甲辰客 李，与西安袁绮香征君寓斋较近。袁固知医，好服药饵。余初往访，见方书药
碗，
野狼藉几案，盖其修合炮制，咸所自为。尝出一方示余曰∶“此亦出名人手，因其药味平易，
又少补益，故姑置之。”余曰∶“君知补字之义乎？凡物缺则补，譬冠服未损，而欲补之使
坚浓，则反为疵累矣。药能利人，亦能损人。若果察其阴阳，辨其气味，偶举一二，用之通
神，岂必以方奇品异为能哉。昼长多暇，姑述一二经验之症，以醒睡魔。曩治缪理堂司马细
君，经阻年余，腹形渐大，呕不纳谷，日仅饮藕汁一二杯，已待毙矣。延余往诊，见其弱不
胜衣，喘不成语，按脉左三部细若游丝，而右关独大，知病在厥阴，而损及太阴。阅前医立
案，或言气聚，或曰 瘕，杂投辛香燥散，以至危殆。爰以甘缓之剂，一进而逆止，再进而
食增，继以育阴益气，经月而胀满悉除矣。是症初不过液枯气结，木乘中土，惟攻伐过甚，
阴液日涸，遂至肝阳莫制，阳明受困。夫阳土喜柔，甘能缓急，进甘缓者，治肝即所以救胃
，此一举兼备法也。又癸丑寓乡，有舵工子，夏患疮疡，医投苦寒之品，至秋渐至浮肿。继
延幼科，更进利导，肿势日甚。病及半年，仅存一息，绝食已二日矣。其父上镇市棺，将为
待
死计，或谓余知医，遂踵门求治。余鉴其诚，往视。肿势已甚，面目几不可辨，脉亦无从
据按。因思病久必虚，且多服寒凉，脾土益衰而及于肾，肾水泛溢，三焦停滞，水渗皮肤，
注
于肌肉，水盈则气促而欲脱，拟急进独参汤，以助肺气，盖肺主一身气化，且有金水相生之
义也。时逆氛未靖，乡间无从觅参，乃以仙居术一两，令浓煎徐服，尽一器，喉间痰声觉渐
退。于是叠进六君，重用参、术，甫半月而肿尽消。此二症皆以平淡取效，可见方不在奇，
在用之得当耳”袁曰∶“君用法良善，未悉业受何人，法宗何派？”余曰∶“幼年病弱，悉
屏
经史子集，食饱睡余，惟以方书消遣，其时已略能理会，迨侍疾椿庭，杜门不出者数年，因
遂搜采群书，究心《灵素》，而于切脉调剂之法，亦渐通贯，此业之所由成也。嗣是偶有所
得
，笔以记之，积为一十二卷，名曰《侍亲一得》，暇当就正也。”翌日袁过余斋，遂以书授
，厥后屡以医学问。余谓凡人受病，虽不离乎
寒热虚实，然有虚中实，实中虚，寒化热，热生寒之异，临症施治，必求其克制之功，与相
生之义，使之并行不悖，乃为善耳。至调剂之法，不过藉气味偏胜以图功。如《内经》咸胜
苦，苦胜辛之类。盖医者意也，方者法也。必读古而不泥于古，采方而不囿于方，神明其
意于
法之中，研穷其理于意之外，斯则化裁之妙，存乎其人矣。袁极称善。明春，袁适有楚南
之
行，遂别。嗣以兵阻断音问，近始得函，悉此管窥所着，竟欲代付手民，自笑于前贤诸籍
，未能兼综条贯，矜其一得，适足贻笑方家。然如袁君之嘉善，至老不袁，遭此纷乱，而拙
本袭藏，俾不散佚，感何如乎。特笔所谭，以志相交之有自云。
两苍氏曰∶余不知医，但尝闻医通于易。夫易之为义，自不易外，交易变易，动而不居
。可
见医无执着处，既宜多哀前言，尤贵不拘成法，实其腹而虚其心，应以自然，而非出于必然
，医如是，亦庶几矣。篇中所论，恰如我意所欲出，其殆有相视而笑，目逆于心者欤。
甲辰年，我客居李地，与西安的袁绮香征君（尊称）住所相近。袁先生本来精通医术，喜欢服用药物。我初次去拜访他时，看见方书和药碗杂乱地散落在几案上，大概是因为他自己进行药物的调配和炮制。他曾拿出一张方子给我看说：“这也是出自名家之手，但因为药味平和，又缺少补益作用，所以我暂时把它放在一边。”我说：“您知道‘补’字的含义吗？凡是物体缺损了才需要修补，比如帽子和衣服没有损坏，却想要修补它使其更加坚固浓密，这反而会成为瑕疵累赘。药物能利于人，也能损害人。如果能确实察辨阴阳，辨别药性气味，偶尔选用一两味药，运用得当就能达到神奇的效果，哪里一定要以方剂奇特、药材珍稀为能事呢？白天漫长多有闲暇，姑且叙述一两个我经验过的病症，来唤醒那些沉睡在迷梦中的人。从前我治疗缪理堂司马的夫人，月经阻滞一年多，腹部逐渐变大，呕吐不能进食，每天只喝一二杯藕汁，已经等待死亡了。请我去诊治，见她瘦弱得几乎承受不住衣服的重量，气喘得说不出话，切脉左手三部细得像游丝一样，唯独右关脉独大，我知道病在厥阴经，并且损伤到了太阴经。查阅前医的病历，有的说是气聚，有的说是瘕积，杂用辛香燥散的药物治疗，以至于病情危急。于是我用甘缓的药剂，服一次后逆气停止，服两次后食欲增加，接着用滋养阴液、益气的方法，一个月后胀满全部消除了。这个病症起初不过是津液枯竭、气机郁结，肝木乘克脾土，只是攻伐太过严重，阴液日渐枯竭，导致肝阳无法制约，阳明胃腑受到困阻。阳土（胃）喜欢柔和，甘味能缓解急迫，进用甘缓的药物，治疗肝脏就是拯救胃腑，这是一举两得的办法。又在癸丑年寓居乡下时，有个船工的儿子，夏天患疮疡，医生投用苦寒的药物，到了秋天逐渐出现浮肿。后来请儿科医生诊治，更使用利水导下的药物，肿胀日益严重。患病半年，只剩下一口气，已经两天没吃东西了。他的父亲去镇上买棺材，准备等待死亡，有人说我懂医术，于是登门求治。我鉴于他的诚意，前往查看。肿胀已经很严重，面目几乎分辨不清，脉象也无法依据切按。我想病久必然虚弱，而且多服寒凉药物，脾土更加衰弱并波及肾脏，肾水泛溢，三焦停滞，水渗皮肤，注入肌肉，水盈满则气促欲脱，打算紧急进用独参汤，以助肺气，因为肺主一身的气化，且有金水相生的道理。当时局势动荡不安，乡间无处寻找人参，就用仙居术一两，令其浓煎慢慢服用，喝完一器后，喉间的痰声觉得渐渐消退。于是连续进用六君子汤，重用参、术，刚半个月肿胀就全部消退。这两个病症都是以平淡的药方取得疗效，可见方剂不在于奇特，在于使用得当罢了。”袁先生说：“您的用法很好，不知道您师从何人，法宗哪一派？”我说：“幼年时身体病弱，完全摒弃了经史子集，吃饱睡醒之后，只用方书消遣，那时已经略微能理解其中的意思，等到侍奉父亲治病，闭门不出几年，于是搜集采择各种书籍，专心研究《灵枢》和《素问》，对于切脉调制药物的方法，也逐渐贯通，这就是我的医术形成的原因。此后偶尔有所心得，便记录下来，积累成十二卷，名叫《侍亲一得》，有空时请您指正。”第二天袁先生经过我的书房，我就把书交给他，此后多次拿医学问题问我。我认为凡人患病，虽然离不开寒热虚实，但有虚中实、实中虚、寒化热、热生寒的不同，临症施治，必须寻求克制之功与相生之义，使它们并行不悖，这才是好的。至于调剂的方法，不过是借助药性的偏胜来图谋功效。如《内经》所说咸胜苦、苦胜辛之类。大概医者靠的是意会，方剂靠的是法则。必须读古书而不拘泥于古书，采集方剂而不局限于方剂，在法则中神妙地运用心意，在意念之外穷究其理，这就是化裁的奥妙，取决于个人了。袁先生非常称赞好。第二年春天，袁先生恰好有楚南之行，于是告别。后来因战乱断绝音讯，最近才收到信，得知他把这些管窥之见竟然想交付刻印出版，自嘲在前贤的各种典籍面前，未能兼综条贯，夸耀自己的一点心得，恰恰足以被行家嘲笑。然而像袁君这样嘉许善行，直到老也不改变，遭遇这种纷乱，而我的拙劣本子得以收藏保存，不至于散失，感激之情如何呢？特意写下所谈的内容，以记录交往的由来。
两苍氏说：我不懂医术，但曾听说医术通于易经。易经的含义，除了不易之外，还有交易、变易，运动不停留。可见医术没有执着的地方，既应该多参考前人的言论，尤其可贵的是不拘泥于固定的法则，充实内心而虚心，顺应自然，而不是出于必然，医术如果这样，也就差不多了。篇中所论述的，恰如我心中所想表达的，大概是有着相视而笑、心意相通的感觉吧。
In the year Jia Chen, I was a guest in Li, living near the residence of Yuan Qixiang, a distinguished scholar (Zhengjun) from Xi'an. Mr. Yuan was already knowledgeable in medicine and fond of taking medicinal substances. When I first visited him, I saw medical texts and medicine bowls scattered messily on the tables and desks; it seemed he performed the compounding and processing of medicines himself. He once showed me a prescription and said, "This also comes from the hand of a famous person, but because the medicinal ingredients are mild and lack tonifying properties, I have temporarily set it aside." I said, "Do you understand the meaning of 'tonification' (Bu, 补)? Tonification is needed only when something is deficient. For example, if a hat or clothes are not damaged, trying to repair them to make them thicker and stronger would actually create flaws. Medicines can benefit people, but they can also harm them. If one can accurately observe Yin and Yang and distinguish the flavors and properties, occasionally selecting one or two herbs and using them appropriately can achieve miraculous effects. Is it necessary to rely on unusual prescriptions or rare ingredients? During the long days with much leisure, I will briefly narrate one or two cases treated by my experience to awaken those trapped in sleep/delusion. Previously, I treated the wife of Sima Miao Litang. She had amenorrhea for over a year, her abdomen gradually enlarged, she vomited and could not retain food, drinking only one or two cups of lotus root juice daily, and was waiting for death. I was invited to diagnose her. She was so weak that she could barely support her own weight, panting so severely she could hardly speak. Palpation revealed the three positions on the left wrist were fine like a wandering silk thread, while the Guan position on the right was uniquely large. I knew the disease was in the Jueyin channel and had damaged the Taiyin organ. Reviewing the previous doctors' records, some attributed it to Qi accumulation, others to mass formations (Jia, 瘕). They indiscriminately administered acrid, aromatic, dry, and dispersing agents, leading to a critical condition. Therefore, I used a sweet and緩 (Gan Huan, 甘缓 - sweet and relaxing) formula. After one dose, the rebellious Qi stopped; after two doses, appetite increased. Subsequently, using methods to nourish Yin and boost Qi, within a month the distension and fullness were completely eliminated. This case initially involved only fluid depletion and Qi stagnation, with Wood (Liver) overacting on Earth (Spleen/Stomach). However, due to excessive attacking and purging, Yin fluids dried up day by day, leading to uncontrolled Liver Yang and distress of the Yang Earth (Stomach). Yang Earth prefers softness; sweetness can relieve urgency. Administering sweet and relaxing agents treats the Liver, which thereby saves the Stomach; this is a method achieving two goals with one move.
Again, in the year Gui Chou, while staying in the countryside, there was a boatman's son who suffered from sores and ulcers in summer. The doctor prescribed bitter-cold substances. By autumn, edema gradually developed. Later, a pediatrician was consulted, who further administered diuretic and draining treatments, causing the swelling to worsen daily. The illness lasted half a year; he was left with only a breath of life and had been without food for two days. His father went to town to buy a coffin, preparing to await death. Someone suggested I knew medicine, so they came to my door seeking treatment. Seeing his sincerity, I went to examine him. The swelling was severe, making his face and features almost unrecognizable, and the pulse was too weak to palpate reliably. I reasoned that chronic illness leads to deficiency, and since he had taken many cold-cooling drugs, his Spleen Earth had further declined and affected the Kidney. Kidney water overflowed, the Sanjiao (Triple Burner) stagnated, water seeped into the skin and muscles. With excess water, Qi became short and threatened to collapse. I planned to urgently administer Du Shen Tang (Single Ginseng Decoction) to assist Lung Qi, as the Lung governs the Qi transformation of the whole body and embodies the principle of Metal generating Water. At that time, the situation was turbulent, and ginseng could not be found in the countryside. Instead, I used one liang of Xianju Atractylodes macrocephala (Xianju Zhu, 仙居术), instructed to decoct it strongly and take it slowly. After finishing one vessel, the rattling phlegm sound in his throat gradually subsided. Thereafter, I repeatedly administered Liu Jun Zi Tang (Six Gentlemen Decoction), heavily utilizing Ginseng and Atractylodes. Within half a month, the swelling completely disappeared. These two cases achieved efficacy with plain formulas, showing that prescriptions need not be exotic, but must be used appropriately." Mr. Yuan said, "Your methods are excellent. Whose teaching did you receive, and which school does your method belong to?" I said, "In my youth, being sickly, I abandoned the Classics, Histories, Philosophers, and Collectanea. After eating and sleeping, I only used medical texts for entertainment, at which time I could roughly understand them. Later, while attending to my father's illness, I stayed indoors for several years. Thus, I collected various books and devoted myself to studying the Ling Shu (Spiritual Pivot) and Su Wen (Basic Questions). My understanding of pulse diagnosis and medication adjustment gradually became coherent; this is how my medical practice was formed. Since then, whenever I had occasional insights, I recorded them, accumulating twelve volumes named Shi Qin Yi De (One Insight from Attending to Parents). I shall seek your correction when free." The next day, Mr. Yuan passed by my study, and I gave him the book. He subsequently asked me many questions about medicine. I believe that although human diseases generally do not deviate from Cold, Heat, Deficiency, and Excess, there are variations such as Deficiency containing Excess, Excess containing Deficiency, Cold transforming into Heat, and Heat generating Cold. In clinical treatment, one must seek the function of mutual restraint and the meaning of mutual generation, allowing them to coexist without conflict; this is considered good. As for the method of adjusting medications, it merely relies on the bias of flavors and properties to achieve results. For instance, as stated in the Nei Jing: Salty overcomes Bitter, Bitter overcomes Acrid. Generally, the physician relies on intuition/intent (Yi, 意), and the prescription relies on method/law (Fa, 法). One must read ancient texts without being bound by them, collect prescriptions without being confined by them, apply divine intent within the method, and exhaustively investigate principles beyond intent. This subtlety of adaptation depends on the individual. Mr. Yuan highly praised this. In the following spring, Mr. Yuan traveled to Chu Nan, and we parted. Later, war cut off communication. Recently, I received a letter stating that he intended to publish these superficial observations, laughing at himself for failing to comprehensively organize the works of former sages and boasting of his single insight, which might only invite ridicule from experts. However, for Mr. Yuan to appreciate goodness until old age, and for my clumsy manuscript to be preserved amidst chaos without being lost, how grateful I am! I specifically write down what we discussed to record the origin of our friendship.
Liangcang Shi says: I do not know medicine, but I have heard that medicine connects with the Yi Jing (Book of Changes). The meaning of Yi includes Bu Yi (Unchanging), Jiao Yi (Interchangeable), and Bian Yi (Changing); it moves without remaining static. This shows that medicine has no rigid attachments. It is appropriate to refer extensively to past words, but even more valuable is not being constrained by established methods. One should fill the belly (substance) and empty the heart (mind), respond naturally rather than necessarily. If medicine is like this, it would be sufficient. The discussions in this chapter exactly match what I wished to express; perhaps there is a sense of smiling at each other and understanding in the heart.