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Shang Han Lun · Treatise on Cold Damage
Zhang Zhongjing's Original Preface
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The discussion says: whenever I read of Yueren's examination on entering Guo and his observation of the complexion of the lord of Qi, I cannot help admiring and sighing over his exceptional talent. I find it strange that the gentlemen of the present world pay no attention to medicine and do not investigate its methods deeply: above, to treat the illnesses of their rulers and parents; below, to rescue the poor and lowly from distress; and in between, to preserve their own bodies intact and nourish their lives. Instead, they compete for honor and power, stand on tiptoe toward the influential and wealthy, and labor anxiously at nothing but reputation and profit. They adorn the branches while neglecting the root, making the exterior splendid while the interior withers. If the skin no longer exists, to what can the hair cling?
Only when suddenly struck by harmful wind-qi and seized by an extraordinary illness, when distress and disaster arrive, do they tremble. They humble their ambitions and bend their principles, looking reverently to shamans and invocators, appealing to Heaven in their extremity, and accepting defeat with folded hands. Carrying a life that might last a hundred years, holding this most precious vessel, they entrust it to an ordinary physician and allow him to do whatever he chooses. Alas! Once the body has perished and its spirit and awareness are extinguished, it becomes another thing and sinks into the deep springs below; only weeping remains. How painful!
The whole world is bewildered, with no one able to awaken. They do not cherish life and treat it so lightly: what then is the use of honor and power? In public life they cannot care for others or understand them; in private they cannot care for themselves or know themselves. Meeting disaster and misfortune, they stand in peril, dim and ignorant, senseless as wandering souls. How lamentable! Those who chase the fashions of the world race after empty splendor, fail to secure their roots, and forget their bodies in pursuit of things. Their danger, like standing on ice over a deep valley, has reached this point!
My extended family was formerly large, numbering more than two hundred. Since the beginning of the Jian'an era, before even ten years had passed, two-thirds had died; seven in ten of those deaths were from cold damage. Moved by these losses and grieved that untimely deaths could not be rescued, I diligently sought ancient teachings and widely collected formulas. Drawing on the Suwen, Nine Scrolls, Eighty-One Difficulties, Great Treatise on Yin and Yang, and Tailu Yaolu, together with assessment of pulses and discrimination of presentations, I composed the Shanghan Zabing Lun in sixteen scrolls. Although it cannot cure every illness completely, I hope that it may allow one to see an illness and recognize its source. Anyone able to pursue what I have collected will already have gained more than half the understanding required.
Heaven distributes the five phases to set the myriad kinds in motion; human beings receive the five constants and thereby possess the five viscera. Channels, networks, bowel regions and transport points allow yin and yang to meet and communicate. Their workings are dark, hidden and subtle, and their transformations are difficult to exhaust. Without exceptional talent and exquisite discernment, how could anyone explore their principles?
In high antiquity there were Shennong, Huangdi, Qibo, Bogao, Leigong, Shaoyu, Shaoshi and Zhongwen; in the middle ages, Changsang and Bian Que; in the Han, Gongcheng Yangqing and Master Cang. Of those who came afterward, I have heard nothing comparable.
Looking at today's physicians, I see that they do not think to seek the meaning of the classics and develop what they know. Each inherits a family technique and follows old practice from beginning to end. In examining illnesses and asking about complaints, they aim at verbal fluency. After facing a patient for only a moment—the supplied text also gives a variant with the two words for 'a moment' reversed—they prescribe decoctions and medicines.
They press the cun position without reaching the chi, and grasp the hands without reaching the feet. They do not compare the three regions, including Renying and Fuyang; their count of pulse movements during breathing does not reach fifty. They do not know how to decide a diagnosis and its near-term course, and have scarcely any conception of the nine indicators. The Mingtang, Que and Ting regions of the face go entirely unexamined. This is what is called looking through a narrow tube. To distinguish death from life in this way is truly difficult!
Confucius said: 'Those who know from birth are highest; those who learn come next.' Hearing much and knowing widely come next to innate knowledge. I have always esteemed the medical arts; I ask to put these words into practice.
Zhang Ji of Nanyang, Governor of Changsha under the Han.
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