夫医者意也,谓以己之意迎合伊芳之病也。故善医者必待望闻问切而后详理开方,此古今
一定不易之理也。盖幼稚小儿,天真浑噩,无识无知,肌肉莹澈,脉络分明。其病不过风寒
暑湿燥火,饮食停聚而已,举目可见。岂如壮者之人或因酒色过度,或由思虑受伤之纷纭杂
沓,难为措手哉。故观其面色,闻其啼声,即可知其病之所从来,与夫药之所宜用,而无毫
厘或爽也。无如世之庸医,不察夫体属婴孩,一染微 ,并不细心体贴,概以惊风险剂投之
,往往有误。不知实而误补,不过增病,虚而误攻,不可救药,故全生者少而垂毙者多矣。
王君亚拙,医道高明,慈爱为怀,不殚劳瘁,合选古今方而斟之酌之,汇为一册。适予过访
,蒙以见示。见其理精法密,指点亲切,较诸幼科所传方书,倍加详明透彻,亟劝其付诸枣
梨,以公诸世。将见此书一出,可以指庸医之迷,延幼稚之命,其为益岂浅鲜哉,是为叙。
时道光二十七年岁次丁未桂月朔日江阴廪生杜价禄宾五氏拜序
鑫曩者从事觉来先生有年,倏一日问于先生曰∶医书以幼科为哑科,谓其有疾,不能自
言也,岂不难乎?先生曰∶夫幼子者精神未受七情六欲之攻,脏腑未经八珍五味之渍,投之
以药,易为见功,犹膏粱之变难穷,而藜藿之腹易效也,有何难哉。但今之医,见小儿烧热
,未审关纹浮沉,悉用表药以汗之;睹稚子号啼,不按胸腹强弱,尽行消药以攻之。不知胎
婴元气微薄,用药一误,变证百出矣,可不慎乎?继而训曰∶凡看小儿先观元气浓薄,手探
口息寒热,次察唇舌润燥,再看关纹色气,问其饮食二便,方才酌方调治,庶不有误。余体
先生之训,不敢自私。至于暇日,将历来幼科善本,摘其切实认证之法,选其当要历验之方
,每证之下,专变阴阳诸方之中,悉论虚实,故颜之曰《幼科切要》。意欲公诸同人,使穷
乡僻壤得见是篇。见小儿有恙,轻者不必求医,病重者不为医误。能读而习之,终身知医。
奈历年来 务鞅掌,有志未逮。迄丁未余客渝城,幸遘傅君怡如、艾君顼堂、邱君东山并坐
谈心,与言及此,遂毅然有倡助之意,实先得我心之所同,然者遂将诸科亦同付之剞劂。不
数月书成,惟冀四方乐善君子,广为印布,于保赤子之意,不无小补,庶不负觉来先生训诲
之心,而诸公公世之忱,亦不致湮没矣,是为序。
时道光二十七年丁未岁桂月朔日鱼泉王锡鑫亚拙氏谨识
【杜价禄序】
医生行医靠的是“意”,即用医生的思维去契合患者的病情。所以,善于治病的医生,必定在仔细观察、听声音、询问病史和切脉之后,再详细分析病机并开具处方,这是古今不变的道理。
因为年幼的孩童,天真烂漫,没有世俗的见识,肌肉透明,脉络清晰可见。他们的疾病不过是风寒暑湿燥火六淫侵袭,或是饮食停滞积聚罢了,一眼就能看出来。哪里像成年人那样,有的因为酒色过度,有的因为思虑过度导致身心受损,病情纷繁复杂,难以着手治疗呢?因此,观察孩子的面色,听他们的哭声,就可以知道病因所在以及适宜使用的药物,不会有任何差错。
无奈世间庸医,不考察患者是婴幼儿这一特点,一旦染上轻微的风邪,并不细心体贴病情,一概使用惊风类的猛烈药剂投喂,往往造成误治。不知道实证误用补法,只会增加病痛;虚证误用攻伐之法,则会导致不可救药的局面,所以保全生命的少,濒临死亡的多了。
王亚拙先生,医术高明,心怀慈悲,不辞辛劳,搜集古今方剂加以斟酌筛选,汇编成一册。恰逢我拜访他,他蒙惠展示给我看。见其理论精妙、方法严密,指点亲切,比市面上流传的儿科方书更加详细明了透彻,于是极力劝他刻印出版,以公之于众。预计这本书一出,可以指明庸医的错误,挽救幼儿的生命,其益处难道不大吗?为此作序。
道光二十七年(丁未年)农历八月朔日,江阴廪生杜价禄宾五氏拜序
【王锡鑫自序】
我早年跟随觉来先生学习多年,有一天我问先生:“医书中认为儿科是‘哑科’,说孩子生病不能自己说话,这难道不是很难吗?”先生说:“幼儿的精神尚未受到七情六欲的侵害,脏腑未曾被八珍五味所浸渍,给他们用药,容易见效,就像富贵人家饮食变化多端难调理,而贫苦人家粗茶淡饭反而容易见效一样,有什么难的?只是现在的医生,看到小儿发热,不审察指纹的浮沉,一律用解表药发汗;看到小孩啼哭,不按揉胸腹判断强弱,一律用消导药攻下。不知道胎儿婴儿元气薄弱,用药一旦失误,就会变证百出,能不谨慎吗?”接着教导我说:“凡是诊治小儿,先观察元气的浓薄,用手探摸口鼻气息的寒热,其次察看嘴唇舌头的润燥,再看食指络脉(关纹)的颜色气色,询问饮食和二便情况,然后才斟酌处方调治,这样才不会出错。”
我体会先生的教诲,不敢独自私藏。于是在闲暇之日,将历来儿科善本中切实有效的辨证方法摘录出来,选取重要且经过验证的方剂,在每个病症之下,专门辨析阴阳诸方中的虚实情况,所以将此书命名为《幼科切要》。意图将其公之于同好,使偏远乡村也能见到这篇著作。看到小儿有病,轻症不必求医,重症不被医生误治。如果能阅读并学习它,终身懂得医术。
无奈多年来事务繁忙,有志向却未能实现。直到丁未年我客居重庆,有幸遇到傅怡如、艾顼堂、邱东山诸位先生坐在一起谈心,谈及此事,他们毅然表示愿意资助刊印,这确实符合我们共同的心愿,于是决定将各科内容一并交付刻印。不到几个月书就编成了,只希望四方乐善的君子广泛印刷散布,对于保护赤子的初衷,或许会有小小的补充,这样才不辜负觉来先生的教诲之心,也不让各位先生公之于世的诚意被埋没,为此作序。
道光二十七年(丁未年)农历八月朔日,鱼泉人王锡鑫亚拙氏谨识
[Preface by Du Jialu]
The practice of medicine relies on "Yi" (mental perception/intuition), meaning the physician must use their cognitive judgment to align with the patient's condition. Therefore, a skilled physician must always observe, listen, inquire, and palpate before carefully analyzing the pathology and prescribing a formula; this is an unchanging principle from ancient times to the present.
This is particularly true for young children, who are innocent and unworldly, lacking worldly knowledge. Their muscles are translucent, and their meridians are clearly visible. Their illnesses are merely due to the invasion of the six pathogenic factors—wind, cold, summer-heat, dampness, dryness, and fire—or the stagnation of food intake, which can be seen at a glance. How can they compare to adults, whose conditions may be complicated by excesses in alcohol and sexual activity or injuries from excessive mental worry, presenting a chaotic array of symptoms that are difficult to address? Thus, by observing the child's facial complexion and listening to their crying sounds, one can determine the origin of the disease and the appropriate medications to use, without the slightest error.
Regrettably, mediocre physicians in the world fail to consider that the patient is an infant. Upon contracting even a slight wind-pathogen, they do not carefully empathize with the condition but instead indiscriminately administer harsh medicines intended for convulsions (Jing Feng), often causing misdiagnosis and mistreatment. They do not realize that treating excess syndromes with tonification only increases the illness, while attacking deficiency syndromes leads to incurable states. Consequently, few survive, while many approach death.
Mr. Wang Yazhuo possesses profound medical skills and a compassionate heart. He spared no effort in laboriously selecting and refining formulas from both ancient and modern sources, compiling them into a single volume. When I visited him, he graciously showed it to me. I found its principles refined and methods rigorous, with guidance that was intimate and clear. Compared to pediatric texts circulating in the market, it was significantly more detailed, lucid, and thorough. I strongly urged him to have it woodblock printed and made public. It is anticipated that once this book is published, it will expose the delusions of mediocre physicians and extend the lives of infants; its benefits would surely be immense. This serves as the preface.
On the first day of the eighth lunar month in the year Dingwei (1847), Du Jialu, courtesy name Binwu, a government-supported scholar (Linsheng) from Jiangyin, respectfully wrote the preface.
[Autobiographical Preface by Wang Xixin]
In my early years, I studied under Master Juelai for several years. One day, I asked him, "Medical texts regard pediatrics as the 'mute department' because sick children cannot speak for themselves. Is this not extremely difficult?" The master replied, "Infants' spirits have not yet been assaulted by the seven emotions and six desires, nor have their zang-fu organs been soaked by rich foods and flavors. Medications administered to them yield results easily, just as changes in the diet of the wealthy are hard to predict, whereas the stomachs of those eating coarse vegetables respond readily. What difficulty is there? However, current physicians, seeing fever in children, fail to examine the floating or sunken nature of the finger vein (Guan Wen), using all surface-releasing medicines to induce sweating; seeing infants cry, they do not palpate the chest and abdomen to assess strength, resorting entirely to digestive-purgative medicines to attack. They fail to know that fetal and infant primal qi is thin and weak; a single error in medication can lead to a hundred variable manifestations. Can one not be cautious?" He then instructed, "When examining a child, first observe the density or thinness of their primal qi, feel the temperature of breath from the mouth and nose with your hand, next inspect the moisture or dryness of the lips and tongue, then look at the color and qi of the Guan Wen (finger vein), ask about diet and urination/defecation, and only then deliberate on the prescription for treatment. This way, errors will be avoided."
I internalized my master's instructions and dared not keep them private. During my leisure time, I excerpted practical methods for syndrome differentiation from reputable pediatric texts and selected important, frequently verified formulas. Under each syndrome, I specifically discussed the yin-yang aspects and the deficiency-excess nature within various formulas. Hence, I titled this book *Youke Qieyao* (Essentials of Pediatrics). My intention was to make it available to colleagues so that people in remote villages could see it. Seeing a child ill, mild cases need not seek a doctor, and severe cases will not be mistreated. Those who read and study it will understand medicine for life.
However, burdened by official duties over the years, I had the ambition but lacked the opportunity. Until the year Dingwei, when I was staying in Yucheng (Chongqing), I fortunately met Mr. Fu Yiru, Mr. Ai Xutang, and Mr. Qiu Dongshan. Sitting together chatting, we discussed this matter, and they resolutely expressed willingness to sponsor its publication. This truly resonated with our shared sentiments. Thus, we decided to submit the contents of various departments to the engraver. Within a few months, the book was completed. I only hope that benevolent gentlemen everywhere will widely print and distribute it. This may offer a small contribution to the preservation of infants, thereby honoring Master Juelai's heart of teaching and ensuring that the sincerity of the gentlemen in making it public is not lost. This serves as the preface.
Respectfully recorded by Wang Xixin, courtesy name Yazhuo, from Yuquan, on the first day of the eighth lunar month in the year Dingwei (1847).