盖闻上古之世，方不如医，中古之世，医不如方甚矣。医与方之并重也，世降而方愈凌
杂，莫不各据一家言，彼此互相是非，间有二三验方，亦惟是父师传之子弟，绝不轻以示人
。而其镌行于世者，率皆依样葫芦，时或改头换面以博名高则已矣。余独取《外台秘要》付
之剞劂者何？请得而备言之。盖自神农氏深明药性，着《本草经》三卷而未有方也，轩辕氏
日与岐伯、雷公剖析病机，着《素问》、《灵枢经》各九卷而未有方也；商周之间如伊芳尹、如
和、如缓、如跗，皆以医名而未有方也；越人受长桑君之禁方，所传于世者，《八十一难经
》及治虢太子尸厥耳，而其为带下医、小儿医、耳目痹医，俱未悉其所以为方也。仓公受公
乘阳庆之禁方，所可晓者莨菪子汤、苦参汤耳，其他火齐汤、下气汤、阳剂刚石、阴剂柔石
，亦未悉其所以为方也。若夫刳肠、湔胃无论，其方不传，即令华元化方传至今而亦难乎效
其为方也。惟是仲景氏出有《卒病论》以治伤寒，着方一百一十三；有《金匮要略》以治杂
病，着方一百一十二医方，实开先焉，盖鼻祖也。又得叔和王氏为之诠次，俾仲景之微旨益
以彰明，叔和氏不更立方，即述仲景之方为方者也。皇甫士安之《甲乙经》特重针刺而无方
，巢元方之《病源》每病必有源，源必立论而无方。览者，咸以无方致憾。迨唐有孙真人者
，初着方三十卷，晚复增三十卷，自珍其方曰《千金》，医方较明备焉，盖大宗也。乃前后
乎孙真人者，人则有深师、崔尚书、孙处士、张文仲、孟同州、许仁则、吴升若而人，方则
有《广济》、《录验》、《删繁》、《肘后》、《延年》、《短剧》、《必效》若而方，门分派别，编帙
从未有综而辑之者，独刺史王焘先生，前居馆阁二十年，采摭群书，汇成方略，上溯炎昊，
下及诸家。《伤寒》一遵仲景，发论率冠《病源》，虽置针法不言，而大唐以前之方
《千金》则居多焉。卷凡四十，方余六千，盖集医方之大成者。题曰《秘要》，
要也。自宋皇 诏谕刊布，后无复锓梓以广其传，岂非沿习时尚而探源证本者之寡其俦哉！
夫天下何事不宜师古，文则六经之外必追秦、汉，字则篆 而后必法钟、王，至
不然？昔祖讷云∶辨释经典，小有异同，不足以伤风教，汤药小小不达，则后人
此余亟欲以《外台秘要》公诸海内之深意也。向购写本，讹缺颇多，因复殚力校 。遇有疑
义，则旁引类证，录于篇侧，其无文可征者，不敢强释，以俟解人。十载始竣厥工。客阅而
谓余曰∶奥义之难析也，圆机之莫辨也，浅识可以漫试乎？余曰∶用其所信，阙
也。又谓∶世代之推迁也，风气之殊尚也，陈辙可以适时乎？余曰∶不师其法，
可也。且谓同病而异方也，同方而异治也，毫厘不几千里乎？余曰∶三部微妙，
五脏精华，察之在目，合色脉而后定方，求其曲当可也。总之，以方为方，方遂一成而不易；
以矩为方，方乃万变而不穷。诚究心于平昔，会其所以立方之意，斟酌于临时
症之方，果属热而当寒，何不参之河间？湿而宜燥，何不参之东垣？可汗、可吐而可下，何
不
参之子和？阴阳乖错，营卫失调，何不参之丹溪？博洽前方，勿执我见，期于实有拯救，不
愧
前贤济民利物之心，则请以《外台秘要》一书为医家之筌蹄也，亦奚不可？
新安后学程衍道敬通父谨识
我听说上古时代，医术不如方剂重要；中古时代，方剂不如医术重要，差别很大。医学与方剂并重，随着世道变迁，方剂越来越杂乱，各家都坚持自己的说法，彼此互相非议。偶尔有两三个有效的验方，也只是父传子、师传弟，绝不轻易示人。而那些刊印流传于世的书籍，大多都是依样画葫芦，有时改头换面以博取名声罢了。我唯独选取《外台秘要》交付刻版印刷，为什么呢？请让我详细陈述。
自从神农氏深明药性，撰写《本草经》三卷，但当时没有方剂；轩辕氏（黄帝）每天与岐伯、雷公剖析病机，撰写《素问》和《灵枢经》各九卷，但当时也没有方剂；商周之间如伊尹、如和、如缓、如跗，都以医术闻名，但也没有方剂；扁鹊（越人）接受长桑君的禁方，流传于世的是《八十一难经》以及治疗虢太子尸厥症的方法，而他作为带下医（妇科）、小儿医、耳目痹医，都不清楚他具体的方剂用法。仓公（淳于意）接受公乘阳庆的禁方，可以知晓的是莨菪子汤、苦参汤，其他的火齐汤、下气汤、阳剂刚石、阴剂柔石，也不清楚他具体的方剂用法。至于华佗（字元化）的刳肠、湔胃等手术，无论其方剂是否流传，即使华佗的方剂流传至今，也很难效法他使用方剂的原理。
只有张仲景出现，著有《卒病论》以治疗伤寒，记载方剂一百一十三首；著有《金匮要略》以治疗杂病，记载方剂一百一十二首。医方实际上是从这里开创先河的，可以说是鼻祖。又得到王叔和为之编排整理，使张仲景的精微旨意更加彰显明白。王叔和不再创立新方，只是阐述张仲景的方剂作为方书。皇甫士安（皇甫谧）的《甲乙经》特别重视针刺而没有方剂，巢元方的《诸病源候论》每病必有病因，病因必有理论论述而没有方剂。阅读的人，都因为没有方剂而感到遗憾。
到了唐代有孙思邈（孙真人），起初编写方剂三十卷，晚年又增加三十卷，自己珍视这些方剂称为《千金》，医方比较明确完备，可以说是大宗。而在孙思邈前后的人，有深师、崔尚书、孙处士、张文仲、孟同州、许仁则、吴升若等人；方剂有《广济方》、《录验方》、《删繁方》、《肘后备急方》、《延年方》、《短剧方》、《必效方》等若干种。门派分派别，编册从未有人综合辑录过。唯独刺史王焘先生，先前在馆阁二十年，采集摘录群书，汇集成方略，上溯炎帝、黄帝，下及诸家。《伤寒论》完全遵循张仲景，发论大多冠以《诸病源候论》，虽然置针法而不谈，但大唐以前的方剂，《千金方》占了多数。全书共四十卷，方剂六千余首，可以说是集医方之大成。题目叫《秘要》，意思是精要。自从宋代皇帝诏令刊布后，后来没有再刻印以广泛传播，这难道不是沿袭时尚而探究本源考证根本的人太少了吗！
天下有什么事情不应当效法古代呢？文章则在六经之外必须追摹秦汉，字体则在篆书之后必须效法钟繇、王羲之，难道不是吗？从前祖讷说：“辨析解释经典，小有异同，不足以损伤风教；汤药稍微不理解，那么后人……”这是我急切想要将《外台秘要》公之于众的深意啊。之前购买抄写本，讹误缺失很多，因此又尽力校勘。遇到有疑问的地方，就旁征博引类比证明，记录在篇章侧面，那些没有文字可考证的，不敢强行解释，以等待懂行的人。十年才完成这项工作。客人阅读后对我说：“奥妙的义理难以分析，圆通的机变难以辨别，浅薄的见识可以随意尝试吗？”我说：“使用自己所相信的，保留空缺即可。”客人又说：“时代的推移，风气的殊异崇尚，旧的辙迹可以适应时宜吗？”我说：“不效法它的方法，是可以的。”并且说：“同样的病有不同的方剂，同样的方剂有不同的治法，毫厘之差岂不是千里之谬吗？”我说：“三部脉象微妙，五脏精华，观察在于眼睛，结合面色脉象然后确定方剂，求得恰当是可以的。”总之，把方剂当作固定的方剂，方剂就会一成不变；把规矩当作方剂的原则，方剂才能万变而不穷。如果确实用心于平日的研究，领会其创立方剂的意图，斟酌于临时病症的方剂，果真是热证而应当用寒药，为什么不参考刘河间（刘完素）？湿证而适宜燥湿，为什么不参考李东垣（李杲）？可以用汗法、吐法或下法，为什么不参考张子和（张从正）？阴阳乖错，营卫失调，为什么不参考朱丹溪（朱震亨）？广泛考察前人的方剂，不要固执己见，期望切实有拯救效果，不愧对前贤济民利物的初心，那么请将《外台秘要》这本书作为医家的工具（筌蹄指捕鱼的竹器，比喻达到目的的手段），又有什么不可以呢？
新安后学程衍道恭敬地通父谨识
I have heard that in ancient times, medical art was less important than prescriptions; in middle antiquity, prescriptions were less important than medical art, with a significant difference. When medicine and prescriptions were given equal weight, as the world declined, prescriptions became increasingly chaotic. Each school adhered to its own theories, mutually criticizing one another. Occasionally, there were two or three effective empirical prescriptions, but these were passed from father to son and master to disciple, never lightly shown to others. Those printed and circulated in the world were mostly mere copies, sometimes changing their appearance to seek fame. Why did I exclusively choose *Waitai Miyao* (Secret Essentials of the Outer Cabinet) for publication? Let me explain in detail.
Since Shennong deeply understood the properties of herbs and wrote the *Shennong Bencao Jing* (Divine Farmer's Materia Medica) in three volumes, there were no prescriptions at that time. Xuanyuan (Yellow Emperor) daily analyzed pathological mechanisms with Qibo and Leigong, writing nine volumes each of the *Suwen* (Basic Questions) and *Lingshu* (Spiritual Pivot), yet there were still no prescriptions. During the Shang and Zhou dynasties, figures such as Yi Yin, He, Huan, and Fu were famous for their medical skills, but they had no prescriptions. Bianque (Yue Ren) received secret prescriptions from Changsang Jun; what was transmitted to the world were the *Nanjing* (Classic of Difficult Issues) and the treatment of the Crown Prince of Guo's corpse-like coma. However, regarding his practices as a gynecologist, pediatrician, and specialist in eye, ear, and bi-syndromes, his specific prescription methods are not fully known. Cang Gong (Chunyu Yi) received secret prescriptions from Gongcheng Yangqing; what is clear are the Langdangzi Tang (Henbane Seed Decoction) and Kushen Tang (Sophora Root Decoction). The Huoji Tang (Fire Equilibrium Decoction), Xiaqi Tang (Descending Qi Decoction), Yangji Gangshi (Yang Agent Hard Stone), and Yinji Roushi (Yin Agent Soft Stone) do not reveal his specific prescription logic. As for Hua Tuo's (courtesy name Yuanhua) intestinal excavation and stomach washing surgeries, regardless of whether his prescriptions were transmitted, even if Hua Tuo's prescriptions had survived to today, it would be difficult to emulate his method of prescribing.
Only Zhang Zhongjing emerged, authoring *Zhubing Lun* (Treatise on Epidemic Diseases) to treat Shaoyin Cold Damage (Taiyang Bing), recording 113 prescriptions; and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) to treat miscellaneous diseases, recording 112 prescriptions. Medical prescriptions truly began here, making him the ancestral founder. Wang Shuhe then edited and arranged them, making Zhang Zhongjing's subtle principles even more manifest. Wang Shuhe did not create new prescriptions but compiled Zhang Zhongjing's prescriptions into a formulary. Huangfu Mi's (*courtesy name Shi'an*) *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion) emphasized acupuncture without prescriptions. Chao Yuanfang's *Bingyuan* (General Treatise on Pathogenesis and Symptoms of Various Diseases) stated that every disease has a source, and every source has a theoretical discussion, but no prescriptions. Readers often regretted this lack of prescriptions.
In the Tang Dynasty, Sun Simiao (Sun Zhenren) initially compiled thirty volumes of prescriptions, later adding another thirty volumes. He treasured these prescriptions, calling them *Qianjin* (Thousand Gold). His medical prescriptions were relatively clear and complete, representing a major lineage. Between those preceding and following Sun Simiao, there were individuals such as Shenshi, Cishangshu, Sun Chushi, Zhang Wenzhong, Meng Tongzhou, Xu Renze, and Wu Shengruo; and prescriptions such as *Guangji Fang*, *Luyan Fang*, *Shanfan Fang*, *Zhouhou Fang*, *Yannian Fang*, *Duanju Fang*, and *Bixiao Fang*. With various schools and branches, no one had ever comprehensively collected and edited them. Only Wang Tao, the Prefect, who served in the imperial library for twenty years, gathered excerpts from numerous books, compiling them into strategies. Tracing back to Yan Di and Huang Di, and down to various schools, the *Shanghan* section strictly followed Zhang Zhongjing, with discussions often preceded by references to *Bingyuan*. Although acupuncture methods were omitted, most prescriptions before the Great Tang came from *Qianjin Fang*. The work comprises forty volumes and over six thousand prescriptions, representing the culmination of medical prescriptions. It is titled *Miyao* (Secret Essentials), meaning "essentials." Since the Song Dynasty emperor ordered its publication, it has not been reprinted to spread widely. Is this not because few people follow contemporary trends while seeking origins and verifying roots?
Why should any matter in the world not emulate antiquity? In literature, beyond the Six Classics, one must trace back to Qin and Han; in calligraphy, after seal script, one must model after Zhong You and Wang Xizhi. Was it not so? Zu Nuo once said: "Analyzing and interpreting classics, slight differences do not harm moral teachings; slight misunderstandings in herbal decoctions..." This is my deep intention to urgently make *Waitai Miyao* public. Previously purchased manuscript copies had many errors and omissions, so I exerted great effort to collate them. Where doubts arose, I cited parallels and evidence, recording them in the margins. For those lacking textual evidence, I dared not force interpretations, waiting for experts. It took ten years to complete. A guest read it and asked: "The profound meanings are hard to analyze, and flexible wisdom hard to discern; can shallow knowledge casually attempt this?" I replied: "Use what you believe, leave gaps." The guest continued: "As eras shift and customs change, can old tracks adapt to current times?" I replied: "Not emulating its methods is acceptable." And he added: "Same disease with different prescriptions, same prescription with different treatments—can a slight error lead to a thousand-mile deviation?" I replied: "The subtleties of the three pulses and the essence of the five zang organs are observed visually; combining complexion and pulse to determine the prescription allows for appropriateness." In short, treating prescriptions as fixed entities makes them unchangeable; treating principles as the basis of prescriptions allows them to be infinite in variation. If one studies diligently, understands the intent behind creating prescriptions, and adjusts them according to temporary symptoms, when heat requires cold, why not refer to Liu Wanhe (Hejian)? When dampness requires drying, why not refer to Li Dongyuan (Dongyuan)? When sweating, vomiting, or purging are applicable, why not refer to Zhang Congzheng (Zihe)? When yin and yang are disordered and Ying and Wei qi are imbalanced, why not refer to Zhu Danxi? Broadly examining previous prescriptions without clinging to personal views, aiming for genuine salvation and honoring the benevolent hearts of former sages, why not take *Waitai Miyao* as a tool for physicians?
Cheng Yandao, a junior scholar from Xin'an, respectfully recorded this.