前哲徐洄溪曰。医者之学问。全在明伤寒之理。则万病皆通。故仲景之书有二。《伤寒论》治时病之法也。《金匮要略》治杂症之法也。而《金匮》之方。则又半从《伤寒论》中来。则伤寒乃病中之第一症。而学医者之第一功夫也。俞东扶曰。伤寒为大病。治法为最繁。必熟读仲景书。再遍读后贤诸书。临症方有把握。仲景书为叔和编次。或有差误。而聊摄注解。殊觉稳当。续注者。张卿子王三阳唐不岩沈亮宸张兼善张隐 林北海诸人。总不越其范围。程扶生《经注》尤为明白易晓。然亦不敢直指原文之错误。自方程喻三家。各以已意布置。而仲景原文。从此遂无定局。至柯氏来苏集始放胆删改。而以方名编次。又是一局。徐灵胎《伤寒类方》实宗其式。然予细绎柯氏删改处。万不及《医宗金 伤寒论》之精当。先刊仲景原文。另立正误存疑二篇。应改者注小字于旁。可删者摘诸条于后。是非判然。智愚皆晓。他如江西舒诏《伤寒集注》大半斥为伪撰。并取数方。痛加诋毁。别拟方以换之。以视汪琥将阴阳二候。分为二编。各补后贤之方。其意均欲使初学人不泥古方以害人。而汪犹拘谨。舒则放纵矣。惟吴绶蕴要节 《六书》王宇泰《伤寒准绳张路玉伤寒绪论》俱有裨于后人。即有功于仲景。
合二家之说观之。仲景《伤寒论》为千古用方之祖。且其阐明医理。尤为中国至精之本。惜其书难免错简。必参观后贤诸书。核对互勘。始有头绪。阅周 之读伤寒论法。颇有见地。爰节述其说曰。《伤寒》非奇症也。《伤寒论》非奇书也。仲景据其所见。笔之于书。非既有此书。而天下之人。根据书而病也。读者须每读一段。即设一病者于此。以揣
其病机治法。而后借证于书。不得专在文本上安排。总之读《伤寒论》只当涵泳白文。注家虽有数十。以予所见二十余种。皆不免穿鉴附会。言似新奇。莫能见之行事。鄙见只当分作四会。曰伤寒初起本证治法。曰伤寒初起兼证治法。曰伤寒日久化寒。并误治化寒证治。曰伤寒日久化热。并误治化热证治。其霍乱、风湿、食复、劳复。以杂症附之。再参之陶节 书。及各家论温热书。互相考证。庶于读书有条理。而临证亦可有径途矣。盖经脉部位。与夫形层表里浅深之事。固不可不讲。而究不可过执也。着力乃在气化上推求。不得专在部位上拘泥。此书在唐以前。已非一本。其章节离合。本无深意。论中叙证。有极简者。有极繁者。有方证不合者。有上下文义不贯者。经设身处境。实在难以遵行。安知非错简说简耶。读者只应各就本文思量。不必牵扯上下文。积久自能融会贯通。此真善读伤寒论之活法也。
前清《俞根初》先生。在干嘉之间。盛行四五十年。着《通俗伤寒论》十二卷。第一编第一章、勘伤寒要诀。第二章、六经方药。第二编病理诊断。第三章、表里寒热。第四章、气血虚实。第五章、伤寒诊法。第六章、伤寒脉舌。第三编证治各论。第七章、伤寒本症。第八章、伤寒兼证。第九章、伤寒夹证。第十章、伤寒坏症。第十一章、伤寒复证。第四编调理诸法。第十二章、瘥后调理法。其辨析诸症。颇为明晰。其条列治法。温寒互用。补泻兼施。亦无偏主一格之弊。方方切用。法法通灵。其定方宗旨。谓古方不能尽中后人之病。后人不得尽泥古人之法。全在一片灵机。对症发药。庶病伤寒者真有豸乎。善夫俞惺齐先生有言曰。读书与治病。时合时离。古法与今方。有因有革。善读书斯善治病。非读死书之谓也。用古法须用今方。非执板方之谓也。专读仲景书。不读后贤书。譬之井田对建。周礼周官。不可以治汉唐之天下也。仅读后贤书。不读仲景书。譬之五言七律。 体宫词。不可以代三百之雅颂也。俞氏此着。劝求古训。博采众法。加以临证多年。经验丰富。故能别开生面。独树一帜。多发前人所未发。一洗阴阳五行之繁文。真苦海之慈航。昏衢之巨烛也。学人诚能从此书切实研求。广为探索。则历代伤寒名家。皆堪尚友矣。兼臣研究之余。略
附臆说于后。阅者谅之。
公元一九一六年丙辰四月望
何廉臣印岩识于绍城卧龙山麓之宣化坊
The former sage Xu Huixi said: "A physician's learning lies entirely in understanding the principles of *Shanghan* (Cold Damage). If one understands the principles of *Shanghan*, all diseases can be comprehended." Therefore, Zhang Zhongjing's works are twofold: *Shanghan Lun* (Treatise on Cold Damage) deals with the methods for treating epidemic diseases (exogenous febrile diseases), while *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) deals with the methods for treating miscellaneous internal diseases. The prescriptions in *Jingui Yaolue* are derived half from *Shanghan Lun*. Thus, *Shanghan* is the primary among diseases and the first skill a medical student must master.
Yu Dongfu stated: "*Shanghan* is a major disease, and its treatment methods are the most complex. One must thoroughly read Zhang Zhongjing's books, and then extensively read the works of later virtuous physicians, to have confidence in clinical practice." Zhang Zhongjing's original text was compiled by Wang Shuhe, which may contain errors. However, Liu Wansu's (styled Liaoshe) annotations are considered particularly sound. Later annotators, such as Zhang Qingzi, Wang Sanyang, Tang Buyan, Shen Liangchen, Zhang Jianshan, Zhang Yin'an, and Lin Beihai, generally did not exceed the scope of Liu's annotations. Cheng Fusheng's *Jingzhu* (Commentary on the Classic) is especially clear and easy to understand. However, they dared not directly point out errors in the original text. It was only with Fang Youzhi, Yu Jiayan, and Zhang Luyu that each rearranged the content according to their own ideas, causing the original text of Zhang Zhongjing to lose its fixed structure. When Ke Qin (courtesy name Yunbo, pseudonym Laisu) compiled *Shanghan Lansuji* (Collected Commentaries on Shanghan), he boldly deleted and altered the original text, organizing it by prescription names, creating a new format. Xu Lingtai's *Shanghan Leifang* (Classified Formulas for Shanghan) essentially followed this model. However, upon careful examination of Ke Qin's alterations, I found them far less precise than those in *Yizong Jinjian·Shanghan Lun* (Golden Mirror of Medicine: Treatise on Cold Damage). *Yizong Jinjian* first published Zhang Zhongjing's original text, separately establishing chapters on "Correcting Errors" and "Preserving Doubts," noting corrections in small print beside the text and extracting deletable items at the end, making right and wrong clear to both the wise and the foolish. Others, such as Shu Zhao's *Shanghan Jizhu* from Jiangxi, largely dismissed the text as apocryphal, criticized specific prescriptions harshly, and substituted his own formulas. This intent was similar to Wang Hu's division of yin and yang syndromes into two sections with added later prescriptions, aiming to prevent beginners from blindly following ancient formulas to harm patients. Yet Wang was cautious, whereas Shu was too liberal. Only Wu Shou's *Shanghan Yunyao Quanshu* (Complete Book of Essential Secrets for Shanghan), Wang Yutai's *Shanghan Zhunsheng* (Standard Rules for Shanghan), and Zhang Luyu's *Shanghan Xulun* (Continuation of Discourses on Shanghan) were beneficial to later generations, thus meriting credit to Zhang Zhongjing.
Synthesizing these views, Zhang Zhongjing's *Shanghan Lun* is the ancestor of formula usage for millennia, and its elucidation of medical principles is the most profound foundation of Chinese medicine. Regrettably, the book inevitably suffers from bamboo slip disarray; one must consult later works and cross-reference them to find order. Zhou Yangjun's (courtesy name Yucai) method of reading *Shanghan Lun* offers great insight. I briefly summarize his view: *Shanghan* does not record strange diseases, nor is *Shanghan Lun* a strange book. Zhang Zhongjing recorded what he observed clinically; it is not that people fell ill because the book existed. Readers should imagine a patient whenever reading a passage, deduce the pathogenesis and treatment, and then verify with the text, rather than focusing solely on textual arrangement. In short, one should immerse oneself in the plain text. Although there are dozens of commentators, the more than twenty I have seen all fall into forced interpretations and far-fetched associations; their words seem novel but cannot be applied in practice. My view is to divide the study into four aspects: 1. Treatment of primary syndromes at the onset of *Shanghan*; 2. Treatment of concurrent syndromes at the onset; 3. Transformation into cold syndromes after prolonged duration or due to mis-treatment, and their treatments; 4. Transformation into heat syndromes after prolonged duration or due to mis-treatment, and their treatments. Conditions like cholera, wind-dampness, food relapse, and labor relapse are attached as miscellaneous diseases. By referencing Tao Hua's works and various texts on warm-heat diseases, and cross-verifying them, one can read systematically and find a path for clinical practice. While meridians, locations, and the depth/superficiality of tissue layers must be studied, one must not be overly rigid. Effort should focus on exploring Qi transformation, not being confined to anatomical locations. Before the Tang Dynasty, this book already existed in multiple versions; its chapter divisions had no deep meaning. Some syndrome descriptions are extremely brief, others extremely detailed; some prescriptions do not match syndromes; some contexts are disjointed. Strict adherence is difficult. Could this not be due to misplaced or lost slips? Readers should contemplate the text itself without forcing connections to other parts; over time, integration will occur naturally. This is the true dynamic method for reading *Shanghan Lun*.
Mr. Yu Genchu of the late Qing Dynasty flourished during the Qianlong and Jiaqing reigns for forty to fifty years. He authored *Tongsu Shanghan Lun* (Popular Treatise on Cold Damage) in twelve volumes. Volume 1, Chapter 1: Key Essentials for Examining Shanghan; Chapter 2: Six Meridians' Formulas and Herbs. Volume 2: Pathology and Diagnosis; Chapter 3: Exterior/Interior, Cold/Heat; Chapter 4: Qi/Blood, Deficiency/Excess; Chapter 5: Diagnostic Methods for Shanghan; Chapter 6: Pulse and Tongue for Shanghan. Volume 3: Specific Syndrome Treatments; Chapter 7: Primary Syndromes of Shanghan; Chapter 8: Concurrent Syndromes; Chapter 9: Clashing Syndromes; Chapter 10: Ruined Syndromes; Chapter 11: Relapsing Syndromes. Volume 4: Various Conditioning Methods; Chapter 12: Post-recovery Conditioning. His analysis of syndromes is clear; his listed treatments combine warming and cooling, tonification and purgation, avoiding bias toward any single approach. Every formula is practical; every method is flexible. His principle for prescribing is that ancient formulas cannot fully address modern patients' conditions, and modern practitioners should not rigidly adhere to ancient methods. It relies entirely on adaptability and prescribing according to the specific syndrome, so that those suffering from *Shanghan* may truly benefit. Mr. Yu Xingqi rightly said: "Reading and treating illness sometimes align, sometimes diverge. Ancient methods and modern formulas involve both inheritance and reform. Good reading leads to good treating; this does not mean reading dead texts. Using ancient methods requires using modern formulas; this does not mean sticking to rigid prescriptions. Reading only Zhang Zhongjing and ignoring later scholars is like trying to govern the Han and Tang dynasties with Well-field systems or *Rites of Zhou*. Reading only later scholars and ignoring Zhang Zhongjing is like expecting five-character or seven-character regulated verse to replace the Odes and Hymns of the *Classic of Poetry*." Yu's approach encourages seeking ancient teachings, collecting diverse methods, and applying years of clinical experience, thereby opening new paths and establishing a unique school, expressing insights previously unarticulated, and clearing away the verbosity of Yin-Yang and Five Elements theories. It is indeed a compassionate boat in the sea of suffering and a great candle in dark streets. If learners earnestly study and explore this book, they can associate with past masters of *Shanghan*. After my own research, I append my humble opinions below. Readers please forgive me.
April 15, Bingchen Year (1916 AD)
He Lianchen (Yinyan) noted at Xuanhua Fang, foot of Wolong Mountain, Shaoxing