一、《伤寒论》一书,自叔和编次后,仲景原篇不可复见。虽章次混淆,犹得寻仲景面目。方、喻辈各为
更定。《条辨》既中邪魔。《尚论》浸循陋习矣,大背仲景之旨。琴有志重编,因无所据,窃思仲景有太阳
证、桂枝证、柴胡证等辞,乃宗此义,以症名篇,而以论次第之。虽非仲景编次,或不失仲景心法耳。
一、起手先立总纲一篇,令人开卷便知伤寒家脉症得失之大局矣。每经各立总纲一篇,读此便知本经之脉症
大略矣。每篇各标一症为题,看题便知此方之脉证治法矣。
一、是编以症为主,故汇集六经诸论,各以类从。其症是某经所重者,分列某经,如桂枝、麻黄等症列太
阳,栀子、承气等症列阳明之类。其有变证化方,如从桂枝症更变加减者,即附桂枝症后,从麻黄症更变加减
者,附麻黄证后。
一、叔和序例,固与仲景本论不合,所集脉法,其中有关于伤寒者,合于某证,即采附其间,片长可取,
即得攀龙附骥耳。
一、六经中有症治疏略,全条删去者,如少阴病下利白通汤主之、少阴病下利便脓血桃花汤主之等类,为
既有下利脉微者与白通汤、腹痛小便不利与桃花汤主之之详,则彼之疏略者可去矣。又有脉症各别,不相统摄
者。如太阳病发汗太多因致 ,与脉沉而细,病身热足寒等症,三条合一,论理甚明,故合之。
一、本论每多倒句,此古文笔法耳。如太阳病血症麻黄汤主之句,语意在当发其汗下。前辈但据章句次序,
不审前后文理,罔顾衄家禁忌,竟谓衄后仍当用麻黄解表。夫既云衄乃解,又云自衄者愈,何得阵后兴兵?衄
家不可发汗,更有明禁,何得再为妄汗?今人胶柱者多,即明理者,亦多为陶氏所惑,故将麻黄、桂枝、小青
龙等条,悉为称正。
一、条中有冗句者删之,如桂枝症云。“先发汗不解,而复下之,
脉浮者不愈。浮为在外,须解外则愈。”何等直捷!在外下更加“而反下之,故令不愈,今脉浮,故知在外”
等句,要知此等繁音,不是汉人之笔。凡此等口角,如“病常自汗出”条,亦从删例。
一、条中有衍文者删之,有讹字者改之,有阙字者补之。然必详本条与上下条有据,确乎当增删改正者,直
书之。如无所据,不敢妄动,发明注中,以俟高明之定夺。
一、加减方分两、制度、煎法,与本方同者,于本方下书本方加某味、减某味。或一篇数方,而后方煎法
与前方同者,于方末书煎法同前。方中药味修治同前者,如麻黄去节、杏仁去皮之类,但不再注;附子必炮,
若有生用者注之。
一、可汗不可汗等篇,鄙俚固不足取,而六经篇中多有叔和附入,合于仲景者取之。如太阳脉浮动数三、
阳明论脾约脉症等条,与本论不合,无以发明,反以滋惑,剔出附后,候识者辨焉。
一、正文逐句圈断,俱有深意。如本论中一字句最多,如太阳病。“脉、浮、头、项、强、痛”六字,当作
六句读,言脉气来尺寸俱浮,头与项强而痛。若脉浮两字连读,头项强痛而恶寒,作一句读,疏略无味。则字
字读断,大义先明矣。如心下温温欲吐,郁郁微烦之类,温温、郁郁,俱不得连读,连读则失其义矣。
1. Since Wang Shuhe compiled and arranged the *Treatise on Cold Damage* (Shanghan Lun), Zhang Zhongjing's original chapters can no longer be seen. Although the order of chapters is confused, one can still trace the original appearance of Zhang Zhongjing's work. Fang Youzhi and Yu Jiayan each made their own revisions. Fang's *Shanghan Lun Tiaobian* has deviated from the right path, and Yu's *Shanglun Pian* has gradually followed bad habits, greatly departing from Zhang Zhongjing's intent. I, Ke Qin, have the ambition to recompile it. Lacking a basis, I privately considered that Zhang Zhongjing often used terms such as "Taiyang Syndrome" (disease pattern involving the Taiyang channel), "Guizhi Syndrome" (pattern treated by Cinnamon Twig Decoction), and "Chaihu Syndrome" (pattern treated by Bupleurum Decoction). Therefore, following this principle, I named chapters after symptoms and arranged the discussions sequentially within them. Although this is not Zhang Zhongjing's original arrangement, it may well preserve his essential method.
2. At the beginning, a general outline is established so that upon opening the book, one immediately understands the overall situation regarding the gains and losses in pulse and symptoms for treating cold damage diseases. Each of the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin) has its own general outline; reading this allows one to grasp the general pulse and symptom patterns of that specific channel. Each chapter is titled with a primary symptom, allowing one to understand the corresponding pulse, symptoms, and treatment methods simply by looking at the title.
3. This compilation focuses on symptoms; therefore, various discussions from the Six Channels are collected and categorized accordingly. If a certain symptom is emphasized in a specific channel, it is listed under that channel. For example, Guizhi Tang (Cinnamon Twig Decoction) syndrome and Mahuang Tang (Ephedra Decoction) syndrome are listed under the Taiyang channel, while Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) syndrome and Chengqi Tang (Order the Qi Decoction) syndrome are listed under the Yangming channel. If there are modified syndromes or altered formulas, such as those derived from modifications of Guizhi Tang syndrome, they are attached after the Guizhi Tang syndrome section; similarly, those derived from Mahuang Tang syndrome are attached after the Mahuang Tang syndrome section.
4. Wang Shuhe's preface and examples do not align with Zhang Zhongjing's original text. However, among the pulse methods he collected, those relevant to cold damage and consistent with specific syndromes are adopted and inserted therein, taking advantage of their merits to attach them to the classic.
5. In the Six Channels, some sections on syndrome and treatment are sparse or entirely deleted. For instance, "Shaoyin disease with diarrhea, Bai Tong Tang (White Connector Decoction) governs it" and "Shaoyin disease with diarrhea and pus/blood in stool, Tao Hua Tang (Peach Blossom Decoction) governs it." Since there are already detailed descriptions for "diarrhea with faint pulse treated with Bai Tong Tang" and "abdominal pain with difficult urination treated with Tao Hua Tang," the sparser versions can be removed. There are also cases where pulses and symptoms differ and are not unified. For example, combining three clauses: "Taiyang disease caused by excessive sweating leading to..." with "pulse deep and fine, disease with body heat and cold feet," makes the reasoning very clear, so they are combined.
6. The original text often uses inverted sentences, which is an ancient literary style. For example, in the sentence "Taiyang disease, a person prone to epistaxis (nosebleed), Mahuang Tang governs it," the meaning lies in the necessity to induce sweating to release the exterior. Predecessors, relying only on the sequence of clauses without examining the context, ignored the contraindications for patients with epistaxis, claiming that Mahuang Tang should still be used to release the exterior after bleeding. Since it is stated that "epistaxis leads to resolution" and "spontaneous epistaxis results in healing," how can one deploy troops (metaphor for using medicine) after the bleeding has occurred? There is a clear prohibition against inducing sweating in patients prone to epistaxis; why would one recklessly induce sweating again? Many people today are rigid and inflexible; even those who understand the principles are often confused by Tao Hua (Tao Jian'an). Thus, clauses regarding Mahuang Tang, Guizhi Tang, and Xiao Qing Long Tang (Minor Green Dragon Decoction) are all regarded as correct/standard.
7. Redundant sentences in clauses are deleted. For example, regarding Guizhi Tang syndrome: "If initial sweating does not resolve the condition, and purgation is repeated, and the pulse remains floating, it will not heal. Floating indicates the pathogen is outside; resolving the exterior will lead to healing." How direct! Adding phrases like "but contrary purgation was used, thus causing non-healing; now the pulse is floating, thus knowing it is outside" below "outside" introduces verbosity. Such verbose language is not characteristic of Han dynasty writing. All such wordiness, such as in the clause "the disease constantly causes spontaneous sweating," is handled according to the deletion example.
8. Derivative texts (extra characters) are deleted, erroneous characters are corrected, and missing characters are supplemented. However, this must be done only after carefully verifying evidence from the current clause and adjacent clauses, ensuring that the addition, deletion, or correction is definitive. It is written directly if justified. If there is no basis, I dare not act rashly but instead explain it in the annotations, awaiting the judgment of superior scholars.
9. For modified formulas, if the dosage, processing methods, and decoction techniques are the same as the base formula, it is noted below the base formula which herbs are added or removed. If multiple formulas appear in one chapter and the decoction method of subsequent formulas is the same as the preceding one, it is noted at the end of the formula that the decoction method is the same as before. If the processing of herbs in the formula is the same, such as removing the joints of Ephedrae Herba (Mahuang) or peeling Apricot Kernels (Xingren), it is not repeated. Aconite Root (Fuzi) must be processed (pao); if raw usage occurs, it is specifically noted.
10. Chapters discussing whether sweating is indicated or contraindicated contain vulgar content that is indeed unworthy of adoption. However, many sections in the Six Channels were appended by Wang Shuhe; those consistent with Zhang Zhongjing's intent are selected. For example, clauses like "Taiyang pulse floating, moving, rapid, three [types]" and the discussion on "Spleen Constraint" (Pi Yue) pulse and symptoms in the Yangming chapter do not align with the main text, fail to elucidate medical principles, and instead cause confusion. They are extracted and attached to the end for discerning experts to evaluate.
11. The punctuation breaks in the main text carry profound meaning. For instance, in the original text, single-character clauses are most common. Take "Taiyang disease." The characters "Pulse, Floating, Head, Neck, Stiffness, Pain" should be read as six separate clauses, meaning the pulse qi arrives floating at the Cun, Guan, and Chi positions, and the head and neck are stiff and painful. If "Pulse Floating" is read together and "Head, Neck, Stiffness, Pain, and Aversion to Cold" is read as one clause, it becomes sparse and lacks flavor. By breaking down character by character, the major principles become clear first. Similarly, in phrases like "warmth in the chest prompting vomiting, slight irritability," "Wenwen" (warmth/discomfort) and "Yuyu" (oppression/irritability) should not be read as connected compounds; doing so would lose their specific meaning.