忆余幼时，偕郑春江姊丈同受业于淮南姜村阮师之门，时松陵灵胎徐丈往来吴中，旅居
与姜村师衡宇相望也，亦频相过从，每窃闻其绪论。徐丈方辑《难经经释》诸书，尝质正于
师。师曰∶“丈之外科，洵精且博矣。而用力乃专意于内科何哉？”丈曰∶“凡言外科者，未有
不本于内科者也，若不深明内科之旨，而徒抄袭旧方以为酬应，鲜有不蹈橐驼肿背之诮矣。
余心韪之。今阅高子锦庭之书而益信。锦庭积学工医，临证已三十余年，精习经方，洞晓脉
理，虽治外科，而必熟复于《内经》诸圣贤之书，洵能探其本不袭其末者欤。故其治病也，
不胶于成见，不涉于附和，或症同而治异，或症异而治同，神存于心手之际，务使三缚悉除
，四难并解，非意会于中，超然有悟者其孰能之！颜曰心得，诚自道其所得也。书成将付
剞劂，以嘉惠后学，可见用心之浓。而世之习是科者，得此书而循诵习传，奉如圭臬，亦
可不迷于向往也已。今灵胎徐丈之哲嗣渔村先生，世其家学，公卿倒屣，名重海内，与予春
江姊丈有姻谊，暇日当寄览焉，未知渔村以为何如也？
嘉庆丙寅仲夏吴趋郭一临题于锡学之如舟小舍
医者意也。昔人谓意之所解，口不能宣，而着书为无益。语虽超妙，而不得其平。向
使《灵枢》《素问》诸经不传于世，而周秦以下鲜有论述，则后世益惊疑回惑于生死之交，
而庸医之误人者，直恒河沙数矣。夫应变呼吸，得心应手，驱使草木，如行三军，此不可得
而言也。至于血脉、经络、阴阳、表里之会，审乎百病之原而兼治之，是犹闭门造车，出门
合辙，何不可言，而亦何可不言。锡山高子锦庭以疡医名。习是业者，往往不衷于古，不通
于今，守其不经之才，变万而治一，毒流于人而不自知其非。高子则曰外科必从内治，熟读
《内经》然后可以临证。故其HT 疡也，先究乎色声味之淫，进察乎精气神之变，寒热虚实，
洞见 结，由是刮杀以破之，针灸以出之。当其定方，则又君臣佐使，子母兄弟井井然，铢
两因心。盖病家之濒于危而受活者不少焉。余莅锡数载，家人有患疡，属治辄效。今年夏，
幼子肿发于面，自唇齿间延缘颊颧而及于目，恶月溃腐，甚创且殆。高子乃傅以良膏，饮以
和剂，拔毒剔骨，痂脱而病瘥。迨入冬，余姊陡发肝气，日夜掣痛，以年逾六旬，平素气血
虚怯，深患之。亟延高子至，曰∶痈脓已成，幸生皮里膜外。 之脓出盏许，痛止即安，余
甚感之。既乃出所为书，丐余叙。读其论，幼孩有所谓腮与多骨及肠痈者，即余家之两病。
其它辨析微至，历有经验，而创论获解，虽前人或未之逮，然后叹高子之肱折深，而其书未
可以暗昧而不显也。因亟劝之梓，而名其集曰《心得》。是固医之所以为意，绝非有胶柱之
迹存，且能深悯夫庸医之误人，有以发其蒙而救其失，其用意尤浓矣。嗟乎！士大夫高谈经
济，或鲜能及物，而仁人君子之术，顾得诸方技之中，则是书之有裨于世，岂浅鲜哉。至若
运用之妙，则非高子不能言，而余又乌能代为言耶。
嘉庆乙丑小春上浣山右杨润叙
回忆我年幼时，与郑春江（我的）姐夫一同在淮南姜村拜阮老师为师求学。当时，松陵人灵胎徐先生往来于吴中地区，旅居在与姜村老师住所相望的地方，也频繁互相拜访，我常常私下听闻他的学术绪论。徐先生当时正在编纂《难经经释》等书籍，曾向老师请教并校正。老师说：“先生的外科医术确实精妙且广博，但为何用力专意于内科呢？”徐先生说：“凡是谈论外科的人，没有不以内科为根本的。如果不深入明白内科的宗旨，只是徒然抄袭旧方来应付应酬，很少有不遭到‘驼背’（指只知表面不知根本）讥笑的。我心里很赞同他的观点。现在阅读高锦庭先生的书，更加相信这一点。高锦庭积累学问、精通医理，临证治疗已有三十多年，精熟研习经典方剂，透彻了解脉理，虽然治疗外科疾病，但必定反复研读《内经》等圣贤著作，这确实是能探求根本而不沿袭末节的人啊。所以他治病，不拘泥于成见，不盲目附和，有时症状相同而治疗方法不同，有时症状不同而治疗方法相同，神韵存于心手之间，务必使各种束缚全部解除，各种疑难一并解决，如果不是心中有所领会、超然有感悟的人，谁能做到这样！书名题为‘心得’，确实是他在陈述自己的所得。书编成后将交付刻印，以恩惠后世学者，可见其用心之深厚。而世上学习这一科的人，得到这本书后遵循诵读学习传承，奉为圭臬（准则），也可以不在向往中迷失了。如今灵胎徐先生的长子渔村先生，继承家学，公卿权贵争着去迎接他，名重海内，与我春江姐夫有姻亲关系，闲暇时日应当寄给他阅览，不知道渔村先生认为怎么样？
嘉庆丙寅年（1806年）仲夏，吴趋郭一临题写于锡学的如舟小舍。
医生靠的是意念。古人说心意所领悟的，口不能表达，所以著书是无益的。这话虽然高超微妙，但不够公允。假使《灵枢》《素问》等经典不流传于世，而周秦以后很少有论述，那么后世人在生死关头会更加惊疑困惑，而庸医误人的情况，简直像恒河沙数一样多了。至于随机应变，得心应手，驱使草木药材，如同指挥军队，这是不可用言语完全描述的。至于血脉、经络、阴阳、表里的交汇，审察百病的根源而兼治，这就像闭门造车，出门却符合车辙，有什么不可以说的，又有什么不可以说的呢？锡山高锦庭先生以疡医（外科医生）闻名。学习这一行业的人，往往不遵从古代法度，不通晓当今实际，守着不经之谈的才能，变化万千却只治疗一种病，毒气流布于人身上而自己不知道错误。高先生却说外科必须从内科治疗，熟读《内经》然后才可以临证。所以他治疗疡疾，先探究色、声、味的过度（病因），进而观察精气神的变化，寒热虚实，洞察结聚，于是用刮杀法破除它，用针灸引出脓毒。当他确定方剂时，又君臣佐使、子母兄弟井然有序，分量随心而定。大概病人濒临危险而得以存活的不少。我任职锡山几年，家人患疡疾，请他治疗总是有效。今年夏天，我的小儿子面部肿胀，从唇齿间蔓延到脸颊颧骨直至眼睛，恶月（农历五月）溃烂腐坏，伤势严重且危险。高先生于是敷上良膏，喂服调和的药剂，拔毒剔骨，痂皮脱落而病愈。等到入冬，我姐姐突然发作肝气痛，日夜抽掣疼痛，因为年龄超过六十岁，平时气血虚弱怯懦，对此深感忧虑。急忙延请高先生到来，他说：“痈脓已经形成，幸好生在皮肤里面的膜外。”脓液流出约一盏的量，疼痛停止就安定了，我很感激他。之后拿出他所写的书，请求我为之作序。读他的论述，其中有关于幼孩所说的腮部肿病和多骨疽以及肠痈的，正是我家中的两种病症。其他辨析细微周到，历来有经验验证，而且创立新论获得解释，即使前人或许未曾达到，然而感叹高先生的医术精深，而他的书不应该因昏暗不明而不显扬。于是急忙劝他刻印，并将文集命名为《心得》。这固然是医生之所以称为“意”的原因，绝对没有拘泥固执的痕迹存在，而且能深切怜悯庸医误人，以此启发蒙昧而补救过失，他的用意尤其深厚啊。唉！士大夫高谈经世济民之道，或许很少能惠及万物，而仁人君子的医术，反而得自于方技之中，那么这本书对世间的裨益，难道浅薄吗？至于运用的奥妙，不是高先生不能说，我又怎么能代为言说呢？
嘉庆乙丑年（1805年）小春（十月）上浣（初旬），山右杨润作序。
Translation:
I recall that in my youth, I studied under Master Ruan at Jiangcun in Huainan together with my brother-in-law, Zheng Chunjiang. At that time, Mr. Xu Lingtai from Songling traveled frequently between Wu and the central regions, residing in a place opposite to Master Ruan's residence, and they visited each other often. I often overheard his preliminary theories. Mr. Xu was compiling works such as *Nanjing Jing Shi* (Commentary on the Classic of Difficult Issues) and consulted with our master for corrections. The master said, "Your expertise in external medicine is indeed profound and extensive. Why do you devote your efforts specifically to internal medicine?" Mr. Xu replied, "Those who speak of external medicine invariably base it on internal medicine. If one does not deeply understand the principles of internal medicine but merely copies old prescriptions for social obligations, few will escape the ridicule of being like a 'hunchback' (knowing only the surface). I heartily agreed with him. Now, reading Mr. Gao Jinting's book, I am even more convinced. Jinting has accumulated learning and mastered medical arts, having practiced clinically for over thirty years. He is proficient in classic prescriptions and thoroughly understands pulse diagnosis. Although he treats external diseases, he diligently reviews the writings of sages such as those in the *Neijing* (Inner Canon). Truly, he is one who explores the root without imitating the branches. Therefore, in treating diseases, he is not dogmatic nor blindly conformist; sometimes symptoms are the same but treatments differ, and sometimes symptoms differ but treatments are the same. His spirit resides between mind and hand, ensuring that all constraints are removed and difficulties resolved. Only someone with intuitive insight and transcendent understanding can achieve this! The title 'Xinde' (Heart-Mind Insights) truly reflects his personal acquisitions. Upon completion, the book will be printed to benefit future students, showing his deep dedication. Those practicing this specialty who obtain this book, study it faithfully, and hold it as a standard will not be lost in their aspirations. Today, Mr. Yucun, the eldest son of Mr. Lingtai Xu, inherits the family learning. Distinguished by nobles and renowned throughout the land, he has marital ties with my brother-in-law Chunjiang. I shall send him a copy for review when free, wondering what he thinks.
Written by Guo Yilin of Wuchu at the Ruzhou Small Study in Xixue during mid-summer of the Bingyin year of the Jiaqing reign.
A physician relies on intuition (*yi*). Ancients said that what is understood by the mind cannot be fully expressed by words, so writing books is useless. While this statement is profound, it is not entirely fair. Had classics like the *Lingshu* (Spiritual Pivot) and *Suwen* (Basic Questions) not been transmitted, and if there were few discussions since the Zhou and Qin dynasties, later generations would have been even more bewildered at the threshold of life and death, and the number of quacks harming people would have been countless as the sands of the Ganges. Adapting to changes, acting with ease, and employing herbal medicines like commanding an army—these are beyond verbal description. However, regarding the convergence of blood vessels, meridians, yin-yang, and exterior-interior, and examining the origins of hundred diseases to treat them comprehensively—it is like building a cart behind closed doors yet fitting the tracks upon exiting. Why should this not be spoken of? Gao Jinting from Xishan is famous as a surgeon (yangyi). Practitioners of this field often fail to adhere to ancient standards or understand contemporary realities, relying on unorthodox talents, varying endlessly while treating only one condition, spreading toxicity to others without realizing their errors. Mr. Gao states that external diseases must be treated from the internal perspective; only after mastering the *Neijing* can one practice clinically. Thus, when treating ulcerative diseases, he first investigates excesses in complexion, voice, and taste, then observes changes in essence, qi, and spirit. Regarding cold, heat, deficiency, and excess, he sees through the accumulation. He uses scraping methods to break it and acupuncture to drain pus. When prescribing, the roles of sovereign, minister, assistant, and courier are orderly, following generative cycles, with dosages determined by heart. Many patients on the brink of danger were saved. During my tenure in Xishan, family members suffering from ulcers were effectively treated by him. This summer, my youngest son developed facial swelling extending from the lips and teeth to the cheeks, zygoma, and eyes. In the unlucky fifth lunar month, it ulcerated and rotted, becoming critical. Mr. Gao applied excellent ointments and administered harmonizing decoctions, extracting toxins and removing necrotic bone until the scab fell off and the disease healed. In winter, my elder sister suddenly suffered from liver qi stagnation with day-and-night pulling pain. Being over sixty and generally deficient in qi and blood, she was deeply worried. Mr. Gao was urgently summoned and diagnosed, "The abscess has formed but fortunately lies within the membrane outside the skin." After about a cup of pus drained, the pain ceased, and she recovered. I was deeply grateful. He then presented his manuscript and requested a preface. Reading his discussions, I found descriptions of childhood mumps, multiple bone necrosis, and intestinal abscesses, which corresponded exactly to two illnesses in my family. Other analyses are meticulous and empirically verified. His innovative explanations, though perhaps surpassing predecessors, reveal his profound surgical skill, and his book should not remain obscure. I urged him to print it and named the collection *Xinde*. This embodies the physician's reliance on intuition, devoid of rigidity, and shows deep compassion for quacks' errors, aiming to enlighten the ignorant and correct mistakes, demonstrating particularly profound intent. Alas! Scholars may talk grandly about governing the world but rarely benefit living beings, whereas the art of benevolent gentlemen is found in technical skills. Thus, the benefit of this book to the world is far from slight. As for the subtleties of application, only Mr. Gao can explain them, and how could I presume to speak for him?
Preface by Yang Run of Shanyou, early days of the tenth lunar month (Xiaochun), in the Yichou year of the Jiaqing reign.