雄按∶《鸡峰普济方》论外感诸疾有云∶四时之中,有寒暑燥湿风五气相搏,善变诸疾。今就五气中分其清浊,则暑
燥为天气,系清邪;风寒湿为地气,系浊邪。然则仲圣所云∶清邪中上者,不仅雾露之气已,而书传兵火之余,难免遗
亡之憾。否则,疫乃大证,圣人立论,何其略耶?后贤论疫,各有精义,亦皆本于仲圣清浊互中之旨。若但中暑燥之清
邪,是淫热为病,治法又与嘉言、又可异,汪按∶须知此篇乃专治燥热之疫。学人切记自不致误用矣。后人从未道及。
惟秦皇士云∶燥热疫邪,肺胃先受。故时行热病,见唇焦消渴者,宜用白虎汤。惜语焉未详。夫暑即热也。燥即火也。
金石不堪其流烁,况人非金石之质乎?徐后山《柳崖外编》尝云∶乾隆甲子,五六月间,京都大暑,冰至五百文一斤。
热死者无算。九门出榇,日至千余。又纪文达公云∶乾隆癸丑,京师大疫。以景岳法治者多死;以又可法治者,亦不验。
桐乡冯鸿胪星实姬人,呼吸将绝,桐城医士投大剂石膏药,应手而痊。踵其法者,活人无算。道光癸未,吾乡郭云台纂
《证治针经》,特采纪说,以补治疫之一法。然纪氏不详姓氏,读之令人怅怅,越五载毗陵庄制亭官于长芦,重镌《疫疹
一得》。书出始知纪氏所目击者,乃余君师愚也。原书初刻于乾隆甲寅,而世鲜流行,苟非庄氏几失传矣。汪按。余氏以
亲所试验者笔之于书。发前人所未发。非妄作也。无如世皆崇信温补。余氏之书非所乐闻。间有信余氏之论者。又不问
是否燥热为病随手妄施。以致误人。论者。益复集矢于余氏矣。此余氏之书。所以不行于时也。然岂余氏之过哉。昔王
白田先生作石膏辨。力辟石膏以为受害者甚多。岂知误用之而杀人者。善用之即可救人乎。余读之,虽纯疵互见,而独
识淫热之疫,别开生面,洵补昔贤之未逮,堪为仲景之功臣,不揣疏庸,节取而删润之,纂作圣经之纬。
王士雄按语:《鸡峰普济方》在论述外感各类疾病时曾说:四季之中,有寒、暑、燥、湿、风这五种气候之气相互搏结,容易引发各种疾病。现在从这五种气中区分其清浊属性,则暑和燥属于天气,是清邪;风和寒、湿属于地气,是浊邪。既然如此,那么张仲景所说的“清邪中上者”,不仅仅指雾露之气罢了,只是书籍经过兵火战乱之后,难免有遗失亡佚的遗憾。否则,疫病是大证候,圣人确立理论,怎么会如此简略呢?后世的医家论述疫病,各有精辟见解,也都基于张仲景关于清浊邪气互中的宗旨。如果仅仅认为是中暑燥这种清邪致病,那就是淫热为患,治疗方法又与喻嘉言、余师愚不同。(汪氏按语:须知这一篇是专门治疗燥热疫病的。学者切记,自然不会误用。)后人从未提及这一点。只有秦皇士说:燥热疫邪,首先侵犯肺和胃。所以时令流行的热病,出现嘴唇焦裂、极度口渴症状的,适宜使用白虎汤(Baihu Tang, White Tiger Decoction)。可惜他说得不够详细。暑就是热,燥就是火。金石都承受不住它的销熔,何况人不是金石的体质呢?徐后山在《柳崖外编》中曾记载:乾隆甲子年,五六月间,京都大热,冰的价格高达五百文一斤。因热致死的人不计其数。九个城门每天运出的棺材有一千多具。还有纪文达公说:乾隆癸丑年,京城发生大瘟疫。用张景岳的方法治疗的,大多死亡;用余师愚(字师愚)的方法治疗的,也不见效。桐乡冯鸿胪星实的姬妾,呼吸即将断绝,桐城的医生投以大剂量的石膏药,随即痊愈。跟随这种方法治疗的,救活了无数人。道光癸未年,我的同乡郭云台编纂《证治针经》,特意采纳了纪氏的说法,以补充治疗疫病的一种方法。然而纪氏没有注明姓氏,读起来让人惆怅。过了五年,毗陵庄制亭在长芦任职时,重新刊印了《疫疹一得》。书出版后才知道,纪氏所目睹的案例,原来是余君师愚。原书最初刻印于乾隆甲寅年,但世间很少流传,如果不是庄氏,几乎失传了。(汪氏按语:余氏将亲身试验的经验记录下来写成书。发挥了前人未曾阐发的内容,并非妄作。无奈世人皆崇尚温补疗法,对余氏的书不乐意听闻。偶尔有相信余氏论点的人,又不问是否属于燥热为病,就随手乱用,以致误人。评论者,更加集中指责余氏了。这就是余氏的书当时不能流行的原因。但这难道是余氏的过错吗?昔日王白田先生撰写《石膏辨》,极力批驳使用石膏造成的危害很多。哪里知道误用会杀人,善用就能救人呢?我读这本书,虽然优点缺点并存,但唯独识别出淫热性质的疫病,别开生面,确实弥补了前代贤人的不足,堪称张仲景的功臣。我不揣冒昧,节选并删改润色,编纂成《温热经纬》的纬部。)
Wang Shixiong's commentary: The *Jifeng Puji Fang* (Comprehensive Benefiting Formulas of the Chicken Peak) states in its discussion of various exogenous diseases: "In the four seasons, the five qi of cold, heat, dryness, dampness, and wind contend with each other, readily giving rise to various diseases." Now, distinguishing their clear and turbid qualities among these five qi, summer-heat and dryness belong to heavenly qi and are clear pathogens; wind, cold, and dampness belong to earthly qi and are turbid pathogens. If so, then what Zhang Zhongjing said regarding "clear pathogens affecting the upper body" refers not only to mist and dew. It is merely that books, surviving the ravages of war and fire, inevitably suffer from loss and omission. Otherwise, epidemic disease is a major syndrome; why would the Sage establish theories so briefly? Later scholars' discussions on epidemics all contain profound insights, yet they are all based on Zhang Zhongjing's principle of mutual contamination by clear and turbid pathogens. If one assumes only the clear pathogens of summer-heat and dryness cause illness, this constitutes pathogenic excessive heat. The treatment method would differ from those of Yu Jiayan and Yu Shiyu. (Commentary by Wang: Note that this section specifically treats epidemic diseases caused by dryness-heat. Students must remember this to avoid misuse.) Later authors have never mentioned this. Only Qin Huangshi stated: "The dryness-heat epidemic pathogen first affects the Lung and Stomach." Therefore, for seasonal febrile diseases presenting with cracked lips and extreme thirst, Baihu Tang (White Tiger Decoction) is appropriate. Alas, his explanation was not detailed. Summer-heat is heat; dryness is fire. Metals and stones cannot withstand its melting intensity, let alone human bodies, which are not made of metal or stone. Xu Houshan recorded in *Liuya Waibian* (External Compilation of Liuya): "In the year Jiazi of the Qianlong reign, during the fifth and sixth months, the capital experienced extreme heat. Ice cost 500 cash per jin. Countless people died from heat. Each day, over a thousand coffins were carried out through the nine city gates." Additionally, Ji Wenda stated: "In the year Guichou of the Qianlong reign, a great epidemic occurred in the capital. Those treated according to Zhang Jingyue's methods mostly died; those treated according to Yu Shiyu's methods also proved ineffective." A concubine of Feng Xingshi, a Honglu official from Tongxiang, was on the verge of death due to respiratory failure. A physician from Tongcheng administered a large dose of Shi Gao (Gypsum Fibrosum), and she recovered immediately. Following this method saved countless lives. In the year Guiwei of the Daoguang reign, my fellow townsman Guo Yuntai compiled *Zhengzhi Zhenjing* (Needle Canon of Syndrome Differentiation and Treatment) and specifically adopted Ji's account to supplement a method for treating epidemics. However, Ji did not mention the surname, leaving readers feeling regretful. Five years later, Zhuang Zhiting, serving in Changlu, reprinted *Yizhen Yi De* (One Gain from Epidemic Rashes). Upon its publication, it became known that the case witnessed by Ji was actually that of Mr. Yu Shiyu. The original book was first printed in the year Jiayin of the Qianlong reign but rarely circulated in the world. Had it not been for Zhuang, it would almost have been lost. (Commentary by Wang: Yu recorded his personally tested experiences in this book, revealing what predecessors had not expounded. This was not reckless fabrication. Unfortunately, the world reveres warm-tonic therapies and dislikes hearing about Yu's works. Occasionally, those who believe in Yu's theories do not inquire whether the condition is indeed dryness-heat, applying treatments indiscriminately, thereby harming patients. Critics thus direct their arrows at Yu. This is why Yu's book did not circulate at the time. But is this Yu's fault? Previously, Mr. Wang Baitian wrote *Shigao Bian* (Discussion on Gypsum), vigorously refuting the harm caused by gypsum usage. How could he know that while misuse kills, proper use saves lives? I read this book; although it has both merits and flaws, its unique identification of epidemic diseases characterized by excessive heat opens new ground. It truly supplements the deficiencies of past sages and deserves to be a meritorious successor to Zhang Zhongjing. Not presuming upon my own dullness, I have excerpted, edited, and polished these texts to compile the 'Weaving' section of *Wenre Jingwei*.)