上古之人。禀天地浑穆之气以生。寿永而无病。中古自轩辕氏尝百草分经络。始知有药。始知有病。岐伯氏通脉
理辨病因。始知有医。圣人惧后世疾痼而不求治。则着灵枢素问内经诸书以垂世。后人宗之。代有名医。各有
着论。随时施治。无非救世之苦心。然而病情多端。其变幻叵测而速于死者。莫如伤寒一症。药一误投。
病不可挽。诸名家述伤寒略而不周。惟张仲景先生定一百一十三方。治分六经。可谓该之。后学误以类伤寒作正
伤寒治。而不分手足。无怪乎病之浅者深。深者危。危者莫救。浙西吴坤安先生。亲炙吴中叶天士薛生白两先生。
深探伤寒之秘旨。应世三十年。凡伤寒一症。在经治经。杜传经之渐。无论虚实。数剂而愈。使病者
不伤元气。易于痊复。仁心妙手。闻之耳熟。先生安于家。不肯轻出。余羁职守。南朔间隔。徒忻慕焉。乃弟友
石。辑先生平日所着书为四卷。名之曰伤寒指掌。北来就正于余。并嘱序。余读其自序。观其门类。及论症用药处方。
分条析理。古今来治伤寒之法。莫能越其范围。知先生得力于仲景者深矣。而前后条辨诸书。胥成渣滓。
余乐为之序以共世也。学人获此卷读之。循序而进。以治伤寒。分六经之法治杂
症。无不应手以尽其妙。岂独治伤寒一症哉。
时嘉庆十有二年岁次丁卯中秋太医院院使花映墀拜题
上古时代的人，禀受天地浑厚纯一的气而生存，寿命长久且没有疾病。中古时期，自从轩辕氏（黄帝）品尝百草、划分经络以来，人们才开始知道有药物，才知道有疾病。岐伯通晓脉理、辨析病因，人们才开始知道有医学。圣人担心后世之人疾病深重却不去求治，于是撰写了《灵枢》《素问》《内经》等书籍流传于世。后人尊崇这些经典，代代都有名医出现，各自著书立说，根据时宜施以治疗，无不是出于救世救人的苦心。然而病情变化多端，其中变幻莫测且致死迅速的，没有比得上伤寒这一病症的。如果用药错误，病情就无法挽回。许多名家论述伤寒，往往简略而不周全。只有张仲景先生确定了113首方剂，治疗分为六经辨证，可以说是非常完备的。后学者误将“类伤寒”当作“正伤寒”来治疗，且不区分手经和足经，难怪轻病转重，重病转危，危重者无法救治。浙西吴坤安先生，亲自师从苏州地区的叶天士、薛生白两位先生，深入探究伤寒的奥秘宗旨。他行医三十年，凡是遇到伤寒病症，在经则治经，杜绝传经的趋势，无论虚实，只需几剂药即可痊愈，使患者不损伤元气，容易康复。他那仁心妙手的医术，早已闻名遐迩。吴先生安于居家生活，不肯轻易出诊。我因公务羁绊，南北相隔，只能心中欣羡仰慕。他的弟弟吴友石，辑录先生平日所著的书籍为四卷，命名为《伤寒指掌》，北上向我请教指正，并嘱托我作序。我阅读了他的自序，观察其门类编排，以及论症、用药、处方的内容，条理清晰，析理透彻。古往今来治疗伤寒的方法，都不能超出这本书的范围。我知道吴先生深得张仲景学说的精髓。而前后其他条辨类的书籍，相比之下都成了糟粕。我很乐意为此书写序以公之于众。学习中医的人获得这本书阅读，循序渐进地学习，用它来治疗伤寒，用分六经的方法来治疗杂症，没有不能随手应验、发挥其奥妙的。这哪里仅仅是治疗伤寒这一种病症呢？
时为嘉庆十二年（丁卯年）中秋节，太医院院使花映墀敬题。
In ancient times, people were born endowing themselves with the pure and undifferentiated Qi of Heaven and Earth; they enjoyed long life and were free from disease. In the middle antiquity, since Xuanyuan (the Yellow Emperor) tasted hundreds of herbs and delineated the meridians, people began to know of medicines and diseases. Qibo mastered pulse diagnosis and differentiated etiologies, thereby establishing the practice of medicine. The Sages, fearing that future generations would suffer from entrenched illnesses without seeking treatment, composed works such as *Ling Shu* (Spiritual Pivot), *Su Wen* (Basic Questions), and *Nei Jing* (Inner Canon) to transmit them to posterity. Later generations revered these texts, producing renowned physicians in each era who wrote treatises and applied treatments according to the times, all driven by a sincere desire to save the world. However, clinical manifestations are manifold; among those that are unpredictable and rapidly fatal, none surpasses Shanghan (Cold Damage). A single misapplication of medication can render the condition irretrievable. Many experts' discussions on Shanghan are brief and incomplete. Only Mr. Zhang Zhongjing established 113 formulas and categorized treatment into Six Meridians (Six Stages: Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin), which was indeed comprehensive. Later students mistakenly treated Lei Shanghan (Shanghan-like conditions) as Zheng Shanghan (True Cold Damage) without distinguishing between Hand and Foot meridians. No wonder mild cases became severe, severe cases became critical, and critical cases became incurable.
Mr. Wu Kun'an from western Zhejiang personally studied under Master Ye Tianshi and Master Xue Shengbai in the Suzhou region, deeply exploring the secret principles of Shanghan. For thirty years of practicing medicine, whenever he encountered Shanghan, he treated the affected meridian directly, preventing the progression of transmission. Regardless of deficiency or excess, recovery was achieved within a few doses, preserving the patient's Yuan Qi (Primal Qi) and facilitating easy convalescence. His benevolent heart and skillful hands have long been well-known. Mr. Wu preferred a quiet domestic life and was reluctant to practice publicly. Bound by official duties, I lived far apart from him to the north and south, able only to admire him with joy. His younger brother, Wu Youshi, compiled his master's daily writings into four volumes, titled *Shanghan Zhizhang* (Guiding Palm for Cold Damage), came north to seek my correction, and requested a preface. Having read his self-preface, observed the classification of categories, and analyzed the discussions on symptoms, medication, and prescriptions, I found the reasoning clear and meticulous. Methods for treating Shanghan throughout history cannot exceed the scope defined herein. I realize that Mr. Wu has profited deeply from the teachings of Zhang Zhongjing, whereas other treatises preceding and following it have become mere dregs. I am pleased to write this preface to share it with the world. Students who obtain this volume and study it step-by-step to treat Shanghan, or apply the Six Meridians method to treat miscellaneous diseases, will find their interventions effective and profound. This is not limited merely to treating Shanghan.
Written respectfully by Hua Yingchi, Director of the Imperial Medical Bureau, during the Mid-Autumn Festival of the Dingmao year, the 12th year of the Jiaqing reign.