人之有生禀受五气养以五味 为五色发为五声五者相得气血和平五者一失疾 乃生
由外之
阴
脏剖腹湔肠极形无尚多出神奇理明义畅非谓万病尽可生全膏肓骨髓视之了然慨夫晚近风气浸
薄冬不潜阳雷电间作未春先荣未秋先落根浅干柔花娇实剥其在于人质鲜古朴朝夕营营声色
利贷仁浓少存神气萧索夭折匪天本根先断我心鉴此游艺医林会以儒理出以佛心参形合数援古
症
今七方十剂运用时钦究惭浅学是用规箴
一拙性耽闲散且有希夷先生之癖时或懒于酬应故不敢悬壶以完吾璞
一诊病必详问病因参以色脉务得其表里虚实不敢少存率略
一立方不拘大小奇偶必法古而不滞于古务期当理中病
一用药不取隐僻奇异之品用引不过借以引经不学时习多选新奇希贵之物以标异邀名
一病有万变治亦有万变非具圣明之质不能尽彻其微予或心有疑似即使就正明哲不敢苟且
一贪欲无度怪僻反常者不治
一有挟自任轻医试药者不治
一病家乱杂疑忌多端者不治
一家人怨詈与病患违忤者不治
一不守医戒阳奉阴违者不治
凡此五者皆由人作苟自知所病不治亦治明者鉴之
人之所以能够生存,是因为禀受了五气,以五味滋养身体,表现为五色,发出五声。这五者协调和谐,气血才能平和;一旦其中任何一者失调,疾病就会发生。
从外部观察,内脏受损如同剖腹洗肠般严重,形体极度消瘦,这种情况往往难以治愈,极少有神奇疗效。道理明了,义理通畅,并不是说所有疾病都能完全治愈。对于膏肓之疾、骨髓之病,医生必须看得透彻明白。感慨的是,近代风气日益淡薄,冬天阳气不能潜藏,导致雷电般的异常气候频繁出现;春天未到草木先荣,秋天未至树叶先落。树木根浅干柔,花朵娇嫩果实剥落,这在人的体质上表现为缺乏古朴之气,整日忙于声色货利,仁爱之心淡薄,神气萧索,导致早夭。这是因为先天本根已经断绝。我以此作为鉴戒,在医学领域游历学习,用儒家的道理来指导实践,用佛家的心肠来对待患者,参合形体与数理,援引古代案例并结合当今病症,运用“七方”和“十剂”的理论,虽然深感自己学识浅陋而惭愧,但仍制定这些规诫以自勉。
第一,我生性拙劣,喜好闲散,且有希夷先生(陈抟)那样的癖好,有时懒得应酬交际,所以不敢开设医馆行医,以保全我的真朴本性。
第二,诊断疾病时,必定详细询问病因,结合面色和脉象,务必搞清楚表里虚实的情况,不敢有一丝一毫的草率疏忽。
第三,开具处方时,不拘泥于药味数量的大小或奇偶,但必须效法古人而不拘泥于古人,务必使药物符合医理,击中病灶。
第四,用药不选取隐僻奇异的材料,使用引经药不过是为了引导药力到达经络,不效仿世俗习气,多选新奇稀贵的物品来标新立异、邀取名誉。
第五,病情变化万千,治疗方法也随之变化万千,非具有圣明资质的人不能完全洞察其微妙之处。如果我心中有所疑惑,即使向明智哲人请教,也不敢苟且行事。
第二,倚仗权势、轻视医生、随意试药的患者,不予治疗。
第三,家属杂乱、猜疑忌妒多端的患者家庭,不予治疗。
第四,家人互相辱骂,且病患与家人关系违背冲突的,不予治疗。
第五,不遵守医嘱,表面顺从背后违逆的患者,不予治疗。
以上五种情况都是由人为因素造成的,如果患者自己知道病因所在,即便不治也能自愈。明智的人应当以此为鉴。
Human life is sustained by inheriting the Five Qi (Five Elemental Energies), nourished by the Five Flavors, manifested as the Five Colors, and expressed through the Five Sounds. When these five elements are in harmony, Qi and Blood remain balanced; however, if any one of them is disrupted, disease arises.
Externally, damage to the Zang organs can be as severe as opening the abdomen and washing the intestines, leading to extreme emaciation. Such conditions rarely yield miraculous results. Although the principles may be clear and the rationale sound, it does not mean that all diseases can be completely cured. For illnesses affecting the Gaohuang (vital areas of the back) and Marrow, physicians must perceive them with clarity. It is lamentable that in recent times, social morals have deteriorated. Winter fails to store Yang energy, causing abnormal climatic phenomena like thunder and lightning; vegetation flourishes before spring arrives, and leaves fall before autumn sets in. Trees with shallow roots and weak trunks produce delicate flowers and shriveled fruits. Similarly, human constitutions lack simplicity and robustness. People busy themselves day and night with sensual pleasures and profit-seeking, lacking genuine benevolence and spiritual vitality, leading to premature death. This is because their congenital root has already been severed. I take this as a warning, wandering in the medical field, applying Confucian principles to practice, and treating patients with a Buddhist heart. I integrate physical examination with numerical theory, reference ancient cases while considering current symptoms, and apply the theories of Seven Formulas (Qifang) and Ten Dosage Forms (Shiji). Though ashamed of my shallow learning, I establish these guidelines for self-discipline.
First, my nature is clumsy and fond of leisure, possessing a disposition similar to Master Xiyi (Chen Tuan). Sometimes too lazy for social engagements, I dare not open a clinic to preserve my innate simplicity.
Second, when diagnosing illness, I must inquire thoroughly about the etiology, combine observations of complexion and pulse, and ascertain the exterior-interior and deficiency-excess patterns without any negligence.
Third, when prescribing formulas, I do not adhere strictly to the number or parity of ingredients but follow ancient methods without being bound by them, ensuring that the treatment aligns with pathological principles and targets the disease accurately.
Fourth, I avoid obscure or exotic herbs. The use of guiding herbs (Yinjing Yao) is solely to direct medicinal action to specific meridians. I do not imitate worldly habits of selecting novel or expensive items merely to distinguish oneself or seek fame.
Fifth, diseases manifest in myriad ways, and treatments must vary accordingly. Only those with sage-like wisdom can fully comprehend these subtleties. If I harbor doubts, even after consulting wise scholars, I will never act rashly or carelessly.
First, patients who are insatiable in desire and exhibit eccentric or abnormal behavior are not treated.
Second, patients who rely on status, look down upon physicians, and experiment with medicines arbitrarily are not treated.
Third, households where family members are chaotic, suspicious, and jealous are not treated.
Fourth, families where members curse each other and the patient conflicts with their relatives are not treated.
Fifth, patients who do not follow medical advice, appearing compliant on the surface but violating instructions behind the scenes, are not treated.
All five categories result from human conduct. If patients understand their own condition, they may heal even without treatment. Wise individuals should take this as a lesson.