此篇书例∶以经所从始曰“起”,以连本经之脏腑者曰“属”,以本经萦相表里之脏腑
者曰“
络”,由此适彼曰“循”,自下而上曰“上”,自上而下曰“下”,过乎他经曰“行”,过
乎肢节之旁曰“过”,穿乎其中曰“贯”,并乎两旁曰“挟”,彼此相互曰“交”,巡绕四
边曰“环”,直达其所曰“抵”,自外至里曰“入”,本隐忽见曰“出”,直行曰“直”,
平行曰“横”,半横曰“斜”,两支相并曰“合”,一支而歧曰“别”,疾行往聚曰“趣”
,去此复回曰“还”。
《内经》中句斟字酌,无过此篇,仿佛《禹贡》山脉水道书例。惜乎马元台辈,未能一
一注
明也。且此篇与《经筋》、《卫气》、《营气》及《素问》所载阴阳大论诸篇,皆古之奇文
,当熟读而精通之。而此篇叙营卫各病之原尤切要。故既校其文,复书其书例于后。
读仲景书,而穷源于《灵枢》、《素问》,人知之;读仲景书,当竟委于《千金》、《
外台》
,人不知。盖《千金》、《外台》之视若僻书也久矣。抑思仲景之书,其文简,其义隐,其
症略,其方约,其药省;除伤寒桂枝、麻黄、柴胡、四逆等汤症反复辨论外,大抵为后学发
凡起例,未暇致详,墨守其书无益也。惟《千金》、《外台》两书,根柢仲景而推衍之,集
九代之精华,成千秋之钜制,元关秘 ,发泄无遗。若能从此上溯,而于其参互合并、厘析
移易、变通脱化之处,以意逆志,斯仲景之症类赅、方用神、药例见,久之可以窥其堂奥矣
。况有逸论逸方,足补王、林(王,王洙;林,林亿,俱北宋人)之本缺;古说古义,堪砭成
、赵,(成,成无己,宋人;赵,赵良,元人之传讹。学人舍是,其何以问南阳之津哉?)夫
儒家文宗韩、柳,诗宗李、杜,经义宗陆、孔,书法宗欧、柳,皆唐法也,则唐人之守先传
后可知也。惟医亦然。
这篇书籍的体例:经脉从起始处开始称为“起”,连接本经所属脏腑的称为“属”,联络互为表里的其他脏腑的称为“络”,由此处到达彼处称为“循”,自下向上称为“上”,自上向下称为“下”,经过其他经脉称为“行”,经过肢体关节旁边称为“过”,穿过其中称为“贯”,并行于两旁称为“挟”,彼此相互交叉称为“交”,环绕四周称为“环”,直达其终点称为“抵”,从外部进入内部称为“入”,原本隐蔽忽然显现称为“出”,直行称为“直”,平行称为“横”,半斜向称为“斜”,两支经脉合并称为“合”,一支经脉分叉称为“别”,快速前行汇聚称为“趣”,离开此处又返回称为“还”。
《黄帝内经》中这种字斟句酌的写法,没有超过这一篇的,仿佛《禹贡》中记载山脉水道的体例。可惜马元台等人,未能一一加以注释说明。而且这一篇与《经筋》、《卫气》、《营气》以及《素问》中记载阴阳大论的各篇,都是古代的奇文,应当熟读并精通它。而这一篇叙述营气和卫气各种疾病的起源尤其切要。所以在校勘了文字之后,我又将这篇书的体例写在后面。
读张仲景的书,知道其根源在于《灵枢》和《素问》,这是人们所知道的;读张仲景的书,应当将其委曲详尽之处追溯至《千金方》和《外台秘要》,这是人们所不知道的。大概《千金方》和《外台秘要》被视为偏僻之书已经很久了。再思考张仲景的书,其文字简练,其义理隐微,其症状描述简略,其方剂简约,其药物精简;除了对伤寒病的桂枝汤、麻黄汤、柴胡汤、四逆汤等证候反复辨析讨论外,大体上是为后学者确立纲领和先例,无暇做到详尽细致,如果墨守成规地死守他的书是没有益处的。只有《千金方》和《外台秘要》这两本书,以张仲景的理论为根基并加以推演发展,集九代人的精华,成就千秋万代的巨著,阐发医理奥秘,毫无遗漏。如果能从此向上追溯,并在它们参互合并、厘清分析、移易变换、变通脱化的地方,通过揣测作者意图来理解其宗旨,那么张仲景的症状分类就完备了,方剂运用就神妙了,药物使用法则就显现了,久而久之就可以窥探到其中的奥妙了。况且还有散逸的论述和散逸的方剂,足以补充王洙、林亿(王洙和林亿都是北宋人)版本中的缺失;古人的学说和义理,足以纠正成无己、赵良(成无己是宋代人;赵良是元代人)流传中的讹误。学者舍弃这些,凭什么去询问南阳(张仲景)医学的门径呢?儒家文章推崇韩愈、柳宗元,诗歌推崇李白、杜甫,经义推崇陆德明、孔颖达,书法推崇欧阳询、柳公权,这些都是唐代的法度,那么唐代人守护前人传统、传递后世可效法之处的情况就可以知道了。医学也是如此。
The conventions of this text: The starting point of a meridian is termed "Qi" (起, rise/start); connecting to the zang-fu organs belonging to the same meridian is termed "Shu" (属, belong/associate); linking to the zang-fu organs that are exterior-interiorly related is termed "Luo" (络, connect/network); moving from one place to another is termed "Xun" (循, follow/circulate); moving upward from below is termed "Shang" (上, ascend); moving downward from above is termed "Xia" (下, descend); passing through other meridians is termed "Xing" (行, travel/proceed); passing beside limb joints is termed "Guo" (过, pass/go by); penetrating through the interior is termed "Guan" (贯, penetrate/pierce); running parallel on both sides is termed "Jia" (挟, flank/clasp); mutually intersecting is termed "Jiao" (交, cross/intertwine); encircling all around is termed "Huan" (环, circle/encircle); reaching directly to its destination is termed "Di" (抵, arrive/reach); entering from the exterior to the interior is termed "Ru" (入, enter); appearing suddenly from concealment is termed "Chu" (出, emerge/exit); moving in a straight line is termed "Zhi" (直, straight); moving parallel is termed "Heng" (横, horizontal/transverse); moving obliquely is termed "Xie" (斜, slant/diagonal); two branches merging together is termed "He" (合, combine/unite); one branch dividing into two is termed "Bie" (别, separate/diverge); moving swiftly to converge is termed "Qu" (趣, hasten/converge); leaving here and returning is termed "Huan" (还, return).
In the *Neijing* (*Yellow Emperor's Inner Classic*), no passage exhibits such meticulous wording as this one, resembling the conventions of geographical descriptions of mountains and waterways in the *Yu Gong* (*Tribute of Yu*). It is regrettable that Ma Yuantai and others failed to annotate these points one by one. Furthermore, this chapter, along with chapters such as *Jing Jin* (Meridian Sinews), *Wei Qi* (Defensive Qi), *Ying Qi* (Nutritive Qi), and various chapters in the *Suwen* (*Basic Questions*) discussing the Great Theory of Yin and Yang, are ancient extraordinary texts that should be studied thoroughly and mastered. This chapter is particularly crucial in describing the origins of diseases related to Ying Qi and Wei Qi. Therefore, after collating the text, I have recorded its conventions below.
When reading the works of Zhang Zhongjing, people know that he traces his origins to the *Lingshu* (*Spiritual Pivot*) and *Suwen*; however, few know that when studying Zhang Zhongjing, one should trace the detailed developments to the *Qianjin Yaofang* (*Essential Prescriptions Worth a Thousand Gold*) and the *Waitai Miyao* (*Secret Essentials of the Outer Terrace*). For a long time, the *Qianjin Yaofang* and *Waitai Miyao* have been regarded as obscure or peripheral texts. Consider that Zhang Zhongjing’s writings are concise in language, profound in meaning, brief in symptom description, simple in formulas, and economical in herbs; apart from the repeated discussions on syndromes treated by Guizhi Tang (Cinnamon Twig Decoction), Mahuang Tang (Ephedra Decoction), Chaihu Tang (Bupleurum Decoction), and Sini Tang (Frigid Extremities Decoction) for Shanghan (Cold Damage), his work generally serves to establish principles and examples for later students, without sufficient detail. Blindly adhering to his books is of no benefit. Only the *Qianjin Yaofang* and *Waitai Miyao*, which build upon Zhang Zhongjing’s foundation and expand upon it, collecting the essence of nine dynasties to create monumental works that reveal medical secrets without omission, allow one to trace back. By understanding their methods of integration, analysis, modification, and transformation through interpreting the author's intent, one can comprehend the comprehensive nature of Zhang Zhongjing’s syndromes, the efficacy of his formulas, and the principles of his herbal usage. Over time, one can glimpse the profound mysteries of his teachings. Moreover, these texts contain lost discussions and prescriptions that supplement deficiencies in the editions by Wang Zhu and Lin Yi (both from the Northern Song Dynasty); ancient theories and interpretations correct errors propagated by Cheng Wuji (Song Dynasty) and Zhao Liang (Yuan Dynasty). Without these, how can scholars access the gateway of Nanyang (Zhang Zhongjing’s) medicine? Just as Confucian scholars revere Han Yu and Liu Zongyuan for prose, Li Bai and Du Fu for poetry, Lu Deming and Kong Yingda for classic exegesis, and Ouyang Xun and Liu Gongquan for calligraphy—all representing Tang Dynasty standards—so too does the preservation of tradition and transmission of knowledge in the Tang era illustrate the importance of such sources. Medicine is no different.