中之为道,无所不涵,无所不彻,推之医理,尤不可忽。盖万病由于乖戾,用药惟以调和,益其不足,损其有余,
温凉攻补,必归于中而后可。夫中者,不偏不倚,无过不及之谓也。故中无定体、随时而在,一病有一中,不可偏向一
病,而今日如此为中,明日如彼为中,慎勿固执。且同一病而此,则如此为中者,彼则如此而又非中,无穷活变。故中
者,如权之称物,如镜之取火,少越焉,太过矣;少退焉,不及矣;总在死机之顺应也。医之中道,非不寒、不热,不
补、不泻之谓,中病即是中,中病而毫无偏倚,毫无过不及,即是至中。是以补如参、地,泻如硝、黄,热如姜、附,
寒如膏、连,散如麻、桂,毒如虻、蛭,合宜而用,何一非大中之理乎,是在平时穷理精而辨症明,则临病自生变
化,能统万理于一原,自能通一心于万事也。尝怪前贤往哲,代不乏人,其聪明才辩之资,纵横反复,蹈奇入险,固皆
医林之杰也,然而适中者寡矣。《书》曰,“允孰厥中。”子曰∶中庸不可能也,医虽小道,何独不然?
仲景《伤寒》书为叔和编次,已失其真,即林亿校本,亦已难得,今世所传,惟成无已注释之本而已。至三百九十
七法,莫不津津乐道,而究鲜确指。汪苓友亦云∶前人所未明言,其引张孝培《伤寒类疏》桂枝汤服后至以助药力为一
法,温覆至如水流漓又一法,称与诸家不同,顾吾不知其何本而有此。考前明有吾虞赵开美翻刻宋板《伤寒论》全文,
其三百九十七法,于每篇之首注共几法,先则节录原文,开明第一、第二,次于原文之下,复列一、二、三之数,总计
全
书治法,了如也。但不知出自叔和,出自林亿,今之传本亡之者,殆为无己所删乎?后人未见宋刻,茫然不晓,如王安
道亦未之见也。国朝王晋三虽于每方之下注以各法,亦不过继张孝培、汪苓友之志而爱礼存羊,究有未能悉洽者。故愚
以为注书不应改移,止宜就文辨论,如朱子之贤,阙文错简,皆仍其旧,无已何人,而乃擅削,以致迄今,盈庭聚讼也。
仆先祖笠山公,精于医理,傅极群书,临症之暇,静坐小斋,手不释卷,虽至老不倦。于暮年采取诸同学高论,辑
成《吴医汇讲》行世。旧存见闻篇什,及诸公送来佳作,先祖必反复细阅,再商之二三老友,考订尽善,方始付梓。是
以采取者果多,存止者亦复不少,缘集行海内,同人之公论系焉,不苟采选,可见仆先祖慎且重也。选至十一卷周省吾
先生佳章之后,忽抱沉 ,于辛酉岁辞世,迄今十四载矣,痛音容之已杳,幸《汇讲》之流传。庆耆仅守遗板,即以十
一卷第八页省吾先生佳作为止。庆耆年幼无知,不能克承家学,医林典籍,未经探讨,虽承佳章赐教,不敢续入集内,
所以遵先祖慎采之遗意也。爰书数语,附于简末。
嘉庆十九年岁次甲戌春正月孙男庆耆百拜谨识
中医的“中道”这一理念,无所不包,无所不通,推演到医学原理上,尤其不可轻视。大概万病产生于阴阳气血的乖张悖逆,用药只在于调和,补益其不足,削减其有余,无论是温法、凉法、攻法还是补法,必须归于“中”的原则之后才能施行。所谓“中”,就是不偏不倚,没有过度也没有不及的意思。所以“中”没有固定的形态,而是随着时机变化而存在,一种病有一个“中”的标准,不能固执地偏向某一种病,认为今天这样是“中”,明天那样也是“中”,千万不要固执己见。况且同样的病,在此处如此处理算是“中”,在彼处如此处理却又不是“中”,变化无穷,灵活多变。因此,“中”就像秤称量物体一样,稍微偏离一点,就太过分了;稍微退后一点,又不够了;关键在于顺应疾病变化的机理。医生的“中道”,不是说不用寒药、不用热药、不补也不泻,而是药力恰好击中病灶就是“中”,击中病灶且毫无偏倚,毫无过与不及,这就是最高的“中”。所以,像人参、地黄这样的补药,像芒硝、大黄这样的泻药,像干姜、附子这样的热药,像石膏、黄连这样的寒药,像麻黄、桂枝这样的发散药,像虻虫、水蛭这样的有毒破血药,只要合乎病情使用,哪一个不是符合“大中至正”的道理呢?这取决于平时对医理探究精深且辨证明确,那么面对疾病自然能产生变化,能将万理统摄于一个本源,自然能通晓一心应对万事。我曾奇怪前代的贤哲,代代不乏其人,他们凭借聪明才智和辩才,纵横捭阖,反复推敲,涉足奇险之境,固然是医学界的杰出人物,然而能达到“适中”境界的却很少。《尚书》说:“确信并持守中正之道。”孔子说:“中庸之道是不可能完全做到的。”医学虽然是小道,难道唯独例外吗?
张仲景的《伤寒论》经过王叔和编次整理,已经失去了原本的真貌,即使是林亿校订的版本,现在也难以得到,当今世间流传的,只有成无己注释的本子罢了。至于书中提到的三百九十七法,人们无不津津乐道,但究竟很少有确切的指认。汪苓友也说:前人没有明确说明这一点,他引用张孝培《伤寒类疏》中的观点,认为桂枝汤服用后喝热粥以助药力算作一法,温覆身体直到大汗淋漓如水流下又算作一法,声称这与各家说法不同,但我不知道他依据的是什么版本而有此说法。考察前明时期,我们虞地的赵开美翻刻了宋版《伤寒论》全文,其中关于三百九十七法,在每篇之首注明共有几法,先节录原文,标明第一、第二,然后在原文之下,再列出第一、第二、第三等数字,总计全书治法,清晰明了。只是不知道这些内容出自王叔和,还是出自林亿,如今流传的版本中这部分缺失了,大概是成无己删减掉的吧?后人没有见过宋刻本,茫然不知晓,比如王安道也没有见过。本朝的王晋三虽然在每个方剂之下注以各法,也不过是继承张孝培、汪苓友的志向,为了保存礼制形式而保留羊皮(比喻保留部分精华),终究有不能完全契合原意的地方。所以我以为注释书籍不应该随意改动移易,只应当就着文章进行辨析讨论,像朱熹那样的贤人,遇到缺文错简,都仍然保持旧貌,成无己是什么人,竟然擅自删削,导致至今争论不休。我的先祖笠山公,精通医理,博览群书,在临症之余,静坐小斋,手不释卷,即使到了老年也不疲倦。在晚年时,他采纳各位同学的精辟论述,编辑成《吴医汇讲》流行于世。对于旧存的见闻篇章,以及各位先生送来的佳作,先祖必定反复细读,再与两三位老友商量,考证订正达到完美,才交付刻印。因此,采纳的内容确实很多,最终保留下来的也不少,因为集子行销海内外,代表了同仁们的公论,不苟且采选,可见我的先祖谨慎且重视。选录到第十一卷周省吾先生的精彩文章之后,他突然患上重病,在辛酉年去世,到现在已经十四年了,悲痛于音容笑貌已杳无踪迹,庆幸《汇讲》得以流传。庆耆仅守着遗留的刻板,就以第十一卷第八页周省吾先生的佳作作为结尾。庆耆年幼无知,不能继承家学,医学典籍未曾深入探讨,虽然承蒙佳章赐教,不敢续入集内,所以遵循先祖谨慎采选的遗愿。于是写下这几句话,附在书简末尾。
嘉庆十九年岁次甲戌春正月孙男庆耆百拜谨识
The "Middle Way" (Zhong Dao) in medicine encompasses everything and penetrates all things; when extended to medical principles, it is particularly important not to neglect. Generally, myriad diseases arise from the discordance and perversity of physiological states, and medication should only aim at harmonization: tonifying deficiencies and reducing excesses. Whether employing warming, cooling, purging, or tonifying methods, they must ultimately return to the principle of the "Middle" before they can be applied. The "Middle" refers to being neither biased nor leaning, without excess or deficiency. Therefore, the "Middle" has no fixed form but exists according to circumstances; each disease has its own standard of the "Middle." One cannot rigidly adhere to a specific bias for one disease, thinking that what constitutes the "Middle" today will be the same tomorrow. One must be cautious against stubbornness. Moreover, for the same disease, a certain approach may constitute the "Middle" in one context, while in another context, even if similar, it may not be the "Middle," demonstrating infinite flexibility. Thus, the "Middle" is like a scale weighing objects: deviate slightly, and it is excessive; retreat slightly, and it is insufficient; it always lies in adapting to the dynamic changes of the pathology. The physician's "Middle Way" does not mean avoiding cold, heat, tonification, or purgation; rather, hitting the target of the disease is the "Middle." Hitting the target with absolutely no bias, no excess, and no deficiency is the ultimate "Middle." Therefore, tonics like Ginseng Radix et Rhizoma (Renshen) and Rehmanniae Radix (Dihuang), purgatives like Natrii Sulfas (Xiaomangxiao) and Rheii Radix et Rhizoma (Dahuang), hot herbs like Zingiberis Rhizoma (Jiang) and Aconiti Lateralis Radix Praeparata (Fuzi), cold herbs like石膏 (Shigao) and Coptidis Rhizoma (Huanglian), dispersants like Ephedrae Herba (Mahuang) and Cinnamomi Ramulus (Guizhi), and toxic blood-breaking agents like Tabanidae (Mengchong) and Hirudo (Shizhi)—when used appropriately, which one does not embody the principle of the Great Middle? This depends on thoroughly investigating principles during ordinary times and clearly differentiating syndromes, so that when facing illness, one naturally generates adaptations, unifying myriad principles into one source, thereby comprehending all matters through a single mind. I often marvel that among past sages and worthies, who are numerous across generations, although their intelligence and eloquence allow them to maneuver freely, explore extremes, and venture into dangerous territories—making them outstanding figures in the medical field—few truly achieve the state of "appropriateness" (Zhong). The Book of Documents states, "Sincerely hold fast to the Middle." Confucius said, "The practice of the Mean is impossible for a long time." Medicine, though a minor art, why would it be an exception?
Zhang Zhongjing's *Treatise on Cold Damage* (*Shanghan Lun*) was compiled and arranged by Wang Shuhe, having already lost its original authenticity. Even the edition collated by Lin Yi is now difficult to obtain; what circulates in the world today is merely the version annotated by Cheng Wuji. Regarding the 397 methods mentioned therein, people speak of them with great enthusiasm, yet few provide precise definitions. Wang Lingyou also stated: "Predecessors did not explicitly clarify this." He cited Zhang Xiaopei's *Classification of Cold Damage Syndromes*, noting that taking Guizhi Tang (Cinnamon Twig Decoction) followed by drinking hot porridge to assist medicinal power counts as one method, and covering oneself until sweating profusely like flowing water counts as another method, claiming this differs from other schools. However, I do not know what basis he had for this. Examining the Ming Dynasty, Zhao Kaimai from our region of Yu reprinted the Song edition of the full text of *Shanghan Lun*. In this edition, regarding the 397 methods, at the beginning of each chapter, it noted the total number of methods, first excerpting the original text and marking First, Second, etc., then below the original text, listing numbers one, two, three again, totaling the treatment methods of the entire book clearly. It is unknown whether these originated from Wang Shuhe or Lin Yi; in current transmitted versions, this part is missing, likely deleted by Cheng Wuji? Later generations, having never seen the Song block prints, were ignorant and confused; for instance, Wang Andao also did not see them. In our dynasty, Wang Jin-san annotated various methods under each formula, but this merely continued the intentions of Zhang Xiaopei and Wang Lingyou, preserving fragments out of respect for tradition, yet still failing to fully align with the original intent. Therefore, I believe that annotating books should not involve arbitrary alterations or shifts; one should only analyze and discuss based on the text itself. Just as Zhu Xi, despite his virtue, retained old texts with missing characters or misplaced slips, how could Cheng Wuji, who was nobody special, dare to arbitrarily delete content, causing endless disputes to this day? My ancestor, Mr. Lishan, was proficient in medical principles and extensively read various books. During leisure from clinical practice, he sat quietly in his small study, never putting down a scroll, remaining tireless even in old age. In his later years, he collected profound discussions from fellow students and compiled them into *Wu Yi Hui Jiang* (Collected Lectures of Wu Physicians) for publication. For old records of observations and excellent works sent by various gentlemen, my ancestor would carefully review them repeatedly, consult with two or three old friends, verify and perfect them, and only then submit them to printing. Thus, while many were adopted, many were also retained, because the collection circulated throughout the country, representing the public opinion of colleagues; it was not casually selected, showing my ancestor's caution and reverence. After selecting up to the excellent essay by Mr. Zhou Xingwu in Volume Eleven, he suddenly fell seriously ill and passed away in the Xin You year. Fourteen years have passed since then. Grieving that his voice and visage have vanished, yet fortunate that the *Collected Lectures* continue to spread. Qingqi merely guards the remaining printing blocks, ending with Mr. Zhou Xingwu's work on page eight of volume eleven. Qingqi is young and ignorant, unable to inherit the family learning, and has not explored medical classics. Although honored by the gift of excellent essays, I dare not continue adding them to the collection, thus following my ancestor's legacy of cautious selection. Therefore, I write these few words, attached to the end of this brief record.
In the spring of the first month of the Jia Xu year, the nineteenth year of the Jiaqing reign, your grandson Qingqi bows respectfully and records this.