议曰信夫执术为医荷术至重其或轻举有乎得共稍共其理如盲索途事致疏虞呜呼断不复
续死不
复生哀哀之诚谁为罹叹当知医家一门上古圣贤测天征道详气四时逆顺阴阳痞通表里然后察之
五脏六腑三焦百脉究竟标本盈亏参审绝生变动代谢荣枯流行注厥如此知义少契古风然有侥幸
侮玩狂暴轻欺者众矣侥幸者恃其时运以夸HT 侮玩者以道之亨通而慢易狂暴者不能务本以从师
轻欺者肆意妄执以为是四者人事何掌博古穷经明心尽性者邪医之务业其道有四不可遗其一焉
行之恻
悯施之乔惠存之周至受之平等恻悯者每务仁慈消惠者常加爱护周至者运用无亏平等者勿论高
下如此推诚稍入医学之道若也纵恣身心嬉游妄作及其访问临时检来以齐规矩斯乃自败之端殃
积于后野老数年江湖抱街活人亲见同道谷有耽僻终不为良或好笼浪或贪传奕或纲或钓或射
或猎或讴或饮或歌或舞佞游花衢狂穿抑陌或习弓弩或纵 缰或乐烟粉怪词或悦风情可意此未
用心不常僻性诡异滥檷医士得无诉乎其实非诈其用以证凡百枉究总涉狂佞须知医家者流遵九
道聊伸鉴诫犯者贵已为幸志在前贤圣哲无时不习者方可谓良医受道之职也杲能守之以道分之
以安天地副焉神明钦焉
议曰晋朝有医工钱氏(讳乙)设方用药明症识候直究竟婴孩脏腑令热表里虚实传变顿取
其效正所谓医孩童
之意准绳法则之道如此后世欲以及其议者盖阙如也往往诵钱君之书记钱君之药钱君之意旨
未之
闻也愚详其意径且直其说劲旦锐其方截而良其用功而速深违其要广操其言万世不可掩其妙四
方皆可遵其说九八十一家者谷述精通莫若钱君智意克效究竟不劳再三亦无中道而废门人阎公
编集未具钱君心服想计恢洪纯粹妙理希奇纸笔不可得而录者耶时有高见之士一悟钱君
意旨
HT之与药规矩法度无以异钱君运乎中显乎机而自然造化者莫之能语也良工妙用
信乎野老之言毋曰管见后之学人尽心讨论必有深着于胸次且德义于人扬名于后
世之道不亦宜乎
议论说:确实如此,掌握医术行医,责任极其重大。如果轻率行事,即使有所收获,也未能完全通晓其原理,就像盲人摸索道路一样,做事难免疏忽失误。唉!断绝生机者不能再续接,死亡者不能再复生,这悲哀的诚意,谁会为遭受此祸的人叹息呢?应当知道,医家这一门学问,上古圣贤通过观测天象、探究大道,详细考察四时气候的逆顺、阴阳的痞塞与通畅、表里的变化,然后察验五脏六腑、三焦及全身百脉,彻底究明标本、盈亏、生死、变动、代谢、荣枯、流行及厥逆等规律。如果能这样理解义理,稍微契合古人的风范,然而侥幸、轻慢、狂暴、轻欺的人却很多了。侥幸的人倚仗时机运气来夸耀自己;轻慢的人因为道义的亨通而傲慢随意;狂暴的人不能致力于根本而听从老师教导;轻欺的人肆意妄为,固执己见认为自己是正确的。这四种人在人事上如何掌控?那些博通古今、穷尽经典、明心尽性的人,才是邪僻之医所务求的职业之道。其道有四个方面不可遗漏其一:施行时要怀有恻隐之心,施予时要像给予恩惠一样,存心要周全细致,接受(对待病人)要平等。所谓恻隐,是每事都追求仁慈;所谓恩惠,是常常加以爱护;所谓周全,是运用没有亏缺;所谓平等,是不论地位高低。如此推诚相待,稍微进入医学的门道。如果放纵身心,嬉游妄作,等到临时询问时,才匆忙检寻以整齐规矩,这是自我败坏的开始,灾殃积累在后头。乡野老人多年在江湖间行走,亲眼见到活人无数,同辈中也有沉迷于怪癖最终不能成为良医的,或者喜欢赌博,或者贪恋下棋,或者钓鱼,或者射箭,或者打猎,或者唱歌,或者饮酒,或者吟诗,或者跳舞,或者谄媚游玩于花街柳巷,或者狂乱穿行于深巷陌路,或者练习弓箭弩机,或者纵马驰骋,或者喜爱烟粉怪词,或者悦情风月可意之事。这些都没有用心,不常保持本性,性格诡异,滥竽充数做医士,难道不会受诉吗?其实并非欺诈,其用途用来验证,凡是各种冤枉究查,总涉及狂妄谄媚。必须知道,医家这类人,遵循九道,姑且伸出鉴戒警示,犯者改正为幸。立志在前贤圣哲,无时不学习,才可以称为良医,承受道的职责。果真能守之以道,分之以安天地,符合神明,敬仰焉。
议论说:晋朝有位医生钱氏(名乙),设立方剂用药,明确病症识别候气,直接究明婴孩脏腑,使热证表里虚实传变得以顿取疗效。这正是所谓“医孩童”的意思,准绳法则之道就是如此。后世想要继承他议论的人,大概阙如很少。往往诵读钱君的书,记录钱君的药,但钱君的心意旨趣,却没有听说有人真正领悟。我详细考察他的心意,径自且直截;他的学说强劲且锐利;他的方剂简截而精良;他的效用功效快速。深得其中要害,广操其言论,万世不可掩盖其妙处,四方都可以遵循他的学说。九八十一家的流派,叙述精通,没有比得上钱君的智慧和意念能够见效,彻底究明而不劳烦再三,也没有中途废弃的。门人阎公编集,尚未完备钱君的心法,想必是恢弘纯粹、妙理希奇,纸笔不可得而录下的吧?当时有高见的士人,一旦领悟钱君的心意旨趣,如同使用药物和规矩法度没有差异。钱君运化于心中,显发于机枢,而自然的造化之力,没有人能言语形容它。良工的精妙作用,确实是乡野老人的话。不要说是浅见,后来的学人尽心讨论,必定有深刻的见解在心中。况且德义于人,扬名于后世的道理,不也是应该的吗?
Commentary states: Indeed, mastering medical arts to practice medicine carries a heavy responsibility. If one acts lightly or rashly, even if some success is achieved, the underlying principles may not be fully understood, akin to a blind person groping for a path, leading to negligence and errors in handling matters. Alas! Once life is severed, it cannot be renewed; once death occurs, it cannot be reversed. Who would sigh with sincere sorrow for those who suffer such misfortunes? One must know that in the field of medicine, ancient sages observed celestial phenomena and explored the Great Dao, meticulously examining the reversals and compliance of the four seasons, the blockage and flow of Yin and Yang (Yin-Yang), the interior and exterior relationships, and then inspecting the Five Zang Organs (Five Viscera) and Six Fu Organs (Six Bowels), the San Jiao (Triple Burner), and all hundred vessels, thoroughly investigating the root and branch, deficiency and excess, life and death, transformation, metabolism, flourishing and withering, circulation, and reversal patterns. By understanding these principles, one can slightly align with the ancient traditions. However, there are many who rely on luck, show disrespect, act violently, or treat the profession lightly. Those relying on luck boast based on favorable timing and fortune; those showing disrespect become arrogant and casual due to the smooth progress of the Dao; those acting violently fail to cultivate their foundation and follow their teachers' guidance; those treating lightly act arbitrarily and stubbornly believe themselves correct. How can these four types of people manage human affairs? Scholars who are versed in antiquity, exhaust classics, clarify the mind, and fulfill their nature pursue this as the professional duty of physicians. There are four aspects of this duty that cannot be omitted: practicing with compassion, bestowing benefits as if giving grace, maintaining thoroughness and care, and treating patients equally. Compassion means always striving for benevolence; bestowing benefits means constantly adding care; thoroughness means application without deficit; equality means disregarding social status. By extending sincerity in this manner, one gradually enters the path of medicine. Conversely, indulging the body and mind, playing frivolously, and acting recklessly, then hastily consulting texts when questioned to enforce rules, is the beginning of self-destruction, accumulating disaster for the future. Old villagers who have wandered the rivers and lakes for years have personally witnessed countless lives saved. Among peers, some indulge in eccentricities and never become good doctors; some love gambling, others chess, fishing, archery, hunting, singing, drinking, reciting poetry, dancing, flattery in pleasure quarters, wild wandering in alleys, practicing with bows and crossbows, riding horses freely, enjoying strange tales of tobacco and powder, or delighting in romantic affairs. These individuals do not devote their minds, fail to maintain their true nature, possess bizarre personalities, and fraudulently serve as medical practitioners. Would they not face complaints? In truth, it is not deception; their usage serves as proof. All grievances and investigations ultimately involve arrogance and flattery. It must be known that those in the medical profession should follow the Nine Paths, offering warnings and admonitions. It is fortunate if offenders repent. Setting one's will before the sages and worthies of old, studying at all times, allows one to be called a good doctor, bearing the responsibility of the Dao. Truly, by holding fast to the Dao, distributing peace to Heaven and Earth, and aligning with the Divine Spirits, one commands reverence.
Commentary states: During the Jin Dynasty, there was a physician named Qian (personal name Yi). He established prescriptions and used herbs, clearly identifying symptoms and signs, directly investigating the viscera of infants and children, achieving immediate effects in resolving heat syndromes, interior-exterior conditions, and deficiency-excess transformations. This precisely embodies the concept of "treating infants and children," establishing standards and laws. Later generations wishing to inherit his discussions find them lacking. Often, people recite Master Qian's books and record his medicines, but few have truly heard of or understood his inner intent and purport. I have carefully examined his intent: it is direct and straightforward; his theories are vigorous and sharp; his prescriptions are concise and excellent; his efficacy is rapid. He grasps the essential points deeply and expresses them broadly. His subtleties cannot be obscured for ten thousand generations, and his teachings can be followed throughout the four directions. Among the eighty-one schools of thought, none surpass Master Qian in wisdom and intent to achieve results. His thorough investigation requires no repeated efforts, nor does he abandon treatment midway. His disciple, Lord Yan, compiled his works, but they were incomplete regarding Master Qian's mental methods. Perhaps these were grand, pure, miraculous, and rare principles that could not be fully recorded in paper and ink. At that time, enlightened scholars, upon once comprehending Master Qian's intent, found no difference between his approach and using standard drugs or rules. Master Qian operated from within, revealing mechanisms naturally. The creative power of nature is beyond words. The wondrous applications of skilled craftsmen confirm the words of old villagers. Do not dismiss this as shallow insight. Future students who discuss and analyze with full dedication will surely have profound insights in their hearts. Moreover, benefiting others through virtue and righteousness, and gaining fame in later generations—is this not appropriate?