医之为道至矣。周官有疾医。视万民四时之病。春之 首。夏之痒疥。秋之疟寒。冬之嗽咳。分而治之。验其状而
制其禄。复世官寝失职。故于其术。每择之不精。吾同县戴原礼。从朱先生彦修学。治疾往往多奇验。原礼从叔仲章。
六月患大热。面赤口谵语。身发红斑。他医投以大承气汤。而热愈极。原礼脉之。曰。左右手皆浮虚无力。非真热也。
张子和云。当解表而勿攻里。此证似之。法当汗。遂用附子干姜人参白术为剂。烹液冷冻饮料之。大汗而愈。槠概方氏子妇。
疟后多汗。呼媵人易衣不至。怒形于色。遂昏厥若死状。灌以苏合香丸而苏。自后闻人步之重。鸡犬之声。辄厥逆如初。
原礼曰。脉虚甚。重取则散。是谓汗多亡阳。正合经意。以黄 人参日补之。其惊渐减。至浃旬而安。松江诸仲文。长
夏畏寒。身常挟重缠。食饮必热如火。方下咽。微温则呕。他医授以胡椒煮伏雌之法。日啖鸡者三。病逾亟。原礼曰。
脉数而大且不弱。刘守真云。火极似水。此之谓矣。椒发阴经之火。鸡能助痰。只以益其病尔。以大承气汤下之。昼夜
行二十余。顿减纩之半。复以黄连导痰汤。益竹沥饮之。竟瘳。姑苏朱子明之妇。病长号。数十声暂止。复如前。人以
为万所凭莫能疗。原礼曰。此郁病也。痰闭于上。火郁于下。故长号则气少舒。经云。火郁则发之是已。遂用重剂涌之。
吐痰如胶者无算。乃复初。药原忠妻。因免乳后。病惊。身翩翩然。如升浮云之上。举目则室庐旋运。持身弗定。他医
饮以补虚治惊皆无验。原礼曰。左脉虽芤且涩。神色不动。是因惊致。心包络积污血尔。法宜下之。下积血如漆者一斗。
即愈。留守卫吏。陆仲容之内子。病热。妄见神鬼。手足 动。他医用黄连清心汤。不中。原礼视之。曰。形瘦而色不
泽。乃虚热耳。法当以李杲甘温除大热之法为治。即经所谓损者温之者也。服人参黄 而安。他若此者甚众。夫医之为
道。本于素问内经。其学一坏于开元。再坏于大观。习俗相仍。绝不知究其微指。唯执一定之方。类刻舟而求剑者。人
訾之。则曰我之用此。不翅足矣。又恶事内经为。宋之钱仲阳。独得其秘于遗经。而扩充之。金之张刘李诸家。又从而
衍绎之。于是内经之学大明。刘之学。朱先生得之最深。大江以南。医之道本于内经。实自先生发之。原礼乃其高弟弟
子。其传授有要。故察证无不中。服其剂者。沉 豁然如洗。昔司马迁作仓公传。载其应诏所对。自齐御史成至公乘项
处。凡二十有三。书治病之状甚具。予仿此义。稍陈原礼疗疾。奇中者系之首简。若周官疾医。四时治证之概。知言者。
必有所择焉。
医学这门道，真是至高无上的啊。《周礼》中有疾医一职。负责诊治万民在四季中患有的疾病。春季多为首风（头部受风邪），夏季多为瘙痒疥疮，秋季多为疟疾寒热，冬季多为咳嗽气喘。分别进行治疗。根据病情症状来评定医生的俸禄。后来世袭官职逐渐失职，所以对于医术，往往选择得不够精纯。我的同乡戴原礼，跟随朱彦修先生学习。治疗疾病常常有奇特的疗效。戴原礼的堂叔戴仲章，在六月患了大热病。面色红赤，口出谵语，身上发出红斑。其他医生投以大承气汤，但热势更加严重。戴原礼诊察其脉象，说：左右手脉象都浮虚无力，这不是真热证。张子和曾说：应当解表而不要攻里。这个证候与此相似。治法应当发汗。于是用附子、干姜、人参、白术组成方剂。将药液煮好后放冷服用。患者大汗出而痊愈。槠概方氏的儿子媳妇，疟疾后出汗很多。呼唤侍女换衣服，侍女没到。她怒形于色，随即昏厥，像死了一样。灌服苏合香丸后苏醒。从此以后，听到人脚步重的声音，鸡犬的叫声，就会像当初一样昏厥。戴原礼说：脉象非常虚弱，重按则散乱，这叫作汗多亡阳。正符合经旨。用黄芪、人参每日补益它。患者的惊恐逐渐减轻，过了十天就安稳了。松江诸仲文，长夏时节怕冷，身体常常感觉沉重缠绕，饮食必须像火一样热。刚下咽，稍微温一点就会呕吐。其他医生传授用胡椒煮雌鸡的方法，每天吃三次鸡，病情更加急迫。戴原礼说：脉象数而且大，并不弱。刘守真说：火极似水。说的就是这个情况。胡椒激发阴经之火，鸡肉能助生痰湿，只会增加他的病痛罢了。用大承气汤泻下他。昼夜排便二十多次，病情顿时减轻了一半。再用黄连导痰汤，加竹沥饮用。最终痊愈。姑苏朱子明的妻子，生病时长时间嚎叫，几十声暂时停止，然后又像之前一样。人们认为是鬼神附身，无法治疗。戴原礼说：这是郁病。痰闭阻于上焦，火郁结于下焦。所以长时间嚎叫后气机稍微舒畅。经书说：火郁则发之。正是这个道理。于是用重剂催吐。吐出像胶一样的痰不计其数，于是恢复如初。药原忠的妻子，因为难产后，得了惊悸病。身体飘飘然，好像升在浮云之上。睁眼则房屋旋转运动，手持东西不稳。其他医生服用补虚治惊的药物都没有效果。戴原礼说：左脉虽然芤且涩，但神色没有变动。这是因为惊吓所致。心包络积聚了污血罢了。治法应当泻下。排出像漆一样的积血一斗，立即痊愈。留守卫吏陆仲容的妻子，患热病。胡言乱语看见神鬼，手足抽搐。其他医生用黄连清心汤，不对症。戴原礼诊视后说：形体消瘦且面色不润泽，这是虚热罢了。治法应当采用李杲甘温除大热的方法来治疗。就是经书所说的“损者温之”。服用人参、黄芪后就安好了。像这样的情况还有很多。医学这门道，本源于《素问》《内经》。它的学问第一次败坏是在开元年间，第二次败坏是在大观年间。习俗沿袭，完全不知道探究其中的微妙旨意。只执着于固定的方子，就像刻舟求剑一样。被人指责，就说我使用这个，足够了。又何必从事研究《内经》呢？宋代的钱仲阳，独自从遗经中得到秘传，并加以扩充。金代的张元素、刘完素、李杲等各家，又进而演绎发挥。于是《内经》的学问大大显明。刘完素的学问，朱彦修先生领悟得最深。大江以南，医学之道本于《内经》，实际上是从朱先生开始发扬的。戴原礼是他的高弟弟子。他的传授有所要诀。所以辨证没有不准确的。服用他药剂的人，重病豁然如洗去污垢。从前司马迁作《仓公传》，记载他应诏所回答的病例，从齐御史成到公乘项处，共二十三个。记录治病的情况很详细。我仿照这个义理，稍微陈述戴原礼治疗疾病的案例。奇特准确的病例列在首简。如果像《周礼》疾医那样，四季治疗病症的大概情况，懂行的人，必定会有所选择。
The Way of medicine is indeed supreme. The *Rites of Zhou* mentions the position of Physician for Diseases, who was responsible for treating illnesses among the people according to the four seasons. In spring, diseases often affected the head (head wind); in summer, itching and scabies; in autumn, malaria and chills; and in winter, coughing and asthma. Treatments were administered separately based on these conditions, and physicians' salaries were determined by evaluating their clinical outcomes. However, as hereditary official positions gradually lost their effectiveness, the selection of medical practitioners became less rigorous, resulting in imprecise techniques.
My fellow townsman, Dai Yuanli, studied under Mr. Zhu Yanxiu. He frequently achieved remarkable cures. When his cousin, Dai Zhongzhang, suffered from severe heat syndrome in the sixth lunar month, presenting with a red face, delirious speech, and erythematous macules on the body, other physicians prescribed *Da Chengqi Tang* (Major Order the Qi Decoction), which only exacerbated the heat. Dai Yuanli palpated the pulse and observed that both left and right pulses were floating, deficient, and weak, concluding it was not a true heat syndrome. Citing Zhang Hezi, he stated, "One should release the exterior rather than attack the interior." This case resembled such a pattern. The treatment method should induce sweating. Thus, he formulated a decoction containing *Fuzi* (Aconiti Lateralis Radix Praeparata), *Ganjiang* (Zingiberis Rhizoma), *Renshen* (Ginseng Radix et Rhizoma), and *Baizhu* (Atractylodis Macrocephalae Rhizoma). The liquid was cooled before administration. The patient sweated profusely and recovered.
The wife of Fang's son in Zhugai suffered from excessive sweating following malaria. Upon calling for a maid to change her clothes, she grew angry when the maid did not arrive immediately, leading to syncope resembling death. She revived after being administered *Suhe Xiang Wan* (Styrax Pill). Thereafter, any loud noises, such as heavy footsteps or barking dogs, triggered similar syncope. Dai Yuanli diagnosed a very deficient pulse that scattered upon deep pressure, identifying this as Yang collapse due to excessive sweating, consistent with classical teachings. He prescribed daily tonification with *Huangqi* (Astragali Radix) and *Renshen*. Her fright gradually subsided, and she stabilized within ten days.
Zhu Zhongwen from Songjiang suffered from cold intolerance during late summer, feeling heavy and burdened. His food and drink had to be extremely hot; even slightly warm substances induced vomiting. Other physicians advised consuming three roasted hens daily cooked with *Huajiao* (Zanthoxyli Pericarpium). His condition worsened. Dai Yuanli noted a rapid, large, yet non-deficient pulse. Quoting Liu Shouzhen, "Extreme fire resembles water," he explained that *Huajiao* stimulates fire in the Yin meridians, while chicken promotes phlegm, thereby aggravating the disease. He treated him with *Da Chengqi Tang* to purge accumulation. After more than twenty bowel movements over day and night, his symptoms halved. Subsequently, he was given *Huanglian Daotan Tang* (Coptis Phlegm-Resolving Decoction) mixed with *Zhuli* (Bambusa Textilis Caulis Juice), leading to complete recovery.
The wife of Zhu Ziming from Gusu suffered from prolonged screaming, pausing briefly every few dozen cries. Others believed she was possessed and deemed her untreatable. Dai Yuanli diagnosed it as a depression syndrome, where phlegm obstructed the upper jiao and fire was constrained in the lower jiao. Screaming allowed slight relief of qi stagnation. As the classics state, "When fire is constrained, it must be dispersed." He used a strong emetic, expelling copious amounts of gelatinous phlegm, restoring her health.
Yuan Zhong's wife developed fright after difficult labor, experiencing vertigo as if floating above clouds, with room spinning upon opening her eyes and unsteady posture. Tonics for deficiency and calming spirit treatments failed. Dai Yuanli observed a knotted and choppy left pulse but stable facial expression, attributing the condition to fright causing blood stasis in the Pericardium. He employed purgation, evacuating one *dou* (approx. 10 liters) of dark, lacquer-like stagnant blood, resulting in immediate cure.
The wife of Lu Zhongrong, an official in the Guard, suffered from fever, hallucinations of spirits, and convulsions. *Huanglian Qingxin Tang* (Coptis Heart-Clearing Decoction) prescribed by others was ineffective. Dai Yuanli noted her emaciation and dull complexion, diagnosing empty heat. He applied Li Gao's method of using sweet-warm herbs to resolve great heat, aligning with the classic principle, "Worsen with warmth." Administration of *Renshen* and *Huangqi* brought stability. Many such cases existed.
Medicine originates from the *Suwen* and *Neijing*. Its learning deteriorated first during the Kaiyuan era and again during the Daguan era. Customs prevailed, ignoring subtle principles, relying rigidly on fixed formulas like carving a mark on a boat to find the sword. When criticized, they claimed sufficiency in their methods, rejecting study of the *Neijing*. Qian Zhongyang of the Song Dynasty uniquely mastered ancient texts and expanded them. Zhang Yuansu, Liu Wansu, Li Gao, and others of the Jin Dynasty further elaborated, making Neoteric studies prominent. Mr. Zhu Yanxiu deeply understood Liu Wansu's theories. South of the Yangtze, Neoteric medicine truly flourished through him. Dai Yuanli, his distinguished disciple, inherited essential transmission methods, ensuring accurate diagnosis and miraculous recoveries, akin to washing away filth.
Sima Qian's *Biographies of Medical Officers* recorded twenty-three cases answered by Cang Gong, detailing treatments from Cheng to Xiang Chu. I emulate this intent, listing Dai Yuanli's most striking cases at the beginning. Like the seasonal treatments in the *Rites of Zhou*, discerning readers will surely select valuable insights.