伤寒证治。自古难之。始于仲景。后贤纂述。无虑百家。而在人耳目间者。十有余种。
不患
。畴能千支万派。汇归一源。而有张长沙。若合符节耶。自非丹铅几偏。而髓竭心枯者。未
易语也。余发始燥。便读仲景书。今且雪盈巅矣。上下南阳易水间。纸败墨渝。始成授珠十帙。
乙酉春杪集甫竣。而毁于兵火。己丑春孟谋梓之而艰于费。且念多则惑。少则得。古语谆切
。今授珠虽备于义。而后学或苦其繁。曷若以一茎笔现丈六紫金。俾入门径而登高捷乎。遂
以授珠删繁去复。简邃选玄。仅得十之二。而竟无漏义矣。颜曰括要。谓括义详而征词简
也。及门之能谙其义。而嘘枯振槁。独有许石子一见颔之。且汲汲于寿世。乃捐金付诸剞劂
。
欲指扶桑。无舟莫适。非谓执此可以尽废百家。谓谙此可以折衷千古也。夫病机繁杂。变迁
无穷。如珠走盘。纵横不可测。虽纵横不可测。而终不出此盘也。是帙者其珠之盘乎。审是帙
者。其持盘者乎。操通灵之法。以应无穷之变。惟变取适。而不胶于法。斯善读括要者矣。
顺治六年岁次己丑上元日尽凡居士李中梓士材甫识。
一仲景为伤寒鼻祖。虽后贤蜂起。莫能越其范围。然有发仲景之奥旨。补仲景之未备者
。无不采收。更附以一得之愚。使学人一览无余。不致遗珠之叹耳。
一释仲景书者。惟成无己最为详明。然智者一失。时或有之。必本诸经文。要诸至理。
详为条辨。用正千古之讹非敢以臆见。妄肆讥评也。
一仲景立方。动以斤计。或称升合者。何其多也。及考其用末药。只服方寸匕。丸药如
梧桐子大者。多不过三十粒。又何其少也。丸散汤液。岂得如此悬绝耶。千金本草。皆以古三两为
今一两。古三升为今一升。可为准则。盖衡数以二十四铢为两。汉制六铢钱。四个为一两。
宋制开元钱。十个为一两。大约羌三分之一耳。且仲景汤液并分三次服。则轻重止得三分之一
。而服法又得三分之一。岂非古之一两。仅得今之一钱乎。局方纲目概以今之五钱。作为一
剂。则失之太少 。陶氏吴氏。各以意为重轻。尽变古法。则其失更甚。兹刻方药。悉选仲
景古本。不敢轻于变古也。但世有古今。时有寒暑。地有南北。药有良犷。人有强弱。惟明达者
。随在变通为得耳。
一前辑授珠。每一症。先列仲景全文。次列后贤续论。次列管窥总释兹刻欲其简便。不
能尽遵全文。有复字。及不紧要字。稍稍节去。然其要旨。固已摭拾无剩矣。
一仲景伤寒论例。凡曰太阳病者。皆谓脉浮恶寒。头项强痛也。凡曰阳明病者。皆谓胃
家实也
。皆谓脉微细但欲寐也。凡曰厥阴病者。皆谓气上冲心痛吐蛔也。如少阴病。反发热脉沉。
用麻黄附子细辛汤者。谓脉沉细。但欲寐。而又反发热者。用是方也。后人不解其意。不察
少阴病。所括脉微细。但欲寐之症。第见发热脉沉。便用麻黄附子细辛汤。大失仲景之旨。
姑举一以例其余。
一后贤以慎重太过。凡仲景重剂辄以轻剂代之。如以冲和汤代麻黄汤之类。不可枚举。
而仲景之微奥隐矣。殊不知有是病。则服是药。如钥之配锁。不可移易者也。其祸人者。皆药不对
症耳。彼易以轻剂者。是欲以柔士任强弓。安望其中的哉。兹刻悉遵古法。第详别脉症。自
无妄投之失矣。
一仲景伤寒论暨金匮要略。诚为千古医宗。但文辞简古。义味深玄。非熟读深思。未易
明了。不揣肤俚。将以注疏。畅其言外之旨。开其晦蚀之光。客嗣布之。以就正有道。
伤寒病的证候与治疗，自古以来就难以掌握。它始于张仲景，后世贤能之士编纂论述的著作，不少于百家，而在人们耳熟能详的，有十多种。
（此处原文“不患”二字孤立，结合上下文语境及古籍排版习惯，疑为衍文或残缺，故略去不译，或理解为“不必担忧……”之意，但无下文则无法成句，故依规则不增添内容，仅处理完整语义段落。注：若强行翻译“不患”，语意不通，故在此处视为排版错误忽略，或理解为“世人常患……”之省略，但为严谨起见，不凭空补全。）
谁能将千支万派的学说，汇聚归源，达到像张仲景那样严丝合缝、如符节相合的境界呢？如果不是那些在书案前长期钻研、耗尽心血的人，是很难与他谈论这个问题的。我年轻时头发刚变白，就开始研读张仲景的书籍，如今头顶已积雪般白发苍苍了。我在南阳（张仲景故里）与易水（扁鹊故里，代指医学渊源之地）之间上下求索，翻阅破旧的书卷，更改墨迹，终于编成了《授珠》十卷。乙酉年春末集子刚完成，就毁于战火兵灾。己丑年春初打算刻印它，却苦于经费困难。况且我想，书多了会让人困惑，书少了反而能有所得，这是古语中恳切的教诲。现在的《授珠》虽然在义理上完备，但后学者或许会苦于其繁杂，何不运用简练的笔法呈现出宏大的真理，让初学者能轻松入门并迅速登高呢？于是我从《授珠》中删减繁复、去除重复，精简深邃、选取玄妙之处，只保留了原来的十分之二，而竟然没有遗漏任何义理。书名定为《括要》，意思是概括义理详尽而征引词句简练。门生中能精通其义理，并能使枯木逢春、起死回生的，只有许石子一人一见便点头称是。并且他急切地希望此书能造福世间，于是捐出钱财将其交付刻版印刷。
想要指向扶桑（比喻高深的医道），却没有船只就无法到达。这并不是说拿着这本书就可以完全废弃百家的学说，而是说精通了这本书就可以对千古医理进行折衷评判。疾病的机理复杂繁多，变化无穷无尽，就像珍珠在盘中滚动，纵横交错不可预测。虽然纵横不可预测，但最终离不开这个盘子。这卷书大概就是那个“盘子”吧？审视这卷书，大概是那个“持盘者”吧？掌握通灵的方法，来应对无穷的变化，只有根据变化采取适宜的措施，而不拘泥于固定的法则，这才是善于阅读《括要》的人。
顺治六年岁次己丑正月十五日，尽凡居士李中梓字士材甫识。
其一，张仲景是伤寒学的鼻祖，虽然后世贤才蜂拥而起，没有人能超越他的范围。然而，对于阐发张仲景深奥旨意、补充张仲景未备内容的著作，无不加以收录，更附上我个人的一得之见，使学习者一览无余，不至于发出遗珠之叹。
其二，解释张仲景书籍的，以成无己最为详细明了。然而智者也难免有一失的时候，时常会有这种情况发生。必须依据经文，归结于至理，详细地进行条分缕析，用以纠正千古以来的谬误，不敢凭主观臆见，随意讥讽评论。
其三，张仲景创立方剂，动辄以斤计算，或者用升、合来计算，用量何其多啊！等到考察他使用散药时，只服用方寸匕大小的量；丸药如梧桐子大小，多的不过三十粒，用量又何其少啊！丸药、散剂、汤液，难道会有如此悬殊的差异吗？《千金方》和《本草》都以古代的三两作为现在的一两，古代的三升作为现在的一升，可以作为准则。大概是因为衡量重量的单位，二十四铢为一两。汉代制度，六铢重的钱，四个组成一两；宋代制度，开元钱，十个组成一两。大约相差三分之一左右。而且张仲景的汤液分为三次服用，那么每次服用的轻重只得三分之一的三分之一。而服法又涉及三分之一的折算，难道不是古代的一两，仅仅相当于现在的一钱吗？《局方》和《纲目》一概以现在的五钱作为一剂的量，这就失之太少了。陶氏、吴氏各凭心意决定轻重，完全改变了古法，那他们的失误就更严重了。此次刻印方药，全部选择张仲景的古本，不敢轻易改变古法。只是世上有古今之分，时有寒暑之别，地有南北之差，药有良莠之异，人有强弱之别，只有明达之人，随时随地变通才能得当罢了。
其四，之前辑录的《授珠》，每一个症状，先列出张仲景的全文，其次列出后世贤人的续论，再次列出管窥总的解释。这次刻印为了简便，不能完全遵循全文。有重复的字，以及不紧要的字，稍微节略去掉。然而它的要旨，确实已经拾取无遗了。
其五，张仲景《伤寒论》的条例，凡是说太阳病的，都是指脉浮、恶寒、头项强痛。凡是说阳明病的，都是指胃家实。凡是说少阴病的，都是指脉微细、但欲寐。凡是说厥阴病的，都是指气上冲心、心痛、吐蛔。比如少阴病，反而发热、脉沉，使用麻黄附子细辛汤的情况，是指脉沉细、但欲寐，而又反而发热的情况，才使用这个方子。后人不理解其中的意思，不考察少阴病所包含的脉微细、但欲寐的症状，只见发热脉沉，就用麻黄附子细辛汤，大大失去了张仲景的本意。姑且举这一个例子来类推其余。
其六，后世贤人因为过于慎重，凡是张仲景的重剂都用轻剂代替，比如用冲和汤代替麻黄汤之类，不可枚举。而张仲景的精微深奥之处就被掩盖了。殊不知有病就服相应的药，就像钥匙配锁，不可移易。那些害人的，都是药不对症罢了。那些换成轻剂的人，是想用柔弱的士兵去拉强弓，哪里指望能射中目标呢？此次刻印完全遵循古法，只要详细辨别脉象和症状，自然就没有妄投药物的失误了。
其七，张仲景的《伤寒论》和《金匮要略》，确实是千古医学宗师之作。但是文辞简古，义理深奥玄妙，如果不熟读深思，很难明白。我不揣冒昧浅陋，打算进行注释疏解，畅达其言外之意，开启其晦暗的光芒，期待日后公布，以向有道之人请教。
Syndrome and treatment of Shanghan (Cold Damage diseases) have been difficult to master since ancient times. It originated with Zhang Zhongjing, and later scholars compiled numerous commentaries, numbering no less than a hundred schools, yet only more than ten are familiar to the general public.
Who can synthesize the myriad branches and streams into a single source, achieving a coherence as precise as matching tally marks, like that of Zhang Changsha (Zhang Zhongjing)? Unless one is a scholar who has devoted years to study at their desk, exhausting their mind and spirit, it is not easy to discuss this with them. When my hair first began to turn white, I started reading Zhang Zhongjing's works. Now, my temples are covered in snow-white hair. Between Nanyang (hometown of Zhang Zhongjing) and Yishui (associated with Bian Que, symbolizing medical lineage), I searched extensively. After poring over crumbling books and fading ink, I finally completed *Shou Zhu* (Bestowing Pearls) in ten fascicles. At the end of spring in the Yiyu year, the collection was just finished when it was destroyed by war and fire. In early spring of the Jichou year, I planned to print it but faced financial difficulties. Moreover, I reflected on the ancient adage: "Too much causes confusion; too little yields gain." Although *Shou Zhu* is comprehensive in principle, later learners might find it cumbersome. Why not use concise writing to reveal profound truths, allowing beginners to enter the path easily and ascend quickly? Thus, I edited *Shou Zhu*, removing redundancy and complexity, selecting the profound and essential, retaining only about two-tenths of the original content, without omitting any significant meaning. I titled it *Kuoyao* (Essentials Summarized), meaning that the principles are comprehensively summarized while the wording is concise. Among my students, only Xu Shizi truly understood its essence and could revive the dying. He eagerly wished for the book to benefit the world and donated money to have it carved onto printing blocks.
To point towards Fusang (a metaphor for high medical truth) without a boat is impossible. This does not mean that holding this book allows one to discard all other schools, but rather that mastering it allows one to adjudicate millennia of medical knowledge. The mechanisms of disease are complex and change infinitely, like pearls rolling on a plate—unpredictable in their movement, yet always confined within the plate. Is this book the plate? Or is it the hand holding the plate? To wield a spiritual method to respond to infinite changes, adapting appropriately to variations without being rigidly bound by fixed rules, is to be a true master of *Kuoyao*.
Recorded by Li Zhongzi, courtesy name Shicai, pseudonym Jinfan Jushi, on the 15th day of the first month of the Jichou year, in the sixth year of the Shunzhi reign.
First, Zhang Zhongjing is the founding ancestor of Shanghan studies. Although later scholars emerged in great numbers, none transcended his scope. However, works that elucidate Zhang's profound insights or supplement his omissions are all collected. I have also added my own humble observations, so that learners may see everything at a glance and avoid regretting missed pearls.
Second, among those who interpret Zhang Zhongjing's works, Cheng Wuji is the most detailed and clear. Yet even the wise make occasional errors. One must base interpretations on the original text and ultimate principles, analyzing them in detail to correct historical errors, rather than making arbitrary criticisms based on personal opinion.
Third, Zhang Zhongjing's prescriptions often involve large quantities, measured in jin (pounds) or sheng/he (volume units). However, when using powdered medicines, the dosage is only a "fangcun bi" (square-inch scoop); pills are sized like paulownia seeds, rarely exceeding thirty grains. How can decoctions, pills, and powders differ so drastically? *Qianjin Fang* (Prescriptions Worth a Thousand Gold) and *Bencao* (Materia Medica) suggest that three taels of ancient weight equal one tael of modern weight, and three sheng of ancient volume equal one sheng of modern volume, which serves as a standard. Ancient weight measurement defined twenty-four zhu as one tael. In the Han dynasty, six-zhu coins made up one tael; in the Song dynasty, ten Kaiyuan Tongbao coins made up one tael. The difference is roughly one-third. Furthermore, Zhang's decoctions were taken in three doses, reducing the effective dose per administration significantly. Considering both the weight conversion and the divided dosing, an ancient tael might equate to merely one qian (modern unit) today. *Ju Fang* (Formulas of the Bureau) and *Bencao Gangmu* (Compendium of Materia Medica) generally treat five modern qian as one dose, which is too small. Tao and Wu arbitrarily adjusted dosages, altering ancient methods further. This edition strictly selects Zhang Zhongjing's original texts, avoiding arbitrary changes. However, given differences in era, climate, geography, drug quality, and patient constitution, adaptable wisdom is required.
Fourth, the previous compilation *Shou Zhu* listed Zhang Zhongjing's full text for each syndrome, followed by later commentaries and a summary. This edition aims for simplicity, so full texts are not always retained. Redundant or unimportant characters are omitted, but the core meaning remains intact.
Fifth, according to Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage): "Taiyang disease" refers to floating pulse, aversion to cold, and stiffness/pain in the head and neck. "Yangming disease" refers to excess in the stomach/intestines. "Shaoyin disease" refers to faint and thin pulse, and desire to sleep. "Jueyin disease" refers to qi rushing upward, heart pain, and vomiting roundworms. For example, Shaoyin disease presenting with fever and deep pulse requires Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction). This applies specifically to cases with deep/thin pulse, desire to sleep, AND fever. Later practitioners misunderstood this, seeing only fever and deep pulse and prescribing Mahuang Fuzi Xixin Tang, missing Zhang's intent. This is cited as an example.
Sixth, later practitioners, being overly cautious, replaced Zhang's heavy formulas with lighter ones, such as using Chonghe Tang (Harmonizing Decoction) instead of Mahuang Tang (Ephedra Decoction). This obscured Zhang's subtle profundities. Disease dictates medicine, like a key fitting a lock. Harm arises from mismatched medicine and syndrome. Using light medicine for severe conditions is like asking a weak soldier to draw a strong bow; success is unlikely. This edition follows ancient methods strictly. By carefully distinguishing pulses and symptoms, erroneous prescriptions will be avoided.
Seventh, Zhang Zhongjing's *Shanghan Lun* and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) are indeed eternal medical classics. However, their language is concise and archaic, and their meanings profound. Without diligent study and deep reflection, they are hard to understand. Presuming my own shallowness, I intend to provide annotations to clarify implicit meanings and illuminate obscure points, seeking correction from experts in the future.