帮助寿夭而复治,则不怨冤死。
医者遇病,宜先审其人之将死与否,若贸然定方与药,药纵无害,及死则必归咎于医者,
虽百喙其难辞也。故欲攻医,宜先精相。相者何,望之义也。先生遇病者,先能知其人之寿
夭,此非得自仙传,乃缘临症多使然耳。尝有疾者诣先生求治,先生曰∶“君病根既深,宜
剖脏腑,治之当愈。然君寿不过十年,病不能相杀也。”疾者不堪其苦,必欲除之,先生乃
施破术,应时愈。十年后竟亡。(孙思邈注)
中有所壅,吐为便。医法有不宜明言而奏效甚速者。
仲景治伤寒,以升吐为第一义。先生得医经,亦曾及此。先生尝行道中,见有咽塞者,
因语之曰∶“向者道隅,有鬻饼人,萍荠甚酸,可取二升饮之,病自当去。”其人如先生言,
立吐一蛇,乃悬于车而候先生。时先生小儿,戏于门中,逆见自相谓曰∶“客车旁悬有物,
必系逢我翁也。”及客进顾,视壁北悬蛇以十数,乃知其奇。
按∶先生治此症,精且玄矣。知其腹中有蛇,未尝明言,恐其惧耳。惧则蛇亦畏缩,不
肯随吐而出。医家有以后患,详告病者,致其人不敢服药,令病加剧者,观于先生之治腹蛇,
可
生腥化虫,虽出有伏。
按∶以鱼腥杂碎和糖与粉,埋土中,经宿成虫如蚯蚓,畜鸡者恒以此饲鸡,较他虫速且
繁。盖天道本先生不已,以生物求生物,诚不生而自生也。广陵太守陈登,忽患胸中烦懑,
面赤不食,先生脉之曰∶“使君胃中有虫,欲成内疽,腥物所为也。”即作汤二升服之,至再,
有顷即大呕,中有小虫头赤而能动,其半尚为鱼脍,所苦即愈。先生曰∶“此病后三期当发
,因其中尚有遗种,种难尽绝也。遇良医可救。”及期疾动,佗适他往,登遂死。(孙思邈
注)
To assist in prolonging life and curing diseases, one avoids unjust death.
When a physician encounters a patient, they should first assess whether the person is near death. If a prescription and medication are administered rashly, even if the medicine is harmless, upon the patient's death, blame will inevitably fall on the physician.
It would be difficult to defend oneself despite having a hundred mouths. Therefore, to master medicine, one must first master "Xiang" (observation/inspection). What is "Xiang"? It refers to inspection (Wang Zhen, 望诊), specifically visual examination. When Mr. Hua encountered a patient, he could first determine the person's lifespan. This was not derived from immortal transmission but resulted from extensive clinical experience. Once, a patient sought treatment from Mr. Hua. Mr. Hua said, "Your disease root is deep; it requires dissecting the viscera to cure. However, your lifespan does not exceed ten years, and the disease cannot be completely eradicated." Unable to bear the suffering, the patient insisted on removal of the ailment. Mr. Hua then performed surgery, and the patient recovered immediately. Ten years later, the patient indeed passed away. (Commentary by Sun Simiao)
If there is stagnation in the middle jiao (middle burner), vomiting provides relief. There are medical methods that should not be explicitly stated but yield very rapid effects.
Zhang Zhongjing treated Shanghan (Cold Damage) by prioritizing emesis (inducing vomiting). Mr. Hua, having studied medical classics, also addressed this. Once, while walking on the road, Mr. Hua saw someone with throat obstruction.
He told him, "Earlier by the roadside, there was a pancake seller; the Pingqi (a type of sour vegetable/herb) is very sour. You can take two sheng [approx. 0.4 liters] and drink it; the illness will naturally go away." The person followed Mr. Hua's advice and immediately vomited up a snake. He then hung the snake on his carriage and waited for Mr. Hua. At that time, Mr. Hua's young son was playing inside the gate. Seeing the scene, the boy said to himself, "There is something hanging beside the guest carriage; it must be because he met my father." When the guest entered and looked back, seeing dozens of snakes hanging on the north wall, he realized Mr. Hua's miraculous nature.
Note: Mr. Hua's treatment of this condition was exquisite and profound. Knowing there was a snake in the abdomen, he did not explicitly state it, fearing the patient's terror. Fear causes the snake to shrink,
preventing it from being expelled via vomiting. Some physicians, worrying about future complications, explain details too thoroughly to patients, causing them to refuse medication and worsening the illness. Observing Mr. Hua's treatment of abdominal snakes illustrates this point.
Raw fishy substances transform into parasites, though they originate from hidden sources.
Note: Mixing fishy offal with sugar and flour, and burying it in the soil overnight produces worms resembling earthworms. Poultry keepers often use this to feed chickens, as they grow faster and more abundantly than other insects. This reflects the Heavenly Dao's endless generation; seeking life through living things results in spontaneous generation without deliberate creation. Chen Deng, the Grand Administrator of Guangling, suddenly suffered from chest distress and fullness, red face, and loss of appetite. Mr. Hua took his pulse and said, "Sir, you have parasites in your stomach, which will form Neiju (Internal Carbuncle/Abscess), caused by raw fishy foods." He immediately prepared a decoction (Tang), two sheng in volume, for him to take. After taking it twice, within a short while, he vomited violently. Small worms with red heads that could move were found, half of which were still part of the raw fish sashimi. His suffering was immediately relieved. Mr. Hua said, "This disease will recur in three years,
because residual eggs remain in the body; these eggs are difficult to completely eradicate. With a good physician, it can be saved." When the time came for the disease to flare up, Hua Tuo happened to be away, and Chen Deng subsequently died. (Commentary by Sun Simiao)