《素问》,载道之书也。词简而义深,去古渐远,衍文错简,仍或有之,故非吾儒不能读。学人以易心求之,宜其茫
若望洋,淡如嚼蜡。遂直以为古书不宜于今,厌而弃之,相率以为《局方》之学;间有读者,又以济其方技,漫不之省。
医道隐晦,职此之由。可叹也!震昌三十岁时,因母之患脾疼,众工束手,由是有志于医。遂取《素问》读之,三年似
有所得。又二年母氏之疾,以药而安。因追念先子之内伤,伯考之瞀闷,叔考之鼻衄,幼弟之腿痛,室人之积痰,一皆
殁于药之误也。心胆摧裂,痛不可追。然犹虑学之未明,至四十岁复取而读之。顾以质钝,遂朝夕钻研,缺其所可疑,
通其所可通。又四年而得罗太无讳知悌者为之师,因见河间、戴人、东垣、海藏诸书,始悟湿热相火为病甚多。又知医
之为书,非《素问》无以立论,非《本草》无以主方。有方无论无以识病,有论无方何以模仿?夫假说问答,仲景之书
也,而详于外感;明着性味,东垣之书也,而详于内伤。医之为书,至是始备;医之为道,至是始明。由是不能不致疑
于《局方》也。《局方》流行,自宋迄今,罔间南北,翕然而成俗,岂无其故哉!徐而思之,湿热相火,自王太仆注文已
成湮没,至张、李诸老始有发明。人之一身,阴不足而阳有余,虽谆谆然见于《素问》,而诸老犹未表章,是宜《局方》
之盛行也。震昌不揣芜陋,陈于编册,并述《金匮》之治法,以证《局方》之未备,间以己意附之于后,古人以医为吾
儒格物致知一事,故目其篇曰《格致余论》。未知其果是否耶?后之君子,幸改而正诸。
《素问》(黄帝内经素问),是一部阐述医学大道的著作。其文字简练而义理深奥,由于年代久远,书中难免存在衍文(多出的文字)和错简(竹简顺序错乱)的情况,因此如果不是精通儒家经典的学者,很难读懂它。学医者如果以轻视的心态去研读,自然会感到茫然无措,如同面对浩瀚海洋不知深浅,枯燥乏味如同咀嚼蜡块。于是他们直接认为古书不适合当今使用,厌恶并抛弃了它,转而竞相学习《局方》(太平惠民和剂局方)的学问;偶尔有阅读《素问》的人,也只是用它来辅助他们的方技之术,并不深入省察。医道之所以隐晦不明,正是由于这个原因。真是令人感叹啊!
我震昌三十岁时,因为母亲患有脾疼(脾胃疼痛),众医生束手无策,从此立志学习医学。于是取来《素问》研读,三年后似乎有所心得。又过了两年,母亲的疾病得以用药物治愈。于是追念先父的内伤(内部脏腑损伤),伯父的昏闷(神志昏蒙烦闷),叔父的鼻衄(鼻出血),幼弟的腿痛,以及妻子的积痰(痰饮积聚),这些人都因为用药错误而去世。我心胆俱碎,悲痛无法追回。然而仍担心自己学识不明,到了四十岁再次取来《素问》研读。只因为我资质愚钝,便日夜钻研,对于可疑之处存疑,对于可通之处贯通。又过了四年,拜罗太无(罗知悌)为师,因而看到了河间(刘完素)、戴人(张从正)、东垣(李杲)、海藏(王好古)等人的书籍,这才领悟到湿热相火(湿热与相火致病)导致的疾病非常多。又知道医学著作,没有《素问》就无法确立理论,没有《本草》(神农本草经等药学著作)就无法主导处方。有方无论无法识别疾病,有论无方如何模仿?那些假托问答形式的,是仲景(张仲景)的著作,侧重于外感病;明确阐述药性味道的,是东垣的著作,侧重于内伤病。医学著作,至此才完备;医学之道,至此才明朗。由此我不能不对《局方》产生怀疑。《局方》流行,自宋代至今,不分南北,一致形成习俗,难道没有原因吗?慢慢思考,湿热相火的理论,自从王太仆(王冰)注释《素问》以来已经湮没无闻,直到张、李诸位老前辈才开始阐明。人的身体,阴气不足而阳气有余,虽然这在《素问》中谆谆告诫,但各位前辈尚未加以表彰,这适宜于《局方》的盛行。
我不揣冒昧,将这些内容编入册中,并陈述《金匮要略》的治疗法则,以证明《局方》的不完备,偶尔附上自己的见解在后面。古人将医学视为儒家“格物致知”(探究事物原理从而获得知识)的一个方面,所以将此篇命名为《格致余论》。不知道这究竟是否正确呢?后来的君子,希望改正并指正它。
<Suwen> (The Yellow Emperor's Inner Canon: Suwen), is a book that expounds the great Dao of medicine. Its language is concise yet its meaning profound. As time has passed since antiquity, there are still instances of superfluous text and misplaced bamboo slips; therefore, only those Confucian scholars who are well-versed in classics can read it. If students approach it with a casual mind, they will naturally feel lost as if gazing at the vast ocean, and find it as dull as chewing wax. Consequently, they directly deem ancient books unsuitable for the present age, discard them with disgust, and flock to study the methods of <Jufang> (Formulas of the Bureau of Taiping Huimin). Those who occasionally read it merely use it to supplement their technical skills, without deep reflection. The obscurity of the medical way stems from this reason. It is truly lamentable!
When I, Zhenchang, was thirty years old, my mother suffered from spleen pain. Since all physicians were helpless, I resolved to study medicine. I then took up the <Suwen> for study, and after three years, I seemed to have gained some understanding. Two years later, my mother's illness was alleviated by medication. Reflecting on my late father's internal injury, my eldest uncle's mental confusion and oppression, my second uncle's epistaxis, my younger brother's leg pain, and my wife's phlegm accumulation—all of whom died due to erroneous medication—I felt my heart and gallbladder shattered, with regret beyond retrieval. However, fearing my knowledge was not yet clear, at forty years old I resumed studying the <Suwen>. Given my dull nature, I studied day and night, suspending judgment on what was doubtful and clarifying what was understandable. Four years later, I became a disciple of Luo Taiwu (Luo Zhiti) and thus encountered the works of Hejian (Liu Wansu), Dairen (Zhang Congzheng), Dongyuan (Li Gao), and Haicang (Wang Haoxu). Only then did I realize that diseases caused by damp-heat and ministerial fire are numerous. I also came to know that medical texts cannot establish theory without the <Suwen>, nor can they direct prescriptions without the <Bencao> (Materia Medica). Having formulas without theory makes it impossible to recognize diseases; having theory without formulas makes imitation impossible. The works featuring hypothetical Q&A formats belong to Zhongjing (Zhang Zhongjing) and focus on external contractions; the works clearly detailing properties and flavors belong to Dongyuan and focus on internal injuries. Medical literature became complete at this point; the Way of Medicine became clear at this point. Thus, I could not help but doubt the <Jufang>.
The <Jufang> has circulated from the Song Dynasty to the present, across both north and south, forming a common custom. Could there be no reason? Upon careful thought, the theory of damp-heat and ministerial fire had been submerged since Wang Taipu (Wang Bing)'s commentary on the <Suwen>, until the elders Zhang and Li began to elucidate it. In the human body, Yin is insufficient while Yang is in excess. Although this is earnestly stated in the <Suwen>, previous elders had not yet highlighted it, which explains the prevalence of the <Jufang>.
I, unassuming and humble, have compiled these contents into this volume, stating the treatment methods of the <Jingui Yaolue> (Essential Prescriptions from the Golden Cabinet) to demonstrate the incompleteness of the <Jufang>, occasionally appending my own opinions afterwards. Ancients regarded medicine as an aspect of "Gewu Zhizhi" (investigating things to extend knowledge) for Confucian scholars; hence, I titled this section <Gezhi Yulun> (Supplementary Discussions on Investigating Things to Extend Knowledge). I do not know if this is correct. May future gentlemen kindly correct and rectify it.