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Guo Yu of the Han Dynasty said: "When a person of high status treats a subject from a position of superiority, and the subject serves with fear and reverence, there are four difficulties in treatment. The first is when the patient is self-willed and does not trust the physician; the second is when the patient's own conduct is not careful; the third is when the patient's joints are not strong and cannot cooperate with medication; the fourth is when the patient loves ease and hates labor. Guo Yu was a renowned craftsman of his generation, yet he faced such difficulties, let alone in traditional Chinese medicine (TCM). If a physician faces someone with authority and majesty, they will surely be terrified and lose their composure, leading to errors in medical practice. The *Medical Cases of Xue Lijia* records: A midwife had only one daughter who died during childbirth without delivering due to fright caused by a patrol censor who happened to order an inspection of her room. Later, upon seeing the censor's stern demeanor, and when examining the mother, although the fetus was in a normal position but tilted to one side causing difficult labor, the physician dared not intervene due to fear of the censor's authority, resulting in the death of both mother and child. From this, it can be inferred that in seeking medical treatment for illness, one must absolutely not rely on the prestige of one's social status.

Whenever a disease cannot heal itself, one must seek treatment from a physician, and the key points are fourfold. First, selection of the physician must be strict; since physicians vary in character and learning, one must choose those who are sincere, cautious, and proficient in their profession to ensure success. Second, the description of symptoms must be detailed; pulse diagnosis is profound and subtle, understood by few, so inquiry is necessary to ascertain the condition. However, physicians who are self-righteous often tire of trivial details, while patients fail to describe thoroughly, which is a major error. Therefore, when seeking a doctor, one must detail the origin of the illness without fearing tediousness. Third, examination of medicines must be cautious; besides fake drugs, even common herbs may be adulterated by careless pharmacists, so one must inspect them personally to avoid mistakes. Methods of processing and decocting should also be precise to ensure efficacy. Fourth, recording prescriptions must be diligent; commonly, prescriptions are discarded after use. I suggest compiling them in a book for reference. This is a minor effort, but for the attentive person, the successful treatments of expert physicians can serve as models, and the cases of average physicians can reveal the depth of their knowledge and the quality of their character, aiding in decision-making.

The *Qiantang County Annals · Biography of Medical Practitioners* states: Shen Haowen specialized in pediatrics, particularly in treating smallpox. Jiang Lutao's son, aged one, had only three smallpox pustules appearing on the forehead, behind the ears, and beside the lips. Shen Haowen said, "The location of the child's smallpox indicates a reverse transmission involving the Heart, Kidney, and Spleen meridians. Earth overcomes Water, and Water overcomes Fire. It is appropriate to attack [the pathogen] rather than tonify. Attacking disperses the toxin, while tonifying harms the internal organs." By the fourteenth day, the pustules were bright and moist, nearing maturity. Shen Haowen said, "Using Shigao (Gypsum Fibrosum) might damage Stomach Earth and Kidney Water." Quack doctors, pitying the child's young age, erroneously administered Ginseng Radix et Rhizoma (Renshen). Upon seeing this, Shen Haowen exclaimed in alarm, "Has Ginseng been taken? The child will not survive past the twenty-first day." The child indeed died. Although the treatment of smallpox had shown effectiveness, it was ultimately ruined by quacks because common sentiment fears attacking pathogens and prefers tonification. This serves as a warning against inconsistent choice of physicians.

Poems dedicated to physicians are rarely good. Recently, I read *Haoyun Lou Chuji* by Li Xiaohu Huiqing (Lian) of Linchuan, which contains a poem dedicated to the physician Fei Jinqing Mingjing, with words that are particularly cautionary. During the Xianfeng era, Huiqing served as the Education Commissioner of Jiangsu, learning of two famous physicians there: Wu Zhongshan (Feirong) of Yanghu, residing at Yinshu, and Fei Jinqing Boxiong of Wujin, residing at Menghe City. He visited both. Wu Zhongshan, knowing Huiqing had no heir, prescribed tonic formulas to plan for offspring. Fei Jinqing diagnosed that Huiqing had excessive Liver Yang and deficiency in both Heart and Kidney, prescribing formulas to nourish the Heart and pacify the Liver. Huiqing adopted Fei's advice and presented a poem: "In the Confucian circles and literary academies,千秋 shines through the bamboo slips. Are there no arts transmitted? To specially honor the sages of the world. Hua Tuo and Xu Yingzong, women and children marvel at them as immortals. Three thousand flavors in the *Bencao*, eighty chapters of the *Nanjing*. Investigating things is the sage's study, fame and spirit are transmitted. Moreover, using [medicine] to save from danger, one can seize the power of creation. Saving lives compared to good ministers, unknown who comes first. Shang and Wang did not meet in the alley, one hand cannot turn back heaven. A commoner of Mengcheng, those who met him received life and preservation. Daily saving dozens or hundreds, merit and virtue nearly ten thousand. Great is the work of Nongxuan, entrusted..."