石顽老人跌坐绳床，有弟子进问医学宗旨，老人怃然叹曰；崇古圣人立一善政。后世辄增一害民之事。只今伪君
子之风。良由文本。夭生民之患。咎始神丹，吾尝纵观万类。无物不有成败之机。人禀造化之灵。不能超乎万类。
地水火风。常交战于一体。虽有志者。不无疾 之危。一有小剧。即从事于医药。往往贪生失生。深可
哀悯。逮如愚下无知。罔悟前车已覆之鉴。缘是不得正命者。日以继踵。若夫未达不敢尝者。自古及今。能
几人哉。当世之名于医者。有三种大病。一种藉世医之名。绝志圣学。株守家传。恣行削伐。罔顾本元。斯皆
未闻大道之故。一种弃儒业医。徒务博览。不卒师传。专事温补。极诋苦寒。斯皆不达权变之故，一种欺世
盗名，借口给之便佞，赖声气之交通。高车炫术，曲体趋时。日杀无辜。以充食客之肠。竭厥心力。以博妻孥
之笑，斯皆地狱种子。沉沦业识之故，此三种病。非药可除。吾今伏医王力。运六通智。开个教外别传。普
救夭札底微妙法门。汝等若有疑团。向前执问。但须迅扫胸中积染。向白地上从新点出个指下工夫。若能顿然
超悟。立正宗风。何虑不直接南阳先师一脉乎。
或问医药之书。汗牛充栋。当以何者为先。答曰。医林著作日繁。葛藤益甚。而识见愈卑。总皆窃取狐涎。
搜罗剩语。从无片言发自己灵者。吾故曰。教外别传。不欲汝等堕诸坑堑也。近来留心斯道者。纷如泥沙。求其具夙根
者。卒不可得。是不得不稍借文本。以为接引之阶梯。但此夺权造化。负荷非轻。即有真心向道，以天下生民为己任者。
入门宗派不慎。未免流入异端。向后虽遇明师检点。头绪决不能清。头绪不清。审证必不能确。审证不确。下手亦无辣
气。安望其有转日回天之 乎。有志之士。务在先明灵枢素问伤寒论金匮要略四经。为医门之正法眼藏。然皆义深辞简
，质奥难明。读者不可随人作解。以障己之悟门。或遇不能透脱处。撞着银山铁壁相似。于挨拶不入处。忽地
顶门迸裂。自然洞若观火。然后看古人注释。却不仍其纰缪。直待胸中学识坚固。随意综览诸家。无往非受
其益。即如刘张李朱。世推四大家。观其立言之旨。各执一偏。河间之学。悉从岐伯病机十九条入首。故其立方
。一于治热。戴人专于拨乱除邪上起见。故汗吐下法。信手合辙。要知二子道行西北。地气使然之故。不可强也。
东垣志在培土以发育万物。故常从事乎升阳。丹溪全以清理形气为本。故独长于湿热。二子之道。虽皆行于东
南。然一当颠沛。一当安和。补泻升沉之理。不可不随时迁变也。在学识粗浅者。不能委悉其全。即当因材教
诲。指与个快捷方式工夫。
一般到家。惟脉学之言。自古至今。曾无一家可宗者。某不自揣。窃谓颇得其髓。惜不能力正习俗之讹。
咸归先圣一脉。是不能无愧于心。或云。夫子之道。昭乎日月。而尚有不辨明暗者。何也。曰。是某之机缘不
契。亦众生之机缘不契也。教乘所谓时节因缘。非可强也。吾闻佛法无边。能度一切有情。而不能化导无缘。
岂区区智力。能充 法界。使悉归心至教乎。今观游时师之门者。一皆羊质虎皮。问其所学。无非伪诀药性
等书。家弦户诵。不过如斯。今古相仍。莫知其谬。盖伪诀出自高阳生。昔戴起宗尝着刊误以辟其妄。而聋
之师。犹视以为资生至宝者。以其编成俚语。易于习诵也。药性赋不知出自何人。乃诬妄东垣所着。尤为发指。
吾愿祖龙有知。凡有二书处。请用从火。造福无涯矣。至于王氏脉经。杨（原误全）氏太素。多拾经语。溷厕
杂毒于中。偶一展卷。不无金屑入眼之憾。他如紫虚四诊。丹溪指掌。撄宁枢要。濒湖脉学。士材正眼等。
靡不称誉于时。要皆刻舟求剑。按图索骥之说。迨夫得心应手之妙。如风中鸟迹。水上月痕。苟非智能辨才，
乌能测识其微于一毫端上哉。只今诸方云集。向某问个脉法大义。吾当以三昧水涤除尘见。显示个头头
是道底活法悟门。不涉纤微陈迹。便可言下荐机。学人毋以余言为尚异也。要知冰即是水。别传之义。原不外
乎轩岐仲景祖祖相承之心印。但较当世所言七表八里之法。趋舍殊途。宗旨迥乎角立耳。
石顽老人盘腿端坐在绳床上，有弟子进前询问医学的宗旨。老人怅然叹息道：“推崇古代圣人设立一项善政，后世却随即增加一件害民的事。如今的伪君子之风，确实源于对文本的拘泥。残害百姓的祸患，罪过始于那些所谓的‘神丹’（指代盲目迷信或错误的医疗手段）。我曾广泛观察万物，没有哪一样事物不具备成败转化的契机。人禀受了造化的灵性，却无法超脱于万物之外。地、水、火、风四大元素，常在人体内相互交战。即使是有志气的人，也难免有疾病的危险。一旦病情稍重，便从事医药治疗，往往因为贪生怕死反而导致死亡，这实在令人哀悯。至于像愚昧无知的人，不明白前车之覆的教训，因此不得善终的人，每天接踵而至。至于那些尚未通达医理就不敢轻易尝试用药的人，从古至今，能有几个呢？
当今世上的名医，有三种大病：第一种是借世家医生的名声，断绝了向圣学追求的心志，死守家传秘方，肆意攻伐，不顾护人体本元。这都是因为没有听闻大道的缘故；第二种是放弃儒业转而学医，只追求博览群书，不彻底继承师传，专门从事温补疗法，极力诋毁苦寒药物。这都是不懂得权变之道的缘故；第三种是欺世盗名，借口便利而巧言令色，依赖人际关系的疏通。乘坐高车炫耀医术，曲意迎合时俗，每日杀害无辜之人来填饱食客之肠，耗尽自己的心力来博取妻儿的欢笑。这都是地狱种子的根源，沉沦于业识之中的缘故。这三种病，不是药物可以去除的。我现在仰仗医王的力量，运用六通智慧，开设教外别传的教法，普救夭折和瘟疫的微妙法门。你们如果有疑惑，上前执意发问，但必须迅速扫除胸中的积习染污，在白纸地上重新点出指下的功夫。如果能顿然超凡领悟，确立正宗风气，何愁不能直接承接南阳先师（张仲景）的一脉相承呢？
有人问：医药书籍多如牛毛，应当以哪一本为先？回答说：医林著作日益繁多，纠缠不清的现象更加严重，而见识却越来越低下。全都是窃取狐涎（比喻虚假不实的东西），搜集剩语残篇，从来没有一句能发自自己灵性的言论。所以我说是教外别传，是不希望你们陷入坑堑之中。近来留心此道的人，多如泥沙，想要找到具有夙根（先天资质好）的人，最终不可得。因此不得不稍微借助文本，作为接引的阶梯。但这夺取造化之功，负荷非轻。即使有真心向道，以天下苍生为己任的人，如果入门宗派不慎，未免流入异端。以后虽然遇到明师指点，头绪也绝不能理清。头绪不清，审证必然不能准确；审证不确，下手也就没有辣手回春的气魄，怎能期望有转日回天的功效呢？有志之士，务必先明了《灵枢》、《素问》、《伤寒论》、《金匮要略》这四部经典，这是医门的正法眼藏。然而这些书义理深奥、文辞简练，质地古奥难以明白。读者不可随顺他人的解释，以免障碍自己的悟门。如果遇到不能透脱的地方，就像撞着银山铁壁一样，在挨拶不入之处，忽然头顶迸裂（比喻豁然开朗），自然洞若观火。然后再看古人的注释，就不会沿袭他们的纰缪。直待胸中学识坚固，随意综览诸家学说，无处不是受益。就像刘完素、张从正、李东垣、朱震亨，世人推为四大家，看他们立言的宗旨，各执一端偏颇。河间（刘完素）的学问，完全从岐伯的《病机十九条》入手，所以他立方，一味治热；戴人（张从正）专门从拨乱除邪的角度着眼，所以汗、吐、下三法，信手合辙。要知道这两人行医于西北，是地气使然，不可勉强。东垣立志通过培土来发育万物，所以常从事于升阳；丹溪全以清理形气为本，所以独长于湿热。这两人的道理，虽然都行于东南，但一个处于颠沛流离之时，一个处于安和太平之日，补泻升沉的道理，不可不随时迁移变化。对于学识粗浅的人，不能完全知晓其全貌，就应当因材施教，指引快捷方式的功夫。一般都能达到同样的境界。
只有脉学的言论，从古至今，曾没有一家可以作为宗法的。我不自量力，窃以为颇得其精髓，可惜不能力正习俗的错误，全部归入先圣一脉，心中不能无愧。有人说：夫子之道，昭如日月，却还有不辨明暗的，为什么呢？我说：这是我的机缘不契合，也是众生的机缘不契合。佛教所谓时节因缘，是不可强求的。我听说佛法无边，能度一切有情众生，但不能化导无缘之人。岂是我区区智力，能充满法界，使所有人都归心至教呢？现在观察游历于时师门下的人，全都是羊质虎皮（外表像老虎，本质是羊，比喻虚有其表）。问他们所学，无非是伪诀、药性等书，家家弦诵，不过如此。古今相沿，没人知道其中的谬误。大概伪诀出自高阳生，过去戴起宗曾著刊误来辟斥其妄，但聋聩的老师，还视其为资生至宝，因为其编成俚语，易于习诵。药性赋不知出自何人，却诬陷是东垣所著，尤为令人发指。我希望秦始皇若有知，凡有这两本书的地方，请用火烧掉，造福无涯矣。至于王叔和的《脉经》，杨上善的《太素》，多是拾取经文语句，混杂杂毒在其中，偶尔翻开一卷，不免有金屑入眼的遗憾。其他如紫虚四诊、丹溪指掌、撄宁枢要、濒湖脉学、士材正眼等，无不当时称誉。但都是刻舟求剑、按图索骥的说法。等到得心应手的妙处，如同风中的鸟迹、水上的月痕，如果不是智能辩才，怎么能在一毫端上测识其细微呢？如今各方云集，向我询问脉法大义，我将用三昧水涤除尘见，显示头头是道的活法悟门。不涉丝毫陈迹，便可言下荐机（当下推荐玄机）。学人不要认为我的话是标新立异。要知道冰即是水，别传的意义，原本不外乎轩岐仲景祖祖相承的心印，只是与当世所说的七表八里之法，趋舍殊途，宗旨迥然对立罢了。
The old man Shiweng sat cross-legged on a rope bed. A disciple approached and asked about the fundamental principles of medicine. The old man sighed with a melancholy expression and said, "We revere the ancients for establishing good governance, yet later generations have added harmful practices to the people. The current trend of hypocritical scholars stems largely from an over-reliance on texts. The calamity befalling the common people originates from the misuse of so-called 'miracle elixirs' (referring to blind faith in or erroneous medical interventions). I have observed all living things extensively; nothing lacks the potential for success or failure. Humans are endowed with the spirit of creation but cannot transcend the realm of all things. The four elements—Earth, Water, Fire, and Wind—constantly battle within the body. Even those with strong wills are not immune to the danger of disease. Once illness becomes severe, they turn to medicine, often losing their lives due to greed for survival, which is truly pitiable. As for the ignorant who fail to learn from past mistakes, those dying prematurely follow one after another day by day. As for those who dare not try treatments until they fully understand them, how many such people have there been from ancient times to the present?
There are three major diseases among today's famous physicians: First, some rely on the reputation of family doctors, abandon the pursuit of sage learning, rigidly adhere to family secrets, practice indiscriminate purging and attacking, and disregard the patient's original vitality. This is because they have not heard of the Great Dao. Second, some abandon Confucian studies for medicine, merely pursue extensive reading without thoroughly inheriting their master's teachings, specialize in warm and tonifying methods, and vehemently condemn bitter and cold drugs. This is due to a lack of understanding of flexibility and adaptation. Third, some deceive the world and steal fame, using flattery and relying on social connections. They ride in high carriages to show off their skills, cater to contemporary trends, kill innocent people daily to fill the bellies of their guests, and exhaust their mental energy to win the smiles of their wives and children. These are seeds of hell, destined to sink into karmic consciousness. These three diseases cannot be cured by medicine. Now, relying on the power of the Medical King and wielding the wisdom of the Six Supernormal Powers, I open a transmission outside the scriptures to save those suffering from premature death and plague through subtle dharma gates. If you have doubts, come forward and ask firmly, but you must swiftly sweep away the accumulated stains in your mind and start anew on a blank slate regarding your clinical skills. If you can suddenly attain enlightenment and establish the orthodox style, why worry about not directly inheriting the lineage of Master Nanyang (Zhang Zhongjing)?
Someone asked: Medical books are as numerous as oxen carrying loads of books. Which should be prioritized? I replied: Medical writings increase daily, becoming more tangled, while insight becomes lower. All are merely stealing fox saliva (metaphor for false and insubstantial content) and collecting leftover words. Never has a single word emerged from one's own spirituality. Therefore, I speak of a transmission outside the scriptures, not wanting you to fall into pitfalls. Recently, those paying attention to this path are as numerous as sand and mud, but finding those with innate roots (innate aptitude) is impossible. Thus, we must slightly rely on texts as a ladder for guidance. However, this usurping of creation's work carries a heavy burden. Even those with true hearts towards the Dao, taking the welfare of the people as their responsibility, if they are careless about their initial school of thought, may drift into heterodoxy. Later, even if they meet a wise teacher to correct them, the threads of logic will never be clear. Unclear threads lead to inaccurate syndrome differentiation; inaccurate differentiation leads to hesitant treatment. How can one expect miraculous cures? Those with ambition must first clearly understand the *Ling Shu* (Spiritual Pivot), *Su Wen* (Basic Questions), *Shang Han Lun* (Treatise on Cold Damage), and *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet). These are the eye treasury of the orthodox method in medicine. However, their meanings are profound, language concise, and nature obscure and difficult to comprehend. Readers must not accept others' interpretations blindly, lest they block their own doors to enlightenment. When encountering places that cannot be penetrated, it feels like hitting an iron mountain or wall. Suddenly, at the point where entry seems impossible, the top of the head bursts open (metaphor for sudden clarity), and everything becomes clear as fire. Only then should one look at ancient commentaries, avoiding their errors. Wait until one's theoretical knowledge is solid, then freely browse various schools, benefiting everywhere. Take Liu Wansu, Zhang Congzheng, Li Dongyuan, and Zhu Zhenheng, known as the Four Great Masters. Their doctrines each hold a bias. Hejian's (Liu Wansu) learning starts from Qibo's Nineteen Pathogenic Mechanisms, so his prescriptions focus entirely on treating heat. Dairen (Zhang Congzheng) focuses on restoring order and eliminating evil, so his sweating, vomiting, and purging methods fit perfectly. Know that these two practiced in the Northwest due to local climate conditions, which cannot be forced. Dongyuan aimed to cultivate Earth to nurture all things, so he often engaged in raising Yang. Danxi focused on clearing and regulating form and Qi, so he excelled in treating damp-heat. Although both of their paths were followed in the Southeast, one faced turmoil while the other enjoyed peace. The principles of tonification, purgation, ascending, and descending must change according to the times. For those with shallow knowledge who cannot grasp the whole, teaching should be tailored to the student, pointing out quick methods. Generally, they reach the same destination.
However, regarding pulse diagnosis, no single school since ancient times has been worthy of worship. I, presumptuously, believe I have grasped its essence, but alas, I could not correct popular errors to return to the lineage of the Sages, leaving me with a guilty conscience. Some say: The Master's Way is bright as the sun and moon, yet there are still those who cannot distinguish light from dark. Why? I say: It is my karma that does not align, and also the beings' karma that does not align. Buddhist doctrine speaks of timing and conditions, which cannot be forced. I hear that Buddha's Dharma is boundless, able to save all sentient beings, but cannot transform those without affinity. How can my limited intellect fill the Dharma Realm and make everyone submit to the supreme teaching? Now, observing those visiting contemporary teachers, they are all sheep with tiger skins (superficial appearance). Asking what they learned, it is nothing but fake formulas and Materia Medica rhymes, recited in every home. Ancient and modern customs persist, unaware of the errors. The fake formulas originated from Gaoyang Sheng. Dai Qizong once wrote corrections to expose his falsehoods, but deaf teachers still regarded them as treasures for life because they were written in colloquial language and easy to memorize. The *Materia Medica Rhyme* (*Yao Xing Fu*) authorship is unknown, yet falsely attributed to Dongyuan, which is infuriating. I wish if Qin Shi Huang had any awareness, he would burn these two books, bringing boundless merit. As for Wang Shuhe's *Mai Jing* (Pulse Classic) and Yang Shangshan's *Tai Su*, they mostly pick up scriptural phrases, mixing impurities within. Opening them occasionally causes regret like gold dust entering the eyes. Others like *Zi Xu Si Zhen*, *Dan Xi Zhi Zhang*, *Ying Ning Shu Yao*, *Bin Hu Mai Xue*, and *Shi Cai Zheng Yan* are praised at the time. But they are all like carving a mark on a boat to find a sword, or looking for a horse by picture. When reaching the subtlety of heart and hand coordination, it is like bird tracks in the wind or moon reflections on water. Without intelligence and eloquence, how can one perceive the micro-details? Today, various schools gather. If you ask me the general principles of pulse diagnosis, I will use the Water of Samadhi to wash away dusty views and reveal the living dharma gate where everything is right. Not touching the slightest trace, one can recommend the mechanism instantly. Students, do not think my words are eccentric. Know that ice is water. The meaning of this special transmission is originally no different from the mind-seal passed down from Xuanyuan, Qibo, and Zhongjing. It only differs from the contemporary methods of Seven Surfaces and Eight Interiors, taking different paths and standing in stark contrast in principle.