医，小道也，精义也，重任也，贱工也。古者大人之学，将以治天下国家，使无一夫不
被其
之近，不能兼及。况乎不可治者，又非使能起死者而使之生，其道不已小乎？虽然，古圣人
之治病也，通于天地之故，究乎性命之源，经络、脏腑、气血、骨脉，洞然如见，然后察其
受病之由，用药以驱除而调剂之。其中自有玄机妙悟，不可得而言喻者，盖与造化相维，其
义不亦精乎？道小，则有志之士有所不屑为，义精，则无识之徒有所不能窥也。人之所系，
莫大乎生死。王公大人，圣遇豪杰，可以旋转乾坤，而不能保无疾病之患。一有疾病，不得
不听之医者，而生杀唯命矣。夫一人系天下之重，而天下所系之人，其命又悬于医者。下而
一国一家所系之人更无论矣，其任不亦重乎？而独是其人者，又非有爵禄道德之尊，父兄师
保之重。既非世之所隆，而其人之自视，亦不过为衣服口食之计。虽以一介之微，呼之而立
，至其业不甚贱乎？任重，则托之者必得伟人；工贱，则业之者必无奇士。所以势出于相违
，而道因之易坠也。余少时颇有志于穷经，而肉数人疾病连年，死亡略尽。于是博览方书，
寝食俱废。如是数年，虽无生死骨肉之方，实有寻本溯源之学。九折臂而成医，至今尤信。
而窃概唐宋以来，无儒者为之振兴，视为下业，逡巡失传，至理已失，良法并亡。 焉伤怀
，恐自今以往不复有生人之术。不揣庸妄，用敷厥言，倘有所补所全者，或不仅一人一世已
乎？
乾隆丁丑秋七月洞溪徐大椿书于吴山之半松书屋
医学，是一门看似微小、实则义理精深、责任重大，却被视为低贱技艺的学问。古代君子求学，旨在治理天下国家，使没有一个人不被恩泽所及，（因为事务繁杂）不能兼顾到细微之处。况且那些无法治愈的疾病，又不是能让死者复生，这难道不是显得医术渺小吗？虽然如此，古代圣人治病，通晓天地运行的规律，探究生命本源的奥秘，对于经络、脏腑、气血、骨脉等，看得清清楚楚，然后观察病人受病的缘由，用药来驱除病邪并调理身体。这其中自有玄妙奥悟，难以用言语形容，大概是与造化自然相维系，其义理不也是极其精深吗？如果认为道术微小，那么有志之士就会不屑于从事；如果义理精深，那么无见识的人就无法窥探门径。人所牵挂的，没有比生死更大的了。王公大人、圣明君主、英雄豪杰，可以扭转乾坤，但不能保证没有疾病的祸患。一旦患病，不得不听命于医生，生死掌握在医生手中。一个人的性命系于天下的重任，而天下所依赖之人的性命又悬于医生之手。下至一国一家所依赖的人更不用说了，这责任不也是重大吗？然而唯独行医之人，又没有爵位俸禄的道德尊贵，也没有父兄师保那样的地位重要。既然不为世俗所推崇，而他们自己看待自己，也不过是为了衣食生计。虽然身份卑微，一呼即应，但这行业不是很低贱吗？责任重大，所以托付者必须得到伟人；行业低贱，所以从业者必然没有奇士。因此形势相互违背，道统因此容易坠落。我年轻时颇有志于穷究经书，但亲戚朋友多年疾病缠身，死亡殆尽。于是博览医方书籍，废寝忘食。这样过了几年，虽然没有起死回生的秘方，确实有寻本溯源的学问。“九折臂而成医”，至今我尤其相信。但我私下感慨唐宋以来，没有儒者来振兴它，将其视为卑下的职业，导致犹豫不前、失传，至理已经丧失，良法一并消亡。为此感到悲伤，恐怕从今以后不再有救活人的技术。不顾平庸狂妄，陈述我的言论，倘若有所补益保全，或许不仅限于一人一世吧？
乾隆丁丑年秋七月，洞溪徐大椿写于吴山半松书屋
Medicine is a seemingly minor art, yet it possesses profound principles and heavy responsibilities, while being regarded as a lowly craft. In ancient times, the learning of great men aimed to govern the world and the state, ensuring that not a single person was left without receiving its benefits; (due to the complexity of affairs) they could not attend to every minute detail. Moreover, regarding diseases that are incurable, medicine cannot bring the dead back to life; does this not make the art appear insignificant? Nevertheless, when the sages of old treated diseases, they understood the laws of heaven and earth, investigated the source of life and nature, and clearly perceived the meridians (Jingluo), zang-fu organs, qi and blood, bones, and vessels. Then, they observed the cause of the disease and used herbs to expel pathogens and regulate the body. Within this process lies profound mystery and intuitive insight, which cannot be fully expressed in words; it seems to be intertwined with creation itself, making its principles indeed extremely refined. If the Dao is considered minor, then those with ambition will disdain to practice it; if the principles are too profound, then the ignorant will be unable to penetrate them. Nothing is more significant to humans than life and death. Princes, ministers, sage rulers, and heroes can turn the tide of history, but they cannot guarantee immunity from illness. Once ill, they must submit to the physician, with life and death at his disposal. The fate of an individual carries the weight of the world, and the lives of those upon whom the world relies hang in the balance of the physician's hands. This applies even more so to those relied upon by a nation or a family; thus, is not the responsibility immense? Yet, the physician himself lacks the noble status conferred by rank and salary, nor does he hold the authority of fathers, brothers, teachers, or guardians. Since he is not esteemed by society, and views his own role merely as a means to secure clothing and food, although humble in status and ready to respond to any call, is not this profession considered lowly? Because the responsibility is heavy, those who entrust their lives must find a great man; because the profession is lowly, those who engage in it are rarely extraordinary talents. Thus, the circumstances contradict each other, and the Dao easily falls into decline. In my youth, I had ambitions to thoroughly study the Classics, but relatives and friends suffered from illnesses for years, and many died. Consequently, I extensively studied medical texts, neglecting sleep and food. After several years, although I possessed no miraculous prescriptions to reverse death, I did acquire the learning of tracing origins and seeking roots. "Nine broken arms make a physician," a saying I still firmly believe. However, I secretly lament that since the Tang and Song dynasties, no Confucian scholars have revitalized this field, viewing it as a subordinate occupation, leading to hesitation and loss of transmission. The profound truths have been lost, and good methods perished together. I am deeply grieved, fearing that henceforth there will be no techniques to save lives. Presuming my mediocrity and presumption, I present these words. If they offer any benefit or preservation, perhaps they will extend beyond just one person or one generation?
Written by Xu Dachun of Dongxi in the Half-Pine Study on Wu Mountain, in the seventh month of autumn, Ding Chou year of Qianlong.