扁鹊有言∶疾在腠理,熨 之所及;疾在血脉,针石之所及;其在肠胃,酒醪之所及。是针
灸药三者得兼而后可与言医。可与言医者,斯周官之十全者也。曩武谬以活人之术止于药,故弃
针与灸而莫之讲。每遇伤寒、热入血室、闪挫诸疾,非药饵所能愈而必俟夫刺者,则束手无策,
自愧技穷。因悟治病犹对垒,攻守奇正,量敌而应者,将之良;针灸药因病而施治者,医之良也。
夫用药如用刑,误即便隔死生。然刑有司鞫成,然后议定,议定然后书罪。盖人命一死不可
复生,故须如此详谨。用药亦然。今医者至病家,便以所见用药。若高医识病知脉,药相当,如
此即应手作效。或庸下之流孟浪,乱施汤剂,逡巡便至危殆。如此杀人,何太容易?良由病家不
善择医,平日未尝留心于医术也。可不慎哉!(《本草类方》)
世间多有病患亲友故旧交游来问疾,其人曾不经事,未读方书,自骋了了,诈作明能,谈说
异端。或言是
虚,或道是实,或云是风,是云是气。纷纷谬说,种种不同。破坏病患心意,不知孰是,迁延未
就,时不待人。焰然致祸,各自走散。是须好人及好名医,识病深浅,探赜方书,博览古今,方
可倚任,不尔,太误人事。(《千金方》)
相彼天下之人所重者生也,生之所系者医也,医之所原者理也。上古有黄帝岐伯扁鹊华佗,
苏死更生醒魂夺命之术,以至三代而降,学是者疏莽聊略,不致精玄,时时有贼夫人者何也?盖
于阴也而体之以阳,阳也而拟之以阴,虚也而推之以实,实也而度之以虚;外也而揣之以内,内
也而像之以外;急也而料之以缓,缓也而亿之以急;进也而窥之以退,退也而探之以进。孟浪以
诊其脉,浮浅以察其证,苍黄以稽其声,恍惚以征其色。所以颠倒施蒙聩之工,舛差用跣盲之药;
斩绵绵未艾之年,绝婉婉方增之齿;俾含枉而下世,抱屈而归泉。天下之夭折者,诚为庶哉!
嗟嗟!医本活人,学之不精,反为夭折。(《刘党二书·序》)
扁鹊曾说:疾病在皮肤纹理之间,是熨法所能达到的范围;疾病在血脉之中,是针石(针灸)所能达到的范围;疾病在肠胃之内,是药酒(酒醪)所能达到的范围。因此,只有兼通针灸和药物疗法的人,才可以与他谈论医学。能够谈论医学的人,就是《周礼》中所说的“十全”(医术高明、治愈率极高)的医生。
过去我错误地认为救人的技术仅限于药物,所以放弃了针灸而不加研习。每当遇到伤寒、热入血室(邪热侵入子宫或胞宫)、闪挫(扭伤挫伤)等各种疾病时,发现单靠药物无法痊愈,必须等待针刺治疗,这时我就束手无策,自愧技艺穷尽。由此我领悟到,治病如同两军对垒,进攻与防守、奇兵与正兵的运用,能根据敌情灵活应对的是良将;而根据病情施用针灸和药物的是良医。
用药就像执行刑罚一样,一旦失误就会隔绝地狱与生死(导致死亡)。然而刑罚需要经过审讯定罪,定罪之后才能书写罪状。因为人的生命一旦死亡就无法复生,所以必须如此详细谨慎。用药也是如此。现在的医生到了病人家,就根据所见直接用药。如果是高明的医生,能识别病症并知晓脉象,药物使用恰当,就能立刻见效。但如果是庸碌低下的医生轻率鲁莽,乱用汤剂,很快就会导致病情危重。像这样杀人,为何如此容易?这主要是因为病人家属不善于选择医生,平时也没有留心研究医术。能不慎重吗!(出自《本草类方》)
世间常有病患的亲友故交前来询问病情,这些人未曾经历过世事,没有读过医书,却自以为是,假装精通,谈论各种异端邪说。有的说是虚证,有的说是实证,有的说是风邪,有的说是气滞。谬论纷纷,各不相同。这破坏了病人的信心,使其不知谁是谁非,延误了治疗时机,时光不等人。灾祸如火般迅速降临,众人各自散去。因此,必须依靠好人及名医,他们能识别病情的深浅,探究医书的奥义,博览古今医籍,这样才能信赖托付,否则,会严重耽误人事。(出自《千金方》)
看那天下之人所重视的是生命,生命的维系在于医生,医生的根本在于医理。上古时代有黄帝、岐伯、扁鹊、华佗,拥有使死者复生、唤醒灵魂、夺取死神的医术。以至于到了夏商周三代以后,学习医学的人粗疏草率、浅尝辄止,不能达到精深玄妙的境界,为什么时常出现伤害他人生命的情况呢?大概是因为他们在诊断时:阴证却用阳的方法去体察,阳证却用阴的方法去模拟,虚证却用实的方法去推断,实证却用虚的方法去度量;外感病却从内部去揣测,内伤病却从外部去比照;急症却用缓治的方法来料想,缓症却用急治的方法来推测;进补却窥探退法的运用,退法却探查进补的策略。轻率鲁莽地诊察脉象,浮浅地观察症状,惊慌失措地听声音,恍惚不定地审视面色。所以导致颠倒错乱地使用蒙昧无知工匠的手法,差错百出地选用盲目瞎配的药材;斩断了绵延未绝的年轻生命,断送了刚刚成长的少年年华;使得含冤而死的人离开人世,带着委屈归于黄泉。天下夭折的人,确实太多了!唉!医学本是救人的学问,如果学习不精,反而成为导致夭折的原因。(出自《刘党二书·序》)
Bian Que once said: When the disease is in the skin and hair follicles (Couli), it can be reached by moxibustion heat application (Wen); when the disease is in the blood vessels, it can be reached by acupuncture and stone needles (Zhen Shi); when the disease is in the stomach and intestines, it can be reached by medicinal wine (Jiulao). Therefore, only those who are proficient in both acupuncture/moxibustion and herbal medicine can be spoken to regarding medicine. Those who can speak of medicine are what the *Rites of Zhou* calls "perfect ten" (Shiquan - referring to physicians with a high cure rate).
In the past, I erroneously believed that the art of saving lives lay solely in herbal medicine, so I abandoned acupuncture and moxibustion without studying them. Whenever I encountered diseases such as Cold Damage (Shanghan), Heat Entering the Blood Chamber (Re Ru Xue Shi), or sprains and contusions, and found that they could not be cured by herbs alone but required needling, I would be at a loss for measures, feeling ashamed of my limited skills. From this, I realized that treating illness is like military confrontation; employing attack and defense, surprise and orthodox tactics, and responding according to the enemy's situation makes a good general; similarly, applying acupuncture and medicine according to the disease makes a good physician.
Using herbs is like administering punishment; a mistake can separate life from death. However, punishment requires interrogation and conviction before sentencing is written. Since human life, once lost, cannot be regained, such detail and caution are necessary. The same applies to using herbs. Today, physicians go to the patient's home and prescribe medication based on their immediate observations. If a skilled physician correctly identifies the disease and pulse, and the prescription matches the condition, efficacy will be immediate. But if mediocre or inferior practitioners act rashly and indiscriminately administer decoctions, the patient may quickly reach a critical state. Killing people in this manner is too easy. This is largely because patients' families fail to select physicians wisely and have not paid attention to medical knowledge in daily life. Can one not be cautious? (From *Bencao Leifang*)
In the world, it often happens that relatives, friends, and acquaintances of patients come to inquire about the illness. These individuals, having no experience and having never read medical texts, act self-assured and pretend to be knowledgeable, discussing heterodox theories. Some say it is deficiency (Xu), some say it is excess (Shi), some claim it is wind (Feng), others say it is qi stagnation. Such erroneous statements are numerous and varied. They disrupt the patient's mindset, leaving them unsure of what is correct, leading to delays in treatment. Time waits for no one. Disaster strikes swiftly like fire, and everyone scatters. Therefore, one must rely on virtuous individuals and renowned physicians who can discern the depth of the disease, explore the mysteries of medical texts, and have extensive knowledge of ancient and modern medicine. Only then can they be trusted; otherwise, serious mistakes will be made regarding human affairs. (From *Qianjin Fang*)
Observe that among all people in the world, life is highly valued. Life depends on physicians, and physicians depend on medical principles. In ancient times, there were Huang Di, Qi Bo, Bian Que, and Hua Tuo, possessing techniques to revive the dead, awaken souls, and snatch life from death. However, from the Three Dynasties onwards, those who studied medicine were negligent, superficial, and brief, failing to achieve profound and mysterious expertise. Why do they frequently harm others? It is likely that in diagnosis, they treat Yin conditions with Yang methods, simulate Yang conditions with Yin methods, deduce deficiency with excess, and measure excess with deficiency; they speculate on internal issues based on external signs, and infer external conditions from internal states; they estimate acute conditions with slow approaches, and guess chronic conditions with urgent strategies; they peek at retreat methods when advancing, and probe advance methods when retreating. They diagnose pulses rashly, observe symptoms superficially, listen to sounds in panic, and inspect colors vaguely. Consequently, incompetent and confused practitioners make chaotic errors, and blind physicians use mismatched medicines; they cut short young lives that should have continued, and sever the youth of those just growing up; causing the wronged to leave the world and the aggrieved to return to the underworld. The number of premature deaths in the world is indeed vast! Alas! Medicine is originally meant to save lives; if one does not study it thoroughly, it instead becomes a cause of premature death. (From *Preface to Liu Dang Er Shu*)