夫医教者,源自伏羲,流于神农,注于黄帝,行于万世,合于无穷,本乎大道,法乎自
然之理。孔安国序《书》曰∶
伏羲、神农、黄帝之书,谓之三坟,言大道也。少昊、颛顼、
高辛、唐、虞之书,谓之五典,言常道也。盖五典者,三坟之末也,非无大道,但专明治世
之道;三坟者,五典之本也,非无常道,但以大道为体,常道为用,天下之能事毕矣。然而
玄机奥妙,圣意幽微,浩浩乎不可测,使之习者,虽贤智明哲之士,亦非轻易可得而悟矣。
洎乎周代,老氏以精大道,专为道教;孔子以精常道,专为儒教。由是儒、道二门之教着
矣。归其祖,则三坟之教一焉。儒、道二教之书,比之三坟之经,则言象义理,昭然可据,
而各得其一意也。故诸子百家,多为着述,所宗之者,庶博知焉。
呜呼!余之医教,自黄帝之后,二千五
百有余年,汉末之魏,有南阳太守张机仲景,恤于生民多被伤寒之疾,损害
横夭,因而辄考古经,以述《伤寒卒病方论》一十六卷,使后之学人,有可根据。然虽所论未备诸病,仍为要
道,若能以意推之,则思过半矣,且所述者众,所习者多,故自仲景至今,甫仅千岁,凡着
述医书,过往古者八、九倍矣。夫三坟之书者,大圣人之教也。法象天地,理合自然,本乎
大道,仲景者,亚圣也。虽仲景之书,未备圣人之教,亦几于圣人,文亦玄奥,以致今之学
者,尚为难焉。故今人所习,皆近代方论而已,但究其末,而不求其本。
况仲景之书,复经晋·王叔和撰次遗方,宋开宝中,节度使高继冲编集进上。虽二公操心用智,自出心意,广
其法术,杂于旧说,亦有可取。其间或失仲景本意,未符古圣之经,愈令后人学之难也。况
仲景之世四升,乃唐、宋之一升,四两为之一两;向者人能胜毒,及多 咀,汤剂有异
今时之法。故今人未知其然,而妄谓时世之异,以为无用,而多不习焉。惟近世朱奉议多得
其意,遂以本仲景之论,而兼诸书之说,编集作《活人书》二十卷。其门多,其方众,其言
直,其类辨,使后学人,易为寻检施行,故今之用者多矣。然而其间亦有未合圣人之意者,
往往但相肖而已。由未知阴阳变化之道,所谓木极似金,金极似火,火极似水,水极似土,
土极似木者也。故《经》曰∶“亢则害,承乃制。”谓己亢过极则反似胜己之化也。俗
未之知,认似作是,以阳为阴,失其意也。
嗟夫!医之妙用,尚在三坟,观夫后所着述者,
必欲利于后人,非但矜炫而已,皆仁人之心也,非不肖者所敢当。其间互有得失者,由乎言
本求其象,象本求其意,意必合其道,故非圣人,而道未全者,或尽其善也鲜矣。岂欲自涉
非道而乱圣经,以惑人志哉。
自古如祖圣伏羲画卦,非圣人孰能明其意二万余言?至周文王方始立象演卦,而周公述
爻,后五百余年,孔子以作《十翼》,而《易》书方完然。后易为推究,所习者众,而注说
者多。其间或所见不同而互有得失者,未及于圣,窃窥道教故也。易教体乎五行八卦,儒教
存乎三纲五常,医教要乎五运六气,其门三,其道一,故相须以用而无相失,盖本教一而已
矣。若忘其根本,以求其华实之茂者,未之有也。
故《经》曰∶“夫五运阴阳者,天地之道也,万物之纲纪,变化之父母,生杀之本始,神
明之府也。可不通乎?”《仙经》曰∶“大道不可以筹算,道不在数故也。可以筹算者,天地之数也。若得天地之数,则
大道在其中矣。”经曰∶“天地之至数,始于一而终于九。数之可十,推之可百,数之可千,推之可万,万之大不可胜数
,然其要一也。”又云∶“知其要者,一言而终,不知其要,流散无穷。”又云∶“至数之机,迫迮
而微,其来可见,其往可追,敬之者昌,慢之者亡,无道行私,必得天殃。”又云∶“治不法天
之纪,地之理,则灾害至矣。”又云∶“不知年之所加,气之兴衰,虚实之所起,不可以为工矣
。”由是观之,则不知运气而求医无失者,鲜矣!
今详《内经·素问》,虽已校正改误音释,
往往尚有失古圣之意者,于俗闻之,未必不曰,尔何人也,敢言古昔圣贤之非?嗟夫!圣人之
所为,自然合于规矩,无不中其理者也!虽有贤哲,而不得自然之理,亦岂能尽善而无失乎
?况经秦火之残文,世本稀少。故自仲景之后,有缺“第七”一卷,天下至今无复得其本。然虽存者,布行于世,后之
传写镂板,重重差误,不可胜举。以其玄奥而俗莫能明,故虽舛讹,而孰知之!故近代敕勒
孙奇,高保衡、林亿等校正,孙兆改误,其序有言曰∶“正谬误者,六千余字,增注义者,二
千余条。”若专执旧本,以为往古圣贤之书,而不可改易者,信则信矣,终未免泥于一隅。
及夫唐·王冰次注序云∶“世本纰缪,篇目重迭,前后不伦,文义悬隔,施行不易,披会亦难。
岁月既淹,习以成弊,或一篇重出,而别立二名。或两论并合,而都为一目;或问答未已,
而别树篇题;或脱简不书,而云世缺。重《合经》而冠《针服》;并《方宜》而为《咳篇》
;隔《虚实》而为《逆从》;合《经络》而为《论要》;节《皮部》而为《经络》,退《至
教》以先《针》。如此之流,不可胜数。”又曰∶“其中简脱文断,义不相接者,搜求经论所有
,迁移以补其处;篇目坠缺,指事不明者,详其意趣,加字以昭其义;篇论吞并,义不相涉
,缺漏名目者,区分事类,别目以冠篇首;君臣请问,义理乖戾者,考较尊卑,增益以光其
意;错简碎文,前后重迭者,详其旨趣,削去繁杂,以存其要,辞理秘密,难粗论述者,别
撰《玄珠》,以陈其道。凡所加字,皆朱书其文,使今古必分,字不杂糅。”然则岂但仆之言
哉!设若后人或怒王冰、林亿之辈,言旧有讹谬者,弗去其注,而惟攻其经,则未必易知而
过其意也。
然而王冰之注,善则善矣,以其仁人之心,而未备圣贤之意。故其注或有失者也
。由是校正改误者,往往证当王冰之所失,其间不见其失,而不以改证者,不为少矣。虽称
校正改误,而或自失者,亦多矣。呜呼!不惟注未尽善,而王冰迁移加减之经,亦有臆说,而不合古圣之意者也。虽言
凡
所加字皆朱书其文,既传于世,即世文,皆为墨字也。凡所改易之间,或不中其理者,使智哲以理
推之,终莫得其真意,岂知未达真理,而不识其伪所致也。近世所传之书,若此说者多矣。
然而非其正理,而欲求其真意者,未之有也,但略相肖而已。虽今之经与注,皆有舛讹,比之
旧者,则易为学矣。若非全元起本,及王冰次注,则林亿之辈,未必知若是焉,后之知者多因
之也。今非先贤之说者,仆且无能知之,盖因诸旧说,而方入其门,耽玩既久,而粗见得失
。然诸旧失,而今有得者,非谓仆之明也;因诸旧说之所得者,以意类推,而得其真理,自
见其伪,亦皆古先圣贤之道也。仆岂生而知之者哉!
夫别医之得失者,但以类推运气造化之理,
而明可知矣。观夫世传运气之书多矣,盖举大纲,乃学之门户。皆歌颂钤图
而已,终未备其体用,及互有得失,而惑人志者也。况非其人,百未得于经之一二,而妄撰运气之书,传于
世者,是以矜己惑人,而莫能彰验,致使学人不知其美,俾圣经妙典,日远日疏,而习之者
鲜矣。悲夫!世俗或以谓运气无征,而为惑人之妄说者。或但言运气为大道玄机,若非生而知之则莫
能学之者。由是,学人寡而知者鲜。设有攻其本经,而复有注说雕写之误也,况乎造化玄奥
之理,未有比物立象以详说者也。
仆虽不敏,以其志慕兹道,而究之以久,略得其意,惜乎
天下尚有未若仆之知者。据乎所见,而辄伸短识,本乎三坟之圣经,兼以众贤之妙论,编集
运气要妙之说。十万余言,九篇三部,勒成一部,命曰《内经运气要旨论》,备见圣贤之妙用
。然妙则妙矣,以其妙道,乃为对病临时处方之法,犹恐后学未精贯者,或难施用。复宗
仲景之书,率参圣贤之说。推夫运气造化自然之理,以集伤寒杂病脉证方论之文,一部三卷
,十万余言,目曰《医方精要宣明论》。凡有世说之误者,详以此证明之,庶令学人,真伪自分,而易为得用。
且运气者得于道同,盖明大道之一也。观夫医者,唯以别阴阳虚实,最为枢要,识病之法,以其病气归于五
运六气之化,明可见矣。谨率《经》之所言,二百余字,兼以语辞,二百七十七言,绪归五运六
气而已。大凡明病阴阳虚实,无越此法。虽已并载前之二帙,复虑世俗多出妄说,有违古圣
之意。今特举二百七十七字,独为一本,名曰《素问玄机原病式》。遂以比物立象,详论天
地运气造化自然之理二万余言,仍以改证世俗谬说。虽不备举其误,其意足可明矣;虽未备
论诸疾,以此推之,则识病六气阴阳虚实,几于备矣。盖求运气言象之意,而得其自然神妙
之情理。《易》曰∶“书不尽言,言不尽意,设卦以尽情伪,系辞焉以尽其言,变而通之以尽
利,鼓之舞之以尽神。”《老子》曰∶“不出户知天下,不窥牖见天道。其出弥远,其知弥少。”
盖由规矩而取方员也。夫运气之道者,犹诸此也。嗟夫!仆勉述其文者,非但欲以美于己而
非于人,矜于名而苟于利也,但贵学人易为晓悟,而行无枉错耳。如通举《内经运气要旨
论》及《医方精要宣明论》者,欲令习者求其备也。其间或未臻其理者,幸冀将来君子以改
正焉。但欲同以宣扬古圣之妙道,而普救后人之生命尔。
The teaching of medicine originates from Fuxi, flows through Shennong, is annotated by the Yellow Emperor, practiced for ten thousand generations, and aligns with the infinite. It is rooted in the Great Dao (Great Way) and follows the principles of nature. Kong Anguo, in his preface to the *Book of Documents* (*Shangshu*), stated: The books of Fuxi, Shennong, and the Yellow Emperor are called the "Three Tombs" (*Sanfen*), speaking of the Great Dao. The books of Shaohao, Zhuanxu, Gaoxin, Tang Yao, and Yu Shun are called the "Five Classics" (*Wudian*), speaking of the constant way. Generally, the "Five Classics" are the offshoots of the "Three Tombs"; they do not lack the Great Dao, but focus specifically on the way of governing the world. The "Three Tombs" are the root of the "Five Classics"; they do not lack the constant way, but take the Great Dao as their substance and the constant way as their application. Thus, all affairs of the world are completed. However, the profound mysteries are subtle, and the sages' intentions are obscure and deep. Vast and unfathomable, even for those who study them, it is not easy for even the wise, intelligent, and enlightened to grasp and comprehend them lightly.
By the Zhou Dynasty, Laozi mastered the Great Dao and established the Daoist religion; Confucius mastered the constant way and established the Confucian religion. Thus, the teachings of the Confucian and Daoist schools became prominent. Tracing back to their origin, the teachings of the "Three Tombs" were one. Compared to the classics of the "Three Tombs," the books of the Confucian and Daoist schools have clear images, words, meanings, and principles that can be relied upon, each obtaining its own specific intent. Therefore, the various philosophers and hundred schools mostly produced writings, aiming to broadly understand these doctrines.
Alas! My medical teaching, after the Yellow Emperor, has passed more than two thousand five hundred years. At the end of the Han Dynasty and beginning of Wei, there was Zhang Ji (courtesy name Zhongjing), Governor of Nanyang. Pitying that the people suffered greatly from cold damage diseases (*Shanghan*) and suffered premature death, he researched ancient classics and compiled the *Treatise on Cold Damage and Miscellaneous Diseases* (*Shanghan Zabing Lun*) in sixteen volumes, so that later learners would have something to follow. Although his discussions did not cover all diseases, they remain essential principles. If one can deduce them by mind and intention, half of the understanding will be achieved. Since his works were numerous and widely studied, only a thousand years have passed since Zhongjing to the present. Yet, the number of medical books written exceeds ancient ones by eight or nine times. The books of the "Three Tombs" are the teachings of the Great Sages. They model heaven and earth, harmonize with nature, and are rooted in the Great Dao. Zhongjing is the Sub-Sage. Although Zhongjing's books do not fully contain the teachings of the Sages, they are close to them, and the text is also profound and obscure, making it difficult for contemporary scholars. Thus, what people study today are merely modern formulas and theories, investigating only the branches without seeking the root.
Moreover, Zhongjing's book was further edited by Wang Shuhe of the Jin Dynasty and compiled and presented by Gao Jichong, Military Commissioner, during the Kaibao era of the Song Dynasty. Although these two gentlemen used their minds and wisdom, creating new ideas and expanding methods, mixing them with old theories, there are valuable aspects. However, some deviated from Zhongjing's original intent and did not conform to the ancient sages' classics, making it even harder for later generations to learn. Furthermore, four sheng (a unit of volume) in Zhongjing's time equaled one sheng in the Tang and Song dynasties, and four liang (a unit of weight) equaled one liang. People in the past could tolerate stronger medicines and often chewed herbs directly, so decoction methods differed from today. Because modern people do not know this, they wrongly claim that due to the change of times, these methods are useless, and thus rarely study them. Only Zhu Fengyi (Zhu Gong) of recent times grasped its essence well. He based his work on Zhongjing's discussions and incorporated other books' theories, compiling the *Huoren Shu* (*Book for Reviving People*) in twenty volumes. Its categories are many, formulas numerous, language direct, and classifications clear, making it easy for later learners to find and apply. Hence, it is widely used today. However, some parts do not align with the sages' intent, merely resembling them superficially. This is because they do not understand the way of yin-yang transformation, where extreme wood resembles metal, extreme metal resembles fire, extreme fire resembles water, extreme water resembles earth, and extreme earth resembles wood. Thus, the *Classic* says: "Excess causes harm, and control comes from succession." This means that when one element becomes excessive, it may resemble the element that controls it. Laypeople do not understand this, mistaking resemblance for reality, confusing yang with yin, and losing the true meaning.
Alas! The wonderful application of medicine lies in the "Three Tombs." Looking at later writings, they aim to benefit future generations, not just for display. They reflect the hearts of benevolent people, which unworthy individuals dare not assume. The gains and losses among them arise because words seek images, images seek meanings, and meanings must align with the Dao. Therefore, unless one is a Sage whose Dao is complete, few can achieve perfection. Would anyone intentionally stray from the Dao to confuse the sacred classics and mislead people?
Since ancient times, such as the ancestor Fuxi drawing hexagrams, only a Sage could understand the meaning behind over twenty thousand words. It was not until King Wen of Zhou that images were established and hexagrams deduced, and the Duke of Zhou expounded the lines. Five hundred years later, Confucius wrote the *Ten Wings*, completing the *Book of Changes* (*Yijing*). Later, many studied it, and many commented on it. Differences in view led to gains and losses because they had not reached the level of a Sage and secretly窥探ed Daoist teachings. The *Yijing*'s core lies in the Five Phases and Eight Trigrams; Confucianism focuses on the Three Bonds and Five Constants; medicine focuses on the Six Qi and Five Movements. Though their doors differ, their Dao is one. They rely on each other without deviation, for their source is one. To forget the root and seek lush flowers and fruits is impossible.
Thus, the *Classic* says: "The Five Movements and Yin-Yang are the Dao of heaven and earth, the net of all things, the parents of change, the origin of life and death, and the mansion of spirit. How can one not understand them?" The *Immortal Classic* says: "The Great Dao cannot be calculated, for it is not in numbers. What can be calculated are the numbers of heaven and earth. If one obtains the numbers of heaven and earth, the Great Dao is within them." The scripture says: "The ultimate numbers of heaven and earth begin with one and end with nine. Numbers can extend to ten, then to a hundred, to a thousand, to ten thousand. The vastness of ten thousand is incalculable, yet its essence is one." It also says: "Those who know the essence need only one word to conclude; those who do not know it scatter infinitely." And: "The mechanism of the ultimate numbers is urgent and subtle. Its coming can be seen, its going can be traced. Respect it, and you prosper; slight it, and you perish. Acting unrighteously and selfishly invites heavenly disaster." And: "If treatment does not follow the laws of heaven and the principles of earth, disasters will arrive." And: "Not knowing the annual additions, the rise and fall of qi, and the onset of deficiency and excess, one cannot be a physician." From this, we see that few can practice medicine without error if they do not understand the Movements and Qi.
Now, examining the *Suwen* section of the *Neijing*, although corrections and annotations have been made, many still lose the intent of the ancient sages. To the common ear, one might ask: "Who are you to criticize the ancient sages?" Alas! The actions of sages naturally conform to rules and principles. Even the wise and enlightened, lacking natural principles, cannot be perfect without error. Moreover, due to the Qin dynasty's book burning, texts were damaged and rare. After Zhongjing, the seventh volume was lost, and no one has recovered the original. Although existing parts circulate, copying and printing errors are countless. Because the text is profound and laypeople cannot understand, errors go unnoticed. In recent times, Sun Qi, Gao Baoheng, Lin Yi, etc., were ordered to correct errors, and Sun Zhao amended mistakes. Their preface states: "Corrected over six thousand erroneous characters and added over two thousand explanatory notes." If one strictly adheres to old editions as immutable sacred texts, while faithful, one remains stuck in a corner.
Wang Bing of the Tang Dynasty, in his commentary preface, said: "World versions are flawed, chapters overlap, order is illogical, meaning is disconnected, practice is difficult, and comprehension is hard. Over time, bad habits formed. Some chapters repeat with different names; some combined theories are merged into one item; some Q&A sections are split into new titles; some bamboo slips are missing, claimed as lost. *He Jing* is placed before *Zhen Fu*; *Fang Yi* is merged into *Ke Pian*; *Xu Shi* is separated into *Ni Cong*; *Jing Luo* is merged into *Lun Yao*; *Pi Bu* is abbreviated to *Jing Luo*; *Zhi Jiao* is moved after *Zhen*. Such changes are countless." He also said: "For missing slips and broken texts, I searched for original content to fill gaps. For lost chapter titles, I clarified meaning and added words. For merged chapters with unrelated meanings, I classified topics and added titles. For inconsistent ruler-minister dialogues, I adjusted hierarchy and added content to clarify intent. For scattered slips and repetitive texts, I removed redundancy to keep essentials. For secret meanings hard to explain, I wrote *Xuanzhu*. All added words were written in red ink to distinguish ancient from modern." Does this not support my words? If later generations anger at Wang Bing and Lin Yi for pointing out errors, refusing to remove their notes and attacking only the text, they will not easily understand or surpass their intent.
However, Wang Bing's commentary, though good, lacked the full intent of the sages due to his benevolent heart. Thus, his comments sometimes erred. Correctors often proved Wang Bing's errors, but many errors went uncorrected. Despite claiming correction, many new errors were introduced. Alas! Not only were the comments imperfect, but Wang Bing's rearranged and added/deleted texts also contained subjective views contrary to ancient sages. Although he said added words were in red, once published, they became black ink. Where changes were unreasonable, even the wise cannot find the true meaning, failing to realize that ignorance of truth leads to accepting falsehoods. Many recent books propagate such views. Without correct principles, seeking true meaning is futile; only superficial resemblance exists. Although current texts and comments have errors, they are easier to learn than old ones. Without Quanyuanqi's version and Wang Bing's commentary, Lin Yi et al. would not have known how to proceed, and later scholars followed them. I do not deny previous sages' words but admit my limited knowledge. Entering the field through old theories, I have spent long studying and seeing gains and losses. My insights are not due to my brilliance but deducing truth from old theories, revealing falsehoods, following the path of ancient sages. Am I born with knowledge?
To judge medical gains and losses, one only needs to deduce the principles of Movements, Qi, and creation. Many books on Movements and Qi exist, outlining general principles as entry points. They are mostly chants and diagrams, lacking full substance and function, causing confusion. Unqualified people write such books based on little understanding, boasting and misleading, preventing students from appreciating the classics, causing them to drift away. Sad! Some say Movements and Qi are unverifiable superstitions; others say they are profound mysteries only for the born-wise. Thus, few learn them. Those who study the original text face errors in commentaries and engravings. The profound principles of creation lack detailed analogical explanations.
Though not smart, I admire this Dao and studied it for a long time, grasping its essence. Regrettably, others know less than I. Based on my views, I briefly share my shallow insights, rooting in the "Three Tombs" classics and incorporating wise men's theories, compiling essential theories on Movements and Qi. Over 100,000 words, nine chapters in three parts, forming a book titled *Neijing Yunque Yaozhi Lun* (*Discussion on the Essentials of Movements and Qi in the Neijing*), showing the sages' wonders. Though wonderful, as a method for prescribing based on disease, it might be hard for beginners to apply. So, relying on Zhongjing's book and sages' words, deducing natural principles of Movements and Qi, I collected texts on pulse, symptoms, and formulas for cold damage and miscellaneous diseases. One book, three volumes, over 100,000 words, titled *Yifang Jingyao Xuanming Lun* (*Clear Exposition of Essential Medical Formulas*). I verify worldly errors with evidence, hoping students can distinguish true from false and apply them easily.
Movements and Qi derive from the same Dao, clarifying the unity of the Great Dao. For physicians, distinguishing yin-yang and deficiency-excess is crucial. Identifying disease involves attributing pathological qi to the transformations of the Six Qi and Five Movements, which is clear. Briefly summarizing the *Classic* in over 200 characters, plus 277 explanatory words, all return to the Six Qi and Five Movements. Clarifying yin-yang and deficiency-excess relies on this method. Although included in previous volumes, fearing worldly false theories contradicting sages, I extracted these 277 words into a separate book named *Suwen Xuanji Yuanbing Shi* (*Original Causes of Disease Explained by Mysteries in Suwen*). Using analogy, I discussed natural principles of heaven, earth, Movements, and Qi in over 20,000 words, correcting worldly errors. Though not listing all errors, the intent is clear. Though not covering all diseases, deducing from this, identifying the Six Qi, yin-yang, and deficiency-excess is nearly complete. Seeking the meaning of words and images reveals natural spiritual principles. The *Yijing* says: "Books cannot fully express speech, speech cannot fully express intent. Hexagrams express intent, words express speech. Change and adapt for benefit, inspire for spirit." Laozi says: "Know the world without leaving home, see heavenly Dao without looking out the window. The farther one goes, the less one knows." This is like using rules to draw squares and circles. The Dao of Movements and Qi is similar. Alas! I wrote this not to praise myself or blame others, nor for fame or profit, but to help students understand and act correctly. Including *Neijing Yunque Yaozhi Lun* and *Yifang Jingyao Xuanming Lun* aims to provide completeness. If any principles are incomplete, I hope future scholars will correct them. My sole wish is to promote the sages' wonderful Dao and save lives.