某年某月。某地某人。年纪若干。形之肥瘦长短若何。色之黑白枯润若何。声之清浊长短若何。人之
形志苦乐若何。病始何日。初服何药。次后再服何药。某药稍效。某药不效。时下昼夜孰重。寒热孰多。
饮食喜恶多寡。二便滑涩无有。脉之三部九候。何候独异。二十四脉中。何脉独见。何脉兼见。其症或内伤。
或外感。或兼内外。或不内外。根据经断为何病。其标本先后何在。汗吐下和寒温补泻何施。其药宜用七方中
何方。十剂中何剂。五气中何气。五味中何味。以何汤名为加减和合。其效验定
于何时。一一详明。务令纤毫不爽。起众信从。允为医门矜式。不必演文可也。
某年者。年上之干支。治病先明运气也。某月者。治病必本四时也。某地者。辨高卑燥湿五方异宜也。
某龄某形某声某气者。用之合脉图万全也。形志苦乐者。验七情劳逸也。始于何日者。察久近传变也。历问
病症药物验否者。以之斟酌己见也。昼夜寒热者。辨气分血分也。饮食二便者。察肠胃乖和也。三部九
候。何候独异。推十二经脉受病之所也。二十四脉见何脉者。审阴阳表里无差忒也。根据经断为何病者。名正
则言顺。事成如律度也。标本先后何在者。识轻重次第也。汗吐下和寒温补泻何施者。求一定不差之法也。
七方大小缓急奇偶复。乃药之制。不敢滥也。十剂。宣通补泄轻重滑涩燥湿。乃药之宜。不敢泛也。
五气中何气。五味中何味者。用药最上之法。寒热温凉平。合之
酸辛甘苦咸也。引汤名为加减者。循古不自用也。刻效于何时
者。逐款辨之不差。以病之新久五行定痊期也。若是则医案之
在人者。工拙自定。积之数十年。治千万人而不爽也。
胡卣臣先生曰。此如条理始终。然智圣之事已备。
某年某月,某地某人。年龄多少。体型的肥瘦长短如何。肤色的黑白枯润如何。声音的清浊长短如何。人的形体与情志的苦乐状况如何。疾病始于哪一天。最初服用了什么药。之后又服用了什么药。哪种药稍微有效,哪种药无效。当下白天和黑夜哪个症状更重,寒证和热证哪个更多。饮食的喜好厌恶及食量多少。大小便的通利或涩滞情况如何。脉诊的三部九候中,哪一个部位特别异常。在二十四种脉象中,哪一种脉象单独出现,哪一种脉象兼见。其病症或是内伤,或是外感,或是内外兼有,或是不内外因。根据经典理论判断是什么病。其标本先后的关系在哪里。汗法、吐法、下法、和法、寒法、温法、补法、泻法分别如何施用。药物应当选用“七方”中的哪一方,“十剂”中的哪一剂,“五气”中的哪一气,“五味”中的哪一味。以何种汤名为基础进行加减合用。疗效确切定在何时。一一详细阐明,务必做到细微之处毫不差错,从而赢得众人的信任与遵从,确实成为医学界的典范准则。不必堆砌辞藻即可。
所谓“某年”,是指年份的天干地支,治病首先要明了五运六气的变化。“某月”,是指治疗必须顺应四季的变化。“某地”,是指辨别高下燥湿不同地域的五方适宜性。“某年龄、某体型、某声音、某气息”,是为了使用脉图以求万全。“形志苦乐”,是用来验证七情(喜、怒、忧、思、悲、恐、惊)和劳逸的影响。“始于何日”,是用来观察病程的久近和传变规律。“历问病症药物验否”,是用来斟酌自己的见解。“昼夜寒热”,是用来辨别气分和血分的病变。“饮食二便”,是用来察知肠胃的调和与否。“三部九候,何候独异”,是用来推究十二经脉受病的部位。“二十四脉见何脉者”,是用来审察阴阳表里没有差错。“根据经断为何病者”,是名称正确则言语顺当,事情处理如法律度量般准确。“标本先后何在者”,是识别轻重缓急的次序。“汗吐下和寒温补泻何施者”,是寻求一定不差的治疗方法。“七方”包括大、小、缓、急、奇、偶、复,这是药物的制剂规范,不敢滥用。“十剂”包括宣、通、补、泄、轻、重、滑、涩、燥、湿,这是药物的适宜分类,不敢泛用。“五气中何气,五味中何味者”,是用药的最高法则,寒、热、温、凉、平,配合酸、辛、甘、苦、咸。“引汤名为加减者”,是遵循古法而不擅自妄为。“刻效于何时者”,是逐条辨析不出差错,根据疾病的新久和五行生克来定痊愈期限。如果是这样,医案中的医生高明或拙劣自然显现,积累数十年,治疗千万人而不出差错。
胡卣臣先生说:这如同梳理事物的始终条理,然而智慧圣人的诊疗之事已经完备了。
In a certain year and month, in a certain place, for a certain person. What is the age? How are the body's fatness, thinness, length, and shortness? How are the complexion's blackness, whiteness, witheredness, and moistness? How are the voice's clarity, turbidity, length, and shortness? What is the state of physical and mental suffering or joy? On which day did the disease begin? What medicine was taken initially? What medicines were taken subsequently? Which medicine showed slight efficacy, and which showed no efficacy? In the present situation, which is more severe, daytime or nighttime? Is there more cold or heat? What are the preferences and aversions regarding diet, and the quantity consumed? Are urination and defecation smooth or obstructed? Among the three positions and nine inspections (Sanbu Jiuhou, a pulse diagnosis method involving multiple sites) of the pulse, which inspection is uniquely abnormal? Among the twenty-four pulse types, which pulse appears alone, and which pulses appear concurrently? Is the syndrome due to internal injury (Neishang), external contraction (Waigan), both internal and external, or neither internal nor external? Based on the classics, what is the diagnosed disease? Where lie the root (Ben) and branch (Biao), and their sequence? How should sweating (Han), vomiting (Tu), purging (Xia), harmonizing (He), cold (Han), warm (Wen), tonifying (Bu), and draining (Xie) methods be applied? Which formula from the "Seven Forms" (Qifang: Large, Small, Slow, Urgent, Odd, Even, Compound) should be used? Which agent from the "Ten Categories" (Shiji: Emetic, Purgative, Tonifying, Draining, Light, Heavy, Slippery, Astringent, Dry, Damp)? Which Qi from the "Five Qis"? Which Flavor from the "Five Flavors"? With which decoction name should modifications and combinations be made? When exactly will the efficacy be determined? Explain each point in detail, ensuring that not even the finest details are inaccurate, thereby gaining public trust and compliance, truly serving as a model for the medical profession. No need for rhetorical flourishes.
The term "certain year" refers to the Heavenly Stems and Earthly Branches of the year; treating diseases requires first understanding the movement of Five Yuns and Six Qi (Wuyun Liujia). The term "certain month" implies that treatment must be based on the Four Seasons. The term "certain place" involves distinguishing the suitability of the Five Directions regarding altitude, dryness, and humidity. "Certain age, certain body type, certain voice, certain Qi" are used in conjunction with pulse diagrams to ensure completeness. "Physical and mental suffering or joy" serves to verify the impact of the Seven Emotions (Qi Qing: Joy, Anger, Worry, Thought, Sorrow, Fear, Fright) and labor/rest. "Starting from which day" is to observe the duration and transmission/variation of the disease. "Asking about symptoms and whether previous medications were effective" is to deliberate one's own judgment. "Daytime and nighttime cold and heat" are to distinguish between Qi-level and Blood-level involvement. "Diet and excretion" are to inspect the harmony of the stomach and intestines. "Three positions and nine inspections, which is uniquely abnormal" is to deduce the location of disease in the Twelve Meridians. "Which of the twenty-four pulses appears" is to examine Yin and Yang, Exterior and Interior without error. "Diagnosing the disease based on the classics" ensures that correct naming leads to smooth expression and orderly conduct. "Where lie the root and branch, and their sequence" is to recognize the order of severity and priority. "How sweating, vomiting, purging, harmonizing, cold, warm, tonifying, and draining methods are applied" is to seek a precise and infallible method. The "Seven Forms" (Large, Small, Slow, Urgent, Odd, Even, Compound) constitute the preparation of medicines, preventing abuse. The "Ten Categories" (Emetic, Purgative, Tonifying, Draining, Light, Heavy, Slippery, Astringent, Dry, Damp) constitute the appropriateness of medicines, preventing indiscriminate use. "Which Qi from the Five Qis, which Flavor from the Five Flavors" represents the highest principle of medication, combining Cold, Heat, Warmth, Coolness, and Neutralness with Sour, Acrid, Sweet, Bitter, and Salty. "Citing decoction names for modification" follows ancient traditions without arbitrary innovation. "Specifying when efficacy occurs" involves item-by-item analysis without error, determining the recovery period based on the novelty/chronicity of the disease and the Five Elements. If this is done, the skill or lack thereof of the physician in the medical case is self-evident; accumulated over decades, treating thousands without error.
Mr. Hu Youchen said: This is like sorting out the beginning and end systematically; thus, the affairs of the wise and sage are fully prepared.