易曰。天地 。万物化醇。男女构精。万物化生。盖人之生也。必禀天地之正气以成
形。藉阴阳之化育而赋命。而上古元气浑庞。太和洋溢。八风正而寒暑调。六气和而雨 若
。人情朴实。风俗贞纯。是以上古之民。恒多寿而少病。即内经所谓上古之人。和于阴阳。
明于术数。起居有度。不妄作劳。春秋皆度百岁而去者是也。迨于后世。元气渐薄。风俗烦
偷。人情穿凿。名利有不时之扰。嗜欲多无厌之求。是以近日之民。恒多病而少寿。即内经
所谓中古之人。以酒为浆。以妄为常。醉以入房。以欲竭其精。以耗散其真。不知持满。不
时御神。未至半百而衰者是也。夫以黄帝之时。即称中古。迄今复数千年来。权其气化。不
更薄耶。是凡习儿医者。须知今昔气运不同。禀赋根 愈薄。凡于小儿之病。更宜加意培植
。保护元气。不可妄用攻伐之剂。以贻人夭札之祸也。乃近日幼科。不明此理。动辄攻伐。
而又绝其乳食。其呱呱者。口不能言。任医冤杀。束手待毙。底于死亡。悲夫。此等恶习。
不知始自何人。遂至相习成风。流祸无已。愚夫愚妇。溺于其说。至死不悟。为婴儿之大患
而惟扬属为尤甚。吁可恨也。至若书称若药弗瞑眩。厥疾弗瘳。此盖当时因事取譬之辞。非
教人
谓芽儿者。如草木之萌芽。其一点方生之气甚微。栽培护养。惟恐不及。而堪加之以剥削之
挠。施之以斧斤之利乎。此诚不可也。原夫易无妄九五爻辞云。无妄之疾。勿药有喜。象曰
。无妄之药。不可试也。观此则知圣人或亦有以鉴夫瞑眩之非。故特示勿药有喜之戒。而我
夫子亦有未达不敢尝之语。又张仲景先生伤寒论内。亦有勿药为中工之训。又张子和着儒门
事亲书。其中有语友人陈敬之云。小儿有病。不如勿用庸医。但恐妻外家怪其不医。宜用汤浸
蒸饼令软。丸作白丸。给其妻外家。以为真药。服之以听天命。最为上药。后丙戌岁。群儿
病泄泻。用药者皆死。惟敬之守子和之戒。其儿虽病。得以无恙。以上所引。一为圣人之至
训。一为名医之精论。载在简册。昭于日月。人第习而不察耳。夫以伤寒剧病。抑且可以勿药
。而况小儿气血几何。岂可委之以庸医之手。试之以无妄之药乎。此子和之所以教敬之之
不服药为愈也。仆承师训。久悯于此。欲效忠告之良谋。用救方今之恶习。爰列若干门于
后。以贻夫世之贵小儿而好服药者。奉为金鉴云。
《易经》说：“天地交感，万物化育醇厚；男女交合，万物由此化生。”大概人的诞生，必须禀受天地的正气来形成形体，借助阴阳的化育作用而赋予生命。上古时期元气浑厚庞博，太和之气洋溢，八风（指来自八个方向的风，古人认为与气候及疾病有关）正常而寒暑调和，六气（指阴、阳、风、雨、晦、明六种自然气象变化）和顺而雨水适时。人情朴实，风俗贞洁纯正。所以上古时代的百姓，大多长寿而少病。这就是《黄帝内经》所说的上古之人，能与阴阳和谐相处，通晓养生术数，起居有节制，不妄自劳作，活到百岁才离世的情况。
到了后世，元气逐渐变薄，风俗变得浮躁苟且，人心变得巧诈穿凿，名利不时地扰乱身心，嗜欲多有无休止的追求。因此近代的百姓，大多多病而短寿。这就是《黄帝内经》所说的中古之人，把酒当作浆水喝，把妄为当作常态，醉酒后行房事，因欲望耗尽精气，因耗散而流失真气，不知道保持精气的充盈，不能适时地驾驭精神，不到五十岁就衰老了的情况。
以黄帝那个时代，就已经被称为“中古”，到现在又过了几千年，权衡其气化运行，难道不是更变薄了吗？所以凡是学习儿科医学的人，必须知道古今的气运不同，小儿禀受的根基更加薄弱。对于小儿的疾病，更应该注意培植和保护元气，不可妄用攻伐的药物，以免留下让人早夭的灾祸。
然而近日的小儿科医生，不明白这个道理，动辄使用攻伐之法，又断绝乳食。那些刚出生的婴儿，口不能言，任由医生冤杀，束手待毙，最终导致死亡，真是可悲啊！这种恶劣的习俗，不知始于何人，以至于相沿成风，流祸无穷。愚昧的夫妇沉溺于这种说法，至死都不醒悟，成为婴儿的大患，其中扬州地区尤为严重，令人痛恨。
至于书中说“如果服药后没有瞑眩反应，疾病就不会痊愈”，这大概是当时借事取喻的说法，并不是教导人们说：婴儿就像草木的萌芽，那一点刚刚产生的元气非常微弱，栽培护养还唯恐来不及，怎么能够加以剥削干扰，施加斧斤般的伤害呢？这确实是不可以的。
考察《易经》无妄卦九五爻辞说：“无妄之疾，勿药有喜。”《象传》说：“无妄之药，不可试也。”看这一点就知道圣人或许也有鉴于“瞑眩”并非良策，所以特别示警不要用药反而有喜。我们的孔子也有“未达不敢尝”的话语。另外张仲景先生在《伤寒论》中，也有“勿药为中工之训”的教诲。还有张子和撰写《儒门事亲》一书，其中有对友人陈敬之说的话：“小儿有病，不如不用庸医。只是恐怕妻子和外家责怪他不医治，应该用汤浸泡蒸饼使其变软，丸作白色药丸，欺骗其妻外家，作为真药给他们服用，以此听凭天命，这才是最好的药。”后来丙戌年，许多儿童患泄泻病，用药治疗的都死了，只有陈敬之遵守张子和的告诫，他的孩子虽然生病，得以安然无恙。以上所引用的，一个是圣人的至高训诫，一个是名医的精辟论述，记载在书籍上，昭如日月。人们只是习惯而不察觉罢了。
以伤寒这种重病，尚且可以不用药，何况小儿气血几何，岂可委托给庸医之手，尝试那些无妄之药呢？这就是张子和之所以教导陈敬之“不服药为愈”的原因。我秉承师训，长久以来对此感到怜悯，想要效法忠告的良好谋略，用以挽救当今的恶劣习俗。于是列出若干门类在后面，留给世上珍爱小儿却喜好服药的人，奉为黄金鉴戒。
The *I Ching* (Book of Changes) states: "When Heaven and Earth interact, the transformation of all things becomes rich and substantial; when male and female combine their essence, all things are born." Generally, human life is formed by inheriting the upright Qi (vital energy) of Heaven and Earth, and is endowed with destiny through the nurturing transformation of Yin and Yang. In ancient times, the primordial Qi was profound and complete, and the Great Harmony (Taihe) permeated everywhere. The Eight Winds (winds from eight directions, associated with climatic factors and diseases) were regular, and cold and heat were balanced. The Six Qi (the six natural atmospheric changes: Yin, Yang, Wind, Rain, Obscurity, and Brightness) were harmonious, and rain fell in due season. People's sentiments were simple and honest, and customs were pure and upright. Therefore, people in ancient times were often long-lived and rarely ill. This corresponds to what the *Huangdi Neijing* (Yellow Emperor's Inner Canon) describes as people of antiquity who harmonized with Yin and Yang, understood the arts of longevity, maintained regulated daily routines, did not labor wantonly, and lived beyond a hundred years before passing away.
In later generations, however, the primordial Qi gradually became thin, customs grew frivolous and lax, and people became cunning and contrived. Disturbances of fame and profit occurred irregularly, and desires involved endless demands. Consequently, people in recent times suffer from frequent illness and short lifespans. This aligns with the *Neijing*'s description of people of middle antiquity who treated wine as water, made recklessness a habit, engaged in sexual intercourse while intoxicated, exhausted their essence through desire, dissipated their true Qi, failed to maintain fullness, did not regulate their spirit in time, and showed signs of decline before reaching fifty.
Even during the time of the Yellow Emperor, the era was already referred to as "middle antiquity." Since then, thousands of years have passed. Judging by the transformation of Qi, has it not become even thinner? Therefore, anyone studying pediatrics must understand that the Qi and fortune of the present differ from the past, and children's constitutional roots are increasingly weak. Regarding pediatric diseases, one must pay special attention to cultivating and protecting the Yuan Qi (primordial vital energy), and must not recklessly use attacking or purgative formulas, lest one bring about the disaster of premature death.
Yet, in recent pediatric practice, doctors fail to grasp this principle. They frequently employ attacking methods and further deprive infants of milk and food. These newborns, unable to speak, are left at the mercy of physicians who unjustly cause their deaths, helpless and awaiting demise, ultimately leading to death. How tragic! This vicious custom, originating from an unknown person, has become prevalent, causing endless harm. Ignorant men and women are drowned in these theories, remaining unenlightened until death, creating major hazards for infants. This is particularly severe in the Yangzhou region, which is truly detestable.
As for the saying in books, "If the medicine does not produce a dizzying reaction (mingxuan), the disease will not be cured," this was likely a metaphorical expression used at the time, not an instruction to treat infants as if they were sprouting plants. An infant's nascent Qi is extremely fragile. Cultivation and protection are done with fear of insufficiency; how could one subject them to exploitation and disturbance, applying the sharpness of axes and hatchets? This is certainly inadmissible.
Examining the line text of the Ninth Five position in the Wu Wang (Without Falsehood) hexagram of the *I Ching*: "Diseases arising without falsehood, do not use medicine; there will be good fortune." The *Xiang Zhuan* (Image Commentary) states: "Medicine arising without falsehood should not be tested." From this, we can see that sages may have had reservations about the efficacy of "dizzying reactions" and thus specifically warned against using medicine, suggesting that refraining from medication brings auspicious results. Our Confucius also said, "When I do not fully understand something, I dare not taste it." Furthermore, in his *Shanghan Lun* (Treatise on Cold Damage), Mr. Zhang Zhongjing included the teaching that "refraining from medication is the mark of a competent physician." Additionally, in his book *Rumen Shiqin* (The Confucian Approach to Medicine), Zhang Zihe wrote to his friend Chen Jingzhi: "When a child is ill, it is better not to use quack doctors. However, fearing that his wife and her family would blame him for not treating, he should soak steamed cakes in decoction until soft, form them into white pills, deceive his wife's family by presenting them as real medicine, and let them take it to await fate. This is the best medicine." Later, in the Bingxu year, many children suffered from diarrhea. Those who used medication all died, whereas Chen Jingzhi adhered to Zhang Zihe's advice; although his children were ill, they remained safe. The above citations include one supreme teaching from a sage and one profound discussion from a renowned physician, recorded in books and shining like the sun and moon. People merely follow them out of habit without scrutiny.
Given that even severe conditions like Shanghan (Cold Damage) can be managed without medication, how much more so for children with limited Qi and Blood? How can they be entrusted to quacks and subjected to reckless medications? This is why Zhang Zihe taught Chen Jingzhi that "not taking medicine leads to recovery." I, having inherited my master's teachings, have long lamented this situation. Desiring to offer loyal advice and remedy the current vicious practices, I have listed several categories below, to serve as a golden mirror for those in the world who cherish their children yet favor medication.