治阴阳易。
上取妇人中 近隐处。剪烧灰。以水和服方寸匕。日三服。小便即利。阴头微肿。则愈。
妇人病。取男子中 烧服。
歌曰 近阴裆裤剪来烧。研末还须用水调。同气相求疗二易。长沙无法不翘翘。
张隐庵曰。 裆乃阴吹注精之的。盖取彼之余气劫彼之余邪。邪毒原从阴入。复使之从
阴以出。故曰。小便利。阴头微肿。即愈。
治大病瘥后。劳复者主之。若有宿食。加大黄。
枳实（三枚 炙。） 栀子（十四枚） 香豉（一升）
上三味。以清浆水七升。空煮取四升。内枳实、栀子。煮取二升。下豉。更煮五六沸。
去滓。温分再服。覆令微似汗。
歌曰 一升香豉枳三枚。十四山栀复病该。（伤寒论只以大病后劳复者六字该之。不着
其病形。）浆水法煎微取汗。食停还藉大黄开。（若有宿食者。加大黄如博棋子大五六枚。）
张隐庵曰。大病瘥后。则阴阳水火始相交会。劳其形体。则气血内虚。其病复作。其证不一
。故不着其病形。只以此方统治之。方中栀子清上焦之烦热。香豉启下焦之水津。枳实炙香
宣中焦之土气。三焦和立三百九十七法。法以方而行。方以法而定。开千百年之法眼。不可
专谓为方。仲景后。此道渐晦。至唐。赖有孙思邈起而明之。着千金方。其方俱从伤寒论套
出。又将伤寒论一一备载不遗。惜其字句不无增减。章节不无移易。又不能闱发其奥蕴。徒
汲汲于论中各方。临摹脱换。以求新异。且续刻千金翼以养性补益。各立一门。遂致后医以
补脾补肾。脾肾双补。补气补血。气血两补。温补凉补。不温不凉之平补等方。迎合于富贵
之门。鄙陋之习。由此渐开。究非千金方之过。不善读千金方之过也。后学若取其所长。弃
其所短。则千金书何尝非仲景书之翼也耶。千金私淑仲景。时有羹墙之见。其方托言龙宫秘
方。盖以仲景居卧龙冈。其伤寒金匮方即为龙宫方。老生恒谈。神明瘁鬼神来告。岂其真为
神授哉。家严少孤。家徒四壁。半治举子业。半事刀圭家。日见各医竞尚唐宋各汇方。金元
刘张朱李四大家。以及王宇泰、薛立斋、张景岳、李士材辈。滥收各方而为书。是有方之书
行而无方之书逐废。心甚悯之。每欲以家藏各方书付之祖龙。而于无方之本经、内经、难经
。及祖述伊芳圣经方之仲景书。寝食数十年弗倦。自千金以下无讥焉。壬子登贤书后。寓都门
。适伊芳云林先生患中风证。不省人事。手足偏废。汤米不入者十余日。都门名医。咸云不治
。家严以二大剂起之。名噪一时。就诊者门外无虚辙。后因某当事强令馆于其家。辞弗就。
拂其意。癸丑秋托病而归。后出宰畿辅。恐以医名蹈癸丑岁之前辙。遂绝口不谈。而犹私自
着书。尝语蔚曰。三不朽事。立言居其一。时文词赋不与焉。有人于此。若能明仲景之道。
不为异端末学所乱。民不夭札。其功德且及于天下后世也。前刻公余医录等书。皆在保阳
己注释后。若存若没。千有余年。至今日方得其真谛。与时俗流传之医书大有分别。所苦者
方中分两轻重。煮渍先后。分服、顿服、温服、少冷服等法。毫厘间大有千里之判。不得不
从俗本。编为歌括。以便记诵。命蔚于歌括后各首拟注。亲笔改易。其于蔚之千虑一得处。
则圈之又圈。点之又点。意欲大声疾呼。唤醒千百医于靡靡欲寤中忽然警觉而后快。至于金
匮方。又命弟元犀韵之。蔚则仿建安许氏内台方议体。为之逐条立议焉。盖以高年之心。不
堪多用。蔚与弟元犀不过效有事服劳之道。非敢轻动笔墨也云尔。时嘉庆二十四年岁次己卯
冬至后五日也。男蔚谨识。
蔚再按。以上拟注及附识一条。皆家严亲自裁定。付刻后。每欲于注中说未了者。续出
数条。庶无剩义。因阅时贤徐灵胎医书六种。其首卷有论六条。颇见晓畅。蔚可以不必再续
也。今附录于后。以公同好。
治疗阴阳易病。
取妇人阴部附近衣物，剪碎烧成灰。用水调和，服用一方寸匕。每日三次。小便通畅，阴头轻微肿胀，即痊愈。
若是男子患此病，取男子的衣物烧服。
歌诀说：
剪下靠近阴部的裤裆来烧制，
研成粉末还需用水调匀。
同气相求以治疗两种“易”病，
长沙（指张仲景《伤寒杂病论》）的方剂无不精妙高超。
张隐庵说：
裆部是精气吹注、排泄的精确部位。大概是取对方的残余之气，来劫除对方体内的残余邪气。邪毒原本从阴部进入，现在又使其从阴部排出。所以说，小便通利，阴头轻微肿胀，就是痊愈的标志。
主治大病初愈后，因劳累而复发者。如果有宿食停滞，加大黄。
枳实（三枚，炙过）、栀子（十四枚）、香豉（一升）。
以上三味药，用清浆水七升，先空煮至四升。加入枳实、栀子，煮取二升。再加入香豉，继续煮五六沸。
滤去药渣。温服，分两次服用。服药后覆盖衣被，使身体微微似有汗出。
歌诀说：
一升香豉配三枚枳实，十四枚山栀能涵盖复病的各种情况。（《伤寒论》仅用“大病后劳复者”六个字概括，不具体描述病症形态。）
用浆水煎煮以求微汗，若有食物停滞，还须借助大黄来开通。
张隐庵说：
大病初愈，阴阳水火才开始交会。如果劳累形体，则气血内部虚弱，疾病因此复发。其证候不一，所以不具体描述病症形态，只用这个方子统摄治疗。方中栀子清除上焦的烦热，香豉开启下焦的水津，炙过的枳实宣通中焦的土气。三焦调和，立刻衍生出三百九十七种治法。法通过方来施行，方通过法来确定。这开启了千百年来的医学法眼，不能仅仅把它看作一个方子。张仲景之后，这门学问逐渐晦暗不明，到了唐代，幸亏有孙思邈兴起并阐明它，撰写了《千金方》。其中的方剂都出自《伤寒论》的套路，又将《伤寒论》一一详细记载，毫无遗漏。可惜其文字句子不免有所增减，章节也不免有所移易，又不能阐发其中的深奥蕴意，只是急切地临摹变换《伤寒论》中的各方，以求新奇特异。并且续刻《千金翼方》专门讲养性补益，各立一门，于是导致后世医生迎合富贵人家，推崇补脾补肾、脾肾双补、补气补血、气血两补、温补凉补、不温不凉的平补等方剂，这种鄙陋的风气由此渐渐打开。究其根本，并非《千金方》的过错，而是不善于阅读《千金方》的过错。后学者如果取其长处，弃其短处，那么《千金方》何尝不是《仲景书》的羽翼呢？孙思邈私下尊崇仲景，常有仰慕如见其人之感。他的方剂托言是龙宫秘方，大概因为仲景居住在卧龙冈，其《伤寒金匮方》就被称为龙宫方。老生常谈，神明憔悴时鬼神来告知，难道真的是神授吗？
家父年少丧父，家中贫穷，只有四面墙壁。他一半时间从事科举学业，一半时间钻研医术。每天看到各位医生竞相崇尚唐宋以来的各种汇编方书，以及金元时期刘完素、张元素、朱震亨、李东垣四大家，还有王宇泰、薛立斋、张景岳、李士材等人，广泛收集各方编撰书籍。这使得有方剂的书籍流传，而没有方剂的根本经典——《本经》、《内经》、《难经》，以及祖述伊尹《汤液经法》的仲景之书，却逐渐被废弃。心中对此深感怜悯。常常想把家中收藏的各种方书付之一炬，而对于没有方剂的本经、内经、难经，以及祖述伊尹圣经方的仲景之书，几十年来寝食不忘，不知疲倦。对于《千金方》以下的书籍，没有什么可非议的。
壬子年考中举人后，寓居京城。恰逢伊云林先生患中风证，人事不省，手足偏废，汤药米食不进已有十多天。京城的名医都说无法医治。家父用两大剂药将他救起，名声震动一时。就诊的人门外没有空的车辙。后来因为某位官员强行邀请他在家里做幕僚，他推辞不去，触怒了对方。癸丑年秋天，他借口生病回家。后来那位官员出任畿辅地区的长官，担心家父以医名重蹈癸丑年的旧辙，于是家父绝口不谈医术，但仍然私下著书。曾对我说：“三不朽的事业，立言居其一，但八股时文词赋不算在内。如果有人能阐明仲景之道，不被异端末学所扰乱，百姓不遭夭折病痛，其功德将惠及天下后世。”之前刊刻的《公余医录》等书，都是在保定己卯年注释之后，若存若没，一千多年，直到今天才得到真谛，与时俗流传的医书大有分别。所苦恼的是，方中药物的分量轻重，煎煮浸泡的先后顺序，分服、顿服、温服、少冷服等方法，毫厘之间就有千里之差，不得不依照世俗版本，编写为歌括，以便于记诵。命令我在歌括后面每首拟定注释，亲自修改润色。对我那些千虑一得的见解，则圈之又圈，点之又点，意图大声疾呼，唤醒千百名医生在萎靡欲睡中忽然警觉，然后才感到痛快。至于《金匮方》，又命令弟弟元犀将其押韵成歌。我则仿照建安许氏《内台方议》的体例，为之逐条设立议论。大概是因为父亲年事已高，精力不堪多用，我与弟弟元犀不过是效仿有事则效劳的道理，不敢轻易动笔写作罢了。时间是嘉庆二十四年岁次己卯冬至后第五日。儿子蔚谨识。
蔚再按：以上拟定的注释及附识一条，都是家父亲自裁定。付印之后，常常想在注释中说未尽之意，打算续出几条，以免留有遗憾。因为阅读了当代贤人徐灵胎的《医书六种》，其首卷有六条论述，颇为明白晓畅，我可以不必再续写了。现在附录在后面，与志同道合者共享。
Treats Yin-Yang Yi (Yin-Yang Exchange Disease).
Take the garment near the female's genitalia, cut it into pieces and burn it to ash. Mix with water and administer one Fangcun Bi (a traditional Chinese measure for powder, approx. 1 cubic inch) at a time. Take three times daily. When urination becomes smooth and the glans penis/vulva swells slightly, the patient will recover.
If it is a male suffering from this condition, take the male's garment, burn it, and administer it.
The Song states:
Cut the crotch area of the underwear near the genitals and burn it;
Grind into powder and mix with water.
Seeking resonance in similar Qi to treat the two types of "Yi" exchange;
The formulas of Changsha (referring to Zhang Zhongjing's *Shanghan Zabing Lun*) are unsurpassed in excellence.
Zhang Yinan says:
The crotch area is the precise site where Jing (Essence) is exhaled and injected. It is likely that by taking the residual Qi of the other party, one can seize and eliminate the residual pathogenic factors of the other party. Since the pathogenic toxin originally entered through the Yin region, it is now made to exit through the Yin region. Therefore, it is said that when urination is smooth and the glans swells slightly, recovery is indicated.
It is the primary formula for cases where illness recurs due to overexertion after a major disease has healed. If there is retained food, add Da Huang (Rhubarb Root).
Zhi Shi (Immature Bitter Orange, 3 pieces, processed with heat), Zhi Zi (Gardenia Fruit, 14 pieces), Xiang Chi (Prepared Soybean, 1 Sheng).
Take the above three herbs, boil them in 7 Sheng of Qing Jiang Shui (Clear Fermented Grain Water) until reduced to 4 Sheng. Add Zhi Shi and Zhi Zi, boil until reduced to 2 Sheng. Then add Xiang Chi, boil for five or six more boils.
Strain the dregs. Take warm, divided into two doses. Cover the patient to induce a slight sweat.
The Song states:
One Sheng of Xiang Chi combined with three pieces of Zhi Shi;
Fourteen Zhi Zi can cover the various manifestations of post-illness recurrence. (*Shanghan Lun* only uses the six characters "recurrence after major illness due to labor" to summarize, without specifying the clinical presentation.)
Decoct with Jiang Shui to induce slight sweating; if food stagnation exists, rely on Da Huang to open the blockage.
Zhang Yinan says:
After a major illness heals, the Yin and Yang, Water and Fire begin to interact. Overexertion of the body leads to internal deficiency of Qi and Blood, causing the disease to recur. The symptoms vary, so the specific clinical presentation is not detailed; instead, this formula is used to govern all such cases. In the formula, Zhi Zi clears the irritant heat of the Upper Jiao (Upper Burner); Xiang Chi opens the fluid metabolism of the Lower Jiao (Lower Burner); roasted Zhi Shi promotes the Qi circulation of the Middle Jiao (Middle Burner). Once the Three Jiaos are harmonized, three hundred and ninety-seven treatment methods arise immediately. Methods are executed through formulas, and formulas are established through methods. This opens the medical perspective for thousands of years; it cannot be regarded merely as a single formula. After Zhang Zhongjing, this Dao gradually became obscure. It was not until the Tang Dynasty that Sun Simiao rose to clarify it, writing the *Qianjin Fang*. All its formulas were derived from the patterns of *Shanghan Lun*, which he recorded completely without omission. Unfortunately, his text had additions and omissions, and chapters were rearranged. He failed to elucidate the profound mysteries, being merely eager to imitate and transform the formulas in *Shanghan Lun* to seek novelty. Furthermore, in his sequel *Qianjin Yifang*, he established separate sections for nourishing nature and tonification. This led later physicians to cater to the wealthy by promoting formulas for tonifying Spleen and Kidney, dual tonification of Qi and Blood, warm and cool tonifications, and neutral tonifications. This vulgar practice gradually opened up. Ultimately, this is not the fault of *Qianjin Fang*, but the fault of those who do not know how to read it properly. If later students take its strengths and discard its weaknesses, then *Qianjin Fang* is indeed the wing of Zhang Zhongjing's works. Sun Simiao privately revered Zhongjing, often feeling as if he could see him face-to-face. His formulas claimed to be secret prescriptions from the Dragon Palace, likely because Zhongjing resided at Wolong Gang, making his *Shanghan Jin Gui Fang* synonymous with the Dragon Palace Prescriptions. Old sayings suggest that when the spirit is exhausted, spirits and ghosts reveal secrets; is it truly divine revelation?
My father lost his father early in life and lived in poverty. Half his time was spent on civil service examinations, and half on medicine. He saw daily how physicians competed in compiling various formularies from the Tang and Song dynasties, as well as the works of the Four Great Masters of Jin and Yuan (Liu, Zhang, Zhu, Li), and later figures like Wang Yutai, Xue Lizhai, Zhang Jingyue, and Li Shicai, indiscriminately collecting formulas into books. Consequently, books containing formulas circulated widely, while fundamental classics without formulas—such as *Shennong Bencao Jing*, *Huangdi Neijing*, *Nanjing*, and Zhongjing's works based on Yi Yin's *Tangye Jingfa*—were neglected. He pitied this situation greatly. He often wished to burn his family's collection of formula books, yet devoted decades to studying the classics and Zhongjing's texts without tiring. He found little to criticize in works below *Qianjin Fang*.
In the Renzi year, after passing the provincial examination, I resided in the capital. At that time, Mr. Yi Yunlin suffered from stroke, losing consciousness, with hemiplegia, unable to take soup or rice for over ten days. Famous doctors in the capital all declared it incurable. My father revived him with two large doses, gaining fame overnight. Patients filled the courtyard outside his door. Later, an official forced him to stay as a private physician; he refused, offending the official. In the autumn of the Guichou year, he returned home citing illness. Later, when that official took office in the Ji Fu region, fearing my father's medical fame would repeat the previous incident, my father ceased discussing medicine publicly, though he continued writing privately. He once told me: "Establishing words is one of the three immortals' deeds, excluding eight-legged essays and poetry. If someone can clarify the Dao of Zhongjing, free from heterodox studies, benefiting people from premature death and disease, their merit will extend to the world and future generations." Previous publications like *Gongyu Yilu* were annotated after the Ji Mao year in Baoyang. For over a thousand years, they existed in obscurity, until today when their true essence was realized, differing greatly from popular medical books. The difficulty lies in the precise dosage, order of decoction, and administration methods (divided doses, single dose, warm, cool, etc.), where a slight difference leads to vast discrepancies. Thus, I had to follow common editions and compile them into songs for memorization. I instructed Yu to draft annotations for each song, which my father revised personally. Where Yu offered unique insights, he circled and dotted them repeatedly, intending to awaken physicians from their lethargy. As for the *Jin Gui Fang*, he ordered my brother Yuanxi to rhyme them. I followed the style of Xu's *Neitai Fangyi* from Jian'an, providing commentary for each clause. Given my father's advanced age and limited energy, my brother and I merely performed filial duties, not daring to write lightly. Dated the fifth day after Winter Solstice, Ji Mao year, 24th Year of Jiaqing. Son Yu respectfully records.
Yu adds: The above annotations and notes were personally approved by my father. After printing, I often wished to add unfinished explanations, planning to publish several more items to avoid leaving loose ends. However, upon reading the *Six Medical Books* by the contemporary scholar Xu Lingtai, whose first volume contains six clear and lucid discussions, I felt no need to continue. I append them here to share with fellow enthusiasts.