喉科之书,所见凡十有余家,或详或略,各有所长。至若治验神速,莫如秘授,三十六症,自治疗以来活人
甚广。然未尝论证与脉要之总是死法,未为尽善也。余惧医家各执秘授,不知通变,往往反因而误事,故与环川
方子岫云∶博采古今之书,纂为续编,以补诸家之未备,其中指示色脉,辩别症因,以至用药加减之法,至详极
慎,医者诚能遵而用之,神而明之,庶不致胶柱刻舟之诮,其于仁术或未必无小补云。
双桥枢扶氏若溪郑瀚识
歙县西园郑氏,以喉牙科名,历世相传,实擅起死回生之能术,而通乎神者矣。顾甚居奇守秘声价自高,殊
不知其所以炫世惊人攫盛名赚金钱者,全藉《重楼玉钥》一书而已也。书分正续两编,正编早已盛行于世,习是
科者罔不奉为圭皋,尽皆谓为完壁,足以应用而有余,而弗料其更有玄妙之续编在也。观枢扶氏之自序言,是书
之珍秘得书之艰难,至有不再他传之哲,固属从前人务独善,不知道德之陋习,盖其灵验可贵之价值,实有倍于
寻常之喉牙诸书者焉。正编言为仆人窃出,展转传钞致坊间,亦得刊售,续编之什袭珍藏,当更较格外慎重矣。
余家所藏之册,系用桃花纸钞订者,字迹恶劣而潦草,装订粗率而颠错,一见可知为乘机偷暇之所成折开印写之
情形犹宛在也。原书经枢扶先生一再增辑,特于喉症白腐专论加详,近今坊本陈修园医书中及以外有数种专言此
症者,殊皆不及此书之缜密妥当也。此册主页有道光元年辛己岁大吕月歙南昌溪吴季儒钞十八字,计其年月,距
嘉庆九年,枢扶先生自序时才十有七年,正郑氏鼎盛期间,万无沽售流行之理,必属至亲密友,侦知藏处,如如
姬盗兵符遵王赚竹 之故事,以智诱计,取而得之者无疑也。同治初年,兵燹方定,我邑莲川周丈邦彦以数十青
得此于裨贩担头庋置架间,一未寓目,以己习内科,此属非其所学也。先君子萃庵公,见而喜之,假以归涉阅
一周,谓之曰∶此郑氏秘笈也。喉牙口舌得此,可以名家矣。周丈顿悟,急即索回。越数岁,家计益窘,又值其
子将续弦乃以此册作赠而告借银币,念番先君子,慨然允之,书遂为我家有矣。先君子豁达多能,望隆乡邑,排
纷解难,应给不暇,医药堪舆,虽皆素嗜,而迫于环境,不克精专,致此书亦从耽滞,历廿余年也,末一试用
也。斯时先五兄石农挈眷居仁里岳家,从其外舅程金门先生兼习儒与医学,光绪甲午菊秋,嫂氏徒婴喉患,先即
翁婿合治,继延歙东舍头专科程炳文,暨绩城名医葛巨川、章仪廷,仲贻诸先生诊视,济济一堂,愈治愈剧,奄
然一息,卧莫能兴。石农乃函致家中筱涛大侄,备述病危,商量后事,尚欲秘弗与先祖母朱太宜人知,恐其年高
钟爱有素,致伤起居也。筱涛禀诸先居子倏尔忆及是书,急命检出,专人星夜 去,相距四十里以酉正发亥末至
矣,方忧其经多延误,不及挽救,复虑其治法少验徒劳无功,举室旁皇扰攘达旦。错午使者回言,至即照书配药,
煎服头剂,得效如神,晨间再进一剂,己刻已起坐索粥,病去大半,我动身时,谆谆乞告堂上勿再记念,某已霍然
就廖矣。盖其所采用只养阴清燥汤,神功丹二方而已。于是乃共宝此书翁婿于数日中,倩人各钞二册,以备转借
之有失也。嗣后患此者较多,而愈可速。里中有患者,亦辄就先君子求诊皆随治而疗焉。戊戌仲春先君子捐馆舍,
石农回里行道汽后历游宣城受聘豫章,俱以善治喉名缘以此为师承也。余步石农之后悬壶七载,喉牙疾患疗愈百
数,实亦得此书之资益者也。亲友中习医及好义者,皆就索钞,无不如愿以偿之,然余拙不自藏,夙怀普济,思
钞传之有限,欲付梓而不能,力与心违时与弗逮憾。欣得裘吉生先生有征刊医书之盛举,此书可不患湮没而其传
益广矣,岂非治牙喉科者,又得一指迷之宝筏也哉!前经手钞,副本寄呈先生,恳与审定印入《三三医书》,旋
蒙来札惠允,心包经。人迎后属手阳明大肠经。(《准绳》)十二经中,惟足太阳膀
胱之脉上额,交巅,络脑,下项循肩膊,挟脊,抵腰,结于缺盆,不循咽喉,然下项结缺盆,则亦不离咽喉左
右矣。(岫云)咽喉者,水谷之道也。喉咙者,气之所以上下者也。厌者,声音之户也。悬雍者,声音之关
也。(《内经》)咽与喉、会厌与舌,此四者同在一门,而其用各异,喉以纳气,故喉气通于天,咽以纳食,
故咽气通于地,会厌管乎其上以司开阖。掩其厌则食
下,不掩其喉必错。以舌抵上颚,则会厌能闭其喉,四者交相为用,缺一则饮食废而死矣。(子和)咽在喉之
前,所以咽物,喉在咽之后,所以候气。谓咽在喉后者,杨上善之误也。(《准绳》)
喉科方面的书籍,我所见到的共有十多家,有的详尽有的简略,各自都有长处。至于治疗见效神速,没有比得上秘传的“三十六症”疗法了,自治疗以来救治的人非常广泛。然而,这些秘传之法未曾论证脉象的要领,终究是死板的方法,并不算是尽善尽美。我担心医家们各自执着于秘传之法,不懂得变通,往往反而因此误事,所以与环川的方子岫云商量:广泛采集古今的书籍,编纂成《续编》,以补充各家学说的不足之处。其中指示色脉、辨别症状病因,以及用药加减的方法,都极其详细谨慎。医者如果真能遵循并运用它,灵活掌握其精神,大概就不会遭到拘泥固执、不知变通的讥笑,对于仁术或许未必没有小小的补益吧。
双桥枢扶氏若溪郑瀚识
歙县西园的郑氏家族,以喉牙科闻名,世代相传,确实擅长起死回生的神奇医术,通达神明之境。但他们往往珍视奇货,坚守秘密,使声价自高,殊不知他们用来炫耀世人、震惊大众、攫取盛名和赚取金钱的,全靠《重楼玉钥》这一本书罢了。这本书分为正编和续编两大部分,正编早已在世上盛行,学习这一科的人无不奉为圭臬(准则),都认为它是完美无缺的,足以应用且绰绰有余,却没料到还有更为玄妙的续编存在。看枢扶先生的自序所言,此书珍贵神秘,得到它的艰难程度,甚至到了不再向他人传授的地步,这固然是从前的人只顾独善其身,不懂道德共享的陋习,但其灵验可贵的价值,确实比普通寻常的喉牙诸书高出数倍。正编说是被仆人偷窃传出,辗转传抄导致坊间得以刊售,而续编则被层层珍藏,应当更加格外慎重。
我家所收藏的这一册,是用桃花纸抄写装订的,字迹恶劣潦草,装订粗率颠倒,一看就知道是在乘机偷闲时匆忙完成的折页印写情形,至今宛然在目。原书经过枢扶先生一再增补编辑,特别对喉症中的白腐症进行了详细论述。近今坊间陈修园的医书中及另外几种专门谈论此症的书籍,都不如这本书缜密妥当。这一册首页上有道光元年辛巳岁大吕月歙南昌溪吴季儒抄写的十八个字,计算年月,距离嘉庆九年枢扶先生自序时才十七年,正是郑氏家族的鼎盛时期,绝无公开售卖流行的道理,必定是至亲密友,探知藏处,如同如姬盗取兵符、遵王骗取竹符的故事一样,用智谋计策诱导,才得以获取,这是毫无疑问的。
同治初年,战乱刚刚平定,我县莲川的周邦彦先生从小贩担头用几十钱购得此书,放置在架子上,从未看过,因为他自己研习内科,认为这不属于他的所学。先父萃庵公看到后很高兴,借回家翻阅了一周,对它说:“这是郑氏的秘笈啊。有了它,在喉、牙、口、舌方面可以成为名家了。”周先生顿时醒悟,急忙索回。过了几年,他家计日益窘迫,又正值他儿子要续弦,便以此册作为赠礼并告借银币,念及先父的情分,慷慨答应,书于是成了我家的财产。先父豁达多能,在乡里声望很高,排忧解难,应付不暇,医药堪舆虽然都是他素来喜爱的,但迫于环境,不能精专,导致这本书也搁置停滞了二十多年,未曾试用。
当时,我的五兄石农带着家眷居住在仁里岳家,跟随他的岳父程金门先生兼修儒学与医学。光绪甲午年秋天,嫂子突然患上喉病,我先让翁婿二人共同治疗,接着延请歙东舍头的专科医生程炳文,以及绩溪的名医葛巨川、章仪廷、仲贻等先生诊视,济济一堂,结果越治病情越重,奄奄一息,卧床不能起身。石农于是写信给家中的筱涛大侄,详细陈述病情危急,商量后事,还想要隐瞒不让先祖母朱太宜人知道,恐怕她年老钟爱孙子,会因悲伤而损伤身体。筱涛禀报后,先父倏忽想起这本书,急忙命人找出,派人星夜送去,相距四十里,从酉时出发到亥时末到达。正担心经过多次延误,来不及挽救,又担心治疗方法少有效验,徒劳无功,全家彷徨扰攘直到天亮。中午使者回来报告,一到就照书配药,煎服第一剂,效果神速,早晨再进一剂,巳时已经起床索要粥喝,病去大半。我动身时,谆谆恳求长辈不要再挂念,我已经痊愈了。原来他所采用的只有养阴清燥汤、神功丹两个方子而已。于是大家共同珍视此书,翁婿二人在数日内,请人各抄录两册,以备转借时若有遗失。此后患此病的人较多,而治愈速度很快。乡里有患者,也随即向先父求诊,都随治而愈。
戊戌年仲春,先父去世,石农回乡行道气后,历游宣城,受聘豫章,都以善于治疗喉病闻名,这都是因为师承于此。我追随石农之后行医七年,喉牙疾患治愈数百人,实在也是得益于这本书的资助。亲友中习医及喜好义举者,都向我索取抄本,无不如愿以偿。但我拙劣不善隐藏,一向怀有普救众生的想法,想抄传却有限,想付梓刻印却无力,力不从心,时不我待,深感遗憾。庆幸裘吉生先生有征集刊印医书的盛大举动,这本书可不担心湮没,而且流传会更广,这难道不是治疗牙喉科的又一指路明灯吗?此前经手抄写的副本寄呈先生,恳请审定印入《三三医书》,随即蒙来信函惠允,心包经。人迎穴后属手阳明大肠经。(《准绳》)十二经中,只有足太阳膀胱之脉上额,交巅,络脑,下项循肩膊,挟脊,抵腰,结于缺盆,不循咽喉,然而下项结缺盆,也就离不开咽喉左右了。(岫云)咽喉者,是水谷通行的道路。喉咙者,是气上下通行的地方。会厌者,是声音的门户。悬雍者,是声音的关卡。(《内经》)咽与喉、会厌与舌,这四者同在门口,但作用各异。喉用来纳气,所以喉气通于天;咽用来纳食,所以咽气通于地。会厌管乎其上以司开阖。掩住会厌则食物下行,不掩住则会出错。用舌头抵住上颚,则会厌能关闭喉部,四者交互为用,缺一个就会导致饮食废绝而死。(子和)咽在喉之前,用来吞咽食物;喉在咽之后,用来候气。说咽在喉后面的是杨上善的错误。(《准绳》)
Books on throat diseases, I have seen more than ten families, some detailed and some brief, each having its own strengths. Regarding treatment with miraculous speed, none surpasses the secret transmission of the "Thirty-Six Syndromes," which has saved a vast number of people since its inception. However, these secret methods do not discuss pulse diagnosis essentials, remaining rigid and thus not perfect. I feared that physicians would cling to their secret transmissions without understanding adaptability, often causing harm through such rigidity. Therefore, I consulted with Fang Zixiuyun from Huan Chuan: extensively collecting ancient and modern texts to compile this "Continuation" to supplement the deficiencies of various schools. It details color and pulse indications, syndrome differentiation, etiology, and medication adjustments with extreme caution. If physicians can truly follow and apply it, grasping its spirit flexibly, they will avoid ridicule for being pedantic and unadaptable, offering perhaps a small contribution to the benevolent art.
Zheng Han, styled Ruoxi, identified at Shuangqiao Shufu
The Zheng family of Xiyuan in Shexian is famous for throat and dental care, passing down their skills through generations, possessing the miraculous ability to revive the dying and attain spiritual proficiency. Yet, they hoard their secrets, inflating their reputation, unaware that their fame and wealth rely entirely on the book *Chonglou Yuyue* (Jade Key to the Throat). The book consists of a Main Compilation and a Continuation. The Main Compilation has long been prevalent; practitioners revere it as the standard, believing it complete and sufficient, unaware of the even more profound Continuation. As stated in Mr. Shufu's preface, the book's rarity and the difficulty in obtaining it led to decisions against further transmission, reflecting an old habit of selfishness rather than moral sharing. Its value, due to its efficacy, far exceeds ordinary throat and dental texts. While the Main Compilation was leaked by a servant and copied widely, the Continuation is kept under strict secrecy.
My family's copy is handwritten on peach-blossom paper, with poor, sloppy handwriting and hasty, disordered binding, clearly showing it was compiled in haste during stolen moments. The original text was repeatedly edited by Mr. Shufu, particularly expanding on white patches in throat syndromes. Recent editions in Chen Xiuyuan's medical books and others specializing in this condition are less rigorous and appropriate than this text. The first page bears the inscription: "Copied by Wu Jiru of Nanxi, Shexian, in the first month of Xin Si, the first year of Daoguang." This date is only seventeen years after Mr. Shufu's preface in Jiading Year 9, during the Zheng family's peak, making public sale impossible. It must have been obtained by close friends through stealth, akin to the stories of Ru Ji stealing the tiger tally or Zun Wang deceiving for the bamboo tally.
In the early Tongzhi era, after the war settled, Mr. Zhou Bangyan of Lianchuan in my county bought this book from a peddler for a few coins and stored it on a shelf, never reading it, as he practiced internal medicine. My late father, Mr. Cuian, saw it, borrowed it, read it for a week, and said, "This is the Zheng family's secret manual. With it, one can become a master in throat, tooth, mouth, and tongue diseases." Mr. Zhou realized his mistake and retrieved it. Years later, facing financial distress and his son's remarriage, he gifted the book to borrow silver. Remembering my late father, he generously agreed, and the book became ours. My late father was versatile and respected, busy helping others. Though fond of medicine and fengshui, circumstances prevented deep specialization, so the book lay unused for over twenty years.
At that time, my fifth brother, Shinong, lived with his wife's family in Renli, studying Confucianism and medicine under his father-in-law, Mr. Cheng Jinmen. In the autumn of Jiawu (Guangxu reign), his daughter-in-law suddenly suffered a throat ailment. Initially treated by the father-in-law and son-in-law, then by specialists Cheng Bingwen from Shetou, Shexian, and renowned doctors Ge Juchuan, Zhang Yiting, and Zhongyi from Jixi. Despite many experts, the condition worsened until she was near death, unable to rise. Shinong wrote to our nephew Xiaotao, detailing the crisis and planning funeral arrangements, trying to hide it from our grandmother, Lady Zhu, to spare her grief. Xiaotao informed my late father, who suddenly remembered the book. He ordered it fetched and sent overnight. The distance was forty li; departure was at You hour (5-7 PM), arrival at Hai hour (9-11 PM). We worried about delays and ineffective treatments, keeping the house in turmoil until dawn. At noon, the messenger returned, reporting that upon arrival, medicine was prepared according to the book. After the first dose, the effect was miraculous. A second dose in the morning allowed her to sit up and ask for porridge by Si hour (9-11 AM); the illness had largely subsided. When I departed, I was earnestly told not to worry, as she had fully recovered. Only two formulas were used: Yangyin Qingzao Tang (Nourishing Yin and Clearing Dryness Decoction) and Shengong Dan (Divine Merit Pill). Thus, we treasured the book. Within days, the father-in-law and son-in-law hired scribes to make two copies each, to prevent loss if lent out. Subsequently, many patients were cured quickly. Locals seeking treatment from my late father were also healed.
In mid-spring of Wuxu, my late father passed away. Shinong traveled to Xuancheng and accepted an appointment in Yuzhang, gaining fame for treating throat diseases, owing to this lineage. I followed Shinong into practice for seven years, curing hundreds of throat and dental cases, greatly aided by this book. Friends and relatives practicing or interested in medicine requested copies, all satisfied. I lacked discretion but harbored a wish to save all, yet copying was limited, and printing was beyond my means, leaving me regretful. Fortunately, Mr. Qiu Jisheng undertook the grand project of publishing medical books, ensuring this work would not be lost and would spread widely, serving as another guiding light for throat and dental practitioners. Previously, I sent a handwritten copy for review to be included in *San San Yi Shu*, and received his consent.
The Pericardium Meridian. The Renying acupoint belongs to the Hand-Yangming Large Intestine Meridian (*Zhunsuo*). Among the twelve meridians, only the Foot-Taiyang Bladder Meridian goes up to the forehead, crosses the vertex, connects with the brain, descends the nape, follows the shoulder blades, flanks the spine, reaches the waist, and knots at the Quepen acupoint, not traversing the throat. However, knotting at Quepen after descending the nape places it near the throat. (Xiuyun) The throat and pharynx are the pathways for food and drink. The larynx is where Qi ascends and descends. The epiglottis is the door of sound. The uvula is the gate of sound. (*Neijing*) The pharynx, larynx, epiglottis, and tongue reside in the same area but function differently. The larynx receives Qi, connecting to Heaven; the pharynx receives food, connecting to Earth. The epiglottis controls opening and closing above. Covering the epiglottis allows food to descend; failing to cover it causes error. Pressing the tongue against the palate allows the epiglottis to close the larynx. These four interact; lacking one leads to inability to eat or drink and death. (Hezi) The pharynx is in front of the larynx, for swallowing food; the larynx is behind the pharynx, for receiving Qi. Claiming the pharynx is behind the larynx is an error by Yang Shangshan. (*Zhunsuo*)