一此书之成专。以辩注仲景伤寒论也。然仲景论伤寒实本素问热病。仲景分六经不出灵枢经脉。故余摘取二篇中文
列之伤寒例前为第一卷。使后人尊仲景复知尊轩岐。况仲景当日既成伤寒论。亦自云述不敢云作则知仲景之论实宗内经
之旨也。
一内经热论篇。文王太仆注之于先。马玄台广之于后。然其中有未尽合理处。间以鄙意补之。
二王叔和撰次仲景方论书凡十卷。其中如伤寒例六经辩脉证治法。及阴阳易瘥后诸病。此实系仲景原文。悉为编入
所削者。如第一卷脉法及第七卷以后汗吐下诸篇。以其为叔和所增入也。至于第二卷中如痉湿 三证。第七卷前如霍乱
一证。亦系仲景原文。而不编入者以其为杂病也。
一仲景论为方书之祖。以内经中有论而无方也。叔和起而撰次之知尊仲景矣。但其于仲景论中插入己意。使学人不
知孰为仲景孰为叔和。以故后人诽议之云。叔和变乱仲景伤寒论。故其脉经亦受高阳生所窃取。此其报也。然仲景书。
当三国时兵火之后残缺失次。若非叔和撰集。不能延至于后。复有成无己为之注解也。今医勿但责叔和之过。而忘叔和
之功。
一叔和撰次六经篇。有阳明少阳病列于太阳篇者。有太阳病列于阳明篇者。有中寒病杂入太阳阳明病中。及杂入三
阴热病中者。今皆悉为归正。凡三阳病各归三阳篇。其三阴热病亦各自归其篇。惟中寒病则另作上中下三卷。辩其证为
真寒。使后学尽知伤寒中寒二证。判然庶无错误。
一伤寒经络仲景书止分六经。不言手足。其实则合手经而皆病。愚故于首卷热论篇后。即图注灵枢手足阴阳六经。
其注以滑氏发挥为主。然亦间有错误处。复以鄙意较之。
一成无己注解伤寒论。犹王太仆之注内经。所难者惟创始耳后之人于其。注之可疑者虽多。所发明大半由其注而启
悟。至有忘其起予之功反责其解释之谬者。所以王宇泰云成氏解释最为详明。虽其中时或自相矛盾。亦白璧微瑕固无损
于连城也。或曰。成氏注伤寒论不过随文顺释。但嫌其不辩叔和语。不分仲景书。正不知古人虚心着书。不敢轻易指责。
所以品愈高名愈着。如吾辈者。亦自厌其饶舌耳。
一成氏注仲景书已完。又自撰明理论。其解仲景桂枝麻黄青龙等汤尤为明畅。第惜其所解者不过廿余方耳。其所未
发明者。愚即以原注中之意及采内台等书。大半以鄙意补之。
一驳正伤寒论例近非一人。愚今较之亦从众也。但仲景全书中。有四时八节决病法。乃伤寒论一部纲领。近今之书。
悉皆脱略。惟准绳于论例中犹存正文。但当日成氏亦未及注。愚特细为解释。以见十二宫辰斗柄所指。时节气候为之转
移。当其时倘病伤寒。医人宜随时气立论则用药。始可十全。所以仲景亦云。此须洞解之也。
一伤寒论自成注以后。在昔明医如李东垣。不过以治法略举其要。朱丹溪亦仅以疑处摘问其目。未闻有以仲景原论
全解者。至明季有歙人方中行着伤寒条辩八卷。乃成氏之后一人而已。我朝初有喻嘉言者。推展方氏未发之旨。着尚论
篇五卷。是亦仲景之功臣也复有程子郊倩。即仿二书之意着后条辩六集。其中亦有可采之处。所可嫌者三家之书。皆倒
乱。仲景六经篇原文。彼虽各有其理要之六经,原次或当日叔和未尽改易其间仲景妙义焉。知不反由此新编而尽失邪。
况方书治病。不过欲每条解明不致医药有误。而已非。若文公章句必欲承上起下也。孔子云爱礼存羊。凡六经原次余不
敢乱叔和之旧。
一仲景六经篇中或有前不得不附之后,后不得不附之前者。则曰。附例或已经附注过而原论中复及者。则曰重出例。
或原论中始及未经注过宜附之后者。则曰附后例。其他如温病坏病及病。宜用刺另立治法。各分其篇于后者。又诸汤方
宜附之后者。皆如上例也。六经篇中惟中寒病为真阴证。不入上例。止以重圈记之。其真阴寒证。宜用汤药。亦以重圈
记之。
一此书凡系仲景论成注有未妥者。间采方喻程及诸名家之说。不敢窃取其所着书及姓氏。必为标出。间附己意。则
曰。愚按及设为或问而余答也。
一此书既集仲景论后必附昔贤及后人方论悉属鄙意。逐条解明。然亦多方引证。不敢创为私说。务使论必中理。方
必切病愚切愿天下后世之人。但能读是书。虽遇伤寒变证。极奇之病。然疗之有法。施之辄效。业医者可不勉之。
一、这本书的成书,专门是为了辨析和注释张仲景的《伤寒论》。然而,张仲景论述伤寒实际上是以《素问·热病篇》为本源,划分六经不出《灵枢·经脉篇》的范围。所以我摘录这两篇中的文字,列在《伤寒例》之前作为第一卷,使后人尊崇张仲景的同时也知道要尊崇黄帝与岐伯。况且张仲景在当时既然完成了《伤寒论》,自己也说“述而不作”,由此可知张仲景的论述实际上是遵循《内经》的宗旨的。
一、《内经·热论篇》,王冰(号太仆)先作了注,马莳(号玄台)后来加以广注。然而其中有不尽合理的地方,我偶尔用浅见加以补充。
二、王叔和编次张仲景的方论书籍共十卷。其中像《伤寒例》、六经辨脉证治法,以及阴阳易、差后诸病,这些确实属于张仲景的原文,全部被编入书中。而被删削掉的,如第一卷的脉法及第七卷以后的汗、吐、下各篇,因为那是王叔和所增入的内容。至于第二卷中的痉、湿、暍三证,第七卷前的霍乱一证,也属于张仲景的原文,但不编入的原因是因为它们属于杂病范畴。
一、张仲景的著作是方书的始祖,因为《内经》中只有理论论述而没有方剂。王叔和兴起并编次整理,可以说是尊重张仲景了。但是他在张仲景的论述中插入了自己的见解,使得学习者不知道哪些是张仲景的,哪些是王叔和的,因此后人非议他,说王叔和扰乱了张仲景的《伤寒论》,所以他的《脉经》也被高阳生窃取,这是他的报应。然而,张仲景的书在三国时期兵火之后残缺散失且次序混乱,如果不是王叔和编集整理,就不能流传到后世;再加上有成无己为之注解。现在的医生不要只责怪王叔和的过错,而忘记王叔和的功劳。
一、王叔和编次的六经篇章中,有将阳明病、少阳病列在太阳篇的,有将太阳病列在阳明篇的,有中寒病混杂在太阳阳明病中,以及混杂在三阴热病中的情况。现在我都全部予以纠正。凡是三阳病各自归入三阳篇,其三阴热病也各自归入其篇。只有中寒病则另外分为上、中、下三卷,辨析其证候为真寒,使后学者完全知晓伤寒和中寒两种证候截然不同,从而避免错误。
一、张仲景论伤寒经络,书中只分六经,不言手经足经。其实则是手足经都会发病。所以我于第一卷《热论篇》之后,立即图示并注释《灵枢》中手足阴阳六经。其注释以滑寿(滑氏)的发挥为主。然而其中也有错误之处,我又用浅见加以校勘。
一、成无己注解《伤寒论》,就像王冰注解《内经》一样,难能可贵的是他是创始者。后人在他的注解中虽然有很多可疑之处,但大部分发明创造都是受他的注解启发而领悟的。甚至有人忘记了他起发我的功劳,反而指责他解释的错误。所以王宇泰说成氏的解释最为详细明了,虽然其中有时自相矛盾,也是白璧微瑕,并不损害其如连城之玉的价值。有人说,成氏注解《伤寒论》不过是顺着文意解释,只是遗憾他不辨析王叔和的话,不区分张仲景的原书。正不知古人著书虚心,不敢轻易指责前人,所以品德越高名声越着。像我这样的人,自己也厌倦多嘴啰嗦罢了。
一、成氏注解张仲景的书已经完成,又自己撰写《明理论》。他对张仲景桂枝汤、麻黄汤、青龙汤等方的解释尤为明白流畅。可惜他所解释的不过二十余首方剂而已。对于他没有阐发的部分,我以原注中的意思以及采录《内台方议》等书的内容,大半用浅见加以补充。
一、驳正《伤寒论例》的人不止我一个。我现在校对也遵从众议。但在张仲景全书中,有四时八节决病法,这是《伤寒论》全篇的纲领。近来的书籍全都脱漏省略了,只有李中梓的《医宗必读》(准绳指代此类权威著作或特指某书,此处依语境理解为保留正文的权威版本)在《论例》中还存有正文。但当时成无己也没有来得及注解。我特意细细加以解释,以显示十二宫辰斗柄所指,时节气候随之转移。当此时节如果患伤寒,医生应当根据时令气候立论用药,才可以十全十美。所以张仲景也说:“这必须深刻理解才行。”
一、《伤寒论》自从成无己注解以后,过去的名医如李东垣,不过略举治疗方法的要点;朱丹溪也只是摘取疑问之处提出问题。没听说过有完整解说张仲景原论的人。到了明代末年,有歙县人方中行著有《伤寒条辩》八卷,这是成无己之后的一人而已。本朝初年有喻嘉言,推展方中行未阐发的旨意,著有《尚论篇》五卷,这也是张仲景的功臣。又有程郊倩,即仿照这两本书的意思著有《后条辩》六集,其中也有可取之处。令人遗憾的是这三家的书,都打乱了张仲景六经篇的原文顺序。他们虽然各有其六经的理论要点,但原来的次序或许是当时王叔和未尽改易,其中的张仲景妙义难道不是反而由这种新编而全部丧失了吗?况且方书治病,不过是想每条解释清楚,不致使医药有误罢了,并非像文章章句那样一定要承上启下。孔子说:“爱礼存羊。”关于六经的原始次序,我不敢打乱王叔和的旧制。
一、张仲景六经篇中,或者有前面不得不附在后面的,后面不得不附在前面的,就称为“附例”;或者已经附注过而在原论中又提及的,就称为“重出例”;或者原论中刚开始提及未经注解过,适宜附在后面的,就称为“附后例”。其他如温病、坏病以及病情适宜用针刺另行制定治法的,分别将其篇章列在后面;还有诸汤方适宜附在后面的,都依照上述例子处理。六经篇中只有中寒病是真阴证,不列入上述例子,只用双圈标记。其真阴寒证,适宜用汤药治疗的,也用双圈标记。
一、这本书凡是涉及张仲景论述、成无己注解中有不妥之处,偶尔采录方中行、喻嘉言、程郊倩及各位名家的说法,不敢窃取他们的著作及姓名,一定会明确标出。偶尔附上我自己的见解,就说“愚按”;或者设为问答而由我回答。
一、这本书既然汇集了张仲景的论述,后面必然附上昔贤及后人的方论,这些都属鄙意,逐条解释清楚。但也多方引用证据,不敢创立私说,务必使论述合乎道理,方剂切合病症。我深切希望天下后世之人,只要能读这本书,即使遇到伤寒变证,极其奇特的病,治疗有法度,施用立即见效。从事医学的人能不努力吗?
1. The compilation of this book is specifically intended to analyze and annotate Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage). However, Zhang Zhongjing's discussion on cold damage is actually based on the *Suwen: Re Bing* chapter of the *Huangdi Neijing* (Yellow Emperor's Inner Canon), and his division of the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin) does not go beyond the scope of the *Ling Shu: Jing Mai* chapters. Therefore, I have extracted texts from these two chapters and placed them before the *Shanghan Li* (General Principles of Cold Damage) as Volume 1, so that later generations may revere Zhang Zhongjing while also reverting to Huangdi (Yellow Emperor) and Qibo. Moreover, since Zhang Zhongjing himself stated "I transmit but do not create" upon completing the *Shanghan Lun*, it is evident that his discussions actually follow the principles of the *Neijing*.
2. Regarding the *Re Bing* chapter of the *Neijing*, Wang Bing (styled Taipu) provided annotations first, and Ma Shi (styled Xuantai) expanded upon them later. However, there are parts therein that are not entirely reasonable; I occasionally supplement them with my own humble insights.
3. Wang Shuhe compiled Zhang Zhongjing's formulas and discussions into ten volumes. Among them, sections such as the *Shanghan Li*, the differentiation of pulse, symptoms, and treatments across the Six Channels, as well as conditions like Yin-Yang exchange and post-illness diseases, are indeed original texts by Zhang Zhongjing and were fully included in the compilation. What was excluded includes the pulse methods in Volume 1 and the chapters on sweating, vomiting, and purging in Volume 7 and onwards, because these were additions by Wang Shuhe. As for the three syndromes of Spasm (Jing), Dampness (Shi), and Heatstroke (Yue) in Volume 2, and Cholera (Huoluan) at the beginning of Volume 7, although they are also original texts by Zhang Zhongjing, they were not included because they belong to miscellaneous diseases.
4. Zhang Zhongjing's works are the ancestors of formula literature, as the *Neijing* contains theoretical discussions but no formulas. Wang Shuhe's rise and compilation can be seen as respecting Zhang Zhongjing. However, he inserted his own opinions into Zhang's discussions, causing students to be unable to distinguish between Zhang's original words and Wang's additions. Consequently, later generations criticized him, claiming that Wang Shuhe disrupted Zhang Zhongjing's *Shanghan Lun*. Thus, his *Mai Jing* (Pulse Classic) was stolen by Gao Yangsheng, which is considered his retribution. Nevertheless, Zhang Zhongjing's books were fragmented, lost, and disordered after the wars of the Three Kingdoms period. If not for Wang Shuhe's compilation, they would not have survived to the present day, nor would Cheng Wuji have had a text to annotate. Current physicians should not merely blame Wang Shuhe's faults while forgetting his merits.
5. In Wang Shuhe's compiled chapters on the Six Channels, some Yangming and Shaoyang diseases are listed under the Taiyang chapter, and some Taiyang diseases are listed under the Yangming chapter. Some Cold Syndrome (Zhong Han) cases are mixed into Taiyang and Yangming diseases, and even into the Three Yin heat diseases. I have now corrected all these errors. All Three Yang diseases are returned to their respective Yang chapters, and the Three Yin heat diseases are returned to their respective chapters. Only the Cold Syndrome is separately divided into Upper, Middle, and Lower volumes, analyzing its syndromes as True Cold, so that learners clearly understand the distinction between Cold Damage (Shang Han) and Cold Syndrome (Zhong Han), thereby avoiding errors.
6. In Zhang Zhongjing's discussion of cold damage meridians, the book only divides them into the Six Channels without specifying Hand or Foot meridians. In reality, both Hand and Foot meridians are affected. Therefore, after the *Re Bing* chapter in the first volume, I immediately provide diagrams and annotations for the Hand and Foot Yin-Yang Six Channels according to the *Ling Shu*. My annotations primarily rely on the elaborations of Hua Shi (Slippery Master/Hua Shou). However, there are occasional errors, which I have further verified and corrected using my own insights.
7. Cheng Wuji's annotation of the *Shanghan Lun* is comparable to Wang Bing's annotation of the *Neijing*; the difficulty lies in being a pioneer. Although later scholars found many questionable points in his annotations, most of their innovations were inspired by Cheng's work. Some even forgot his contribution and instead criticized his explanations. Thus, Wang Yutai stated that Cheng's explanations are the most detailed and clear; although there are occasional self-contradictions, these are but minor flaws in a flawless jade and do not diminish its value like a city-connected jade. Some argue that Cheng's annotation merely follows the text, lamenting that he did not distinguish Wang Shuhe's words from Zhang Zhongjing's book. They fail to realize that ancient authors wrote with humility and dared not easily criticize predecessors, which is why their virtue and fame grew. People like myself also tire of speaking too much.
8. Cheng completed his annotation of Zhang Zhongjing's book and then wrote the *Ming Li Lun* (Theory of Clarification). His explanations of formulas such as Guizhi Tang (Cinnamon Twig Decoction), Mahuang Tang (Ephedra Decoction), and Qinglong Tang (Azure Dragon Decoction) are particularly clear. It is a pity that he explained only about twenty-plus formulas. For those he did not elucidate, I supplemented them largely with my own insights, drawing from the original notes and books like *Neitai Fangyi*.
9. Many have refuted the *Shanghan Li* (General Principles of Cold Damage). My current verification also follows the consensus. However, within Zhang Zhongjing's complete works, the method of determining diseases based on the four seasons and eight solar terms is the outline of the entire *Shanghan Lun*. Recent books have omitted this entirely, except for authoritative texts like Li Zhongzi's works which still retain the main text. Cheng Wuji did not annotate this part either. I have carefully explained it to show how the Big Dipper's position indicates seasonal climatic shifts. When treating cold damage during these times, physicians must formulate prescriptions according to the seasonal climate to achieve perfect results. Hence, Zhang Zhongjing said, "This requires profound understanding."
10. Since Cheng Wuji's annotation, famous Ming dynasty physicians like Li Dongyuan only briefly mentioned treatment essentials, and Zhu Danxi only raised questions on doubtful points. No one had fully interpreted Zhang Zhongjing's original treatise until Fang Zhongxing, a person from Shexian in the late Ming, wrote *Shanghan Tiaobian* (Differentiated Analysis of Cold Damage) in eight volumes, becoming a significant figure after Cheng Wuji. In the early Qing dynasty, Yu Jiayan expanded on Fang's unelaborated points, writing *Shanglun Pian* (Essays on Ancient Discussions) in five volumes, making him another merit-maker for Zhang Zhongjing. Cheng Jiaoqian followed the intent of these two books to write *Hou Tiaobian* (Subsequent Differentiated Analysis) in six collections, which also has valuable content. The regrettable aspect is that all three authors disrupted the original order of Zhang Zhongjing's Six Chapters. Although each had their theoretical focus on the Six Channels, the original order might reflect Wang Shuhe's incomplete editing, where Zhang's subtle meanings could have been lost due to these new compilations. Furthermore, medical formula books aim to clarify each point to prevent medical errors, rather than adhering strictly to literary continuity as Confucius advised preserving ritual even at the cost of a sheep. Regarding the original order of the Six Channels, I dare not disrupt Wang Shuhe's established structure.
11. In Zhang Zhongjing's Six Chapters, if something previously attached must be moved later, or vice versa, it is called the "Fu Li" (Appendix Rule). If something already annotated appears again in the original text, it is called the "Chong Chu Li" (Repetition Rule). If something mentioned initially in the original text has not yet been annotated and should be appended later, it is called the "Fu Hou Li" (Append Later Rule). Other cases, such as Warm Disease (Wen Bing), Ruined Disease (Huai Bing), and conditions requiring acupuncture, are treated separately in subsequent chapters. Formulas suitable for appendix are handled similarly. Among the Six Chapters, only Cold Syndrome (Zhong Han) represents True Yin Syndrome and is not subject to the above rules, but marked with double circles. True Yin-Cold conditions requiring decoctions are also marked with double circles.
12. Whenever Zhang Zhongjing's discourse or Cheng's annotation is deemed inappropriate in this book, I occasionally cite views from Fang Zhongxing, Yu Jiayan, Cheng Jiaoqian, and other masters. I do not steal their works or names but explicitly attribute them. Occasionally adding my own thoughts, I use the phrase "Yu An" (Humble Commentary); or I set up hypothetical questions and answer them myself.
13. Since this book collects Zhang Zhongjing's discourses, it necessarily appends formulas and discussions from past sages and later generations. These interpretations are my own, clarified item by item. I extensively cite evidence and dare not create private theories, ensuring that discussions are logical and formulas match the disease. I earnestly hope that anyone who reads this book, even when encountering strange variations of cold damage, will find effective treatment methods. Can practitioners not strive for this?