司命之难也在识证，识证之难也在辨证，识其为阴为阳，为虚为实，为六淫，为七情，而不同揣合
也。辨其在经在络，在腑在脏，在营卫，在筋骨，而非关臆度也。顾脉理易淆，洞垣谁属，赖古作家别类分
门，条列治要，且于一症，错综疑似，缕析丝分，参合脉象，详哉言之，仰见心裁独出矣。然不先窥《内
经》奥旨，则皆无本之学也。遂古圣人，尽己性，尽人性，参赞元化，仁寿斯民，其心法备载《灵》、《素》
各八十一篇。自越人祖述心法，垂为《难经》，嗣后长沙论《伤寒》，分究六经。河间治温热，专主三焦。
东垣倡益气补中。丹溪创滋阴降火，济偏补缺。要皆上阐经训，下启法门，卓然自成大家。由有明迄今，
诸名家亦无不根柢圣经，发挥心得，以着于篇。学人研经，旁及诸家，泛览沉酣，深造自得，久之源流条贯，
自然胸有主裁。第学不博无以通其变，思不精无以烛其微；惟博也故腕妙于应，而生面别开；惟精也故悟彻
于元，而重关直辟。平时灼有定见，临证不设成心，诊毕矣审用何法，法合矣选用何方，权衡乎禀之浓薄，
病之浅深，治之标本，药之浮沉，及一切正治从治，上取下取，或上病取下，下病取上，或从阴引阳，从
阳引阴，必先岁气，无伐天和。乃知执一者拘，多歧者泛，师心者愎，随俗者庸。至于体贴病情，曲折都尽，
刀圭所授，立起沉 ，善矣！若犹未也，一法未合，虽古法宜裁；一方未纯，虽古方宜裁；必吻合而后已。
此其难，殆又在识证辨证后乎。乃观近日悬壶家，大率学殖荒芜，心思肤浅，甚则治温疫以伤寒法，治血枯
以通瘀法，与
夫喜行温补，罔顾留邪，动辄攻消，不知扶正，轻者重，重者死矣。予思矫而正之，己巳计偕后，归而就馆，
笔墨少闲，爰始搜辑。丙戍后，又苦南北奔驰，今老矣，分编讨究，惧有遗珠，除《伤寒》全帙无容赘衍外，
余多宗经立论，酌古用方，更欲略辑疡科，兼及幼科，而老病浸寻，来日苦短，缺略之憾，统俟续成。且生平
本不业医，间有治案，附于症后，非云程序也，聊存梗概，以寓别裁之微意云尔。编名《治裁》，愿与有志
医学人共裁之。
道光十九年岁次己亥端午日丹阳林 琴自题
掌握生命救治之难，关键在于识别证候；而识别证候之难，又在于辨析证候。需要辨别其属于阴还是阳，属于虚还是实，是由六淫（风、寒、暑、湿、燥、火六种外感病邪）引起，还是由七情（喜、怒、忧、思、悲、恐、惊七种情志变化）所致，而不是随意揣测拼凑。
需要辨别病位在经（经脉）还是在络（络脉），在腑（六腑）还是在脏（五脏），在营气（行于脉中、具有营养作用的气）和卫气（行于脉外、具有保卫作用的气），还是在筋骨之间，而不是依靠主观臆断。
然而脉理容易混淆，谁能像扁鹊那样洞察体内情况呢？幸好古代医家能够分类整理，条理分明地列出治疗要点，并且针对每一个症状，在错综复杂、疑似难辨的情况下，细致分析，结合脉象，详尽阐述，展现出独特的匠心。
但是，如果不先窥探《黄帝内经》的深奥旨意，那么所有的学问都成了无源之水、无本之木。远古圣人，充分发挥自己的本性，充分理解人的本性，参与并辅助天地自然的化育，使百姓仁爱长寿，他们的心法全部记载在《灵枢》和《素问》各八十一篇中。
自从秦越人（扁鹊）继承并阐述这些心法，流传为《难经》之后，随后张仲景论述《伤寒论》，深入研究六经（太阳、阳明、少阳、太阴、少阴、厥阴）辨证。刘完素（河间）治疗温热病，专门主张从三焦辨证。李东垣倡导益气补中法。朱丹溪创立滋阴降火法，以纠正时弊、弥补不足。这些都上阐发经典训诫，下开启治疗法门，卓越地自成一家。
从明朝到现在，各位名家也无不以经典为根基，发挥个人心得，著书立说。学习者研究经典，旁及各家学说，广泛阅读并沉浸其中，深入钻研从而有所自得，久而久之，对源流脉络自然心中有主见。
只是学识不广博就无法通晓变化，思考不精密就无法洞察细微之处；正因为广博，所以手腕灵活应对自如，开创独特局面；正因为精密，所以彻悟根本原理，直辟重重难关。平时要有坚定的见解，临证时不设固定成见，诊察完毕后审慎使用何种治法，治法确定了选用何方剂，权衡患者体质的浓薄，疾病的浅深，治疗的标本缓急，药物的升降浮沉，以及一切正治（逆着病性治疗）和从治（顺着病性治疗），上病取下或下病取上的方法，或者从阴引阳、从阳引阴的方法，必须首先考虑当年的岁气，不要破坏人体的自然和谐。
这样才知道拘泥于一法是狭隘的，多歧路是泛滥的，凭主观心意是刚愎自用的，随波逐流是平庸的。至于体贴病情，穷尽曲折，所给予的药量极少，却能立即起死回生，这是很好的！如果还没有达到这个境界，一种治法不符合病情，即使是古法也应该裁减；一方剂不够纯正，即使是古方也应该裁减，必须完全吻合才罢休。
这其中的困难，大概又在识别证候和辨析证候之后吧。再看当今行医之人，大多学识荒芜，心思肤浅，甚至用治疗伤寒的方法来治温疫，用通瘀的方法治血枯，以及喜欢使用温补之法，不顾留滞病邪，动辄使用攻伐消导之法，不知道扶助正气，导致轻病变重，重病致死。
我思考要矫正并纠正这种风气，己巳年参加乡试后，回家教书，笔墨闲暇较少，才开始搜集编辑。丙戌年后，又苦于南北奔波，如今老了，分门别类探讨研究，担心有遗漏，除了《伤寒论》全卷无需赘述外，其余大多依据经典立论，斟酌古人方剂，更想略辑外科，兼及儿科，但老病渐侵，来日苦短，缺略的遗憾，暂且等待日后续成。
况且生平本来不以行医为业，偶尔有治疗案例，附在病症之后，并非说是程序规范，只是姑且保存梗概，以寄托别出心裁的微意罢了。编名为《治裁》，愿与有志于医学的人共同裁度讨论。
道光十九年岁次己亥端午日，丹阳林琴自题。
The difficulty in saving lives lies in recognizing the syndrome (Zheng, a pattern of disharmony); and the difficulty in recognizing the syndrome lies in differentiating it. One must distinguish whether it is Yin or Yang, deficiency or excess, caused by the Six Excesses (Liu Yin, external pathogenic factors: wind, cold, summer-heat, dampness, dryness, fire) or the Seven Emotions (Qi Qing, emotional responses: joy, anger, worry, thought, grief, fear, fright), rather than making random guesses or forced combinations.
One must differentiate whether the pathology is in the Channels (Jing, meridians) or Collaterals (Luo), in the Fu Organs (Zang Fu, hollow organs) or Zang Organs (solid organs), in the Ying Qi (Nutritive Qi) or Wei Qi (Defensive Qi), or in the sinews and bones, rather than relying on subjective speculation.
However, pulse theory is easily confused; who can see through walls like Bian Que? Fortunately, ancient masters categorized diseases, listed treatment essentials systematically, and for each symptom, amidst complex and ambiguous presentations, analyzed them meticulously, integrating pulse findings to explain them in detail, demonstrating unique insight.
Yet, without first grasping the profound principles of the *Huangdi Neijing* (Yellow Emperor's Inner Canon), all learning becomes rootless. The sages of antiquity fully realized their own nature and human nature, assisted in the transformation of the cosmos, and ensured benevolence and longevity for the people. Their therapeutic methods are fully recorded in the 81 chapters of the *Lingshu* (Spiritual Pivot) and *Suwen* (Basic Questions).
Since Yue Ren (Bian Que) inherited and expounded upon these methods, passing them down in the *Nanjing* (Classic of Difficult Issues), subsequently Zhang Zhongjing discussed *Shanghan Lun* (Treatise on Cold Damage), investigating the Six Stages (Liu Jing: Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin). Liu Wansu (Hejian) treated warm-heat diseases, focusing on the Sanjiao (Triple Burner). Li Dongyuan advocated tonifying Qi and supplementing the Middle Jiao. Zhu Danxi created methods for nourishing Yin and descending Fire, correcting biases and filling gaps. All these elucidated classical teachings from above and opened new therapeutic gates below, standing out as distinct masters.
From the Ming Dynasty to the present, various notable physicians have all rooted their work in the Classics, expounding personal insights in their writings. Students who study the Classics, branch out to other schools, read extensively and immerse themselves, achieving deep understanding through independent effort, will naturally have a clear grasp of the origins and continuity over time.
However, without broad learning, one cannot comprehend changes; without precise thinking, one cannot illuminate subtleties. Because of breadth, one handles situations with skill and opens new perspectives; because of precision, one thoroughly comprehends the fundamental principles and breaks through barriers directly. With firm views during daily practice and no preconceived notions during clinical application, after diagnosis, one carefully selects the method; once the method is set, one selects the formula, weighing the patient's constitution (thick or thin), the depth of the disease, the priority of root versus branch, the ascending/descending properties of herbs, and all orthodox treatments (Zheng Zhi, treating contrary to the disease nature) or following treatments (Cong Zhi, treating according to the disease nature), upper diseases treated via lower points, lower diseases via upper points, drawing Yang from Yin or Yin from Yang, always considering the annual climate qi first, without violating the harmony of Heaven and Humanity.
Thus, one knows that sticking to one method is rigid, following many paths is superficial, acting on one's own mind is obstinate, and following customs is mediocre. As for understanding the condition thoroughly, exhausting all nuances, prescribing minimal doses yet instantly curing severe conditions, this is excellent! If not yet there, if one method does not fit, even ancient methods should be discarded; if one formula is not pure, even ancient formulas should be discarded, until they perfectly match.
This difficulty likely lies beyond just recognizing and differentiating the syndrome. Observing contemporary practitioners, most have barren scholarship and shallow thinking. Some even treat warm epidemics using Shanghan methods, or treat blood depletion using blood-stasis-resolving methods. Others favor warming and tonifying, ignoring retained pathogens; or frequently use attacking and reducing methods, failing to support healthy Qi, turning mild cases severe and severe cases fatal.
I considered correcting this trend. After the Jisi year when I took the provincial examination, I returned home to teach. With little leisure for writing, I began collecting materials. After the Bingxu year, suffering from travel between north and south, now old, I divide and discuss topics, fearing omissions. Except for the complete volume of *Shanghan*, which needs no redundancy, the rest mostly establish theories based on Classics and select ancient formulas. I also wished to briefly compile surgical and pediatric sections, but illness and age advance, days are short. Regrets of omission await future completion.
Moreover, my profession was never medicine. Occasional case records attached after symptoms are not meant as standard procedures, but merely to preserve outlines, expressing my intent for unique selection. The book is named *Zhicai* (Selected Treatments), hoping those interested in medicine will review and judge it together.
On the Dragon Boat Festival day of the Jisi year, in the 19th year of Daoguang, Lin Qin of Danyang inscribed this.