古人有三不朽,曰立德,其次立功,又次立言。余何人也,岂敢妄发言哉!敢于功德自
夸耶?
从幼年来,体弱多病,思阅方书,因从书贾购得吾郡良医乌镇逸林僧所遗医书甚伙。自轩歧
仲圣逮今诸家注论,靡不收采,略得心领神会。遂弃诸子业,从我郡吴古年夫子游,将历代
名医着述书籍,探本穷源,随时就正,读破万卷,讲论偏见
错谬之处,或自昏黄达旦。先生年届古稀,日逐临症,得有余暇,犹不辞倦,且谆谆训曰∶
医关性命,不可苟且,一病有一经所发,若察脉辨证,尤宜加谨,恐失之毫厘,谬于千里也
。先生袖出一帙曰∶本草分队。取其用药如用兵之意,盖脏腑,即地理也,处方如布阵也,
用药如用兵将也。病本在于何经,即以君药主将标于何经。为臣使之药,即所以添兵弁。识
得地理,布成阵势,一鼓而战,即能殄灭贼氛,即所谓病退也。然后调摄得宜,起居如常,
即兵家善后事宜,民得安居乐业也。苟调度不精,一或失机,一败涂地,即用药不审,草菅
人命也。
奈近时医者,一到病家,不先看脉审证,遂听病家自述病情,随即写药数味,曰∶某汤
主治
。粗知大略,用某药能除某病,如此治病,则仁人必深虑而痛恨之。虽业医临症,有望闻问
切四诊之说,然望是观其气色,如经云∶青欲如苍碧之泽,不欲如蓝也。闻是听其声音清浊
高低,即宫商角征羽五者,属五脏也。问是问其老少男女,平素劳逸喜恶,起患何时,始得
何病,曾服何药,问病源也。切是最要之事,诊得浮沉迟数滑涩大小长短诸脉,见于左右寸
关尺部,辨明虚实表里寒热。何证发于何经,应用寒热温凉之药,定方进药,君臣佐使,配
合得宜,如汤沃雪,诸恙若失,方能起死回生,岂有害哉!
凡药有利必有害,但知其利,不知其害,如冲锋于前,罔顾其后也。余业是道,二十余
年,
遇证则慎思明辨,然后下笔,补偏救弊,贻误者少。审识药品出产形状,亲尝气味,使药肆
中不敢伪充而误人耳。
先生之分队一书,尚未刊行于世。遂集各家本草,补入药之害于病者,逐一加注,更曰
《本
草害利》,欲求时下同道,知药利必有害,断不可粗知大略,辨证不明,信手下笔,枉折人
命。用是不揣固陋,集古今名医之说,删繁就简,撰述成书,以付剞劂,公诸同好,并就正
于海内明眼,亦慎疾之一端云尔。
咸丰壬戌年,吴兴凌奂晓五自序。
古人有“三不朽”的说法,分别是树立德行、建立功业、著书立说。我是什么人呢?哪里敢随意发表言论呢!又怎么敢自夸功德呢?
我自幼体弱多病,想要阅读医书,于是从书商那里购得了我们郡县良医乌镇逸林僧所遗留的大量医书。从黄帝、岐伯到张仲景,直到近代各家学者的注解论述,无不搜集收录,逐渐领会其精髓。于是放弃了其他学业,跟随本郡吴古年先生学习,探究历代名医著作的本源,随时请教纠正,读破万卷书,讨论其中偏颇错误的地方,有时从天黑一直讲到天亮。先生年近七十,每天亲自诊病,虽然还有空闲时间,仍不辞辛劳,并且谆谆教导说:医学关乎人的性命,不可马虎草率。每一种疾病都发源于某一经络,在诊察脉象和辨证时,尤其应当谨慎,恐怕失之毫厘,结果就会谬以千里。
先生拿出一部书稿说:《本草分队》。这是取用药如同用兵的意思。脏腑,就像地理形势;处方,就像布置阵势;用药,就像派遣将领士兵。疾病的根本在于哪一经,就用君药(主药)作为主将标示于该经。臣药、佐使药,就像是增派的兵卒。认识了地理形势,布好了阵势,一鼓作气作战,就能消灭贼寇的声势,这就是所谓的病邪退去。然后调理摄生得当,起居恢复正常,就像军队打仗后的善后事宜,百姓得以安居乐业。如果调度不精密,一旦错失战机,就会一败涂地,这就像用药不审慎,视人命如草芥一样。
无奈近时的医生,一到病人家,不看脉象、不审察证候,就听病人自己描述病情,随即开几味药,说:“某某汤主治”。粗略知道大概,认为用某种药能去除某种病。像这样治病,仁人君子必定会深思并痛恨这种行为。虽然从事医学临症,有“望闻问切”四诊的说法,但“望”是观察病人的气色,正如经典所说:“青色要像苍碧那样润泽,而不喜欢像蓝草那样枯暗。”“闻”是听病人的声音清浊高低,即宫、商、角、徵、羽五音,分别对应五脏。“问”是询问病人的老少男女、平素的劳逸喜好厌恶、发病时间、最初得的什么病、曾经服用过什么药,这是为了探求病源。“切”是最重要的一环,诊察浮、沉、迟、数、滑、涩、大、小、长、短等各种脉象,出现在左、右寸、关、尺各部,辨别清楚虚、实、表、里、寒、热。确定证候发于哪一经,应用寒、热、温、凉性质的药物,确定方剂并给药,君、臣、佐、使配合得当,就像热水浇雪一样迅速见效,各种病症消失,才能起死回生,哪里有危害呢!
凡是药物有利必有害,只知道它的好处,不知道它的坏处,就像冲锋在前,不顾及后方一样。我从事这个行业二十多年,遇到证候则慎重思考、明辨是非,然后下笔开方,弥补偏差、挽救弊端,造成的误治较少。仔细识别药品出产地的形状特征,亲自品尝气味,使得药店不敢伪冒充数而误导他人。
先生的《分队》一书,尚未刊行于世。于是汇集各家本草著作,补充加入药物对病患的危害之处,逐一加注,改名为《本草害利》,希望当时的同行们知道药物的利益必然伴随危害,绝对不可以粗略知晓大概,辨证不明就信手下笔,枉折人命。因此我不揣冒昧,收集古今名医的说法,删减繁复、简化内容,撰写成书,交付刻印,公之于众,并向海内外的高明之士请教,这也是谨慎对待疾病的一个方面罢了。
咸丰壬戌年,吴兴凌奂晓五自序。
The ancients spoke of the "Three Immortalities": establishing virtue, establishing merit, and establishing words (writings). What kind of person am I? How dare I speak lightly! Nor do I dare to boast of my own merits and virtues.
Since childhood, I have been frail and prone to illness. Desiring to read medical texts, I purchased a large collection of medical books left behind by Wu Lin Seng, a skilled physician from Wuzhen in our county, from a bookseller. From Huangdi (Yellow Emperor) and Qibo to Zhang Zhongjing, down to the annotations and discussions of various schools up to the present, I collected them all without exception, gradually grasping their essence. Consequently, I abandoned other studies and followed Master Wu Guniann of our county in learning, exploring the origins of writings by famous physicians of past dynasties, seeking guidance and correction at every turn. Having read through ten thousand volumes, we discussed biased or erroneous points, sometimes talking from dusk until dawn. The Master was nearing seventy years old, seeing patients daily; although he had spare time, he did not decline to be weary, and earnestly instructed me: Medicine concerns life and death; one cannot be casual. Every disease originates from a specific meridian. When examining pulses and differentiating syndromes, one must be especially cautious, for a miss is as good as a mile. If one errs by a hair's breadth, the result will be off by a thousand miles.
The Master took out a manuscript and said: *Bencao Fen Dui* (Classification of Materia Medica into Formations). This takes the meaning that using medicine is like using troops. The Zang-Fu organs are like geographical terrain; prescribing formulas is like deploying formations; using herbs is like dispatching generals and soldiers. If the root of the disease lies in which meridian, the Jun herb (Sovereign herb) acts as the main general and is marked on that meridian. Chen herbs (Minister herbs), Zuo herbs (Assistant herbs), and Shi herbs (Envoy herbs) act as additional troops. One must understand the geography (terrain/organs), deploy the formation (formula), and upon striking once, eliminate the enemy's momentum, which is what is meant by the disease retreating. Then, with proper regulation and care, and normal daily routine, it is like the aftermath management of a military campaign, allowing the people to live in peace and work happily. If the command is not precise, and one misses the opportunity even slightly, it leads to total defeat; this is like using medicine imprudently, treating human lives as if they were grass.
Regrettably, physicians nowadays, upon arriving at a patient's home, do not first examine the pulse or assess the syndrome. Instead, they listen to the patient's self-description of symptoms, then immediately prescribe a few herbs, saying, "This decoction treats [condition]." With only a superficial knowledge, believing that a certain herb can cure a certain disease, treating illness in this manner would cause benevolent people to ponder deeply and feel intense indignation. Although those practicing medicine follow the theory of the Four Diagnostic Methods (Wang Wen Wen Qie - Observation, Auscultation/Olfaction, Inquiry, Palpation), "Observation" involves viewing the complexion. As the classics state: "Green should resemble the luster of dark jade, not the dullness of indigo." "Auscultation and Olfaction" involve listening to the clarity, turbidity, pitch, and volume of the voice, corresponding to the five tones (Gong, Shang, Jue, Zhi, Yu) and the five Zang organs. "Inquiry" involves asking about age, gender, habitual labor and rest, preferences, onset time, initial disease, and previous medications, aiming to identify the source of the disease. "Palpation" is the most critical task. Diagnosing pulses such as floating, deep, slow, rapid, slippery, choppy, large, small, long, and short, appearing at the Cun, Guan, and Chi positions on both wrists, allows one to distinguish deficiency, excess, exterior, interior, cold, and heat. Determining which meridian the syndrome originates from, applying herbs of cold, hot, warm, or cool properties, determining the formula and administering it, with proper coordination of Sovereign, Minister, Assistant, and Envoy herbs, is like pouring boiling water on snow—rapidly effective, causing all ailments to vanish, thereby bringing the dying back to life. How could there be harm?
All medicines have benefits and harms. Knowing only the benefits but ignoring the harms is like charging forward while disregarding the rear. I have practiced this profession for over twenty years. Upon encountering a syndrome, I think carefully and discriminate clearly before writing the prescription, correcting biases and saving from errors, resulting in fewer misdiagnoses. I carefully identify the origin and physical characteristics of medicinal materials and personally taste their flavors and odors, ensuring that pharmacies dare not substitute fake products and mislead people.
The Master's book *Fen Dui* has not yet been published. Therefore, I compiled various Materia Medica works, added notes on the harms of medicines to diseases, annotated them item by item, and renamed it *Bencao Hai Li* (Harms and Benefits of Materia Medica). I hope contemporary colleagues will know that where there is benefit, there is necessarily harm, and absolutely avoid superficial understanding, unclear differentiation of syndromes, and reckless prescribing, which wastes human lives. Thus, not presuming my own ignorance, I collected statements from famous physicians of ancient and modern times, deleted redundancy, simplified content, wrote this book, submitted it for printing, made it public, and sought corrections from enlightened scholars within and beyond the seas. This is also one aspect of being cautious regarding illness.
Preface by Ling Huan, courtesy name Xiaowu, of Wuxing, in the Renxu year of Xianfeng.