余绍兴辛巳。为叶表弟桷伯材集方六卷。前叙阴阳病脉证。次及所因之说。集注脉经。类分八十一门。方若干
道。题曰根据源指治。伯材在行朝。得书欲托贵人刊行。未几下世遂已。淳熙甲午。复与友人汤致德远。庆德夫。论及
医事之要。无出三因。辨因之初。无逾脉息。遂举脉经曰。关前一分。人命之主。左为人迎。右为气口。盖以人迎
候外因。气口候内因。其不应人迎气口。皆不内外因。傥识三因。病无余蕴。故曰医事之要。无出
此也。因编集应用诸方。类分一百八十门。得方一千五十余道。题曰三因极一病
源论粹。或曰现行医方山积。便可指示。何用此为。殊不知晋汉所集。不识时宜。或诠次混淆。或附会杂揉。古文简脱。
章旨不明。俗书无经。性理乖误。庸辈妄用。无验有伤。不削繁芜。罔知枢要。乃辨论前人所不了义。庶几开古贤之
蹊径。为进学之 。使夫见月忘指可也。于是乎书。
青田鹤溪陈 言无择序
学医之道,须知五科七事。五科者,脉病证治及其所因;七事者,所因中复分为三,博
约之说,于斯见矣。脉为医门之先,虽流注一身,其理微妙,广大配天地,变化合阴阳,六
气纬虚,五行丽地,无不揆度。是以圣人示教,有精微气象之论;后贤述作,为《太素》《
难经》之文。仲景类集于前,叔和诠次于后,非不昭着。六朝有高阳生者,剽窃作歌诀,刘
元宾从而解之,遂使雪曲应稀,巴歌和众,经文溺于覆瓮,正道翳于 辞,良可叹息。
今乃料简要义,别白讨论,分人迎气口,以辨内外因;列表里九道,以叙感伤病。六经不昧
,五脏昭然,识病推因,如指诸掌,类明条备,文略义详,倘能留神,则思过半矣。
我于绍兴辛巳年,为表弟叶桷(字伯材)汇编了六卷医方。前面叙述阴阳、病脉、证候,接着论述病因之说,汇集注解《脉经》,分类为八十一门,共有若干首方剂,题名为《根据源指治》。伯材当时在朝廷任职,得到这本书后想托付权贵刊印发行,不久他去世便作罢。淳熙甲午年,我又与友人汤致德远、庆德夫讨论医学的要领,认为没有超出“三因”的范畴。辨别病因之初,没有比诊察脉息更重要的。于是引用《脉经》说:“关前一分,是人命的主宰。左手为人迎,右手为气口。”大概是用“人迎”来候测外因,用“气口”来候测内因。那些既不应验于人迎也不应验于气口的,都属于不内外因。如果认识了“三因”,疾病就没有什么遗漏的了。所以说医学的要领,没有超出这个范围的。因此编纂收集应用的各方,分类为一百八十门,得到方剂一千零五十余首,题名为《三因极一病源论粹》。有人说:现在流行的医方堆积如山,就可以直接指示使用,何必还要这样做呢?殊不知晋朝、汉朝所收集的方书,不符合当时的实际情况。有的编排次序混乱,有的附会杂揉;古文简略脱漏,章节主旨不明;世俗书籍没有经典依据,性理乖谬错误。庸俗之辈妄加使用,不仅无效反而造成伤害。如果不删减繁杂芜杂的内容,就无法知晓关键要领。于是辨析论述前人未能阐明的义理,希望以此开辟古代贤人的路径,作为增进学问的途径,使人们能够见月忘指(即透过现象看本质)就可以了。于是写下这篇序言。
青田鹤溪陈言无择 序
学习医学的道理,必须知道五科七事。所谓五科,就是脉、病、证、治以及病因;所谓七事,是指病因中又分为三类,博学与约取的说法,在这里就体现出来了。脉诊是医学入门的首要环节,虽然它流注全身,其道理微妙,广大如配天地,变化契合阴阳,六气经纬虚空,五行附着大地,无不加以揣度衡量。因此圣人展示教导,有关于精微气象的论述;后辈贤人著述,成为《太素》《难经》等文章。张仲景在前面分类汇集,王叔和在后面编排次序,并非不显著明白。但六朝时有个叫高阳生的人,剽窃经文写成歌诀,刘元宾进而解释它,致使高雅的歌曲应和者稀少,通俗的歌曲应和者众多,经文被埋没在破瓮之中,正道被隐晦的文辞遮蔽,实在令人叹息。如今选取简要精要的意义,分别明确地加以讨论,区分人迎和气口,以辨别内因和外因;列出表里九道脉象,以叙述感伤疾病的演变。六经不致迷乱,五脏清晰可见,识别疾病推求病因,就像指着手掌一样清楚,分类明确条理完备,文字简略而义理详尽,如果能够留心研究,那么思虑就已经超过一半了。
In the Xinsi year of the Shaoxing era, I compiled six volumes of medical prescriptions for my cousin Ye Jue (courtesy name Bocai). The preface discussed Yin and Yang, disease pulses, and syndromes, followed by an exposition on the causes of disease. It collected annotations on the *Mai Jing* (Pulse Classic), categorized into eighty-one sections, containing a certain number of prescriptions, titled *Genyuan Zhizhi* (Tracing the Source to Direct Treatment). At that time, Bocai was serving in the imperial court. Upon receiving this book, he wished to entrust it to influential figures for publication, but before he could do so, he passed away, and the project was abandoned. In the Jiawu year of the Chunxi era, I again discussed the essentials of medicine with friends Tang Zhi De Yuan and Qing Defu. We concluded that nothing surpasses the "Three Causes" (San Yin). To distinguish the causes, there is nothing superior to examining the pulse. Thus, citing the *Mai Jing*: "The one-fen area anterior to the Guan position is the master of human life. On the left is Renying (Human Welcome), and on the right is Qikou (Qi Port)." Generally, Renying is used to observe external causes, while Qikou is used to observe internal causes. Those that do not correspond to either Renying or Qikou all belong to non-internal and non-external causes. If one understands the Three Causes, no aspect of disease remains hidden. Therefore, it is said that the essence of medicine lies in this. Consequently, I compiled and collected applicable prescriptions, categorized into one hundred and eighty sections, obtaining over one thousand and fifty prescriptions, titled *Sanyin Ji Yi Bingyuan Lun Cui* (Essence of the Treatise on the Three Causes Leading to the Ultimate Source of Disease). Some might say: Current medical prescriptions are piled up like mountains; why not just point them out directly? What is the need for this? They fail to realize that collections from the Jin and Han dynasties do not suit contemporary needs. Some have confused ordering, others involve eclectic mixing; ancient texts are brief and omit details, chapter themes are unclear; popular books lack canonical basis, their principles are erroneous. Ignorant practitioners use them recklessly, resulting in ineffectiveness and harm. Without pruning the superfluous, one cannot grasp the key points. Therefore, I analyzed and expounded upon meanings previously unclarified by predecessors, hoping to open paths trodden by ancient sages and facilitate learning, allowing people to see the moon and forget the finger (i.e., perceive the essence beyond the signifier). Thus, I wrote this preface.
Preface by Chen Yan Wuyue of Hexi, Qingtian
To learn medicine, one must understand the Five Departments and Seven Matters. The Five Departments refer to pulse, disease, syndrome, treatment, and its cause; the Seven Matters refer to the division of causes into three categories, illustrating the concepts of comprehensiveness and conciseness. Pulse diagnosis is the gateway to medicine. Although it circulates through the whole body, its principles are subtle, vast as heaven and earth, and changing in harmony with Yin and Yang. The Six Qi (Six Excesses) weave through the void, and the Five Elements adhere to the earth, all subject to measurement and estimation. Thus, the Sages provided teachings on subtle phenomena; later scholars produced works such as the *Taisu* (Great Simplicity) and *Nanjing* (Classic of Difficult Issues). Zhang Zhongjing classified and collected earlier, and Wang Shuhe arranged them subsequently; their work was indeed clear and manifest. However, during the Six Dynasties, a man named Gaoyang Sheng plagiarized scriptures into rhymed verses, and Liu Yuanbin explained them, causing high-brow songs to find few harmonizers while vulgar songs found many. Scriptures were buried in broken jars, and the orthodox path obscured by obscure language, which is truly lamentable. Now, I select concise and essential meanings, discuss them clearly, distinguishing Renying and Qikou to differentiate internal and external causes; listing nine pulse positions of interior and exterior to narrate febrile diseases. The Six Channels will not be obscured, the Five Viscera will be clear. Identifying diseases and deducing causes will be as clear as pointing at one's palm. Categories will be explicit and items complete, text concise yet meaning detailed. If one pays attention, half of the understanding will already be achieved.