(慎疾刍言)
凡病只服煎药而愈者。惟外感之症为然。其余诸症。则必用丸散膏丹。针灸砭镰。浸洗
熨
。蒸提按摩等法。因病施治。乃今之医者既乏资本。又惜功夫古方不考手法无传。写一通治
煎方其技已毕而病家不辞远涉不惜重聘。亦只求得一煎方。已大满其愿。古昔圣人穷思极
想。制造治病诸法。全不一问。如此而欲愈大症痼疾。无是理也。所以今人患轻浅之病。犹
有服煎药而愈者。若久病大症。不过迁延岁月。必无愈理也。故为医者。必广求治法。以应
病者之求。至尝用之药。一时不能即合者。亦当豫为修制。以待急用所谓工欲善其事。必先
利其器。奈何事救人之术。而全无救人之具也。
(古数如左。然骨有大者则太过。小者则不及。此亦言其则耳)
头之大骨围二尺六寸。(头骨谓之髑髅。男子自项及耳并脑后共八片。惟蔡州人多一共
九片
脑后横一缝当正直下至发际别有一直缝。女人头骨六片亦脑后一横缝。当正直下则无缝也)
发所覆者。颅至项一尺二寸。(覆者。言前发际至后项发际也。)发以下至颐长一尺。两颧相
去七寸。(目下高骨曰颧)耳前当耳门者。广一尺三寸。耳后当完骨者广九寸。(完骨。耳后
发际高骨也。左右相去广九寸。○以上头部前后之尺寸)
结喉以下至缺盆中长四寸。(缺盆。天突穴处也。)缺盆以下至 长九寸。( 鸠尾也。)
以下至天枢长八寸 天枢以下至横骨长六寸半(当作五寸。横骨阴毛中曲骨也)横骨横长
六寸半。(一曰七寸半。)胸围四尺五寸。(乳之间为胸。胸前横骨三条左右肋骨各十二条。
八长四短。女人多檠夫骨二条。左右各十四条。)腰围四尺二寸。(平脐周遭曰腰。人之肥瘦
不同。腰之大小亦异。四尺二寸。以中人之大略言也。)两乳之间广九寸半。两髀之间广六
寸半。(此当两股之中。横骨两头之处。俗名髀缝。○以上胸腹部)角以下至柱骨长一尺。(
头侧大骨曰角颈项根曰柱骨。)行腋中不见者长四寸。(自柱骨通腋中。不见之处也。)腋以
下至季胁长一尺二寸(自腋至胁下尽处也)季胁以下至髀枢长六寸。(足股曰髀。髀上外侧骨
缝曰枢。此运动之机也。○以上头身侧部。)
项发以下至背骨长三寸半。(自后发际以至大椎项骨三节处。灵枢作二寸半。图翼作三
寸半
。今根据折法为三寸。)膂骨以下至尾 二十一节长三尺。(膂骨脊骨也。脊骨外小而内巨。共
二十四节。今云二十一节者。除项骨三节不在内也。男子尾 骨尖。女子尾 骨平。○以上
头背部)
肩至肘长一尺七寸。肘至腕长一尺二寸半。(臂掌之节曰腕。)腕至中指本节长四寸。本
节至
其末长四寸半。(指之后节曰本节。其末。指端也○手之大指三节。两节在外。本节在掌食
指中指无名指小指俱四节。三节在外。本节在掌。其节节交接处皆有碎骨筋膜联系足趾同)
横骨上廉下至内辅之上廉长一尺八寸。(骨际曰廉膝旁之骨内曰内辅外曰外辅。)内辅之上廉
以下至下廉长三寸半 内辅下廉下至内踝长一尺三寸。(踝。髁骨也)内踝以下至地长三寸。
(自横骨至此皆内侧。以下皆外侧)髀枢下至膝中长一尺九寸。(膝中。言膝外侧骨缝之次。)
膝以下至外踝长一尺六寸 外踝以下至京骨长三寸。(京骨。足小指本节后大骨下赤白肉际
也)京骨以下至地长一寸。膝 以下至跗属长一尺二寸。(膝在前 在后跗属者凡两踝前后胫
掌所交之处。皆为跗之属也。)跗属以下。至地长三寸。足长一尺二寸。广四寸半。(足。足
掌也。广阔也○以下四肢部)
(慎疾刍言)
凡是只服用汤药就能痊愈的疾病,只有外感病是这样。其余各种病症,则必须使用丸剂、散剂、膏剂、丹剂等内服药物,以及针灸、砭石、镰刀放血、浸泡清洗、热敷熏蒸、推拿按摩等治疗方法,根据病情实施治疗。然而现在的医生既缺乏资金储备,又吝惜功夫,不考究古方,也不传承手法,只是抄写一个通用的煎煮方子,便自以为技艺已尽。而病人不辞路途遥远,不惜重金聘请,也只求得到一个汤药方子,就已经大大满足了他们的愿望。古代的圣人深思熟虑,制造了各种治病的方法,对此却全不过问。像这样还想治愈大病和顽固性疾病,是没有道理的。所以现在的人患上轻浅的疾病,还有服用汤药痊愈的;如果是久病大病,不过是拖延岁月,必定没有痊愈的道理。所以作为医生,必须广泛寻求治疗方法,以应对病人的需求。至于曾经使用过的药物,如果一时不能立即配制好,也应当预先准备好,以备急需。俗话说:“工匠想要做好他的工作,必须先使工具锋利。”为什么从事救人的医术,却完全没有救人的器具呢?
(古代骨度尺寸如左所示。然而人的骨骼有大的则超过标准,小的则不及标准,这里也只是说明一般的准则罢了)
头部大骨的周长为二尺六寸。(头骨称为髑髅,男子从颈部到耳朵并脑后共有八片,只有蔡州人多一片共九片。脑后有一条横缝,当正直向下至发际处另有一条直缝。女人头骨六片,也是脑后一条横缝,当正直向下则没有缝隙。)头发覆盖的部分,从颅顶到项部为一尺二寸。(“覆”指从前发际到后项发际。)发际以下到下巴长一尺,两颧骨之间的距离为七寸。(眼睛下方的高骨称为颧。)耳前正当耳门的地方,宽度为一尺三寸。耳后正当完骨的地方,宽度为九寸。(完骨,是耳后发际处的隆起高骨。左右相距宽度为九寸。○以上是头部前后尺寸)
结喉以下到缺盆穴中间长度为四寸。(缺盆,即天突穴所在处。)缺盆以下到鸠尾穴长度为九寸。(鸠尾穴。)鸠尾以下到天枢穴长度为八寸,天枢以下到横骨长度为六寸半(应当是五寸,横骨位于阴毛中的曲骨处)。横骨横向长度为六寸半。(另一种说法是七寸半。)胸部周长为四尺五寸。(两乳之间为胸,胸前有三条横骨,左右肋骨各十二条,其中八根长四根短,女人多两根架夫骨,左右各十四条。)腰部周长为四尺二寸。(平齐肚脐周围称为腰,人的肥瘦不同,腰的大小也不同,四尺二寸是以中等身材的大略情况而言。)两乳之间宽度为九寸半,两大腿内侧之间宽度为六寸半。(这位于两股之中,横骨两端之处,俗名髀缝。○以上是胸腹部)
头侧角骨以下到柱骨长度为一尺。(头侧面大骨称为角,颈项根部称为柱骨。)行走时腋下看不见的部分长度为四寸。(从柱骨通到腋中,看不见的地方。)腋下到季胁长度为一尺二寸(从腋下到胁下尽头处)。季胁以下到髀枢长度为六寸。(大腿称为髀,髀上外侧骨缝称为枢,这是运动的枢纽。○以上是头身侧部)
后发际以下到背骨长度为三寸半。(从后发际到大椎项骨三节处,《灵枢》作二寸半,《图翼》作三寸半,现在根据折算法定为三寸。)脊骨以下到尾骨二十一节长度为三尺。(膂骨即脊骨。脊骨外小内大,共二十四节,现在说二十一节,是因为除去了不在内的项骨三节。男子尾骨尖,女子尾骨平。○以上是头背部)
肩膀到肘部长一尺七寸,肘到手腕长一尺二寸半。(手臂掌部的关节称为腕。)手腕到中指尖第一节长四寸,第一节点到末端长四寸半。(手指的后一节称为本节,其末端是指端。○手的大拇指有三节,两节在外,本节在掌心;食指、中指、无名指、小指都有四节,三节在外,本节在掌心。其节节交接处都有碎骨筋膜联系,脚趾相同。)
横骨上缘向下到内辅骨上缘长一尺八寸。(骨际称为廉,膝旁骨头内侧称为内辅,外侧称为外辅。)内辅骨上缘向下到下缘长三寸半,内辅骨下缘到内踝长一尺三寸。(踝,即髁骨。)内踝以下到地面长三寸。(从横骨到这里都是内侧,以下都是外侧。)髀枢下到膝中长一尺九寸。(膝中,指膝外侧骨缝旁边。)膝盖以下到外踝长一尺六寸,外踝以下到京骨长三寸。(京骨,是足小趾本节后大骨下赤白肉交界处。)京骨以下到地面长一寸,膝盖以下到跗属长一尺二寸。(膝在前,踝在后,跗属是指凡两踝前后胫骨与足掌交接之处,都称为跗之属。)跗属以下到地面长三寸。足长一尺二寸,宽四寸半。(足,指足掌,广阔之意。○以下是四肢部)
(Shenji Chuyan - Advice on Cautious Treatment of Illness)
For diseases that can be cured solely by taking decoctions, this applies only to exogenous patterns (patterns caused by external pathogenic factors). For all other conditions, it is necessary to employ internal medicines such as pills (Wan), powders (San), pastes (Gao), and elixirs (Dan), as well as therapeutic methods including acupuncture (Zhenjiu), stone needle therapy (Bianshi), cupping with scarification (Bianlian), soaking and washing, hot compresses and fumigation (Yun), and tuina massage. Treatments must be applied according to the specific disease. However, contemporary physicians lack financial resources and are reluctant to invest effort; they do not study ancient prescriptions nor inherit manual techniques. Instead, they merely copy a universal decoction formula, considering their skills complete. Meanwhile, patients do not hesitate to travel long distances or pay high fees, seeking only a single decoction prescription, which greatly satisfies their wishes. The sages of antiquity pondered deeply and devised various methods for treating diseases, yet these are completely ignored today. Under such circumstances, expecting to cure major illnesses and stubborn chronic diseases is unreasonable. Therefore, people nowadays may still recover from mild and superficial conditions by taking decoctions; however, for long-standing or severe diseases, time will merely pass, and recovery is impossible. Thus, as a physician, one must extensively seek treatment methods to meet the patients' needs. Regarding medications previously used, if they cannot be prepared immediately, one should prepare them in advance for emergency use. As the saying goes: "A craftsman who wishes to do his work well must first sharpen his tools." Why would one engage in the art of saving lives while possessing no tools to save lives?
(Ancient bone measurements are listed below. However, some individuals have larger bones, exceeding the standard, while others have smaller bones, falling short of it; this text merely states the general principle.)
The circumference of the cranial bones is two chi six cun. (The skull is called 'Dulou'. In men, there are eight bones from the neck to the ears and the back of the head; people from Caizhou have nine bones. There is a transverse suture at the back of the head, and another vertical suture directly below it down to the hairline. In women, there are six skull bones, also with a transverse suture at the back of the head, but no vertical suture directly below it.) The area covered by hair, from the vertex to the nape, measures one chi two cun. ("Covered" refers to the distance from the anterior hairline to the posterior hairline at the nape.) From the hairline to the chin measures one chi. The distance between the two zygomatic bones is seven cun. (The high bone below the eye is called 'Quan'.) The width at the ear front, corresponding to the Ear Gate point, is one chi three cun. The width at the back of the ear, corresponding to the Complete Bone point, is nine cun. (Complete Bone refers to the prominent bone behind the ear at the hairline. The distance between left and right is nine cun. ○ Above are the dimensions of the front and back of the head.)
From the Adam's apple to the middle of the Clavicle Fossa point is four cun. (Clavicle Fossa corresponds to the location of Tiantu CV22.) From the Clavicle Fossa to Jiuwei CV15 is nine cun. (Jiuwei.) From Jiuwei to Tianshu ST25 is eight cun, and from Tianshu to Henggu is six and a half cun (should be five cun; Henggu is located in the pubic hair region, corresponding to Qugu CV2). The horizontal length of Henggu is six and a half cun. (Another version says seven and a half cun.) The chest circumference is four chi five cun. (The chest is between the breasts. There are three transverse bones in the front of the chest, and twelve ribs on each side, eight long and four short. Women have two additional clavicular-like bones, fourteen on each side.) The waist circumference is four chi two cun. (The waist is defined as the area surrounding the umbilicus. Due to differences in body fat, waist sizes vary; four chi two cun represents the average measurement for a medium-sized person.) The distance between the two breasts is nine and a half cun. The distance between the inner sides of the two thighs is six and a half cun. (This corresponds to the middle of the thighs, where the ends of the pubic bones meet, commonly known as the thigh seam. ○ Above are the dimensions of the chest and abdomen.)
From the lateral corner bone of the head to the pillar bone (base of the neck) is one chi. (The large bone on the side of the head is called 'Jiao'; the root of the neck is called 'Zhugu'.) The invisible portion when walking, from the pillar bone through the axilla, is four cun. (The part from the pillar bone to the axilla that is not visible.) From the axilla to the costal margin (Ji Xie) is one chi two cun. (From the axilla to the end of the hypochondrium.) From the costal margin to the Bi Shu point (hip pivot) is six cun. (The thigh is called 'Bi'; the bony groove on the outer upper thigh is called 'Shu', which is the pivot of movement. ○ Above are the dimensions of the lateral head and body.)
From the posterior hairline to the dorsal bone is three and a half cun. (From the posterior hairline to the third cervical vertebra at Dazhui GV14. *Ling Shu* states two and a half cun, *Tu Yi* states three and a half cun; here it is calculated as three and a half cun.) From the spinal column to the coccyx, comprising twenty-one segments, is three chi. (Lv Gu refers to the spine. The spine is small externally and large internally, totaling twenty-four segments. The mention of twenty-one segments excludes the three cervical vertebrae. Men have pointed coccyges, while women have flat ones. ○ Above are the dimensions of the head and back.)
From the shoulder to the elbow is one chi seven cun. From the elbow to the wrist is one chi two and a half cun. (The joint of the arm and palm is called 'Wan'.) From the wrist to the proximal interphalangeal joint of the middle finger is four cun. From the proximal joint to the tip is four and a half cun. (The distal segment of the finger is called 'Ben Jie'; its end is the fingertip. ○ The thumb has three segments, two outside and one in the palm; the index, middle, ring, and little fingers have four segments each, three outside and one in the palm. All joints are connected by fragmented bones and fascia, similar in the toes.)
From the upper border of the pubic bone to the upper border of the medial epicondyle is one chi eight cun. (Bone edge is called 'Lian'; the inner bone beside the knee is the medial condyle/epicondyle, and the outer is the lateral.) From the upper border of the medial condyle to the lower border is three and a half cun. From the lower border of the medial condyle to the medial malleolus is one chi three cun. (Malleolus refers to the condylar bone.) From the medial malleolus to the ground is three cun. (From the pubic bone to here is the medial side; below is the lateral side.) From the Bi Shu point to the middle of the knee is one chi nine cun. (Middle of the knee refers to the space next to the lateral bony groove of the knee.) From the knee to the lateral malleolus is one chi six cun. From the lateral malleolus to Jinggu BL64 is three cun. (Jinggu, located at the red-white flesh junction below the large bone behind the base of the fifth toe.) From Jinggu to the ground is one cun. From the knee to the dorsum of the foot (Fu Shu) is one chi two cun. (Knee is anterior, ankle is posterior; Fu Shu refers to the junction of the tibia, ankle, and sole anteriorly and posteriorly.) From the dorsum of the foot to the ground is three cun. The foot is one chi two cun long and four and a half cun wide. (Foot refers to the sole, implying breadth. ○ Below are the dimensions of the limbs.)