余赋质椎鲁。家世业儒。舞象时即肄力于八股之间。学未窥斑而严君见背。时先师戴望之以明经高
等擅岐黄业。语余云。先正有言。不为良相。则为良医。治生即治世也。子盍图之。遂奋志攻苦。一切桐君
之所秘。雷公之所传。琼函宝笈。靡不搜采。大约内科一门。前贤之论述似详且尽。而外科诸书。或博而
寡要。或隐而未备。鹤长凫短。豕腹龙头。心窃疑之。简练揣摩。少有弋获。幸而入侍内庭。谬承委试。奏功
甚多。然亦并无他术。惟能辨气禀有浓薄之殊。风土有寒温之异。今所不经见之异症。古所不必有之
奇方。驱一己匠心。变通于前辈之遗意。日积月累。未能成帙。庚子春。先慈弃世。读礼之余。悉取诸书而
折衷之。有言症而不言脉者。有图形象定名色而不分穴次者。有辨大毒而忽小 者。有小毒反详而
大毒反略者。紊乱无次。未可枚举。僭为考订。汇成一书。重者删之。缺者补之。讹者正之。乱者绪之。其法
首列六脉。则邪正虚实若眉分。次列三因。则病源若犀照。再次则列阴阳善恶生死顺逆之诀。辨之则
吉凶立判再次则列肿疡溃疡二治，则先后治法内外诸方无不具矣。又按部位分经络定穴次辨名
色。各列于后焉。其调理总不外乎前肿溃二治之中。其稍异者则列本症之下。以补缺略也。其中又有
内外相似者。又列各门于本部之后。以便参考。少赘以区区之一得。是集也。辨症辨名从博。虽微疵悉
备而不遗。用药用方从约。在单刀直入以取效。至于独悟之心法。不传之秘方。皆为一盘托出。不复珍
惜。嗟乎。自古用药者如用兵。兵有以正胜、奇胜、多胜、寡胜、车胜、骑胜、舟胜、五花胜、八阵胜。在审其势之
所必用。故一发而奏功。攻毒者如攻贼。贼必有穴。即左洞庭。右太行。铁壁千层。羊肠九叠。而察其穴之
所必在。驰一旅可以受缚奏凯之续。岂曰小成。因名其集曰外科大成。以公天下。坤也不敏。大成讵敢
易名哉。不过因累积之功而统言之耳。爰使天下之人。偶有滑和之患。开卷了然。可以尽谢医师矣。乌
得云以书为御者。不尽马之情耶。因缕述一腔之苦衷如下。不敢乞光于大人先生之鸿藻。弁端以张
楚。
时康熙四年岁在乙巳仲秋之吉太医院御医燕越祁坤广生甫识。
我天资愚钝。家族世代研习儒家经典。在十五岁左右时，我便致力于八股文的写作。学问尚未入门，严父便去世了。当时我的老师戴望之凭借精通经学且成绩优异，擅长岐黄之术（中医医术）。他对我说：“先贤有言：‘做不了好的宰相，就做好的医生。’谋生之道即是治理世道。你何不以此图谋前程呢？”于是我发愤刻苦钻研，桐君（药神）所秘传的、雷公（医药之神）所传授的、珍贵的医书典籍，无不广泛搜集采择。大致而言，内科一门，前贤的论述似乎详尽完备；而外科方面的书籍，有的广博却不得要领，有的隐晦而不完备。如同鹤腿长鸭脚短，猪肚大龙头小，心中暗自怀疑。经过简练提炼和反复揣摩，稍有收获。幸而入宫侍奉皇帝，误受委任参加考试，奏效甚多。然而也没有其他法术，只是能够辨别体质禀赋有浓薄之分，风土气候有寒温之异。对于现今不常见到的奇异病症，古代未必有的奇特方剂，运用个人的匠心，在前辈遗留意旨的基础上变通运用。日积月累，未能成书。庚子年春天，慈母去世，在守孝读礼之余，将各种书籍加以折衷取舍。有的只讲症状不讲脉象，有的画图形象确定名称颜色却不分穴位次序，有的辨别大毒却忽略小毒，有的对小毒反而详细而对大毒反而简略。杂乱无章，无法一一列举。我冒昧地进行考订整理，汇集成一本书。重要的删减，缺失的补充，错误的纠正，混乱的梳理条理。其方法首先列出六脉，则邪正虚实如眉毛般分明；其次列出三因（内因、外因、不内外因），则病源如犀角照物般清晰；再次则列出阴阳善恶生死顺逆的诀要，辨析清楚则吉凶立刻判断；再次则列出肿疡和溃疡两种治疗方法，则先后治法及内外各方无不具备。又按照部位区分经络，确定穴位次序，辨别名称颜色，分别列在后面。其调理总不外乎前述肿疡、溃疡两种治疗之中，其中稍有不同的则列在本症之下，以补缺略。其中又有内外相似的，又在各门之后列出本部内容，以便参考。加上我个人些许的一得之见，这部集子，辨症辨名从博，虽然细微瑕疵都具备而不遗漏；用药用方从约，在于单刀直入以求取效。至于独自领悟的心法，不传的秘方，全都全盘托出，不再珍惜。唉！自古以来用药如同用兵，军队有以正胜、奇胜、多胜、寡胜、车胜、骑胜、舟胜、五花阵胜、八阵胜。关键在于审察形势中必须使用的策略，所以一发就能奏效。攻毒如同攻贼，贼人必有穴窍，即左洞庭、右太行，铁壁千层，羊肠九叠，而察知穴窍所在之处，派出一旅兵力即可擒获贼人并凯旋。这岂能说是小小的成就？因此命名这部集子为《外科大成》，以公开于天下。我祁坤并不聪敏，怎敢轻易更改“大成”之名呢？不过是依据累积之功而统而言之罢了。于是希望天下之人，偶然患有滑利调和之患（此处指疾病困扰），打开书卷一目了然，可以完全推谢医师（意指依书自疗或指导医师）。怎么能说拿着书来驾驭的人，不能完全了解马的情况呢？因此详细陈述一腔苦衷如下，不敢向大人先生们求取光辉藻饰，仅在篇首题写张楚二字。
时在康熙四年，岁次乙巳，仲秋吉日，太医院御医燕越祁坤广生甫识。
I am endowed with dull intelligence. My family has been engaged in Confucian studies for generations. When I was around fifteen years old, I devoted myself to the composition of eight-legged essays. Before my learning had even begun to glimpse its essence, my strict father passed away. At that time, my teacher, Dai Wangzhi, who excelled in the classics and achieved high honors, was proficient in Qihuang (Traditional Chinese Medicine). He said to me, "The sages of old have said: 'If one cannot be a good prime minister, then one should be a good physician.' Pursuing a livelihood is akin to governing the world. Why do you not plan for this path?' Thus, I resolved to study diligently and bitterly. All secrets guarded by Tongjun (the God of Medicine) and teachings transmitted by Leigong (the Divine Farmer), as well as precious medical texts and treasured scrolls, were extensively collected and studied. Generally speaking, regarding internal medicine, the discussions of former sages seemed detailed and comprehensive. However, books on surgery were either broad yet lacking in essentials, or obscure and incomplete. Like the long legs of a crane and the short feet of a duck, or the large belly of a pig and the head of a dragon, I secretly harbored doubts. Through refinement and careful contemplation, I gained some insights. Fortunately, I entered the imperial court to serve, and erroneously accepted an appointment for examination, achieving many successes. Yet, I possessed no other special techniques; I could only distinguish differences in constitutional endowment (thick vs. thin) and variations in local climate (cold vs. warm). For rare diseases not commonly seen today, and unique prescriptions not necessarily existing in ancient times, I applied my own ingenuity, adapting and varying within the legacy of predecessors. Accumulating day by day, it did not form a complete volume. In the spring of Gengzi year, my beloved mother passed away. During the period of mourning and reading rites, I took all various books and synthesized them. Some discussed symptoms but not pulse diagnosis; some illustrated shapes, fixed names and colors, but did not differentiate acupoint sequences; some distinguished major toxins while ignoring minor ones; some detailed minor toxins but briefly mentioned major ones. They were chaotic and unordered, too numerous to list. I presumptuously conducted textual research and collation, compiling them into a single book. Important contents were streamlined, missing parts supplemented, errors corrected, and chaos organized. The methods first list the six pulses, so that pathogenic and righteous factors, deficiency and excess are as clear as distinct eyebrows; next, they list the Three Causes (internal, external, and non-internal/external causes), so that disease origins are as clear as a rhinoceros horn's light; subsequently, they list the principles of Yin and Yang, auspiciousness and malignancy, life and death, and favorable and adverse outcomes, so that upon differentiation, fortune and misfortune are immediately judged; again, they list the treatments for abscesses (Zhongyang) and ulcers (Kuiyang), so that sequential treatment methods and internal and external prescriptions are all included. Furthermore, based on anatomical locations, meridians are differentiated, acupoint sequences determined, and names and colors identified, listed separately thereafter. Regulation generally falls within the aforementioned two treatments for abscesses and ulcers; those slightly different are listed under their respective symptoms to fill gaps. Where internal and external conditions appear similar, relevant sections are listed after the main categories for reference. Adding my modest personal insights, this collection differentiates symptoms and names broadly, ensuring even minor flaws are recorded without omission; it employs medicines and formulas concisely, aiming for direct effectiveness. As for my unique intuitive methods and secret prescriptions, I reveal them all openly, sparing no reservation. Alas! Since ancient times, using medicine is like using troops. Armies can win through orthodoxy, surprise, numerical superiority, inferiority, chariots, cavalry, boats, Wuhua formations, or Bazhen formations. It depends on assessing the necessary circumstances, so that a single move achieves success. Attacking toxins is like attacking bandits. Bandits must have weak points, such as Lake Dongting on the left and Mount Taihang on the right, with thousand-layer iron walls and nine-fold winding paths. By identifying these critical points, a small detachment can capture them and return victorious. How can this be considered a minor achievement? Therefore, I named this collection *Waike Dacheng* (Great Compendium of Surgery) to share it with the world. I, Kun, am not intelligent; how dare I change the name 'Dacheng'? It is merely a summary of accumulated efforts. Thus, I hope that people in the world, occasionally suffering from ailments, can understand clearly upon opening the book, thereby fully relieving themselves of reliance on physicians. How can one say that someone wielding a book cannot fully understand the horse's nature? Therefore, I detail my heartfelt struggles below, not daring to seek grand eloquence from great scholars, but simply adding Zhang Chu at the beginning.
In the fourth year of Kangxi, in the year Yisi, during the auspicious days of mid-autumn, Qi Kun, courtesy name Guangsheng, Imperial Physician of the Imperial Medical Bureau, recorded this.