许嗣宗善医。言∶病与药,惟用一物攻之,则气纯而愈速。今人多其物以幸其功,他物
相制
,不能专力。按∶药用一味为单方,施于轻浅之症,何尝不可。古方莫如《内经》半夏秫米
汤、鸡矢醴,雀卵丸,亦并非独用。至孙思邈《千金方》,王焘《外台秘要》,如淮阴用兵
,多多益善。对症施之,其应如响,亦何尝因多药而相制耶?
古之圣王贤臣,始辨药味,原病因以救人疾患,岂小道哉?《周礼》设司医之官,岁终
则稽
其医事,十全为上,十失一次之,十失四为下。上世之见于史传者,惟仓公、扁鹊、淳于意
、华佗,数人而已;魏晋及前明见于方术传者,屈指亦不过百余人耳。可见为名医有着述传
世,亦云难矣!何近来为医之多耶?殆有说焉。天下之广,通都大邑无论矣。穷乡僻壤,必
欲如古之名医,始可为治,非化意兆身,岂能遍哉?其势不得不取其近便,或邀或就,而求
为延医。夫为医者,始则习举业而不售,为商贾而乏资,为农无力,为工不屑。于是手择易
知易
见之方书,春习而夏;而质稍慧者,借病为鹄,渐能知黑道白;其愚者依样葫芦,虽至老死
,终无所得。古来如狄梁公之针难产,海陵王纂之疗邪鬼,皆为一代名臣,非专专于是业者
,而其技仰何神耶!吾愿天下之人,有学而志淡功名,有业而不谋衣食。任聪明年壮之时,
博览古圣前贤之说,更访明理造诣之家,沟求精蕴,志存拯济,为一代善良。可得也耶!可
得也耶!
许嗣宗擅长医术。他说:治病与用药,如果只用一味药来攻治疾病,那么药气纯正,见效就快。现在的人往往增加药物种类以侥幸求取功效,导致其他药物相互制约,不能专心发挥效力。
我认为:药用一味作为单方,施用于轻浅的疾病,何尝不可以呢?古代方剂没有比《内经》中的半夏秫米汤、鸡矢醴、雀卵丸更简单的了,但也不是都只使用单味药。到了孙思邈的《千金方》和王焘的《外台秘要》,(用药之多)就像淮阴侯韩信用兵一样,越多越好。只要对症施用,疗效迅速,又何尝因为药物多而相互制约呢?
古代的圣王贤臣,开始辨别药味,探究病因来救治人们的疾患,这难道是微不足道的小道吗?《周礼》设立了司医这一官职,到年终则考核其医疗事务,治愈十例算上等,失误一例算次等,失误四例算下等。上古时期见于史书记载的,只有仓公、扁鹊、淳于意、华佗这几个人;魏晋及前明时期见于方术传记载的,屈指计算也不过一百多人罢了。可见成为名医并有著述传世,也是很难的啊!为什么近来行医的人这么多呢?大概有其中的原因吧。天下如此广阔,大城市且不用说。穷乡僻壤,如果一定要像古代的名医那样,才可以进行治疗,除非是化身千万,否则怎么能遍及各地呢?形势迫使人们不得不选择就近方便的医生,或者邀请或者前往,以求延请医生。
那些行医的人,起初学习科举文章却考不中,做商人又缺乏资本,务农又无力气,做工又看不惯。于是随手挑选容易理解、容易看到的方书,春天学习夏天背诵;资质稍聪明的人,借治病作为靶子练习,渐渐能分清黑白是非;那些愚笨的人依样画葫芦,虽然直到老死,最终也一无所得。自古以来像狄梁公(狄仁杰)针刺治疗难产,海陵王(杨俊之子,此处指代某位有医术的名臣或传说人物,原文为“海陵王纂”,疑为笔误或特定典故,按原文提取)治疗邪鬼,都是一代名臣,并非专门从事这个行业的人,他们的技艺仰仗什么神奇之处呢!我希望天下的人,有学问而淡泊功名,有职业而不谋求衣食温饱。趁着聪明年壮的时候,博览古代圣贤的说法,再拜访明理造诣深的家庭,深入钻研精微奥义,立志存心拯救救济世人,成为一代善良之人。这能做到吗?这能做到吗!
Xu Sizong was skilled in medicine. He said: "When treating diseases and prescribing medicines, if only one herb is used to attack the disease, the medicinal qi will be pure and the recovery will be faster. Nowadays, people often increase the number of herbs to seek success by chance, causing other herbs to restrain each other, preventing them from exerting their full force."
I observe: Using a single herb as a simple prescription (Danfang) for mild and superficial symptoms is certainly feasible. Ancient prescriptions such as Banxia Shumi Tang (Pinellia and Millet Decoction), Jishi Li (Chicken Dropping Wine), and Queluan Wan (Sparrow Egg Pill) found in *Huangdi Neijing* (The Yellow Emperor's Inner Canon) were not exclusively single-herb formulas. However, in Sun Simiao's *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) and Wang Tao's *Waitai Miyao* (Secret Essentials of the Outer Palace), the use of multiple herbs is abundant, much like Han Xin (Marquis of Huaiyin) deploying troops: the more, the better. As long as they are applied according to the syndrome, the response is immediate, so why should there be mutual restraint simply because of the large number of herbs?
The sage kings and virtuous ministers of ancient times began by distinguishing herbal flavors and investigating the causes of diseases to save people from ailments; how could this be considered a trivial pursuit? The *Rites of Zhou* established the official position of Siyi (Director of Physicians). At the end of each year, they would review medical cases: ten cures with no errors were rated superior, ten cures with one error were rated secondary, and ten cures with four errors were rated inferior. In ancient history, those recorded in historical biographies were limited to figures such as Cang Gong, Bian Que, Chunyu Yi, and Hua Tuo. During the Wei, Jin dynasties and the Ming Dynasty, those recorded in biographies of arts and skills numbered no more than a hundred when counted on fingers. Thus, it can be seen that becoming a famous physician and having works passed down through generations is indeed difficult! Why are there so many physicians nowadays? There must be an explanation. Given the vastness of the world, let alone the metropolises, in remote villages, if one insists on finding a physician comparable to the famous doctors of antiquity to provide treatment, unless one could transform into millions of bodies, how could they cover every place? Under such circumstances, people are forced to choose convenient, nearby options, either inviting or visiting, to seek medical attention.
Those who practice medicine today often started by studying for the imperial examinations but failed, lacked capital for commerce, were physically weak for farming, or looked down upon manual labor. Consequently, they casually selected easy-to-understand and easy-to-see medical formularies, memorizing them from spring to summer. Those with slightly better intelligence used patients as targets for practice, gradually learning to distinguish right from wrong. The foolish ones merely copied patterns blindly; even until death, they achieved nothing. Historically, figures like Di Lianggong (Di Renjie), who treated difficult childbirth via acupuncture, and Hailing Wang Zuan, who treated demonic possession, were all renowned ministers of their generation, yet they were not professionals dedicated solely to this trade. What divine skill did their techniques rely upon? I wish that among the people of the world, those who have learned but are indifferent to fame and official rank, or those who have a profession but do not seek mere livelihood, would take advantage of their youth and sharp minds. They should extensively study the teachings of ancient sages and worthies, visit families with profound understanding and attainment, delve into the essence of medical knowledge, and aspire to save and assist others, thereby becoming benevolent individuals of their era. Is this achievable? Is this achievable?