儒书有经子史集,医书亦有经子史集。《灵枢》、《素问》、《神农本经》、《难经》、《伤寒论》、《
金匮玉函经》,为医门之经;而诸家注论、治验、类案、本草、方书等,则医之子、史、集也。经细而子、史、
集粗,经纯而子、史、集杂,理固然也。学人必不可
不尊经,不尊经则学无根柢,或流于异端;然尊经太过,死于句下,则为贤者过之,《孟子》所谓∶尽信
书,则不如无书也。不肖者不知有经,仲景先师所谓∶各承家技,终始顺旧,省疾问病,务在口给,相
对斯须,便处汤药,自汉时而已然矣,遑问后世,此道之所以常不明而常不行也。
本论第一方用桂枝汤者,以初春余寒之气未消,虽曰风温(系少阳之气),少阳紧承厥阴,厥阴根
乎寒水,初起恶寒之证尚多,故仍以桂枝为首,犹时文之领上文来脉也。本论方法之始,实始于银翘散。
吴按∶六气播于四时,常理也。诊病者,要知夏日亦有寒病,冬日亦为温病,次年春夏尚有上
年伏暑,错综变化,不可枚举,全在测证的确。本论凡例内云∶除伤寒宗仲景法外,俾四时杂感,朗
若列眉,后世学人,察证之时,若真知确见其为伤寒,无论何时,自当仍宗仲景;若真知六气中为何
气,非伤寒者,则于本论中求之。上焦篇辨伤寒温暑疑似之间最详。
儒家著作有经、子、史、集四类,医学著作同样也有经、子、史、集四类。《灵枢》、《素问》、《神农本草经》、《难经》、《伤寒论》、《金匮玉函经》,是医学界的“经”;而各家注释论述、治疗验案、分类医案、本草药物、方书等,则是医学的“子”、“史”、“集”。经典内容精微细致,而子、史、集类内容较为粗疏;经典纯正,而子、史、集类驳杂,道理本来就是这样的。学习的人一定不能不尊重经典,不尊重经典则学问没有根基,或者流于异端邪说;然而如果尊重经典过度,死守字句而不通变,那就是贤者做得过火了,《孟子》所说的:“完全相信书本,还不如没有书本。”不肖之徒不知道有经典的存在,正如张仲景先师所说:“各自继承家传技艺,始终沿袭旧法,诊察疾病询问病情,只凭口舌巧辩,相对片刻,便开出处方汤药”,这种情况从汉代就已经存在了,何况后世呢?这就是中医之道常常不明朗且难以推行的原因。
本论第一方使用桂枝汤(Cinnamon Twig Decoction),是因为初春残留的寒气尚未消散,虽然说是风温(属于少阳之气),但少阳紧接着厥阴,厥阴根源于寒水,初起时恶寒的症状还很多,所以仍然以桂枝汤为首选,就像八股文中承接上文脉络一样。本论治疗方法的真正开始,其实是从银翘散开始的。吴鞠通按语:六气散布于四季,这是常理。诊治疾病的人,要知道夏天也会有寒病,冬天也会得温病,次年春夏还有上年潜伏的暑邪,错综变化,不可枚举,全在于对证候判断准确。本论凡例中说:“除了伤寒遵循张仲景的方法外,使四季杂感之病,清晰如眉目般分明,后世学人在观察证候时,如果真知确见其为伤寒,无论何时,自然应当仍遵循张仲景的方法;如果真知六气中为何种气,非伤寒者,则在本论中寻求方法。”上焦篇辨别伤寒与温暑疑似之间的区别最为详细。
Confucian classics are categorized into Jing (Classics), Zi (Masters), Shi (History), and Ji (Collections); medical literature is similarly categorized into Jing, Zi, Shi, and Ji. *Ling Shu* (Spiritual Pivot), *Su Wen* (Basic Questions), *Shen Nong Ben Cao Jing* (Divine Farmer's Materia Medica), *Nan Jing* (Classic of Difficult Issues), *Shang Han Lun* (Treatise on Cold Damage), and *Jin Gui Yu Han Jing* (Golden Cabinet Jade Box Classic) constitute the "Jing" (Classics) of medicine; whereas commentaries by various schools, clinical records, categorized case studies, materia medica, and formularies constitute the "Zi", "Shi", and "Ji" categories of medicine. The Classics are subtle and detailed, while the Zi, Shi, and Ji categories are relatively coarse; the Classics are pure, while the Zi, Shi, and Ji categories are mixed and diverse—this is the natural order. Students must certainly respect the Classics; failing to do so leaves their learning without foundation, leading them astray into heterodox paths. However, respecting the Classics excessively and becoming rigidly bound by literal interpretations represents an excess even among the virtuous. As stated in *Mengzi* (Mencius): "If one believes everything in books, it is better to have no books at all." Ignorant practitioners disregard the Classics, just as Master Zhang Zhongjing described: "Each follows family techniques, perpetuating old methods from start to finish; when examining illnesses and asking about symptoms, they rely merely on verbal fluency, and after a brief exchange, immediately prescribe decoctions." This situation existed since the Han Dynasty, let alone later periods; this is why the Dao of medicine often remains obscure and unimplemented.
The first formula used in this treatise is Guizhi Tang (Cinnamon Twig Decoction). This is because residual cold qi persists in early spring. Although the condition is termed Wind-Warmth (Feng Wen, associated with Shaoyang Qi), Shaoyling directly follows Jueyin, and Jueyin roots in Cold Water. Consequently, aversion to cold remains a common initial symptom, warranting the use of Guizhi Tang as the primary choice, analogous to how an essay introduces the context from preceding text. However, the true beginning of the therapeutic methods in this treatise actually starts with Yinqiao San (Honeysuckle and Forsythia Powder). Wu Juzhong notes: The distribution of the Six Qi (Six Climatic Factors) across the four seasons is a constant principle. Practitioners must understand that cold diseases occur in summer, and warm diseases occur in winter; furthermore, latent summer-heat from the previous year may persist into the following spring and summer. These complexities and variations are countless and cannot be exhaustively listed; success depends entirely on accurate syndrome differentiation. The General Principles of this treatise state: "Except for Shang Han (Cold Damage), which follows the methods of Zhang Zhongjing, other miscellaneous affections caused by the four seasons should be clearly distinguished like distinct eyebrows. When future students observe syndromes, if they truly recognize and confirm it as Shang Han, regardless of the season, they should adhere to Zhang Zhongjing’s methods. If they truly identify which of the Six Qi is involved and it is not Shang Han, they should seek methods within this treatise." The Upper Jiao Chapter provides the most detailed differentiation between suspected Shang Han and Warmth/Summer-heat conditions.