伤寒。病因也。非病证也。以因为名。求本也。伤寒见证。变化无端。非仲景六经主证。所能赅括。后人拘执。
凡不在仲景文内者。概不敢求之伤寒。间有窥见一隙。又不敢显违众论。但曲为之说曰。是伤寒杂证也。夫伤寒之
证自杂安得复有伤寒杂证者也。晋唐诸贤。以温病热病。本于伤寒之转变而别。以温毒与寒毒相对待。至哉言乎。
温病热病。且以为本于伤寒。况其本寒证者乎。学人能知伤寒见证。不止仲景原文。仲景文外。尚有伤寒证治。庶
乎其可与读伤寒之论。治伤寒之病矣乎。王叔和作伤寒例。以明即病为伤寒伏气变为温热之事。用意甚盛。惜其语
焉不详。揆之事例。仍多未备。学海读内经后。读仲景书。参以临诊。觉于伤寒偏死下虚人一语。稍有领会。于是
有见辄录。积久成帙。虽无深义。要是拾遗发覆之一端。名曰伤寒补例。不敢补仲景也。补叔和云尔。
乙巳孟冬健之记
医惟实事。弗尚空谈。仲景书。所以传世不朽者。以其言皆实事。百家莫及也。然缺略难读。尤在叙证太简。
常与方药不相对。近贤多以方释证。惟成氏能先证后药。亦未能大畅厥旨。非成氏拙于注释。实仲景之文。有难释
者也。前人谓初学。必先读伤寒论。以立根本。予独谓不然。当先读内经难经。接读金匮。参以外台千金。而后及
伤寒论。以考其变。即如每节首署太阳病云云。有直指发热恶寒项背强痛者。有谓先见太阳病。今又接见下文诸证
者。有谓本是太阳病。今忽转见下文诸证者。果有日久及发汗吐下后等语。犹有转接之迹可寻。无之。便苦上下不
贯矣。况夫邪气之何以发为太阳病少阳阳明三阴病也。三阳三阴病之何以各见某证也。发汗吐下后之何以变见某证
也。某证之何以应用某方、加减某药也。一概不曾道破。间有一二。亦断碎而不续。此虽智者。不能得其脉络之所
在。而责之初学。不亦难乎。王叔和作伤寒例。仅提其纲。陶节庵作六书与全生集。未竟其绪。深望世有高贤。取
仲景书。合之内经。参之诸家。补发其所未备。三阳三阴病上补发邪气来路。病下补发转证机括。某方主之。上下
补发。对治气宜切定实事。勿谈空理。国中末候。条理分明。使读者对书如对病患焉。确有可循。不致眩惑。斯生
灵之幸也。小子愚陋。愧不及此。仅发其端。以待来者。
Shanghan (Cold Damage), as a pathogenic cause, is not a specific disease syndrome. Naming it by its etiology aims to seek the root of the disease. The manifestations of Shanghan are unpredictable and cannot be fully encompassed by the main syndromes of the Six Channels (Liu Jing) proposed by Zhang Zhongjing. Later physicians were rigid and dogmatic; for anything not contained within Zhang Zhongjing's original text, they generally dared not attribute it to Shanghan. Occasionally, some glimpsed a fragment of truth but dared not openly contradict the prevailing views, instead offering forced explanations that these were "mixed syndromes of Shanghan." However, if they are already mixed syndromes, how can they still be called "mixed syndromes of Shanghan"?
The sages of the Jin and Tang dynasties distinguished Warm Diseases (Wen Bing) and Heat Diseases (Re Bing) from Shanghan, considering them as transformations originating from Shanghan, and set up a contrast between Warm Toxins (Wen Du) and Cold Toxins (Han Du). This was indeed a profound insight! If even Warm Diseases and Heat Diseases are considered to originate from Shanghan, how much more so for those conditions that are fundamentally cold in nature? If scholars could recognize that the manifestations of Shanghan are not limited solely to Zhang Zhongjing's original text, and that there are treatments and syndromes related to Shanghan beyond his writings, then perhaps they would be qualified to study the *Treatise on Cold Damage* (*Shanghan Lun*) and treat Shanghan diseases.
Wang Shuhe authored the *Example of Shanghan* (*Shanghan Li*), intending to clarify immediate-onset Shanghan and the transformation of latent pathogens into warm-heat conditions. His intention was noble. Alas, his descriptions were vague, and upon examining the structure, many aspects remained incomplete. After reading the *Inner Canon* (*Neijing*), I studied Zhang Zhongjing's works and combined this with clinical practice. I felt I had gained some understanding of the phrase "Shanghan tends to kill those with deficiency in the lower jiao" (*pian si xia xu ren*). Thus, I recorded my insights whenever they arose, which over time accumulated into a volume. Although it lacks profound meaning, it serves as one aspect of gathering omissions and revealing hidden truths. It is named *Supplementary Examples of Shanghan* (*Shanghan Bu Li*), not to supplement Zhang Zhongjing, but to supplement Wang Shuhe.
Recorded in the first month of winter in the Yisi year, Jian Zhi.
Medicine values practical facts and does not advocate empty talk. The reason Zhang Zhongjing's book has been immortalized is that its statements are based on facts, unmatched by other schools. However, it contains omissions and is difficult to read, especially because the description of symptoms is too brief and often does not correspond directly to prescriptions. Recent virtuous scholars have mostly used prescriptions to explain symptoms. Only Cheng Wuji managed to list symptoms before prescriptions, yet he still failed to fully elucidate the core principles. This was not due to Cheng Wuji's incompetence in annotation, but rather because Zhang Zhongjing's text itself is difficult to interpret.
Predecessors believed that beginners must first read the *Treatise on Cold Damage* to establish a foundation. I personally disagree. One should first read the *Inner Canon* (*Neijing*) and the *Classic of Difficult Issues* (*Nan Jing*), then proceed to the *Essential Prescriptions Worth a Thousand Gold* (*Jingui Yaolue*), referencing the *External Cabinet Secret Formulas* (*Waitai Miyao*) and *Thousand Golden Prescriptions* (*Qianjin Fang*), and only then study the *Treatise on Cold Damage* to examine its variations. For instance, each section begins with "Taiyang Disease..." Some directly point out symptoms such as fever, aversion to cold, and stiffness/pain in the neck and back. Others state that Taiyang disease appeared previously, and now various subsequent symptoms are appearing. Still others say it was originally Taiyang disease, but suddenly transformed into the subsequent symptoms. If there are phrases like "after many days" or "after sweating, vomiting, or purging," traces of transition can still be found. Without such phrases, it becomes difficult to connect the preceding and following texts.
Moreover, why do pathogens manifest as Taiyang, Shaoyang, Yangming, and the Three Yin diseases? Why do the Three Yang and Three Yin diseases present specific symptoms respectively? Why do certain symptoms appear after sweating, vomiting, or purging? Why should specific formulas and herb modifications be applied to specific symptoms? These points are not explicitly explained. Occasional mentions are fragmented and discontinuous. Even a wise person cannot discern the underlying logic, so demanding this of beginners is indeed difficult.
Wang Shuhe's *Example of Shanghan* only outlined the general principles. Tao Jie'an's *Six Books* (*Liu Shu*) and *Complete Life Collection* (*Quansheng Ji*) did not complete the thread. I deeply hope that future virtuous scholars will take Zhang Zhongjing's work, integrate it with the *Neijing*, reference various schools, and supplement what is lacking. Above the sections on the Three Yang and Three Yin diseases, supplement the explanation of the origin of pathogens. Below the disease descriptions, supplement the mechanisms of symptom transformation. For "governed by [Formula Name]," provide supplementary explanations above and below, ensuring that the treatment aligns with the appropriate qi dynamics and concrete facts, avoiding empty theories. Clarify the climatic characteristics of the current era with distinct logic, so that readers facing the book feel as if they are facing a patient, with clear paths to follow, avoiding confusion. This would be a blessing for the people. I am foolish and shallow, ashamed to fall short of this goal, so I merely raise this topic for later generations to develop.