钱乙,字仲阳。上世钱塘人,与吴越王有属。 纳土,曾祖 随以北,因家于郓。父颢,
善针医,然嗜酒喜游。一旦匿姓名,东游海上,不复返。乙时三岁。母前亡,父同产姑,嫁医吕氏,哀
其孤,收养为子。稍长读书,从吕君问医。吕将殁,乃告以家世。乙号泣,请返迹父。凡五六返,乃得
所在。又积数岁,乃迎以归。是时乙年三十余。乡人惊叹,感慨为泣下,多赋诗咏其事。后七年,父以寿
终,丧葬如礼。其事吕君,犹事父。吕君殁,无嗣,为之收行葬服,嫁其孤女,岁时祭享,皆与亲等。乙
始以《颅囟方》着山东。元丰中,长公主女有疾,召使视之,有功,奏授翰林医学,赐绯。明年,皇
卷。夫当诸臣搜采之日,天下藏书之家,莫不争献秘笈。卒未得是书真本,而今乃复见于世,岂非古
人精气有不可磨灭者欤?是书原刻阎名作“孝忠”,“真诀”作“直诀”,今未敢易也。“聚珍本”往往
有阎氏方论误入钱书者,今根据朱本,则各得其所矣。其药味分量间有不同,今各注于本方之末。至《薛氏
医案》本已为薛氏所乱,不足引证云。
光绪十七年辛卯长夏内阁中书周学海谨记
小儿在母腹中,乃生骨气,五脏六腑,成而未全。自生之后,即长骨脉,五脏六腑之神
智也。变者,易也。(巢论云∶上多变气。)又生变蒸者,自内而长,自下而上,又身热,故以生
之日后,三十二日一变。变每毕,即情性有异于前。何者?长生腑脏智意故也。何谓三十二
日
十段而上之,十日百段。三十二日计三百二十段,为一遍。亦曰一蒸。骨之余气,自脑分入
龈中,作三十二齿。而齿牙有不及三十二数者,由变不足其常也。或二十八日即至,长二十
八齿,以下仿此,但不过三十二之数也。凡一周遍,乃发虚热,诸病如是。十周则小蒸毕也
。计三百二十日生骨气,乃全而未壮也。故初三十二日一变,生肾生志。六十四日再变生
膀胱。其发耳与KT 冷。肾与膀胱俱主于水,水数一,故先变。生之九十六日三变,生心喜。
一百二十八日四变生小肠。其发汗出而微惊。心为火,火数二,一百六十日五变生肝哭。一
百九十二日六变生胆。其发目不开而赤。肝主木,木数三。二百二十四日七变生肺声。二百
五十六日八变生大肠。其发肤热而汗或不汗。肺属金,金数四。二百八十八日九变生脾智。
三百二十日十变生胃。其发不食,肠痛而吐乳。此后乃齿生,能言知喜怒,故云始全也。太
仓云∶气入四肢,长碎骨于十变。后六十四日长其经脉,手足受血,故手能持物,足能行立
也。经云∶变且蒸,谓蒸毕而足一岁之日也。师曰∶不汗而热者,发其汗,大吐者,微下,
不可余治。是以小儿须变蒸。脱齿者,如花之易苗。所谓不及三十二齿,由变之不及。齿当
与变日相合也,年壮而视齿方明。
钱乙,字仲阳。祖上为钱塘人,与吴越王有亲属关系。吴越国归顺宋朝后,他的曾祖父随朝廷北上,于是定居在郓州。父亲钱颢,擅长针灸和医术,但嗜好饮酒且喜欢游历。有一天,他隐瞒姓名,向东游历海上,再也没有回来。当时钱乙年仅三岁。母亲早已去世,父亲同父异母的姐姐嫁给了一位姓吕的医生,同情钱乙孤苦无依,便收养他为子。钱乙渐渐长大开始读书,跟随吕先生学习医术。吕先生临终前,才告诉钱乙他的身世家世。钱乙痛哭流涕,请求寻找父亲的踪迹。前后往返五六次,终于找到了父亲的下落。又过了几年,才将父亲接回家中。这时钱乙已经三十多岁了。乡人对此惊叹感慨,感动得流泪,许多人写诗咏叹这件事。七年后,父亲寿终正寝,丧葬礼仪合乎规范。钱乙侍奉吕先生,就像侍奉父亲一样。吕先生去世后,没有后代,钱乙为他收敛尸身、办理丧事并服丧,还将他的孤女嫁出去,逢年过节祭祀供奉,都如同对待亲生父母一般。钱乙起初凭借《颅囟方》闻名于山东。元丰年间,长公主的女儿生病,召钱乙去诊治,疗效显著,因此被奏请授予翰林医学之职,赐穿绯色官服。第二年,皇帝下诏征集天下医书。当各位大臣搜罗采集的时候,天下藏书之家,无不争相献出秘本。最终未能得到这本书的真本,如今却再次见于世间,这难道不是古人的精气有不可磨灭之处吗?此书原刻版作者署名为“阎忠”,书名作“真诀”,现在不敢轻易更改。“聚珍本”中往往混入了阎氏的方论进入钱乙的书里,现在根据朱熹的版本,使得各归其位。其中药味分量间有不同,现在分别注在本方之后。至于《薛氏医案》版本已被薛氏改动混乱,不足以作为引证依据。
光绪十七年辛卯年长夏,内阁中书周学海谨记。
脉象紊乱则难治,气机不和则脉弦急,伤食则脉沉缓,虚惊则脉促急,风邪则脉浮,寒冷则脉沉细。
小儿在母腹中时,才开始生成骨气,五脏六腑成形但未完全发育。出生之后,骨骼脉络迅速生长,五脏六腑的神智也随之开启。所谓“变”,就是改变的意思。(巢元方论述说:上部多变的气。)所谓“变蒸”,是指从体内向外生长,从下向上发展,并且身体发热,所以以出生之日算起,每三十二天发生一次“变”。每次“变”结束,性情就会与之前有所不同。为什么呢?因为这是脏腑智慧意趣生长的缘故。什么是三十二日一变呢?(原文此处似有脱漏或排版错误,结合上下文理解为)十段为一节,十日百段。三十二日共计三百二十段,称为一遍,也称为一“蒸”。骨骼的余气,从脑部渗入牙龈,形成三十二颗牙齿。而有些儿童牙齿不足三十二颗,是因为“变”的过程未达到常态所致。有的二十八天就达到,长出二十八颗牙齿,以下类推,但不会超过三十二颗的数量。凡是一个周期走完,会出现虚热,各种病症也是如此。十个周期结束后,小蒸就完成了。共计三百二十天生成骨气,此时形体完备但还不够强壮。所以前三十二天第一次变,生肾,主志。六十四天第二次变,生膀胱。发作时耳朵发凉。肾与膀胱都主管水,水的成数是1,所以最先变。出生后九十六天第三次变,生心,主喜。一百二十八天第四次变,生小肠。发作时出汗且轻微惊恐。心属火,火的成数是2。一百六十天第五次变,生肝,主哭。一百九十二天第六次变,生胆。发作时眼睛睁不开且发红。肝主木,木的成数是3。二百二十四天第七次变,生肺,主声。二百五十六天第八次变,生大肠。发作时皮肤发热且有汗或无汗。肺属金,金的成数是4。二百八十八天第九次变,生脾,主智。三百二十天第十次变,生胃。发作时不吃东西,肠痛且吐乳。此后牙齿生出,能说话知晓喜怒,所以说此时形体始全。太仓公曾说:气进入四肢,在第十变时长出碎骨。再过六十四天长出经脉,手足得到血液滋养,所以手能拿东西,脚能行走站立。经书说:变且蒸,指的是蒸毕满一岁之时。老师说:不出汗而发热的,用发汗法治疗;剧烈呕吐的,用微下的方法治疗,不可用其他方法治疗。因此小儿必须有变蒸过程。换牙,就像花更换幼苗一样。所谓牙齿不足三十二颗,是由于变蒸过程未达标准。牙齿应当与变蒸的天数相吻合,等到年纪大了看牙齿情况才能明白。
Qian Yi, courtesy name Zhongyang. His ancestors were from Qiantang and were related to the King of Wuyue. After the surrender of Wuyue, his great-grandfather moved north with the court and settled in Yunzhou. His father, Qian Hao, was skilled in acupuncture and medicine but had a penchant for wine and travel. One day, he concealed his identity, traveled east along the sea, and never returned. At that time, Qian Yi was only three years old. His mother had passed away earlier, and his father's half-sister, who had married a physician surnamed Lv, pitied his orphaned state and adopted him as her son. As he grew older and began studying, he learned medicine from Master Lv. Before Master Lv's death, he revealed Qian Yi's family background. Qian Yi wept bitterly and requested to search for his father. After five or six trips, he finally found his father's whereabouts. Several more years passed before he could bring his father home. By then, Qian Yi was over thirty years old. The townspeople were amazed and moved to tears by this story, with many composing poems to praise it. Seven years later, his father died of old age, and his funeral rites were conducted according to propriety. Qian Yi served Master Lv as if he were his own father. When Master Lv died without heirs, Qian Yi arranged for his burial and mourning attire, married off his orphaned daughter, and offered sacrifices to him during festivals, treating him exactly like his biological parents. Qian Yi initially gained fame in Shandong through the *Cranial Fontanelle Formula* (*Luxin Fang*). During the Yuanfeng era, the daughter of the Eldest Princess fell ill; Qian Yi was summoned to treat her and achieved significant results. Consequently, he was recommended for the position of Hanlin Medical Officer and granted permission to wear a crimson official robe. The following year, an imperial edict collected medical texts from across the land. When officials were gathering materials, families possessing secret books competed to offer them. However, the authentic version of this book was not obtained at that time. Now that it has reappeared in the world, is it not because the essence and spirit of the ancients are indestructible? The original printed edition attributed the authorship to "Yan Zhong" and titled the work "Zhen Jue" (True Secrets); I dare not change this now. The "Juzhen Edition" often contains Yan's formulas and discussions mistakenly inserted into Qian's book. Based on the Zhu edition, these have been correctly separated. Differences in herbal ingredients and dosages are noted at the end of each respective formula. As for the *Xue Shi Yi An* (Xue's Medical Cases) edition, it has been altered by Xue and is insufficient for citation.
Recorded with caution by Zhou Xuehai, Middle Secretary of the Grand Secretariat, in the long summer of Xinmao, the 17th year of Guangxu.
A chaotic pulse indicates untreatability; a wiry and rapid pulse indicates disharmony of Qi; a deep and slow pulse indicates food stagnation; a hurried and rapid pulse indicates deficiency fright; a floating pulse indicates wind; a deep and fine pulse indicates cold.
While in the womb, the infant begins to develop bone Qi, and the Zang-Fu organs take shape but are not fully mature. After birth, the skeletal channels grow rapidly, and the spiritual intelligence of the Zang-Fu organs awakens. "Bian" (Change/Transformation) refers to alteration. (Chao Yuanfang states: Upper changes involve Qi.) "Zheng" (Steaming) refers to internal growth extending outward and upward, accompanied by body heat. Therefore, every thirty-two days after birth constitutes one "Bian." Upon completion of each "Bian," the child's temperament differs from before. Why? Because this process generates the wisdom and intent of the Zang-Fu organs. What does the thirty-two-day cycle entail? Ten segments form a section, and ten days comprise one hundred segments. Thirty-two days amount to three hundred twenty segments, constituting one full cycle, also called one "Zheng." The residual Qi of bones enters from the brain into the gums, forming thirty-two teeth. Some children have fewer than thirty-two teeth due to incomplete transformation cycles. Some may reach maturity in twenty-eight days, growing twenty-eight teeth, and so forth, but never exceeding thirty-two. Upon completing one full cycle, deficient heat may appear, and various ailments may arise similarly. After ten cycles, the minor steaming concludes. Three hundred twenty days generate bone Qi, resulting in completeness but not yet robustness. Thus, the first Bian at thirty-two days generates the Kidney and governs Will (Zhi). The second Bian at sixty-four days generates the Bladder, manifesting as cold ears. Since Kidney and Bladder govern Water, and the number of Water is one, they transform first. The third Bian at ninety-six days generates the Heart and governs Joy (Xi). The fourth Bian at one hundred twenty-eight days generates the Small Intestine, manifesting as sweating and slight fright. The Heart belongs to Fire, and the number of Fire is two. The fifth Bian at one hundred sixty days generates the Liver and governs Crying (Ku). The sixth Bian at one hundred ninety-two days generates the Gallbladder, manifesting as eyes that cannot open and appear red. The Liver governs Wood, and the number of Wood is three. The seventh Bian at two hundred twenty-four days generates the Lungs and governs Voice (Sheng). The eighth Bian at two hundred fifty-six days generates the Large Intestine, manifesting as skin heat with or without sweat. The Lungs belong to Metal, and the number of Metal is four. The ninth Bian at two hundred eighty-eight days generates the Spleen and governs Intelligence (Zhi). The tenth Bian at three hundred twenty days generates the Stomach, manifesting as refusal to eat, intestinal pain, and vomiting milk. Thereafter, teeth emerge, speech develops, and emotions like joy and anger are understood, hence it is said that completeness begins. Tai Cang Gong stated: Qi enters the four limbs, and fragmented bones grow during the tenth Bian. Sixty-four days later, meridians grow, and blood nourishes the hands and feet, enabling grasping and walking. The classics state: "Bian and Zheng" refers to the completion of steaming upon reaching one year of age. The Master said: For fever without sweating, induce sweating; for severe vomiting, use mild purgation; do not use other treatments. Thus, infants must undergo Bian-Zheng. Shedding teeth is like flowers replacing seedlings. Teeth numbering less than thirty-two result from incomplete Bian processes. Tooth development should align with Bian days; clarity comes with age.