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(Ke's edition changes "Zu" (sudden) to "Za" (miscellaneous), which should be followed. See details in the General Overview. Versions from Fang Shi onwards do not have the character "Ji" (Collection).)

The Treatise states: Whenever I read about Yue Ren (referring to Bian Que) diagnosing the Crown Prince of Guo and observing the complexion of the Duke of Qi (these two events are recorded in *Records of the Grand Historian: Biography of Bian Que*), I cannot help but sigh with admiration for his outstanding talent. ("Kai" is interchangeable with "Kai"; *Shuowen Jiezi* explains it as a sigh. *Book of Songs: Wang Feng* mentions "his sigh," and *Cao Feng* mentions "I sigh awake, Kai," where "Kai" is the same as "Kai." Note: In Jin Dynasty Pan Yue's *Preface to Leisurely Living*, Pan Yue reads the *Biography of Ji An*. Upon reaching Sima An's four promotions to the Nine Ministers, recorded by good historians under the label of "clever official," Pan Yue could not help but sigh and put down his book. The legal structure is similar, both originating from *Records of the Grand Historian: Biography of Mencius*.)

I am surprised that scholars of today do not pay attention to medicine or carefully study medical arts. (See *Records of the Grand Historian: Annals of Qin Shi Huang* regarding the summoning of literary and technical experts, and *Annals of Emperor Ping of Han* regarding technical arts and materia medica.) They fail to treat the illnesses of rulers and parents above, rescue the poor and lowly below, nor preserve their own bodies for longevity to nourish life. Instead, they compete for glory and power, stretching their necks and standing on tiptoes to admire powerful nobles. (*Han Shu: Biography of Xiao Wangzhi* states: "Scholars of the world stretch their necks and stand on tiptoes, competing to offer their services.") They strive diligently and anxiously, devoted only to fame and profit, honoring superficialities while neglecting the root, appearing splendid on the outside but emaciated within. If the skin does not exist, where will the hair attach? (From *Zuo Zhuan*, 14th year of Duke Xi.) Suddenly encountering pathogenic wind, they suffer from unusual diseases. ("Ying Ji" also appears in *Hou Han Shu: Biography of Li Ying*.) When disaster strikes, they tremble in fear, lowering their ambitions and compromising their integrity. (*Analects: Wei Zi*: "Do not lower your ambition, do not humiliate your body." *Kongzi Jiayu*: Zai Yu said to Confucius, "For the Master regarding the position of Siko, though the time was short, he compromised his integrity many times. Can this stop?" ) They respectfully hope for shamans and diviners. (*Erya*: "Qin" means respectful. *Guoyu*: "Male is Xi, female is Wu." *Shuowen Jiezi*: "Zhu" refers to the one who recites prayers during sacrifices.) Finding no recourse, they blame Heaven, surrendering themselves to defeat. ("Shu Shou" appears in *Hou Han Shu: Annals of Guangwu*.) A lifespan of a hundred years (The character should be "Shou" (longevity); "Shou" and the original character are synonymous; *Qianjin Fang* uses another variant, meaning to hold/keep. *Zuo Zhuan* commentary on 32nd year of Duke Xi: Upper longevity is 120 years, middle is 100, lower is 80. *Zhuangzi: Robber Zhi*: Human upper longevity is 100, middle 80, lower 60.) entrust this precious vessel (the body) to mediocre physicians, allowing them to act arbitrarily. Alas! (He Xiu's commentary on *Gongyang Zhuan*: "Yi, duojie are sounds of sighing.") The body perishes, spirit and consciousness vanish, transforming into a strange object. (Jia Yi's *Owl Fu*: "Transformed into a strange object, why worry?") The soul sinks deep into the underworld. (Jiang Yan's *Lament*: "The beauty returns to the heavy spring." Li Shan's commentary cites Pan Yue's *Mourning for the Dead*: "This person returns to the dark spring, separated forever by layers of earth.") Only leaving relatives to weep in vain. Alas, the whole world is confused and unaware, failing to realize the truth, disregarding their lives, treating life so lightly—what talk of glory and power is there then? (Note: From "scholars of today" to here, Sun Simiao's *Preface to Qianjin Fang* quotes Zhang Zhongjing, with slight textual differences.) Advancing, they cannot love or understand others; retreating, they cannot love or understand themselves. Encountering disaster, they find themselves in dire straits. ("E" is written as "Si" (death) in He's version.) Muddled and ignorant, like a wandering soul. (In *Qianjin Fang* it is written as "Zhang," in Ke's edition as "Chun." *Book of Rites: Ai Gong Wen*: "I am foolish and dark." *Book of Changes: Xi Ci Xia*: "Wandering souls undergo change." Huangfu Mi's *Preface to Jiayi Jing*: "Receiving the body of ancestors, having an eight-foot stature, yet not knowing medical affairs—this is called a wandering soul. This is the meaning.") How sorrowful for those scholars pursuing worldly trends, racing in vanity, not securing the root, sacrificing their bodies for external things. (*Zhuangzi: Rang Wang*: "Current secular gentlemen endanger their bodies and abandon life to pursue external objects.") Dangerous as if walking on ice near a valley. (Pan Yue's *Widow's Lament*: "Like treading on ice facing a valley." Li Shan's commentary cites *Mao Shi*: "Trembling with care, like facing a valley." Also: "Trembling and cautious, like treading on thin ice." *History of Northern Dynasties: Annals of Emperor Wu of Zhou*: Edict says, "Whenever I think of it, it is like facing ice and valleys.") To this extent.

My clan has always been large, formerly numbering over two hundred. Since the Jian'an era, less than ten years have passed. (Note: "Jinian" refers to the year of the era. *Han Shu: Annals of Wu Di*: Yuan Shou 1st year, winter October, sacrificed to the Five Spirits, captured a one-horned beast, used it for sacrifice, and began using heavenly omens to name the era.) Among them, two-thirds have died. (Note: This is because contemporary scholars entrust their lives to mediocre physicians, hence such results.) Seven out of ten deaths were due to Cold Damage (Shanghan). Grieving the loss of the past, pained by the untimely deaths that could not be saved, I diligently sought ancient teachings, extensively collected various prescriptions, utilized the *Suwen* (Plain Questions), *Jiujuan* (Nine Volumes), *Bayishinan* (Eighty-One Difficulties), *Yinyang Dalun* (Great Treatise on Yin and Yang), *Tailu Yaolu* (Record of Fetal Structure and Drugs), and combined pulse diagnosis and syndrome differentiation to compile the *Shanghan Zabing Lun* (Treatise on Cold Damage and Miscellaneous Diseases) in sixteen volumes. Although unable to cure all diseases completely, it may allow one to see the disease and know its source. If you study my compilation, you will gain more than half the benefit. (*Book of Changes: Xi Ci Xia*: "The wise observe the Tuan Commentary and gain more than half the benefit." Wang Bi says: "Is it not appropriate to gain more than half?" Kong Yingda says: "Intelligent and aware persons, observing the Tuan Commentary, can gain beneficial thoughts, considering it more than half complete.")

Heaven distributes the Five Elements to operate all categories; humans receive the Five Constants to possess the Five Zang Organs. (*Baihu Tong*: What are the Five Constants? Benevolence, Righteousness, Propriety, Wisdom, and Trustworthiness. Five Zang correspondences: Liver-Benevolence, Lung-Righteousness, Heart-Propriety, Kidney-Wisdom, Spleen-Trustworthiness.) Meridians and Fu organs, Yin and Yang connect and communicate. (*Book of Changes: Xi Ci Shang*: "Observe their convergence and communication to practice rituals and institutions.") Profound and subtle, changes are hard to exhaust. Unless one has high talent and profound insight, how can one explore its principles? (Note: "High talent" corresponds to "outstanding talent" in the first paragraph.) In ancient times, there were Shennong, Yellow Emperor, Qibo, Bo Gao, Leigong, Shaoyu, Shaoshi, and Zhongwen. (Note: "Zhongwen" is not found in historical medical biographies.) In the middle ages, there were Changsang Jun and Bian Que; in the Han Dynasty, there were Gongcheng Yangqing and Cang Gong. Since then, nothing has been heard of.

Observing current physicians (those referred to as mediocre physicians in the previous section), they do not reflect on seeking the essence of classics to expand their knowledge. Each inherits family skills, continuously following old methods. When examining illnesses, they rely on glib speech. (*Analects*: "Deceive people with glib speech." He Yan's commentary: "Flatterers speak quickly and cleverly.") Facing each other for a moment ("Sisu" means a brief instant. *Book of Rites: Yue Ji*: "Rituals and music cannot be absent for even a moment."), they immediately prescribe decoctions. Palpating the Cun (inch) position without reaching the Chi (cubit) position; holding the hand without reaching the foot; Renying, Duyang, and the three positions are not cross-referenced. (*Shibian Liangfang* cites Wang Kuang's *Pulse Classic*: "The method of discussing pulses has three essentials. One is Renying, beside the larynx, corresponding to Heaven. Two are the Three Positions, Cun-Guan-Chi, on the wrist, corresponding to Man. Three is Duyang, on the top of the foot where shoes are tied, corresponding to Earth. These three are the vital points of Qi entry and exit, thus determining fortune and misfortune, life and death. If the size, speed, and rhythm at these three places correspond equally, it indicates a healthy person. Thus it is said: 'If Renying, Duyang, and the three positions are not cross-referenced, and the pulse moves rapidly with breaths fewer than fifty, one cannot know life or death.' Therefore, these three are key to deciding life and death.") If the pulse moves rapidly and breaths are fewer than fifty... (*Ling Shu: Gen Jie*: "If the pulse does not move fifty times before stopping, one Zang lacks Qi, so one must wait for fifty movements.") Short-term lifespan is unknown, diagnostic decisions are made, yet there is no resemblance to the Nine Pulse Positions (see *Suwen: Sanbu Jiuhou Lun*). There is no semblance of understanding. (*Shuowen Jiezi*: "Fang" means similar, "Fo" means unclear observation.) The Ming Tang (nose), Que (between eyebrows), and Ting (forehead) are not observed. (*Ling Shu: Se Se Pian*: "Ming Tang" is the nose, "Que" is between the eyebrows, "Ting" is the forehead.) This is merely looking through a tube. (*Zhuangzi*: Wei Mou told Gongsun Long: "You seek observation rigidly and analyze辨析, this is simply using a tube to view heaven and a cone to point at earth, is it not small?") To distinguish death from life is truly difficult. (Note: Duke Qi was still alive, yet his impending death was observed; the Crown Prince of Guo was already dead, yet his life was distinguished. Starting with Bian Que's talent, ending with these two sentences. ○ From "Heaven distributes Five Elements" to "truly difficult," *Qianjin Fang* *General Examples for Treating Disease* preface has slightly different text.) Confucius said: "Those who know from birth are superior; those who learn are next best; those who hear much and know widely are next after that." (*Analects: Ji Shi*: Confucius said: "Those born with knowledge are superior; those who acquire knowledge through learning are next; those who learn when troubled are next again." Text differs, meaning is close.) I have long esteemed medical arts; please let me practice these words. (*Analects: Yan Yuan*: Yong says, "Though I am not quick-witted, please let me practice these words." ○ Note: "Those born with knowledge" refers to "outstanding talent" mentioned earlier. "Learning and broad knowledge" refers to "diligently seeking ancient teachings and extensively collecting prescriptions." Being born with knowledge is heaven-endowed and unattainable; learning and broad knowledge are human capabilities achievable through diligence. Contemporary scholars neglect medicine and fail to study arts carefully; only Zhongjing has long esteemed them. Lacking Bian Que's talent, he seeks to refine through broad knowledge, hence quoting Confucius to keep it in mind. This is likely Zhongjing's modesty.)

Written by Zhang Ji, Courtesy Name Zhongjing, Administrator of Changsha, Han Dynasty, from Nanyang.

Cheng Yingmao says: Note that the main intent of ancient books is often raised in the preface. Therefore, good readers read the preface before the book. By reading the whole book through the preface's method, the subtle words and great meanings appear clearly. Reading Zhang Zhongjing's self-preface to the *Shanghan Lun*, it is essentially a text mourning the world and pitying people. Starting the treatise from here embodies the subtle intent of Confucius fearing chaos and writing the *Spring and Autumn Annals*.

Preface by Lin Yi et al., editors: Zhang Zhongjing has no biography in the *Han Shu*, but is seen in *Famous Doctors Record*. It says he was from Nanyang, named Ji, with Zhongjing as his courtesy name. Recommended as Xiaolian, he rose to the office of Taishou (Administrator) of Changsha. He initially received his art from his fellow townsman Zhang Bozu. People of the time said his precision and subtlety in application exceeded his teacher. (*Taiping Yulan* cites Zhongjing's *Prescription Preface*, text is the same.) According to Huangfu Mi's *Preface to Jiayi Jing*: In the Han Dynasty, there were Hua Tuo and Zhang Zhongjing. Zhongjing saw Attendant Wang Woxuan, who was over twenty years old, and said, "You have an illness. Your eyebrows will fall out at forty, and six months after they fall, you will die. Taking Wushi Tang could prevent this." Woxuan disliked his blunt words, accepted the prescription but did not take it. Three days later, Zhongjing saw him again and asked, "Did you take the medicine?" Woxuan said, "Yes." Zhongjing said, "Your complexion certainly does not match the diagnosis of taking the medicine. Why do you disregard your life?" Woxuan remained silent. Twenty years later, his eyebrows indeed fell out, and he died 187 days later, exactly as predicted. Even Bian Que and Cang Gong could not surpass this. (*Taiping Yulan* cites He Bie's *Biography*, text is the same.) Also, *Jin Shu: Biography of Huangfu Mi* states Zhongjing's subtlety lay in fixed prescriptions. *Baopuzi* mentions Zhongjing prescribing a chest-opening red pill (found in *Chuxue Ji* and Wang Bing's commentary on *Suwen*, but not in extant *Baopuzi*). The Jin dynasty was not far removed from the Han; how highly he was regarded at the time is evident. Although Zhongjing has no biography in the *Han Shu*, he is undoubtedly a late Han figure. (*Hou Han Shu: Biography of Liu Biao*: Jian'an 3rd year, Zhang Xian, Taishou of Changsha, led Lingling and Guiyang commanderies to rebel against Liu Biao. Liu Biao sent troops to besiege and defeated Xian. Commentary citing *Yingxiong Ji*: Zhang Xian was from Nanyang, likely a clansman of Zhongjing. Was Zhongjing appointed to replace him after Liu Biao defeated Xian?)