读书宜识字,顾名即思义,人事尽如斯,少弊自多利。
今医者满天下矣,试问以医字作何解说,莫不张口茫然,如坠烟雾。字且不识,而欲其
技之良、道之精,得乎?
医之字义从匚从矢从 从酉。匚受物之器,受矢于器为医。《说文》训为“盛弓弩短矢
器”,加 于右上, 亦兵器,下复从酉,酉,古酒字,古为毒物,故大禹绝之(石顽谓为从古
服药多以酒助,非也)。神农尝毒,经谓药多为毒物,凡治某病皆谓以某药毒之,《内经》亦多
如此,即以毒攻毒之义,可见医之为用尽伤人之具矣。病者既积矢 、毒酒之属于一身,其
危已可想见,医者如再不慎之又慎,不更危乎其危乎?黄帝以治兵之余治病,于是医字下笔
从医,国语兵不解医本此所谓用药如用兵也,凡欲为医者,可不知所从事哉?
古之医者,人皆神圣而又贵为天子,富有四海,或为大臣,如歧伯、伊芳尹是,或为达官,
如长沙太守仲景是。大臣达官虽富贵不逮天子,而身家皆自优裕,得以专一于医,而无别
虑萦扰,且复药皆自尝自备(今之西医、东医亦自备药,颇合吾国古法,此其一得),一遇病
者,无不应手奏效。盖先于经络脏腑,洞见 结,更于气化传变,预为防制,非若今之西医,
必待其人死后,购而剖解,始知其病之所在,自以为实验,人亦莫不以为然,然究不知其病
之所在也。人唯有生气,方有气化传变,既死
则气已绝而无迹可寻。如咳嗽病,有因外感,有因内伤,有因外感而变成内伤,或只关本
脏,或为火刑金,或为子累母,或为母累子,或不能胜其所胜而转使胜其所不胜。《内经》所
云∶五脏皆令人咳,甚则移传六脏。此皆古圣神人明气化传变之理,传之至今,历历不爽者
也。西医则剖解后见肺叶焦枯,或且溃烂,遂只名之曰肺炎。凡遇咳嗽,概以肺炎治之,无
论寒热有异,即只以肺炎论,亦不知其炎之由于心,由于肾,由于脾胃与肝胆,徒执一本位
为治。无怪其多不效,而转以为本不治,是皆由于不明五运六气以及脉息之确有可凭,故
虽至死亦不知病之所以然。今之重视西医、从学西医者,直与西医同梦,吾所以为医者立自
医之方,并欲以开通西医者,以其一也。类乎此者,不知凡几。
又如寻常疟疾,寒热来往,作止有时,一证既有,来往之名必有来往之处,来从何作?
往从何止?医者昧昧,漫不加察,虽中古以后之名大家亦皆不知其病之所在,稍贤明者,不
过能分十二经络,或阴或阳,于邪来时,所注重之经界,经界既正,则药力专到,不致累及
无辜。然必既专且久,邪始渐衰而退,非能直指病之来源也。下此则皆囫囵乱治,抄撮本证
数方投之,或以止截为功,或当邪衰自愈,以故病疟者无不经年累月受害。西医亦只知以
金鸡纳霜截之,然亦有效有不效(阴虚者,则多不效,且不宜服)。即使收效一时,后必再
发,更或变生他证而不可救,吾见不可殚述。岂知凡病皆不离经络、脏腑,唯此病若不在经
络、脏腑而别有所寄发作时,始由经络而脏
腑,退止时又由脏腑而经络而止其所休焉。以时来往者,则又胃气为之也。胃于五行属土,
于五德属信,故有信若潮,如人饥则思食,皆胃之日信,与妇女之月信同。然此虽予一人之
私言,然物理验有得,圣人复起不易吾言矣。《内经》阴阳疟论,歧伯曰∶疟之将来也,阴阳
之且移也,必从四末始也,坚束其处而决去之。只此四语,贼情,贼踪,贼窟,治法无不毕
具。如法为之,无论何疟,莫不霍然,所谓捣其老巢,老贼净尽,非圣人而能若是乎?非真洞
见脏腑经络而能若是乎?又何须效西医之剖解而始为实验耶!恐虽剖解,亦莫名其妙也。
今特为医者揭之,以为自医医人最便宜方,更以开通西医,使知吾国古圣人之法,不事剖
解,向能洞见经络脏腑之神(此证唯张子和、喻嘉言见及经旨,惜皆不能笃守圣法而杂出
多方)。
今之医者,大率下愚者多,其较古之圣神不知几千万里。且又皆读书不成,别业不就,
无聊之极,思始遁于医之一途。于是圣神与天地参之道,遂变为至愚无聊者之逋逃薮,况当
世界,苟且轻贱之积习牢不可破,其欲以为利者亦未矣。或别有会心者藉此以夤缘入官,遇
上官病,或其家属病,不俟延请,行同毛遂,时运一至,偶然幸中,美差优缺,纷至踏来,上官
亦最乐,此所谓惠而不费也。富贵逼人,亦常有事,是则不必问其道之若何矣。若其不善夤
缘,又无真实本领,不过聊为糊口计,且有时并口亦不能糊,徒见轻鄙于世界,且并贻讥于
外人,以为吾国医者如是,任意推测古圣之道,亦不过如是言。念及此,吾又不愿人之再
业此,如果有发愤而欲为此者,则请相率而进吾之方,毋虑其愚也,以学愈之,毋虑其贫也,
以勤俭愈之,毋虑其糊口不能也。以夷齐首阳之日孔子在陈之时较之,虽饿死事小也,能如
是天下何事不可为乎?则再请进吾之多方更以自医。
医道务从正心博学为体,而以继往开来为用,其间息邪说,距 行贯治道功夫,亦万
不可少。若徒以日诊数人,月好数病,年活多人为毕能事,而于国家元气,天下 毫无所
裨,人虽视我甚重,自待未免尚轻,良医良相之说,非虚语也。燮理阴阳,且足以弥天地之
灾,于人事更无论矣,相位不可必期,道理要归一致,出位之思君子,当不禁此,且不必
问朝廷世界对待医者何如,而只裕吾胞与之怀时,切饥溺之思尤于贫贱,富贵不易其心,
所谓宁可人负我,不可我负人,此正心之说也,即自医之第一方也。
博学人于识字读书之始即以《灵》、《素》、《内经》、《难经》、《伤寒论》、《金匮玉函经》、《甲乙
经》、《活人书》、合《四子》、《五经》、《尔雅》先后并读,更于性理经济书多读,然后再读《神农本
草经》、《长沙方》,经唐、宋、金、元、明代、国朝各大名家着述,以及欧亚之《儒门事亲》,西医
五种广学汇编,英国产科诸书择其大要者,次第阅之。其余如《千金》、《外台》、《圣济总录》、《证
治准绳》、《古今医统》、《名医类案》、《三因方》之类,不过为医家之大类书,略为涉猎,以备参
考可耳,至若邪说 行,有乖圣道古法而误世者,则概从阁置,或直以从火,只读时须精考
古书之简脱,与后儒之参附者,勿使为其蒙蔽而贻误,尤须于经史子集中不明言医而于医
道有合者,心领而神会之,所谓无字句间之医也。此博学而又须善学人也,自医之第二方也。
学医最忌先看本草与各方书,一经寓目,即可略识药品,聊记汤头,凑杂成方,于天地
阴阳五运六气,全无理会,于人身经络脏腑、病机脉情,毫无觉察。一遇病者,遂觉技痒,为
之延医,偶然幸中,自鸣得意。人有见之,亦谓知医,于是误尽苍生,终无入道之日。今之医
者大都如是。况所阅本草,既非《神农本经》所见,方书又非古圣经方,不过坊间所刊俗本,
如《本草备要》、《医方集解》、《验方新编》、《三指禅》、《笔花医镜》、《万病回春》、《冯氏锦囊》、《东医
宝鉴》、《医宗必读》之类,此种最易误人之书,却最盛行于今之世,几于家置一编,以为医道
尽于此矣。况且并此种类,亦未尽读熟读,凡有病家必为彼辈先试其手,及至辗转贻误,始
思一延名医,而时所谓名医者,又不过薛立斋、赵养葵、张景岳、李士材、陈修园之徒。然
其自命亦颇不凡,意谓较多读书,总属儒医,其实于医道仍是隔靴搔痒,不知取法乎上,仅
得其中,取法乎中,品斯下矣。又况等而下之耶,有志医道,其唯从吾息邪说距 行而直入
于圣人之室。
学医尤忌误解《伤寒论》,案仲景自序云∶作《伤寒杂病论》合十六卷,原为万病立法,所
谓法者,即六经气化传变,而方药随之而变之法也。以六经提纲者,使医者必先明六经经
界,则万病不外乎六经。唐宋以来,致力于《伤寒论》者无虑百数十家,究其所作,不出二义。
一则因本文为之注疏,犹公谷之说春秋,一则引本文而为立论,犹韩婴说诗。外传非多,以
辞害义,即失断章取义。自王叔和编次伤寒、杂病分为两书,于本论削去杂病而论中杂病
又存,而未去者尚多,且参以私意,紊乱仲景原文,改头换面不少,以致世之读《伤寒论》者
谓能治伤寒即能治杂病,遂多以杂病当伤寒,以伤寒概杂病而混治之。不知天下之病杂病
多而伤寒少,如地当西北,时当严寒,或多伤寒,外此则皆杂病矣。若地当东南,则杂病温
病为多,实时当严寒亦不过感寒冒寒而已。医者不明六经之法是统伤寒杂病而论,只以治
伤寒之方药概治杂病,而不知以六经之法分治杂病,此皆叔和阶之厉也。叔和序例所引
《内经》,莫不增句易字,况仲景耶!欲识真仲景者,当于原书本论逐条察其笔法,知考工记
自不合于周官,褚先生大不侔于太史,世皆以《金匮要略》为仲景《杂病论》,有若似圣人唯
曾子以为不可耳。柯韵伯《伤寒论翼》辨之最精且详,吾敢附于柯曰∶王叔和者,岐伯、仲景
之罪人,而后世医道之蝥贼也。虽《金匮》由叔和而始彰,其功亦不可没,然究功不掩罪,有
志医道者,不得仲景《伤寒杂病论》原本十六卷而读之,慎勿以伤寒之药治杂病而误尽苍
生,幸甚幸甚。
学医必须讲究气化传变,欲知气化传变又必先明阴阳,切忌混论阴阳,不分六经经
界。脏腑固分阴阳,而一脏又各有阴阳,一腑亦各有阴阳,俱宜逐脏逐腑一一厘清,气化传
变始能分晓。此在古名大家已少概见,今世中外业此者更无。徒梦见人身只阴阳两端,一病
则千头万绪,非能先正经界,鲜不堕入迷途,差之毫厘,谬以千里,世之学人既不曾闻大
道,又不力追上乘,只以苟且从事,因陋就简,谬以袭谬,歧之又歧,全不知气化为何事,何
能梦岐景耶!不能窥见岐景,又何能与论医道耶!君子之道,辟如行远必自迩,辟如登高必
自卑,所谓下学而上达也。若夫医道,则必上学而旁达,笃守古圣之法,然后旁通四达,以
斯推展博大而收土壤细流之助,仍不出古圣范围,方为医学正宗。
学医更须知凡病是随脏腑之气而变,又随药气而变。如太阳恶寒,非必伤寒始恶寒
也,无论风寒湿暑燥火,邪气一入太阳,无不恶寒。盖以太阳本寒水经,邪入触动寒水之
气,遂自恶寒。阳明发热,非必中热即发热也,阳明为南方火部,无论何邪,一入阳明,未有
不发热也。如入少阳,少阳为太阳阳明转枢,在半表半里之间,故又有寒热往来之势。或又
随药气而变使然。不然,何以伤寒在太阳有桂枝麻黄等方,一入阳明、少阳又有葛根、白虎、
承气、大小柴胡等方,是一经界中已有在经在脏在腑之别。若邪未入阳明,尚在太阳,一用
葛根未有不入阳明也。尚在太阳或在阳明,一用柴胡未有不入少阳也。是皆脏腑气化传变
与药气传变之故也。不独伤寒为然,杂病亦莫不然。不独三阳为然,即六阳六阴亦莫不然。
仲景《伤寒杂病论》先以六经提纲者,亦此之故,虽未条分缕晰,善学人,要当善悟而三反
也。世之混论阴阳,只论寒热虚实者,何能语于医道?而况乎能辨寒热虚实者亦寡矣,学人
可不知所务乎?西医不亦闻所未闻乎!
用药如用兵,兵法之要在明地势,用药之要在明经界。凡治病必先明六经之界,始知贼
邪所从来,知某方是某府来路,某方是某郡去路。来路如边关三阳是也,去路如内境三阴是
也。六经来路各不同,太阳是大路,少阳是僻路,阳明是直路,太阴近路也。少阴后路也,厥
阴斜路也。客邪多从三阳来,主邪多由三阴起。犹外寇自边关至,乱民自内地生也。明六
经地形,始得握万病之枢机;详六经来路,乃能操治病之规则。如伤寒,大寇也,病从外来;
中风,流寇也,病因旁及;杂病、内病,乱民也,病由中起,既认为何等之贼,又知为何地所
起,发于其境,便御之本境,移祸邻郡,即两路来攻,如邪入太阳地面,即汗而散之,犹陈利
兵于要害,乘其未定而击之也。邪之轻者在卫,重者在营,尤重者在胸膈。犹寇之浅者在
关外,其深者在关上,尤深者在关内也。是麻黄为关外之师,桂枝为关上之师,大小青龙为
关内之师矣。凡外寇不靖,内地盗贼必起而应之,因立两解法,故又有大小青龙及桂枝麻黄
加减诸方。如前军无纪,致内乱蜂起,当重内轻外,因有五苓、十枣、陷胸、抵当等汤也。邪
入少阳地面,宜杂用表里寒热攻补之品,为防御和解之法,如偏僻小路利于短兵,不利于矛
戟,利于守备,不利于战争也。邪之轻者入腠理,重者入募原,尤重者入脾胃,小柴胡腠理
之剂也,大柴胡募原之剂也,小建中、半夏泻心、黄芩、黄连四汤少阳脾剂也,柴胡加芒硝
Reading requires recognizing characters; upon seeing a name, one should ponder its meaning. Human affairs are no different from this: if done so, drawbacks will naturally decrease and benefits increase.
Today, doctors are everywhere. If we ask them to explain the character "Yi" (Medicine), none can answer without gaping in confusion, as if lost in smoke. If they cannot even recognize the character, how can they be expected to possess excellent skills and profound Dao?
The etymology of the character "Yi" consists of *fang* (匚, a container), *shi* (矢, arrow), *jian* (幵, weapons), and *you* (酉, wine). *Fang* is a vessel for holding objects; receiving arrows within the vessel constitutes "Yi". *Shuowen Jiezi* defines it as "a vessel for holding short bows and arrows." Adding *jian* (also a weapon) to the upper right, and *you* below, where *you* is the ancient character for wine, which was considered toxic in antiquity, hence Yu the Great prohibited it (Shiwan incorrectly believed that ancients used wine to assist in taking medicine). Shennong tasted toxins; the *Neijing* states that medicines are mostly toxic substances. Treating a certain disease by saying "use the toxicity of substance X to cure it" appears frequently in the *Neijing*. This illustrates the principle of using toxicity to combat toxicity. Thus, the function of "Yi" is entirely a tool for harming people. Patients already accumulate arrows, toxic wines, and other hazards within their bodies; their danger is evident. If doctors are not extremely cautious, will they not be even more dangerous? The Yellow Emperor treated diseases after managing military affairs. Thus, the character "Yi" incorporates elements related to warfare. The *Guoyu* states that military strategy and medicine share the same origin. This is what is meant by "using medicine like using troops." Anyone wishing to become a doctor must know their direction of endeavor.
Ancient doctors were regarded as sacred and divine. Some were as noble as emperors, possessing the four seas; others were high ministers, such as Qibo and Yi Yin; or high officials, such as Zhang Zhongjing, Governor of Changsha. Although ministers and officials were not as wealthy as emperors, their personal and family lives were comfortable enough to allow them to focus exclusively on medicine without distraction. Moreover, they tasted and prepared their own herbs (modern Western and Eastern doctors also prepare their own medicines, aligning with ancient Chinese methods, which is one advantage). When encountering patients, they achieved immediate effects. This is because they had clear insight into meridians and zang-fu organs, and could anticipate and prevent the transmission of Qi transformation. Unlike modern Western medicine, which waits for death to purchase corpses for dissection to locate disease—claiming this as experimentation, which people accept but ultimately fails to identify the true source of disease. Only when alive does Qi transformation occur; after death, Qi ceases, leaving no trace. For example, coughing may result from external pathogens, internal injury, or external pathogens transforming into internal injury. It may affect only the primary organ, or involve Fire insulting Metal, Child affecting Mother, Mother affecting Child, or failure to overcome what it normally controls, leading to being controlled by what it cannot overcome. The *Neijing* states: "All five Zang organs can cause coughing, and severe cases may transmit to the six Fu organs." These principles of Qi transmission, elucidated by ancient sages, remain accurate to this day. Western medicine, however, observes scorched or ulcerated lung lobes post-dissection and names it pneumonia. All coughs are treated as pneumonia, regardless of cold or heat differentiation. Even limiting diagnosis to pneumonia, they fail to recognize whether inflammation stems from the Heart, Kidney, Spleen/Stomach, or Liver/Gallbladder. They stubbornly treat from a single anatomical site. No wonder efficacy is low, and they attribute failure to incurability. This stems from ignorance of the Five Movements and Six Qi and reliable pulse diagnosis. Thus, they die without understanding the root cause. Those who value and study Western medicine today dream the same dream as Westerners. Therefore, I prescribe self-medication formulas for doctors and aim to enlighten Western medicine, for this very reason. Countless similar cases exist.
Take common malaria, characterized by alternating chills and fever at specific times. Since there is a pattern of coming and going, there must be a place of origin and cessation. Where does it come from? Where does it stop? Doctors are ignorant and fail to investigate. Even famous masters since ancient times did not know the disease's location. The slightly wiser could distinguish the twelve meridians, yin or yang, focusing on the meridian boundaries during pathogen arrival. Once boundaries are correct, medicinal power reaches specifically without harming the innocent. However, treatment must be consistent and prolonged for pathogens to gradually decline; it does not directly target the disease source. Inferior practitioners treat indiscriminately, copying several prescriptions for the syndrome, aiming to intercept malaria or waiting for spontaneous recovery upon pathogen decline. Consequently, malaria patients suffer for years. Western medicine uses Cinchona bark powder to intercept, but efficacy varies (ineffective and unsuitable for Yin deficiency). Even if temporary relief occurs, relapse is inevitable, potentially leading to untreatable complications. I have witnessed countless such cases. Do they not know that all diseases relate to meridians and zang-fu organs? Only when this disease resides elsewhere, transmitting via meridians to zang-fu during onset, and returning from zang-fu to meridians during remission, does it follow this pattern. Timely alternation is governed by Stomach Qi. The Stomach corresponds to Earth in the Five Elements and Trustworthiness in the Five Virtues, hence its regularity resembles tides, just as hunger prompts eating (daily trust) and menstruation (monthly trust). Though this is my personal view, physical verification supports it; even if sages rose again, they would not change my words. In the *Neijing*'s discussion on Yin-Yang Malaria, Qibo stated: "When malaria is about to arrive, Yin and Yang are shifting, starting from the four extremities. Bind firmly at these points and rupture them to expel it." These four sentences cover pathology, symptoms, location, and treatment perfectly. Following this method, any malaria resolves instantly, destroying the nest and eliminating the thief. Only a sage could achieve this. Only one with profound insight into zang-fu and meridians could do so. Why emulate Western dissection for experimentation? Even dissection would yield confusion.
I reveal this now as the most economical prescription for doctors to heal themselves and others, and to enlighten Western medicine regarding ancient Chinese methods that洞察 (insight into) meridians and zang-fu without dissection (Only Zhang Zihe and Yu Jiayan touched upon this essence, but failed to strictly adhere to sage methods, mixing multiple approaches).
Modern doctors are largely foolish, far inferior to ancient sages. Having failed in studies and other professions, driven by extreme boredom, they flee into medicine. Thus, the sacred Dao of participating with Heaven and Earth becomes a refuge for the foolish and bored. Given the current world, where superficiality and contempt are entrenched, those seeking profit find little hope. Some use this to climb social ladders; encountering illness in superiors or their families, they volunteer uninvited like Mao Sui. With luck, they succeed, gaining lucrative positions. Superiors are pleased, achieving benefit without cost. Wealth and status may force themselves upon them, rendering their medical ethics irrelevant. Those unable to flatter and lacking real skill merely struggle to survive, often failing even that, facing scorn from society and ridicule from foreigners who assume all Chinese doctors are incompetent guessers. Reflecting on this, I discourage others from entering this field. However, for those determined to pursue it, come receive my prescriptions. Do not fear stupidity; learning cures it. Do not fear poverty; diligence cures it. Do not fear starvation. Compared to Boyi and Shuqi starving on Mount Shouyang or Confucius stranded in Chen, starvation is minor. If one can endure this, what task cannot be accomplished? Then accept my multiple prescriptions for self-healing.
Medical practice must take Righteous Mind and Broad Learning as its foundation, and inheriting the past while opening the future as its application. Efforts to reject false doctrines and resist evil practices to integrate therapeutic paths are indispensable. Merely treating a few patients daily, curing a few monthly, and saving many annually as one's life's work, contributing nothing to national vitality or the world, shows that although others value me highly, I undervalue myself. The saying "Good Doctor, Good Minister" is not empty talk. Regulating Yin and Yang can remedy heavenly disasters, let alone human affairs. While political office is uncertain, the underlying principles are consistent. A gentleman contemplating duties beyond his station should reflect on this. Regardless of how the court or world treats doctors, one should expand compassion, constantly thinking of relieving hunger and drowning, especially for the poor and lowly, maintaining heart unchanged by wealth or status. "Better that others wrong me than I wrong others." This is the doctrine of Righteous Mind, the first prescription for self-healing.
For broad learning, start reading *Ling Shu*, *Su Wen*, *Neijing*, *Nanjing*, *Shanghan Lun*, *Jingui Yufan Jing*, *Jiayi Jing*, *Huo Ren Shu*, along with the *Four Books*, *Five Classics*, and *Erya*. Read extensively on moral philosophy and statecraft. Then study *Shennong Bencao Jing* and *Changsha Fang*. Proceed through major works of Tang, Song, Jin, Yuan, Ming, and Qing dynasties, European texts like *Rumen Shiqin*, compilations of Western medicine, and key British obstetrics books. Miscellaneous encyclopedic works like *Qianjin Fang*, *Waitai Miyao*, *Shengji Zonglu*, *Zhengzhi Zhunsheng*, *Gujin Yitong*, *Mingyi Leian*, and *Sanyin Fang* are merely reference materials; skim them. Discard false doctrines and harmful texts violating sage methods, even burning them. Carefully verify ancient texts for missing bamboo slips and later Confucian interpolations to avoid deception. Especially, comprehend medical principles hidden within historical and philosophical classics—the "medicine between the lines." This is broad yet wise learning, the second prescription for self-healing.
The greatest taboo in learning medicine is studying Materia Medica and formula books first. Doing so allows superficial recognition of herbs and memorization of decoctions, leading to haphazard prescription composition. Ignorance of Heaven-Earth Yin-Yang, Five Movements, and Six Qi; lack of awareness of meridians, zang-fu, pathology, and pulse conditions. Upon encountering patients, one feels eager to demonstrate skills. Accidental success breeds arrogance. Others perceive this as medical knowledge, leading to mass harm and never entering the true Dao. Modern doctors are mostly like this. Moreover, the Materia Medica studied is rarely the authentic *Shennong Bencao Jing*, and formula books are not ancient classics but popular commercial editions like *Bencao Beiyao*, *Yifang Jijie*, *Yanfang Xinbian*, *Sanzhi Chan*, *Bihua Yijing*, *Wanbing Huichun*, *Fengshi Jinnang*, *Dongyi Baojian*, and *Yizong Bidu*. These misleading books are prevalent, found in almost every home, mistaken for the entirety of medical knowledge. Furthermore, even these are not thoroughly mastered. Families try these practitioners first; only after repeated errors do they seek famous doctors. But "famous doctors" are often followers of Xue Lizhai, Zhao Yangkui, Zhang Jingyue, Li Shicai, and Chen Xiuyuan. Though proud of being scholar-doctors, they scratch the surface of medicine, failing to aim high. Aiming high yields medium results; aiming medium yields low results. How much worse is aiming lower? Those aspiring to the medical Dao must reject false doctrines and enter the Sage's chamber directly.
The greatest error in learning medicine is misunderstanding the *Shanghan Lun*. According to Zhang Zhongjing's preface, he wrote *Shanghan Zabing Lun* in sixteen volumes, establishing laws for all diseases. These laws refer to the Six Channels' Qi transformation and corresponding formula variations. Using Six Channel outlines ensures doctors understand channel boundaries, encompassing all diseases within the Six Channels. Since Tang and Song, over a hundred scholars have commented on the *Shanghan Lun*. Their works fall into two categories: annotations akin to Gongyang and Guliang commentaries on the *Spring and Autumn Annals*, or theoretical expansions akin to Han Ying's commentary on the *Book of Songs*. Deviating from the text harms the meaning. Wang Shuhe separated Shanghan and Zabing into two books, removing Zabing from the main text but retaining scattered references, altering Zhongjing's original text with personal biases. This led readers to believe treating Shanghan equates to treating Zabing, causing confusion. In reality, Zabing is more common than Shanghan, except in northwest regions during extreme cold. In southeast regions, Zabing and warm diseases dominate; even cold weather causes mild cold exposure. Doctors ignoring Six Channel laws treat all diseases with Shanghan formulas, failing to differentiate Zabing by Six Channels. This disaster stems from Wang Shuhe. His preface altered *Neijing* quotes; imagine his handling of Zhongjing! To know true Zhongjing, examine the original text's style. Just as *Kaogong Ji* differs from *Zhou Li*, and Chu Sheng's writings differ from Sima Qian's, the world mistakes *Jingui Yaolue* for Zhongjing's *Zabing Lun*, a view contested by Zengzi. Ke Yunbo's *Shanghan Lun Yi* analyzes this precisely. I agree: Wang Shuhe is the enemy of Qibo and Zhongjing, and a pest of later medical Dao. Although *Jingui* gained prominence through him, his merit does not outweigh his fault. Those aspiring to the medical Dao must read the original sixteen volumes of *Shanghan Zabing Lun*. Do not use Shanghan formulas for Zabing and harm the people.
Learning medicine requires understanding Qi transformation. To know Qi transformation, one must first understand Yin-Yang, avoiding confusion and distinguishing Six Channel boundaries. Zang-Fu have Yin-Yang, and each Zang/Fu has its own Yin-Yang, requiring clear distinction to understand Qi transmission. Ancient masters rarely saw this; modern practitioners worldwide lack it. Dreaming of only Yin-Yang leads to complexity in disease. Without correcting boundaries, one falls astray. A slight error leads to huge mistakes. Scholars unaware of the Great Way, seeking neither high levels nor rigorous study, settle for mediocrity, compounding errors. Ignorant of Qi transformation, how can they dream of Qibo and Zhongjing? Without glimpsing their realm, how can they discuss medical Dao? The gentleman's path is like traveling far from near, climbing high from low—learning basics to reach higher truths. Medical Dao requires foundational learning and broad extension, strictly adhering to sage methods, then expanding widely within the sage's scope, constituting orthodox medicine.
One must know diseases change with Zang-Fu Qi and medicinal Qi. Taiyang aversion to cold is not exclusive to cold damage; any pathogen entering Taiyang causes aversion because Taiyang is a Cold-Water channel, and pathogens disturb Cold-Water Qi. Yangming fever is not exclusive to heat damage; Yangming is the Southern Fire region; any pathogen entering causes fever. Shaoyang, the pivot between Taiyang and Yangming, located between exterior and interior, causes alternating chills and fever. Medicinal Qi also induces changes. Hence, Taiyang Shanghan uses Guizhi and Mahuang formulas; Yangming/Shaoyang uses Gegen, Baitu, Chengqi, and Chaihu formulas. Within one channel boundary, distinctions exist between channel, Zang, and Fu. Using Gegen while pathogen is still in Taiyang drives it to Yangming. Using Chaihu in Taiyang/Yangming drives it to Shaoyang. These are results of Zang-Fu Qi transmission and medicinal Qi transmission. This applies to Zabing and all Six Yin/Yang channels. Zhongjing's Six Channel outlines serve this purpose. Learners must悟 (comprehend) and reflect. Those confusing Yin-Yang and discussing only cold/heat/deficiency/excess cannot discuss medical Dao, let alone distinguish these patterns. Can Western medicine hear of this?
Using medicine is like using troops; military strategy emphasizes terrain, medicine emphasizes channel boundaries. Treat diseases by defining Six Channel boundaries to identify pathogen origin. Incoming paths resemble border Three Yang channels; outgoing paths resemble inner Three Yin channels. Taiyang is the main road, Shaoyang the remote path, Yangming the direct route, Taiyin the close path, Shaoyin the rear path, Jueyin the diagonal path. External pathogens usually enter via Three Yang; internal pathogens originate from Three Yin. Like invaders from borders or rebels from interior. Understanding Six Channel terrain grasps the pivot of all diseases; detailing incoming paths dictates treatment rules. Shanghan is a major invasion from outside; Fengzhong is a roaming bandit spreading from sides; Zabing/internal disease is internal rebellion arising from within. Identifying the type of "thief" and its origin allows defense in the originating territory. If threat spreads to neighboring territories, attack from both routes. If pathogen enters Taiyang, induce sweating to disperse it, like deploying elite troops at strategic points to strike before consolidation. Light pathogens are in Wei (Defensive) level, heavy in Ying (Nutritive) level, critical in Chest/Diaphragm. Like enemies outside, inside, or deep within the pass. Mahuang is the army outside the pass, Guizhi at the pass, Da/Xiao Qinglong inside. Unrest outside invites internal rebellion; thus, dual-resolution formulas like Da/Xiao Qinglong and modified Guizhi/Mahuang are used. If front-line discipline fails causing internal chaos, prioritize internal over external, using Wuling, Shizao, Xianxiong, Didang decoctions. Pathogens entering Shaoyang territory require mixed exterior-interior, cold-heat, attack-tonification strategies for defense and reconciliation, like narrow paths favoring short weapons over spears, defense over offense. Light pathogens enter Couli (Pores), heavy enter Muyuan (Membrane Source), critical enter Spleen/Stomach. Xiao Chaihu treats Couli, Da Chaihu treats Muyuan. Xiao Jianzhong, Banxia Xiexin, Huangqin, Huanglian treat Shaoyang-Spleen. Chaihu plus Mangxiao...