余性素拘。凡所着述。皆言其所明。弗明者弗敢言也。夫明非不喻其理之谓。谓必得所传授。亲习其事。有以证其
理之不差。而后晓然于心者。亦晓然于手与目。斯之谓明也。如是言之。则皆确凿可据。非浮光掠影之谈。非臆测傅会
之语耳。余于医传自孙庆曾先生。凡男妇大小。为脉为症。皆得之亲受。故试之诊视。罔弗取效。前着伤寒纲目。杂病
源流。妇科玉尺。皆晓然于心与手目。一一笔之于书者也。幼科中独痘疮一症。其旨微。其候险。其变化百出。尤必临
症指示。而后能悉其精微。知其蕴奥。孙先生与前辈叶天士同出一门。固精于痘。而余于受业时。非专属行医。弗获相
随痘家。亲聆教诲。故独于痘。弗敢言也。虽古痘医。首推钱仲阳、陈文中。后如曾氏、万氏、汤氏、魏氏。皆接两家
宗派。而翟氏、聂氏。尤能阐明钱陈底蕴。其书具在。未尝不深切究明。晓然于理之所在。然未得临症指示。所谓晓然
于心。未能晓然于手与目也。既不能晓然于手与目。其敢自谓已明。而妄有言乎。故辑幼科释谜六卷。共分二十四门。
独阙痘症。非竟阙也。庸有待也。孙先生虽已捐世。或得一精其业者。受其传焉。则阙者未尝不可补矣。释谜既成。因
书其故以冠于首。
时乾隆三十九年甲午十二月上浣无锡沈金鳌芊绿氏自书。
我生性向来严谨拘谨。凡是所撰写的著作，都是阐述我所真正明白的道理；对于不明白的，我不敢妄加评论。所谓的“明”，并不是仅仅懂得其中的道理就叫做明，而是必须得到师长的传授，亲自实践操作，有确凿的证据证明其道理没有差错，然后才能在心中透彻理解，并且也能在手头操作和肉眼观察上做到清晰明了。这才叫做“明”。像这样写出来的文字，都是确凿有据的，不是浮光掠影的空谈，也不是主观臆测、牵强附会的言语。
我的医学传承自孙庆曾先生。无论是男性、女性还是儿童的各种脉象和症状，都是我亲自接受教导所得。因此，我在进行诊断和治疗时，没有不取得疗效的。之前撰写的《伤寒纲目》、《杂病源流》、《妇科玉尺》，都是在心中和手上、眼中都透彻明白后，一一记录在书中的。而在儿科中，唯独痘疮（天花）这一病症，其旨意微妙，病情险恶，变化多端，尤其必须通过临床实际指导，才能完全掌握其精微之处，了解其深奥内涵。孙先生与前辈叶天士出自同一师门，原本精通痘科治疗，但在我跟随他求学期间，并不专门从事行医，因此未能随同他接触痘科患者，亲耳聆听教诲。所以唯独对痘科，我不敢妄言。虽然古代痘科医生首推钱乙（钱仲阳）、陈文中，后来如曾氏、万氏、汤氏、魏氏，都继承了两家的宗派，而翟氏、聂氏，更能阐明钱乙和陈文中的深层底蕴。他们的书籍都存在，我也未曾不深入探究明白，知晓其中道理的所在。然而，因为没有得到临床实际的指导，所谓在心中透彻明白，却未能在手头和眼中做到清晰明了。既然不能在手头和眼中做到清晰明了，怎敢自称已经明白，从而妄加言论呢？
因此，我编纂了《幼科释谜》六卷，共分二十四门，唯独缺失了痘症这一部分。并非真的缺失，而是有待将来填补。孙先生虽然已经去世，但如果能找到一个精通此业的人，接受他的传承，那么缺失的部分未尝不可以补全。《幼科释谜》完成后，于是写下这些原委放在书的开头。
时在乾隆三十九年甲午年十二月上旬，无锡沈金鳌芊绿氏亲手书写。
My nature has always been rigorous and cautious. In all my writings, I expound only upon principles that I truly understand; for those I do not comprehend, I dare not speak. The term "understanding" (Ming) does not merely mean grasping the theoretical logic; it implies receiving transmission from a teacher, personally practicing the skills, and having empirical evidence to verify that the theory is flawless. Only then can one clearly comprehend it in the mind, as well as execute it with the hands and observe it with the eyes. This is what constitutes true understanding. Thus, the words written are solid and verifiable, not superficial chatter or speculative conjecture.
My medical lineage traces back to Mr. Sun Qingzeng. For all pulse diagnoses and symptoms regarding men, women, and children, I received direct instruction. Consequently, in my clinical practice, my treatments have invariably been effective. My previous works, *Shanghan Gangmu* (Outline of Cold Damage), *Zabing Yuanliu* (Source and Flow of Miscellaneous Diseases), and *Fuke Yuchi* (Jade Ruler for Gynecology), were all recorded after achieving clarity in both mind and practical execution. Among pediatric conditions, however, smallpox (Douchuang) stands alone. Its etiology is subtle, its prognosis perilous, and its manifestations highly variable. It requires clinical demonstration to fully grasp its subtleties and profundities. Mr. Sun shared the same lineage as the senior physician Ye Tianshi and was indeed proficient in smallpox treatment. Yet, during my apprenticeship, my studies were not exclusively focused on clinical practice, so I did not accompany him in treating smallpox cases nor receive his direct teachings on this subject. Therefore, I dare not write about smallpox.
Although ancient authorities on smallpox primarily cite Qian Zhongyang (Qian Yi) and Chen Wenzhong, later physicians such as Zeng, Wan, Tang, and Wei inherited their schools. Specifically, Zhai and Nie elucidated the depths of Qian and Chen's theories. Their texts remain extant, and I have studied them thoroughly to understand their theoretical foundations. However, lacking clinical guidance, while I may understand them intellectually, I cannot apply them with confidence in practice. Since I lack this practical mastery, how could I claim to understand and thus speak recklessly?
Therefore, I compiled *Youke Shiming* (Explaining the Mysteries of Pediatrics) in six volumes, divided into twenty-four categories, deliberately omitting the section on smallpox. This omission is not permanent but pending future supplementation. Although Mr. Sun has passed away, if a successor skilled in this field arises to inherit his knowledge, the gap may be filled. Having completed *Youke Shiming*, I record these reasons at the beginning of the book.
Written by hand by Shen Jin'ao, courtesy name Qianlü, of Wuxi, in the first ten days of the twelfth month of the Jiawu year, the 39th year of the Qianlong reign.