『金匮要略』一书,其世远而就阙误也,与『伤寒论』等。如□饦之「□」字,与缓
中补虚用大黄□虫圆主之之类,俱不可以为法。爰加斟酌其改移删补诸式,与夫存疑
之二十八条,悉仿『伤寒论』叙次云。
┌───────────────────────────────────┐
│补注:正误各条置于引号内者为改正正确者,置于中括弧内者为应删错误原文。│
└───────────────────────────────────┘
师曰:病人语声寂然,喜惊呼者,骨节间病;语声谙谙然,不彻者,心膈间病;语声
啾啾然,细而长者,「腹」〔头〕中病。
【按】
头中病之「头」字,当是「腹」字,经中从无头中病之文,且文义不属,当改之。
师曰:吸而微数,其病在中焦,实也,当下之即愈,虚者不治。在上焦者,其吸「远
」〔促〕;在下焦者,其吸「促」〔远〕,此皆难治。呼吸动摇振振者,不治。
【按】
吸促之「促」字,当是「远」字,吸远之「远」字,当是「促」字;方合病义,当移
之。
问曰:〔寸脉沉大而滑,沉则为实,滑则为气,实气相搏,〕「厥」〔血〕气入藏即
死,入府即愈,此为卒厥,何谓也?师曰:唇口青,身冷,为入藏,即死;如身和,
汗自出,为入府,即愈。
【按】
「寸脉沉大而滑,沉则为实,滑则为气,实气相搏」之十八字,文理不顺,衍文也,
当删之。血气入藏之「血」字,当是「厥」字,始与卒厥相合,当改之。
问曰:阳病十八,何谓也?师曰:头痛,项、腰、脊、臂、脚掣痛。阴病十八,何谓
也?师曰:欬,上气,喘,哕,咽,肠鸣,胀满,心痛,拘急。五藏病各有十八,合
为九十病;人又有六微,微有十八病,合为一百八病。五劳、七伤、六极,妇人三十
六病,不在其中。清邪居上,浊邪居下,大邪中表,小邪中里,「漀」〔□〕饦之邪
,从口入者,宿食也。五邪中人,各有法度,风中于前,寒中于暮,湿伤于下,雾伤
于上,风令脉浮,寒令脉急,雾伤皮腠,湿流关节,食伤脾胃,极寒伤经,极热伤络
。
【按】
字典无「□」字,当是「漀」字,漀音倾,侧水也。后之积聚门,□气之「□」字,
亦误。
问曰:病有急当救里救表者,何谓也?师曰:病,医下之,续得下利清谷不止,身体
疼痛者,急当救里;后身体疼痛,清便自调者,急当救表也。
【按】
此条注,详见『伤寒论·太阴篇』内,故不复释。
夫诸病在藏,欲攻之,当随其所得而攻之,如渴者「小便不利」,与猪苓汤,余皆仿
此。
【按】
如渴者之下,当有「小便不利」四字,必是遗失,当补之。
The book *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), due to its great age, has suffered from omissions and errors, similar to those found in *Shanghan Lun* (Treatise on Cold Damage). For instance, the missing character (□) in "Tuō" (a type of food or symptom context), and the missing character (□) in the prescription "Da Huang Zhe Chong Wan" (Cinnabar and Ground Beetle Pill) used for treating "Huan Zhong Bu Xu" (relaxing the middle and tonifying deficiency), cannot be taken as standard methods. Therefore, after careful consideration, the various forms of modification, relocation, deletion, and supplementation have been arranged, along with the twenty-eight items retained for doubt, all following the narrative order of *Shanghan Lun*.
┌───────────────────────────────────┐
│Supplementary Note: Items placed in quotation marks are corrected to their proper form; items placed in square brackets are erroneous original texts that should be deleted.│
└───────────────────────────────────┘
The Master said: When a patient's voice is silent but they frequently startle with loud cries, the disease is in the joints; when their voice is muffled and indistinct, failing to resonate clearly, the disease is in the heart and diaphragm region; when their voice is fine and prolonged, the disease is in the head [original text says "abdomen", here under suspicion].
[Commentary]
The character "head" in "disease in the head" should be "abdomen". There is no mention of "disease in the head" in the classics, and the meaning does not fit; it should be corrected.
The Master said: If inspiration is slightly rapid, the disease is in the Middle Jiao (Middle Burner), which is an Excess pattern; purgation will lead to recovery. If it is a Deficiency pattern, it is difficult to treat. If the disease is in the Upper Jiao (Upper Burner), inspiration is [original text says "prolonged/deep", here under suspicion]; if the disease is in the Lower Jiao (Lower Burner), inspiration is [original text says "rapid/shallow", here under suspicion]. These are all difficult to treat. If there is trembling and shaking during respiration, it is a death sign and untreatable.
[Commentary]
The character "rapid" in "rapid inspiration" should be "prolonged/deep"; the character "prolonged/deep" in "prolonged inspiration" should be "rapid". This aligns with the pathological meaning and should be swapped.
Question: [If the Cun position pulse is deep, large, and slippery, deep indicates Excess, slippery indicates Qi stagnation, and Excess and Qi struggle together,] "Jue" [Blood] Qi entering the Zang organs leads to death, while entering the Fu organs leads to recovery. This is called "Cu Jue" (Sudden Jue), what does this mean? The Master said: Blue lips and mouth, cold body, indicate entry into the Zang organs, leading to death; if the body is warm and sweat comes out spontaneously, it indicates entry into the Fu organs, leading to recovery.
[Commentary]
The eighteen characters "Cun pulse deep, large, and slippery, deep indicates Excess, slippery indicates Qi, Excess and Qi struggle together" do not flow logically and are superfluous text (derivative error); they should be deleted. The character "blood" in "Blood Qi entering Zang" should be "Jue" (Cold/Reversal). Only then does it correspond to "Su Jue" (Sudden Jue/Cold Reversal); it should be corrected.
Question: What are the Eighteen Yang Diseases? The Master said: Headache, stiffness/pain in the neck, waist, spine, arms, and pulling pain in the legs. What are the Eighteen Yin Diseases? The Master said: Cough, rebellious Qi, wheezing, hiccups, throat discomfort, borborygmus (intestinal rumbling), distension and fullness, heart pain, and spasm/tightness. Each of the Five Zang organs has eighteen diseases, totaling ninety diseases. Humans also have Six Micro (minor) conditions, each having eighteen diseases, totaling one hundred and eight diseases. The Five Labors, Seven Injuries, Six Extremes, and Thirty-Six Women's Diseases are not included within these counts. Clear pathogens reside in the upper part, turbid pathogens reside in the lower part, major pathogens strike the exterior, minor pathogens strike the interior. Pathogens of "Qi Tuō" [□] entering through the mouth are retained food (undigested food). The five types of pathogens attacking humans follow specific laws: Wind attacks in the morning (front), Cold attacks in the evening, Dampness injures the lower part, Fog injures the upper part. Wind causes the pulse to be floating, Cold causes the pulse to be tight. Fog injures the skin and interstices, Dampness flows into the joints. Food damages the Spleen and Stomach, extreme Cold damages the meridians, extreme Heat damages the collaterals.
[Commentary]
The dictionary does not contain the character "□"; it should be "Qi" (漀), pronounced "qing," meaning water flowing sideways. In the later section on Accumulation and Gathering, the character "□" in "□ Qi" is also an error.
Question: In diseases, when should one urgently rescue the Interior or the Exterior? What does this mean? The Master said: If a patient was treated by a physician with purgatives, and subsequently suffers from continuous diarrhea with undigested food, accompanied by body pain, one must urgently rescue the Interior. Later, if the body pain persists but bowel movements and urination are normal, one must urgently rescue the Exterior.
[Commentary]
For the commentary on this item, see *Shanghan Lun*, Taoin Chapter, so it is not explained again here.
For any disease located in the Zang organs, if one wishes to attack it, one should follow where the pathogen has gathered to attack it. For example, for thirst with "difficulty in urination," administer Zhu Ling Tang (Polyporus Decoction); apply this principle to others.
[Commentary]
After "for thirst," the four characters "difficulty in urination" should exist; they were likely lost and should be supplemented.