医之有案, 于史传,附载于诸子百家,所以纪治验、彰学术也。降及近世,乃多专刻,若喻氏嘉言、徐氏
洄溪、王氏孟英等,皆扼其要略,作为论断。至以完全方案刊行者,惟叶氏临证指南。夫叶氏天姿明敏,
见解超脱,治案颇多可采,然肤浅通套,实开后世庸流简便之门,耳食之士,奉为掌中珠、枕中秘,晚近
叶派之称,毁誉盖参半焉。先生于是书尝三购而三焚之,其高尚之志趋,即此可见一斑。然则医案之
刻,非先生志也。曰、不然。先生以毕世精神,消耗于延医之事,常思老而退休,本生平之阅历,专心着述。
天不假年,未遂厥志,著作阙如。行道而未暇明道,诚憾事也。然先生之诊病也,必先澄心凝虑,而后下
笔立案,故本经论以抒心得,隐微曲折之处,实足发前人所未及发,言众人之不能言,论证既精,处方
更确,议病议药,一以贯之,行道在是,明道在是,断非抄袭敷衍陈陈相因之方案所可比拟,讵能任其
湮没而不传哉。涵负笈先生门,尚在锡邑,两阅寒暑,亲炙无多,存有方案论说若干卷。后邵正蒙君从
游沪上,抄得巨册携归示涵,读之狂喜雀跃,以为可法传之稿,具在于是。茫茫数载,正蒙君已仙化,稿
交郭级 君珍藏什袭。丙辰秋,涵与郭君谋公诸世,郭君欣然出稿,爰重行检阅,分类排比,两载告成,
付之剞劂,其中缺点,尚祈诸同学有道者匡正焉。民国七年戊午秋受业吴文涵敬识
戊午长夏,张氏医案排印将蒇事,追维钞辑之始及其成功,而不禁有余慨焉。泰幼侍先君读,先君尝
与人谈医,亟称聿青先生审病之精、处方之当不置,以吾乡就诊先生,获睹其方案也。岁甲午,先君弃
养,遗命从子安家叔习医,居常欲搜求张氏案而不得。既而同里邵先生正蒙受业张氏门下,曾致书
同门,征集方案谋汇刊,搜罗特广。讵丙午春邵公谢世,事遂寝,稿本托泰收藏。叶先生立庵儒而好医,
下榻邵氏,尝手录此稿,谓泰宜相机刊印。尘事牵迫,未有宁晷。越十年丙辰,赴常熟晤吴先生玉纯谈
刊案事。乃云与邵公有宿约,时谋付刊,乏同志赞助耳。泰闻言欣然,怂涌即出原稿,由吴先生详加编
次,泰任誊正之责。恐藏稿尚非全豹,邮函四达,借阅增补,冀成完璧,应之者有包君镜澄、张君绍曾。泰
与吴先生邮筒往还越两载,始告厥成。今春复由吴先生付印出版,一切手续,独任其难,热忱毅力,洵
为当今希有。顾溯编钞至今阅十余年,商印成书又三四年,其迟迟也如是,因慨天下事之类此者不
少矣。至是编之手眼高妙,蹊径独开传序已详言之,兹不赘。
后学江阴郭汇泰谨跋
医生留下的医案,在史传中,附载于诸子百家的著作里,是用来记录治疗验证、彰显学术成果的。到了近代,则多有专门刻印的医案集,如喻嘉言(喻昌)、徐洄溪(徐大椿)、王孟英(王士雄)等人,都扼要地概括其要点,作为论断。至于将完整治疗方案刊行的,只有叶天士的《临证指南医案》。叶天资质聪明敏锐,见解超脱,其治疗案例大多值得采纳,然而其中也有肤浅和通套之处,实际上开启了后世庸医追求简便的门路。那些道听途说的人,将其奉为掌中明珠、枕中秘宝,晚近以来对叶派的评价,毁誉参半。张先生对此书曾三次购买又三次焚毁,他高尚的志趣趋向,由此可见一斑。那么,刊刻医案并非张先生的本意吗?我说:不是这样的。先生将毕生精力消耗在诊治病人上,常想年老退休,凭借生平阅历,专心著述。上天不假以年寿,未能实现他的志向,著作缺失。忙于行道却无暇阐明道理,确实是憾事。然而先生诊病时,必定先澄澈心神、凝聚思虑,然后下笔立案,所以依据经典论述来抒发心得,在隐微曲折之处,确实足以发掘前人未曾发掘的,说出众人不能说的,论证既精妙,处方更准确,议病与议药,一以贯之,行道在此,明道亦在此,绝非抄袭敷衍、陈陈相因的方案所能比拟,怎能任其湮没而不流传呢?我吴文涵背着书箱在先生门下求学,当时还在无锡县,历经两个寒暑,亲身受教不多,存有若干卷方案论说。后来邵正蒙君在上海跟随先生学习,抄得巨册带回给我看,我读后狂喜雀跃,认为可以传授后世的稿本,就在这里了。茫茫数年间,邵正蒙君已去世,稿件交给郭级君珍藏。丙辰年秋天,我与郭君商议公之于世,郭君欣然拿出稿件,于是重新检阅,分类排比,两年后完成,交付刻印,其中的缺点,还希望各位同学中有道行的人匡正。民国七年戊午秋,学生吴文涵敬识。
戊午年长夏,张氏医案排印即将完成,追忆起抄录编辑的开始及其成功,不禁有所感慨。我年幼时侍奉父亲读书,父亲曾与人谈论医学,极力称赞聿青先生诊断疾病的精妙、处方的恰当,不停口。因为我家乡的人就诊于先生,得以看到他的方案。甲午年,父亲去世,留下遗命让侄子安家叔学习医学,平时想搜求张氏医案却得不到。不久同乡邵正蒙先生拜入张先生门下,曾写信给同门,征集方案谋求汇刊,搜罗特别广泛。岂料丙午年春天邵公去世,事情便搁置,手稿托付给我收藏。叶立庵先生儒雅而爱好医学,住在邵家,曾亲手抄录此稿,对我说应当相机刊印。尘世事务牵迫,没有空闲时间。过了十年丙辰年,去常熟会见吴玉纯先生谈论刊印医案的事。他说与邵公有旧约,时常谋划付梓刊印,只是缺乏同志赞助罢了。我听后很高兴,怂恿他立即拿出原稿,由吴先生详细编排次序,我负责誊写校正。担心收藏的手稿尚非全貌,四处发信借阅增补,期望成为完璧,响应的是包镜澄君、张绍曾君。我与吴先生通过书信往来两年多,才告成功。今年春天再由吴先生付印出版,一切手续独自承担艰难,热忱毅力,实在当今稀有。回顾编钞至今已过十余年,商量印成书又三四年,拖延如此之久,因此感叹天下类似的事情不少。至于本编的手法高妙,蹊径独开,传序中已详细说明,这里不再赘述。
后学江阴郭汇泰谨跋
Medical records kept by physicians, as recorded in historical biographies and appended to the works of various schools of thought, serve to document clinical efficacy and highlight academic achievements. In later times, there have been many specialized printed editions, such as those by Yu Jiayan (Yu Chang), Xu Huixi (Xu Dachun), and Wang Mengying (Wang Shizhong), who all summarized key points to form their judgments. Among these, only Ye Tianshi's *Linzheng Zhinan Yian* (Guide to Clinical Practice) presents complete treatment plans for publication. Ye possessed natural intelligence and acute perception, with a transcendent understanding; his clinical cases are largely worth adopting. However, some are superficial and formulaic, inadvertently opening the door for later mediocre practitioners to seek convenience. Those who rely on hearsay treat them as pearls in hand or secrets hidden in pillows. In recent years, evaluations of the Ye school have been mixed, with both praise and criticism. Mr. Zhang purchased this book three times and burned it three times, revealing his noble aspirations and high moral standards. Thus, publishing medical records was not Mr. Zhang's original intention? I say: no. Mr. Zhang devoted his life to treating patients, often wishing to retire in old age to focus on writing based on his lifelong experience. Heaven did not grant him longevity, so his ambition remained unfulfilled, and his writings were lacking. He was busy practicing medicine but had no time to elucidate its principles, which is indeed a regret. However, when diagnosing patients, Mr. Zhang would first clear his mind and concentrate his thoughts before writing down his cases. Thus, he expressed his insights based on classical theories. In subtle and complex aspects, he truly uncovered what predecessors had missed and articulated what others could not say. His arguments were precise, and his prescriptions even more accurate. His discussion of diseases and herbs was consistent throughout. Here lies the practice of the Way, and here lies the elucidation of the Way. Such work cannot be compared to plagiarized, perfunctory, or repetitive records. How can we allow it to remain obscure and untransmitted? I, Wu Wenhan, studied under Mr. Zhang while carrying my books, still in Xiyi (Wuxi). After two winters and summers, although personal instruction was limited, I retained several volumes of his case records and discussions. Later, Mr. Shao Zhengmeng studied under Mr. Zhang in Shanghai, copied a large volume, and brought it back to show me. Reading it, I was overjoyed, believing that the manuscript suitable for transmission was found here. Over the course of several years, Mr. Shao passed away, and the manuscript was entrusted to Mr. Guo Ji for safekeeping. In the autumn of Bingchen year, Mr. Guo and I discussed making it public. Mr. Guo gladly produced the manuscript. We re-examined it, classified and arranged it, completing the task after two years, and submitted it for printing. Any shortcomings are humbly requested to be corrected by learned colleagues. Respectfully recorded by student Wu Wenhan in the autumn of Wuwu year (1918), the 7th year of the Republic of China.
In the height of summer during the Wuwu year, as the typesetting of *Zhang's Medical Cases* was nearing completion, recalling the beginning of the copying and editing process and its eventual success, I could not help but feel emotional. In my youth, I attended to my father while he read. My father often discussed medicine with others, repeatedly praising Mr. Yuqing's precision in diagnosis and appropriateness in prescription. Since people from our hometown sought treatment from Mr. Zhang, I had the opportunity to see his cases. In the Jiawu year, my father passed away, leaving instructions for my uncle, Anjia, to study medicine. He frequently wished to collect Mr. Zhang's cases but failed to do so. Soon after, Mr. Shao Zhengmeng from our locality enrolled as a student under Mr. Zhang. He wrote to fellow students to collect cases for compilation, gathering an extensive collection. Unexpectedly, in the spring of Bingwu year, Mr. Shao died, and the matter was shelved. The manuscripts were entrusted to me for storage. Mr. Ye Li'an, a scholar who loved medicine, stayed at the Shao residence and personally copied this manuscript, advising me to publish it when appropriate. Due to worldly obligations, I had no free time. Ten years later, in the Bingchen year, I visited Mr. Yu Chun in Changshu to discuss publishing the cases. He mentioned a prior agreement with Mr. Shao to publish them but lacked supporters. Hearing this, I was delighted and urged him to produce the original manuscript. Mr. Wu carefully edited and organized it, while I took responsibility for transcription. Fearing the stored manuscript was incomplete, I sent letters far and wide to borrow and supplement materials, hoping to create a complete edition. Respondents included Mr. Jingcheng Bao and Mr. Shaozeng Zhang. Through correspondence with Mr. Wu over two years, the project finally succeeded. This spring, Mr. Wu handled the printing and publication, bearing all difficulties alone. His enthusiasm and perseverance are truly rare today. Looking back, more than ten years have passed since the editing began, and another three or four years since we planned to print the book. The delay has been long, prompting reflections on how many similar situations exist in the world. As for the exquisite editorial skill and unique approach of this compilation, they have been detailed in the preface, so I will not repeat them here.
Respectfully postscripted by junior scholar Guo Huitai of Jiangyin.