医书之繁，汗牛充栋，然剽袭伪托者多矣，何从而信之哉，亦在慎辨之尔。辨
之法有三∶考其年以求其世；此后味其辞而索其旨之浅深；临其诊以证其言之是非，
而真伪无所匿矣。执是以观古今医籍，益十不失一焉。若世传之《难经》者，杨玄
操序言渤海秦越人所作，殆难穷考，而仲景《伤寒论》自序，有撰用《素问》九
卷、《八十一难》云云，其为汉以前书无疑，是即史迁仓公传所谓扁鹊之脉书也。而
《隋书·经籍志》云∶《黄帝八十一难》二卷，与杨氏之序不侔。夫难，问难也。
经者，问难《黄帝内经》之义也。云黄帝者，或原于此，越人之作，似属可信。自
古言医者，皆祖述《内经》，而《内经》十八卷，西晋乱后，亡佚益多，《素问》九
卷，梁《七录》全元起注本，祗存其八，已佚第七一卷，王太仆拉杂《阴阳大论》
之文，以补其亡，妄托得自张公秘本，殊不足据。《针经》九卷，唐人搜其残帙，
易名《灵枢》，亦非庐山真面。越人去古未远、采摘《内经》精要，意周旨密，
虽为华元化烬余之书、经吕广编次，不无衍阙，然医经补逸，独赖此篇，厥功伟矣。
惟理趣深远，非浅学得窥堂奥，故诠注者，亡虑数十家，间见精义，究不能
处处实有指归，岂得为后学津筏，读者病之。霖学识庸陋，难探玄微，谨考
经文，寻其意旨，旁采群籍，资为左证，质以诸贤之笺释，西士之剖验，以正其义，
非敢启幽前秘，嘉惠来兹，唯在讲肄之际，取便翻阅尔。
时光绪二十一年春正月扬州叶霖书于石林书屋
医书数量繁多，堆积如山，但其中剽窃抄袭、伪造托名的著作很多，从哪里去相信它们呢？这也在于谨慎辨别罢了。辨别的方法有三条：考证其年代以推求其所处的时代；其次品味其文辞以探究其旨意的浅深；再次亲临临床诊察以验证其言论的是非，这样真伪就无处隐藏了。拿着这个标准来观察古今的医籍，大概十本中不会错漏一本。至于世间流传的《难经》，杨玄操在序言中说它是渤海人秦越人所作，这很难彻底考证清楚。而张仲景在《伤寒论》自序中提到“撰用《素问》九卷、《八十一难》”等语，可以确定这是汉代以前的书籍，也就是司马迁《史记·扁鹊仓公列传》中所说的扁鹊的脉书。然而《隋书·经籍志》记载：“《黄帝八十一难》二卷”，这与杨氏的序言不符。“难”，是问难的意思。“经”，是问难阐释《黄帝内经》义理的书。说它是黄帝所作，或许原本源于此，说是秦越人所作，似乎更可信。自古以来谈论医学的人，都尊崇述说《内经》，而《内经》共十八卷，西晋战乱之后，亡佚散失的越来越多，《素问》九卷，梁代《七录》中全元起的注本，只存留了八卷，已经遗失了第七和第十一两卷（注：原文“第七一卷”疑为衍文或指代特定缺失部分，此处依文意理解为有缺失），王冰（王太仆）杂乱地采集《阴阳大论》的文字来填补空缺，妄称是从张公处得到的秘本，这非常不足为据。《针经》九卷，唐人搜集其残存的篇章，改名为《灵枢》，也不是庐山真面目。秦越人与古代相距不远，采摘《内经》的精要，意思周全，旨意严密，虽然可能是华佗（字元化）焚书余下的残篇，经过吕广编次整理，不免有增补或缺失，然而作为医经的补充逸文，唯独依靠这篇，其功劳很大。只是其中的理趣深远，不是浅薄的学识所能窥探堂奥的，所以诠释注释的著作，无虑几十家，偶尔见到精妙的义理，终究不能处处都有明确的归宿，怎么能成为后学者的渡河工具呢？读者对此感到遗憾。我叶霖学识平庸浅陋，难以探求玄妙细微之处，只能谨慎考证经文，寻究其意旨，广泛采择群籍，作为佐证，参照各位贤人的笺释，以及西方人士的解剖验证，来纠正其中的义理，不敢说是开启前人的幽秘，恩惠后来者，只是在讲解研习的时候，方便翻阅罢了。
清光绪二十一年春正月，扬州叶霖写于石林书屋
Medical books are numerous, filling warehouses and oxen with sweat (an idiom for a vast quantity), yet many are plagiarized or falsely attributed. How can one trust them? It lies in cautious discrimination. There are three methods of discrimination: examine the era to determine its historical context; savor the language to probe the depth of its meaning; and apply clinical diagnosis to verify the correctness of its statements, thereby leaving no room for truth or falsehood to hide. Using this standard to evaluate ancient and modern medical texts ensures that one errs in only one out of ten cases. Regarding the *Nanjing* (Classic of Difficult Issues) circulated in the world, Yang Xuancao stated in his preface that it was authored by Qin Yueren of Bohai, which is difficult to verify thoroughly. However, Zhang Zhongjing’s self-preface to the *Shanghan Lun* (Treatise on Cold Pathogenic Diseases) mentions "utilizing nine volumes of *Suwen* and eighty-one *Nans*" (Difficulties). This undoubtedly indicates it is a book from before the Han Dynasty, specifically the pulse book of Bian Que mentioned in Sima Qian’s *Records of the Grand Historian* (*Shiji*) under the biography of Bian Que and Cang Gong. Yet, the *Book of Sui* (*Sui Shu*), Treatise on Bibliography (*Jingji Zhi*), records "Huangdi Bayishinan" (Yellow Emperor's Eighty-One Difficulties), two volumes, which contradicts Yang’s preface. "Nan" means questioning or debating difficulties. "Jing" here refers to the text questioning and elucidating the principles of the *Huangdi Neijing* (Yellow Emperor's Inner Canon). The attribution to the Yellow Emperor may stem from an original source, but authorship by Qin Yueren seems more credible. Since antiquity, medical scholars have revered and expounded upon the *Neijing*. After the turmoil of the Western Jin Dynasty, much of the eighteen volumes of the *Neijing* were lost. In the *Suwen* (Basic Questions), nine volumes originally existed, but in Quan Yuanqi’s annotated edition recorded in Liang Dynasty’s *Qilu*, only eight remained, with the seventh and eleventh volumes missing. Wang Bing (Wang Taipu)杂乱ly compiled passages from the *Yinyang Dalun* (Great Treatise on Yin and Yang) to fill these gaps, falsely claiming they came from a secret manuscript of Master Zhang, which is hardly reliable evidence. The *Zhenjing* (Pulse Classic), nine volumes, had its fragments collected by Tang dynasty scholars who renamed it *Lingshu* (Spiritual Pivot), but this too is not the true face of the original work. Qin Yueren lived not long after ancient times; he extracted the essence of the *Neijing*, presenting comprehensive meanings and dense intentions. Although it might be a remnant book burned by Hua Tuoyuanhua (Hua Tuo) and later edited by Lü Guang, inevitably containing additions and omissions, it alone serves as a supplement to lost medical classics, achieving great merit. However, its theoretical profundity is beyond the reach of superficial learning. Consequently, there are dozens of commentators, occasionally revealing profound insights, yet failing to provide consistent, clear guidance everywhere. Thus, it cannot serve as a ferry for beginners, a fact lamented by readers. My knowledge is mediocre and shallow, unable to explore the profound mysteries. I have carefully examined the canonical text, sought its intent, gathered evidence from various works, referenced annotations by sages, and incorporated Western anatomical verification to correct its meanings. I do not dare claim to reveal hidden secrets or benefit future generations, but merely hope it facilitates reading during study sessions.
Written by Ye Lin of Yangzhou at Shilin Study Room in the first month of spring, 21st year of Guangxu, Qing Dynasty.