余老友赵君晴初。生平手不释卷。尤邃于轩岐之学。初不以医自名。命剂辄效。有不可为者。顾能早决之。以是四
方求治者。接踵无虚日。君犹虑耳目之隘也。虚心访道。不惮涉历。孜孜焉。汲汲焉。盖靡刻不留意于活人济世。余
懵不知医。而乐与君游。尝聆其绪论。阐发义理。剀陈利弊。足以拓医家之胸臆。释病者之迷罔。非钻研深。阅历久。
不克臻是。每举其所话。以话于朋辈中之从事于医及见困于病者。惟恐其传之不能遍也。又恐君之苦酬应。不
遑燕居。而未尝笔之于书也。一日。见示是编。受而读之。则其活人济世之怀。俱蔼然流露于楮墨间。而知向之因
其所话以觇其平日之钻研阅历者。犹只十一二焉。今年秋。其友姚静庵广文请付剞劂以行世。余亟怂恿之。爰
不自揣谫陋。焉缀数语于简端。且曩者欲遍布其话而不可得。而今乃得家置一编焉。并以志余之喜也。
光绪辛巳冬月同邑孙垓
事有古守其常而今穷其变者。法家例医家方其是已。夫事物变无穷也。有其备之变。更出所备外。故变无穷。穷
其变者有穷。变无穷。穷其变者当与为无穷。自非挟百试之才。享神明之寿。多其阅历。神其 悟。鲜有能相 相
守。以穷无穷之变者。古锦充囊。积羽折轴。而成书出焉。晴初赵子。精于医。无虚日。年且老。成医话一书。其言曰。
意度者勿录也。道听者勿录也。袭古与违古勿录也。违古而适合乎古。食古而不泥乎古。时或拾古之遗。纠古之失。
补古之阙。释古之疑。或日一得焉。或月一得焉。或积日月而竟无得焉。盖四十年于兹矣。夫岐黄而下至于仲圣。
亦犹夫人耳。某药药某病。某病药某药。上古固无书读也。彼何师而得之与。得之病耳。问得其由。切得其象。而病
诏我矣。问得其象中由。切得其由中象。而病又诏我矣。虽然。中一矢而曰吾善射。捷一战而曰吾善兵。是强狱隶
着刑书也。神而明之存乎证。以问证切。以切证问。以甲证乙。以一证千。而同中之异出焉。夫是之为病证。证者。证
也。法家所谓比例。例者。比也。无以比诸。乌乎例诸。无以证诸。乌乎治诸。如晴初者。可谓老于证治。而善读书者
矣。顾自以为是焉可乎。误于两似而得其一真。悔于百非而衷于一是。是则穷其变而又善自变之说也。晴初之话
医也。暴其短。不炫其长。幸其得。犹悔其失。粹然儒者之言。其临证也。如驾危樯。行大川。守孤城。御 敌。一不
得当。而覆败随之。其生人杀人。不有甚于亭疑狱之平者乎。抑予更有感于天地之好生焉。虑阴阳饮食之杀吾生也。
苦不自知。而脉也贡之。又博生万物。俾各能入人而药之。向非圣人。又谁与起病者而试尝之。此造物之所以大
也。不明乎此。而假手于庸庸者流。几何而不蹈杀人之律乎哉。呜呼危哉。予向不能医。不幸而先人皆痛于沉痼。
其于病也。三折肱矣。读晴初书。为言天下事物之变之无穷而未易穷其变也。其见于一人之身者已如此。
时光绪癸未五月山阴陈锦作于蕺山讲舍
My old friend, Mr. Zhao Qingchu, never let a book slip from his hands throughout his life. He was particularly profound in the study of *Huangdi Neijing* and Qibo's medical theories (Xuanqi Zhi Xue). Initially, he did not identify himself as a physician, yet the prescriptions he made were invariably effective; for conditions that were incurable, he could make early judgments and inform the patients. Consequently, people seeking treatment from all directions came continuously, with no day passing without visitors. Mr. Zhao still worried about the narrowness of his own vision and experience, so he humbly sought the Way, unafraid of hardship and travel, diligent and eager, paying attention to saving lives and benefiting the world at every moment.
I am ignorant of medicine, but I enjoy associating with Mr. Zhao. I have listened to his preliminary discussions, which elucidate principles and earnestly state pros and cons, sufficient to broaden the minds of physicians and dispel the confusion of patients. Such depth is not achievable without profound study and long-term experience. I often recounted what he discussed to friends engaged in medicine or those troubled by illness, fearing that his insights might not spread widely. I also worried that his busy social engagements left him no leisure to write them down. One day, he showed me this manuscript. Upon reading it, I found that his benevolent intention to save lives and benefit the world flowed naturally and gently through the ink on paper. I realized that my previous understanding of his daily study and experience, based merely on his conversations, had grasped only one or two parts out of ten.
This autumn, his friend, Scholar Yao Jing'an, requested the printing of this work for public circulation. I eagerly encouraged him and, presuming upon my own limited knowledge, wrote a few words at the beginning of this slim volume. Moreover, whereas before I desired to disseminate his words widely but could not, now everyone can possess a copy, which also expresses my joy.
Winter of the Xin-Si Year of Guangxu (1881), Sun Gai, fellow townsman
There are matters where ancients adhered to constants while moderns exhaust variations; the formulation of prescriptions by physicians exemplifies this. The changes in things are infinite; some changes occur beyond what is prepared for, hence changes are endless. To exhaust these changes has limits, but since changes are infinite, the capacity to exhaust them must also be infinite. Unless one possesses talent proven a hundred times, enjoys a lifespan like a deity, has extensive experience, and divine insight, few can maintain adherence to principles while exhausting infinite changes. Just as ancient brocade fills a bag and feathers accumulate until they break an axle, a book emerges.
Mr. Zhao Qingchu excelled in medicine, never wasting a day, and having reached old age, he completed a book of Medical Conversations (*Yi Hua*). He stated: "Do not record subjective speculations; do not record hearsay; do not record blind imitation of ancients or deviation from them. Deviate from ancients yet conform to their spirit; consume ancient knowledge yet do not be rigid by it. Occasionally pick up ancient omissions, correct ancient errors, supplement ancient deficiencies, and explain ancient doubts. Sometimes gaining insight in a day, sometimes in a month, sometimes accumulating days and months without gain. This has continued for forty years."
From Huangdi and Qibo down to Zhang Zhongjing, they were merely humans. Certain herbs treat certain diseases; certain diseases require certain herbs. In ancient times, there were no books to read. Who did they learn from? They learned from patients. By asking, they obtained the cause; by palpation, they obtained the pulse image, and the disease instructed them. By asking, they obtained the cause within the pulse image; by palpation, they obtained the pulse image within the cause, and the disease instructed them again. Nevertheless, hitting one target and claiming skill in archery, or winning one battle and claiming skill in warfare, is akin to forcing prison inmates to write penal codes. Divine illumination resides in the syndrome differentiation (*Zheng*). Through inquiry and palpation, verify the syndrome; through palpation and inquiry, verify the syndrome; use Syndrome A to verify Syndrome B, and use one syndrome to deduce thousands, thereby revealing differences within similarities. This is called "Disease-Syndrome" (*Bing Zheng*). "Syndrome" (*Zheng*) means evidence or proof. What physicians call "proportion" (*Bi Li*), "Example" (*Li*) means analogy. Without analogy, how can rules be applied? Without syndromic evidence, how can treatment proceed? Someone like Mr. Zhao can be said to be experienced in syndrome differentiation and treatment, and skilled in reading books. However, can one be self-righteous? Mistaking one truth amidst two similar possibilities, and regretting hundreds of errors to ultimately adhere to correctness—this is the theory of exhausting variations and being good at self-transformation.
When discussing medicine, Mr. Zhao exposes his shortcomings rather than boasting of strengths; he feels fortunate for gains yet regrets losses. These are the words of a pure Confucian scholar. When treating patients, he acted like navigating a dangerous ship across a great river, guarding a lonely city, or repelling enemies; any misstep led to ruin. Did his actions in saving or taking lives not carry greater weight than judging doubtful cases? Furthermore, I am moved by Heaven and Earth's love for life. I worry that Yin-Yang imbalance and dietary errors kill us; we suffer without knowing why, so we entrust ourselves to pulse diagnosis. Heaven and Earth produce myriad things, enabling them to enter the human body as medicines. If not for sages, who would test these herbs on behalf of the sick? This is the greatness of Creation. Failing to understand this, and relying on mediocre practitioners, how many would not tread the path of killing? Alas, how perilous!
I previously knew no medicine, but unfortunately, my ancestors all suffered from chronic ailments; thus, regarding illness, I have "broken my arm three times" (a metaphor for gaining experience through repeated failure). Reading Mr. Zhao's book, he speaks of the infinite changes in worldly affairs, difficult to fully exhaust. Even manifested in one person, it is thus complex.
May, Gui-Wei Year of Guangxu (1883), Chen Jin of Shanyin, written at Jishan Lecture Hall