夫天布五行以植万类，人禀五常以为五脏，经络腑输，阴阳会通，玄冥幽微，变化难极。
《易》曰∶非天下之至赜，其孰能与于此？观今之医，不念思求经旨，以演其所知，各承家
技，始终循旧，省病问疾，务在口给。相对斯须，便处汤药，按寸不及尺，握手不及足，人
迎趺阳，三部不参，动数发息，不满五十，短期未知决诊，九候曾无仿佛，明堂阙庭，尽
不见察，所谓窥管而已。夫欲视死别生，固亦难矣。此皆医之深戒，病者可不谨以察之，而
自防虑也。
古来医人，皆相嫉害。扁鹊为秦太医令李醯所害，即其事也。一医处方，不得使别医和
合，脱或私加毒药，令人增疾，渐以致困。如此者非一，特须慎之，宁可不服其药，以任天
真，不得使愚医相嫉，贼人性命，甚可哀伤。
夫百病之本，有中风伤寒、寒热温疟、中恶霍乱、大腹水肿、肠 下痢、大小便不通、
奔豚上气、咳逆呕吐、黄胆消渴、留饮癖食、坚积症瘕，惊邪癫痫、鬼疰、喉痹齿痛、耳聋
目盲，金疮 折、痈肿恶疮、痔 瘤瘿，男子五劳七伤、虚乏羸瘦，女子带下崩中、血闭阴
蚀，虫蛇蛊毒所伤，此皆大略宗兆，其间变动枝叶，各根据端绪以取之。又有冷热劳损，伤饱
房劳，惊悸恐惧，忧恚怵惕，又有产乳落胎，堕下瘀血，又有贪饵五石，以求房中之乐。此
皆病之根源，为患生诸枝叶也。不可不知其本末，但向医说，男女长幼之病，有半与病源相
附会者，便可服药也。男子者，众阳所归，常居于燥。阳气游动，强力施泄，便成劳损。
损伤之病，亦以众矣。若比之女人，则十倍易治。凡女子十四以上，则有月事。月事来日得
风冷湿热、四时之病相协者，皆自说之。不尔与治误相触动，更增困也。处方者，亦应问之。
凡用药皆随土地所宜，江南岭表，其地暑湿，其人肌肤薄脆，腠理开疏，用药轻省。关
中河北，土地刚燥，其人皮肤坚硬，腠理闭塞，用药重复。
世有少盛之人，不避风湿，触犯禁忌，暴竭精液，虽得微疾，皆不可轻以利药下之。一
利大重，竭其精液，困滞着床，动经年月也。凡长宿病，宜服利汤，不须尽剂，候利之足则
止。病源未除者，于后更合耳。稍有气力堪尽剂，则不论也。
病源须服利汤取除者，服利汤后，宜将丸散时时助之。
凡病服利汤得瘥者，此后慎不中服补汤也。若得补汤，病势还复成也，更重泻之，则其
人重受弊也。若初瘥，气力未甚平复者，但消息之，须服药者，当以平药和之。夫常患之人
，不妨行走，气力未衰，欲将补益。冷热随宜丸散者，可先服利汤，泻除胸腹中壅积痰实，
然后可服补药也。夫极虚劳应服补汤者，不过三剂即止。若治风病应服治风汤者，皆非三五
剂可知也。自有滞风洞虚，即服十数剂，乃至百余日可瘥也。故曰∶实则泻之，虚则补之。
夫二仪之内，阴阳之中，唯人最贵。人者，禀受天地中和之气，法律礼乐，莫不由人。
人始生，先成其精，精成而脑髓生。头圆法天，足方象地，眼目应日月，五脏法五星，六腑
法六律，以心为中极。大肠长一丈二尺，以应十二时；小肠长二丈四尺，以应二十四气；身
有三百六十五络，以应一岁；人有九窍，以应九州；天有寒暑，人有虚实；天有刑德，人有
爱憎；天有阴阳，人有男女；月有大小，人有长短。所以服食五谷不能将节，冷热咸苦更相
抵触，共为攻击，变成疾病。凡医诊候，固是不易，又问而知之，别病深浅，名曰巧医。仲
景曰∶凡欲和汤合药，针灸之法，宜应精思，必通十二经脉，辨三百六十孔穴荣卫气行，知
病所在，宜治之法，不可不通。古者上医相色，色脉与形不得相失，黑乘赤者死，赤乘青者
生。中医听声，声合五音，火闻水声，烦闷干惊；木闻金声，恐畏相刑。脾者土也，生育万
物，回助四旁，善者不见，死则归之，太过则四肢不举，不及则九窍不通，六识闭塞，犹如
醉人。四季运转，周而复始。下医诊脉，知病源由，流转移动，四时逆顺，相害相生，审知
脏腑之微，此乃为妙也。
上天分布五行以生成万物，人禀受五常之气而形成五脏，经络与腑穴相连，阴阳相互贯通，其机理幽深微妙，变化无穷。
《易经》说：“如果不是天下最深奥的道理，谁能达到这种境界呢？”看现在的医生，不思考探究医经的宗旨来推演扩充自己的知识，只是各自继承家传技艺，始终沿袭旧法。诊察病情询问疾病时，只注重口舌伶俐。相对片刻，就开出处方用药，切脉时只按寸口而不按尺部，只握手部而不按足部，人迎穴和趺阳穴也不参合诊察；呼吸次数未数满五十次便停止，对于预知生死期限的诊法一无所知，对九候脉象毫无了解，明堂、阙庭等面部部位也完全不见观察，这不过是像从管子里看天一样狭隘罢了。想要通过诊察区分死生，确实很难了。这些都是医生应当深深警惕的，病人怎能不谨慎地考察医生，并自我防备呢？
自古以来的医生，常常互相嫉妒陷害。扁鹊被秦国的太医令李醯杀害，就是其中的事例。一位医生开具处方，不允许其他医生参与调配，倘若有人私自添加毒药，使人病情加重，逐渐导致困顿。这样的情况不止一次，特别需要谨慎，宁可不服用他的药，以顺应自然本性，也不能让愚昧的医生因嫉妒而残害人性命，这非常令人哀伤。
各种疾病的根本原因，包括中风、伤寒、寒热温疟、中恶霍乱、大腹水肿、肠澼下痢、大小便不通、奔豚上气、咳逆呕吐、黄疸消渴、留饮癖食、坚积症瘕、惊邪癫痫、鬼疰、喉痹齿痛、耳聋目盲、金疮骨折、痈肿恶疮、痔瘤瘿，男子五劳七伤、虚乏羸瘦，女子带下崩中、血闭阴蚀，以及虫蛇蛊毒所伤，这些是大略的征兆，其中具体的变动细节，都要根据端绪去探求。又有冷热劳损、饮食过饱、房事过度、惊恐恐惧、忧愁愤怒、惊吓惕惧，还有产后乳汁不足、流产堕胎、瘀血内停，以及贪服五石散以求房中之乐。这些都是疾病的根源，由此产生各种枝叶般的症状。不可不知其本末，只要向医生说明，男女老幼的疾病，有一半是与病源相附会的，就可以服药了。男子是众阳汇聚之处，常处于燥热状态。阳气游动，强力施泄，便形成劳损。损伤类的疾病也很多。如果与女人相比，则十倍容易治疗。凡是女子十四岁以上，就有月经。月经来潮之日，若遇到风冷湿热或四季之病相夹杂的情况，都要自己说明。否则若误治触动，反而增加困顿。开处方时，也应询问这些情况。
凡是用药都要依据土地适宜性。江南岭表地区，地势暑湿，人的肌肤薄脆，腠理开疏，用药宜轻简。关中河北地区，土地刚燥，人的皮肤坚硬，腠理闭塞，用药宜重复（剂量较大或药味较多）。
世上有年轻力壮的人，不避风湿，触犯禁忌，突然耗竭精液，即使得了小病，都不可轻易用利药攻下。一旦利药作用过大过重，会竭尽精液，使人困顿卧床，动辄经过数月甚至一年。凡是长期宿疾，适宜服用利汤的，不必喝完一剂，等到通便足够就停止。病源未除者，之后再重新配制服用。稍有气力能喝完一剂的，则不论此限。
病源必须服用利汤才能去除的，服用利汤后，适宜用丸散药时时辅助调理。
凡是生病服用利汤后痊愈的，此后要谨慎，不要立即服用补汤。如果服用补汤，病势会复发，再重新泻下，那人就会再次受到损害。如果初愈，气力尚未完全恢复，只需慢慢调养，需要服药时，应用平和的药物调和它。那些经常患病但不妨碍行走，气力未衰，想要进补的人，若有适合寒热的丸散药，可先服用利汤，泻除胸腹中的壅积痰实，然后才可服用补药。极度虚弱劳损应服用补汤的，不过三剂就停止。若治疗风病应服用治风汤的，都不是三五剂就能见效的。自有滞风洞虚之证，即服用十数剂，乃至百余日才能痊愈。所以说：实证用泻法，虚证用补法。
天地之间，阴阳之中，唯人最尊贵。人禀受天地中和之气，法律礼乐，无不源于人。人刚开始形成，先成其精，精成而后脑髓生成。头圆象征天，足方象征地，眼睛对应日月，五脏对应五星，六腑对应六律，以心为中枢。大肠长一丈二尺，对应十二时辰；小肠长二丈四尺，对应二十四节气；身体有三百六十五络，对应一年三百六十五日；人有九窍，对应九州；天有寒暑，人有虚实；天有刑德，人有爱憎；天有阴阳，人有男女；月有大小，人有高矮。所以服用五谷不能节制，冷热咸苦相互抵触，共同攻击人体，变成疾病。凡医生的诊察，本来就不易，又能通过问诊得知病情，辨别病位深浅，这叫巧医。张仲景说：“凡是要调和汤剂、合制药材、使用针灸之法，应当精心思考，必须通晓十二经脉，辨明三百六十孔穴及营卫气血运行，知道病所在之处，适宜的治疗法则，不可不通晓。”古时候的上医观察面色，色、脉与形不得相失，黑色乘袭红色者死，红色乘袭青色者生。中医听声音，声音符合五音，听到水声如火般烦躁闷乱惊恐；听到金声如木受金克般恐惧畏缩。脾属土，生育万物，回助四方，好的时候看不见，死了才归之于它，太过则四肢不能举动，不及则九窍不通，六识闭塞，如同醉汉。四季运转，周而复始。下医诊脉，知道病源由来，流转移动，四时逆顺，相害相生，审知脏腑的微妙变化，这才是妙处。
Heaven distributes the Five Phases (Wu Xing) to cultivate all living things; humans receive the Five Constants (Wu Chang) to form the Five Zang Organs. The meridians and fu acupoints are connected, yin and yang communicate with each other, their principles are profound and subtle, and their changes are inexhaustible.
The *Book of Changes* (*Yi Jing*) states: "If it were not the most profound principle under heaven, who could achieve this?" Observing physicians of today, they do not ponder and seek the purport of the classic texts to expand their knowledge; instead, they merely inherit family techniques, adhering strictly to old methods throughout. When examining patients and inquiring about illnesses, they focus only on being eloquent. After a brief conversation, they immediately prescribe decoctions. They palpate the cun position but neglect the chi position, hold the wrist but ignore the foot, and do not cross-reference the Renying (ST 9) and Duyang (ST 42) pulses. They do not count fifty breaths during pulse diagnosis, have no idea how to predict life expectancy through short-term prognosis, show no understanding of the nine pulse positions (Jiu Hou), and fail to inspect the Ming Tang (glabella area) and Que Ting (forehead). This is akin to looking at the sky through a tube. To distinguish between death and life through diagnosis is indeed difficult. These are deep warnings for physicians; how can patients not carefully evaluate them and take precautions?
Since ancient times, physicians have often been jealous and harmful to one another. Bian Que was harmed by Li Xi, the Imperial Physician of Qin, which is a case in point. When one physician prescribes a formula, they should not prevent other physicians from compounding it. If someone privately adds toxic substances, it may worsen the illness and lead to debilitation. Such cases are not rare; one must be particularly cautious. It is better to refuse the medication and rely on natural vitality than to let ignorant physicians, driven by jealousy, harm human lives, which is deeply sorrowful.
The root causes of various diseases include wind-stroke (Zhong Feng), cold damage (Shang Han), alternating chills and fever with warm malaria (Wen Nue), sudden evil (Zhong E) and cholera (Huo Luan), abdominal edema (Da Fu Shui Zhong), dysentery (Chang Pi Xia Li), obstruction of urination and defecation, rushing qi ascending (Ben Tun Shang Qi), coughing and vomiting, jaundice and wasting-thirst (Xiao Ke), retained fluid and food stagnation (Liu Yin Pi Shi), hard accumulations and masses (Jian Ji Zheng Jia), fright evil and epilepsy (Jing Xie Dian Xian), ghost attachment (Gui Zhu), throat obstruction and toothache (Hou Bi Chi Tong), deafness and blindness (Er Long Mu Mang), metal wounds and fractures (Jin Chuang Zhe), carbuncles, sores, and malignant ulcers (Yong Zhong E Chuang), hemorrhoids, tumors, and goiters (Zhi Liu Ying), five labors and seven injuries in men (Nan Zi Wu Lao Qi Shang), deficiency and emaciation (Xu Fa Lei Shou), leukorrhea and metrorrhagia in women (Nv Zi Dai Xia Beng Zhong), blood obstruction and genital erosion (Xue Bi Yin Shi), and injuries from insects, snakes, and gu poison. These are general indications; the specific variations and branches must be investigated according to their origins. There are also cold-heat exhaustion, overeating, sexual excess, fright and fear, worry and anger, postpartum lactation issues, miscarriage, and retained blood stasis. Additionally, there is the greed for taking the Five Minerals (Wu Shi) powder to seek sexual pleasure. These are the roots of disease, giving rise to various branch symptoms. One must know the root and the branches. Merely telling the doctor about the illness, whether male or female, young or old, half of which may be attributed to the disease source, allows for medication. Men are the gathering place of all yang energies and are often dry. Yang energy moves freely; excessive force and emission lead to exhaustion. Diseases of injury are numerous. Compared to women, they are ten times easier to treat. Women above the age of fourteen have menstruation. On the days of menstruation, if affected by wind, cold, dampness, heat, or seasonal pathogens, these must be reported. Otherwise, incorrect treatment may trigger complications and increase debility. Prescribers should inquire about these conditions.
Medication should always suit the local environment. In Jiangnan and Lingbiao regions, where the climate is hot and damp, people have thin and fragile skin with open pores, requiring light and simple medications. In Guanzhong and Hebei, where the land is rigid and dry, people have tough skin and closed pores, requiring heavier or more complex medications.
Among the young and vigorous, those who do not avoid wind and dampness, violate taboos, and suddenly exhaust their essence, even if they contract minor illnesses, should not be lightly treated with purgative medicines. If the purgative effect is too strong, it will deplete the essence, causing bedridden debilitation lasting months or even a year. For chronic diseases suitable for purgative decoctions, one need not finish the entire dose; stop when bowel movement is sufficient. If the disease source remains, prepare another dose later. If the patient has enough strength to finish the dose, this rule does not apply.
For diseases requiring purgative decoctions to remove the source, pill and powder preparations should be taken intermittently afterward to assist recovery.
After a patient recovers from a purgative decoction, one must be cautious and not immediately administer tonic decoctions. If tonics are given, the disease may return, and subsequent purging would cause further harm. If the patient has just recovered and strength is not fully restored, one should observe and wait. If medication is needed, use mild harmonizing drugs. For those who suffer from frequent illnesses but can walk and have not lost strength, wishing to take tonics, if there are pills or powders suitable for their cold or heat condition, they should first take a purgative decoction to clear phlegm and solid accumulation in the chest and abdomen, and only then take tonics. For extreme deficiency and exhaustion requiring tonics, three doses are sufficient. For treating wind diseases with wind-dispelling decoctions, improvement is not seen in three to five doses. Conditions like stagnant wind and hollow emptiness may require ten or more doses, sometimes taking over a hundred days to heal. Thus it is said: Excess is treated by purging; deficiency is treated by tonifying.
Within the two realms (Heaven and Earth), among yin and yang, humans are the most precious. Humans receive the harmonious qi of heaven and earth; laws, rites, and music all originate from humans. At conception, essence forms first; when essence is complete, brain and marrow are generated. The head is round, modeling Heaven; the feet are square, modeling Earth; eyes correspond to the sun and moon; the five zang organs correspond to the five planets; the six fu organs correspond to the six musical pitches, with the heart as the central pole. The large intestine is one zhang and two chi long, corresponding to twelve double-hours; the small intestine is two zhang and four chi long, corresponding to twenty-four solar terms; the body has three hundred and sixty-five collaterals, corresponding to the days of a year; humans have nine orifices, corresponding to the Nine Provinces; Heaven has cold and heat, humans have deficiency and excess; Heaven has punishment and virtue, humans have love and hate; Heaven has yin and yang, humans have male and female; the moon has waxing and waning, humans have tall and short. Therefore, improper consumption of the five grains, conflicting cold, heat, salty, and bitter flavors, attacking each other within the body, leads to disease. Diagnosis by physicians is inherently difficult; adding inquiry to discern the depth of the disease is called skillful medicine. Zhang Zhongjing said: "When preparing decoctions, compounding medicines, or using acupuncture and moxibustion, one must think carefully, must understand the twelve meridians, differentiate the three hundred and sixty acupoints and the circulation of ying and wei qi, know the location of the disease, and master the appropriate treatment methods." Ancient superior physicians observed complexion; color, pulse, and form must not contradict each other. Black overcoming red indicates death; red overcoming green indicates survival. Intermediate physicians listened to sounds; sounds conform to the five tones. Hearing water sounds like fire causes irritability and panic; hearing metal sounds like wood implies fear and punishment. Spleen belongs to earth, nourishing all things and assisting the four directions. When healthy, it is unseen; when dead, it returns to it. Excess leads to inability to move the limbs; deficiency leads to obstruction of the nine orifices, closure of the six senses, resembling drunkenness. The four seasons rotate in a cycle. Inferior physicians diagnose by pulse, knowing the origin of the disease, its flow and movement, the reversals and順逆 of the four seasons, mutual harm and generation, and comprehending the subtleties of the zang and fu organs; this is truly wonderful.