甚矣,吾道之不孤也。沪上行医人多于鲫,然求其精通三坟五典绩学之士,惜焉罕觏。
良以频年兵火灾 ,致入山之吏、失幕之儒为饥驱所迫,略知汤头本草,陡然大胆悬壶。世有以
耳代目之俦,乐为揄扬,十失三四,偶尔徼幸时髦,遂以成名。以此例彼,皆因成本尚轻
,不惜以医为市,遑论利害死生。性命攸关,出必高车驷马,俨然医界万能,询以《素问》
、《灵枢》、《难经》、《金匮》、《外台》、《千金》、《神农本草》、《太素》、《脉经》、《巢氏病源》、
《圣济总录》、《王氏准绳》、《医宗金鉴》,以及前后四大名家诸先贤医学薪 传,乃瞠乎其
目,曰现下新法,勿用旧方,趁我十年运,有病早来医而已。从此医倪莫别,男妇不分,无
怪癸丑岁刘、汪两教育部长有废弃中医之议。咏曾仕山东,岁庚子拳匪滋扰京师时,项城袁
大帅开府齐鲁统领武卫全军驻此,缘其生母刘太夫人病亟,经徐大军医长华清等六十人轮流
进院调治,医药无功,帅心焦急,乃邀胡方伯景桂潘廉访延祖两司上院商榷,于同僚中可有
知医者否。两司以咏暨陕西张兰洲封翁举荐,经姜军门桂题劝进服咏拟方,一药顿瘳,神乎
技矣。兄世廉、弟世辅互相为之骇愕(方案曾登上海医报)。嗣即奉委步卫军粮台差使。回忆
日武卫同辈,半多民国伟人,亦幸事也。有此原因,民国二年,沪上诸同志发起神州医药总会
,公举咏为文牍员,明知滥竽充数,然尝闻顾亭林先生有言∶国家兴亡,匹夫有责。当仁不
让,聊尽义务。废弃中医之议起,适大总统府内秘书长阮斗瞻旧友忠枢衔命南来,调和张冯
对调事宜。 帷暂驻南京四象桥湖楚军械所,咏乃趋谒南京寓门帘桥广陵春旅馆守候四天晚
上,始见面,将公订申办理由五端呈览。阅竣,回言∶甚好,此事废不了。咏即切恳云∶苟
能转圆,为苍生一线生机,公乃万家生佛也。告辞返沪,次年春奉大总统发下政务院第三十
五号命令,会长余德埙等原呈批谕中有初非有废弃中医之意也句,得达目标不废,咏以年老
力衰,文牍非我所能为,就此卸肩告辞。此举多阮君斡旋之力。而中医所以不废者,要各有
其渊源,并非中医竟若牛溲马勃,用药投机,亦可赏鉴乎。宗工寒家医学溯自唐都察院,竹
隐公避居苕濠,藉医济世,代有传人,入志乘者不鲜。咏为先胞伯晓五公第七弟子侍诊十年
,其时就诊者户限几穿,门墙甚盛,见多识广,济以经书,知认证当以阴阳寒热表里虚实八
字辨
别的确,方可称为有道之士。更于一发千钧之际,能下重剂,希冀转危为安,斯即道德犹存
,仁人之术,医所以寄死生,半积阴功,半养身,谈何容易。若以之谋利,因循误事,则其
心不可问矣。沪上医家林立,不乏专长,先府君嘉六公及咏尤以妇女科鸣于市,社会信用幸
尚不恶,古者扁鹊自称带下医,《金匮》书中载有古人列经脉为病三十六种,皆谓之带下病
,非今人所谓赤白带下也。至其阴阳虚实之机,针药安危之故,苟非医者辨之有素,乌能施
之而无误耶?三十六病者,如十二 、九痛、七害、五伤、三痼是欤。后贤群起,又有一百
八病之论,总之妇女病有与男子不同者,盖有冲任督带阴阳跷维、奇经八脉之辨别,病由
斯致为多。先哲且云∶崩中日久为淋带,漏下多时骨髓枯。故有“宁治十男子,莫治一妇人
”之诫,而乌 雀卵经籍载有专方。盖以妇女病有种种隐情难以形容者,在言传意会,固非
人人可学也。若杂乱无章,莫衷一是,何从何去,端赖发明。是以先府君嘉六公心焉伤之,
乃纂辑诸大名家要义,名曰《女科折衷纂要》,经胞兄先师晓五公鉴定,咏妄参末议,不揣
谫陋,详加引注。孟子曰∶人之患在好为人师。所以先府君只收梁溪李澹平君燮一徒而已,
斯稿本作子孙师范模型简易楷则不敢问世,兹承越中裘君吉生暨社中诸同仁,有流传遗稿之
求,发刊凌氏医学遗书之议,爰将先府君嘉六公德采入《上海县志》艺文游宦类诸遗稿邮
呈斧政,曷敢自秘,公诸同好,瑜瑕不计,要使后学率循有自,简练揣摩,方知妇女科中有
此一苇慈航,未始不可宝庆耳。
藏庚申上丁祭孔日,安吉凌咏言医叟谨识于上海乔居寿世堂之尚素轩,时年七十有二
太伟大了,我的医学之道并不孤单。在上海行医的人多如鲫鱼,然而寻求那些精通“三坟五典”(泛指古代深奥典籍)且学问扎实的医生,可惜很难见到。
这是因为连年战乱和火灾,导致隐居山林的官吏、失去幕僚职位的儒生被饥饿驱使,稍微懂得一些汤头歌诀和本草知识,就大胆地悬壶济世。世间有以耳代目之辈,乐于吹捧宣扬,十次诊疗中有三四次失误,偶尔侥幸迎合时尚,便以此成名。以此类推,都是因为成本尚轻,不惜将医学当作市场交易,哪里还顾得上利害关系和生死存亡。性命攸关之事,出门必坐高车驷马,俨然一副医界万能的样子,若询问《素问》、《灵枢》、《难经》、《金匮要略》、《外台秘要》、《千金方》、《神农本草经》、《太素》、《脉经》、《诸病源候论》、《圣济总录》、《医宗必读》、《医宗金鉴》,以及前后四大名家等先贤医学传承,他们则瞪大眼睛茫然无知,说道:“现在的新方法,不用旧方子,趁着我这十年运气好,有病早点来医治罢了。”从此医道混乱不分,男女病症混淆,难怪癸丑年(1913年)刘、汪两位教育部长提出废除中医的议案。
我曾任职山东,在庚子年(1900年)拳匪滋扰京城时,项城袁大帅(袁世凯)在齐鲁开设府署统领武卫全军驻扎于此,因其生母刘太夫人病情危急,经过徐大军医长华清等六十人轮流入院调治,医药无效,元帅心中焦急,于是邀请胡方伯景桂、潘廉访延祖两司上院商议,在同僚中是否有懂医术的人。两司推荐了我以及陕西张兰洲封翁,经由姜军门桂题劝服服用我拟定的药方,一服药便痊愈,神奇至极啊!兄长世廉、弟弟世辅对此感到惊愕(方案曾刊登于上海医报)。随后我便奉命担任步卫军粮台的差事。回忆当时武卫同辈,多半成为民国伟人,也是一件幸事。
由于有此原因,民国二年(1913年),上海各位同志发起成立神州医药总会,公举我为文牍员,明知自己是滥竽充数,但曾听说顾亭林先生有言:“国家兴亡,匹夫有责。”当仁不让,姑且尽一份义务。废除中医的议案兴起时,适逢大总统府内秘书长阮斗瞻(阮忠枢)旧友衔命南来,调和张勋与冯国璋对调事宜,暂时驻在南京四象桥湖楚军械所。我前往南京寓所门帘桥广陵春旅馆守候四天晚上,才得以见面,将公订申办理由五端呈览。阅毕,他回话说:“很好,此事废不了。”我随即恳切地说:“如果能转圜成功,为苍生留下一线生机,您就是万家生佛啊。”告辞返回上海,次年春奉大总统发下政务院第三十五号命令,会长余德埙等人的原呈批谕中有“初非有废弃中医之意也”一句,得以达成不废除的目标。我以年老力衰,文书工作非我所擅长,就此卸任告辞。此举多亏阮君斡旋之力。而中医之所以没有被废除,关键在于各有其渊源,并非中医竟像牛溲马勃(比喻微贱无用之物)那样,用药投机取巧,就可以被赏识鉴赏吗?
我家医学追溯自唐代都察院,竹隐公避居苕濠,凭借医术救济世人,代代有传人,载入地方志的不鲜见。我是先胞兄晓五公的第七弟子,侍诊十年,那时就诊者门槛几乎被踏破,门庭甚盛,见多识广,辅以经书知识,知道辨证应当以阴阳、寒热、表里、虚实八字辨别确切,才可称为有道之士。更在于一发千钧之际,能下重剂,希冀转危为安,这就是道德犹存,仁人之术,医学寄托着生死,一半积阴功,一半养身,谈何容易。如果用来谋利,因循守旧误事,那他的心肠就不堪设问了。
上海医家林立,不乏专长,先父嘉六公和我尤其以妇女科闻名于世,社会信用尚且不坏。古时候扁鹊自称带下医,《金匮要略》书中记载古人列经脉为病三十六种,都称之为带下病,并非今人所谓的赤白带下。至于其阴阳虚实的机理,针药安危的缘故,如果不是医者平时辨析有素,怎么能施治而无误呢?三十六病,如十二瘕、九痛、七害、五伤、三痼是这类吧。后贤群起,又有一百零八病的论述,总之妇女病有与男子不同的地方,大概因为有冲任督带、阴阳跷维、奇经八脉的辨别,病由此导致居多。先哲曾说:“崩中日久为淋带,漏下多时骨髓枯。”所以有“宁治十男子,莫治一妇人”的告诫,而且乌喙雀卵等经籍载有专方。因为妇女病有种种隐情难以形容,在言传意会之间,固非人人可学。若杂乱无章,莫衷一是,从何而去,端赖发明。因此先父嘉六公为此伤心,于是编纂辑录各位大名家要义,名为《女科折衷纂要》,经胞兄先师晓五公鉴定,我妄加参与末议,不顾浅陋,详细加以引注。孟子说:“人的毛病在于喜欢做别人的老师。”所以先父只收梁溪李澹平君燮一个徒弟而已,这份稿子本作为子孙师范模型简易楷则,不敢问世,如今承蒙越中裘君吉生及社中各位同仁,有流传遗稿的请求,发起刊印凌氏医学遗书的议论,于是将先父嘉六公德行采入《上海县志》艺文游宦类,并将诸遗稿邮呈斧正,怎敢自私自秘,公之于同好,不论瑜瑕,要使后学者遵循有自,简练揣摩,方知妇女科中有这一叶慈航,未始不可以宝贵庆祝耳。
藏庚申年(1920年)上丁祭孔日,安吉凌咏言医叟谨识于上海乔居寿世堂之尚素轩,时年七十有二。
It is truly great that my medical Dao (Way of Medicine) is not alone. There are as many doctors practicing in Shanghai as there are carp, yet it is rare to find those who have mastered the "San Fen Wu Dian" (a term referring to ancient profound classics) and possess substantial learning.
This is largely due to years of war and fire disasters, which forced officials living in seclusion and scholars who had lost their positions into poverty. Having merely learned some herbal formulas and materia medica, they boldly began practicing medicine. There are those in society who rely on hearsay rather than observation and are eager to praise such practitioners. With three or four errors out of ten treatments, occasional luck and catering to trends allow them to gain fame. By analogy, this is because the cost is low, and they do not hesitate to treat medicine as a market commodity, disregarding consequences, benefits, harms, life, and death. When lives are at stake, they travel in high carriages with four horses, acting as if they are omnipotent in the medical field. If asked about the *Suwen* (Basic Questions), *Lingshu* (Spiritual Pivot), *Nanjing* (Classic of Difficult Issues), *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), *Waitai Miyao* (Secret Essentials of the Outer Terrace), *Qianjin Fang* (Prescriptions Worth a Thousand Gold), *Shennong Bencao Jing* (Divine Farmer's Materia Medica), *Taisu*, *Maijing* (Pulse Classic), *Chushi Bingyuan* (Source of Diseases by Master Chao), *Shengji Zonglu* (General Records of Sacred Relief), *Yizong Bixiu* (Medical Master's Essential Readings), *Yizong Jinjian* (Golden Mirror of Medicine), as well as the medical heritage of the Four Great Masters and other sages, they stare blankly and say, "Use new methods now, do not use old prescriptions; take advantage of my ten-year fortune, come see me early when sick." Thus, medical standards become confused, distinctions between male and female patients are blurred, and no wonder Ministers of Education Liu and Wang proposed abolishing Traditional Chinese Medicine (TCM) in the year Guichou (1913).
I once served in Shandong. In the year Gengzi (1900), during the Boxer Rebellion's disturbance of the capital, Marshal Yuan Shikai from Xiangcheng established his headquarters in Qilu, commanding the entire Military Guard. Because his biological mother, Lady Liu, was critically ill, sixty physicians including Chief Physician Xu Huaqing treated her in rotation without success. The Marshal was anxious and invited Governors Hu Jinggui and Pan Yanzu to discuss whether any of his colleagues knew medicine. They recommended me and Mr. Zhang Lanzhou of Shaanxi. General Jiang Guidi persuaded the Marshal to try the prescription I formulated. One dose cured her instantly; the skill was miraculous! My brother Shilian and younger brother Shifu were astonished (the prescription was published in the *Shanghai Medical Journal*). Subsequently, I was appointed to the position of Quartermaster for the Infantry Guard. Looking back, many of my contemporaries in the Military Guard became great figures of the Republic of China, which is fortunate.
For this reason, in the second year of the Republic of China (1913), colleagues in Shanghai initiated the establishment of the Divine Land Medical Association and elected me as the clerk. Although I knew I was filling a spot unqualifiedly, I recalled Mr. Gu Tinglin's words: "The rise and fall of the nation concerns every common man." I could not decline responsibility and chose to fulfill my duty. When the proposal to abolish TCM arose, Ruan Zhongshu, an old friend and Secretary-General of the President's Office, came south on a mission to mediate the swap between Zhang Xun and Feng Guozhang. He temporarily stayed at the Huchu Arsenal near Six Elephant Bridge in Nanjing. I waited at the Guanglingchun Hotel near Menlian Bridge in Nanjing for four nights before finally meeting him. I presented five reasons for our application. After reading, he replied, "Very good, this matter cannot be abolished." I earnestly said, "If you can turn things around, providing a ray of hope for the people, you will be the Buddha born to ten thousand families." Upon returning to Shanghai, in the spring of the following year, Order No. 35 of the State Affairs Council issued by the President included the phrase in the approval of President Yu Dexun's petition: "There was initially no intention to abolish TCM." We achieved our goal of non-abolition. Due to my advanced age and declining strength, I felt clerical work was beyond my capability, so I resigned. This outcome relied heavily on Mr. Ruan's mediation. The reason TCM was not abolished is that it has its own origins; it is not that TCM is like "cow urine and horse fungus" (metaphors for worthless things) where opportunistic prescribing can be appreciated.
My family's medical lineage traces back to the Tang Dynasty Censorate. My ancestor Zhu Yin Gong retreated to the Hao River area and used medicine to benefit the world, with successors continuing through generations, many recorded in local gazetteers. I was the seventh disciple of my elder brother, Xiao Wu Gong, serving as an attendant physician for ten years. At that time, the threshold of our clinic was nearly worn through due to the crowd; we saw much and knew widely, supplemented by classical texts. We understood that syndrome differentiation must be accurately identified using the eight characters: Yin-Yang, Cold-Heat, Exterior-Interior, and Deficiency-Excess, to be considered a skilled practitioner. Furthermore, at critical moments, one must dare to administer heavy doses to hope for turning danger into safety. This preserves morality and represents the art of benevolent people. Medicine entrusts life and death; half is accumulated hidden merit, half is self-cultivation. How easy is it? If used for profit, leading to negligence and failure, one's heart would be unfathomable.
Shanghai is filled with doctors, many with specialties. My father, Jia Liu Gong, and I were particularly famous in Gynecology. Our social credit was generally acceptable. In ancient times, Bian Que called himself a specialist in women's diseases (Daixia Yi). The *Jingui Yaolue* records that ancients listed thirty-six types of diseases related to meridians, all termed Daixia Bing (women's diseases), which does not refer to the modern concept of leukorrhea (red and white discharge). Regarding the mechanisms of Yin-Yang deficiency and excess, and the safety of acupuncture and herbs, unless a physician distinguishes them proficiently, how can treatment be error-free? The thirty-six diseases include twelve masses, nine pains, seven harms, five injuries, and three chronic conditions. Later scholars proposed theories of one hundred and eight diseases. In short, women's diseases differ from men's, largely due to the differentiation of the Chong, Ren, Du, Dai meridians, Yin-Yang Qiao Wei vessels, and the Eight Extraordinary Vessels; most illnesses arise from these pathways. Sages stated: "Leukorrhea results from prolonged metrorrhagia; prolonged uterine bleeding dries up the bone marrow." Hence the warning: "Better to treat ten men than one woman." Ancient texts contain specific prescriptions for this. Women's diseases involve subtle circumstances hard to describe, requiring intuitive understanding, which is not learnable by everyone. If chaotic and inconsistent, guidance is needed. Therefore, my father Jia Liu Gong was distressed and compiled essential points from major masters, naming it *Nuke Zhezhong Zuanyao* (Compendium of Gynecological Synthesis). It was authenticated by my elder brother and teacher, Xiao Wu Gong. I presumptuously added notes, disregarding my own shallowness. Mencius said: "The fault of man lies in his liking to instruct others." Thus, my father only accepted one disciple, Li Danping of Liangxi. This manuscript was originally intended as a model for descendants, simple and standard, not for publication. However, urged by Mr. Qiu Jisheng from Yuezhong and colleagues to circulate the legacy, and proposing to publish the Ling Family Medical Legacy, I submitted my father's biography to the *Shanghai County Gazetteer* under Literature and Official Service, along with the manuscripts for correction. I dare not keep them secret but share them with enthusiasts, regardless of flaws, hoping future students will have a guide to follow, study concisely, and realize that within Gynecology lies this boat of compassion, worthy of preservation and celebration.
Recorded respectfully by Ling Yongyan, the Medical Elder of Anji, on the Shangding day of the Confucius Memorial Sacrifice in the year Gengshen (1920), residing at Shangsu Studio, Shoushitang, Shanghai, aged seventy-two.