余自童时。习闻此言。以为伤寒治法。如是之详且备也。及考之成无己注本。则所谓三百九
十七法者。茫然不知所在。于是询诸医流。亦不过熟诵此句而已。欲其条分缕析。以实其数
。则未遇其人。遂乃反复而推寻之。以有论有方诸条数之。则不及其数。以有论有方。有论
无方诸条通数之。则过其数。
除辨脉法。平脉法。
并伤寒例。及可汗。不可汗。可吐。不可吐。可下。不可下诸篇外。止以六经病篇中。有论
有方。有论无方诸条数之。则亦不及其数。以六经病篇。及 湿 霍乱阴阳易瘥后劳复病篇
中。有论有方。有论无方诸条数之。则亦过其数。至以六经病。 湿 霍乱阴阳易瘥后劳复
篇。有论有方诸条数之。则又太少矣。竟不能决。欲以此句。视为后人无据之言而不从。则
疑其或有所据。而或出仲景叔和而弗敢废。欲尊信而必从之。则又多方求合。而莫之遂。宋
林亿等校正伤寒论。其序曰。今校定张仲景伤寒论十卷。总二十篇证外合三百九十七法。余
于是就其十卷二十二篇而求之。其六经篇。霍乱篇。阴阳易瘥后劳复篇中。有方治诸条。以
数为计。又重载于各篇之前。又谓疾病至急。仓卒难寻。复重集诸可与不可方治。分为八篇
。亦以数为计。继于阴阳易瘥后劳复篇之后。其太阳上编。注曰。一十六法。太阳中篇。注
曰。六十六法。太阳下编。注曰。三十九法。阳明篇。注曰。四十四法。少阳篇不言法。太
阴
篇。注曰。三法。少阴篇。注曰。二十三法。厥阴篇。注曰。六法。不可发汗篇。注曰。一
法。可发汗篇。注曰。四十一法。发汗后篇。注曰。二十五法。可吐篇。注曰。二法。不
可
下编。注曰。四法。可下编。注曰。四十四法。汗吐下后篇。注曰。四十八法。以其所注之
数通计之。得三百八十七法。然少阳篇有小柴胡汤一法。其不言者。恐脱之也。又可吐篇。
却有五法。其止言二法者。恐误也。并此脱误四法。于三百九十七法之中。亦仅得三百九十
一法耳。较之序文之说。犹欠六法。乃参之脉经。其可汗。可吐等篇外。比伤寒论又多可温
，可灸可刺。可水。可火。不可刺。不可灸。不可水。不可火诸篇。欲以此补其所欠。则又
甚多。而不可用。元HT 定间程德斋又作伤寒钤法。其自序曰。若能精究是编。则知六经传变
三百九十七法。在于指掌矣。又曰。六经二百一十一法。霍乱六法。阴阳易瘥后劳复六法。
湿 九法。不可汗二十六法。宜汗四十一法。不可吐五法。不可下五法。可汗五法。可吐
五法。余亦以其说通计之。却止得三百一十八法。于三百九十七法中。尚欠七十八法。观其
序文乃如彼。考其所计乃如此。则知其犹未能灼然以得其实数。而无疑也。故下文细数中。
止重叙六经霍乱 湿 阴阳易瘥后劳复诸法而已。彼可汗不可汗等诸法。再不重叙也。近
批
点伤寒论者。何不考其非乃一宗其所钤字号。而不敢少易乎。余由是屏去其说。但即论之本
文。寝食与俱。以绸绎之。一旦豁然始悟其所计之数。于理不通。而
非仲景叔和之说矣。夫伤寒论仲景之所作也。至叔和时已多散落。虽叔和搜采
成书。终不能复其旧。然则今之所传者。非全书也。明矣。后之昧者。乃不察此。必欲以全
书视之。为钤为括断之曰。某经几证。某经几证以谓伤寒治法。略无余蕴矣。殊不知其间有
论无方者甚多。至若前篇引内经所叙六经病证。除太阳少阴证。为后篇所有外。其阳明篇无
目疼。少阳篇言胸胁满。而不言痛。太阳篇无嗌干。厥阴篇无囊缩。若此者。非皆本无也。
必有之。而脱之耳。虽然。为钤括者胶柱调瑟。但知叔和之重载。而莫知其所以重载之意也
。夫叔和既撰次于 采之余。复重载各篇方治。并诸可与不可方治者。非他。不过虑人惑于
纷乱。故示之以简便而已。林亿乃弗解其意。遂不问重与不重。一概通数之。以立总目。
何不观重载八篇之中。其方治者。止有一十五条。为六经篇之所无。其余一百五十三条。皆
六经篇已数过者。安有一法而当两数之理乎。虽程德斋去取。与林亿颇异。然亦五十步。笑
百步耳。其不重数发汗后。并吐汗下后诸法。固为是矣。至于宜汗四十一法。却又俱是一法
当两数者。与林亿所计何以异哉。推原其意。似亦不见林亿所计细数。止闻三百九十七法之
目。遂自就论中。寻而数之。欲以实其总数。然而卒不能实。故为此含糊之说。以欺后人。
反又不逮林亿所言也。窃尝思之。纵使三百九十七法之言。不出于林亿等。而出于亿之前。
亦不足用。此言既出。则后之闻者。必当覆其是非。以归于正。而乃遵守听从。以为千载不
易之定论。悲夫。余今于三百九十七法内。除去重复者。与无方治者。止以有方治。而不
重
复者计之。得二百三十八条。并以治字易法字。而曰二百三十八治。如此则庶或可通也。若
以法言。则仲景一书无非法也。岂独有方者然后为法哉。且如论证论脉。与夫谆谆教戒。而
使人按之以为望闻问切之准则者。其可谓之法乎。其不可谓之法乎。虽然。六经之外诸条。
其二家去取不同。固不必辨。然其于六经之中。尢每有悖理而不通者。姑陈一二。如太阳病
。三日。已发汗。若吐。若下。若温针。仍不解者。此为坏病。桂枝不中与也。观其脉证。
知犯何逆。随证治之。桂枝本为解肌。若其人脉浮紧。发热。汗不出者。不可与之也。常须识
此。勿令误也。若酒客病。不可与桂枝汤。得之则呕。以酒客不喜甘故也。喘家作。桂枝汤
加浓朴杏子佳。凡服桂枝汤吐者。其后必吐脓血也。林亿所校本。则自太阳病。止勿令误也。
为一法。自若酒客病。止杏子佳。为一法。自凡服桂枝汤。止吐脓血也。则为证。不为法。
程德斋钤法。则自太阳病。止随证治之。为一法。自桂枝本为解肌。止必吐脓血也。为一法
。
又林亿本。于病胁下素有痞。连在脐旁。痛引少腹入阴筋者。此名脏结。死。一条。则数为
一法。于其余死不治者。则皆不数。程德斋钤法。于阳明病。下血谵语者。此为热入血室。
但头汗出者。刺期门。随其实而泻之。 然汗出愈。一条。则不数。而太阳刺肝俞。肺俞。
期门。诸条。却又数之而弗遗。余如两条同类。一云当汗而无方。一云当汗而有方。则取其
有
方者。而略其无方者。又如当取而不取。不当取而取者。盖亦甚多。不可悉举。若此者。
悖理不通。二家皆所不免。所谓楚固失矣。齐亦未为得也。苟熟玩论之本文以较其言。则
罅漏出矣。
我自幼时就常听人说起这句话，认为伤寒的治疗方法如此详尽完备。等到我查阅成无己的注本时，却发现所谓“三百九十七法”的地方，茫然不知在哪里。于是向各位医生询问，他们也不过是熟背这一句话罢了。想要让他们条理清晰地分析，以证实这个数量，却从未遇到这样的人。于是我反复推寻考证，如果只计算既有论述又有方剂的条文，则达不到这个数字；如果把既有论述又有方剂、以及有论述没有方剂的条文通盘计算，则超过了这个数字。
除了《辨脉法》、《平脉法》，以及《伤寒例》，还有可汗、不可汗、可吐、不可吐、可下、不可下等篇章之外，仅计算六经病篇中，既有论述又有方剂、以及有论述没有方剂的条文，也达不到这个数字。如果把六经病篇，以及湿病、霍乱、阴阳易、瘥后劳复病篇中，既有论述又有方剂、以及有论述没有方剂的条文通盘计算，又超过了这个数字。如果仅计算六经病、湿病、霍乱、阴阳易、瘥后劳复篇中，既有论述又有方剂的条文，数量又太少了。最终无法决断。想要把这句话视为后人没有根据的言论而不采纳，又怀疑它或许有所依据，可能是张仲景或王叔和所作而不敢废弃；想要尊崇信任并完全遵从它，却又多方寻求符合之处，却无法完全吻合。宋代林亿等人校正《伤寒论》，其序言说：“如今校订张仲景《伤寒论》十卷，总共二十篇，证外合三百九十七法。”我就在这十卷二十二篇中寻求验证。其中六经篇、霍乱篇、阴阳易瘥后劳复篇中有方治的诸条，按数量计算，又在各篇之前重复记载了。又说疾病十分紧急，仓促间难以查找，于是重新汇集各种可与不可治疗的方治，分为八篇，也按数量计算，继在阴阳易瘥后劳复篇之后。其太阳上编，注释说：十六法。太阳中篇，注释说：六十六法。太阳下编，注释说：三十九法。阳明篇，注释说：四十四法。少阳篇未提及法数。太阴篇，注释说：三法。少阴篇，注释说：二十三法。厥阴篇，注释说：六法。不可发汗篇，注释说：一法。可发汗篇，注释说：四十一法。发汗后篇，注释说：二十五法。可吐篇，注释说：二法。不可下编，注释说：四法。可下编，注释说：四十四法。汗吐下后篇，注释说：四十八法。把这些注释的数量通盘计算，得到三百八十七法。然而少阳篇有小柴胡汤一法，那里没写数字，恐怕是脱漏了。又可吐篇，实际上有五法，那里只写两法，恐怕是错误。加上这些脱漏和错误的四法，在三百九十七法之中，也只得到三百九十一法而已。比起序文所说的，还缺少六法。于是参考《脉经》，其在可汗、可吐等篇之外，比《伤寒论》又多出可温、可灸、可刺、可水、可火、不可刺、不可灸、不可水、不可火等篇。想要用这些来补充所缺少的，却又太多且不可使用。元代定年间程德斋又作《伤寒钤法》，其自序说：“如果能精究这部书，就知道六经传变三百九十七法，就在指掌之间了。”又说：“六经二百一十一法，霍乱六法，阴阳易瘥后劳复六法，湿病九法，不可汗二十六法，宜汗四十一法，不可吐五法，不可下五法，可汗五法，可吐五法。”我也把他的说法通盘计算，却只得三百一十八法，在三百九十七法中，尚欠七十八法。看他的序文竟然那样，考察他所计算的数量却是这样，就知道他仍然未能确切地得到真实数量，这是毫无疑问的。所以下文详细计数中，只是重新叙述六经、霍乱、湿病、阴阳易、瘥后劳复诸法而已，那些可汗不可汗等诸法，不再重新叙述。近来批点《伤寒论》的人，为什么不考证它的错误，却一概遵循它所标注的字号，而不敢稍有改动呢？我由此摒弃了这种说法，只就《论》的本文，日夜研读思索，有一天豁然开朗，才明白其所计数的道理不通，并非张仲景、王叔和的说法。《伤寒论》是张仲景所作的。到了王叔和时候已经多有散失脱落，虽然王叔和搜集编纂成书，终究不能恢复旧貌。那么现在所流传的，不是全书，这是很明显的。后来的愚昧之人，不察觉这一点，一定要把它当作全书来看待，制定标准概括断言：某经几证，某经几证，认为伤寒治疗方法，毫无遗漏了。却不知道其中有很多只有论述而没有方剂的。至于前面引用《内经》所叙述的六经病证，除了太阳、少阴证为后篇所有外，阳明篇没有目疼，少阳篇讲胸胁满，却不讲痛，太阳篇没有嗌干，厥阴篇没有囊缩。像这样的情况，并非原本就没有，一定是有的，而脱漏了。虽然如此，那些制定标准概括的人拘泥固执，只知道王叔和的重复记载，却不知道他之所以重复记载的意思。王叔和既然在搜集编纂之余，又重复记载各篇方治，以及诸可与不可方治者，不是为了别的，不过是担心人们被纷乱迷惑，所以展示给他们简便的方法罢了。林亿却不理解这个意思，于是不问重复还是不重复，一概通盘计算，用来确立总目录。为什么不看看重复记载的八篇之中，其中的方治，只有一十五条，是六经篇中没有的，其余一百五十三条，都是六经篇已经计算过的。怎么会有一个法当两个计算的道理呢？虽然程德斋的取舍与林亿颇为不同，但也五十步笑百步罢了。他不重复计算发汗后，以及吐汗下后诸法，固然正确。至于宜汗四十一法，却又都是一法当两数计算的，这与林亿所计算的有什么不同呢？推究他们的意图，似乎也没有看到林亿所计算的细数，只听到三百九十七法的名称，于是自己就在论中寻找并计算，想要证实这个总数，然而最终不能证实。所以做出这种含糊的说法，来欺骗后人，反而还不如林亿所说的。我曾私下思考，即使三百九十七法的说法，不出自林亿等人，而是出自林亿之前的人，也不足为据。这话既已传出，后来听闻的人，必定应当复核其是非，以归于正道，然而却遵守听从，认为是千年不变的定论，可悲啊。我现在在三百九十七法内，除去重复的，以及没有方治的，只以有方治且不重复的来计算，得到二百三十八条。并把“治”字替换“法”字，称为二百三十八治。这样或许可以讲得通。如果以“法”来说，那么仲景的书没有不是法的，难道只有有方剂的才叫作法吗？况且如论证、论脉，以及谆谆教诲告诫，使人按照它们作为望闻问切的准则，这可以称为法吗？不可以称为法吗？虽然如此，六经之外的诸条，这两家的取舍不同，本来不必辨析。然而他们在六经之中，尤其每有违背事理而不通的。姑且陈述一二。如太阳病，三天，已经发汗，如果用吐法、下法、温针，仍然不解的，这叫坏病，桂枝汤不再适用。观察其脉象和证候，知道犯了什么逆乱，随证治疗。桂枝汤本是解肌的，如果病人脉浮紧，发热，汗不出，不可给予它。常常需要记住这点，不要弄错。如果是酒客病，不可给桂枝汤，得了就会呕吐，因为酒客不喜欢甘甜的缘故。患有喘疾的人发作，用桂枝汤加浓朴、杏子较好。凡是服用桂枝汤发生呕吐的，其后必然吐脓血。林亿所校的版本，则从“太阳病”到“勿令误也”，算为一法；从“若酒客病”到“杏子佳”，算为一法；从“凡服桂枝汤”到“吐脓血也”，则为证，不算法。程德斋的《钤法》，则从“太阳病”到“随证治之”，算为一法；从“桂枝本为解肌”到“必吐脓血也”，算为一法。另外林亿本，对于“病胁下素有痞，连在脐旁，痛引少腹入阴筋者，此名脏结，死”一条，计算为一法，对其余死不治的，则都不计算。程德斋《钤法》，对于“阳明病，下血谵语者，此为热入血室，但头汗出者，刺期门，随其实而泻之，濈然汗出愈”一条，则不计算，而太阳刺肝俞、肺俞、期门等条，却又计算而不遗漏。我像两条同类，一条说当汗而无方，一条说当汗而有方，则选取有方的，忽略无方的。又如当取而不取，不当取而取的，大概也很多，不能一一列举。像这样的情况，违背事理不通，两家都未能避免。所谓楚国固然错了，齐国也未必就对。如果熟读玩味《论》的本文来比较他们的言论，那么漏洞就显露出来了。
I have heard this statement since childhood, believing that the treatment methods for cold damage (Shanghan) were so detailed and comprehensive. However, upon consulting Cheng Wuji's annotated edition, I found myself bewildered as to where these so-called "three hundred and ninety-seven methods" were located. I then inquired among physicians, but they merely recited this phrase by rote. When I sought someone who could analyze them systematically to verify the count, none was found. Thus, I repeatedly deduced and searched: if counting only those clauses with both discussion and formula, the number fell short; if counting all clauses with discussion, whether or not accompanied by a formula, the number exceeded it.
Excluding the chapters on Differentiating Pulse Patterns (Bian Mai Fa), Leveling Pulse Patterns (Ping Mai Fa), the Cold Damage Example (Shanghan Li), and the various chapters on permissible and impermissible sweating, vomiting, and purging, and considering only the clauses in the Six Meridian Disease chapters that have both discussion and formula, or discussion without formula, the count still fell short. If including the Six Meridian Disease chapters along with the Dampness (Shi), Huoluan, Yin-Yang Exchange, and Recovery from Labor/Relapse chapters, counting all clauses with or without formulas, the count exceeded it. If counting only those clauses with both discussion and formula in the aforementioned chapters, the number was too small. I could not reach a conclusion. If I dismissed this statement as baseless later addition and rejected it, I suspected it might have some basis, possibly from Zhang Zhongjing or Wang Shuhe, and dared not discard it. If I revered and strictly followed it, I tried多方 to find conformity but failed. In Song Dynasty, Lin Yi and others corrected the *Treatise on Cold Damage* (*Shanghan Lun*), stating in their preface: "We have now collated Zhang Zhongjing's *Treatise on Cold Damage* into ten volumes, totaling twenty chapters, with three hundred and ninety-seven methods outside the disease patterns." I examined these ten volumes and twenty-two chapters. In the Six Meridian, Huoluan, and Yin-Yang Exchange/Recovery chapters, the clauses with formulas were counted, and then repeated at the beginning of each chapter. They also stated that diseases are urgent and hard to find in haste, so they re-collected the permissible and impermissible treatments into eight chapters, again counting them, placed after the Recovery chapter. The Taiyang Upper section is annotated as 16 methods; Taiyang Middle as 66; Taiyang Lower as 39; Yangming as 44; Shaoyang mentions no method count; Taiyin as 3; Shaoyin as 23; Jueyin as 6; Impermissible Sweating as 1; Permissible Sweating as 41; Post-Sweating as 25; Permissible Vomiting as 2; Impermissible Purging as 4; Permissible Purging as 44; Post-Sweating/Vomiting/Purging as 48. Summing these annotations yields 387 methods. However, Shaoyang has one method involving Xiaochaihu Tang, likely omitted due to a lacuna. The Permissible Vomiting chapter actually has five methods, but lists only two, likely an error. Adding these four errors/lacunae to the total gives 391 methods within the claimed 397, still six short of the preface's claim. Consulting the *Pulse Classic* (*Mai Jing*), beyond the permissible sweating/vomiting chapters, there are additional chapters on permissible/impermissible warming, moxibustion, acupuncture, water therapy, and fire therapy. Using these to fill the gap results in an excessive and unusable number. In Yuan Dynasty, Cheng Dezhai wrote *Shanghan Qianfa*, stating in his preface: "One can master the three hundred and ninety-seven methods of Six Meridian transmission at one's fingertips." He further listed: Six Meridians 211, Huoluan 6, Yin-Yang Exchange/Recovery 6, Dampness 9, Impermissible Sweating 26, Suitable Sweating 41, Impermissible Vomiting 5, Impermissible Purging 5, Permissible Sweating 5, Permissible Vomiting 5. Summing these yields only 318 methods, lacking 78 from 397. His preface claims one thing, but his calculation shows another, proving he did not ascertain the true number. Hence, in his detailed list, he only reiterates the Six Meridian, Huoluan, Dampness, Yin-Yang Exchange, and Recovery methods, ignoring the others. Recent annotators of *Shanghan Lun* do not investigate these errors but blindly follow his labels. I discarded this view and studied the original text day and night until I suddenly realized the calculated number was logically inconsistent and not from Zhang Zhongjing or Wang Shuhe. *Shanghan Lun* was written by Zhang Zhongjing. By Wang Shuhe's time, much was lost. Although Shuhe compiled what remained, he could not restore the original. Thus, the extant text is not the complete work. Later ignorant people, failing to realize this, treated it as complete, setting standards like "X Meridian has Y cases," claiming no aspect of cold damage treatment was left out. They ignored that many clauses have discussion but no formula. For instance, quoting *Neijing* on Six Meridian symptoms: Yangming lacks eye pain; Shaoyang mentions chest/hypochondriac fullness but not pain; Taiyang lacks throat dryness; Jueyin lacks testicular retraction. These omissions indicate loss, not absence. Those setting standards were rigid, knowing only of Shuhe's repetitions but not his intent. Shuhe repeated treatments in the eight chapters partly because only 15 were unique to them, while 153 were already counted in the Six Meridian chapters. How can one method be counted twice? Although Cheng Dezhai differed from Lin Yi, he was also flawed. He correctly avoided double-counting post-sweating/vomiting/purging methods, yet in "Suitable Sweating 41," he double-counted methods, just like Lin Yi. Presumably, hearing only of "397 methods," he tried to count them in the text to match the total but failed, offering vague explanations to deceive later generations, performing worse than Lin Yi. Even if the "397 methods" originated before Lin Yi, it is insufficient. Once stated, it should have been scrutinized, yet it was accepted as an immutable truth for millennia—tragic! I now exclude duplicates and formula-less clauses from the 397, counting only unique formula-containing clauses, resulting in 238 "treatments" (Zhi). This makes sense. If using "Method" (Fa), then everything in Zhongjing's book is a method, not just those with formulas. Are discussions on patterns and pulses, and admonitions on diagnosis, not methods? Regarding clauses outside the Six Meridians, the two editors' selections differ, which need not be debated. However, within the Six Meridians, there are illogical inconsistencies. For example, Taiyang disease, after three days and improper treatments (sweating, vomiting, purging, warm needle) remaining unresolved, is termed "ruined disease" (Huai Bing); Guizhi Tang is contraindicated. One must observe pulse and pattern to treat accordingly. Guizhi Tang releases the muscle layer; if pulse is floating-tight, feverish, and anhidrotic, it is contraindicated. Also, patients with alcoholism should not take Guizhi Tang as it causes vomiting due to aversion to sweetness. Asthmatics taking Guizhi Tang may vomit pus and blood. Lin Yi's edition counts "Taiyang disease... do not err" as one method; "Alcoholism... add Polyspora and Apricot Kernel" as another; "Vomiting pus/blood" as a pattern, not a method. Cheng Dezhai's *Qianfa* counts "Taiyang disease... treat according to syndrome" as one method; "Guizhi Tang... vomit pus/blood" as another. Lin Yi counts "Organ Knot (Zang Jie)... death" as one method, excluding other fatal cases. Cheng Dezhai excludes "Yangming disease... heat entering Blood Chamber... puncture Qimen" but includes Taiyang acupuncture points. They selectively include/exclude similar clauses based on presence of formulas or logic, leading to contradictions. Both editors are flawed. Close examination of the original text reveals these loopholes.