素问曰。病为本。工为标。标本不得。邪气不服。
又曰。标本已得。邪气乃服。夫所谓标本者。一体本末
之事。今病与工。自非一体。何其言标本也。盖谓某病为本。则以治某病者为标。因其本而治其标。则工与病。
自成一家矣。且如病伤寒者。以伤寒为本。则亦以能治伤寒之工为标。此所谓标本已得。邪气乃服也。如以伤
寒为本。而以能治痹疝之工为标。则标本不相得。邪气何缘可服哉。素问论此。乃以得不得为言。圣哲之意可
见。况病有轻重。工有高下。重病须高工。亦谓其标本相得也。扁鹊曰。人之所患患疾多。医之所患患道少。
道少疾多。此标本之所难相得也。凡病固皆难。惟伤寒为特甚。盖人之疾痛。或在皮肤。或肌肉。或骨髓。或
五脏六腑。着则久而不去。未有入经与经气流通者。惟伤寒之毒。能入大经。与经气相搏。经气不能胜。反藉
经隧恣意攻人。人为之拱手待毙。昔之所谓流注血气。生养人命之经。今化为寒温热毒。毒人生命之经矣。
是岂他疾之比哉。故自古以为难治之疾。方其疾作之始。日传一经。初传之际。证或难辨。用药尚疑。当是之
时。其工在明。及传证之始。急于用药。犹豫则差。其工在断。一经既过。又将别传。新故相乱。其工在审。
为之工者。自非六日之传。昭然豫判于胸中。亦未易酬对。三阴三阳之变。彼如疾风骏马。过不暂停。而欲逐
其后而攻之。谬矣。况有异气间袭。变动随出。或表或里。超然若神。不可以常拘者。将何应之。故仲景曰。
阴阳虚实之交错。其候至微。发汗吐下之相反。其祸至速。信斯言也。自非心精学博。机运无穷。未有不触途
面墙。倒行逆施者。此所谓贵于标本相得。而后邪气乃服也。惟其最为难治。故自张长沙以来。特为注意。
辨析毫厘。动辄十数万言以训后世。今医方论说。复无详于伤寒者。昔云难治之病。今反为晓然易见之疾。
患在常人苟且。不诵其书耳。则书之为后人利。岂不溥哉。是以陶隐居称仲景之书为众方之祖。孙真人叹其特
有神功。良有以也。雍之仲兄。字子言。尝通守夷陵秭归二郡。幼以多疾喜方。遍访名医。时尚及见常器之、康醇
道辈。
遂悟医师氏之学既久。深得于仲景之论。每叹此学大难穷尽。今则其道将绝。时为雍言之。雍初得闻仲景之书。未
甚领
略。渐磨日久。及老后笃好之。叹已晚矣。昔仲景感往昔之沦丧。伤横夭之莫救。乃撰伤寒杂病论。雍之用心。
亦复为此。虽学识疏略。无高人之见。而一言一事。上必有所本。中必得于心。而后敢笔之于书。尽去世俗妄
论欺惑之术。常如天地父母临其上。庶几后世复有扬子云。始知雍言之不谬也。今所论次。自岐黄以及近代诸
书。凡论辨问答证治。合一千五百余条。总五万言。分七十余门。集成论说二十卷。方药五卷。雍闻医家有好
事。或三十年而着论。或二十载而成书。其用心精专。故足以垂世。如雍行年八十。日暮途远。志在速成。
安能久于斯道。是以不逾年而略举大纲。亦由前人之述已备。继踵有作。不过书札之力而已。未能免疏略 牾
也。后之君子。或怜其衰晚昏谬。疏其失而正之。以成其美。此诚有望焉。嗟乎。予生不辰。上不得见张长沙
孙真人。北面抠衣而请。下不得进于庞朱二氏之前。独抱遗书。呻吟于深山穷谷之间。啜菽饮水而不厌焉者。
乐在其中矣。昔孔子多能鄙事。子夏虽小道必观。圣贤尚且不废。况后人乎。幸不以猥吝见黜也。
淳熙八年岁在辛丑暮春之月河南郭雍谨叙
近世诸家伤寒书。如高文庄伤寒类要。未得本。庞朱二氏。传世已久。常器之补治论。虽略有传。而不
得善本。今有文阙者补之。讹舛者正之。疑不敢用者去之。庶不累其名。后来者惟王仲弓监丞一书。颇有发明。
遇前人阙则取之。自此而下。非所当录。虽有传于世者。未足为后世不刊之说也。
The *Suwen* (Basic Questions) states: The disease is the root (*ben*), and the physician is the branch (*biao*). If the root and branch do not correspond, the pathogenic factor cannot be subdued.
It further states: If the root and branch have corresponded, then the pathogenic factor can be subdued. What is meant by "root" and "branch" is a matter of the beginning and end of a single entity. Today, the patient and the physician are not one entity; why speak of them as root and branch? It is said that a specific disease constitutes the root, and thus the physician who treats that specific disease constitutes the branch. By following the root to treat the branch, the physician and the disease become integrated into one system.
For instance, in a case of *Shanghan* (Cold Damage), *Shanghan* is the root, and the physician capable of treating *Shanghan* is the branch. This is what is meant by "the root and branch have corresponded, and the pathogenic factor is subdued." If *Shanghan* is taken as the root, but a physician skilled in treating *Bishan* (Bi syndrome and hernia) is chosen as the branch, then the root and branch do not correspond; how could the pathogenic factor possibly be subdued? The *Suwen* discusses this in terms of correspondence or non-correspondence, revealing the intent of the sages.
Moreover, diseases vary in severity, and physicians vary in skill. Severe diseases require highly skilled physicians, which refers to the correspondence of root and branch. Bian Que said: "What people worry about is the multiplicity of diseases; what physicians worry about is the paucity of medical principles." When principles are few and diseases many, it is difficult for the root and branch to correspond.
All diseases are indeed difficult, but *Shanghan* is particularly severe. Human ailments may reside in the skin, muscles, bone marrow, or the five zang and six fu organs. Once pathogens attach, they linger and do not depart; normally, they do not enter the meridians and circulate with the meridian qi. Only the toxin of *Shanghan* can enter the major meridians and contend with the meridian qi. If the meridian qi cannot overcome it, it instead utilizes the meridians to attack the body recklessly, leaving the person helpless and awaiting death. The meridians once known for circulating blood and qi and nourishing life have now become pathways for cold, heat, and warm toxins that endanger life. How can this be compared to other diseases?
Therefore, since ancient times, it has been considered a difficult disease to treat. At the onset of the illness, the pathogen transmits through one meridian each day. During the initial transmission, symptoms may be hard to distinguish, and medication choices remain uncertain; at this time, the physician's key lies in clarity (*ming*). When the transmitted symptoms begin to manifest, urgency in medication is required; hesitation leads to error, so the physician's key lies in decisiveness (*duan*). After one meridian stage passes, transmission to another begins, mixing new and old symptoms; here, the physician's key lies in careful examination (*shen*).
A physician must have a clear, pre-judged understanding of the six-day transmission cycle; otherwise, responses will likely be inadequate. The changes of the Three Yin and Three Yang meridians are swift like a gale or a galloping horse, passing without pause. To chase after them and attack is erroneous. Furthermore, when heterogeneous pathogens invade intermittently, variations emerge spontaneously, sometimes in the exterior, sometimes in the interior, transcending normal constraints like spirits. How should one respond?
Thus, Zhang Zhongjing stated: "The interweaving of Yin-Yang deficiency and excess presents subtle signs; the opposition of sweating, vomiting, and purging methods brings rapid disaster." Believing this statement, unless one possesses profound insight, extensive learning, and infinite adaptability, one will inevitably hit a wall and act counterproductively. This emphasizes the importance of the root and branch corresponding, so that the pathogenic factor may be subdued.
Because it is the most difficult to treat, attention has been specially focused on it since Zhang Changsha (Zhang Zhongjing). Analyzing minute details, writing tens of thousands of words to instruct future generations. Among current medical theories and formulas, none are more detailed regarding *Shanghan*. A disease once considered difficult to treat is now clearly visible and easy to understand. The problem lies in ordinary people being negligent and failing to study these books. Thus, the benefit of these books to posterity is indeed vast.
Therefore, Tao Hongjing praised Zhang Zhongjing's book as the ancestor of all formulas, and Sun Simiao sighed at its miraculous efficacy, both having valid reasons. My second brother, courtesy name Ziyan, served as acting governor of Yiling and Zigui commanderies. Suffering from frequent illnesses since childhood, he favored medical prescriptions and visited famous physicians extensively. He was able to meet figures such as Chang Qizhi and Kang Chundao. Consequently, he realized that the art of medicine, having been passed down for a long time, deeply embodies Zhang Zhongjing's theories. He often lamented that this learning is extremely difficult to exhaust and that its lineage is nearing extinction, frequently speaking of this to me.
I initially obtained Zhang Zhongjing's book but did not fully grasp it. Through gradual study over time, I came to love it deeply in my old age, sighing that I had started too late. Formerly, Zhang Zhongjing lamented the loss of past classics and mourned those who died prematurely without rescue, leading him to compile the *Shanghan Zabing Lun* (Treatise on Cold Damage and Miscellaneous Diseases). My intention is the same. Although my knowledge is sparse and lacking in superior insights, every word and deed must have an upper source and inner conviction before I dare record it in writing. I discard worldly absurdities and deceptive techniques, always feeling as if Heaven, Earth, and parents are watching from above. I hope that someone like Yang Xiong will appear in later generations to confirm that my words are not erroneous.
The discussions compiled here range from Qibo and Huangdi to recent works. All debates, Q&A, symptom analysis, and treatments total over 1,500 entries, amounting to 50,000 characters, divided into over 70 categories, forming 20 volumes of theoretical discourse and 5 volumes of formulas and herbs. I have heard that medical scholars who enjoy writing may take thirty years for essays or twenty years for books. Their focused effort allows their work to endure. I am now eighty years old, with the sun setting and the road far; my ambition is quick completion. How can I linger long in this path? Therefore, within a year, I have outlined the main points. Since predecessors' accounts are already complete, subsequent works rely merely on letter-writing efforts and cannot avoid omissions and contradictions. Future gentlemen may pity my senile confusion, correct my errors, and perfect this work, which is indeed hoped for.
Alas! I was born in an ill-fated time. I cannot see Zhang Changsha or Sun Zhenren to bow and ask for instruction; nor can I approach Pang Anshi and Zhu Gong. Alone holding lost texts, groaning in deep mountains and remote valleys, drinking bean soup and water without weariness, finding joy therein. Confucius mastered many humble skills; Zixia said even minor arts must be observed. Even sages did not abandon them, let alone later generations. I hope I am not rejected for my clumsiness and stinginess.
In the eighth year of Chunxi, Xin Chou year, late spring month, Guo Yong of Henan respectfully records this.
Recent scholarly works on *Shanghan*, such as Gao Wenzhuang's *Shanghan Leyao*, I have not obtained the original. The works of Pang Anshi and Zhu Gong have been transmitted for a long time. Chang Qizhi's *Bu Zhi Lun* has slight circulation but no good edition. Where text is missing, I supplement it; where errors exist, I correct them; where doubts persist, I remove them, hoping not to tarnish their reputations. Among later authors, only Wang Zhonggong's monograph shows significant innovation. Where predecessors were deficient, I adopt his views. Below this point, nothing else is suitable for recording. Even if transmitted, they are insufficient to serve as unchangeable doctrines for posterity.