此二句大意，全在“发”“攻”二字。发者，逐之外也。攻者，逐之内也。寒邪在表，非温热之气不
能散，故发表不远热。热郁在内，非沉寒之物不能除，故攻里者不远寒。然亦有用小柴、白虎、益元之
类，而取汗愈病者何也？此因表里俱热，故当凉解，非发之谓也。又有用四逆、理中回阳之类，而除痛去
积者何也？此因阴寒留滞，故当温中，非攻之谓也。所谓发者，开其外之固；攻者，伐其内之实。今昧
者，但见外感发热等病，不能察人伤于寒而传为热者，有本寒标热之义，辄用芩、连等药以清其标。岂
知邪寒在表，药寒在里，以寒得寒，使内外合邪，遂不可解。此发表用寒之害也。故凡寒邪在表未散，外
虽炽热，内无寒症，正以火不在里，最忌寒凉。此而误人，是不知当发者不可远热也。又如内伤喘、痛、
胀、满等症，多有三阴亏损。今人但见此症，不辨虚寒，遽用硝、黄攻里。焉知有假实真虚之病，而复伐
之，则病未去而元气伤。此而误人，是不知当攻者不可远寒也。二者之害颇多，不得不表出之以为戒！
张景岳以医术着声于明万历、天启间，所辑《类经》暨《景岳全书》二种，流播宇内殆遍，惟《质疑
录》一帙，虽已为东海石氏所刊，而人间见者甚少。其书于古名家，若刘、李、朱、张辈，所言稍有偏，
着必加辩正。盖恐后之不善读者，守其一说，未得化裁之用，而因以夭札生民之命，故不惮昌言剧论
以明之。夫岂好于前人洗垢索瘢哉！考其所列诸论，有已见《全书》《类经》中者；亦有与《全书》《类
经》之说少异，而悔畴昔立言之未当者。人以此疑其为晚年未定稿，又以此知其所学愈老愈明，未尝自矜
已得，而孜孜日求正于至当为可则也。就中惟“论伤寒春变温病夏变暑病”之非，此一条殊未是。盖亦
智者千虑之一失耶！叶敬问为景岳作《类经》序，称为会稽杰士，幼禀明慧，六经诸子，无不考镜。鲁谦
庵作《景岳全书》序，称其于书无所不窥。壮年好谈兵，思有所用于世。筮易得天山遁卦，始决意石
隐。黄梨洲作《景岳传》，称其于象数、星纬、堪舆、律吕，皆能究其精蕴。至于辽阳之败亡，中原之
扰乱，皆预决于数年之前，是其所学甚博，不特医术一端矣！
乾隆甲申孟陬望日钱江王琦
这两句话的大意，全在于“发”和“攻”这两个字。所谓“发”，是指将病邪驱逐于体外；所谓“攻”，是指将病邪驱逐于体内。寒邪停留在体表，如果不是温热性质的药物就不能将其驱散，所以发表（解除表证）不避忌热性药。热邪郁结在体内，如果不是沉寒性质的药物就不能将其清除，所以攻里（清除里实）不避忌寒性药。然而，也有使用小柴胡汤、白虎汤、益元散之类的方剂，却通过取汗而治愈疾病的，这是为什么呢？这是因为表里俱有热邪，所以应当用清凉的方法解表清热，这不属于“发汗”的范畴。又有使用四逆汤、理中汤回阳救逆之类的方剂，从而消除疼痛、去除积滞的，这是为什么呢？这是因为阴寒之邪留滞体内，所以应当温补中焦，这不属于“攻下”的范畴。所谓的“发”，是打开体表的闭塞；所谓的“攻”，是削减体内的实邪。
如今那些愚昧的人，只看到外感发热等病症，不能洞察人体伤于寒邪后传变为热证的道理，其中蕴含了“本寒标热”的意义，就随意使用黄芩、黄连等药物来清泄表面的热象。哪里知道寒邪在体表，若用药寒凉则药力作用于体内，以寒对寒，使得内外邪气相合，最终导致病邪无法解散。这就是发表时误用寒凉药物的危害。因此，凡是寒邪在体表尚未消散，虽然外表看似炽热，但体内没有寒症，这正是火不在里的表现，最忌讳使用寒凉药物。在这种情况下误治害人，就是不知道当用发表法时不可远离热性药。又如内伤引起的喘促、疼痛、胀满等症状，大多涉及三阴经的亏损。现在的人只看到这些症状，不辨别是否为虚寒证，就匆忙使用芒硝、大黄等药物攻下里实。哪里知道有“假实真虚”的病证，如果再加以攻伐，那么病邪未去而元气先伤。在这种情况下误治害人，就是不知道当用攻下法时不可远离寒性药。这两种误治的危害很多，不得不明确指出来作为警戒！
张景岳在明朝万历、天启年间以医术闻名，他编纂的《类经》和《景岳全书》两种著作，流传天下几乎遍及各地，只有《质疑录》这一卷，虽然已经被东海石氏刊印，但世间见到的人很少。这本书对于古代名家，如刘完素、李东垣、朱丹溪、张元素等人，如果他们的言论稍有偏颇，必定加以辩驳纠正。大概是担心后世不善于阅读的人，固守他们的一家之言，不懂得灵活变通运用，因而导致百姓夭折，所以不惜直言激烈地论述来阐明真理。这难道是为了挑剔前人的过错吗？考察他所列举的各种论点，有的已经见于《景岳全书》和《类经》中；也有与《景岳全书》和《类经》的说法略有不同，后悔过去立论不当的。人们因此怀疑这是他晚年未定稿，又因此知道他的学问越老越明达，从未自夸已有成就，而是孜孜不倦地每天寻求最恰当的标准。其中唯独关于“论伤寒春变温病夏变暑病”非议的这一条，确实不太妥当。这大概也是智者千虑中的一失吧！叶敬问为张景岳作《类经》序言，称他为会稽地区的杰出人士，自幼禀赋聪明智慧，六经及诸子百家，无不考察研究。鲁谦庵作《景岳全书》序言，称他读书无所不窥。壮年时喜欢谈论兵法，希望能在世上有所作为。占卜得到天山遁卦，于是决意隐居。黄宗羲作《张景岳传》，称他在象数、星象经纬、堪舆风水、音律等方面，都能探究其精微奥妙。至于辽阳战役的失败灭亡，中原地区的动乱，都在几年前就预先预料到了，这说明他的学识非常渊博，不仅仅局限于医术一端啊！
乾隆甲申年正月初十五钱塘王琦
The general meaning of these two sentences lies entirely in the characters "fa" (disperse/release) and "gong" (attack/purge). "Fa" refers to driving pathogens out from the exterior; "gong" refers to driving pathogens out from the interior. When cold pathogen remains at the exterior, it cannot be dispersed unless warm and hot natured agents are used; therefore, when releasing the exterior (Jie Biao), one does not avoid heat. When heat is constrained within the interior, it cannot be eliminated unless heavy cold natured agents are used; therefore, when purging the interior (Gong Li), one does not avoid cold. However, there are cases where formulas such as Xiao Chai Hu Tang (Minor Bupleurum Decoction), Bai Hu Tang (White Tiger Decoction), or Yi Yuan San (Benefit Origin Powder) are used, and recovery is achieved through sweating. Why is this? This occurs because both the exterior and interior are characterized by heat, so a cooling method to resolve the condition is appropriate; this does not constitute "releasing via sweating." There are also cases where formulas for restoring yang, such as Si Ni Tang (Frigid Extremities Decoction) or Li Zhong Tang (Regulate the Middle Decoction), are used to eliminate pain and remove accumulation. Why is this? This occurs because yin-cold stagnates within, so warming the middle jiao is indicated; this does not constitute "purging." What is meant by "fa" is opening the exterior obstruction; what is meant by "gong" is reducing interior excess.
Nowadays, ignorant practitioners only see symptoms such as fever caused by external contraction, but fail to discern that injury by cold transforming into heat involves the principle of "root cold and branch heat" (Ben Han Biao Re). They casually use herbs like Huang Qin (Scutellariae Radix) and Lian Zi (Nelumbinis Semen) to clear superficial heat. They do not realize that if cold pathogen is at the exterior, using cold medicine causes the drug's action to reside in the interior; combining cold with cold causes internal and external pathogens to merge, making the disease impossible to resolve. This is the harm of using cold drugs when releasing the exterior. Therefore, whenever cold pathogen remains at the exterior and has not yet dissipated, even if the exterior appears intensely hot, provided there are no cold signs in the interior, this indicates that fire is not in the interior, and cold-cooling methods are strictly contraindicated. Mistreating patients in this manner demonstrates ignorance that when dispersing is required, one must not avoid heat. Similarly, regarding internal injury conditions such as wheezing, pain, distension, and fullness, these often involve deficiency of the Three Yin channels. Current practitioners, seeing these symptoms, fail to differentiate between deficiency and cold, and hastily use Xie Shi (Natrii Sulfas) or Da Huang (Rhei Radix et Rhizoma) to purge the interior. They do not realize that diseases presenting as "false excess and true deficiency" exist; attacking such conditions further damages the primordial qi before the disease is removed. Mistreating patients in this manner demonstrates ignorance that when purging is required, one must not avoid cold. The harms arising from these two errors are numerous; thus, they must be explicitly stated as a warning!
Zhang Jingyue gained fame for his medical skills during the Wanli and Tianqi reigns of the Ming Dynasty. His compiled works, *Lei Jing* (Classified Classic) and *Jing Yue Quan Shu* (Complete Works of Master Jingyue), circulated widely throughout the realm. Only his single volume, *Zhi Yi Lu* (Records of Questioning Doubts), although published by the Shi family of Donghai, is rarely seen by the public. In this book, regarding ancient masters such as Liu [Wansu], Li [Dongyuan], Zhu [Danxi], and Zhang [Yuansu], if their statements showed any bias, he would certainly refute and correct them. He likely feared that future readers who were not adept might adhere rigidly to one school of thought, failing to grasp the utility of flexible adaptation, thereby causing premature death among the people. Thus, he did not hesitate to speak boldly and argue vigorously to clarify the truth. Was it merely to nitpick predecessors' faults? Examining the various arguments listed therein, some are already found in *Quan Shu* and *Lei Jing*; others differ slightly from those works, reflecting regret over previous imprecise formulations. People suspect this is an unfinished draft from his later years, while others recognize that his learning became clearer with age, never boasting of his achievements, but diligently seeking daily correction toward the ultimate standard. Among these, only his critique regarding "Cold Damage transforming into Warm Disease in Spring and Summerheat Disease in Summer" is particularly questionable. This may well be a lapse in the deliberations of a wise man. Ye Jingwen wrote the preface for *Lei Jing*, calling him an outstanding scholar of Kuaiji, endowed with innate wisdom since childhood, having examined the Six Classics and various philosophical schools without exception. Lu Qian'an wrote the preface for *Jing Yue Quan Shu*, stating that he read everything without omission. In his youth, he enjoyed discussing military strategy, hoping to apply himself to worldly affairs. Upon divining the Hexagram Dun (Retreat) from Heaven Mountain, he resolved to live in seclusion. Huang Zongxi wrote the biography of Zhang Jingyue, noting that he could probe the profound essence of numerical symbolism, astrology, geomancy, and music theory. Regarding the defeat and loss of Liaoyang and the turmoil in the Central Plains, he predicted these events years in advance. This shows his learning was extremely broad, extending far beyond just medicine!
Qianjiang Wang Qi, on the fifteenth day of the first month of the Jiashen year of the Qianlong reign