（潘之淇着）
一、养神明。凡人一身精血从气，气从神。神者，精气之母也。礼曰∶有疾。
疾者斋，养者皆斋。斋也者，清明之至也。心不苟虑，身不苟动，志一气应，达乎
神明，所以理阴阳而迎天庥也。肝主仁。心主礼，肺主义，肾主智，脾主信，性情
之宅也。是故却病法有曰∶静坐观空，觉四大皆从假合，此上之上者也。又曰∶常
将不如我者，巧自宽解。万事到来，以死譬之。庶亦心安意定，清虚日来。又曰∶
时请高明亲友，讲开怀出世之事，亦足以荡涤烦襟，开发志意。若夫愁思缕结，则
神郁于内。内而不出，为滞为幽。暴怒炎攻，则气冲于上。上而不下，为张为蹶。
又或栖栖身后，盼盼妻孥，视眼前一切可欣可喜。难割难舍之物，系恋不已，营度
不休，未有不至于伤生殒命者也。试想到伤生殒命时，那一人能替得我，那一物能
将得去耶。苏东坡曰∶因病得闲殊不恶，安心是药更无方。此真病患一服清凉散也。
一、防邪物。房室不远，则耗其精。劳动不戒，则耗其力。言语不省，则耗其
气，此邪之自内受者也。起居不谨则风露侵，饮食不节则肠胃损，此邪之自外入者
也。健人有此，不免于病，况病者而可以益之毒乎。然病患性情多恣，稍不当意，
忿意生。父母妻子惧其拂也而任之。偏于数事，多所违犯。故病者不可自轻其生，
而侍病者尤不可不慎防密摄，事事留心。若纵其所欲，未有不至于坏者。慎之慎之。
一、戒讳疾。《医家四要》曰∶望、闻、问、切，犹人之有四肢也。一肢废，不
成其为人。一要缺，不成其为医。然必先望、先闻而后切者，所重有甚于切也。乃
病家不知此理，往往秘其所患，以俟医之先言，即以验医之能否。岂知病固有证似
脉同，而所患大相刺谬。若不先言明白，猝持气口，其何能中？昔丹溪有叔祖，年
七十，患泄泻，脉涩而带弦，询其喜食鲤鱼，遂以茱萸、陈皮、生姜、砂糖等药，
探吐胶痰而泻止。又有邻人素患疳疮。夏初泄泻，脉亦涩而弦。丹溪曰∶此下疳之
重者，与当归芦荟丸去麝，四剂而泻止。此两人证似脉同而治之迥别者，以其问之
详，言之明也。又如其人，或先贵后贱，或先贫后富，暴乐暴苦，始乐后苦，及所
思所喜，所恶所欲，所疑所惧之云何。其始病所伤所感，所起所在之云何。以至病
体日逐转变之情形，病后所服药饵之违合，必详言之，则切脉自无疑惑，投剂便可
奏功。若种种讳忌不言，而懵然伸臂授医，使其 邀射覆之一中，是直以性命为戏
也。王海藏曰∶常人求诊，拱默惟令切脉。殊不知气血附于经络，热则脉疾，寒则
脉迟，实则有力，虚则无力。若得病之因与所伤之物，岂能以脉知之乎？苏东坡曰∶
吾疾必尽告医者，使胸中了然，然后诊脉，疑似不能惑也。吾求疾愈而已，岂以困
医为事哉。两翁真高明之见也，病家不可不知。
一、谨微疾。凡服药于微，则其病易疗。若过半而治疗者，什三矣。过七八而
治疗者，什不得一矣。昔齐中尉潘满如小腹痛，仓公诊曰∶病得之酒且内。中尉不
复自止于内。二十八日，当溲血而死。居二十五日，果溲血，三日死。王仲宣年二
十。仲景谓之曰∶君有病，四十岁当眉落，半年而死。授五石汤令服，可免。居数
日，复问之。诡云∶已服汤。仲景曰∶色候固非服汤之诊，君何轻命也。后至期果
如其言，眉落而死。今人染病在身，不自珍惜，罔遵医戒，忽略初机。直至深重，
乃始张惶，卒以丧亡而不救。噫！晚矣。
一、慎药石。病家有三种陋习。一者听信师巫，广行杀戮，祷赛鬼神，而医药
反若可缓，煎调漫托匪人。二者不明药理，旦暮更医，致使源流不清，臧否淆溷，
乱投杂剂，罔知适从。三者自命知医，胶持意见，妄为加减，以掣医人之肘。有此
三弊，虽仓扁无以见其能矣。善养者知之。
（潘之淇著）
一、养神明。凡人的全身精血依赖于气，而气又依赖于神。神，是精气的根本。《礼记》说：人生病时，无论是患病者还是照料者，都应当保持斋戒清净。所谓“斋”，就是达到极致的清明状态。内心不随意思虑，身体不随意动作，意志与气机相应，通达于神明，以此来调理阴阳，迎接上天的福佑。肝主仁，心主礼，肺主义，肾主智，脾主信，这些是性情的居所。因此，有一种祛病的方法叫做：静坐观想虚空，觉得身体的四大（地、水、火、风）都是暂时聚合而成的，这是最高级的方法。又说：经常拿不如自己的人来巧妙宽慰自己。面对万事万物，用死亡来比喻看待它。这样也能使心安意定，清虚之气日渐增长。又说：时常邀请高明的好友亲友，谈论开阔胸怀、超脱世俗的事情，也足以荡涤烦闷的心胸，启发志向心意。如果愁思像丝线一样纠结，那么神就会郁结在体内。郁结在内而不能发散，就会形成停滞和幽暗。突然发怒如火炎上，那么气就会冲逆于上部。冲逆在上而不能下行，就会导致胀满和厥逆。又或者挂念身后的事情，担忧妻儿老小，对眼前一切令人欣喜喜爱、难以割舍的事物，依恋不已，筹划不休，没有不因此伤害生命、导致死亡的。试想一下在伤害生命、导致死亡的时候，哪一个人能替我承受？哪一件物品能被我带走呢？苏东坡说：“因为生病而得到闲暇并不坏，安心才是最好的药方。”这真是病患服用的一剂清凉散。
二、防邪物。房事不知节制，就会耗损精气。劳累过度不加戒备，就会耗损体力。言语过多不懂节省，就会耗损气机，这是邪气从内部受到的损害。起居不慎则受风露侵袭，饮食不节则损伤肠胃，这是邪气从外部侵入的。健康人有这些行为尚且不免于生病，何况是病人，怎么能再增加这种毒害呢？然而病人的性情往往放纵，稍微不如意，愤怒的情绪就会产生。父母妻子害怕违背他的心意而顺从他。偏执于某些事情，多有违犯。所以病人不可轻视自己的生命，而照顾病人的人尤其不可不谨慎防备、严密摄护，事事留心。如果放纵他的欲望，没有不导致病情败坏的。千万要谨慎啊。
三、戒讳疾。《医家四要》说：望、闻、问、切，就像人拥有四肢一样。一只肢体废用，就不成其为人。一个诊法缺失，就不成其为医生。然而必须先望、先闻而后切脉，是因为重视的程度甚于切脉。可是病人不知道这个道理，往往隐瞒自己的病症，以等待医生先说出来，以此验证医生的能力高低。哪里知道疾病确实有症状相似、脉象相同，但实际患的病却大相径庭的情况。如果不先把情况明白地说出来，突然让医生持按气口脉，怎么能切中要害？过去丹溪先生的叔祖，七十岁，患泄泻，脉涩而带弦，询问他喜欢吃什么，得知喜食鲤鱼，于是用吴茱萸、陈皮、生姜、砂糖等药物，探吐胶痰后泄泻停止。又有邻居平时患疳疮，夏初出现泄泻，脉象也是涩而弦。丹溪说：“这是下疳的重症”，给予当归芦荟丸去掉麝香，服用四剂后泄泻停止。这两个人症状相似、脉象相同，但治疗方法截然不同，是因为问诊详细，陈述明确。又如这个人，或者以前尊贵后来卑贱，或者以前贫穷后来富有，突然快乐突然痛苦，开始快乐后来痛苦，以及所思所想所喜好、所厌恶所欲望、所怀疑所恐惧的情况如何。起初发病的原因和感受，起因所在的情况如何。直到病体每天转变的情形，病后所服药物的合适与否，必须详细说出来，那么切脉自然没有疑惑，用药便可奏效。如果种种忌讳不说，茫然伸出胳膊给医生把脉，让医生去猜谜般碰运气，这简直是把性命当儿戏。王海藏说：“普通人求诊，拱手沉默只让医生切脉。殊不知气血依附于经络，热则脉搏快，寒则脉搏慢，实则有力，虚则无力。如果得知生病的原因和所伤之物，怎么能单凭脉象知道吗？”苏东坡说：“我的病一定要全部告诉医生，使医生心中了然，然后诊脉，这样疑似之处就不能迷惑医生。我只求病愈罢了，难道是以难倒医生为事吗？”两位老人的见解真是高明，病人不可不知道。
四、谨微疾。凡是病在轻微时就服药治疗，那么病就容易治愈。如果等到病过半程才治疗，十个人里只能治好三个。如果等到病已七八成重才治疗，十个人里连一个也治不好。过去齐国中尉潘满如小腹痛，仓公诊断说：“这个病得自饮酒且行房事。中尉不再自我节制房事。二十八天后，将会尿血而死。”过了二十五天，果然尿血，三天后死亡。王仲宣二十岁时，张仲景对他说：“您有病，四十岁时眉毛会脱落，半年后死亡。”传授五石汤让您服用，可以避免。过了几天，再次问他，他谎称已经服了汤药。张仲景说：“面色征象本来就不是服用汤药后的表现，您为何轻贱生命呢？”后来到了期限果然像他说的那样，眉毛脱落而死。现在的人染病在身，不自加珍惜，不遵循医嘱，忽略初期的治疗时机。直到病情深重，才开始惊慌失措，最终丧命而无法挽救。唉！太晚了。
五、慎药石。病人家庭有三种陋习。一是听信巫师，大肆杀生，祈祷祭祀鬼神，而医药反而被搁置一旁，煎药调药随意托付给不靠谱的人。二是不明药理，早晚更换医生，致使病因源流不清，好坏混淆，乱投杂药，不知听从谁好。三是自认为懂医，固执己见，妄自行加减药方，以牵制医生的手脚。有了这三种弊端，即使是扁鹊再生也无法施展才能了。善于养生的人应该知晓这一点。
(Pan Zhiqi, Author)
1. Nourish the Spirit (Shen). The essence and blood of the whole body rely on Qi, and Qi relies on the Spirit (Shen, vital spirit/consciousness). The Spirit is the mother of essence and Qi. The Book of Rites states: When one is ill, both the patient and those caring for them should observe abstinence (Zhai, a state of ritual purity and mental clarity). Abstinence refers to reaching the utmost state of clarity and purity. One should not think arbitrarily with the heart, nor move arbitrarily with the body; will and Qi should correspond, extending to the Spirit, thereby regulating Yin and Yang and welcoming heavenly blessings. The Liver governs Benevolence (Ren), the Heart governs Propriety (Li), the Lungs govern Righteousness (Yi), the Kidneys govern Wisdom (Zhi), and the Spleen governs Trustworthiness (Xin); these are the dwellings of temperament and nature. Therefore, there is a method for dispelling disease called: sitting quietly and contemplating emptiness, perceiving that the Four Elements (Earth, Water, Fire, Wind) are merely temporary aggregations; this is the highest level. It is also said: Often comfort yourself cleverly by comparing yourself to those worse off than you. When facing all matters, regard them through the lens of death. This can lead to a calm mind and settled intent, allowing clear and empty energy to increase day by day. It is also said: Frequently invite knowledgeable friends and relatives to discuss matters that broaden the mind and transcend worldly concerns; this is sufficient to cleanse the troubled chest and inspire aspirations. If sorrow and worry are tangled like threads, the Spirit becomes depressed internally. Depressed inside and unable to emerge, it leads to stagnation and obscurity. Sudden anger attacks like fire, causing Qi to rush upward. Rushing upward and failing to descend, it leads to distension and Jue syndrome (reversal cold/heat). Or perhaps worrying about posthumous affairs, fearing for wife and children, clinging endlessly to everything in front of eyes that is delightful and hard to part with, planning ceaselessly; none will not end up harming life and losing their destiny. Try thinking about when life is harmed and destiny lost: who can bear it for me? What object can I take with me? Su Dongpo said: "Gaining leisure due to illness is not bad; calming the mind is the best medicine." This is truly a cooling powder for patients.
2. Guard against pathogenic factors. Sexual activity without restraint depletes Essence (Jing). Labor without caution depletes strength. Excessive speech without conservation depletes Qi; this is pathogenic influence received from within. Irregular living habits allow wind and dew to invade; improper diet damages the intestines and stomach; this is pathogenic influence entering from outside. Even healthy people cannot avoid illness if they have these behaviors, let alone patients who might add such toxicity. However, patients' temperaments are often indulgent; if slightly dissatisfied, anger arises. Parents and wives, fearing to offend him, indulge him. He may be biased in certain matters and frequently violate rules. Therefore, the patient must not slight his own life, and those attending to the patient must be especially cautious, vigilant, and meticulous in every detail. If one indulges his desires, disaster is inevitable. Be extremely cautious.
3. Do not conceal illness. *The Four Essentials of Medical Practice* states: Observation (Wang), Auscultation and Olfaction (Wen), Inquiry (Wen), and Palpation (Qie) are like the four limbs of a person. If one limb is disabled, one is no longer complete as a human. If one essential method is missing, one is no longer a complete physician. However, Observation and Auscultation must precede Inquiry and Palpation because they are valued more highly than palpation alone. Yet patients do not understand this principle; they often conceal their ailments, waiting for the doctor to speak first, thereby testing the doctor's ability. They do not realize that diseases may present with similar symptoms and identical pulses, yet the actual pathology is vastly different. If the situation is not explained clearly beforehand, how can the doctor accurately diagnose by suddenly palpating the radial artery? In the past, Danxi's great-uncle, aged seventy, suffered from diarrhea with a choppy (Se) and wiry (Xian) pulse. Upon asking what he liked to eat, he replied he enjoyed carp. Danxi used Evodia Fructus (Zhuyu), Tangerine Peel (Chenpi), Ginger (Shengjiang), and brown sugar to induce vomiting of sticky phlegm, stopping the diarrhea. Another neighbor, who usually suffered from chancre (Gchuang), developed diarrhea in early summer with a similarly choppy and wiry pulse. Danxi said: "This is a severe case of lower chancre," and prescribed Danggui Luxiao Wan (Angelica and Wormwood Pill) minus Moschus (Shexiang). After four doses, the diarrhea stopped. These two cases had similar symptoms and pulses but required radically different treatments because the inquiry was detailed and the explanation clear. Furthermore, one must ask about the patient's social changes (noble to humble, poor to rich), sudden shifts in emotion (sudden joy or suffering), and their thoughts, preferences, aversions, desires, doubts, and fears. One must know the initial cause of the disease, where it originated, and how the condition changes daily, as well as whether previous medications were appropriate. Only by explaining these details thoroughly can pulse diagnosis be free of doubt and medication be effective. If one conceals information out of various taboos and silently extends an arm for the doctor to feel the pulse, forcing the doctor to guess like solving a riddle, this is treating life as a game. Wang Haicang said: "Ordinary people seeking diagnosis remain silent and only allow pulse taking. They do not know that Qi and Blood attach to the meridians; heat makes the pulse rapid, cold makes it slow, excess makes it forceful, and deficiency makes it weak. If one knows the cause of the disease and what caused the injury, how can it be known solely by the pulse?" Su Dongpo said: "I must tell my doctor everything completely, so that the doctor understands fully before taking the pulse, preventing confusion from similarities. I only seek recovery, not to perplex the doctor." These two sages had truly insightful views; patients must know this.
4. Attend to minor illnesses. If medication is taken while the illness is minor, it is easy to cure. If treatment begins when the illness is half-developed, only three out of ten will recover. If treatment begins when the illness is seven or eight parts advanced, less than one out of ten will recover. In the past, Pan Manru, the Grand Commandant of Qi, suffered from lower abdominal pain. Cang Gong diagnosed: "This disease resulted from drinking alcohol and engaging in sexual intercourse. The Grand Commandant did not restrain himself sexually. Twenty-eight days later, he will pass blood in urine and die." After twenty-five days, he indeed passed blood in urine and died three days later. Wang Zhongxuan was twenty years old. Zhang Zhongjing told him: "You have a disease; at forty, your eyebrows will fall out, and you will die six months later." He prescribed Wushi Tang (Five Minerals Decoction) for him to take to avoid this. A few days later, Zhang asked again. Wang lied, saying he had taken the decoction. Zhang said: "Your complexion does not match the signs of having taken the decoction; why do you slight your life?" Later, when the time came, it happened exactly as predicted; his eyebrows fell out, and he died. Nowadays, people infected with disease do not cherish themselves, ignore medical advice, and neglect the initial stage. Only when the condition becomes severe do they panic, ultimately dying without hope. Alas! It is too late.
5. Be cautious with medicines. There are three vulgar habits among patients' families. First, believing in shamans and witches, slaughtering animals extensively, praying to ghosts and gods, while delaying medical treatment and entrusting decoction and administration to unqualified persons. Second, lacking understanding of pharmacology, changing doctors morning and night, causing the source and flow of the disease to become unclear, mixing good and bad advice, randomly administering mixed prescriptions, and not knowing whom to follow. Third, claiming to know medicine, sticking rigidly to personal opinions, arbitrarily adding or subtracting ingredients, thus hindering the physician's efforts. With these three malpractices, even Bian Que could not demonstrate his skill. Those who know how to properly nourish themselves will understand this.