Library

My grandfather, Mr. Xiushan, once said: An experienced physician judging a disease is like an experienced magistrate adjudicating a case. A physician who is good at diagnosing diseases must also be good at treating them. The former philosopher Lu Jiuzhi stated: "An" (Case Record) means judgment; "Fang" (Prescription) means method. Only when one can make judgments and follow methods can it be called a "Case Record." These words are truly profound.

The invention of medicine in our country has ancient origins. During the Zhou and Qin dynasties, the methods used by physicians to diagnose diseases largely focused on observing complexion and pulse conditions, listening to sounds, and examining forms, as detailed in the *Suwen* (Basic Questions), *Lingshu* (Spiritual Pivot), and *Nanjing* (Classic of Difficult Issues). In the Later Han dynasty, Zhang Zhongjing rose to prominence. Beyond observing nasal and ocular colors, he paid more attention to voice and respiration to correlate with pulse conditions and symptoms. From the Six Dynasties to the Tang dynasty, figures such as Chu Yandao and Sun Simiao emphasized clarifying symptoms, inquiring about preferences, investigating the origin of diseases, distinguishing the deficiency or excess of affected organs, assessing age and physical strength, and weighing the depth of the condition, ultimately relying on extensive experience and frequent diagnoses, repeatedly applying diagnostic principles. This was the general overview of diagnostic techniques from the Zhou-Qin period through the Jin-Tang eras.

Subsequently, the Four Great Masters of the Jin-Yuan dynasties and Ming dynasty famous doctors such as Han Tianjue and Tao Jie'an emerged. They additionally considered local climate and seasonal changes to determine the yin-yang and dryness-moisture nature of diseases, and employed abdominal palpation to supplement the limitations of inspection, auscultation/olfaction, inquiry, and palpation (Wang, Wen, Wen, Qie). This was even more detailed than during the Zhou, Qin, Han, and Jin periods.

In the early Qing dynasty, Yu Jiayan from Jiangxi appeared. He advocated discussing the disease first and then the medication, integrating and mastering ancient diagnostic methods. Factors such as local climate, body constitution (fat or thin), age, duration of illness, emotional states (suffering or joy), current pulse and symptom presentations were all analyzed with extreme precision to determine yin-yang deficiency/excess, external contraction/internal injury, upper/lower, exterior/interior, specific organs involved, causes, and manifestations. Only then would he select which formula from the ancient "Seven Forms" (Qi Fang) or which category from the "Ten Categories" (Shi Ji) to use. The rules were rigorous and orderly. It was only then that Chinese physicians had fixed rules for diagnosing diseases, clearing away the弊 (malpractice) of haphazard and reckless prescription. This is indeed an excellent method that should never be abandoned.

Today, Eastern and Western physicians claim to belong to the substantive school, possessing anatomical knowledge. However, upon private observation, their diagnostic methods rely heavily on sensory diagnosis, as well as the appearance and sediment of urine, feces, sputum, tongue coating, eye expression, body temperature, volume, and findings from instrumental examinations. About half of these correspond with our ancient Chinese methods. Thus, I sigh at the sophistication of Traditional Chinese Medicine (TCM) diagnostics, which is by no means inferior to that of the West. Although instrumental usage is not yet complete, the precision of pulse diagnosis, inspection, inquiry, and abdominal palpation is sufficient to encompass the whole. Moreover, the differentiation of deficiency and excess, separation of qi and blood, and discussion of attacking and tonifying methods were pioneered by past sages, offering unique insights that can supplement Western medicine. Unfortunately, those who truly understand this are hard to find.

Mr. Yuan Guisheng is a famous physician in Wu (Suzhou area). He is profound in medical science, holds balanced views, possesses exquisite academic expertise, and expresses deep emotion, with his fervent desire to preserve national essence evident on paper. He can be said to have understood my thoughts beforehand. Recently, he mailed me his work, *Conggui Caotang Yicao* (Medical Cases of Conggui Cottage), and requested a preface. After reading it, I found his syndrome differentiation earnest and precise, and his prescriptions stable and skillful. In every case description, he presents the facts comprehensively and analyzes them thoroughly, truly capable of enlightening scholars.

Zhou Xuehai once said: Among medical books after the Song dynasty, only case records are best to read, unlike commentaries on ancient texts which often involve forced interpretations. Each set of medical cases must contain the author's most effective experiences, studied deeply, absorbing the strengths of various schools. I believe that among the genre of medical cases, Yu Jiayan's *Yuyi Cao* (Drafts of Intended Meaning) ranks first. Although his cases number only sixty-two, he repeatedly deduces and strives to clarify the rationale behind syndrome differentiation and medication, which differs significantly from other authors' cases that merely state vaguely that a certain disease was cured with a certain drug. The *Siku Quanshu Tiyao* (Abstracts of the Complete Library of Four Treasuries) praises it for its great innovations and ability to inspire enlightenment. Modern famous physicians such as Zhang Shiwang, Ye Xianyan, Gu Songyuan, Xu Lingtai, You Zaijing, Yu Dongfu, Wu Jutong, Wang Mengying, and Lin Qin all adopted his diagnostic methods as a compromise, silently benefiting from his therapeutic efficacy, and published their own cases.

This book by Mr. Yuan today imitates Yu's format: discussing the disease first, then the medication, strictly following Yu's standards. It includes learning from Song and Jin-Yuan masters, from Ming and Qing masters (Zhang, Ye, Xu, Wei, Wu, Wang), as well as the application of classical formulas and original ideas. It truly gathers the strengths of various schools and applies them with spiritual flexibility. Hence, handling it is like guiding a blade through joints—effortless and smooth.

Alas! The current medical ethos is decadent. Published books, except for a few translations, are as rare as phoenix feathers and unicorn horns. Sectarianism and mutual hostility are now rampant. Where is the world heading? How can we hope for national physicians to rise like Mr. Yuan to revive this declining tradition? Writing this preface for Mr. Yuan's book, I cannot help but feel a surge of mixed emotions.

On the 28th day of the sixth month of the Yimao year, He Xiaoyan Lianchen, a physician from Yue, wrote at Xuanhua Fang, at the foot of Wolong Mountain in Shaoxing.