《内经》,医之奥旨也。诸方,医之粗迹也。近代时医,相率以方授受,而求经论者无
之。舍奥旨而务粗迹,安望其术之神良乎。虽然方亦何可废也,方以立法,法以制宜,譬之
工,匠心独创,断未有 规矩而为之者。特神而明之,存乎其人焉耳。古昔方书,得人乃
传,扁鹊仓公,皆称禁方,秘不轻授,所以汉时以前,成方绝少。而仲景为方书之祖也,仲
景以后,方书充栋,无如制方者日益多,而注方者不少概见。宋成无己始将仲景一百十三方,
论而注之,使观者知其端绪,渐得解会,但循文训释,仲景之良法精义,不能尽彻。迄明兴,
始有吴鹤皋之医方考,因病分门,词旨明爽,海内盛行,但搜采不无阙略。近日汪 庵仿成
氏吴氏之意而扩充之,采辑古方,名曰集解,先详受病之由,次解用药之意,硕论名言,采
搜甚富,然不能无承讹袭愆之说,且于新方,总未采录,均未可以语全书也。洛不揣愚陋,
取吴氏汪氏所辑而增改之,得古今良方凡一千一百余首,禀诸经以观其合,订之证以发其微,
编为十三卷,题其端曰,成方切用。以所录皆取切于时用之方,而尤其用方者之切于病情
也。何则,迩来风气浸薄,人之禀受,远不及古,故方有宜古不宜今者。设起仲景于今日,
将必有审机察变,损益无已者,而谓录方可不切于时用乎。且病有标本先后,治有缓急逆从,
医贵通变,药在合宜,苟执一定之方,以应无穷之证,未免实实虚虚,损不足而益有余,反
致杀人者多矣。用方之切于病,岂易易哉,然则如之何而后可,曰∶研穷乎《灵枢》《素问
》,而经义无不通也。详求夫望闻问切,而证因莫能遁也。深悉于气味阴阳,而药性剖其微
也。夫然后经之以法,纬之以方,从斯集而合离变化焉,自迎刃而中其肯綮矣。
乾隆辛巳冬月澉水吴仪洛遵程书于硖川之利济堂
《黄帝内经》是医学深奥精微的宗旨。各种方剂,只是医学表面的痕迹(基础应用)。近代以来的时医,互相传授方剂,却没有人去探究经典理论。舍弃了深奥的宗旨而致力于表面的痕迹,怎么能指望医术神奇良善呢?虽然如此,方剂又怎么可以废弃呢?方剂用来确立治法,治法用来适应病情变化,就像工匠一样,虽然有独创的匠心,但断然没有不遵循规矩法度就能制作器物的。只是能否达到神妙明通的境界,取决于行医者本人罢了。古代的方书,得到合适的人才会传承,扁鹊、仓公都称之为禁方,秘密而不轻易传授,所以在汉代以前,现成的成方极少。而张仲景被尊为方书之祖。张仲景之后,方书堆积如山,无奈制定方剂的人日益增多,而对方剂进行注释解说的人却很少见到。宋代成无己开始将张仲景的一百一十三首方剂,进行论述和注释,使读者知道其头绪,逐渐能够理解领会,但他只是顺着文义进行训释,张仲景的良好方法和精微义理,不能完全透彻地揭示出来。到了明代兴起,才有吴鹤皋的《医方考》,因病证分类,文辞旨意明白清爽,在海内广泛流行,但搜集采录不免有缺漏遗漏。近日汪昂仿照成无己、吴鹤皋的意思而加以扩充,采集辑录古代方剂,命名为《集解》,先详细阐述患病的原因,其次解释用药的意图,宏论名言,搜集非常丰富,然而不能没有沿袭错误、承继过失的说法,并且对于新创的方剂,完全没有收录,这些都还不足以称为完备的全书。我吴仪洛不自量力,采取吴氏、汪氏所辑录的内容而增加修改,得到古今良方共一千一百多首,依据经络理论来观察其是否符合,结合证候来发掘其精微之处,编纂为十三卷,在篇首题名曰《成方切用》。因为所收录的都是切合当时临床使用的方剂,而且更是使用方剂的人迫切契合病情的需要。为什么呢?近来风气逐渐淡薄,人的体质禀赋,远不如古人,所以有的方剂适宜于古人不适宜于今人。假如让张仲景活在今天,一定会有审察病机、洞察变化,不断增减调整的情况,那么记录方剂怎能不切合当时使用呢?况且疾病有标本先后之分,治疗有缓急逆从之别,医生贵在通晓变通,药物在于合乎适宜,如果固执于固定的方剂,来应对无穷无尽的证候,未免会导致实证更实、虚证更虚,损伤不足的正气而助长有余的邪气,反而导致杀人更多了。使用方剂迫切契合病情,难道容易吗?既然如此,那么要怎么做才可以呢?回答说:深入研究《灵枢》《素问》,那么经文的义理就没有不通晓的了。详细探求望、闻、问、切四诊,那么病因证候就无法隐藏了。深刻熟悉药味的阴阳属性,那么药性的精微之处就能剖析清楚了。这样然后用治法作为经线,用方剂作为纬线,从此集合起来,离合变化自然能迎刃而解,击中要害了。
乾隆辛巳年冬月,澉水人吴仪洛遵照程先生的教导,书写于硖川的利济堂。
*Huangdi Neijing* (Yellow Emperor's Inner Canon) represents the profound and essential principles of medicine. Various prescriptions constitute merely the superficial applications or foundational traces of medical practice. In recent times, contemporary physicians have successively transmitted prescriptions to one another, yet few seek to explore the classic theories. Abandoning the profound principles to focus on superficial applications, how can one hope for miraculous and excellent medical skills? Nevertheless, how can prescriptions be discarded? Prescriptions are used to establish treatment methods, and treatment methods are employed to adapt to specific conditions. It is like a craftsman: although possessing unique ingenuity, no one can create objects without adhering to compasses and squares (rules and standards). Whether one can achieve divine and enlightened mastery depends entirely on the practitioner themselves. Ancient medical texts were transmitted only to worthy individuals; Bian Que and Cang Gong both referred to their formulas as "forbidden prescriptions," keeping them secret and not imparting them lightly. Therefore, prior to the Han Dynasty, established prescriptions were extremely rare. Zhang Zhongjing is revered as the ancestor of prescription literature. After Zhang Zhongjing, prescription books piled up like beams, yet while those formulating prescriptions increased daily, those annotating them were rarely seen. In the Song Dynasty, Cheng Wuji began to discuss and annotate the 113 prescriptions of Zhang Zhongjing, allowing readers to understand their sequence and gradually grasp their meaning. However, he merely explained the text literally, failing to fully elucidate the excellent methods and subtle meanings of Zhang Zhongjing. It was not until the rise of the Ming Dynasty that Wu Hegao published *Yifang Kao* (Examination of Medical Prescriptions), categorizing prescriptions by disease with clear and concise language, which became widely popular throughout the realm. Yet, its collection was inevitably incomplete. Recently, Wang Ang, imitating the intentions of Cheng and Wu, expanded upon their work, compiling ancient prescriptions titled *Jijie* (Collected Explanations). He first detailed the causes of disease, then explained the rationale behind medication, gathering abundant grand theories and famous quotes. However, it still contained errors inherited from previous works and failed to include newly created prescriptions, thus falling short of being a comprehensive whole. I, Wu Yiluo, disregarding my own ignorance and limitations, took the compilations of Wu and Wang, added to and revised them, obtaining over 1,100 excellent prescriptions from ancient and modern times. I examined their conformity through the meridians and revealed their subtleties through clinical manifestations, compiling them into thirteen volumes. I titled the beginning section "Chengfang Qieyong" (Essential Use of Established Prescriptions). This is because all recorded prescriptions are those pertinent to current clinical use, and more importantly, they address the urgent needs of practitioners in matching prescriptions to patient conditions. Why is this? The prevailing ethos has gradually deteriorated, and human constitutional endowments today are far inferior to those of antiquity; thus, some prescriptions suitable for ancient times may not be suitable for today. If Zhang Zhongjing were alive today, he would undoubtedly constantly examine pathogenesis, observe changes, and adjust treatments accordingly. Would recording prescriptions not need to be pertinent to current usage? Furthermore, diseases have distinctions of root and branch, priority and sequence, while treatments involve considerations of urgency, slackness, directness, and contrariness. Physicians must excel in adaptability, and medicines must be appropriate. If one rigidly adheres to fixed prescriptions to respond to infinite variations of syndromes, one risks exacerbating excess conditions and depleting deficiency conditions, damaging what is insufficient and augmenting what is already excessive, thereby causing more deaths. Is it easy to apply prescriptions appropriately to match the disease? Then, how should one proceed? The answer is: thoroughly study the *Lingshu* (Spiritual Pivot) and *Suwen* (Basic Questions), so that the meanings of the classics will be fully understood; meticulously inquire through inspection, auscultation/olfaction, inquiry, and palpation, so that the causes and syndromes cannot escape detection; deeply comprehend the flavors and yin-yang properties of herbs, so that the subtleties of drug nature will be clearly analyzed. Only then, using treatment methods as the warp and prescriptions as the weft, can one synthesize knowledge, where integration and transformation occur naturally, resolving difficulties effortlessly and hitting the critical points accurately.
Written in the winter month of Xinsi year of the Qianlong reign, at Liji Hall in Xiachuan, Wu Yiluo of Ganshui, following the teachings of Master Cheng.