一纂伤寒书者众矣知尊仲景书而遗后贤续法者好古之过也类证诸书是也惟俗眼之便而雅俗杂陈溜渑莫辨使世不知
孰为仲景者俗工之谬也琐言蕴要诸书是也惟娄氏纲目列六经正病于前而次合病并病汗吐下后诸坏病于后又次之以四时
感异气而变者与妇婴终焉而每条之中备列仲景法然后以后贤续法附之既该括百家又不相淆杂义例之善无出其右此书篇
目大抵因之
一王叔和编次张仲景伤寒论立三阳三阴篇其立三阳篇之例凡仲景曰太阳病者入太阳篇曰阳明病者入阳明篇曰少阳
病者入少阳篇其立三阴篇亦根据三阳之例各如太阴少阴厥阴之名入其篇也其或仲景不称三阳三阴之名但曰伤寒某病用某
方主之而杂分其篇者则病属阳证发热结胸痞气蓄血衄血之类皆混入太阳篇病属阴证厥逆下利呕吐之类皆混入厥阴篇也
惟燥屎及屎硬不大便大便难等证虽不称名独入阳明篇者由此证类属阳明胃实非太阳厥阴可入故独入阳明也所以然者由
太阳为三阳之首凡阳明少阴之病皆自太阳传来故诸阳证不称名者皆入其篇厥阴为三阴之尾凡太阴少阴之病皆至厥阴传
极故诸阴证不称名皆入其篇后人不悟是理遂皆谓太阳篇诸证不称名者亦属太阳而乱太阳病之真厥阴篇诸证不称名者亦
属厥阴而乱厥阴病之真为大失仲景之法也今于各证分经处尚多仍叔和之旧学人当以意神而明之
一仲景立法凡曰太阳病者皆谓脉浮头项强痛恶寒也凡曰阳明病者皆谓胃家实也凡曰少阳病者皆谓口苦咽干目眩也
凡曰太阴病者皆谓腹满时痛吐利也凡曰少阴病者皆谓脉微细但欲寐也凡曰厥阴病者皆谓气上撞心痛吐蛔也候如少阴病
不一一逐条曰脉微细但欲寐而总用少阴病三字括之者省文也故各条或曰少阴病反发热脉沉用麻黄附子细辛汤者谓脉沉
细但欲寐而又反发热者用其方也或曰少阴病得之二三日以上心烦不卧用黄连阿胶汤者谓得脉微细但欲寐二三日后变心
烦不卧者用其方也后人不悟是理遂皆不察少阴病三字所括脉微细但欲寐之证但见发热脉沉便用麻黄附子细辛汤见心烦
不卧便用黄连阿胶汤尤为大失仲景之法也
一解释仲景书者惟成无己最为详明虽随文顺释自相矛盾者时或有之亦白璧微瑕固无损于连城也后此赵嗣真张兼善
之流皆有发明并可为成氏忠臣张公耳孙故多采掇使学人一览洞然而一得之愚亦时附焉其文义浅近不必训释者则一切省
之内一字赵者嗣真也张者兼善也黄者仲理也活者朱肱活人书也庞者安时也许者叔微学士也本者许之本事方也韩者 和
也孙者兆也洁者洁古张元素也云者洁古之子云岐子也垣者李东垣也丹者朱丹溪也海者王海藏也王者履也罗者天益也戴
者元礼也娄者全善也吴者绶也陶者华也其不系姓字者自篇首辨证数语之外皆仲景论文也
一仲景诸方动以斤计而又有称升合枚者古今度量衡轻重长短不同难以遵用局方纲目又一切裁损每服五钱则失之太
小陶氏吴氏书尽变古方以便时用则其失更远矣今书方药分两一切仍仲景之旧增损出入又当视病情时令神而明之一切古
方皆当如是施用不独仲景书也知此则又何以轻变古法为哉陈无择以钱谱推测度量衡法颇协时宜今引其说于此用古方者
宜详考焉凡度者分寸尺丈引本以一黍之广为分十分为寸十寸为尺十尺为丈十丈为引观今之尺数等不同如周尺长八寸京
尺长一尺六寸淮尺长一尺二寸乐尺长一尺二寸五分并以小尺为率小尺既自三微起却自可准唐武德年铸开元钱径八分当
十二钱半得一尺排钱比之十一个已及一尺又不知唐用何尺顾汉唐龠量并用尺寸分布尺寸如是不齐将何凭据博古君子必
有说矣凡量者龠合升斗斛本以黄钟龠容十二铢合龠为合重二十四铢今以钱准则六铢钱四个比开元钱三个重升斗斛皆垒
而成数汉唐同用至赵宋绍兴升容千二百铢则古文六铢钱二百个开元钱一百五十个以绍兴一升得汉五升其余私有不足计
也凡衡者铢两斤钧石亦以黄钟龠所容重十二铢两之为两二十四铢为两十六两为斤三十斤为钧四钧为石每两则古文六铢
钱四个开元钱三个至赵宋广秤以开元钱十个为两今之三两得汉唐十两明矣千金本草皆以古三两为今一两以古三升为今
一升诸药类例尤为难辨且如半夏一升准五两不知用何升何两此修合制度之要务不可不知汉铜钱质如周钱文曰半两重如
其文孝文五年钱益多而轻乃更铸四铢其文曰半两杂以铅铁锡非淆杂伪巧则不得赢而奸或盗磨钱质取熔有司言钱轻重请
郡国铸五铢钱周郭有质令不得磨取熔则知汉以二半两钱为两重十铢明矣汉唐例以二十四铢为一两抑未知修史人改作唐
例亦不可知观钱谱汉无六铢钱至唐方有今以五铢钱十六个正得开元钱十个重又以六铢钱十二个正得开元钱九个重则知
开元钱每个以重八铢唐武德四年铸开元通宝径八分重二铢四 积十钱为两似难考据明食货者必有说焉按药书汉方汤液
大剂三十余两小剂十有余两水六升或七升多煎取二升三升并分三服若以古龠量水七升煎今之三十两未淹得过况散末药
只服方寸刀圭匕丸子如梧桐大极至三十粒汤液岂得如此悬绝又以风引汤一剂计五十五两每两只用三指撮水三升煮三沸
去滓温服一升观其煮制每只三指撮 不应料剂如此之多此又可疑也今以臆说汉方当用半两钱二枚为一两且以术附汤方较
若用汉两计一百八十铢得开元钱二十二个半重若分三服已是今之七钱半重一服若以唐方准计三百三十六铢得开元钱四
十二个重每服计今之十四钱重大略可知若以开元钱准得一百单五个重分三服每服计三十五钱重此犹是小剂况有大剂名
件两数之多者未易概举留心此道幸少详焉吴绶曰凡方称铢者二十四铢为两一两分为四分六铢为一分计二钱五分也称字
者一钱有四字一字计二分五厘也世有古今时有冬春地有南北药有良犷人有强弱不可执一且如大陷胸汤用大黄六两今用
六钱足矣若人壮病大者宜之人弱病小者又当减半或只用三四之一可也芒硝一升今用二三钱足矣甘遂二两只可用一分或
半分而已若无活法通变而胶柱鼓瑟未有不至于杀人者慎之慎之
一内经云风雨寒暑不得虚邪不能独伤人至于丹溪又云伤寒属内伤者十居八九当以补元气为主由是言之后人治伤寒
者既皆识仲景之法不尽又不知其病本于内伤虚劳而思补养但用汗下致死者其杀人何异刀剑兴言至此切骨痛心今虽以后
贤补养之法附载于篇而书不尽言言不尽意尤望临病之工重人命而惧阴谴熟玩此书无疑于心而后下手用药即不能然宁过
于谨护元气无孟浪汗下而后庶几乎少失也
一屠鹏四时治要云凡欲知阴别阳须当观脉论形视喘息听音声而治病所苦按尺寸观权衡而知病所生然后知其虚实得
其本末更精加察审徐徐取之如仲景活人书下证俱备当行大承气汤必先以小承气汤试之合用大柴胡必先以小柴胡试之及
阴证晓然合用四逆汤必先以理中汤真武汤之属试之此皆大贤得重敌之要学人其可不审乎按汤剂丸散生灵之司命也死生
寿夭伤寒之瞬息也岂以试为言哉盖与其躁暴而多虞宁若重敌而无失鸡峰张锐者宋之神医也疗一伤寒诊脉察色皆为热极
煮承气汤欲饮复疑至于再三如有掣其肘者姑持药以待病者忽发战悸覆绵衾四五重始稍定有汗如洗明目脱然使其药入口
则人已毙矣由是观之则屠氏之探试虽非仲景本旨得非粗工之龟鉴欤
【凡例】
一、编纂伤寒著作的人很多,那些只知道尊崇张仲景的著作而忽略后世贤人补充治法的人,是过于崇古的过失,这类书就是《类证诸书》。它们只迎合世俗读者的便利,雅俗混杂,像水和牛奶混在一起难以分辨,使得世人不知道哪些才是张仲景的真传,这是庸医的错误,这类书就是《琐言蕴要》等书。只有娄全善氏的《纲目》,在前面列出六经的正病,接着排列合病、并病以及经过汗、吐、下法治疗后的各种坏病,然后再按四季感受不同邪气而变化以及妇女婴儿的疾病排列在最后。在每一条中,详尽列出张仲景的治法,然后将后世贤人的补充治法附在后面。这样既包罗了百家的学说,又不相互混淆杂乱,其义例之善,没有能超过它的。这本书的篇目大体上沿用了它。
一、王叔和编次张仲景的《伤寒论》,设立三阳(太阳、阳明、少阳)和三阴(太阴、少阴、厥阴)各篇。他设立三阳篇的规则是:凡是张仲景称为“太阳病”的,就归入太阳篇;称为“阳明病”的,就归入阳明篇;称为“少阳病”的,就归入少阳篇。设立三阴篇也依据三阳的规则,分别以太阴、少阴、厥阴之名归入各自的篇章。如果张仲景不称三阳三阴的名字,只说“伤寒某病用某方主之”,而分散在各篇中的,那么属于阳证发热、结胸、痞气、蓄血、衄血之类的,都混入太阳篇;属于阴证厥逆、下利、呕吐之类的,都混入厥阴篇。只有燥屎、大便硬、不大便、大便难等证候,虽然不称名字,唯独归入阳明篇,是因为这些证候类别属于阳明胃实,不属于太阳或厥阴可以归入的范围,所以唯独归入阳明篇。之所以这样,是因为太阳是三阳之首,凡是阳明、少阴的病都是从太阳传来,所以所有不称名字的阳证都归入太阳篇;厥阴是三阴之尾,凡是太阴、少阴的病都会传到厥阴达到极点,所以所有不称名字的阴证都归入厥阴篇。后人不明白这个道理,于是都认为太阳篇中不称名字的证候也属于太阳,从而扰乱了太阳病的真相;认为厥阴篇中不称名字的证候也属于厥阴,从而扰乱了厥阴病的真相,这大大违背了张仲景的法度。现在在各证候分经的地方,大多仍保留王叔和的旧制,学习者应当用心体悟,使之明晰。
一、张仲景确立法则,凡是说“太阳病”的,都是指脉浮、头项强痛、恶寒。凡是说“阳明病”的,都是指胃家实。凡是说“少阳病”的,都是指口苦、咽干、目眩。凡是说“太阴病”的,都是指腹满、时痛、吐利。凡是说“少阴病”的,都是指脉微细、但欲寐。凡是说“厥阴病”的,都是指气上撞心、心痛、吐蛔。候诊如少阴病,并不逐条说“脉微细、但欲寐”,而是总用“少阴病”三个字来概括,这是省略文字的缘故。所以各条中有的说“少阴病反发热,脉沉,用麻黄附子细辛汤”,是指脉沉细、但欲寐而又反发热的,用这个方子;有的说“少阴病得之二三日以上,心烦不卧,用黄连阿胶汤”,是指得了脉微细、但欲寐两三天后,变为心烦不卧的,用这个方子。后人不明白这个道理,于是都不考察“少阴病”三个字所概括的脉微细、但欲寐的证候,只要见到发热、脉沉就用麻黄附子细辛汤,见到心烦不卧就用黄连阿胶汤,这更是大大违背了张仲景的法度。
一、解释张仲景著作的人,只有成无己最为详细明了,虽然随着文意顺释,有时自相矛盾,也是白璧微瑕,确实无损于连城之价。此后赵嗣真、张兼善等人都有发明,都可以成为成无己的忠臣。张公耳孙因此多采撷他们的观点,使学习者一览洞然,而我的一得之愚也时常附上。其中文义浅近不必训释的,则一概省去。其中提到“赵”的是嗣真,“张”的是兼善,“黄”的是仲理,“活”的是朱肱的《活人书》,“庞”的是安时,“许”的是叔微的《学士》,“本”的是许叔微的《本事方》,“韩”的是韩和,“孙”的是孙兆,“洁”的是洁古张元素,“云”的是洁古之子云岐子,“垣”的是李东垣,“丹”的是朱丹溪,“海”的是王海藏,“王”的是王履,“罗”的是罗天益,“戴”的是戴元礼,“娄”的是娄全善,“吴”的是吴绶,“陶”的是陶华。其中不系姓名的,除了篇首辨证数语之外,都是张仲景的论文。
一、张仲景的各方动辄以斤计算,又有称升、合、枚的,古今度量衡的轻重长短不同,难以遵照使用。局方《纲目》又一切裁减,每服五钱,这就失之太小。陶氏、吴氏的书完全改变古方以便当时使用,那错误就更远了。现在本书方药分量一切仍保留张仲景的旧制,增减出入又应当视病情和时令,神而明之。一切古方都应当如此施用,不只是张仲景的书如此。知道这一点,又何必轻易改变古法呢?陈无择用《钱谱》推测度量衡法,颇合时宜,现在引用他的说法于此,使用古方的人应当详细考证。凡是长度单位:分寸尺丈引,本以一颗黍米的宽度为一分,十分为一寸,十寸为一尺,十尺为一丈,十丈为一引。观察现在的尺数各不相同,如周尺长八寸,京尺长一尺六寸,淮尺长一尺二寸,乐尺长一尺二寸五分,都以小尺为标准。小尺既然从三微开始,却可以为准。唐武德年间铸造的开元钱,直径八分,当十二个半钱重得一尺,排钱相比,十一个已及一尺,又不知唐代用的是什么尺。考虑到汉代和唐代的龠量并用尺寸分布,尺寸如果不齐,将凭借什么作为依据?博古的君子一定有说法。凡是容量单位:龠、合、升、斗、斛,本以黄钟龠容纳十二铢,合龠为合,重二十四铢。现在用钱准则,六铢钱的四个比开元钱三个重,升、斗、斛都是累积而成数,汉唐通用。到了赵宋绍兴年间,升容纳一千二百铢,则是古文六铢钱二百个,开元钱一百五十个,因为绍兴一升相当于汉五升,其余私有的不足计算。凡是重量单位:铢、两、斤、钧、石,也以黄钟龠所容重十二铢,两之为两,二十四铢为两,十六两为斤,三十斤为钧,四钧为石。每两则是古文六铢钱四个,开元钱三个。到了赵宋广秤,以开元钱十个为两,现在的三两得到汉唐十两,明显可知。《千金方》、《本草》都以古三两为今一两,以古三升为今一升,各类药物尤其难以辨别。且如半夏一升准五两,不知用的是什么升、什么两,这是修合制度的要务,不可不知道。汉铜钱质地如周钱,文曰“半两”,重如其文。孝文帝五年,钱增多而轻,于是更铸四铢钱,文曰“半两”,杂以铅铁锡,如果不是淆杂伪巧,就不能获利,或者有人盗窃磨取钱质熔炼。有关部门说钱有轻重,请郡国铸造五铢钱,周郭有质,令不得磨取熔炼,则知汉代以两个半两钱为两,重十铢,明显可知。汉唐惯例以二十四铢为一两,或许也不知道修史人是否改作了唐例,也不可得知。观察《钱谱》,汉代没有六铢钱,到唐代才有。现在以五铢钱十六个正得开元钱十个重,又以六铢钱十二个正得开元钱九个重,则知开元钱每个以重八铢。唐武德四年铸开元通宝,径八分,重二铢四,积十钱为两,似乎难以考据,明晓食货的人一定有说法。按药书,汉代方剂汤液,大剂三十余两,小剂十有余两,水六升或七升,多煎取二升、三升,并分三次服用。如果用古龠量水七升,煎现在的三十两,恐怕淹没过不了。况且散末药只服方寸刀圭匕丸子,如梧桐大小,极至三十粒,汤液岂能如此悬殊?又以风引汤一剂计五十五两,每两只用三指撮,水三升煮三沸,去滓温服一升。观察其煮制,每只三指撮,不应料剂如此之多,这又可疑。现在凭臆测,汉代方剂应当用半两钱二枚为一两。且以术附汤方比较,如果用汉两计一百八十铢,得开元钱二十二个半重,若分三服,已是现在的七钱半重一服。若以唐方准计三百三十六铢,得开元钱四十二个重,每服计现在的十四钱重大略可知。若以开元钱准得一百零五个重,分三服,每服计三十五钱重,这还是小剂,何况有大剂名件两数众多的,不易概举。留心此道的人希望稍微详细考察。吴绶说:凡是方剂称铢的,二十四铢为两,一两分为四分,六铢为一分,计二钱五分。也称字的,一钱有四字,一字计二分五厘。世上有古今时间之分,有冬春季节之别,有南北地域之差,药有良劣之分,人有强弱之别,不可执一。且如大陷胸汤用大黄六两,现在用六钱足够了。如果人壮病大者适宜,人弱病小者又应当减半,或者只用三四之一即可。芒硝一升,现在用二三钱足够了。甘遂二只,只可用一分或半分而已。如果没有活法通变而胶柱鼓瑟,没有不杀人的,慎重啊,慎重啊!
一、《内经》说:“风雨寒暑,不得虚邪,不能独伤人。”至于丹溪又说:“伤寒属内伤者十居八九,当以补元气为主。”由这样的话来看,后人治疗伤寒者,既然都认识张仲景的法度却不尽,又不知道其病本于内伤虚劳而思补养,但只用汗、下法导致死亡的,他们杀人何异于刀剑?想到此处,切骨痛心。现在虽然以后世贤人的补养之法附载于篇,但书不尽言,言不尽意,尤其希望临病之工重视人命而惧怕阴谴,熟玩此书无疑于心而后下手用药。即使不能做到这样,宁可过于谨慎护持元气,不要孟浪汗下,然后才差不多少有失误。
一、屠鹏《四时治要》说:凡是想要区分阴阳,必须观察脉象,论述形体,视喘息,听音声,而治病所苦,按尺寸,观权衡,而知病所生,然后知其虚实,得其本末,更加精加察审,徐徐取之。如《仲景活人书》下证俱备,当行大承气汤,必须先以小承气汤试之;合用大柴胡,必先以小柴胡试之;及阴证晓然,合用四逆汤,必先以理中汤、真武汤之属试之。这都是大贤获得战胜重病的关键学问,学习者岂可不审慎?按汤剂丸散是生灵的主宰,死生寿夭在于伤寒的瞬息之间,岂能以“试”来说呢?大概与其躁暴而多虞,不如重敌而无失。鸡峰张锐,是宋代的神医,治疗一个伤寒患者,诊脉察色皆为热极,煮承气汤欲饮,又怀疑,以至于再三,如有牵制其肘者。姑且持药以待病人,忽然发生战栗悸动,覆盖绵被四五层,始稍定,有汗如洗,明目脱然。使其药入口,则人已毙矣。由此看来,则屠氏的探试虽非张仲景的本旨,难道不是粗工的龟鉴吗?
[General Principles]
1. There have been many authors compiling treatises on *Shanghan* (Cold Damage). Those who only revere Zhang Zhongjing's works while neglecting the supplementary methods of later sages commit the error of excessive antiquarianism; such books include *Lei Zheng Shu*. They cater merely to vulgar convenience, mixing elegant and coarse styles indistinguishably like water and milk, leaving the world unaware of what truly belongs to Zhang Zhongjing. This is the fallacy of mediocre practitioners; such books include *Suo Yan Yun Yao* and others. Only Lou Quanshan's *Gangmu* lists the primary diseases of the Six Channels at the beginning, followed by combined diseases, concurrent diseases, and various deteriorated conditions after sweating, vomiting, or purging therapies. It further categorizes diseases altered by seasonal pathogens and those affecting women and infants. Within each entry, it meticulously records Zhang Zhongjing's methods before appending the supplementary methods of later sages. Thus, it encompasses a hundred schools without confusion, and its principles are unsurpassed. The chapter structure of this book largely follows it.
2. Wang Shuhe, in editing Zhang Zhongjing's *Shanghan Lun*, established chapters for the Three Yang (Taiyang, Yangming, Shaoyang) and Three Yin (Taiyin, Shaoyin, Jueyin). His rule for the Three Yang chapters was: any condition Zhang Zhongjing termed "Taiyang Disease" was placed in the Taiyang chapter; "Yangming Disease" in the Yangming chapter; and "Shaoyang Disease" in the Shaoyang chapter. The Three Yin chapters followed this same logic. However, if Zhang Zhongjing did not use these specific names but described a cold damage condition with a specific formula scattered across chapters, conditions belonging to Yang syndromes—such as fever, chest binding, palpitations, blood stasis, and epistaxis—were mixed into the Taiyang chapter. Conditions belonging to Yin syndromes—such as cold extremities, diarrhea, and vomiting—were mixed into the Jueyin chapter. Only conditions like dry feces, hard stool, inability to defecate, or difficult defecation were exclusively placed in the Yangming chapter, despite lacking specific naming, because they belong to Yangming Stomach excess and cannot be categorized under Taiyang or Jueyin. This is because Taiyang is the head of the Three Yang; all Yangming and Shaoyin diseases originate from Taiyang transmission. Therefore, all unnamed Yang conditions were grouped into the Taiyang chapter. Jueyin is the tail of the Three Yin; all Taiyin and Shaoyin diseases transmit to Jueyin at their peak. Therefore, all unnamed Yin conditions were grouped into the Jueyin chapter. Later scholars failed to understand this logic, erroneously assuming that unnamed conditions in the Taiyang chapter belonged to Taiyang, thereby distorting the truth of Taiyang disease, and similarly distorting Jueyin disease. This greatly deviates from Zhang Zhongjing's methodology. Currently, the classification of conditions by channel in this text retains much of Wang Shuhe's original arrangement. Students should reflect deeply to clarify these points.
3. Zhang Zhongjing established his legal framework thus: Whenever he stated "Taiyang Disease," he referred to floating pulse, stiffness and pain in the head and neck, and aversion to cold. "Yangming Disease" referred to fullness and excess in the stomach/intestines (Wei Jia Shi). "Shaoyang Disease" referred to bitter taste in the mouth, dry throat, and vertigo. "Taiyin Disease" referred to abdominal fullness, intermittent pain, vomiting, and diarrhea. "Shaoyin Disease" referred to faint and thin pulse, and a desire to sleep. "Jueyin Disease" referred to Qi rushing upward hitting the heart, heart pain, and vomiting roundworms. In cases like Shaoyin Disease, he did not repeat "faint and thin pulse, desire to sleep" in every line but summarized them with the term "Shaoyin Disease" to save space. For instance, when a line states "Shaoyin Disease with contrary fever and deep pulse, use Mahuang Fuzi Xixin Tang," it implies the patient has a deep, thin pulse and desire to sleep, plus contrary fever, warranting this formula. When it states "Shaoyin Disease, two to three days later, restlessness and insomnia, use Huanglian Ejiao Tang," it implies the patient had the initial Shaoyin signs for two to three days, which then transformed into restlessness and insomnia, warranting this formula. Later scholars failed to grasp this, ignoring the core symptoms encapsulated by "Shaoyin Disease." They indiscriminately used Mahuang Fuzi Xixin Tang for any fever with deep pulse, and Huanglian Ejiao Tang for any restlessness and insomnia, a grave deviation from Zhang Zhongjing's methods.
4. Among commentators on Zhang Zhongjing's work, Cheng Wuji is the most detailed. Although occasionally self-contradictory in his literal explanations, these are minor flaws in an otherwise flawless jade, not detracting from its immense value. Later scholars like Zhao Sizhen and Zhang Jianshan made significant contributions and can be considered loyal followers of Cheng's school. Their insights are extensively cited here to provide clarity for students, along with some of my own modest observations. Texts that are straightforward require no annotation. Abbreviations used: "Zhao" refers to Sizhen; "Zhang" to Jianshan; "Huang" to Zhongli; "Huo" to Zhu Gong's *Huoren Shu*; "Pang" to Anshi; "Xu" to Shuwei's *Xueshi*; "Ben" to Xu's *Benshi Fang*; "Han" to He; "Sun" to Zhao; "Jie" to Jiegu (Zhang Yuansu); "Yun" to Yunqizi (son of Jiegu); "Yuan" to Li Dongyuan; "Dan" to Zhu Danxi; "Hai" to Wang Haicang; "Wang" to Lu; "Luo" to Tianyi; "Dai" to Yuanli; "Lou" to Quanshan; "Wu" to Shou; "Tao" to Hua. Entries without surnames, except for the initial diagnostic phrases, are quotes from Zhang Zhongjing.
5. Zhang Zhongjing's prescriptions often weigh in jin (pounds), using units like sheng, he, and mei. Due to differences in ancient and modern weights and measures, direct application is difficult. The Bureau Formulary *Gangmu* reduced dosages significantly (e.g., five qian per dose), making them too small. Tao and Wu completely altered ancient formulas for contemporary use, increasing the error. This book retains Zhang Zhongjing's original dosages, advising practitioners to adjust flexibly based on condition and season. Ancient formulas should be applied with discernment, not just Zhang's. Chen Wuyue's use of the *Qian Pu* to deduce measurements is practical and cited here for reference. Length units: Fen, Cun, Chi, Zhang, Yin. One fen equals the width of one grain of millet. Ten fen make one cun; ten cun make one chi; ten chi make one zhang; ten zhang make one yin. Historical rulers varied: Zhou chi was 8 cun, Jing chi 16 cun, Huai chi 12 cun, Yue chi 12.5 cun. The small chi is taken as the standard. Kaiyuan Tongbao coins from Tang Wude era had a diameter of 8 fen; twelve and a half coins weighed one chi. Volume units: Yue, He, Sheng, Dou, Hu. Based on the Huangzhong Yue holding 12 zhu. Two yues make one he, weighing 24 zhu. Using coin standards, four 6-zhu coins equal the weight of three Kaiyuan coins. Han and Tang used similar volume measures. By Song Shaoxing era, one sheng held 1200 zhu (equivalent to 200 ancient 6-zhu coins or 150 Kaiyuan coins), where one Shaoxing sheng equaled five Han shengs. Weight units: Zhu, Liang, Jin, Jun, Shi. Twelve zhu make one liang (historically defined differently); sixteen liang make one jin; thirty jin make one jun; four jun make one shi. In Song Guangcheng, ten Kaiyuan coins equaled one liang. Thus, three current liang equal ten Han/Tang liang. *Qianjin Yaofang* and *Bencao* convert ancient 3 liang to current 1 liang, and ancient 3 sheng to current 1 sheng, causing confusion. For example, Banxia (Pinellia Rhizome) 1 sheng equals 5 liang, but which sheng and liang? This is crucial for compounding. Han copper coins resembled Zhou coins, inscribed "Banliang." Wen Emperor minted lighter 4-zhu coins. Later, Wuzhu coins were cast with raised edges to prevent shaving. Two Banliang coins equaled one liang, weighing 10 zhu. Han/Tang standard was 24 zhu per liang. *Qian Pu* shows no 6-zhu coins in Han, appearing in Tang. Sixteen Wuzhu coins equal ten Kaiyuan coins in weight; twelve 6-zhu coins equal nine Kaiyuan coins. Kaiyuan coins weigh 8 zhu each. Tang Wude Kaiyuan Tongbao weighed 2.4 zhu; ten coins make one liang. Historical analysis suggests Han formulas used larger doses. Decoctions used 30+ liang for large doses, boiled down from 6-7 sheng of water to 2-3 sheng, divided into three doses. If using modern weights/volumes, this seems excessive. Powders were taken in smaller amounts (e.g., Fangcun Dao Gui). Fengyin Tang used 55 liang total, taken in small scoops. Modern speculation suggests Han "one liang" might equal two Banliang coins. Calculations show variations: Han method yields ~7.5 qian per dose for Shufu Tang; Tang method yields ~14 qian; Kaiyuan standard yields ~35 qian per dose. Wu Shou notes: 24 zhu = 1 liang; 1 liang = 4 fen; 6 zhu = 1 fen = 2.5 qian. "Zi" unit: 1 qian = 4 zi; 1 zi = 2.5 li. Practitioners must adapt to times, seasons, regions, drug quality, and patient constitution. Daxianxiong Tang uses 6 liang Dahuang; today 6 qian suffices for robust patients, less for weak ones. Xiaoshao (Magnolia Bark) 1 sheng; today 2-3 qian suffices. Gansui (Kansui Root) 2 zhi; today 1 fen or 0.5 fen suffices. Rigidity leads to death; caution is paramount.
6. *Neijing* states: "Wind, rain, cold, and heat cannot harm alone without deficiency." Danxi added: "Eight or nine out of ten Shanghan cases stem from internal injury; tonifying Yuan Qi is primary." Consequently, later practitioners, knowing Zhang's methods but ignoring the root in internal deficiency, often killed patients by using sweating and purging unnecessarily. This is akin to murder. Though I append later tonification methods, words cannot fully convey intent. Physicians must respect life, study this book thoroughly, and act with caution. Better to over-protect Yuan Qi than to recklessly sweat or purge.
7. Tu Peng's *Sishi Zhiyao* advises distinguishing Yin and Yang by observing pulses, form, breathing, and voice, and diagnosing via Cun and Chi positions. One must carefully assess excess and deficiency before treating. Like *Huoren Shu*, if Da Chengqi Tang is indicated, test with Xiao Chengqi Tang first; if Dahu Chaihu Tang is needed, test with Xiao Chaihu Tang first; for clear Yin syndrome requiring Sini Tang, test with Lizhong Tang or Zhenwu Tang first. These are key strategies of great sages. However, decoctions and pills are matters of life and death in the fleeting moments of Shanghan. Is "testing" appropriate? Better to be cautious than reckless. Zhang Rui, a Song dynasty divine physician, treated a Shanghan case with extreme heat signs. He prepared Chengqi Tang but hesitated repeatedly. The patient suddenly shivered, covered himself with multiple blankets, sweated profusely, and recovered spontaneously. Had he taken the medicine, he would have died. Thus, Tu's "testing" method, while not strictly Zhang's intent, serves as a warning against rashness by mediocre doctors.