伤寒一症。传变不常。有本传、越经传、巡经传、巡经得度传、误下传、表里传、上行传、顷刻之间。生死系焉。
可以寄人死生者。惟医焉耳矣。夫何脉理玄妙。七表八里九道。形似难辨。此庸医所以接踵而杀人者多也。元、若敖氏
抱独见之明。着《金镜录》一书。只以舌证。不以脉辨。其法浅而易知。试而辄效。诚千载不偶之秘书也。惟黑舌之症。
稍有未尽。如舌之黑而紫、黑而湿润、黑而濡滑、黑而柔软、皆寒症也。黑而肿、黑而焦、黑而干涩、黑而卷缩、黑而
坚硬、黑而芒刺、黑而拆裂、皆热症也。学医者推类以尽其余。则庶几矣。予在南都。偶得此书。深珍重之。后会副宪
笃斋汤公。出是编示之。极称其善。已命工梓行会稽郡矣。予患天下之人。未尽知也。复梓之以广其传云。
赐同进士出身大理寺左寺正陈楠书
伤寒一书。自汉张仲景先生究其精微。得其旨趣。乃万世之龟鉴也。论中梓讹难明。晋叔和成其章序。成无己《明
理论》。刘河间五运六气。参同仲景钤法。则病之所变。预可知也。阴阳传变汗瘥图局。曰汗、曰吐、曰下。死生吉凶棺
墓图局。曰死、曰生。随治随效。如附应声。则万举万全矣。元敖氏辨舌三十六法。传变吉凶。深为妙也。舌乃心之苗。
心君主之。官应南方赤色。甚者或燥、或涩、青、白、黑。是数者，热气浅深之谓。舌白者，肺金之色也。由寒水甚而
制火。不能平金。则肺自甚。故色白也。舌青者，肝木之色也。由火甚而金不能平木。则肝木自甚。故色青也。色青为
寒者讹矣。仲景法曰∶“少阴病。下利清谷。”色青者，热在里也。大承气汤下之。舌黄者，由火甚，则水必衰。所以一
水不能制五火而脾土自旺。故色黄也。舌红为热。心火之色也。或赤者，热深甚也。舌黑亦言为热者。由火热过极。则
反兼水化。故色黑也。五色应五脏固如此。敖氏以舌白者邪在表。未传于里也。舌白苔滑者。痛引阴筋。名脏结也。舌
之赤者。邪将入也。舌之紫者。邪毒之气盛也。舌之红点者。火之亢极也。舌之燥裂者。热之深甚也。或有黑圈黑点者。
水之萌发也。舌根黑者。水之将至也。舌心黑者。水之已至也。舌全黑者。水之体也。其死无疑矣。舌黄者。土之正色
也。邪初入于胃。则本色微黄发见。舌黄白者。胃热而大肠寒也。舌之统黄者。则胃实而大肠燥也。调胃承气汤下之。
黄自去矣。舌灰黑者。厥阴肝木相承。速用大承气汤下之。可保。但五死一生。大抵伤寒传变不一。要须观其形、察其
色、辨其舌、审其症、切其脉、对症用药。在于活法。如脉浮紧而涩者。日数虽多。邪在表也。汗之而愈。若脉沉实而
滑。日数虽少。邪在内也。下之而痊。其有半表半里。传到少阳只一证。则小柴胡汤主之。无不效也。太阴腹满自利。
脉沉而细者。附子理中汤主之。太阴腹满时痛便硬者。桂枝加大黄汤主之。少阴舌干、口燥、津不到咽者。人参白虎汤
主之。少阴发热而恶寒。脉沉而迟者。麻黄附子细辛汤。助阳而汗之。厥阴舌卷囊缩。脉沉而弦者。为毒瓦斯藏。脉沉而
短者。用承气汤下之。若厥冷、耳聋、囊缩、脉沉而弦者。少阴两感、不治之症也。此则三阴有可汗、可下、可温之理。
敖君立法辨舌。自为专门体认之精。当时尝着《点点金》及《金镜录》二书。皆秘之而不传。余于正德戊辰岁。见一人
能辨舌色。用药辄效。因扣之，彼终不言。偶于南雍得《金镜录》。归检之。乃知斯人辨舌、用药之妙。皆本是书。惟《点
点金》一书。则于伤寒家多有不切。其与仲景钤法奥旨同者。特《金镜录》尔。故余并刊于官舍。使前人之书。皆得以
行于世。而四方学人。亦知所去取云。时
嘉靖己丑岁仲冬吉旦
南京太医院院判长洲薛己识
青藩良医所良医马崇儒校刊
伤寒这一病症，其传变规律并不固定。有本经传、越经传、循经传、循经得度传、误用下法后的传变、表里传、上行传等，往往在顷刻之间决定生死。
能够寄托患者生死命运的，只有医生罢了。然而脉理玄妙深奥，七表、八里、九道脉象形态相似难以辨别，这就是庸医接踵而至却多因误诊而杀人的原因。元代敖氏怀有独到的见解和明察，撰写了《金镜录》一书，仅凭舌象辨证，而不依赖脉诊。这种方法浅显易懂，尝试使用往往见效，确实是千年难遇的秘藏之书。只是对于黑舌的症状，论述稍有未尽之处。例如：舌色黑而紫、黑而湿润、黑而濡滑、黑而柔软，都属于寒证；舌色黑而肿胀、黑而焦枯、黑而干涩、黑而卷缩、黑而坚硬、黑而有芒刺、黑而皲裂，都属于热证。学医的人推究此类以穷尽其余情况，那就差不多了。我在南京时，偶然得到这本书，非常珍视它。后来遇到副宪笃斋汤公，他拿出这本书给我看，极力称赞其好处，已经命工匠在会稽郡刻印刊行了。我担心天下人未能完全知晓此书的内容，于是再次刻印以广泛传播它。
赐同进士出身、大理寺左寺正陈楠 撰序
伤寒一书，自汉代张仲景先生探究其精微之处，得其主旨意趣，便成为万世的借鉴准则。书中原文因刻印错误难以明了，晋代王叔和整理了篇章序次。成无己著有《明理论》，刘河间结合五运六气学说，参照并印证张仲景的法度，那么疾病的变化就可以预先知晓了。阴阳传变汗瘥图局，分为“汗”、“吐”、“下”三种治法；死生吉凶棺墓图局，分为“死”、“生”两种结果。随着治疗随即见效，如同附子应声而效，那么万次行动万次周全。元代敖氏辨析舌象三十六法，判断传变的吉凶，极为精妙。舌是心的苗窍，由心君主之，官位对应南方赤色。病情严重时或干燥、或涩滞、或呈青色、白色、黑色。这几种颜色，代表热气深浅的不同。舌色白，是肺金的本色。由于寒水过盛制约心火，不能平抑肺金，则肺金自盛，所以舌色白。舌色青，是肝木的本色。由于火气过盛，肺金不能平抑肝木，则肝木自盛，所以舌色青。认为色青为寒是错误的。张仲景的法度说：“少阴病，下利清谷。”舌色青，表示热邪在里。应用大承气汤攻下。舌色黄，是由于火气过盛，则水气必然衰弱。所以一水不能制约五火，脾土自旺，所以舌色黄。舌色红为热，是心火的本色。如果呈赤色，说明热邪深重。舌色黑也说为热，是由于火热过极，反而兼有水化之象，所以舌色黑。五色对应五脏本来就是这样。敖氏认为舌白者邪气在表，未传入里。舌白且苔滑者，疼痛牵引阴筋，名为脏结。舌色赤者，邪气将要入里。舌色紫者，邪毒之气旺盛。舌上有红点者，火气亢盛至极。舌面干燥皲裂者，热邪深重。如果有黑圈黑点者，是水气萌发的征兆。舌根黑者，是水气将至。舌中心黑者，是水气已至。全舌黑者，是水气的主导体征，死亡无疑。舌色黄，是土的正色。邪气初入胃，本色微黄显现。舌黄白相间者，是胃热而大肠寒。舌统体皆黄者，是胃实而大肠燥。应用调胃承气汤攻下，黄色自然去除。舌灰黑者，是厥阴肝木相乘，速用大承气汤攻下，可以保全性命。但五死一生，大抵伤寒传变不一，必须观察其形体、察辨其颜色、分辨其舌象、审察其症状、切按脉象，对症用药，关键在于灵活运用。如脉浮紧而涩，虽然日数多，但邪气在表，发汗即可痊愈。若脉沉实而滑，虽然日数少，但邪气在内，攻下即可痊愈。若有半表半里之证，传到少阳只有一证，则用小柴胡汤主治，没有不生效的。太阴病腹满自利，脉沉细者，用附子理中汤主治。太阴病腹满时痛大便硬者，用桂枝加大黄汤主治。少阴病舌干、口燥、津液不到咽喉者，用人参白虎汤主治。少阴病发热而恶寒，脉沉迟者，用麻黄附子细辛汤，助阳而发汗。厥阴病舌卷囊缩，脉沉弦者，为毒瓦斯内藏，脉沉短者，用承气汤攻下。如果出现厥冷、耳聋、囊缩，脉沉弦者，属于少阴两感，是不治之症。这则是三阴病有可汗、可下、可温的道理。敖君确立立法辨舌的方法，自有专门体认的精妙之处，当时曾著《点点金》及《金镜录》两书，都秘而不传。我在正德戊辰年，见到一个人能辨别舌色，用药辄效，因此询问他，他始终不说。偶然在南京国子监得到《金镜录》，回去查阅，才知道这人辨舌、用药的奥妙，都是依据这本书。只有《点点金》一书，对于伤寒家多有不够贴切之处，其与张仲景法度奥旨相同的，特指《金镜录》罢了。所以我一并刊印于官舍，使前人的书籍都能流传于世，让四方学人也知道如何取舍。
Shanghan (Cold Damage) is a disease whose transmission and transformation are irregular. It may follow the meridian of origin, skip meridians, follow the meridian sequentially, follow the meridian within limits, transmit due to erroneous purgation, transmit between exterior and interior, or ascend, with life and death hanging in the balance within moments.
The fate of patients can only be entrusted to physicians. However, pulse diagnosis is profound and subtle; the seven superficial, eight deep, and nine distinct pulse qualities appear similar and are difficult to distinguish. This is why incompetent physicians often kill patients by following one another. In the Yuan Dynasty, Master Ao possessed unique insight and wrote the book *Jin Jing Lu* (Golden Mirror Record). He relied solely on tongue diagnosis rather than pulse differentiation. His method was simple and easy to understand, yielding immediate results upon application. It is indeed a rare secret treasure of a millennium. However, his discussion on black tongue symptoms was slightly incomplete. For instance: a black tongue that is purple, moist, slippery, or soft indicates a Cold syndrome. A black tongue that is swollen, scorched, dry and rough, curled, hard, has prickles, cracks, or splits indicates a Heat syndrome. Physicians who deduce from these cases to exhaust other possibilities will achieve proficiency. I obtained this book by chance while in Nanjing and cherished it deeply. Later, Vice Censor-in-Chief Tang Duzhai showed it to me, praising its excellence, and ordered its printing in Kuaiji Commandery. Fearing that people throughout the world did not fully know of it, I had it reprinted to spread its transmission.
Chen Nan, Jinshi degree holder and Left Judge of the Court of Judicature and Revision, wrote the preface.
The book on Shanghan was refined by Mr. Zhang Zhongjing of the Han Dynasty, who grasped its essence, making it an eternal guide for ten thousand generations. The original text contained printing errors that made it difficult to understand. Wang Shuhe of the Jin Dynasty organized its chapters and prefaces. Cheng Wuji's *Ming Li Lun* (Clarification of Principles) and Liu Wanjun's integration of the Five Movements and Six Qi theories, referencing Zhang Zhongjing's methods, allow one to predict disease transformations in advance. The diagrams of Yin-Yang transmission and recovery after sweating categorize treatments into Sweating, Vomiting, and Purging; and outcomes into Death and Life. With treatment matching efficacy like the response to Fuzi (Aconite Root), every attempt would be successful. Master Ao's thirty-six methods of tongue differentiation for judging transmission and fortune/fortune were profoundly excellent. The tongue is the sprout of the Heart, governed by the Heart Monarch, corresponding to the South and the color Red. In severe cases, the tongue may become dry, rough, green, white, or black. These colors indicate the depth of Heat. White tongue reflects the color of Lung Metal. When Cold Water is excessive and suppresses Heart Fire, failing to control Lung Metal, Lung Metal becomes hyperactive, resulting in a white tongue. Green tongue reflects the color of Liver Wood. When Fire is excessive and Lung Metal fails to control Liver Wood, Liver Wood becomes hyperactive, resulting in a green tongue. It is erroneous to consider green as Cold. Zhang Zhongjing stated: "Shaoyin disease, with diarrhea of undigested food." A green tongue indicates Heat in the Interior. Apply Da Chengqi Tang (Major Order the Qi Decoction) to purge. Yellow tongue occurs when Fire is excessive and Water is weak. One portion of Water cannot control five portions of Fire, causing Spleen Earth to flourish, resulting in a yellow tongue. Red tongue indicates Heat, reflecting Heart Fire. Crimson tongue indicates deep Heat. Black tongue is also considered Heat because extreme Fire generates a Water-like transformation, resulting in a black color. The correspondence of five colors to five Zang organs is thus established. Master Ao believed that a white tongue indicates pathogenic factors in the Exterior, not yet transmitted to the Interior. A white tongue with slippery coating, accompanied by pain drawing into the yin sinews, is named Zang Jie (Organ Knotting). A crimson tongue indicates pathogens about to enter the Interior. A purple tongue indicates abundant pathogenic toxicity. Red spots on the tongue indicate extreme Hyperactivity of Fire. Dry and cracked tongue indicates deep Heat. Black circles or spots indicate the germination of Water energy. Black at the root of the tongue indicates approaching Water energy. Black in the center of the tongue indicates arrived Water energy. A completely black tongue indicates the substance of Water, leading inevitably to death. Yellow tongue is the proper color of Earth. When pathogens first enter the Stomach, the natural color appears slightly yellow. Yellow and white tongue indicates Stomach Heat and Large Intestine Cold. Uniformly yellow tongue indicates Stomach Excess and Large Intestine Dryness. Apply Tiaowei Chengqi Tang (Regulate the Stomach Major Order the Qi Decoction) to purge, and the yellow color will disappear. Gray-black tongue indicates Jueyin Liver Wood overacting; quickly apply Da Chengqi Tang to purge, ensuring survival. Generally, among five deaths there is one life. Shanghan transmission varies; one must observe the form, inspect the color, differentiate the tongue, examine symptoms, palpate the pulse, and prescribe according to the condition, relying on flexible application. If the pulse is floating, tight, and choppy, even if many days have passed, the pathogen is in the Exterior; sweating will cure it. If the pulse is sunken, solid, and slippery, even if few days have passed, the pathogen is in the Interior; purging will cure it. For half-exterior half-interior conditions transmitting to Shaoyang with only one symptom, Xiao Chaihu Tang (Minor Bupleurum Decoction) is the primary formula, always effective. For Taiyin abdominal fullness and spontaneous diarrhea with sunken, fine pulse, Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) is used. For Taiyin abdominal fullness, intermittent pain, and hard stool, Guizhi Jiadahuang Tang (Cinnamon Twig Plus Rhubarb Decoction) is used. For Shaoyin dry tongue, dry mouth, and lack of fluids reaching the throat, Renshen Baihu Tang (Ginseng White Tiger Decoction) is used. For Shaoyin fever with aversion to cold and sunken, slow pulse, Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) is used to assist Yang and induce sweating. For Jueyin curled tongue and contracted scrotum with sunken, wiry pulse, toxins are stored internally; if the pulse is sunken and short, use Chengqi Tang to purge. If there is cold extremities, deafness, contracted scrotum, and sunken, wiry pulse, it is Shaoyin simultaneous exterior-interior involvement, an untreatable condition. Thus, the three Yin meridians have principles of sweating, purging, and warming. Master Ao's legislation for tongue differentiation possesses specialized precision. At that time, he authored two books, *Dian Dian Jin* (Dot Dot Gold) and *Jin Jing Lu*, keeping them secret. In the year Wuchen of Zhengde, I met someone skilled in tongue differentiation who prescribed effectively but refused to reveal his source. I accidentally obtained *Jin Jing Lu* at the National Academy in Nanjing. Upon checking it, I realized his skills were based on this book. Only *Dian Dian Jin* had some imprecisions regarding Shanghan; its alignment with Zhang Zhongjing's profound principles is found specifically in *Jin Jing Lu*. Therefore, I printed both in my official residence so that predecessors' works could circulate, allowing scholars everywhere to know what to adopt or discard.
Xue Ji, Dean of the Imperial Hospital of Nanjing, recorded this on an auspicious day in mid-winter of the year Jichou of the Jiajing reign.
Ma Chongru, Physician of the Qingfan Good Medicine Office, proofread and published.