麻疹一科。古无专书。惟于痘症后略见之。痘重而麻轻也。近数十年。麻多剧症。较重于痘
。
于是有心济世者。各着书以传之。然犹少刊本。往往私相传抄。矜为秘方。其实瑕瑜不掩。
醇驳杂出。甚至有以蜈蚣全虫五虎散治麻疹。夸为神方。笔之于书。而互相传授者。是可
哀也。余所见麻科。自万氏而后。以谢氏七十二症。赵氏麻 汇补。最为平稳。然谢氏未
免
烦琐。愈烦琐则愈挂漏。盖言其常。风痰食火四者可该。穷其变。则千变万化。非七十二症
所能尽也。赵氏汇补。悉本御定医宗金鉴。故较谢氏尤醇。但变易其方药词句。使若不出于
金鉴者以神为心得。又条款倒置。线索不清。未为善本。总不若金鉴之醇而又醇也。但金鉴
言简而赅。非得其言外之意。必疑其略而不详。余所阐发。未必得其奥旨。然悉本前贤。未
敢杜撰。而所采之说。赵氏尤多。不注姓名者。以便文势耳。非敢掠美也。
岁在HT 蒙大渊献月惟皋诸暨张廉叙。
读书之法。当逐字读。逐句读。逐节读，复举全篇融会贯通而读。斯能得其言外之意。而为
善读书者矣。医门之书。如我朝御定医宗金鉴。言简而意赅。义近而旨远。非易读也。即
其
麻疹一科。凡言某方主之者。言主之必有辅之者矣。所谓逐字读也。于见形条云。有不透彻
。须察所因。言因则因之者广。不可枚举。因之者猝不可预揣。故下第列因风因火因虚可知
之三项。以见举一反三之意。所谓逐句读也。于收没条。言当散不散。内有虚热。不可纯
用寒凉之剂。以柴胡四物汤治之。于身热不退条。言麻既出透。身仍大热。此毒盛壅遏。宜
化毒清表汤治之。疹已没落而身热者。此余热留于肌表。宜柴胡清热饮治之。何言之相反乃
尔
。盖分观则偏。合观则全。所谓逐节读也。详于正症。略于变症。正症可言。变症不胜言也
。详于麻前。略于麻后。麻前得法。麻后自无患也。只言实症。不言虚症。麻为阳毒。绝少
虚
症。麻后之虚。不言可知也。所谓统举全篇。融会贯通而读也。故于主治条曰。此首尾主治
之大法。至于临时权变。惟神而明之而已。富哉言乎。一篇微旨。已揭于此。读是书者。当
无不领略而会悟之。而余复为之阐发者。为浅学通其旨也。然而高明之家。已窃笑其蛇足矣
。乙亥仲夏。
霞溪张廉书于白HT 湖 山之指川书塾。
麻疹这一学科，古代没有专门的著作。只是在治疗痘症（天花）的书籍中略微提及。痘症病情重而麻疹病情轻。近几十年来，麻疹多出现危重证候，比痘症还要严重。
于是有心想救济世人的人，各自撰写书籍来流传它。然而仍然很少有刊印的版本，往往私下互相传抄，自认为是秘方。其实书中内容优缺点并存，精华与糟粕混杂。甚至有使用蜈蚣、全蝎等组成的“五虎散”来治疗麻疹，夸耀为神方，并记录在书中互相传授的，这真是令人悲哀啊。我所见到的麻疹科著作，自从万氏之后，以谢氏的《七十二症》和赵氏的《麻 汇补》最为平稳。然而谢氏的书未免过于繁琐，越繁琐就越容易有遗漏。大概说它的常规情况，风、痰、食、火四种病因可以概括；穷究其变化，则千变万化，不是七十二种证候所能穷尽的。赵氏的《汇补》，完全依据《御定医宗金鉴》，所以比谢氏的书更加纯正。只是改变了其中的方药词句，使其看起来好像不是出自《金鉴》，以此显示是自己的心得。另外条款顺序颠倒，线索不清晰，算不上善本。总不如《金鉴》那样纯正而又纯正。但是《金鉴》言辞简练而含义完备，如果不是领会其言外之意，一定会怀疑它简略而不详细。我所阐发的见解，未必能得其深奥旨意，但都依据前贤，不敢凭空杜撰。而所采用的说法，赵氏的内容尤其多，不标注姓名的原因，是为了行文流畅罢了，不敢掠人之美。
岁在乙亥年，蒙大渊献月，皋诸暨张廉序。
读书的方法，应当逐字读，逐句读，逐节读，最后举起全篇融会贯通地读。这样才能得到其言外之意，成为善于读书的人。医学门类的书籍，如我朝御定的《医宗金鉴》，言辞简练而意义完备，义理浅近而旨意深远，不容易读懂。就拿其中麻疹这一科来说，凡是说某方主治的，意思是说主治的同时必有辅助治疗的药物。这就是所谓的逐字读。在“见形”条文中说：“出疹不透彻，必须考察其原因。”说到原因，导致的原因很广泛，不可一一列举。因为原因突然发生难以预先揣测，所以下面列出因风、因火、因虚这三项，以体现举一反三的意思。这就是所谓的逐句读。在“收没”条文中说：“当发散而不发散，体内有虚热，不可单纯使用寒凉药剂，用柴胡四物汤治疗。”在“身热不退”条文中说：“麻疹既然出透了，身体仍然大热，这是毒气盛而壅遏，宜用化毒清表汤治疗。”疹子已经消退而身体发热的，这是余热留在肌表，宜用柴胡清热饮治疗。为什么话说得相反呢？大概分开看则偏颇，合起来看则全面。这就是所谓的逐节读。详细叙述正症，简略叙述变症。正症可以说清楚，变症说不完。详细叙述出疹前的情况，简略叙述出疹后的情况。出疹前得到正确方法，出疹后自然没有祸患。只说实症，不说虚症。麻疹属于阳毒，极少有虚症。出疹后的虚证，不说也就知道了。这就是所谓的统举全篇，融会贯通地读。所以在主治条文中说：“这是首尾治疗的大法，至于临时的权宜变通，只有靠神明般的智慧去领悟罢了。”这话多么丰富啊！一篇书的微旨，已经揭示在这里了。读这本书的人，应当无不领略并会悟其中的道理。而我再次为之阐发，是为了让浅学之人通晓其旨意。然而高明的人家，或许已经窃笑这是画蛇添足了。乙亥年仲夏，霞溪张廉书写于白湖山之指川书塾。
This discipline of measles (Ma Zhen) had no specialized books in ancient times. It was only briefly mentioned in texts regarding smallpox (Dou Zheng). Smallpox is severe, while measles is mild. In recent decades, however, measles has often presented with critical syndromes, being more severe than smallpox.
Thus, those who wished to benefit the world wrote books to disseminate knowledge on it. Yet, printed editions were scarce; they were often copied privately and touted as secret prescriptions. In reality, these works contained both merits and flaws, mixing pure essence with impurities. Some even recorded the use of "Wu Hu San" (Five Tiger Powder), containing centipedes and whole scorpions, to treat measles, boasting it as a miraculous formula and passing it down through transmission. This is truly lamentable. Among the measles texts I have seen, since Wan's work, Xie's *Seventy-Two Syndromes* and Zhao's *Hui Bu* (Comprehensive Compilation) are considered the most balanced. However, Xie's work is somewhat overly verbose; the more verbose it becomes, the more likely it is to have omissions. Generally speaking its common patterns, wind, phlegm, food stagnation, and fire can cover them. But exploring its variations, which are myriad and ever-changing, cannot be exhausted by merely seventy-two syndromes. Zhao's *Hui Bu* is entirely based on the *Imperial Medical Classic of Gold Mirror* (Yu Ding Yi Zong Jin Jian), making it purer than Xie's. Yet, it alters the formulas, herbs, and wording to appear as if not derived from the *Jin Jian*, thereby claiming original insight. Furthermore, its clauses are disordered and its logical threads unclear, so it is not an excellent edition. It is ultimately inferior to the *Jin Jian*, which is pure and pristine. However, the *Jin Jian* is concise yet comprehensive. Without grasping its implied meaning, one might suspect it to be too brief and lacking detail. My elucidations may not fully capture its profound essence, but they are all based on previous sages, and I dare not fabricate. The theories adopted are largely from Zhao; names are omitted for the sake of textual flow, not to claim others' achievements.
In the year Yihai, during the month of Meng Dayuanxian, Zhang Lian from Gaozhuji wrote the preface.
The method of reading should be: read character by character, sentence by sentence, section by section, and finally integrate the entire text comprehensively. Only then can one grasp the implied meaning and become a proficient reader. Medical texts, such as our dynasty's *Imperial Medical Classic of Gold Mirror*, are concise in language yet rich in meaning, proximate in principle yet distant in significance; they are not easy to read. Taking the measles section as an example: whenever it states that a certain formula governs a condition, it implies that there must be auxiliary treatments accompanying the main treatment. This is reading character by character. In the clause on "Appearance of Rash," it says: "If the rash does not emerge thoroughly, one must investigate the cause." Causes are numerous and cannot be listed exhaustively because sudden causes are unpredictable. Therefore, three items—caused by wind, caused by fire, and caused by deficiency—are listed below to illustrate the principle of inferring other cases from one instance. This is reading sentence by sentence. In the clause on "Resolution/Disappearance," it says: "If dispersion is indicated but not performed, and there is deficient heat internally, cold-cooling agents should not be used purely; instead, Chai Hu Si Wu Tang (Bupleurum Four Substances Decoction) should be used." In the clause on "Persistent Fever," it says: "If the measles have emerged thoroughly but the body remains highly febrile, this indicates excessive toxin stagnation; Hua Du Qing Biao Tang (Toxin-Resolving Surface-Clearing Decoction) should be used." If fever persists after the rash has faded, this indicates residual heat lingering in the muscle layer; Chai Hu Qing Re Yin (Bupleurum Heat-Clearing Drink) should be used. Why do these statements seem contradictory? Viewing them separately leads to bias; viewing them together reveals the whole picture. This is reading section by section. Detailed descriptions are given for typical syndromes (Zheng Zheng), while atypical syndromes (Bian Zheng) are treated briefly, as typical ones can be articulated, whereas atypical ones are endless. Details are provided for the pre-rash phase, while the post-rash phase is simplified; if the pre-rash phase is managed correctly, the post-rash phase will naturally be without trouble. Only excess syndromes are discussed, not deficiency syndromes. Measles is a Yang toxin, rarely presenting as a deficiency syndrome. Post-rash deficiency is self-evident and thus omitted. This is integrating the entire text comprehensively. Therefore, in the governing treatment clause, it states: "These are the major principles of treatment from beginning to end. As for temporary adaptations, one must rely on divine wisdom to understand them." How profound these words are! The subtle purport of the entire text is revealed here. Readers of this book should inevitably comprehend and realize its meaning. My further elucidation is intended to help those with shallow learning understand its purport. However, the insightful may already smile at this as adding feet to a snake. In mid-summer of the year Yihai, Xiaxi Zhang Lian wrote this at Zhichuan Study Hall, Baishan Lake.