医门治例,幼科最难。肠胃脆而多伤乳食,筋骨嫩而易感风
寒。易虚易实兮,变如反掌;或补或泄兮,贵若转丸。咸多泄
肾,酸甚扶肝。苦入心而寒凉损胃,辛走肺而燥热伤元。欲求中
正。无过平甘。或病须于(1)瞑眩兮,勿犯其毒;且从治于权宜兮,
但取其能。中病即已,救本为先。茍误投于汤药,即便致于损
残。此上工誓于活人,而良医验于折耾(2)!
尝闻法无一定,但占症候;医不三世,勿服汤丸。病者详于
择术,医者务于救痊。视疾若己,见利勿贪。先察运气兮,阳明
妙契;次观形色兮,顺逆了然。春夏阳而苦寒可用,在夫人之勇
健;秋冬阴而辛温可参,相其人之劳疳。既温反补,以寒再宣,
七神离散,五脏亏崩。虽留心于方脉兮,何补于世;反致人于伤
夭兮,获罪于天。是故胎疾兮急于解毒,食积兮利在消疳。治分
二法,效可十全。襁褓未宁,但调其母;匍匐不快,当固其元。
悲夫,肠胃中和,岂堪药石;微乎,气血稚弱,以渐发生。治非
得已。病有卒然。如护风烛,心常凛凛;若惜掌珠,意惟拳拳。
医可补乎司命,应无忝于家传。
且如病则热起,热则惊生。或治热以热,或攻热以寒。热在
表而柴葛解肌可饮,热在里而芩连消毒急煎。积热无如集圣;虚
热妙以调元。要在识夫脉色,不可妄投汤丸,贻终身之痼疾,促
婴儿之寿元(3)。轻以变重,功不补患。徒委命于气数,不详审乎
简编。前车既覆,后辙犹然。魂魄游于郊野,哭声达于洲泉。识
此之故,是谁之衍?磋夫!渡蚁驾桥,放雀解樊。况伊万物之灵,
匪值一虫之贱,不知谨密,遽尔轻捐(4)。推恻隐之良心,如见入
井;考圣贤之遗训,如弗及泉。居易虚险,因蹶知便。证随百
出,治无一偏。调变(5)造化,保养真元。善攻不如善守,宜急不
若宜缓。种杏成林,踵当年之董奉;植橘名井,见今日之苏耽。
奈何泻久变痢,积久成疳,疟久生癖,惊久成痈。未至留连兮。
攻之宜速;已见沉苛兮,治之且缓。肠胃闭塞兮,急泄而已;气
血虚赢兮,急补而安。外毒急攻,毌令入腹;表邪急解,毌令再
传。余则缓而调理,常恐急而生变;若药下咽,犹防其过,治或
中病,勿张其能(6)。知者常虑一失,死者不可复全。与其悔于已
误,孰若谨于未然。欲求鱼兔,当守蹄筌(7)。茍多方而治病。宜
三复于斯言!
(1)须于:校注者注,应为"须臾"。
(2)拆纮:山东泰安州李雨沾方悦父发梓版为:"拆纮"。。
(3)寿元:山东泰安州李雨沾方悦父发梓版为"寿年"。
(4)轻捐:山东泰安州李雨沾方悦父发梓版为"轻泛"。
(5)调变:山东泰安州李雨沾方悦父发梓版为"变调"。
(6)勿张其能:有的手抄本作"勿强其能"。
(7)蹄筌:汉阳鹤湄张伯琮校定版为"蹄笙"。
In the medical field, pediatric treatment is the most difficult. The intestines and stomach are fragile and prone to injury from milk and food; the bones and tendons are tender and easily affected by wind and cold. Prone to deficiency or excess, changes occur as quickly as flipping a hand; whether tonifying or purging, flexibility is crucial, like turning a pill. Salty flavors often deplete Kidney Qi, while excessive sour flavors support Liver Qi. Bitter flavors enter the Heart but their cold nature damages the Stomach; pungent flavors travel to the Lung but their dryness and heat damage Yuan Qi. To seek a balanced approach, nothing surpasses flat-natured sweet herbs. If the condition requires sudden dizziness (mingxuan) from potent drugs, do not fear their toxicity; if adopting temporary symptomatic treatment, only seek efficacy. Stop medication once it hits the disease, prioritizing the rescue of the root. Misprescribing decoctions immediately leads to damage and disability. This is the oath of superior physicians to save lives, and the verification of good doctors through practice!
It has been heard that methods are not fixed, but depend on symptoms; if one is not a physician from three generations, do not administer decoctions or pills. Patients should carefully select skilled practitioners, and physicians must strive for cure. View illness as if it were one's own, and do not be greedy for profit. First observe the influence of climate (Yunqi), skillfully aligning with Yangming mechanisms; then observe complexion and physique, clearly understanding favorable and unfavorable trends. In spring and summer, when Yang is abundant, bitter-cold herbs can be used, depending on the patient's robustness; in autumn and winter, when Yin is abundant, pungent-warm herbs can be considered, based on the patient's fatigue and gan syndrome. If warming is needed but cold is used, or if dispersal is needed but warmth is applied, the Seven Spirits will scatter, and the Five Zang organs will collapse. Although paying attention to pulse and prescription studies, what benefit does it bring to the world? Instead causing premature death, this incurs heavenly retribution. Therefore, for congenital diseases, urgent detoxification is required; for food stagnation, eliminating gan syndrome is beneficial. Treatment divides into two methods, achieving perfect efficacy. For infants still unsettled in swaddling clothes, regulate the mother; for toddlers walking unsteadily, consolidate their Yuan Qi.
Alas, the harmonious center of the intestines and stomach cannot withstand medicinal attacks; subtle is the weak and immature Qi and Blood, which develop gradually. Treatment is not out of desperation, but because diseases strike suddenly. Like protecting a candle in the wind, the heart remains vigilant; like cherishing a pearl in the palm, the intention is sincere. Physicians can supplement the Lord of Life, without disgracing family traditions.
For instance, when illness arises, heat emerges; when heat rises, fright occurs. Some treat heat with heat, others attack heat with cold. If heat is in the exterior, Chai Ge Jie Ji Tang (Bupleurum and Pueraria Muscle-Releasing Decoction) can be drunk; if heat is in the interior, Qin Lian Xiao Du Tang (Scutellaria and Coptis Detoxifying Decoction) should be boiled urgently. For accumulated heat, Ji Sheng Wan (Ji Sheng Pill) is unparalleled; for deficient heat, Tiao Yuan Tang (Regulating Yuan Decoction) is excellent. The key lies in recognizing pulses and colors, not recklessly administering decoctions or pills, lest leaving lifelong chronic diseases or shortening the infant's lifespan. Mild conditions becoming severe, the merit does not offset the harm. Merely entrusting fate to destiny, without carefully studying classics. The previous cart overturned, yet the tracks remain the same. Souls wander in the suburbs, cries reach the rivers. Knowing this cause, whose fault is it? Alas! Building bridges for ants, freeing sparrows from cages. How much more so for spirits among all things, not worth less than a worm, if not cautious and meticulous, they are lightly sacrificed. Extending compassionate conscience, as if seeing someone fall into a well; examining sages' teachings, as if fearing failure to save them. Living in ease implies danger, knowing falls teaches caution. Symptoms emerge in hundreds of ways, treatments avoid bias. Harmonize and transform creation, preserve true Yuan. Good offense is inferior to good defense, urgency is preferable to slowness. Planting apricots to form a forest, following Dong Feng of old; planting oranges naming a well, seeing Su Dan of today.
Why does prolonged diarrhea become dysentery, prolonged stagnation become gan syndrome, prolonged malaria produce masses, prolonged fright turn into abscesses? Before lingering sets in, attack should be swift; once severe illness appears, treatment should be gentle. Intestines and stomach blocked, urgently purge; Qi and Blood deficient and emaciated, urgently tonify to stabilize. External toxins attacked urgently, preventing entry into the abdomen; exterior pathogens resolved urgently, preventing further transmission. Others are regulated slowly, fearing rapid changes; once medicine is swallowed, prevent overdose; if treatment hits the disease, do not exaggerate ability. The wise often worry about one mistake, the dead cannot be restored. Better to be cautious before error than regret after misjudgment. To seek fish and rabbits, hold onto the trap and basket. If treating diseases with multiple methods, repeat these words thrice!