清道光朝。浙医王孟英先生名士雄,潜斋半痴梦影。皆研医后之别字。其字梦影者。示药
因证异。不执效方之义。着有温热经纬。即王氏五种行世。就中医案。都凡十一卷。虽大
旨
为救温补而设。实则随证制方。丝丝入扣。果得融会贯通。则古今医籍兼读可。缓读亦可。
先
生深得力于喻子嘉言。(念)读 先生书。而后得门。原案或脉证方药并叙。或叙证遗脉。或
叙脉遗证。若方药注铢两者。则更千百首中一二。窥其编次苦心。殆欲人深思自得。中材而
下。难觅金针。(念)不敢忘得门所自。谨就原案笺释其病情脉义。方药之偶阙者僭补之。铢
两之不注者僭拟之。顾于原案显不吻合者有二。勘病制方。本有得意疾书之乐。移时或铢两
皆忘。何况据案悬拟。元运衰薄。气体渐就劣弱。拟注不得不故减铢两。以便揣摩。若温
病中风升阳浮各案。潜阳重镇之品。不得宗法。 先生函诊杨素园室人方案。一药辄至数两
。匪独偏证偏治急证急治非此不生。并取(念)所屡试屡效者折中规定。不敢执死书以困活人
。览者慎勿疑信参半。致千虑一失。若用多备少服法。分次徐投。药效即止。则无不可。稿
成。颜曰中医指掌。邑同学束子劭直慨任印赀。除(念)续刊最简单之本草外。览者手此一编
。可以寻途辙。资事蓄。谓保国粹。则吾岂敢。
丁巳季春江都兰孙父石念祖自序
清代道光年间,浙江医生王孟英先生,名士雄,号潜斋、半痴、梦影。这些都是他研习医学后使用的别号。他的字“梦影”,寓意药物需根据病症的不同而变化,不固执于固定的效方(即固定有效的处方)。他著有《温热经纬》,连同其他四种著作一起流传于世。其中《中医案》共十一卷。虽然其主要宗旨是为了纠正滥用温补之弊而设立,但实际上却是根据具体证候来制定方剂,丝丝入扣,严谨细致。如果能融会贯通地理解,那么无论是兼读古今医籍,还是暂时搁置慢慢研读,都是可以的。
王先生深受喻嘉言(喻昌)学术思想的影响。阅读先生的著作,才能找到入门的门径。原案中,有时脉象、证候、方药一并叙述;有时只叙述证候而遗漏脉象;有时只叙述脉象而遗漏证候。至于方药中剂量(铢两)的标注,在千百首方子中仅有一二处可见。这可以看出他在编排上的苦心,大概是希望读者深入思考从而自行领悟。对于中等资质以下的人,很难找到那把开启智慧的金钥匙。我不敢忘记得自先生的教导,于是谨在原案基础上进行笺释,阐明病情和脉理意义;对方药中偶尔缺失的部分,我僭越地予以补充;对未标注剂量的部分,我也僭越地加以拟定。
然而,有两点与原案明显不符:一是诊病制方,本有得意疾书的乐趣,过了一段时间可能连剂量都忘记了,更何况是根据案卷凭空推测?二是当时元气运势衰薄,我的体质逐渐变得虚弱,拟注时不得不故意减少剂量,以便揣摩推敲。例如在温病、中风、升阳浮越等病例中,潜阳重镇的药物,不能盲目遵循某种成法。先生为杨素园夫人诊治的方案中,一味药往往用到数两之多。这不仅是因为偏证、急证需要偏治、急治,非此不能救命,也是选取了他屡试屡效的经验折中规定。我不敢死守书本知识而困住活人。读者切勿半信半疑,导致千虑一失。如果采用多备少服的方法,分次缓慢服用,药效达到即止,则没有什么不可以的。
稿件完成后,题名为《中医指掌》。同邑的同学束子劭直慷慨承担印刷费用。除了续刊最简单的本草书籍外,读者手持这一编,可以寻找门径,储备知识。如果说这是为了保存国家国粹,那我岂敢当此赞誉。
丁巳年季春(农历三月),江都兰孙父石念祖作序。
During the Daoguang reign of the Qing Dynasty, Mr. Wang Mengying, a physician from Zhejiang, was named Shixiong, with courtesy names Qianzhai, Banchi, and Mengying. These were all pseudonyms adopted after he delved into medicine. His courtesy name "Mengying" (Dream Shadow) signifies that medicines should vary according to syndromes, reflecting the principle of not adhering rigidly to fixed effective prescriptions (Xiao Fang). He authored *Wenre Jingwei* (The Warp and Weft of Warm-Heat Diseases), which, along with four other works, is circulated in the world. The *Zhongyi An* (Records of Chinese Medicine Practice) consists of eleven volumes. Although its main purport is established to save people from the misuse of warming and tonifying methods, it actually formulates prescriptions according to specific syndromes, fitting tightly like threads through a buckle. If one can integrate and comprehend these thoroughly, then reading ancient and modern medical texts simultaneously or delaying their study are both acceptable.
Mr. Wang derived deep benefit from the teachings of Yu Jiayan (Yu Chang). Reading his works allows one to find the path to entry. In the original records, sometimes pulse, symptoms, formulas, and herbs are narrated together; sometimes symptoms are narrated while the pulse is omitted; sometimes the pulse is narrated while symptoms are omitted. Regarding the dosage (Zhu Liang) of herbs in formulas, such annotations appear in only one or two out of hundreds of cases. This reveals his painstaking effort in compilation, likely intending for readers to think deeply and gain understanding independently. For those of average or lower aptitude, it is difficult to find the golden needle (the key to mastery). Not daring to forget where I found my entry into this field, I have respectfully annotated the original records to explain the disease conditions and pulse meanings. For occasionally missing herbs or formulas, I have presumptuously supplemented them; for unannotated dosages, I have presumptuously estimated them.
However, there are two aspects that do not clearly align with the original records: First, diagnosing diseases and formulating prescriptions often involves the joy of writing quickly when inspired; after some time, even the dosages might be forgotten, let alone speculating based on case records. Second, due to the declining qi fortune of the era and my gradually weakening constitution, I had to deliberately reduce dosages in my annotations to facilitate contemplation and trial. For instance, in cases of warm diseases, wind-stroke, and rising yang floating upward, the use of substances that anchor yang and heavily settle (Qian Yang Zhong Zhen) cannot blindly follow established rules. In the case where Mr. Wang diagnosed and treated Mrs. Yang Suyuan, a single herb often reached several taels. This was not only because biased syndromes and urgent syndromes require biased treatments and urgent interventions, without which life could not be saved, but also because he selected experiences that had repeatedly proven effective as a compromise standard. I dare not hold onto dead books to trap living people. Readers should not be half-believing and half-doubting, causing a loss amidst a thousand considerations. If one adopts the method of preparing more but taking less, administering slowly in divided doses, and stopping when the therapeutic effect is achieved, then nothing is inadvisable.
Upon completion of the manuscript, I titled it *Zhongyi Zhizhang* (Chinese Medicine at Your Fingertips). My fellow townsman Shu Zhi, courtesy name Shaozhi, generously assumed the printing costs. Besides continuing to publish the simplest materia medica, readers holding this volume can find the tracks and paths, and accumulate knowledge for practical matters. To claim that this preserves national essence, I would dare not accept such praise.
Preface by Nianzu, styled Lansun, father of Shishi, from Jiangdu, in the late spring of the Ding Si year.