人生天地间,而阴阳命之气,其受病亦不外乎此。医家言视证察脉,则必本诸阴与阳,
岐以来,诸书可考也。至汉长沙张仲景着《伤寒》一书,其言备矣。其法皆出伊芳尹《汤液》
,如《易》之于数,《春秋》之于法,盖万世不可易者。其论气脉形声,以测人之脏腑经络
之微,亦不过曰∶如是为阳,如是为阴,如是为寒,如是为热,如是为有余,如是为不足,
以决人之死生之变于朕兆之前,使夫学人可以按而知之,苟能详辨而勿失,则思过半矣!然
混茫乎疑似之中, 葛乎毫厘之间,自非精思入神冥合造化,则不能也。是以古者之言医
也,皆聪明有道之士,如孙思邈、陶隐居、葛稚川之徒,何如人也。迨夫叔世末流,多出于
粗工庸人间,裒衣峨冠,挟方寸之囊,自命为医工,然试读其书,音读(音豆)且不知,况能
索理于精微之地哉!如赵括之用兵,徒能诵其父之书,旋取覆败之祸。如又不能诵其书,则
其为败,宜如何哉!夫阴阳二证也,寒与温之味,从而用之,亦二也。其主治嗜好,又有大
不同者,甚者各主一偏,互相诋訾。殊不知桂枝、承气之一倒置,则毙之患立见。异时承平
贵
为人之为病皆然,热黜阴候不论,岂理也哉!且四方风土既殊,而人之禀受亦异,而一律按
之,其可乎?盖亦求其至当而已矣。呜呼!中古以降,老寿少而天阏多,岂真不幸与!盖医者
心术之偏,其蔽必至于杀人,儒者心术之偏,其蔽必至于误天下,如宋之王安石是也。偏之为
害之烈如此。夫窃尝谓受天地中和之性,得圣人公恕之学,不以利欲一毫入于其心,而后可
以为儒为医矣,天地万物一理也,圣人之道一中而已《中庸》曰致中和,天地位焉,万物
育焉,而况医乎!海藏先生王君进之,家世赵人,早以通经举进士,晚独喜言医,始从东垣
李明之,尽传其所学,后乃精研极思轩岐以来诸家书,驰骋上下数千载间,如指诸掌。予在
大梁时,闻其名诸公间籍甚,独以未识为恨,今年秋来晋州,始得候先生于馆舍,观其气和
而凝,志一而定,有道者也。与之游,甚间暇,日出一编书授予,且谓予曰∶伤寒人之大疾
也,其候最急,而阴证毒为尤惨,阳则易辨而易治,阴则难辨而难治。若夫阳证,热深而厥
,不为难辨。阴候寒盛,外热反多,非若四逆,脉沉细欲绝易辨也。至于脉鼓击有力,加阳脉
数倍,内伏太阴,发烦躁欲坐井中,此世之所未喻也。予恐其误,积思十余年,盖考自岐伯
,迄今洁古老人摄其精要,附以己说,厘为三十余条,有证有药,有论有辨,名之曰《阴证
略例》,将锓以传,以诏后学,且与天下卫生之君子共之,子盍为我题其端?予退而伏读之
,善之曰∶异乎哉!未有是书也。其于救物利生之念深矣!至其论阳证见阴脉者死,谓有外伤
内阴,若与阳药犹可生。若及阴阳易分寒热,阴阳易随仲景三经用药,皆出古人言意之表,
学人又不深思而熟味之。噫!世之着书立言者多矣,其甚高难行,泛言无实者亦有之。然则
是书之出,其知者必以为精思妙用所,传证以古今,不可诬也;其不知者则茫然无考,诋以
为悠悠谈甚高难行也。予以为获一人贤者之知,不犹愈千百愚人之不知者,则是书可以传信
行世无疑矣!故内翰王君从之,尝题曰“世所未闻”,真知言哉!比先生过上党,主吾故人文之
,疗数阴疾尤奇中,皆书中所可概见者。文之始亦骇,不敢用,反己试,欢曰∶误人多矣!
昔太仓公所上治验,太史氏列之传末,近代钱仲阳尝所治病,阎孝忠记于论证后。今从先生
得所书主治次第,谨编如下方,亦足以证愚者之不知者。文之姓宋氏,讳廷圭,长平人,世
亦号善医云。
岁癸卯冬十一月中浣日王官麻革信之谨题
人在天地之间,其生命所禀受的阴阳之气,患病也不外乎此理。医家观察证候、诊察脉象,必然以阴和阳为根本,自岐伯以来,各种书籍都可以考证这一点。到了汉代长沙太守张仲景撰写《伤寒论》一书,其中的论述已经非常完备了。他的方法都出自伊尹的《汤液经》,就像《易经》之于数理,《春秋》之于法度,大概是万世不可更改的原则。他论述气、脉、形、声,以此来推测人体脏腑经络的微妙变化,也不过是说:这样是阳,那样是阴;这样是寒,那样是热;这样是有余,那样是不足,从而在病兆显现之前决断人的生死变化,使学习的人能够据此知晓。如果能详细辨别而不失误,那么对医道的理解就超过一半了!然而,在混沌模糊、似是而非之中,在毫厘之间的细微差别里,如果不是精心思考达到神妙境界,与造化自然冥合,是做不到的。所以古代谈论医学的人,都是聪明且有道之士,如孙思邈、陶弘景、葛洪这一类人,他们是什么样的人啊。等到末世流俗,医生多出身于粗鄙平庸之辈,穿着宽大的衣服,戴着高高的帽子,带着小小的药囊,自称是医生,然而试着读他们的书,连音读(音豆)都不知道,何况能探究精微之处的道理呢!这就像赵括用兵,只会背诵他父亲的书,随即招致覆灭的祸患。如果连书都不能背诵,那他们的失败又该怎样呢!
关于阴证和阳证这两种情况,寒性和温性药物的使用,也是两种不同的法则。它们的主治范围和喜好,又有很大的不同,严重的甚至各自偏执一端,互相诋毁指责。殊不知桂枝汤与承气汤一旦用反,死亡的祸患立刻就会显现。后来太平盛世,人们生病的情况都是如此,对于热证排斥阴证候不问,这难道合乎道理吗?况且四方风土既已不同,而人的禀赋也各异,如果用同一标准来衡量,可以吗?大概也只是追求最恰当的方法罢了。唉!中古以后,长寿的人少,早夭的人多,难道真是运气不好吗?大概是因为医者心术偏向,其弊端必然至于杀人;儒者心术偏向,其弊端必然至于误导天下,比如宋代的王安石就是这样。偏颇的危害竟然如此猛烈。我曾私下认为,承受天地中和的本性,获得圣人公正宽恕的学问,不让丝毫利欲进入心中,然后才可以成为儒者或医者。天地万物是一个道理,圣人的道只是“中”而已。《中庸》说:“达到中和的境界,天地便各安其位,万物便生长发育”,更何况是医学呢!
海藏先生王君进之,祖籍赵地,早年因通晓经义考中进士,晚年独喜谈论医学,起初跟随东垣李明之,尽得其所传之学,后来便精研深思自轩辕、岐伯以来的各家书籍,驰骋上下数千年间,如同指掌般清楚。我在大梁时,在各位公卿间听闻他的名声很大,唯独以未曾相识为恨事。今年秋天来到晋州,才得以在馆舍拜访先生,观察他气和而凝重,志一而定,是有道之人。与他交往,非常闲适,他每天拿出一本书稿给我看,并且对我说:“伤寒是人体的大疾,其病势最急,而阴证的毒害尤为惨烈。阳证容易辨别也容易治疗,阴证难辨别也难治疗。至于阳证,热深而四肢厥冷,并不难辨别。阴证候寒盛,外表发热反而多,不像四逆汤证那样,脉沉细欲绝容易辨别。至于脉象鼓击有力,比阳脉数倍,内伏太阴经,出现烦躁想坐在井中的症状,这是世人所未能理解的。我担心误人,积聚思绪十余年,考察自岐伯以来,直到洁古老人摄取其精要,附上自己的说法,整理为三十余条,有证有药,有论有辨,命名为《阴证略例》,将要刻印流传,以告知后学,并与天下爱护生命的君子共同分享,你何不为我题写序言?”
我退下来伏案阅读,称赞道:“奇特啊!没有这本书。”他对救物利生的念头很深啊!至于他论述阳证见阴脉者死,谓有外伤内阴,若给予阳药还可以生还。如果涉及阴阳易分寒热,阴阳易随仲景三经用药,这些都超出古人言语意旨的范围,学习的人又不深入思考细细品味。唉!世上著书立说的人很多,那些极高深难以实行的,泛泛空谈无实际内容的也有。然而这本书的问世,懂的人一定会认为是精思妙用的成果,传承证候古今,不可诬蔑;不懂的人则茫然无据,诋毁它说是悠远高深难以实行。我认为获得一位贤者的了解,不胜过千百个愚人的不了解,那么这本书可以流传于世无疑了!所以内翰王君从之,曾经题写“世所未闻”,真是知言之人啊!
后来先生经过上党,住在我老朋友文之家,治疗几个阴疾尤其神奇准确,都是书中可以概见的情况。文之初也很惊骇,不敢使用,自己尝试后,欢喜地说:“误人太多了!”过去太仓公上报的治疗验证,太史公列在传记末尾,近代钱乙曾经治疗的病,阎孝忠记录在论证之后。现在从先生那里得到所书写的主治次第,谨慎编录如下方,也足以证明愚者不知的情况。文之姓宋氏,名廷圭,长平人,世代也被称为善于医术。
岁次癸卯冬十一月月中旬日,王官麻革信之谨题
Human beings exist between heaven and earth, and the Qi of Yin and Yang that endows their life is such that illness also does not go beyond this principle. Medical practitioners examine symptoms and palpate pulses, which must be based on Yin and Yang; since Qibo (岐伯), various texts can attest to this. When Zhang Zhongjing (张仲景) of Changsha in the Han Dynasty wrote the *Shanghan Lun* (Treatise on Cold Damage), his discussions were comprehensive. His methods all originated from Yi Yin's *Tangye Jing* (Decoction Classic), just as the *I Ching* (Book of Changes) relates to numbers and the *Spring and Autumn Annals* relates to laws; these are principles unchangeable for ten thousand generations. In discussing Qi, pulse, form, and sound to infer the subtleties of human Zang-Fu organs and meridians, he merely stated: "Thus is Yang, thus is Yin; thus is Cold, thus is Heat; thus is Excess, thus is Deficiency," thereby determining changes in life and death before signs appear, so that students may know by following these guidelines. If one can distinguish them in detail without error, then more than half of medical understanding is achieved! However, amidst chaos and ambiguity, within the minute differences of a hair's breadth, unless one thinks deeply to reach a divine state and merges with creation, it cannot be done. Therefore, those who spoke of medicine in ancient times were all intelligent and virtuous scholars, such as Sun Simiao (孙思邈), Tao Hongjing (陶隐居), and Ge Hong (葛洪)—what kind of people they were. By the late eras and declining trends, many doctors emerged from vulgar and mediocre ranks, wearing loose robes and tall hats, carrying small medicine pouches, and calling themselves medical artisans. Yet if one tries to read their books, they do not even know pronunciation (phonetic reading), let alone explore principles in subtle realms! This is like Zhao Kuo using troops; he could only recite his father's book and immediately suffered destruction. If one cannot even recite the book, how much worse would their failure be!
Regarding the two types of syndromes, Yin and Yang, the use of Cold and Warm flavored herbs is also twofold. Their main indications and preferences differ greatly; severely, each side dominates a bias and mutually disparages the other. Little do they know that if Guizhi Tang (Cinnamon Twig Decoction) and Chengqi Tang (Descending the Qi Decoction) are reversed, the danger of death will appear immediately. In later peaceful times, illnesses in people were all like this. Regarding heat syndromes rejecting Yin presentations without inquiry, is this reasonable? Moreover, since the wind and soil of the four directions differ, and human constitutions vary, can one apply a uniform standard? It seems one should only seek the most appropriate method. Alas! Since the middle antiquity, few live long lives while many die prematurely; is this truly bad luck? Probably because the bias in a doctor's mindset leads inevitably to killing; similarly, the bias in a Confucian scholar's mindset leads inevitably to misleading the world, as was the case with Wang Anshi (王安石) of the Song Dynasty. The harm caused by bias is so fierce. I have often said that one must receive the nature of Heaven and Earth's Harmony and Neutrality, acquire the learning of Sages' fairness and tolerance, and allow no trace of profit or desire into one's heart, before one can become a Confucian or a doctor. Heaven and Earth and all things share one principle; the Way of the Sages is simply "The Mean" (Zhong). The *Zhongyong* (Doctrine of the Mean) says: "Achieving Harmony and Neutrality, Heaven and Earth take their proper places, and all things are nurtured." How much more so in medicine!
Mr. Wang Jinzhi, the Master Haicang (Sea Storehouse), was of Zhao ancestry. Early on, he passed the Jinshi examination due to his mastery of classics. Later, he exclusively enjoyed discussing medicine. Initially, he followed Li Dongyuan (Li Mingzhi) of Dongyuan, inheriting all his learning. Afterwards, he meticulously studied and pondered the works of various schools since Xuanyuan and Qibo, traversing thousands of years as easily as pointing at his palm. While I was in Daliang, I heard his fame was great among the nobles, regretting only that I had not met him. This autumn, upon arriving in Jinzhou, I finally had the opportunity to visit the Master at his residence. Observing him, his Qi was harmonious yet condensed, his will single and settled; he was a man of the Way. Associating with him was very leisurely. One day, he presented a manuscript to me and said: "Cold damage is a major disease of humans; its presentation is most urgent, and the toxicity of Yin syndromes is particularly cruel. Yang syndromes are easy to identify and treat, but Yin syndromes are difficult to identify and treat. As for Yang syndromes, deep heat with cold extremities is not hard to identify. Yin presentations involve severe internal cold but external heat, which is not as easy to identify as the Sini Tang (Frigid Extremities Decoction) pattern where the pulse is deep, fine, and nearly absent. However, when the pulse beats forcefully, several times stronger than Yang pulses, with internal concealment in the Taiyin meridian, manifesting as irritability and a desire to sit in a well, this is something the world has not understood. Fearing misdiagnosis, I accumulated thoughts for over ten years, examining from Qibo up to the Elder Jiegu (Jiegu Laoren), extracting their essentials, adding my own comments, organizing them into thirty-plus articles, containing symptoms, herbs, discussions, and distinctions. I named it *Yin Zheng Lue Li* (Brief Examples of Yin Syndromes). I intend to print it to transmit it, instructing future learners, and sharing it with gentlemen of the world who care for health. Would you write an introduction for me?"
Retreating, I read it carefully and praised it, saying: "How extraordinary! Such a book did not exist before." His intention to save beings and benefit life is profound! Regarding his discussion that Yang syndromes presenting with Yin pulses indicate death, stating that there is external injury with internal Yin, and if given Yang-promoting herbs, survival is possible. If involving Yin-Yang exchange distinguishing Cold and Heat, or treating according to the Three Meridians of Zhongjing, these all transcend the literal words and meanings of the ancients, yet learners do not think deeply and savor them. Alas! There are many authors writing books today; some are too high-minded and impractical, or vague and empty. However, the emergence of this book: those who understand will surely see it as the result of profound thought and wonderful application, transmitting symptoms through ancient and modern times, undeniable; those who do not understand will be茫然 (at a loss) without basis, dismissing it as remote, high-minded, and impractical talk. I believe gaining the understanding of one wise person is better than the ignorance of a thousand fools. Thus, this book can undoubtedly be transmitted and circulated in the world! Therefore, Hanlin Academician Wang Congzhi once titled it "Unheard of in the World," which is truly insightful speech!
Later, the Master passed through Shangdang and stayed at the home of my old friend Wenzhi. He treated several Yin diseases with remarkable accuracy, all of which could be inferred from the book. Wenzhi was initially startled and dared not use it. After trying it himself, he rejoiced, saying: "So many people have been misled!" In the past, Taicanggong's (Chunyu Yi) verified treatments were listed at the end of the biography by the Grand Historian; in recent times, Qian Boyang's (Qian Yi) treated cases were recorded by Yan Xiaozhong after the discussions. Now, obtaining the sequence of main treatments written by the Master, I have carefully compiled the following cases, which suffice to prove the ignorance of the foolish. Wenzhi's surname is Song, given name Tinggui, from Changping. His family has also been known for medical skill.
On the middle ten-day period of the eleventh month in the winter of the Gui-Mao year, Ma Ge Xinzhi of Wangguan respectfully inscribed.