古圣王尝百草,着医书,而于万政之余,不肯自暇逸为劳者,诚以民生为大,而医事为重也。
周礼以医事隶于六官,以保王躬,掌民疾,且命医为师,俾出政令,班固汉书,以医并于神仙,
其职贵,其道尊,故其时神良辈出,若周之长桑扁鹊,汉之华陀仲景,俱表表在人耳目间。自兹而
降,上HT 视为奉御之名,下直比于艺术之流,学士大夫,多所弗讲,而业儒不成者;即粗躐方书
,遂号为医,竟借以为肥家之生计,盛盛虚虚,而遗人夭殃,致邪失正,而绝人长命,医学之荒也
,由来久矣。虽唐宋以来,不乏哲人,然究寥寥易数。推其过,总由不学之咎。然学儒之读书也
易,学医之读书也难,儒书则一定之可循,医书则多岐之易炫。儒之书,孔孟之书也,夫人而知读
之矣,弗敢违也,医之书,炎黄之书也,亦夫人而言读之矣,而卒弗读也,何则?文辞古雅,理道
渊深,难以解悟,故庸浅之流,望而蹙额,一见药性赋及症方歌诀等书,便奉为灵宝,不知入门
一错,误已误人,少年不学,老大徒伤,追悔何及。而好高之辈,又辄自称读金匮书,遵仲景法,
偏执不化,疗病投剂,务必争奇求异,是好高偏执之杀人,与庸浅不学之杀人等耳。故张、刘、李、
朱本医之四大家也,其所着书,不过补前人之未备,而自成一家之言。即诸家各有所发明,亦补前
人之未备者居多。是以赵氏云∶读伤寒书,
而不读东垣书,则内伤不明,而杀人多矣,读东垣书,而不读丹溪书,则阴虚不明,而杀人多矣
,读丹溪书,而不读薛氏医书,则真阴真阳不明,而杀人亦多矣。故医而不精深孔孟之理,
洞彻炎黄之义,广征诸子,遍考百家,融会贯通,活泼治病,而欲求如桴鼓附应,犹拔刺雪污,
称为工巧神圣,必无之事,熟云医为小道,而可易视为哉。闻之张长沙云∶居世之士,曾不留
心医术,上疗君亲,下救贫贱,中以保身,但逐荣利,企踵权豪,卒遇非常,身居死地,百年寿
命,委付凡流,岂不危哉!玄晏云∶人受先人之体,有八尺之躯,而不知医事,此所谓游魂耳,
虽有忠孝之心,慈惠之性,君父危困,赤子涂地,无以济之,此圣贤所以精思极论,尽其理也。
予有感于二氏之言,因思古人有不为良相定作良医之语,因遂慨然而叹,谓可以侍君,可以养亲,
可以济世,可以全生,可以成名者,庶几有熊氏之风乎?遂毅然自奋,二十年来夙兴夜寐,殚炎
黄之奥,究仲景之秘,渔猎方书,搜罗医案,忝得萤明。乃辑本草必用,脉法删繁,内景图解,
灵素摘要,格言汇纂,症方发明,分为一十六卷,统名医镜,俱以岐黄仲景为经,诸子百家为纬,
言言采其金石,字字摘其珠玑,明剖疾病之情,悉合时地之宜,俾庸浅者读之,则易为领略,好
高者省之,遂难施险僻。更望当世巨公,慧眼品题,互相倡导,以挽颓风,使人皆得尽其天年,
不负古圣王垂教之仁慈,是则余之大快也,而亦苍生之大幸也。
吴门顾靖远松园甫
古代圣明的君王亲自品尝百草,编写医书,在繁忙的政务之余,不肯让自己闲暇安逸,确实是因为百姓的生命最为重要,而医学事务尤为关键。
《周礼》将医疗事务归属于六官管理,以保护君王的身体,掌管百姓的疾病,并且任命医生为师,让他们参与发布政令。班固在《汉书》中,将医生与神仙并列,说明医生的职位尊贵,其道术崇高,所以那个时代神妙良能的医生层出不穷,像周代的长桑君、扁鹊,汉代的华佗、张仲景,都显赫地存在于人们的耳目之间。
从这以后往下,上层统治者只把医生看作侍奉御用的名号,下层百姓则直接把医生比作技艺工匠一类的人,学士大夫们大多不再研究医学,只有那些科举读书不成的人,才勉强翻阅医书,便号称自己是医生,竟然借此作为富裕家庭生计的手段。结果导致实证用补法使邪气更盛,虚证用泻法使正气更虚,从而给人带来夭折的灾祸;致使邪气侵入,正气丧失,断绝人的长寿生命。医学荒废这种现象,由来已经很久了。
虽然唐宋以来,不乏有智慧的人才,但真正精通医术的却寥寥无几。推究其原因,总归是不学习的过错。然而学习儒家的读书相对容易,学习医家的读书则很难。儒家的书籍有固定的法则可以遵循,医家的书籍则门类繁多容易让人眼花缭乱。儒家的书,是孔孟的书,人们都知道要读它,不敢违背;医家的书,是炎黄(黄帝、神农)的书,人们也口头上说在读它,但最终却不读。为什么呢?因为文辞古雅深奥,道理深远,难以理解领悟,所以平庸浅薄的人,看到就皱眉头,一见到《药性赋》及病症方剂歌诀之类的书,就奉为宝贝,却不知道入门一旦错了,既误了自己又误了别人。少年时不学习,年老时徒然悲伤,追悔莫及。
而那些喜好高深的人,又往往自称读过《金匮要略》,遵循张仲景的法度,偏执而不通融,治疗疾病开处方时,一定要争奇求异。这种好高骛远且偏执的杀人方式,与平庸浅薄不学无术的杀人方式是一样的。
所以张元素、刘完素、李东垣、朱震亨本是医学界的四大家,他们所著的书籍,不过是补充前人的不足,而形成自己的一家之言。即使各家各有发明创造,也是大多补充前人未备之处。因此赵献可说:读《伤寒论》而不读李东垣的书,就不明白内伤病的机理,杀人很多;读李东垣的书而不读朱丹溪的书,就不明白阴虚病的机理,杀人很多;读朱丹溪的书而不读薛己的医书,就不明白真阴真阳的机理,杀人也很多。
所以,做医生如果不精深探究孔孟的道理,不通彻炎黄医学的含义,广泛征引诸子百家,全面考察各家学说,融会贯通,灵活治病,却想达到如鼓应槌那样迅速见效,像拔刺雪污那样彻底治愈,被称为工巧神圣,那一定是办不到的事。谁说医学是小道,可以轻易看待呢?
听说张仲景说:世间士人,不曾留心医术,对上不能治疗君主和父母,对下不能救助贫贱之人,中间不能保全自身,只是追逐荣华利益,仰慕权贵豪门,突然遇到非常变故,身处死亡境地,百年寿命托付给平庸之辈,难道不危险吗!
皇甫谧(玄晏)说:人承受先人的形体,拥有八尺之躯,却不懂医学事务,这就是所谓的游魂罢了。虽然有忠孝之心,慈惠之性,但当君主父亲危难困苦,婴儿百姓受苦受难时,却无法救济他们,这是圣贤所以精心思考极力论述,穷尽医理的原因。
我感慨于这两位先生的言论,因而想到古人有“不为良相,便为良医”的话,于是慨然叹息,认为医学可以侍奉君主,可以赡养父母,可以济世救人,可以保全生命,可以成名立万,这大概符合有熊氏(黄帝)的风范吧?于是毅然自我奋发,二十年来早起晚睡,穷尽黄帝、神农医学的奥秘,探究张仲景的秘旨,广泛涉猎医书,搜罗医案,侥幸得到了一些光明见解。
于是编纂《本草必用》,删减繁杂的《脉法》,图解《内景》,摘要《灵枢》《素问》,汇纂格言,发明症方,分为十六卷,统称《名医镜》。全部以岐伯、黄帝、张仲景的理论为经线,以诸子百家的著述为纬线,句句采纳其如金石般珍贵的内容,字字摘取其如珠玉般的精华,明晰剖析疾病的实情,完全符合时令地理的适宜。使得平庸浅薄的人读了,就容易领会;喜好高深的人看了,也就难以施展险僻的手段。
更希望当代的杰出人士,用慧眼品评题写,互相倡导,以挽回颓废的风气,使人们都能尽享天然寿命,不辜负古代圣明君王垂教仁慈的本意,这就是我最大的快乐,也是苍生百姓的大幸啊。
苏州顾靖远,字松园
Ancient sage kings personally tasted hundreds of herbs, compiled medical texts, and amidst the myriad duties of governance, refused to indulge in leisure or ease. This was truly because the livelihood of the people is paramount, and medical affairs are of critical importance.
The *Rites of Zhou* (*Zhou Li*) placed medical administration under the Six Ministries to protect the royal body and manage the diseases of the populace. It appointed physicians as teachers, empowering them to issue administrative decrees. Ban Gu, in the *Book of Han* (*Hanshu*), grouped physicians with immortals, indicating that their positions were noble and their Dao profound. Consequently, during that era, miraculous and excellent practitioners emerged in abundance, such as Changsang Jun and Bian Que of the Zhou Dynasty, and Hua Tuo and Zhang Zhongjing of the Han Dynasty, all of whom remained prominent in public memory.
Since then, however, the ruling class viewed physicians merely as attendants for imperial service, while the common people regarded them as mere artisans or entertainers. Scholars and literati largely neglected medical study; only those who failed in their Confucian scholarly pursuits would casually browse medical books and claim to be doctors, using it as a means to enrich their families. The result was treating excess conditions with tonics (Sheng Sheng) and deficiency conditions with purgatives (Xu Xu), thereby bringing premature death upon patients; allowing pathogenic factors to invade and healthy Qi to fail, thus cutting short lives. The decline of medicine has been long-standing.
Although since the Tang and Song dynasties there have been no lack of wise individuals, true masters have been few. Tracing the fault back, it stems from a lack of study. Studying Confucian texts is relatively easy, whereas studying medical texts is difficult. Confucian classics follow fixed principles, while medical literature is diverse and easily dazzling. The Confucian books are those of Confucius and Mencius; everyone knows to read them and dares not violate them. The medical books are those of Yan Huang (the Yellow Emperor and Shennong); everyone claims to read them, yet ultimately does not. Why? Because the language is archaic and elegant, and the principles are profound and deep, making them hard to comprehend. Thus, mediocre and shallow individuals frown at them. Upon seeing books like the *Ode to Drug Properties* (*Yao Xing Fu*) or rhymed prescriptions for symptoms, they revere them as sacred treasures, unaware that an error at the beginning leads to mistakes for both themselves and others. Learning in youth prevents regret in old age; without early study, one suffers in vain later, with no time for repentance.
Conversely, those who pride themselves on high learning often claim to have studied the *Jin Gui Yao Lue* (*Essential Prescriptions of the Golden Cabinet*) and followed Zhang Zhongjing’s methods. Yet they remain rigid and inflexible. In treating diseases and prescribing formulas, they strive for novelty and eccentricity. This type of killing due to arrogant pedantry is equivalent to killing due to mediocrity and ignorance.
Therefore, Zhang Yuansu, Liu Wansu, Li Dongyuan, and Zhu Zhenheng are the Four Great Masters of Medicine. Their writings merely supplemented what predecessors had left incomplete, establishing their own schools of thought. Even when each school made innovations, most served to fill gaps left by earlier authors. As Zhao Xianke stated: "If one reads the *Shanghan Lun* (*Treatise on Cold Damage*) but not Li Dongyuan’s works, internal injury remains unclear, leading to many deaths. If one reads Li Dongyuan but not Zhu Danxi’s works, Yin deficiency remains unclear, leading to many deaths. If one reads Zhu Danxi but not Xue Ji’s medical works, the concepts of True Yin and True Yang remain unclear, also leading to many deaths."
Thus, if a physician does not deeply understand the principles of Confucius and Mencius, nor thoroughly grasp the meanings of Yan Huang, and fails to extensively consult various philosophical schools and百家 (hundred schools of thought), integrating them to treat diseases flexibly, one cannot hope to achieve results as immediate as a drum responding to a mallet, or as thorough as removing a thorn or cleaning dirt, nor can one be called a master of skill or divine. Who says medicine is a minor art that can be treated lightly?
It is heard that Zhang Changsha (Zhang Zhongjing) said: "Scholars of the world do not pay attention to medical arts. They cannot treat rulers and parents above, save the poor and lowly below, or preserve themselves in the middle. Instead, they chase glory and profit, aspiring to the status of the powerful. When unexpected crises occur, they find themselves in mortal danger, entrusting their lifespans to the mediocre. Is this not dangerous?"
Huangfu Mi (Xuan Yan) said: "Humans inherit the bodies of their ancestors, possessing eight chi of flesh and blood, yet if they do not know medical matters, they are merely wandering ghosts. Despite having hearts of loyalty and filial piety, and natures of kindness and compassion, when rulers and fathers are in peril, or infants and people suffer, they have no way to rescue them. This is why sages think profoundly and argue extensively, exhausting the principles [of medicine]."
Moved by the words of these two gentlemen, I recalled the ancient saying: "If one cannot become a good prime minister, one should become a good physician." With a sigh, I considered that medicine allows one to serve the ruler, support parents, benefit the world, preserve life, and achieve fame. Does this not resemble the ethos of Youxiong Shi (the Yellow Emperor)? Therefore, I resolutely spurred myself on. For twenty years, rising early and sleeping late, I exhausted myself exploring the mysteries of Yan Huang and the secrets of Zhang Zhongjing. I plundered medical books and collected medical cases, gaining some illumination.
I then compiled *Ben Cao Bi Yong* (Essential Materia Medica), edited the cumbersome *Mai Fa* (Pulse Methods), illustrated *Nei Jing* (Inner Landscape), summarized the *Ling Shu* and *Su Wen*, gathered maxims, and elucidated symptom-formula relationships. These were divided into sixteen volumes, collectively titled *Ming Yi Jing* (Mirror of Famous Physicians). All are based on the theories of Qibo, Huangdi, and Zhang Zhongjing as the warp, and the hundred schools of thought as the weft. Every sentence collects gold and stone [valuable insights]; every word picks out pearls and gems. It clearly dissects the nature of diseases and fully conforms to the appropriateness of time and place. This allows the mediocre and shallow to comprehend it easily, and prevents the pretentious from employing dangerous or obscure methods.
I further hope that eminent figures of the current generation will use their wisdom to critique and promote these works, helping to reverse the declining trends, so that everyone may enjoy their natural lifespan, not failing the benevolence of the ancient sage kings’ teachings. This would be my greatest joy and the great fortune of the common people.
Gu Jingyuan, courtesy name Song Yuan, from Wu Men (Suzhou)