余性好医。知医之难未尝妄为人医。今老矣。阅历益多更不敢谈兹事。惟以诗遣兴而已
弟尚先着外治医说。刊既成易名骈文。属余序言。余观之窃以为可不序也。文已详之矣。然其
中有不必论者。亦有不得不为之辨者。夫其所述天地万物之理。贤圣授受之心。学人格致之
功。乃医之本也。知者自知。不知者自不知也。信者自信。不信者自不信也。此不必论者也
。而其为法。则于前人诸家外独辟一门。人人共见其无害者也。而或以为虽无损于人亦无益
于人。此不得不为之辨者也吾谓其书足。比邵子蠢子之数。方今医学失传久矣。苟中材以下
贫无所藉。俾习其术以养其生。不至重衣食而轻人命。即使无功而阴受其功者多矣。况施济
有年实有可凭者乎。夫蠢子数数之有验者也。故人多学其法。至数之与皇极经世同出于一原。则亦非上智不悟云。
同治三年甲子四月高桥散人书
客有问于余曰。古以医书为活人之书。若君兄之理瀹骈文者其果能活人耶。余曰能活人
曰何以征之。余曰于吾兄之所以施治者而征之。客曰施治如何。余曰泰之东北乡曰俞家垛。
吾兄与余奉母避乱之所居也。余橐笔处州幕。兄在乡自制膏药以为施治。余以时归省。得见
兄之所为施治者。下河数百里。间为庄者一千五百有奇。凡篇值力作之壮男健妇。以及衰老
幼稚居湫隘卑湿之地。而又时为寒暑所侵。内而心腹之患。外而头面身体肌肤之疾。往往困
于力之无如何。委而不治者半。或力能治矣。数医而无验。亦自惜其药之徒费而不复治。闻
施者相率而就。日或一二十人或三四十人。人情莫不安于药饵。狃于其所常而疑于其所异。
彼夫病之久且深者。初请得一纸膏以去。窥其意若不甚释。然至三四易已脱然踵门而谢曰。
吾谒所谓高手者多矣。此独不烦饮药。不待切脉。窃以为疗之难而竟得愈之易也。告于
其所亲。来试之而果验焉。所亲更告于其所知。来试之而又验焉。以是信日益多。传日益广
。凡远近来者日或一二百人。或三四百人。皆各以时聚有舁有负。有扶掖有提携。或倚或蹲
。或立或跪。或瞻或望。或呼或叫。或呻或吟。或泣或啼。拥塞于庭。待膏之救迫甚水火。斯
旁观者莫不慨息。以为绘流民之图。开赈饥之局不过如是。深虑一人胗视之难而力之有所不
暇给也。而吾兄则自晨起。以次呼立于几案前。令自述病因。侧耳听之。若宜补。若宜泻。
若宜凉而宜温略一视颜色。指其部位。分别散给有重症急症膏。外加以药。不半日而毕
。自来医未有如此之捷简者。月治数千人。但有所忌于人无所怨于人。则膏之能活人可知也
。吾兄尝语余曰。医于外症易。内症难。实症易。虚症难。吾之此膏焉能必应。然治得其通
而所包者广。术取其显而所失者轻。可以藏拙。可以观变。可以补过。可以待贤有谓吾取巧者
。吾岂敢取巧哉。吾亦求其心之安而已。噫。是即吾兄用膏施治之本意也。夫亦即此书之所
以为活人也。夫客欣然心悦而退。适鸠工既竣。吾兄命余弁言。遂书其与客问答者如此。
医小道也。而修德积善之方在焉。风尘扰扰。我子若孙其克守此以保家。或不仅为耕读之一助也
岁在甲子孟夏之月官业谨识于海陵寓斋之小鄂不馆
我生性喜好医学。深知行医之难，未曾随意为人诊治。如今我已年老，阅历更加丰富，更不敢谈论此事，只以作诗来抒发兴致罢了。
我的弟弟尚先撰写了《外治医说》，刊印完成后改名为《理瀹骈文》，嘱托我为其作序。我看了之后，私下认为可以不写序言，因为文章已经非常详尽了。然而其中有些内容不必多论，也有不得不为之辩驳的地方。他所阐述的天地万物之理、圣贤传承的心法、学者格物致知的功夫，乃是医学的根本所在。懂的人自然懂，不懂的人自然不懂；相信的人自然相信，不相信的人自然不相信。这是不必多论的。而他的治疗方法，则在前人诸家之外独辟蹊径，人人都看见它对人无害。但有人却认为它虽然对人无害，但也对人无益。这是不得不为之辩驳的。我认为这本书足以与邵雍（邵子）的《蠢子数》相提并论。当今医学失传已久，假如中等资质以下的人贫穷无所依靠，让他们学习这种医术以养生，不至于加重衣食负担而轻视人命，即使没有显著功效，暗中受益的人也很多了。何况施药济人已有多年，确实有凭据可查呢。那《蠢子数》是验证有效的，所以人们多学习它的方法。至于《蠢子数》与《皇极经世》同出一源，那么也不是上等智慧的人不能领悟。
同治三年甲子四月，高桥散人书写。
有位客人问我：“古人把医书称为救活人的书，像您兄长写的《理瀹骈文》，果真能救人吗？”我说：“能救人。”客人问：“怎么证明这一点？”我说：“从我兄长的施治实践中来证明。”客人问：“施治情况如何？”我说：“泰州东北乡有个地方叫俞家垛，是我兄长和我奉养母亲躲避战乱居住的地方。我在处州幕府执笔办公时，兄长留在乡下自制膏药进行施治。我按时回乡探望，得以见到兄长施治的情形。下河一带几百里范围内，有一千五百多个村庄。凡是辛勤劳作的健壮男女，以及衰老幼童，居住在低洼潮湿之地，又时常受到寒暑侵袭，内有心腹之患，外有头面身体肌肤之疾，往往因无力治疗而无奈放弃，委曲求全不治疗的占一半；或者有力气治疗，但找多位医生诊治都没有效果，也爱惜药物白花钱而不继续治疗。听到有施治者，便争相前往，每天可能有一二十人或三四十人。人们的情性大多安于服用汤药，习惯于常规疗法而对异乎寻常的方法产生怀疑。那些患病久且深的人，起初请去一张膏药离开时，看他们的意思似乎并不太放心，然而到了第三次或第四次更换膏药后，病竟完全好了，登门致谢说：‘我拜见过所谓的高手很多了，唯独这里不需要喝药，也不需要切脉，我原以为治疗很难，竟然治愈得这么容易。’告知他的亲友，来尝试果然有效；亲友再告知认识的人，来尝试又有效。因此信任的人日益增多，传播日益广泛。凡是从远近各地来的患者，每天可能有一二百人或三四百人，都按时聚集，有的抬着，有的背着，有的搀扶，有的提携，有的倚靠，有的蹲坐，有的站立，有的跪拜，有的张望，有的呼喊，有的呻吟，有的哭泣，有的啼哭，拥挤堵塞在庭院中，等待膏药救治的迫切程度甚于水火之急。旁观者无不叹息感慨，认为绘制流民图、开设赈饥局也不过如此。深深担忧一人诊视太难而精力有所不及。而我兄长则从早晨起床开始，依次呼唤他们站在几案前，让他们自述病因，侧耳倾听。若适宜补益，若适宜泻实，若适宜清凉或温补，略看一眼面色，指出部位，分别散发重症急症膏药，外加用药，不到半天就结束。自古以来，医生未有如此快捷简便的。每月治疗数千人，只要对别人有所禁忌，就不怨恨别人，可见膏药能救人是显而易见的。我兄长曾对我说：‘医治外症容易，内症难；实证容易，虚证难。我的这些膏药怎能保证一定见效？然而治疗掌握了通则，所涵盖的范围广；技术取显效，所损失的风险轻。可以掩饰不足，可以观察变化，可以弥补过失，可以等待贤才。有人说我取巧，我岂敢取巧呢？我也只求内心安宁罢了。唉，这就是我兄长用膏药施治的本意啊。这也正是这本书之所以能救人的原因。’客人欣然高兴而退去。恰逢工匠完工，我兄长命我写序，于是记下我与客人的问答如下。
医学虽是小道，但其中包含修身积善的方法。风尘扰扰之中，我的子孙若能坚守此道以保全家业，或许不仅是对耕读生活的帮助罢了。
岁在甲子孟夏之月，官业在海陵寓斋的小鄂不馆谨识。”
I have a natural inclination towards medicine. Knowing the difficulty of practicing it, I never casually treated others for medical issues. Now that I am old and my experience has grown even greater, I dare not speak of this matter anymore; I only compose poetry to express my feelings.
My younger brother, Shangxian, wrote *Wai Zhi Yi Shuo* (Medical Treatise on External Therapy). After its publication, he changed its title to *Li Yue Pian Wen* (Parallel Prose on Therapeutic Applications) and requested me to write a preface. Having read it, I privately thought that a preface was unnecessary, as the text was already detailed. However, there are matters that need no discussion, and others that require clarification. The principles of heaven and earth and all things, the transmission of wisdom among sages and worthies, and the scholarly efforts of investigating things to extend knowledge constitute the foundation of medicine. Those who understand will understand naturally; those who do not will not understand naturally. Those who believe will believe naturally; those who do not will not believe naturally. This is what needs no discussion. His methods, however, carve out a unique path distinct from previous schools, which everyone can see is harmless. Yet some argue that while it does no harm, it also does no good. This is what requires clarification. I consider this book comparable to Shaozi's *Chunzi Shu* (Numbers of the Simpleton by Shao Yong). Medicine has been lost for a long time in our current era. If people of average or lower ability, poor and without resources, were to learn these techniques to nourish their lives, they would not burden themselves with heavy clothing and food expenses nor treat human life lightly. Even if there were no obvious efficacy, many would secretly benefit. Moreover, charitable distribution has been practiced for years and is indeed verifiable. The *Chunzi Shu* is known to be effective, so many people learn its methods. As both the *Chunzi Shu* and *Huangji Jingshi* (Supreme Principles Governing the World) originate from the same source, one might say that only those of superior intelligence can comprehend them.
Written in the fourth month of the year Jiazi (1864), by Gaoqiao Sanren.
A guest asked me, "Ancient texts refer to medical books as 'books that save lives.' Can your brother's *Li Yue Pian Wen* truly save lives?" I replied, "Yes, it can." The guest asked, "How can we verify this?" I said, "By examining how your brother applies treatment." The guest asked, "How is the treatment applied?" I said, "In the northeast township of Taizhou, there is a place called Yujia Duo, where my brother and I lived with our mother to escape turmoil. While I served as a clerk in the Chuzhou prefecture, my brother remained in the countryside, making plasters for treatment. When I returned home periodically to visit, I witnessed his therapeutic practices. In the region of Xiahe, spanning hundreds of li, there are over 1,500 villages. Among the hardworking able-bodied men and women, as well as the elderly and young children living in damp, low-lying areas and frequently exposed to cold and heat, internal ailments of the heart and abdomen and external diseases of the head, face, body, and skin often left them helpless due to lack of means, causing half to abandon treatment out of resignation. Others had the means but found no effect after consulting multiple doctors, and out of pity for wasted medicine costs, they ceased treatment. Upon hearing of a provider, they flocked together, numbering ten to thirty or forty daily. People are generally accustomed to herbal decoctions and skeptical of unconventional methods. For those with chronic and deep-seated illnesses, when they initially received a plaster and left, their expressions suggested doubt. However, after three or four applications, they recovered completely and visited to thank us, saying, 'I have consulted many so-called experts, but here, without drinking medicine or pulse diagnosis, I thought treatment would be difficult, yet it was cured so easily.' They informed their relatives, who came to try it and found it effective; these relatives then informed their acquaintances, who also tried it and found it effective. Thus, trust increased day by day, and word spread further. Patients from near and far gathered daily, numbering one or two hundred, or even three or four hundred. They arrived at appointed times, some carried on stretchers, some borne on backs, some supported by arms, some led by hands. Some leaned, some squatted, some stood, some knelt, some gazed, some watched, some shouted, some moaned, some wept, some cried. They crowded the courtyard, desperate for the relief of the plaster, as urgent as fire or water. Bystanders could not help but sigh, remarking that depicting refugee scenes or opening famine relief centers looked no different. There was deep concern that one physician could not possibly examine so many people efficiently. Yet my brother rose early each morning, calling them one by one to stand before the desk, listening attentively as they described their conditions. He determined whether tonification, purgation, cooling, or warming was appropriate, briefly observing their complexion and pointing to specific locations, then distributing plasters for severe or acute conditions, supplemented by other medications. All was completed within half a day. Never before had a doctor been so swift and simple. Treating thousands monthly, imposing restrictions only where necessary and offending no one, it is evident that the plasters save lives. My brother once told me, 'Treating external symptoms is easier than internal ones; excess syndromes are easier than deficiency syndromes. How can I guarantee my plasters always work? However, mastering the general principles allows for broad coverage; employing visible techniques minimizes risk. It allows one to conceal shortcomings, observe changes, correct errors, and await talented practitioners. Some accuse me of taking shortcuts, but I dare not. I merely seek peace of mind. Alas, this is the original intent behind my brother's use of plasters. This is precisely why this book saves lives.'" The guest departed joyful and satisfied. Just as the printing work was completed, my brother instructed me to write the preface. Thus, I record our dialogue as follows.
Medicine may be a minor art, but it contains methods for cultivating virtue and accumulating goodness. Amidst the disturbances of the world, if my descendants can uphold this to preserve their family, it will serve not merely as an aid to farming and reading.
Recorded in the first month of summer in the year Jiazi, at the Xiao E Bu Guan study in the Hai Ling residence, by Guanye.