间或附以论说，以补阙漏。所谓用理来衡量，以归于统一正确，这本书大概差不多吧？缪君以贤良的官员身份乞求退隐，在湖山佳处开辟精舍，在松菊中怡情，在烟霞中寄托傲骨，大概有古人的高致，并且刊刻此书以流行于世，大概是想要穷尽人们的疾苦而让他们登上仁寿之道，这依然是贤良官员爱人无已之心啊。缪君深谙此理，却不屑以医生之名自居，于是写下这些来质询他，或许他能教导我，那就万幸了。
光绪二十年甲午中秋前两日，江阴后学柳宝诒在琴川舟次书写
Medicine originated from the *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions) of the *Huang Di Nei Jing* (Yellow Emperor's Inner Canon), just as Confucianism has the Six Classics. It is the convergence of all principles and the ultimate standard for syndrome differentiation and treatment, much like rivers flowing eternally without ceasing. When Zhang Zhongjing of Changsha emerged, he truly inherited the transmission of Xuanyuan (the Yellow Emperor) and Qibo, expanded the application of Tang Ye (herbal decoctions), and was revered in the medical field as the Supreme Sage; this is indeed not false. Since the Wei and Jin dynasties, medical arts had degenerated into mere techniques, and scholars were ashamed to practice it. The academic tradition became vast and desolate, with only a thread-like continuity remaining. During the Xining era of Emperor Shenzong of Song, institutions such as the He Ji Bureau and Hui Min Bureau were established to treat the people's illnesses. Those from the Imperial Medical Academy who demonstrated proficiency in the principles of the *Ling Shu* and *Su Wen* were examined and granted official positions, thereby allowing medicine to gradually revive. Various schools represented by Liu Wansu, Li Dongyuan, Zhu Danxi, and Zhang Congzheng rose during the Jin and Yuan dynasties. Some discussed warm-heat diseases, others emphasized the spleen and stomach, some specialized in nourishing yin, and others employed purgative methods. Each school held its own theory, and every individual adhered to their own perspective. This was akin to Han dynasty Confucians interpreting classics, each following family traditions without a unified compromise. In the Ming dynasty, virtuous figures such as Wang Ken-tang emerged one after another, filling gaps, correcting omissions, and elucidating the intent of the classics. Thus, this path flourished and reached its peak at that time. Among them, those who stood out prominently and established independent schools included Zhang Fengkui on summer-heat, Wu Youke on epidemics, Yu Chang (courtesy name Xichang) on autumn dryness, and Zhang Jiebin on distinguishing yang deficiency. All were able to blaze new trails within this discipline, not being blinded by old theories. However, some were criticized for being too brief, others for being too rough, some辨析 (differentiation) was overly harsh and deep, while some discussions were superficial. This is similar to Song dynasty Confucians delving into nature and principle,疏释 (explaining) classic meanings. Although they each had their insights and could support the sage's way, each obtained only a partial truth and failed to fully return to the appropriate mean. This profoundly illustrates the depth of this principle and the necessity of having a "balance" (standard of measurement) to adjudicate towards a single correctness.
In our dynasty, medicine has flourished, and famous scholars have emerged continuously. Mr. Ye Tianshi of our Wu region, with his brilliant and agile talent, explored the profound mysteries of medical lore. His reputation for saving lives shook the world. Alas, because there were many seeking treatment, his life's energy was exhausted in curing diseases, leaving no time for writing. Several medical cases circulated in the world were not personally finalized by him. Authenticity and forgery were mixed, virtues and flaws coexisted, causing distress to readers. Furthermore, the book *Jing Yue Fa Hui*, although containing elucidations, was filled with激愤 (indignant remarks), seemingly not conforming to the style of a scholarly work. There were also two works, *Ben Cao Jing Zhu* and *Benshi Fang Shi Yi*, which largely relied on perfunctory combinations of Five Elements and Zang-Fu organs, lacking refined insight. These did not seem to be written by Mr. Ye himself. Perhaps because Mr. Ye was highly renowned at the time, his disciples stole his introductory theories, compiled them into books, and falsely attributed them to him? The volume *Wen Re Lun* (Treatise on Warm-Heat Diseases), though short, elucidates syndrome differentiation and treatment, fills the gaps left by former sages, and points the way for later learners. Its words are essential, and its stance is unwavering; it is truly a work worthy of emulation and transmission. However, the phrase "warm pathogens invading the lung and transmitting reversely to the pericardium" has still been criticized by later generations. This confirms the difficulty of authorship and the necessity of measuring medical principles against a unified standard.
In the midsummer of the Jiawu year, I met Jun Shaochou Miao at the Shimei Jingshe. We engaged in a free discussion of medical principles. Jun Miao did not consider me ignorant and showed me the book *Yi Heng* authored by Mr. Ye, requesting a preface. I received and read it. Although the book draws from predecessors, its scope is broad, and its selection is rigorous. Where content did not accord with reason, it was revised and corrected, occasionally accompanied by commentary to supplement omissions. So, using reason as a balance to aim for unity and correctness—this book seems to achieve that? Jun Miao, a virtuous official, retired and built a study in a beautiful lakeside and mountainous area, finding joy in pines and chrysanthemums, and lodging his pride in mist and clouds, possessing the lofty demeanor of ancients. By publishing this book for the world, he aims to alleviate human suffering and lead people to benevolence and longevity. This reflects the endless love of a virtuous official for his people. Jun Miao is deeply versed in these principles but disdains fame as a physician. Therefore, I write this to seek his instruction. If he can teach me, I would be extremely fortunate.
Written by Liu Baoyi, junior scholar from Jiangyin, in a boat at Qin Chuan, two days before the Mid-Autumn Festival of the 20th year of Guangxu (1894).