按张养之伏热深锢。缠绵七载。罄其家资。更一百十三手之医而莫能愈。无奈多购方书。居然自疗。又误服辛温
之药。王孟英先生。屡谏不止。嗣因恶寒头痛。百治罔效。遂邀孟英诊之。孟英认定脉症。确系实热内蕴。非用硝黄
犀角大剂峻攻。断不能散其久久固结之邪。且邪气与正气交并。与贼寇之盘踞山谷。倚恃险阻。并有莠民为之
内应。而良善亦迫于势而从之。使非雄师大队。具排山倒海之威。既不足夺其气焰。一鼓而下。必将群哄以起。又
何能破坚击锐。权操必胜耶。抑使非秉钧轴者深结主知。太阿在握。则旁挠之议，皆得而阻之矣。纵百战百胜。精
忠贯日。如宋之张、韩、刘、岳、诸大将。又几何不功败垂成。徒扼腕咨嗟。而莫能挽救耶。噫嘻。医虽小技。而用药
生死之机关。诚有与治兵相通者。譬如王孟英之于医林。而神勇不啻四将。遇此体怯阳痿、咳嗽、痰沫、各症。直如金
人久据宋之疆土。四在疮痍。存亡系于呼吸。而内有戚友诋毁百出。外有于某扬言于族党。是又不啻秦桧汪黄之
弄权于肘腋也。使张养之暗昧不明。如宋诸君。则孟英必不能逞其伎俩。而洒泪以班师矣。虽然。孟英与养之知
交有年。观其初犹疑虑。及见方案。始出惟君怜救之言。并后伏枕恭听。大为感悟。则其中已摇摇如悬旌而不为
群议所撼者几希。然当此将信未信。不有如孟英者。一腔热血。和盘托出。独任其咎。毫不推诿。又安得回阳春于
指下哉。可见朋友交际。身命所在。剀切指陈。至于此极。尚有如喻嘉言尚论篇所云者。虽苦口赤心。唾弃一切。往
往付之东流逝水。病家岂诚不知其雄视一时耶。第当局者迷。兼以庸手装出一副规模。似阻非阻。而愚暗者。必
皆为其所中。迨燎原之火。不可扑灭。始知不信任明师之过也。悔已晚矣。况夫君臣之间。名分凛然难犯。万不能
面罄衷曲。而大奸巨憝。又从而倾挤之。不遗余力。其较难辄什百千倍于是者。此有志之士。读史至靖康之际。未
尝不废书而三叹也。
治通于兵。学涉于史。惟根柢之盘深。故枝叶之峻茂。谁谓三折肱之医。不从天根月窟中来。（淞樵评）
张养之体内伏热深重，被紧紧束缚，病情缠绵长达七年。他耗尽了家产，更换了一百零三位医生治疗，却未能痊愈。无奈之下，他大量购买医书，试图自行疗治，却又误服了辛温性质的药物。王孟英先生多次劝谏，但他不听。后来因为出现恶寒、头痛的症状，经过各种治疗都无效，于是邀请王孟英诊治。王孟英通过诊察脉象和症状，确认为实热内蕴于体内，如果不使用大黄、芒硝、犀角等大剂量的峻猛药物攻下，绝对不能驱散这长久固结的邪气。况且邪气与正气相互交争，就像贼寇盘踞在山谷中，倚仗险要地势，并有坏人作为内应，而善良百姓也被迫形势所迫而跟随他们。如果不是拥有雄壮的大军，具备排山倒海的气势，既不足以挫败其气焰，一举攻下，必将导致群起哄乱，又怎么能攻破坚固、打击精锐，掌握必胜的局面呢？再者，如果不是掌权者（君主）深深信任并重用主将，手握兵符大权，那么旁侧干扰的议论，都会阻碍军事行动。纵然百战百胜，精忠贯日，像宋朝的张俊、韩世忠、刘光世、岳飞等大将，又有几人不是功败垂成，徒然扼腕叹息，而无法挽救局势呢？唉！医术虽然是小技，但用药关乎生死的关键，确实有与用兵相通之处。比如王孟英在医学界，神勇不亚于那四位大将。遇到这种身体虚弱、阳痿、咳嗽、痰沫等各种病症，简直就像金人长期占据宋朝疆土，四处疮痍，存亡系于呼吸之间。而且内部有亲戚朋友百般诋毁，外部有姓于的人在宗族乡党中扬言反对，这又不亚于秦桧、汪伯彦、黄潜善等人在身边弄权。如果张养之昏庸不明智，像宋朝的那些君主一样，那么王孟英一定不能施展他的医术，只能洒泪退兵罢了。虽然如此，王孟英与张养之交情多年，看他起初还有疑虑，等到看到治疗方案后，才说出只有我能怜惜救助你的话，并且后来卧病在床恭敬地倾听，大为感悟。那么其中已经动摇不定如悬挂的旗帜而不被群议所撼动的情况就很少了。然而当在此信未信之际，如果没有像王孟英这样的人，一腔热血，全盘托出，独自承担过错，毫不推诿，又怎么能凭指下之术起死回生呢？可见朋友交往，关系到身家性命，恳切直接地指出问题，到了这种极致。尚且有像喻嘉言《尚论篇》中所说的情况，虽然苦口赤心，唾弃一切世俗看法，往往付诸东流。病人难道真的不知道王孟英能雄视一时吗？只是当局者迷，加上庸医装出一副架势，似阻非阻，而愚昧昏暗的人，必定都被他们迷惑。等到燎原之火无法扑灭时，才知道不信任明师的过错。后悔已经晚了。况且君臣之间，名分庄严难以冒犯，绝不能当面倾吐衷曲，而大奸巨恶之人，又从而倾轧排挤，不遗余力。这比上述情况难上千百倍。这是有志之士，读到靖康年间的历史时，未曾不放下书本而三次叹息的。
治疗方法通于兵法，学问涉及历史，正因为根基深厚盘结，所以枝叶才能高耸茂盛。谁说经过多次挫折的良医，不是从天根月窟（指人体生命本源或高深境界）中得来的呢？（淞樵评）
Zhang Yangzhi suffered from deep-seated latent heat tightly bound within, with the condition lingering for seven years. He exhausted his family's wealth and consulted one hundred and thirteen physicians without success. Helpless, he purchased numerous medical texts to treat himself but mistakenly ingested acrid-warm (acrid and warm-natured) herbs. Mr. Wang Mengying repeatedly advised against this, but to no avail. Later, due to aversion to cold and headache, various treatments proved ineffective, so he invited Wang Mengying to diagnose him. Upon examining the pulse and symptoms, Wang Mengying determined that it was indeed excess heat accumulating internally. Without using large doses of harsh purgatives such as Mangxiao (Natrii Sulfas), Huanglian (Coptidis Rhizoma - *Note: Text says Huang, likely referring to Dahuang/Rhubarb or similar purgative context, but strictly "Huang" usually implies Rhubarb in purgative context with Mangxiao*, let's stick to standard interpretation of "Xiaohuang" or just "Rhubarb" if implied, but text says "Xiaohuang" often means Da Huang. Actually "Xiaohuang" isn't a standard single herb name, it's likely "Da Huang" (Rhubarb). The text says "Xiaohuang" which might be a typo for "Dahuang" or refers to "Huanglian/Huangqin" but in context of "Jun Gong" (harsh attack) with Mangxiao, it is almost certainly Da Huang. I will use Da Huang (Rhei Radix et Rhizoma)), and Xijiao (Rhinocerotis Cornu), could the long-standing entrenched pathogenic factor be dispersed. Moreover, the interaction between pathogenic factors and healthy qi is like bandits occupying mountain valleys, relying on treacherous terrain, with evil people acting as internal accomplices, while good people are forced by circumstances to join them. Unless there is a mighty army possessing overwhelming momentum capable of crushing their arrogance and achieving victory in one assault, otherwise chaos will erupt, making it impossible to break strongholds and strike sharp enemies, nor can victory be secured. Furthermore, unless the ruler deeply trusts and empowers the commander, holding the sword of authority firmly, then distracting discussions would hinder military operations. Even if victorious in every battle and displaying loyalty piercing the sun, how many generals of Song Dynasty, such as Zhang Jun, Han Shizhong, Liu Guangshi, and Yue Fei, did not fail at the final stage, sighing in vain without being able to save the situation? Alas! Medicine, though considered a minor art, involves critical decisions regarding life and death through medication, truly sharing similarities with warfare. For instance, Wang Mengying in the medical field possesses divine bravery comparable to those four great generals. Facing conditions such as physical weakness, impotence, cough, and frothy sputum, it is akin to the Jin forces long occupying Song territory, leaving devastation everywhere, with survival hanging by a thread. Internally, relatives and friends launched countless criticisms; externally, individuals named Yu spoke against him among clansmen. This is no different from Qin Hui, Wang Boyan, and Huang Qianshan wielding power at the elbow. If Zhang Yangzhi were obscure and unintelligent, like the rulers of Song, Wang Mengying would not have been able to display his skills and would have had to retreat in tears. Nevertheless, Wang Mengying and Zhang Yangzhi had been close friends for years. Observing his initial doubts, and after seeing the treatment plan, Zhang finally expressed words of trust, saying only you can pity and save me. Later, lying in bed, he listened respectfully and was greatly enlightened. Thus, his wavering mind, like a suspended banner, remained unshaken by group opinions only barely. However, in this state of half-belief, without someone like Wang Mengying pouring out his wholehearted passion, taking full responsibility without shirking, how could he bring back spring-like vitality under his fingers? This shows that in friendships, where life and health are at stake, earnest and direct advice reaches such extremes. There are also cases mentioned in Yu Jiayan's *Shanglun Pian*, where despite bitter words and sincere hearts, rejecting all世俗 views, efforts often go down the drain like flowing water. Do patients truly not know who dominates the era? It is simply that those involved are confused, and incompetent doctors create an appearance of obstruction that is neither clear nor firm, deceiving the ignorant. Only when the prairie fire becomes uncontrollable do they realize the error of mistrusting a renowned master. By then, regret comes too late. Moreover, between ruler and minister, the distinction is solemn and inviolable, making it impossible to speak one's heart face-to-face, while great villains exhaust all efforts to slander and squeeze them out. This difficulty is thousands of times greater than the previous scenario. Ambitious scholars reading history up to the Jingkang incident cannot help but put down their books and sigh three times.
Treatment parallels military strategy, and learning encompasses history. Because the foundation is deeply rooted, the branches flourish vigorously. Who says a physician skilled through repeated failures does not come from the source of heaven and moon (the origin of life)? (Commentary by Songqiao)