大哉医乎。其来远矣。肇自开辟。厥初生民。有寿夭则有札瘥。有札瘥则有医药。故神
百草。黄帝注内经。伊芳尹作汤液。雷公制炮炙。与夫着书立言垂世者。若内经。其言深而要
其旨邃以宏。其考辩信而有征。实为医家之祖。下此则秦越人和缓者。缓独能知晋侯之膏
肓。而未有着述。惟越人所着八十一难经。则皆发明内经之旨。又下此则淳于意华佗。佗之
熊经鸱顾。固亦导引家之一术。至于刳腹背湔肠胃而去疾。则诚精于技矣。意之医状。司
马迁备志之。又下此则张机之金匮玉函经及伤寒诸论。诚千古不刊之妙典。第详于六气之所
伤。而于嗜欲饮食疲劳之所致者。略而不议。又下此则王叔和。篡岐伯华佗等书为脉经。叙
阴阳内外。辨三部九候。分人迎气口。条陈十二经络。洎夫三焦五脏六腑之病。最为着明。
又下此则巢元方病源候论。似不为无所见者。但论风寒。而不着湿热之篇。乃其失也。又下
此则王冰推五运六气之变。撰为天元玉策。周详切密亦人之所难。苟泥之。则局滞而不通矣
又下此则孙思邈王焘。思邈以绝人之识。操慈仁恻隐之心。其叙千金方翼。及粗工害人之
祸。至为愤切。后人稍闯其藩垣。亦足以其术鸣。但不制伤寒之书。或不能无遗憾也。焘
虽阐明外台秘要。所言症治方药灼灸之详。颇有所祖述。然谓针能杀生人。不能起死人者。
则一偏之见也。又下此则钱乙庞安时许叔微。叔微具在准绳尺寸之中。而无所发明。安时虽
能
出奇应变。而终未离于范围。二人皆得张机之粗者也。惟乙深造机之阃奥。而撷其精华。建
五脏之方。各随所宜。谓肝有相火。则有泻而无补。肾为真水。则有补而无泻。皆启内经之
秘。尤知者之所取法。奈世知乙之浅。其遗书散亡。由于阎孝忠所集居多。孝忠之意。初非
乙之本真也。又下此则上谷张元素。河间刘完素。睢水张从政。元素之与完素。虽设为奇梦
异人。以神其授受。实闻乙之风而兴起者焉。若从政则又宗乎完素者也。元素以古方今病决
不能相值。治病一切不以方故其书亦不传。其有存于今者。皆后来之所附会。其学则东垣李
杲深得之。杲推明内外二伤。而多注意于补脾土之设。盖以土为一身之主。土平则诸脏平矣
从政以汗吐下三法。风寒暑湿燥火六门。为医之关键。其治多攻利。不善学人杀人。完素
论风火之病。本内经论病机气宜一十九条。着为原病式。阐奥探微。有非大观官局诸医所可
仿佛究其设施。则不越攻补二者之间也。近代名医。若吴中罗益。沧州吕复。皆承东垣之余
绪。武林罗知悌。丹溪朱彦修。各挹完素之流风。又若台之朱佐。越之滑寿。慈溪王节斋
余杭陶节庵。吴郡薛立斋。咸有着述。未易枚举。嗟夫。自内经以来。医书汗牛充栋。不为
不多。盖医之有内经。犹儒道之六经。无所不备。后贤着述。若仲景东垣河间丹溪四子之说
可谓医书之全备。犹学庸论孟为六经之阶梯。不可缺者也。故曰外感法仲景。内伤法东垣
热病用河间。杂病用丹溪。然素问论病之因。本草着药之性。脉诀详症之原。运气法天之
候。一以贯之于内经。斯医道之大成。乃千古不易之定论。实为万世之师法矣。
医学真是伟大啊。它的起源非常久远。始于天地开辟之初，最初的人类诞生时，就有寿命长短和疾病瘟疫的区别。有了疾病瘟疫，就有了医药。所以神农氏尝百草（制定药物），黄帝注释《内经》，伊尹制作汤液（中药汤剂），雷公制定炮炙（中药加工）方法，以及那些著书立说流传后世的人，像《内经》这样，言辞深刻而精要，主旨深远且宏大，考证辨析真实且有依据，确实是医家的始祖。在此之后，有秦越人（扁鹊）和华佗。华佗独自能知晓晋侯病在膏肓（指病情深重难治），但没有留下著作。只有秦越人所著的《八十一难经》，都阐发了《内经》的宗旨。再往后，有淳于意和华佗。华佗的“熊经鸱顾”（模仿熊攀树、猫头鹰回顾的动作，即导引术），固然是导引家的一种技艺。至于剖开腹部、清洗肠胃以去除疾病，那确实是精通医术了。淳于意的医疗状况，司马迁详细地记载了它。再往后，有张机（张仲景）的《金匮玉函经》及伤寒诸论，确实是千古不可磨灭的经典妙典。只是详细论述了六气（风、寒、暑、湿、燥、火）所致的伤害，而对于嗜欲、饮食、疲劳等所致的问题，则简略而未加讨论。再往后，有王叔和，他编纂岐伯、华佗等人的书籍为《脉经》，叙述阴阳内外，辨别三部九候（切诊部位），区分人迎穴和气口穴的脉象，条理清晰地陈述十二经络，以及三焦、五脏、六腑的疾病，最为显著明确。再往后，有巢元方的《病源候论》，似乎并非没有见解。但只论述风寒，而没有湿热篇章，这是他的缺失。再往后，有王冰推演五运六气的变化，撰写成《天元玉册》，周详严密也是常人难以做到的。如果拘泥于此，就会局限停滞而不通达了。再往后，有孙思邈和王焘。孙思邈凭借超凡的见识，秉持慈仁恻隐之心，他在叙述《千金方》及其补遗，以及粗劣医生害人的祸患时，言辞极为愤慨急切。后人稍微窥探其门径，也足以凭借医术闻名。只是没有撰写关于伤寒的书籍，或许不能没有遗憾吧。王焘虽然阐明了《外台秘要》，其中关于症状治疗、方药、灼灸的详细记载，颇有祖述前人之处。然而他说针灸能杀死活人，却不能救活死人，这是一种偏颇的看法。再往后，有钱乙、庞安时、许叔微。许叔微具备标准规范，但没有新的发明。庞安时虽然能出奇制胜、随机应变，但最终未脱离常规范围。这两人都只是粗略掌握张机（张仲景）医术的人。只有钱乙深入探究张机的奥妙，汲取其精华，建立五脏的方剂，各自随宜而定。认为肝有相火（寄居于肝的命门之火），所以只泻不补；肾为真水（肾阴），所以只补不泻。这些都启发了《内经》的秘密，尤其值得高明者取法效仿。无奈世人只知道钱乙医术浅薄，他的遗书散失亡佚，大多由于阎孝忠所收集的内容居多。阎孝忠的本意，起初并非钱乙的真实原貌。再往后，有上谷的张元素、河间的刘完素、睢水的张从政。张元素与刘完素，虽然设定了奇梦异人的传说，以神化他们的传授，实际上是闻听钱乙之风而起兴学习的。至于张从政，又宗奉刘完素。张元素认为古方今病决不能相吻合，治病一概不拘泥于成方，所以他的书也没有流传下来。现在存留的，都是后来人的附会之作。他的学问，东垣的李杲深得其中精髓。李杲推明内伤和外伤两种病因，而多注重于补益脾土的设立。大概因为土（脾胃）是一身的主宰，土平则诸脏平和了。张从政以汗、吐、下三法，风、寒、暑、湿、燥、火六门，作为医学的关键。他的治疗多以攻伐利导为主，不善学习者用之会杀人。刘完素论述风火之病，本于《内经》论病机气宜一十九条，著作为《原病式》，阐发奥义探索微妙，不是大观官局诸医所能比拟的。究其施设，则不出攻补二者之间。近代名医，如吴中的罗益、沧州的吕复，都承袭东垣的余绪。武林的罗知悌、丹溪的朱彦修，各自汲取刘完素的流风。又如台州的朱佐、越地的滑寿、慈溪的王节斋、余杭的陶节庵、吴郡的薛立斋，都有著作，不易一一列举。唉！自《内经》以来，医书汗牛充栋，不算不多。大概医学有《内经》，就像儒家之道有六经，无所不备。后贤著作，如仲景、东垣、河间、丹溪四人的学说，可称为医书的完备，就像《学》《庸》《论》《孟》是六经的阶梯，不可缺少的。所以说：外感病效法仲景，内伤病效法东垣，热病使用河间，杂病使用丹溪。然而《素问》论述病的成因，《本草》记载药的性味，《脉诀》详述症的根源，运气法天时的气候，一贯贯通于《内经》。这医学道的大成，乃是千古不变的定论，实为万世的师法准则。
Medicine is truly great. Its origins are remote. It began with the creation of heaven and earth. In the early days of humanity, there were differences in longevity and mortality, and there were plagues and diseases. With plagues and diseases, there arose medicine and herbs. Thus, Shennong (Divine Farmer) tasted hundreds of herbs; the Yellow Emperor annotated the *Neijing* (Inner Canon); Yi Yin created decoctions (Tangye); Leigong formulated processing methods (Paozhi); and those who wrote books and established doctrines to pass down to posterity, such as the *Neijing*, whose words are profound yet essential, whose purport is deep and grand, whose examinations and distinctions are credible and evidenced, are indeed the ancestors of medical practitioners. Below them came Bian Que (Qin Yueren) and Hua Tuo. Hua Tuo alone could diagnose Duke Jing of Jin’s disease reaching the *gaohuang* (area beyond reach of acupuncture and moxibustion), but left no writings. Only Bian Que’s *Nan Jing* (Classic of Difficult Issues), consisting of eighty-one chapters, elucidated the principles of the *Neijing*. Further down came Chunyu Yi and Hua Tuo. Hua Tuo’s “bear swinging and owl gazing” (Xiongjing Chigu, a form of Daoyin/qigong exercise) was indeed one technique among daoyin practitioners. As for his surgeries involving opening the abdomen and washing out the intestines to remove disease, this was certainly mastery of skill. The medical cases of Chunyu Yi were fully recorded by Sima Qian. Below them came Zhang Ji (Zhang Zhongjing) and his *Jingui Yufan Jing* (Golden Casket Classic) and various treatises on Shanghan (Cold Damage). These are indeed immortal classics unalterable for millennia. However, they detail injuries caused by the six qi (wind, cold, summer-heat, dampness, dryness, fire) but briefly mention or omit those caused by desires, diet, and fatigue. Below them came Wang Shuhe, who compiled works by Qibo, Hua Tuo, etc., into the *Mai Jing* (Pulse Classic), describing yin and yang, interior and exterior, distinguishing the three positions and nine inspections (Sanbu Jiuhou), differentiating the Renying and Qikou pulses, systematically expounding the twelve meridians, and clarifying diseases of the Sanjiao, five zang organs, and six fu organs most distinctly. Below him came Chao Yuanfang’s *Bingyuan Houlun* (General Treatise on Pathogenesis and Manifestations of Diseases), which seemed not without insight. But it discussed wind and cold while lacking chapters on damp-heat, which was its flaw. Below him came Wang Bing, who deduced the changes of the Five Movements and Six Qi, composing the *Tianyuan Yuce*. His work was detailed and rigorous, difficult for others to match. If one adheres rigidly to it, it becomes restrictive and inflexible. Below him came Sun Simiao and Wang Tao. Sun Simiao, with extraordinary knowledge and a compassionate heart, wrote the *Qianjin Fang* (Thousand Golden Prescriptions) and its supplements, expressing indignation at the disasters caused by incompetent physicians. Later generations who glimpsed his methods could achieve fame through their skills. However, he did not write specifically on Shanghan, which might be considered a regret. Wang Tao, although he clarified the *Waitai Miyao* (Secret Essentials of the Outer Cabinet), detailing symptoms, treatments, prescriptions, and moxibustion, largely followed predecessors. Yet his view that acupuncture can kill living people but cannot revive the dead was a biased opinion. Below them came Qian Yi, Pang Anshi, and Xu Shuwei. Xu Shuwei adhered strictly to standards without significant innovation. Pang Anshi could respond ingeniously but remained within conventional bounds. Both merely grasped the basics of Zhang Ji’s teachings. Only Qian Yi delved deeply into Zhang Ji’s mysteries, extracting the essence, establishing formulas for the five zang organs tailored to specific needs. He posited that the Liver contains Ministerial Fire (Xianghuo), thus requiring draining rather than tonifying; the Kidney is True Water (Zhen Shui), thus requiring tonifying rather than draining. These insights revealed secrets of the *Neijing* and became models for experts. Unfortunately, later generations underestimated Qian Yi, leading to the loss of his original works, largely replaced by compilations by Yan Xiaozhong, which did not reflect Qian Yi’s true intent. Below them came Zhang Yuansu from Shanggu, Liu Wansu from Hejian, and Zhang Congzheng from Suiwater. Zhang Yuansu and Liu Wansu, though associated with miraculous dreams and divine transmission legends, actually rose to prominence inspired by Qian Yi’s style. Zhang Congzheng, in turn, followed Liu Wansu. Zhang Yuansu believed ancient formulas could not fit modern diseases, treating patients without relying on fixed prescriptions, so his own books did not survive. What remains today are later interpolations. His learning was deeply inherited by Li Gao (Dongyuan). Li Gao elucidated internal and external injuries, focusing heavily on tonifying Spleen Earth. Since Earth (Spleen/Stomach) is the master of the body, when Earth is balanced, all organs are balanced. Zhang Congzheng regarded sweating, vomiting, and purging as the three key methods, and wind, cold, summer-heat, dampness, dryness, and fire as the six categories, forming the core of medicine. His treatments often involved aggressive purgation; improper use could be fatal. Liu Wansu discussed wind and fire diseases based on the nineteen pathogenic mechanisms in the *Neijing*, writing the *Yuanbing Shi* (Original Causes of Disease), exploring profound meanings beyond what official hospital physicians could grasp. His methods generally fell between attacking and tonifying. Famous recent physicians include Luo Yi from Wuzhong and Lu Fu from Cangzhou, who inherited Dongyuan’s legacy. Luo Zhiti from Wulin and Zhu Danxi (Zhu Zhenheng) from Danxi drew upon Liu Wansu’s influence. Others such as Zhu Zuo from Taizhou, Hua Shou from Yue, Wang Jiezhai from Cixi, Tao Jian’an from Yuhang, and Xue Lizhai from Wujun also authored works, too numerous to list. Alas! Since the *Neijing*, medical books have been countless. Medicine with the *Neijing* is like Confucianism with the Six Classics—comprehensive. The works of Zhang Zhongjing, Dongyuan, Hejian, and Danxi represent the completeness of medical literature, akin to how the *Great Learning*, *Doctrine of the Mean*, *Analects*, and *Mencius* serve as ladders to the Six Classics, indispensable. Therefore, it is said: For exogenous diseases, follow Zhang Zhongjing; for endogenous injuries, follow Dongyuan; for febrile diseases, use Hejian’s methods; for miscellaneous diseases, use Danxi’s methods. However, the *Suwen* discusses causes of disease, Materia Medica records properties of herbs, Pulse Manuals detail origins of symptoms, and Climate-Luck theories align with heavenly patterns—all integrated within the *Neijing*. This represents the culmination of medical doctrine, an eternal truth for millennia, serving as a model for all ages.