余发始燥,则闻长老道说范文正公未逢时,祷于神以不得为良相,愿为良医。
因叹古君子之存心济物,如此其切也。当是时,颛蒙无所知顾,读岐黄家言,辄心
开意解,若有夙契者。嘉靖丙寅母病阽危,常润名医,延致殆遍,言人人殊,罕得要领,
心甚陋之,于是锐志学医。既起亡妹于垂死,渐为人知,延诊求方,户屣恒满。先
君以为妨废举业,常严戒之,遂不复穷究。无何举于乡,又十年成进士,选读中秘
书,备员史馆,凡四年,请急归,旋被口语,终已不振。因伏自念受圣主作养浓恩,
见谓储相材,虽万万不敢望文正公,然其志不敢不立,而其具不敢不勉,以庶几无
负父师之教,而今已矣。定省之余,颇多暇日,乃复取岐黄家言而肆力焉。二亲笃
老善病,即医非素习,固将学之,而况乎轻车熟路也。于是闻见日益广,而艺日益
精,乡曲有抱沉 ,医技告穷者,叩阍求方,亡弗立应,未尝敢萌厌心,所全
活者,稍稍众矣。而又念所济仅止一方,孰若着为书,传之天下万世耶。偶嘉善高
生隐从余游,因遂采取古今方论,参以鄙见,而命高生次第录之,遂先成杂病论与
方各八巨 。高生请名,余命之曰《证治准绳》。高生曰∶何谓也?余曰∶医有
五科七事,曰脉、曰因、曰病、曰证、曰治为五科,因复分为三,曰内、曰外、曰
亦内亦外,并四科为七事。如阴阳俱紧而浮脉也,伤寒因也,太阳病也,头痛发热
身痛恶寒无汗证也,麻黄汤治也。派析支分,毫不容滥,而时师皆失之不死者,幸
而免耳。自陈无择始发明之,而其为《三因极一方》,复语焉不详。李仲南为《永类
钤方》,枝分派析详矣,而入理不精,比附未确。此书之所以作也。曰五科皆备焉,
而独名证治何也?曰以言证治独详故也。是书出,而不知医不能脉者,因证检书而
得治法故也。虽然,大匠之所取,平与直者准绳也。而其能用准绳者,心目明也。
倘守死句而求活人,以准绳为心目,则是书之刻,且误天下万世,而余之罪大矣。
家贫无赀,假贷为之,不能就其半,会侍御周鹤阳公以接鹾行县至金坛,闻而
助成之,遂行于世。
时万历三十年岁次壬寅夏五月朔旦念西居士王肯堂宇泰识
我头发开始变白时,就听长辈们讲述范文正公(范仲淹)在尚未得志时,向神明祈祷:如果不能成为良相,那就愿做良医。
因此感叹古代君子救济万物的心意,竟是如此迫切。当时我愚昧无知,只是阅读岐黄家的医学著作,总是心中豁然开朗、意念通达,仿佛有前世的契合一样。嘉靖丙寅年,母亲病重濒危,常州、润州的名医几乎都请遍了,但每个人说法不同,很少能抓住要领,我心里很轻视这种状况,于是立志学习医学。不久后我将濒死的妹妹从死亡边缘救回,渐渐被人知晓,前来诊治求药的人,门口常堆满脱落的鞋子。先父认为这妨碍了科举学业,常常严厉告诫我,于是不再深入探究。没过多久我在乡试中举,又过了十年考中进士,被选入翰林院读书,在史馆充数任职,共四年,请假回家后,随即遭到流言攻击,最终仕途不再振兴。于是我私下思量,承受圣主养育的深厚恩情,被视为宰相的人才储备,虽然万万不敢奢望像范文正公那样,但他的志向我不敢不树立,他的才能我不敢不努力,希望能不辜负父亲和老师的教诲,然而如今已经晚了。在早晚问安双亲之余,有很多空闲时间,于是重新拿起岐黄家的医学著作并致力钻研。父母年老多病,即使医学不是我一贯修习的,本来也要去学习,何况是驾轻就熟呢?于是我的见闻日益广泛,医术日益精湛,乡里有怀抱沉疴、医生技艺穷尽无法治愈的人,上门求方,没有不立刻见效的,我从未敢产生厌烦之心,所保全救活的人,逐渐多了起来。我又想到所救济的范围仅止于一方之地,不如著书立说,流传天下万世呢。偶然嘉善的高生隐跟随我游学,于是便采取古今方论,参酌我的见解,让高生依次抄录,于是先完成了《杂病论》与《方》各八卷。高生请求命名,我命名为《证治准绳》。高生问:这是什么意思呢?我说:医学分为五科七事,即脉、因、病、证、治为五科,其中“因”又分为三类,即内、外、亦内亦外,加上四科共为七事。例如阴阳俱紧且浮的脉象是脉,伤寒是因,太阳病是病,头痛发热身痛恶寒无汗是证,麻黄汤是治。派别分析分支明确,丝毫不容混杂,而当时的医生都失之毫厘,不死已经是侥幸免除了。自从陈无择开始阐明这一理论,但他写的《三因极一病证方论》,却又语焉不详。李仲南写的《永类钤方》,分支分析很详细,但入理不精,比附不准确。这就是本书写作的原因。问:既然五科都具备,为什么只叫“证治”呢?回答说:因为关于证治的部分特别详尽的缘故。这本书出来后,不懂医学不能切脉的人,可以根据症状查书而得到治疗方法。虽然如此,高明的工匠所取用的,平直的标准就是准绳。而能够使用准绳的,是因为心目清明。如果死守僵硬的条文去追求灵活救人,把准绳当作心目,那么这本书的刊刻,将会误导天下万世,那我的罪过就大了。家里贫穷没有资金,借贷来制作它,还不足以完成一半,恰逢侍御周鹤阳公因为巡视盐务经过金坛,听说此事后资助完成,于是得以刊行于世。
时值万历三十年岁次壬寅夏五月朔旦,念西居士王肯堂宇泰识记
When my hair first began to turn white, I heard elders recount how Fan Zhongyan (Fan Wenzheng), before achieving success, prayed to the gods: if he could not become a good chancellor, he wished to be a good physician.
Thus, I sighed at how urgent and profound the benevolent intention of ancient gentlemen was in saving people and benefiting all things. At that time, being ignorant and unenlightened, whenever I read the medical writings of Qi Bo and Huang Di (the Yellow Emperor), my mind would suddenly open and my understanding would clarify, as if there were a predestined connection. In the Bingyin year of the Jiajing reign, my mother fell critically ill. Famous physicians from Changzhou and Runzhou were almost all summoned, yet their opinions varied greatly, rarely grasping the essential principles. I felt disdain for such superficiality and thus resolved to study medicine. Soon after, I saved my dying sister from the brink of death, and gradually became known. Patients seeking diagnosis and prescriptions filled my doorstep with worn-out shoes. My father believed this interfered with my preparation for the imperial examinations and often warned me strictly, so I ceased further deep inquiry. Not long after, I passed the provincial examination, and ten years later, I became a Jinshi (degree holder). I was selected to read manuscripts in the Secret Library and served nominally in the History Bureau for four years. After requesting leave to return home, I was soon subjected to slander and gossip, and my official career never recovered. Reflecting privately, I received the profound grace of the Holy Sovereign’s nurturing and was regarded as potential talent for the chancellorship. Although I dared not hope to equal Fan Wenzheng, I dared not fail to establish my aspiration nor neglect to cultivate my abilities, hoping to live up to the teachings of my father and teachers. However, it is now too late. During the spare time available after paying morning and evening respects to my parents, I resumed my efforts on the medical texts of Qi and Huang. My parents were advanced in age and prone to illness; even if medicine were not my lifelong pursuit, I would still have had to learn it, let alone having already mastered the basics. Consequently, my knowledge and experience broadened daily, and my skills became increasingly refined. When villagers suffered from chronic illnesses where other doctors’ skills had failed, they would knock on my door seeking prescriptions, and I never failed to respond immediately. I never harbored any resentment, and the number of lives I preserved and revived gradually increased. Yet, I pondered that the scope of my aid was limited to one locality; why not compile a book to transmit these methods to the world for all generations? Gao, a scholar from Jiashan, happened to study under me. Thus, I collected ancient and modern formulas and theories, incorporated my own insights, and instructed Gao to transcribe them in order. This resulted in the completion of *Treatise on Miscellaneous Diseases* and *Formulas*, each in eight large volumes. Gao asked for a title, and I named it *Zhengzhi Zhunsheng* (Standard Weights for Diagnosis and Treatment). Gao asked, “What does this mean?” I replied, “Medicine is divided into five categories and seven aspects: Pulse, Etiology, Disease, Syndrome, and Treatment constitute the five categories. Etiology is further subdivided into three: Internal, External, and Both Internal and External. Together with the other four categories, these form seven aspects. For example, a pulse that is both Yin-Yang tight and floating indicates the etiology of Cold Damage (Shanghan); Taiyang Disease (Taiyang syndrome) is the disease name; headache, fever, body pain, aversion to cold, and absence of sweating are the syndrome manifestations; and Mahuang Tang (Ephedra Decoction) is the treatment method. The classification is precise and distinct, allowing no ambiguity. Yet, contemporary physicians often miss these distinctions, and patients survive only by luck. Chen Wuzhe was the first to elucidate this theory, but his work *Sanjiu Ji Yi Bing Zheng Fang Lun* (Precise One Formula Book for Three Causes of All Diseases) lacks detail. Li Zhongnan’s *Yonglei Qianfang* (Permanent Type Precious Formulas) analyzes branches and categories in detail, but its theoretical depth is insufficient, and its analogies are inaccurate. This is why this book was written.” Gao asked, “Since all five categories are included, why is it named specifically ‘Diagnosis and Treatment’?” I answered, “Because the sections on Syndrome Differentiation and Treatment are particularly detailed. With this book published, those who do not understand medicine or cannot take pulses can consult the book based on symptoms to find treatment methods.” Nevertheless, the standard used by a master craftsman is the plumb line and straightedge. But the ability to use these standards depends on clear vision and sharp judgment. If one rigidly adheres to fixed rules while trying to treat living patients, treating the standard itself as the eye and mind, then the publication of this book will mislead the world for generations, and my guilt would be immense. Due to poverty, I borrowed money to fund the printing, but funds were insufficient to complete half. Fortunately, Censor Zhou Heyang, inspecting salt administration in Jintan, heard of this and provided financial support, allowing the book to be published.
Recorded by Nianxi Jushi (Lay Buddhist Nianxi), Wang Kentang, courtesy name Yu Tai, on the first day of the fifth month of the summer of Renyin, the 30th year of the Wanli reign.