诊视之要，必先详察形色，然后细问致病之因。闻其声音哑响，察其肌肤肥瘦，问其苦
欲，按其胸腹，视其舌苔，询其渴饮、二便通塞，苟能不惮烦渎，则在里之虚实、寒热已得
其要领矣。
大抵胃有邪滞，舌必有苔，苔之燥润、黄白、浓薄，以辨邪滞之浅深，而用轻下、重下之
方法。至于口渴，能饮者，属实热口渴；不能饮者、属虚热。小溲赤涩、大便燥结者，实热也；
小便清利、大便溏泄者，虚寒也。若潜心推测，则病之寒热、虚实，自无狐疑之惑矣。然后参
乎脉之浮沉、迟数，则标本、虚实更有鉴别矣。
余于切脉辨证，尤加慎审，未敢轻忽。推测历验心得，竟是左手主阴，右手主阳。凡温
热之病，热邪灼阴，右手脉大，左手脉微，迨下
尽热邪，左脉始起，右脉亦平。又沉寒痼冷之 ，右脉极沉微，左脉皆紧盛，直至数温之后，
左脉平而右脉起矣。凡阴阳偏虚，亦验左右可知。阴气先绝者，左脉先绝；阳气先绝者，右脉
先绝。又有紧与数相似，有寒、热相反之别，亟宜辨明。近时温疫证重者，正为邪制，脉反极
微如无，当审其平昔有无宿病，分别老幼、强弱而断之。假如素无疾患，体质强壮者，决其
脉因病变，必视其舌苔黄浊、燥裂，胸腹拒按；一经下后，病邪渐退，而脉亦渐起。如大虚有
盛状、大实有羸形，阳病似阴，阴病似阳，若不细察精详，误人性命岂浅鲜哉！
惟温、清、攻、补四者之中，以平补之补较轻，缘微补不过助疾，且有助正之能，若浊补
则有遏邪之患。况古方每以补正之中，参以逐邪之品；攻下之方，寓以扶正之治。凡大攻、大
热、大寒之剂，稍有疑似，只可渐次加足，切勿过剂伤正。倘虚症误下，则祸不旋踵，挽回莫
及之势矣，谨之、慎之！譬如热而不实者，当用白虎、黄连，若误投承气、抵当，则败；若阴虚
虚热、应用补血滋阴者，若误投黄连、白虎，则亦殆矣。更有实症用下后，病势尽瘳，忽又发
热或寒热不已，乃正气骤虚，即当大补以善其后也。又有寒病化热、热证转寒，虚中夹实、实
症兼虚，变幻多端，要在审辨精当，细心体察，可免实实虚虚之咎，于心无愧。否则，草菅人
命，班实目击心伤。愿人人如我之存心，体上苍好生之德，则天下夭札之患，稍可挽救矣。
澜按∶病证万变，要在审察形色，闻其声音，问其病因，然后切脉。则虚实立辨，寒热立
判，乃不为外象所惑，寒者热之，热者寒之，沉 顿起，良医之名播矣。今读先生手记，处处
以慎审为主，发明左手属阴，右手主阳；凡温热重病，脉见微细如无；以及误攻祸重、误补
增疾等言，皆前人所未言，可谓仁且智矣。况先生之学术深邃，犹且精细若此，存心利济，
愿人人遵而行之，以免草菅人命，可谓仁至义尽。若后进之士，虽不能如先生才识，而效其
存心，学虽不及，则以慎审从事，足以步良医
之后尘矣。
诊视的关键，必须先详细观察患者的面色和形体，然后仔细询问致病的原因。听其声音的嘶哑或洪亮，观察肌肤的肥瘦，询问患者的痛苦与欲望，按压胸腹部，查看舌苔，咨询口渴饮水情况及大小便的通塞状况。如果不怕繁琐重复，那么体内病邪的虚实、寒热性质就能掌握要领了。
大体上，胃中有邪气停滞，舌头上必然有苔。通过苔的干燥或湿润、黄色或白色、厚或薄，来辨别邪气停滞的深浅程度，从而决定使用轻下法还是重下法的治疗方法。至于口渴，能喝水的，属于实热引起的口渴；不能喝水的，属于虚热。小便赤红涩痛、大便干燥结块的，是实热证；小便清长通利、大便稀溏泄泻的，是虚寒证。若能潜心推测分析，那么疾病的寒热、虚实属性，自然就没有疑惑了。然后再参考脉象的浮沉、迟数，对标本、虚实的鉴别就更明确了。
我在切脉辨证方面，尤其谨慎审慎，不敢轻视疏忽。经过长期验证的心得体会，认为左手脉主要反映阴分情况，右手脉主要反映阳分情况。凡是温热性质的疾病，热邪灼伤阴液，表现为右手脉大，左手脉微，等到通过攻下法祛除尽热邪后，左脉才开始恢复，右脉也趋于平和。又有沉寒痼冷之疾，右手脉极沉微，左手脉皆紧盛，直到经过多次温补治疗后，左脉平和而右脉才起。凡是阴阳偏虚的情况，也可以通过左右脉象来验证。阴气先衰竭的，左脉先绝；阳气先衰竭的，右脉先绝。还有紧脉与数脉相似，但有寒、热相反的区别，必须加以辨明。近来重症温疫患者，因正气被邪气遏制，脉象反而极微细若无，应当审查其平时是否有宿疾，区分老少、强弱来判断。假如平素没有疾病，体质强壮的人，判断其脉象因病变所致，必定要看其舌苔黄浊、燥裂，胸腹部拒按；一旦经过攻下治疗，病邪逐渐消退，脉象也会逐渐升起。如果是大虚证表现出盛实的假象，大实证表现出羸弱的假象，阳病似阴，阴病似阳，如果不仔细察验精详，误人性命难道不是小事吗！
在温、清、攻、补四种治疗方法中，以平补的补法较轻，因为轻微的补益不会助长疾病，且有扶助正气的功能，若用滋腻峻补则有遏阻邪气的隐患。况且古方往往在补益正气的方剂中，参入驱逐邪气的药物；攻下的方剂中，寓含扶助正气的治法。凡是药力猛烈的大攻、大热、大寒之剂，稍有疑似之处，只可逐渐加足剂量，切勿过量损伤正气。倘若虚证误用攻下，则灾祸接踵而至，到了无法挽回的地步，务必谨慎、慎重！例如热证但不属实者，应当用白虎汤、黄连，如果误投承气汤、抵当汤，则会导致败坏；若是阴虚虚热，应用补血滋阴者，如果误投黄连、白虎汤，也同样危险。更有实证用攻下法后，病势完全消除，忽然又发热或寒热往来不止，这是正气骤然虚弱，就应当大补以善后。又有寒病转化为热、热证转化为寒，虚中夹实、实证兼虚，变化多端，关键在于审辨精当，细心体察，可以避免“实实虚虚”（使实证更实、虚证更虚）的错误，心中无愧。否则，草菅人命，亲眼目睹令人伤心。希望人人都像我这样用心，体会上苍好生之德，那么天下夭折早逝的祸患，或许可以挽救一些。
澜按：病证变化万千，关键在于审察形色，听其声音，问其病因，然后切脉。这样虚实立刻可以辨别，寒热立刻可以判断，就不会被外在表象所迷惑。寒者热之，热者寒之，沉疴顿起，良医之名也就传播开了。现在读先生的手记，处处以谨慎审慎为主，阐发左手属阴、右手主阳的理论；凡温热重病，脉见微细若无；以及误用攻伐祸害严重、误用补益增加疾病等言论，都是前人未曾说过的，可以说是既仁爱又明智。何况先生的学术深邃，尚且如此精细，存心利于救济世人，希望人人都遵照实行，以免草菅人命，可以说是仁至义尽了。对于后进之士，虽然不能像先生那样才华见识，但如果效法他的用心，学问虽不及，但凭借谨慎审慎的态度行事，足以追随良医的后尘了。
The key to diagnosis and examination lies in first carefully observing the patient's complexion and physique, then meticulously inquiring about the causes of the disease. Listen to the hoarseness or loudness of their voice, observe the leanness or plumpness of their skin and muscles, inquire about their suffering and desires, palpate the chest and abdomen, inspect the tongue coating, and consult on thirst, drinking habits, and the patency or obstruction of urination and defecation. If one is not afraid of tedious repetition, the essential characteristics of deficiency/excess (Xu/Shi) and cold/heat within the interior can be grasped.
Generally speaking, if there is pathogenic stagnation in the Stomach, there will inevitably be a tongue coating. By examining whether the coating is dry or moist, yellow or white, thick or thin, one can distinguish the depth of the pathogenic stagnation and determine whether to use mild purgation or heavy purgation methods. Regarding thirst: those who can drink belong to excess heat causing thirst; those who cannot drink belong to deficiency heat. Reddish, scanty, and painful urination with dry, hard stools indicate excess heat; clear, profuse, and smooth urination with loose, watery stools indicate deficiency cold. If one deduces with deep concentration, the cold/heat and deficiency/excess nature of the disease will naturally be free from doubt. Then, by referring to the floating/sinking (Fu/Chen) and slow/rapid (Chi/Shuo) qualities of the pulse, the differentiation of root/branch (Biao/Ben) and deficiency/excess becomes even clearer.
In my practice of pulse-taking for syndrome differentiation, I am particularly cautious and prudent, daring not to neglect it lightly. My experience derived from long-term verification leads to the conclusion that the Left hand pulse primarily reflects Yin aspects, while the Right hand pulse primarily reflects Yang aspects. In all warm-heat diseases, where heat pathogens scorch the Yin fluids, the Right pulse is large, and the Left pulse is faint. Only after the heat pathogens are completely expelled via purgation does the Left pulse recover, and the Right pulse become peaceful. In cases of deep-seated cold and chronic cold conditions, the Right pulse is extremely deep and faint, while the Left pulse is tight and vigorous. It is only after multiple applications of warming treatments that the Left pulse becomes peaceful and the Right pulse rises. In cases of partial deficiency of Yin or Yang, this can also be verified through the left and right pulses. If Yin Qi fails first, the Left pulse fails first; if Yang Qi fails first, the Right pulse fails first. Furthermore, the Tight pulse (Jin Mai) resembles the Rapid pulse (Shuo Mai), but they differ fundamentally in indicating Cold versus Heat, so they must be clearly distinguished. Recently, in severe cases of warm epidemics, because the healthy Qi is constrained by the pathogen, the pulse may appear extremely faint as if non-existent. One must examine whether the patient had chronic illnesses in the past, and differentiate based on age and physical strength. For instance, if a person has no prior illnesses and possesses a strong constitution, judging that the pulse changes due to the disease, one must look for signs such as a yellow, turbid, dry, and cracked tongue coating, and tenderness/rejection upon pressure in the chest and abdomen. Once purgation is applied, as the pathogenic evil gradually recedes, the pulse will also gradually rise. If a great deficiency presents with an appearance of excess, or a great excess presents with a emaciated form, or Yang disease mimics Yin, or Yin disease mimics Yang, failing to examine carefully and precisely could easily lead to fatal errors!
Among the four therapeutic methods of Warming (Wen), Clearing (Qing), Attacking/Purgation (Gong), and Tonifying (Bu), mild tonification is the lightest. This is because slight tonification does not aid the disease and can assist the healthy Qi, whereas heavy, cloying tonification carries the risk of obstructing the expulsion of pathogens. Moreover, ancient formulas often incorporate pathogen-expelling herbs within tonifying formulas, and include healthy-Qi-supporting strategies within purgative formulas. For potent formulas involving major attacking, major heating, or major cooling properties, if there is any ambiguity, doses should be increased gradually. Never exceed the appropriate dosage to damage the healthy Qi. If deficiency syndromes are mistakenly treated with purgation, disaster follows immediately, reaching a point of no return. Therefore, caution is paramount! For example, in heat syndromes that are not excess, Baohu Tang (White Tiger Decoction) and Huanglian (Coptis Rhizome) should be used. If Chengqi Tang (Major Order the Qi Decoction) or Didang Tang (Defend Against Blood Stasis Decoction) are mistakenly administered, it will lead to deterioration. Conversely, in cases of Yin deficiency with deficiency heat, where blood-nourishing and Yin-moistening are indicated, mistakenly administering Huanglian or Baohu Tang is equally dangerous. Furthermore, after treating an excess syndrome with purgation, if the disease condition is fully resolved but fever suddenly recurs or chills and fever alternate incessantly, this indicates a sudden depletion of healthy Qi, and immediate major tonification is required to conclude the treatment properly. There are also cases where cold diseases transform into heat, or heat syndromes turn into cold, or deficiency contains excess, or excess includes deficiency. These transformations are manifold. The key lies in precise differentiation and careful observation to avoid the error of "reinforcing excess and depleting deficiency" (making excess more excess and deficiency more deficient), thereby keeping a clear conscience. Otherwise, treating human lives as worthless is heartbreaking to witness. I hope everyone adopts this mindset, embodying Heaven's virtue of cherishing life, so that the tragedy of premature death in the world might be somewhat alleviated.
Lan's Note: Disease manifestations change endlessly, but the crux lies in examining complexion and physique, listening to the voice, asking about the cause, and then taking the pulse. In this way, deficiency and excess can be distinguished immediately, and cold and heat judged instantly, preventing confusion by external appearances. Applying "treat cold with heat, treat heat with cold," profound ailments can be cured instantly, and the reputation of a good physician spread. Reading Mr.'s handwritten notes, every part emphasizes caution and prudence. He elucidates that the Left hand belongs to Yin and the Right hand to Yang; in severe warm-heat diseases, the pulse appears faint and minute as if absent; and he discusses the severe consequences of mistaken purgation and the aggravation of disease by mistaken tonification. These insights were not previously stated by predecessors, demonstrating both benevolence and wisdom. Given the profundity of Mr.'s academic knowledge, his attention to detail is still so meticulous. His intention to benefit and rescue others is commendable. I wish everyone would follow his example to avoid treating lives carelessly, which is the ultimate expression of benevolence and righteousness. For junior practitioners, although they may not possess Mr.'s talent and insight, if they emulate his conscientious attitude and proceed with caution and prudence despite lesser learning, they can sufficiently follow in the footsteps of good physicians.