大哉医乎。其来远矣。肇自开辟。厥初生民。有寿夭则有札瘥。有札瘥则有医药。故神
百草。黄帝注内经。伊芳尹作汤液。雷公制炮炙。与夫着书立言垂世者。若内经。其言深而要
其旨邃以宏。其考辩信而有征。实为医家之祖。下此则秦越人和缓者。缓独能知晋侯之膏
肓。而未有着述。惟越人所着八十一难经。则皆发明内经之旨。又下此则淳于意华佗。佗之
熊经鸱顾。固亦导引家之一术。至于刳腹背湔肠胃而去疾。则诚精于技矣。意之医状。司
马迁备志之。又下此则张机之金匮玉函经及伤寒诸论。诚千古不刊之妙典。第详于六气之所
伤。而于嗜欲饮食疲劳之所致者。略而不议。又下此则王叔和。篡岐伯华佗等书为脉经。叙
阴阳内外。辨三部九候。分人迎气口。条陈十二经络。洎夫三焦五脏六腑之病。最为着明。
又下此则巢元方病源候论。似不为无所见者。但论风寒。而不着湿热之篇。乃其失也。又下
此则王冰推五运六气之变。撰为天元玉策。周详切密亦人之所难。苟泥之。则局滞而不通矣
又下此则孙思邈王焘。思邈以绝人之识。操慈仁恻隐之心。其叙千金方翼。及粗工害人之
祸。至为愤切。后人稍闯其藩垣。亦足以其术鸣。但不制伤寒之书。或不能无遗憾也。焘
虽阐明外台秘要。所言症治方药灼灸之详。颇有所祖述。然谓针能杀生人。不能起死人者。
则一偏之见也。又下此则钱乙庞安时许叔微。叔微具在准绳尺寸之中。而无所发明。安时虽
能
出奇应变。而终未离于范围。二人皆得张机之粗者也。惟乙深造机之阃奥。而撷其精华。建
五脏之方。各随所宜。谓肝有相火。则有泻而无补。肾为真水。则有补而无泻。皆启内经之
秘。尤知者之所取法。奈世知乙之浅。其遗书散亡。由于阎孝忠所集居多。孝忠之意。初非
乙之本真也。又下此则上谷张元素。河间刘完素。睢水张从政。元素之与完素。虽设为奇梦
异人。以神其授受。实闻乙之风而兴起者焉。若从政则又宗乎完素者也。元素以古方今病决
不能相值。治病一切不以方故其书亦不传。其有存于今者。皆后来之所附会。其学则东垣李
杲深得之。杲推明内外二伤。而多注意于补脾土之设。盖以土为一身之主。土平则诸脏平矣
从政以汗吐下三法。风寒暑湿燥火六门。为医之关键。其治多攻利。不善学人杀人。完素
论风火之病。本内经论病机气宜一十九条。着为原病式。阐奥探微。有非大观官局诸医所可
仿佛究其设施。则不越攻补二者之间也。近代名医。若吴中罗益。沧州吕复。皆承东垣之余
绪。武林罗知悌。丹溪朱彦修。各挹完素之流风。又若台之朱佐。越之滑寿。慈溪王节斋
余杭陶节庵。吴郡薛立斋。咸有着述。未易枚举。嗟夫。自内经以来。医书汗牛充栋。不为
不多。盖医之有内经。犹儒道之六经。无所不备。后贤着述。若仲景东垣河间丹溪四子之说
可谓医书之全备。犹学庸论孟为六经之阶梯。不可缺者也。故曰外感法仲景。内伤法东垣
热病用河间。杂病用丹溪。然素问论病之因。本草着药之性。脉诀详症之原。运气法天之
候。一以贯之于内经。斯医道之大成。乃千古不易之定论。实为万世之师法矣。
Medicine is truly great. Its origins are remote. It began with the creation of heaven and earth. In the early days of humanity, there were differences in longevity and mortality, and there were plagues and diseases. With plagues and diseases, there arose medicine and herbs. Thus, Shennong (Divine Farmer) tasted hundreds of herbs; the Yellow Emperor annotated the *Neijing* (Inner Canon); Yi Yin created decoctions (Tangye); Leigong formulated processing methods (Paozhi); and those who wrote books and established doctrines to pass down to posterity, such as the *Neijing*, whose words are profound yet essential, whose purport is deep and grand, whose examinations and distinctions are credible and evidenced, are indeed the ancestors of medical practitioners. Below them came Bian Que (Qin Yueren) and Hua Tuo. Hua Tuo alone could diagnose Duke Jing of Jin’s disease reaching the *gaohuang* (area beyond reach of acupuncture and moxibustion), but left no writings. Only Bian Que’s *Nan Jing* (Classic of Difficult Issues), consisting of eighty-one chapters, elucidated the principles of the *Neijing*. Further down came Chunyu Yi and Hua Tuo. Hua Tuo’s “bear swinging and owl gazing” (Xiongjing Chigu, a form of Daoyin/qigong exercise) was indeed one technique among daoyin practitioners. As for his surgeries involving opening the abdomen and washing out the intestines to remove disease, this was certainly mastery of skill. The medical cases of Chunyu Yi were fully recorded by Sima Qian. Below them came Zhang Ji (Zhang Zhongjing) and his *Jingui Yufan Jing* (Golden Casket Classic) and various treatises on Shanghan (Cold Damage). These are indeed immortal classics unalterable for millennia. However, they detail injuries caused by the six qi (wind, cold, summer-heat, dampness, dryness, fire) but briefly mention or omit those caused by desires, diet, and fatigue. Below them came Wang Shuhe, who compiled works by Qibo, Hua Tuo, etc., into the *Mai Jing* (Pulse Classic), describing yin and yang, interior and exterior, distinguishing the three positions and nine inspections (Sanbu Jiuhou), differentiating the Renying and Qikou pulses, systematically expounding the twelve meridians, and clarifying diseases of the Sanjiao, five zang organs, and six fu organs most distinctly. Below him came Chao Yuanfang’s *Bingyuan Houlun* (General Treatise on Pathogenesis and Manifestations of Diseases), which seemed not without insight. But it discussed wind and cold while lacking chapters on damp-heat, which was its flaw. Below him came Wang Bing, who deduced the changes of the Five Movements and Six Qi, composing the *Tianyuan Yuce*. His work was detailed and rigorous, difficult for others to match. If one adheres rigidly to it, it becomes restrictive and inflexible. Below him came Sun Simiao and Wang Tao. Sun Simiao, with extraordinary knowledge and a compassionate heart, wrote the *Qianjin Fang* (Thousand Golden Prescriptions) and its supplements, expressing indignation at the disasters caused by incompetent physicians. Later generations who glimpsed his methods could achieve fame through their skills. However, he did not write specifically on Shanghan, which might be considered a regret. Wang Tao, although he clarified the *Waitai Miyao* (Secret Essentials of the Outer Cabinet), detailing symptoms, treatments, prescriptions, and moxibustion, largely followed predecessors. Yet his view that acupuncture can kill living people but cannot revive the dead was a biased opinion. Below them came Qian Yi, Pang Anshi, and Xu Shuwei. Xu Shuwei adhered strictly to standards without significant innovation. Pang Anshi could respond ingeniously but remained within conventional bounds. Both merely grasped the basics of Zhang Ji’s teachings. Only Qian Yi delved deeply into Zhang Ji’s mysteries, extracting the essence, establishing formulas for the five zang organs tailored to specific needs. He posited that the Liver contains Ministerial Fire (Xianghuo), thus requiring draining rather than tonifying; the Kidney is True Water (Zhen Shui), thus requiring tonifying rather than draining. These insights revealed secrets of the *Neijing* and became models for experts. Unfortunately, later generations underestimated Qian Yi, leading to the loss of his original works, largely replaced by compilations by Yan Xiaozhong, which did not reflect Qian Yi’s true intent. Below them came Zhang Yuansu from Shanggu, Liu Wansu from Hejian, and Zhang Congzheng from Suiwater. Zhang Yuansu and Liu Wansu, though associated with miraculous dreams and divine transmission legends, actually rose to prominence inspired by Qian Yi’s style. Zhang Congzheng, in turn, followed Liu Wansu. Zhang Yuansu believed ancient formulas could not fit modern diseases, treating patients without relying on fixed prescriptions, so his own books did not survive. What remains today are later interpolations. His learning was deeply inherited by Li Gao (Dongyuan). Li Gao elucidated internal and external injuries, focusing heavily on tonifying Spleen Earth. Since Earth (Spleen/Stomach) is the master of the body, when Earth is balanced, all organs are balanced. Zhang Congzheng regarded sweating, vomiting, and purging as the three key methods, and wind, cold, summer-heat, dampness, dryness, and fire as the six categories, forming the core of medicine. His treatments often involved aggressive purgation; improper use could be fatal. Liu Wansu discussed wind and fire diseases based on the nineteen pathogenic mechanisms in the *Neijing*, writing the *Yuanbing Shi* (Original Causes of Disease), exploring profound meanings beyond what official hospital physicians could grasp. His methods generally fell between attacking and tonifying. Famous recent physicians include Luo Yi from Wuzhong and Lu Fu from Cangzhou, who inherited Dongyuan’s legacy. Luo Zhiti from Wulin and Zhu Danxi (Zhu Zhenheng) from Danxi drew upon Liu Wansu’s influence. Others such as Zhu Zuo from Taizhou, Hua Shou from Yue, Wang Jiezhai from Cixi, Tao Jian’an from Yuhang, and Xue Lizhai from Wujun also authored works, too numerous to list. Alas! Since the *Neijing*, medical books have been countless. Medicine with the *Neijing* is like Confucianism with the Six Classics—comprehensive. The works of Zhang Zhongjing, Dongyuan, Hejian, and Danxi represent the completeness of medical literature, akin to how the *Great Learning*, *Doctrine of the Mean*, *Analects*, and *Mencius* serve as ladders to the Six Classics, indispensable. Therefore, it is said: For exogenous diseases, follow Zhang Zhongjing; for endogenous injuries, follow Dongyuan; for febrile diseases, use Hejian’s methods; for miscellaneous diseases, use Danxi’s methods. However, the *Suwen* discusses causes of disease, Materia Medica records properties of herbs, Pulse Manuals detail origins of symptoms, and Climate-Luck theories align with heavenly patterns—all integrated within the *Neijing*. This represents the culmination of medical doctrine, an eternal truth for millennia, serving as a model for all ages.