夫有生必有死万物之常也然死不死于老而死于病者万物皆然而人为甚故圣人悯之而医药兴医药兴而天下之人又不
死于病而死于医药矣智者愤其然因曰病而不药得中医岂不信哉或曰此但为伤寒言之也虽然微独伤寒特伤寒为甚尔盖医
莫不宗本黄岐今其书具在然有论而无方方法之备自张仲景始仲景虽独以伤寒着然二千年以来其间以医名世为后学所师
承者未有不从仲景之书悟入而能径窥黄岐之壶奥者也故黄岐犹羲文也仲景其孔子乎易水师弟则濂洛诸贤金华师弟则关
闽诸大儒也拟人者不伦于此矣王好古曰伤寒之法可以治杂病杂病法不可以治伤寒岂诚然哉伤寒法出于仲景故可以治杂
病而为杂病法者多未尝梦见仲景者也故不可以治伤寒也然则伤寒论可弗读乎而世之医有终身目不识者独执陶氏六书以
为枕中鸿宝尔夷考陶氏之书不过剽南阳唾余尚未望见易水门墙而辄诋伤寒论为非全书聋瞽来学盖仲景之罪人也而世方
宗之夭枉可胜道哉余少而读仲景书今老矣尚未窥其堂室平生手一编丹铅殆遍纸败墨渝海虞严道彻见而爱之欲寿诸梓而
余不之许非靳之盖慎之也 丁酉戊戌间因嘉善高生请始辑杂病准绳而不及伤寒非后之盖难之也今岁秋同年姜仲文知余
所辑杂病外尚有伤寒妇婴疡科为准绳者四遣使来就钞而不知余夺于幽忧冗病未属草也因感之而先成伤寒书八帙始于八
月朔而告完于重九或曰以数十万言成于四旬不太草草乎曰余之酝酿于丹府而渔猎于书林盖三十余年矣不可谓草草也伤
寒一病尔而数十万言不太繁乎曰吾犹病其略也何也是书之设为因证检书而求治法者设也故分证而不详则虑其误也详则
多互见而复出而又安得不繁后之注仲景书读仲景法者或见其大全或窥其一斑皆可以为后学指南具择而载之而又安得不
繁且夫人读一书解一语苛迷其理有碍于胸中以问知者则惟恐其不吾告与告之不详余固驽下然学医之资差不在人后以余
所白首不能究者与天下后世共究之将读之恐其易尽而顾患繁乎哉丹阳贺知忍中秘心乎济物而勇于为义愿为余流通书未
成已鸠工庀具矣余之遄成以此因叙于篇首
时万历三十二年岁次甲辰重九日念西居士王肯堂宇泰甫书
有生命就必然有死亡,这是万物的常态。然而,人并非死于衰老,而是死于疾病,这种情况在万物中虽然普遍,但在人类身上尤为严重。因此,圣人对此感到怜悯,于是医药应运而生。医药兴起后,天下的人又出现了不死于疾病而死于医药的情况。明智的人对此感到愤慨,因而说:“生病而不乱用药,才能符合中道(正确的医疗原则),这难道不是真理吗?”
有人说:“这话只是针对伤寒病而言的。”即使如此,不仅限于伤寒,特别是伤寒病最为严重。
大概医学没有不尊崇黄帝、岐伯(中医始祖)为宗师的,他们的著作如今依然存在。但是,只有理论论述而没有具体方剂,直到张仲景才开始完备。张仲景虽然凭借《伤寒论》独步一时,但两千年来,那些以医术闻名于世、被后世学者所师承的人,无不从研读张仲景的书开始领悟,进而能够直接窥探黄帝、岐伯医学的深奥奥秘。所以,黄帝、岐伯就像伏羲、文王一样是奠基者,而张仲景则像孔子一样是集大成者。易水学派(李东垣等)与他们的老师学生之间的关系,就像濂洛学派(周敦颐、程颢、程颐等)诸贤的关系;金华学派(朱熹等)师徒之间的关系,就像关闽学派(二程及朱熹)大儒的关系。拿这些来比拟是不恰当的(意指张仲景的地位远超一般师徒传承)。
王好古说:“治疗伤寒的方法可以用来治疗杂病,但治疗杂病的方法却不可以用来治疗伤寒。”这真的是这样吗?因为伤寒法出自张仲景,所以可以治疗杂病;而那些治疗杂病的方法,大多连张仲景的门径都没见过,所以不能用来治疗伤寒。
那么,《伤寒论》可以不读吗?然而世间的医生中,有的人终身连这本书都不认识,只执着于陶华(陶节庵)的《六书》,把它当作枕中的珍贵宝物。仔细考察陶氏的书籍,不过是窃取张仲景(南阳)的余唾,尚未看到易水学派的门墙,就贬低《伤寒论》不是完整的书,蒙蔽误导后来的学习者,这简直是张仲景的罪人。然而世人还尊崇他,导致夭折枉死者怎能说得完呢?
我年轻时就读张仲景的书,现在老了,还没有完全窥探到其中的堂奥。平生手捧此书,用丹砂和铅笔批注几乎遍满全书,纸张破旧,墨迹模糊。海虞人严道彻看到并喜爱它,想要刻印出版,我不答应,并不是吝啬,而是慎重。
在丁酉、戊戌年间,因为嘉善的高生请求,我开始编纂《杂病准绳》,但没有包括伤寒,这并不是轻视,而是因为难度太大。今年秋天,同年进士姜仲文知道我所编纂的除杂病外,还有关于伤寒、妇科、儿科、疡科(外科)的内容,统称为“准绳”的四部书,便派使者来抄录。但他不知道我被深深的忧愁和繁杂的病务所困扰,未能起草成文。因此受此触动,先完成了伤寒部分的八卷,从八月初一开始,到重阳节结束。
有人问:“用数十万字在四十天内完成,是不是太草率了?”我说:“我在心中酝酿并在书林中广泛涉猎,已经三十多年了,不能说草率。”
有人问:“伤寒只是一类病,为什么用数十万字,是不是太繁琐了?”我说:“我还担心内容不够详尽呢。”这部书的设立,是为了让读者根据症状查找治疗方法而设计的。所以,如果分证不详,就担心会出错;如果详尽,就会有很多互见和重复出现的内容,怎么能不繁琐呢?
后来注释张仲景书、研读张仲景方法的人,或者见到其全貌,或者窥见其一斑,都可以作为后学的指南。既然要具备选择性地记载所有内容,怎么能不繁琐呢?况且,一个人读一本书,理解一句话,如果迷乱了道理,心里有了障碍,去询问懂行的人,那人唯恐不告诉他。告诉他如果不详细,我虽然愚钝,但学习医学的天资并不比别人差。我用自己白头之年仍未能穷尽的道理,与天下后世之人共同探究,只怕读者觉得容易读懂,反而担心内容太繁琐吗?
丹阳人贺知忍,内心秉持救济万物之心,勇于践行义举,愿意帮我流通这部尚未完成的书籍,已经召集工匠准备材料了。我得以迅速完成,就是因为这个原因,所以在篇首叙述。
时值万历三十二年,岁次甲辰,重阳节日,念西居士王肯堂,字宇泰甫,书写。
Life inevitably leads to death; this is the constant law of all things. However, humans do not die from old age but from disease. While this applies to all living beings, it is particularly severe in humans. Therefore, the Sages felt compassion for this and medicine arose. With the advent of medicine, people began to die not from disease, but from medical treatment. Wise individuals, indignant at this situation, declared: "To fall ill without resorting to indiscriminate medication is to attain the 'Middle Way' (correct medical principle); is this not truly so?"
Some might say: "This statement applies only to *Shanghan* (Cold Damage diseases)." Even so, it is not limited to *Shanghan*, but *Shanghan* is particularly prominent.
Generally, medicine reveres Huangdi (Yellow Emperor) and Qibo as its ancestors, and their works still exist. However, while theories were present, specific prescriptions were lacking until Zhang Zhongjing. Although Zhang Zhongjing is renowned primarily for his work on *Shanghan*, over the past two millennia, those who have gained fame in medicine and served as models for later students have all entered the profound mysteries of Huangdi and Qibo by first comprehending Zhang Zhongjing's writings. Thus, Huangdi and Qibo are like Fuxi and King Wen (founders/civilizers), while Zhang Zhongjing is like Confucius (the synthesizer). The relationship between the disciples and masters of the Yishui School (e.g., Li Dongyuan) is akin to that of the Lian-Luo sages (Zhou Dunyi, Cheng Hao, Cheng Yi); the relationship between the masters and disciples of the Jinhua School (Zhu Xi) is akin to that of the Guan-Min great Confucians (the Cheng brothers and Zhu Xi). Comparisons using these lineages are inadequate to describe Zhang Zhongjing's unique status.
Wang Haogu stated: "The methods for treating *Shanghan* can be used to treat miscellaneous diseases, but the methods for treating miscellaneous diseases cannot be used to treat *Shanghan*." Is this truly the case? Since *Shanghan* methods originate from Zhang Zhongjing, they can treat miscellaneous diseases. Conversely, those treating miscellaneous diseases often have never even glimpsed Zhang Zhongjing's approach, and thus cannot effectively treat *Shanghan*.
Then, must one not read the *Treatise on Cold Damage Pathogenic Factors* (*Shanghan Lun*)? Yet, there are physicians in the world who have never seen this book in their entire lives, clinging instead to Tao Hua’s (Tao Jian'an) *Six Books* as a precious treasure. Upon careful examination, Tao’s works merely plagiarize the remnants of Zhang Zhongjing’s (Nanyang’s) teachings. They have not even reached the threshold of the Yishui School, yet they disparage the *Shanghan Lun* as incomplete. This blinds and misleads future learners, making them true sinners against Zhang Zhongjing. Nevertheless, the world still reveres him, leading to countless premature deaths—how can such tragedies be fully recounted?
I read Zhang Zhongjing’s books when I was young, and now that I am old, I have not yet fully penetrated their inner chambers. Throughout my life, I have annotated nearly every page with cinnabar and pencil; the paper is worn, and the ink faded. Yan Daoche from Haiyu saw and cherished these manuscripts and wished to have them printed. I did not consent, not out of stinginess, but out of caution.
During the Dingyou and Wuxu years, at the request of Gao Sheng from Jiashan, I began compiling the *Zhunsheng* (Standard Mirror) for Miscellaneous Diseases, excluding *Shanghan*. This was not due to neglect, but because of the difficulty involved. This autumn, Jiang Zhongwen, a fellow Jinshi, learned that besides the Miscellaneous Diseases volume, I had also compiled volumes on *Shanghan*, gynecology, pediatrics, and surgery, collectively titled *Zhunsheng*. He sent an envoy to copy them, unaware that I was hindered by deep sorrow and numerous illnesses, preventing me from drafting the text. Moved by this, I completed the eight fascicles on *Shanghan* first, starting on the first day of the eighth month and finishing on the Double Ninth Festival.
Someone asked: "Completing hundreds of thousands of words in forty days—is this not too hasty?" I replied: "My mental preparation and extensive reading spanned over thirty years; it cannot be called hasty."
Another asked: "*Shanghan* is just one category of disease; why use hundreds of thousands of words? Is this not too verbose?" I replied: "I still worry that it is insufficiently detailed." This book is designed for readers to check symptoms to find treatments. If the syndrome differentiation is not detailed, errors may occur. If it is detailed, there will necessarily be cross-references and repetitions, making verbosity inevitable.
Later commentators on Zhang Zhongjing’s works, whether seeing the whole picture or only a part, can serve as guides for students. Since comprehensive selection and recording are required, how can it not be verbose? Furthermore, if a reader misunderstands a concept and feels obstructed, and seeks clarification from an expert, the expert should explain thoroughly. Although I am dull, my aptitude for learning medicine is no inferior to others'. I share with the world and future generations the truths I could not fully grasp even in my white-haired years. Readers may fear the text is too easy to finish, rather than worrying about its length.
He Zhiren from Danyang, whose heart is dedicated to benefiting all beings and who acts bravely in righteousness, has offered to help circulate this unfinished work, having already gathered craftsmen and materials. My ability to complete this quickly is due to this support. Therefore, I write this preface.
In the 32nd year of the Wanli era, in the year Jiachen, on the Double Ninth Festival, Nianxi Jushi (Layman Nianxi), Wang Kentang, courtesy name Yu Taifu, wrote this.