古人治病,药有君臣,方有奇偶,剂有大小,此汤头所由来也。仲景为方书之祖,其《
伤寒论》中既曰太阳证、少阳证、太阴证、少阴证矣,而又曰麻黄证、桂枝证、柴胡证、承
气证等。不以病名病,而以药名病。明乎因病施药,以药合证,而后用之,岂苟然而已哉!
令人不辨证候,不用汤头,率意任情,治无成法,是犹制器而废准绳,行阵而弃行列,欲以
已病却疾,不亦难乎?盖古人制方,佐使君臣,配合恰当;从治正治,意义深长。如金科玉
律,以为后人楷则。惟在善用者,神而明之,变而通之,如淮阴背水之阵,诸将疑其不合兵
法,而不知其正在兵法之中也。旧本有汤头歌诀,辞多鄙率,义弗赅明,难称善本。不揣愚
瞽,重为编辑,并以所主病证括入歌中,间及古人用药制方之意。某病某汤,门分义悉;理
法兼备,体用具全;千古心传,端在于此。实医门之正宗,活人之彀率也。然古方甚多,难
以尽录。量取便用者,得歌二百首。正方、附方共三百有奇。盖易则易知,简则易从。以此
提纲挈领,苟能触类旁通,可应无穷之变也。是在善读者加之意耳。
康熙甲戌夏月休宁八十老人汪昂题
一、本集诸歌,悉按沈约诗韵。其中平仄不能尽页者,以限于汤名、药名,不可改易也
。
二、古歌四句,仅载一方,尚欠详顺。本集歌不限方,方不限句;药味药引,俱令周明
;病证治法,略为兼括。或一方而连汇多方,方多而歌省,并示古人用药触类旁通之妙,间
及加减之法,便人取裁。
三、《医学入门》载歌三百首,东垣歌二百六十八首,皆不分门类。每用一方,搜索殆
遍。本集歌止二百首,而方三百有奇,分为二十门。某病某汤,举目易了。方后稍为训释,
推明古人制方本义,使用药者有所根据,服药者得以参稽,庶觉省便。
四、歌后注释,所以畅歌词之未备,颇经锤炼。读者倘不鄙夷,亦可诵习也。
五、拙着《医方集解》,网罗前贤方论,卷帙稍繁,不便携带。故特束为歌诀,附于本
草之末,使行旅可以轻 ,缓急得以应用也。
六、是书篇章虽约,苟熟读之,可应无穷之变,远胜前人盈尺之书数部。有识之士,当
不以愚言为狂僭也。
庵汪昂 漫识
古人治疗疾病,药物有君、臣之分,方剂有奇数、偶数之别,剂量有大有小,这就是“汤头”(中药汤剂的简称)产生的由来。张仲景是方书之祖,他在《伤寒论》中既提到了太阳证、少阳证、太阴证、少阴证,又提出了麻黄证、桂枝证、柴胡证、承气证等说法。他不以病名来命名病症,而是以药名来命名病症。明白了根据病情施用药物,使药物与证候相契合,然后才使用这些方剂,这难道是随意的吗!如果让人不辨别证候,不使用汤头,随意行事,治疗没有固定的法则,这就如同制作器物却废弃了准绳,布列军阵却抛弃了行列,想要用这种方法去除已有的疾病,难道不是很难吗?大概古人制定方剂,佐药、使药、君药、臣药配合得当;顺治与反治,意义深远。这就像金科玉律一样,作为后人的楷模。只在于善于使用者,能够神妙地领悟它,灵活地变通它,就像韩信背水一战的阵法,众将怀疑它不符合兵法,却不知道它正是在兵法之中啊。旧有的《汤头歌诀》,辞藻大多粗俗直率,含义不够完备清晰,难以称为好的版本。我不揣冒昧,重新编辑整理,并将所主治的病证概括进歌诀中,间或涉及古人用药制方的意图。某种病对应某种汤剂,门类分明,义理清晰;理法兼备,体用具全;千古心传,关键在于此。这确实是医门的正宗,救人的标准规范。然而古方很多,难以全部收录。选取便于使用的,得到歌诀二百首。正方的、附方共有三百多个。大概容易理解就容易知晓,简单明了就容易遵循。以此提纲挈领,如果能够触类旁通,就可以应对无穷的变化。这在于善于阅读的人多加用心罢了。
康熙甲戌年夏季休宁八十岁老人汪昂题写
一、本集所有的歌诀,完全按照沈约的诗韵。其中平仄不能完全符合韵律的,是因为受限于汤剂名称、药物名称,不可更改。
二、古代的歌诀四句,仅记载一方,还不够详细顺畅。本集的歌诀不限定方剂数量,方剂也不限定句子数量;药味和药引,都使其周全明确;病证和治法,略微兼括。或者一方连汇多方,方多而歌诀简省,并展示古人用药触类旁通的妙处,间或涉及加减的方法,方便人们取用裁度。
三、《医学入门》载有歌诀三百首,东垣歌诀二百六十八首,都不分门类。每次使用一方,搜索几乎遍寻。本集歌诀只有二百首,但方剂有三百多个,分为二十个门类。某种病对应某种汤剂,举目即可明了。方剂后面稍作训释,推明古人制定方剂的本义,使用药者有所依据,服药者得以参考,这样觉得省事方便。
四、歌诀后的注释,是为了阐发歌词中未备的内容,颇经锤炼。读者如果不嫌弃,也可以诵读学习。
五、拙作《医方集解》,网罗前贤的方论,卷帙稍微繁杂,不便携带。所以特意编成歌诀,附在本草之后,使旅行者可以轻便携带,缓急之时得以应用。
六、这本书篇章虽然简约,如果熟读它,可以应对无穷的变化,远胜过前人盈尺厚的书籍数部。有见识的人士,应当不会认为我的话狂妄僭越吧。
庵汪昂 漫识
In ancient times, when treating diseases, medicines were categorized into Sovereign (Jun), Minister (Chen), Assistant (Zuo), and Guide (Shi) roles; prescriptions were classified by odd or even numbers of ingredients; and dosages varied in size. This is the origin of "Tangtou" (decoctions). Zhang Zhongjing is the ancestor of prescription books. In his *Shanghan Lun* (Treatise on Cold Pathogenic Diseases), he not only mentioned Taiyang syndrome, Shaoyang syndrome, Taiyin syndrome, and Shaoyin syndrome, but also referred to Mahuang syndrome, Guizhi syndrome, Chaihu syndrome, Chengqi syndrome, etc. He did not name diseases after their pathological names, but after the medicinal herbs used to treat them. Understanding how to administer medicines according to the condition, ensuring that the medicines match the syndromes before use, was certainly not arbitrary! If one fails to differentiate syndromes, does not use decoctions, acts arbitrarily without fixed therapeutic methods, it is like making vessels while discarding the plumb line and square, or arranging troops while abandoning formation. To expect to cure existing diseases this way is indeed difficult. Generally, the ancients formulated prescriptions with appropriate combinations of Sovereign, Minister, Assistant, and Guide herbs; their approaches of following (Cong Zhi) or opposing (Zheng Zhi) treatment principles held profound meanings. These served as golden rules and iron laws for later generations to follow. It depends on the skilled user to comprehend them divinely and apply them flexibly, just as General Han Xin's battle array behind the river seemed to violate military tactics to his generals, yet actually embodied the essence of those tactics. The old version of *Tangtou Gejue* had crude language and incomplete clarity, failing to be a good edition. Presuming my ignorance, I have re-edited it, incorporating the treated syndromes into the verses, and occasionally explaining the ancients' intent in prescribing. For each disease and its corresponding decoction, categories are distinct and principles clear; theory and method are complete, form and function fully integrated; the eternal transmission lies here. This is indeed the orthodox path of medicine and the standard for saving lives. However, there are many ancient prescriptions, impossible to record all. Selecting those convenient for use, I obtained two hundred verses. There are over three hundred main and supplementary prescriptions. Simplicity leads to easy understanding; brevity leads to easy application. By grasping the essentials through these verses, if one can extend knowledge from similar cases, one can respond to infinite variations. This relies on the diligent reader's attention.
Written by Wang Ang, an eighty-year-old elder from Xiuning, in the summer of the Ji Xu year of the Kangxi reign.
1. All verses in this collection strictly follow the poetic rhyme scheme of Shen Yue. Where tonal patterns (Pingze) cannot fully conform due to constraints of prescription names or herb names, they remain unchanged.
2. Ancient four-line verses recorded only one prescription, lacking detail and fluency. This collection allows flexible numbers of prescriptions per verse and lines per prescription; ingredient lists and guiding herbs are made comprehensive and clear; syndromes and treatments are briefly included. Multiple prescriptions may be grouped under one theme; numerous prescriptions may be condensed into fewer verses, demonstrating the ancients' skill in applying knowledge analogously, including modification methods for ease of reference.
3. *Yixue Rumen* contains three hundred verses, and Dong Yuan's works contain two hundred sixty-eight, none categorized by type. Finding a specific prescription required searching extensively. This collection has two hundred verses covering over three hundred prescriptions, divided into twenty categories. Each disease-prescription pair is easily identifiable at a glance. Brief explanations follow each prescription, elucidating the original intent of the ancients, providing basis for prescribers and references for patients, thus offering convenience.
4. Annotations after the verses aim to supplement incomplete aspects of the lyrics, having been carefully refined. Readers who do not disdain them may recite and study them.
5. My work *Yifang Jijie* compiles previous experts' discussions on prescriptions but is voluminous and inconvenient to carry. Therefore, I specifically compiled these verses to attach to the end of Materia Medica texts, allowing travelers to carry them lightly and use them in emergencies.
6. Although concise, thorough study of this book enables response to infinite variations, far surpassing several volumes of thick books by predecessors. Insightful individuals should not consider my words arrogant or presumptuous.
Wang Ang, casually recorded.