先朝都宪节斋王翁,自秀才时,便存心天下,以为吾即不得致君泽民,当以医药寿斯世夭札耳!及
登第,任历中外,皆得人心;至于人之 疾,治无不验。古人所谓良相良医,盖兼体之矣。所着发热等
篇,名《明医杂着》,刊行有年矣。厥问答拟议,悉本《医学纲目》中来,其渊源心力可想见也。然犹不
自满,假当其友之请梓,辞以政余《草集》未及成书,疆而后可,且云俟予晚年林下,更须增损。惜
乎!其未果也。己辄不自分,窃以先生引而未发之意,漫为补注,附以治验焉。或曰∶脉之不知,病安从
识?于是之书,何独略于诊法邪?乃更入滑伯仁先生《诊家枢要》,共六卷,末则续备方饵,以便初学览用。
稿虽苟完,颇多简赘之失,适总宪及斋魏翁,备兵我吴,而翁亦素通于医,盖今日之节斋也。每过余
谈及,率叹民命之当重,而药之不可不讲也。辱就鄙稿加之笔削,行吴邑宋尹阳山梓之,但愧刍荛
枝叶,弗足采择耳!大方其教之,勿以老拙而弃之,曰不足与之言。
大明嘉靖辛亥冬仲吉日前奉政大夫太医院院使后学薛己谨序
或问∶仲景、东垣、河间、丹溪诸书孰优?学之宜何主?曰∶宜专主《内经》,而博观乎四子,斯
无弊矣。盖医之有《内经》,犹儒道之六经,无所不备;四子之说,则犹《学》、《庸》、《语》、
《孟》,为六经之阶梯,不可缺一者也。四子之书,初无优劣,但各发明一义耳!仲景见《内经》载伤
寒,而其变迁反复之未备也,故着论立方,以尽其变。后人宗之,传用既久,渐失其真,用以通治温暑、
内伤诸症,遂致误人。故河间出而始发明治温暑之法,东垣出而始发明治内伤之法。河间之论,即
《内经》五运六气之旨∶东垣之说,即《内经》饮食、劳倦之义。仲景非不知温暑与内伤也。特其
着书未之及。河间、东垣之于伤寒,则尊用仲景而莫敢违矣。至于丹溪出,而又集诸儒之大成,发明
阴虚发热类乎外感,内伤及湿热相火为病甚多,随症着论,亦不过阐《内经》之要旨,补前贤之未备耳!
故曰外感法仲景,内伤法东垣,热病用河间,杂病用丹溪,一以贯之,斯医道之大全矣。
明代先前的都宪节斋王公,从做秀才时起,就心系天下,认为我即使不能辅佐君主、恩泽百姓,也应当用医药来拯救世间早夭之人!等到考中进士后,历任朝廷内外官职,都能赢得人心;至于治疗人们的疾病,没有不灵验的。古人所说的良相与良医,大概在他身上兼具了。他所著的《发热》等篇章,命名为《明医杂着》,刊行已有多年了。其中问答和议论的内容,完全依据《医学纲目》而来,其渊源和心力可以想见。然而他仍不满足,恰逢朋友请求刻印,他以政务之余编写的《草集》尚未成书为由推辞,勉强答应后才同意,并且说等到晚年退隐林下时,还需要增删修改。可惜啊!最终未能实现。我便不自量力,私下里以先生引用而未阐发的意思,随意进行补注,并附上治疗验证的案例。有人说:如果不了解脉象,疾病又从何识别?因此这本书,为何唯独略于诊法呢?于是我又加入了滑伯仁先生的《诊家枢要》,共六卷,最后续备方药,以便初学者阅读使用。稿子虽然粗略完成,但有很多简略和赘余的失误,恰逢总宪及斋魏公,在吴地备兵,而魏公也向来通晓医术,就像今天的节斋公一样。每次经过我这里谈及此事,总是感叹百姓性命应当重视,而药物不可不研究。承蒙他对我粗陋的稿件加以删改,在吴邑宋尹阳山刻印,只是惭愧我的见解如刍荛枝叶般浅薄,不足以被采纳选择!希望大方之家教导我,不要因为我年老拙劣而抛弃它,说不值得与我交谈。
大明嘉靖辛亥年冬月吉日,前奉政大夫太医院院使、后学薛己恭敬作序。
有人问:张仲景、李东垣、刘河间、朱丹溪各位先生的著作哪个更优?学习应该以谁为主?回答说:应当专门以《黄帝内经》为主,而广泛阅览这四位先生的著作,这样就没有弊病了。因为医学有《黄帝内经》,就像儒家之道有六经,无所不备;四位先生的学说,就像《大学》、《中庸》、《论语》、《孟子》,是通往六经的阶梯,不可缺少的。四位先生的书,原本没有优劣之分,只是各自阐发了一方面的义理罢了!张仲景看到《黄帝内经》记载了伤寒,但其变化反复之处尚不完备,所以著论立方的,以穷尽其变化。后人尊崇它,流传使用既久,逐渐失去了真意,用来通用治疗温病、暑病、内伤等各种症状,于是导致误人。所以刘河间出现才开始阐明治疗温病、暑病的方法,李东垣出现才开始阐明治疗内伤的方法。刘河间的理论,就是《黄帝内经》五运六气的宗旨;李东垣的说法,就是《黄帝内经》饮食、劳倦的含义。张仲景并非不知道温病和内伤,只是他的著作中没有涉及。刘河间、李东垣对于伤寒,则是尊奉使用张仲景的方法而不敢违背。至于朱丹溪出现,又集诸儒之大成,阐明了阴虚发热类似外感,内伤以及湿热相火致病很多的情况,随症著论,也不过是阐发《黄帝内经》的要旨,补充前贤未完备的地方罢了!所以说外感病效法张仲景,内伤病效法李东垣,热病使用刘河间的方法,杂病使用朱丹溪的方法,一贯贯通,这就是医道的大全了。
In the previous reign of the Ming Dynasty, Wang Gong (Courtesy Name: Jiezhai), who held the title of Censor-in-Chief, from his time as a student (Xiucai), had already been concerned with the world. He believed that even if he could not assist the ruler and benefit the people, he should use medicine to save those in the world who died prematurely! After passing the imperial examinations and serving in various official positions both inside and outside the court, he won the hearts of the people; as for treating people's diseases, there was no treatment that did not prove effective. The ancient saying about a "good minister" and a "good physician" seemed to be embodied in him. His works, including chapters such as "Fever," were named *Mingyi Zazhu* (Miscellaneous Writings of a Clear Physician) and had been published for many years. The questions and answers, as well as discussions within, were entirely based on *Yixue Gangmu* (Outline of Medical Science), from which one can imagine their origins and mental efforts. However, he was still not satisfied. When friends requested the printing of his work, he declined, citing that his manuscript collection (*Caoji*) compiled during leisure from administrative duties was not yet complete. Only after being strongly urged did he agree, stating that when he retired to the countryside in his later years, further additions and deletions would be necessary. Alas! This was never realized. I, presumptuously, took it upon myself to privately supplement the notes based on the meanings implied but not fully expounded by Mr. Wang, attaching clinical cases of verification. Some might ask: If one does not understand pulse diagnosis, how can diseases be identified? Therefore, why is this book particularly brief regarding diagnostic methods? Consequently, I added Master Hua Borren's *Zhenjia Shuyao* (Key Essentials of Pulse Diagnosis), making it six volumes in total, and appended prescriptions at the end for the convenience of beginners. Although the draft is roughly complete, it contains many errors of being too concise or redundant. Coincidentally, Wei Gong (Courtesy Name: Jizhai), who served as Chief Censor and was stationed in Wu for military preparations, also possessed knowledge of medicine, much like Mr. Jiezhai today. Whenever we met and discussed this, he always sighed that the lives of the people should be valued and that pharmacology must be studied. He graciously edited my humble draft, and it was printed in Wu County by Song Yinyangshan. I only feel ashamed that my insights are as shallow as grass branches, insufficient for selection. I hope great masters will instruct me and not discard my work because I am old and clumsy, saying it is not worth discussing.
Preface respectfully written by Xue Ji, former Fenzheng Dafu (Grand Secretary of the Imperial Medical Bureau), Student of the Late Ming Dynasty, in the winter of the Xinhai year of the Jiajing era.
Someone asked: Among the works of Zhang Zhongjing, Li Dongyuan, Liu Hejian, and Zhu Danxi, which is superior? Whom should one primarily follow in study? The answer is: One should primarily focus on the *Huangdi Neijing* (Yellow Emperor's Inner Canon) and widely observe the works of these four masters; thus, there will be no flaws. Just as the medical field possesses the *Huangdi Neijing*, similar to how Confucianism has the Six Classics, containing everything; the theories of the four masters are like the *Great Learning*, *Doctrine of the Mean*, *Analects*, and *Mencius*, serving as ladders to the Six Classics, indispensable. The books of the four masters originally had no superiority or inferiority; they merely elucidated different aspects of meaning. Zhang Zhongjing saw that the *Huangdi Neijing* recorded Cold Damage (Shanghan), but its variations and complexities were incomplete. Therefore, he wrote treatises and formulated prescriptions to exhaustively cover these variations. Later generations revered it, and after long transmission and use, its true essence gradually became distorted. It was used to generally treat warm diseases, summerheat, internal injury, and other conditions, leading to errors. Thus, Liu Hejian emerged to first elucidate methods for treating warm and summerheat diseases, and Li Dongyuan emerged to first elucidate methods for treating internal injury. Liu Hejian's theory aligns with the principles of the Five Movements and Six Qi in the *Huangdi Neijing*; Li Dongyuan's theory aligns with the concepts of diet and fatigue in the *Huangdi Neijing*. Zhang Zhongjing certainly knew of warm diseases and internal injuries; it was simply that his writings did not cover them. Liu Hejian and Li Dongyuan respected and utilized Zhang Zhongjing's methods for cold damage without daring to deviate. When Zhu Danxi appeared, he synthesized the achievements of various scholars, elucidating that deficiency-fire fever resembles external contraction, and that internal injury and damp-heat ministerial fire cause many illnesses. He wrote treatises according to symptoms, merely elaborating on the essential principles of the *Huangdi Neijing* and supplementing what previous sages had left incomplete. Therefore, it is said: For external contractions, follow Zhang Zhongjing; for internal injuries, follow Li Dongyuan; for febrile diseases, use Liu Hejian's methods; for miscellaneous diseases, use Zhu Danxi's methods. Integrating these consistently constitutes the comprehensive whole of medical science.