昔范文正公云。不能为良相。即当为良医。盖良相者。裁成辅相。立政治以免人之饥寒。良医者。辨证立
方。用药物以救人之夭札。其事不同。其活人均也。然而苏东坡有云。药虽进于医手。方多传于古人。若已经
验于世间。不必皆由于己出。士君子身居草莽。而存活人之心。其可弗博考方书。而师心自用哉。顾医家之所
难治者二。而小儿更甚于妇人。小儿之所难治者亦有二。而麻证更甚于痘证。非敢轻痘重麻。而谬炫己见。盖
缘麻小证大。险甚于痘。况自古治痘之书。不下百家。且有专科。治麻之书。竟不多见。故无名师。然痘有传
苗之法。可以调治于未然。而麻则尽由天时。末由预防于事先。医家临证。往往束手。大方脉以其为婴孩也。
而委之儿科。儿科又以其类痘疮也。而委之痘师。世俗不察。遂谓痘麻相通。治痘之医。即可以治麻。虽痘麻
均属胎毒。而不知痘出于五脏。脏属阴。阴主血。故痘有形而有汁。其证寒热备有。麻发于六腑。腑属阳。阳主
气。故麻有形而不浆。其证多实热而无寒。痘以稀疏为贵。麻以透密为佳。痘以气尊血附为美。麻以血凉肌解
为妙。痘忌汗泻以泄气。麻喜吐衄而分消。二者相去迳庭。其不同若水火然。今责治痘者以治麻。是犹责大禹
而使掌火。伯益而使治水也。其能有济也欤。而要非尽医家之过也。医家非甚无良。谁不存活人之心。谁甘受
杀人之名。活人而反以杀人。是诚何故乎。良以麻证之方书甚少。后学无所取法。即间有传本。亦往往语焉而
不详。择焉而不精。而求其如痘书之明晰者。从未之见。亦何怪乎束手无策。坐视而莫救也耶。余素不通医。
因见夫殇于麻者。不禁勃然兴活人之念。故凡医集中载有麻疹证治者。必积置案头。朝夕探索。深究其奥。颇
有心会。甲寅夏。于友人处。得静远主人麻疹辨证一帙。继又得麻科秘本二卷。余细玩二书之论证立方。较之
密斋全书、张氏医通、朱氏定论。颇更精详。犹病其缺略而不全也。因更将联杏心法、景岳麻诠、经验治法等
书。各家麻疹之论。与治麻之方。悉为录出。移此所有。补彼所缺。以彼所详。益此所略。其有用药适忌。措
方背理者。谬抒狂瞽之见。及余已试而有效者。为之订正。自初潮至已出、已收、收后。论证着明。治方全备。
俾后之学人。开卷了然。有所宗式。而不致束手其间。虽有冗复之处。皆因理所宜用。故不忌重立。以便名公
博览采择。而不致有缺略之欢。良工得此。神而明之。固可收活人之效。庸工得此。墨而守之。亦可免杀人之
惨。自甲寅迄今。十五年中。五经试验。今春麻证震作。变证非常。殇残颇众。凡经余调治者。万获万全。思
欲以一得之愚。公诸同志。爰编订成册。分为四卷。颜之曰麻科活人全书。拟付之剞氏。以求教于当世名师。
奈食指日增。囊无余蓄。有活人之心。而无活人之力。非余本愿也。所望好善君子。梓而布之。此书得以广传
海内。使海内小儿。不复为麻疹所夭札。则活人之功。与范文正公并传。而余 辑编订微劳。又不足言也。是
为序。
乾隆十三年着雍执徐岁壮月安成赤溪璞斋谢玉琼撰
从前范文正公说：“如果不能做优秀的宰相，就应当做优秀的医生。”因为优秀的宰相，能够辅助君主治理国家，建立政治秩序以解除百姓的饥寒之苦；优秀的医生，则通过辨证确立方剂，使用药物来挽救人们因早逝或重病带来的痛苦。他们的事务虽然不同，但救人的宗旨是一致的。然而苏东坡曾说：“药虽然由医生之手施用，但方子大多传承自古人。如果这些方子在世间已经经过验证，就不一定非要出于自己的独创。”士大夫身居民间，却怀有救活他人的心志，怎么能不广泛考证医书，而只凭主观臆断、固执己见呢？
况且医家难以治疗的疾病有两种，其中小儿病比妇人病更难治；小儿病中难以治疗的也有两种，其中麻疹证比痘疮证更难治。这并不是我不敢轻视痘疮而重视麻疹，也不是为了炫耀自己的见解。而是因为麻疹病情看似轻微实则严重，危险程度超过痘疮。况且自古以来治疗痘疮的书籍不下百家，且有专门的学科；而治疗麻疹的书籍却很少见到，因此没有名师指导。痘疮有“传苗”的方法，可以在发病前进行调理预防；而麻疹完全取决于天时气候，无法在事前进行预防。医生面对临床往往束手无策。内科医生因为患者是婴儿，便推给儿科医生；儿科医生又因为麻疹类似痘疮，便推给痘科专家。世俗之人不加考察，于是认为痘疮和麻疹相通，治痘的医生就可以治麻疹。虽然痘疮和麻疹都属于胎毒，但不知道痘疮源于五脏，脏属阴，阴主血，所以痘疮有形且出浆；其症状寒热具备。麻疹发于六腑，腑属阳，阳主气，所以麻疹有形但不出浆；其症状多为实热而无寒象。痘疮以稀疏为贵，麻疹以透发密集为佳。痘疮以气盛血附为美，麻疹以血凉肌解为妙。痘疮忌用汗法、泻法以免泄气；麻疹喜欢吐衄（吐血、鼻出血）以分消邪气。这两者相差甚远，截然不同，就像水和火一样。现在要求治痘的医生去治麻疹，这就像要求大禹去掌管火政，伯益去掌管水政一样，怎么能有成效呢？但这也不完全是医生的过错。医生并非完全没有良知，谁没有救人的心志？谁愿意背负杀人的恶名？本想救人反而害了人，这究竟是什么原因呢？实在是因为关于麻疹的医书太少，后学者没有取法的依据。即使偶尔有流传的版本，也往往语焉不详，选择不够精当，像痘书那样清晰明确的，从未见过。难怪大家束手无策，坐视病人死亡而无法救助。
我向来不通医学，因为看到很多孩子死于麻疹，不禁勃然兴起救人的念头。所以凡是医集中记载有麻疹证治的内容，我都积累放置在案头，早晚探索研究，深入探究其中的奥妙，颇有心得领会。甲寅年夏天，在朋友处得到静远主人所著的《麻疹辨证》一册，随后又得到两卷麻疹科的秘本。我仔细研读这两本书的论证和立方法度，比起密斋全书、张氏医通、朱氏定论等书，显得更为精细详细。但仍遗憾它们有所缺略而不完整。于是又将联杏心法、景岳麻诠、经验治法等书中，各家关于麻疹的论述以及治疗麻疹的方剂，全部摘录出来。用此处的内容补充彼处的缺漏，用彼处详细的内容增益此处简略的内容。对于那些用药禁忌不当、处方违背医理的地方，我狂妄地发表自己的见解，并结合我自己试用有效的案例，进行订正。从初潮期到已出疹、已收靥、收靥后，论证明确，治疗方剂完备，使后来的学习者翻开书就能一目了然，有所遵循法式，而不至于在诊疗过程中束手无策。虽然有些内容重复，都是因为理论上应该这样使用，所以不忌讳重新列出，以便各位名医博览采择，而不至于有遗漏的遗憾。高明的工匠得到此书，神妙地运用它，固然可以收到救人的效果；平庸的工匠得到此书，墨守成规地遵守它，也可以避免杀人的惨剧。
从甲寅年至今，十五年中，经过五次试验。今年春天麻疹盛行，变证非常，夭折残废的人很多。凡是我调治过的，都获得了万无一失的效果。我想以一得之愚见，与志同道合者分享，于是编订成册，分为四卷，命名为《麻科活人全书》，打算交给刻印匠人，以求教于当代的名师。无奈家中人口日益增多，囊中没有积蓄，虽有救人的心志，却没有救人的财力，这不是我的本愿。只希望乐善好施的君子，刊刻并传播此书，使这本书能在海内外广泛流传，让海内的儿童不再因麻疹而夭折，那么救人的功德，将与范文正公一同流传，而我编辑订正的微小功劳，也就不足挂齿了。这就是序言。
乾隆十三年（癸酉年）壮月，安成赤溪璞斋谢玉琼撰写。
Fan Zhongyan once said, "If one cannot serve as a capable prime minister, one should become a capable physician." A capable prime minister assists the ruler in governance, establishing political order to alleviate the hunger and cold of the people. A capable physician diagnoses patterns and establishes prescriptions, using herbal medicines to save people from premature death or severe illness. Although their duties differ, their intent to save lives is the same. However, Su Dongpo stated, "Medicines are administered by the hands of physicians, but prescriptions are mostly inherited from ancients. If they have already been verified in practice, it is not necessary that they must be original creations." Scholars residing among the common people, yet harboring the heart to save lives, how can they fail to extensively examine medical texts and rely solely on subjective assumptions and self-will?
Furthermore, there are two categories of diseases difficult for physicians to treat, with pediatric cases being more difficult than those of women. Among pediatric diseases, there are two types that are particularly difficult, with measles (Mazhen) being more difficult than smallpox (Douchuang). This is not out of disrespect for smallpox or an attempt to boast my own views. Rather, measles appears mild but is actually severe and more dangerous than smallpox. Moreover, since ancient times, books on treating smallpox have numbered over a hundred, with specialized disciplines established; whereas books on treating measles are rarely seen, leading to a lack of master teachers. Smallpox has methods for "transmitting the seed," allowing for regulation and prevention before onset. Measles, however, depends entirely on climatic conditions, making prior prevention impossible. Physicians often find themselves helpless when facing clinical cases. Internal medicine specialists, seeing patients are infants, delegate them to pediatrics; pediatricians, seeing measles resembles smallpox, delegate them to smallpox specialists. The unobservant public assumes smallpox and measles are interchangeable, believing a smallpox doctor can treat measles. Although both are considered fetal toxins, smallpox originates from the Five Zang Organs (Zang organs belong to Yin, which governs Blood); thus, smallpox presents with form and pustules, accompanied by both cold and heat symptoms. Measles emerges from the Six Fu Organs (Fu organs belong to Yang, which governs Qi); thus, measles presents with form but no pustules, characterized mainly by excess-heat without cold. Smallpox values sparsity, while measles values dense eruption. Smallpox is beautiful when Qi is robust and Blood adheres; measles is wondrous when Blood is cooled and muscle pores resolve. Smallpox contraindicates sweating and purging to avoid draining Qi; measles benefits from vomiting and epistaxis to disperse and eliminate pathogens. The difference between the two is vast, distinct as water and fire. To demand a smallpox doctor to treat measles is like demanding Yu the Great to manage fire or Bo Yi to manage water; how could this yield results? Yet this is not entirely the fault of physicians. Physicians are not devoid of conscience; who does not possess the heart to save lives? Who willingly accepts the reputation of killing? Intending to save but instead causing death—what is the reason? It is precisely because medical texts on measles are scarce, leaving later learners without standards for reference. Even existing copies are often vague and imprecise, lacking the clarity found in smallpox texts. No wonder physicians are at a loss, watching patients die without being able to rescue them.
I was never trained in medicine, but upon witnessing many children dying of measles, I was stirred by a sudden desire to save lives. Therefore, whenever I encountered records of measles diagnosis and treatment in medical collections, I accumulated them on my desk, exploring day and night, delving deeply into their mysteries, and gaining personal insights. In the summer of Jiayin year, I obtained a volume titled *Measles Pattern Differentiation* by Master Jingyuan from a friend, followed by two volumes of secret manuscripts on measles science. Carefully studying the pattern differentiation and prescription establishment in these two books, I found them more refined and detailed compared to *Mi Zhai Quan Shu*, *Zhang Shi Yi Tong*, and *Zhu Shi Ding Lun*. However, I still lamented their incompleteness. Thus, I extracted discussions on measles and related prescriptions from various works such as *Lian Xing Xin Fa*, *Jing Yue Ma Quan*, and *Jing Yan Zhi Fa*. I used what was available here to supplement deficiencies elsewhere, and enriched sparse content with detailed information from other sources. For instances where medication taboos were inappropriate or prescriptions contradicted medical principles, I arrogantly offered my own views and corrected them based on my own effective trials. From the initial prodromal stage to eruption, resolution, and post-resolution, the pattern differentiation is clear, and treatment formulas are comprehensive, enabling future learners to understand clearly upon opening the book, having a model to follow, and avoiding helplessness during treatment. Although some repetition exists, it is due to theoretical necessity, so I did not hesitate to restate them, facilitating extensive review by eminent physicians and preventing omissions. A skilled artisan obtaining this book, applying it divinely, can certainly achieve life-saving effects; a mediocre artisan obtaining it, rigidly adhering to it, can also avoid the tragedy of killing.
From Jiayin year to the present, fifteen years have passed, with five rounds of practical application. This spring, measles erupted severely with unusual variations, resulting in many deaths and disabilities. All cases treated by me achieved complete success. Desiring to share my humble insights with like-minded colleagues, I compiled and edited this work into four volumes, naming it *Ma Ke Huo Ren Quan Shu* (Complete Book of Measles Science for Saving Lives), intending to submit it to printers for publication and seek guidance from contemporary masters. Regrettably, household expenses increase daily, and my purse is empty. Having the heart to save lives but lacking the means is not my wish. I only hope benevolent gentlemen will publish and disseminate this book, allowing it to spread throughout the land, so that children across the country will no longer perish from measles. Then, the merit of saving lives will be transmitted alongside Fan Zhongyan's, and my minor efforts in editing would be unworthy of mention. This is the preface.
Written by Xie Yuqiong of Puzhai, Chixi, Ancheng, in the Zhuang Month of Guimao Year (1753), 13th Year of Qianlong Reign.