医之中有其品至下，其为病至深而莫可救者，欺哄诈骗是也。夫医之为道，贵诚笃端方，奈之何有欺哄为事、诈骗为心者？原其人，道不足以活人，人皆弃之。门前冷落，衣食迫肤，百计图利，利足不至，因而思一骗之之法。骗则不得不欺，不得不哄，不得不诈，是欺与哄与诈皆所以为骗之地也。患此病者，犹之瘫癞痈疽，至秽至恶，人不常有，亦未尝无。姑就目击者言之：有病本轻浅，不药亦将自愈者，若人故为凶恶之言，使病人畏死而求治之念切；又夸以举世罔知，惟己独能，使病人欣喜而仰赖之心专。由是议定厚赀，一药而愈，便自居功，怀利而去。此虽计端，却未杀人，其罪尤轻也。乃有病势危急，旦夕就毙，神仙莫救者，诸医尽辞，一医独任。力言包好，否则甘罚。病家喜出望外，不复惜财。骗财到手一剂而毙。此原是必死之人，犹非特杀，其颜虽厚，其罪尤可原也。若夫命介生死之交，全赖得当之药以生之。而若人不识病情，不顾利害，动云保治。巧言蛊惑，议酬若干，先付其半；大言不惭，孟浪用药，使可生者不生。此真骗其财而又杀其命者也。更有他医服药有效将渐次收功者，或已痊愈偶尔又复者，而若人巧说以夺之。或云前药不可再服，再服必将有害；或云前药补早，尚须清开，然后用补；或云服参太多，必将发作为害，亦以药解之；或云前药太温补，致有火起，只宜清补兼施。百种簧口，使病人疑惧，顿令弃彼从此，去生就死。又暗使旁人吹嘘，得财瓜分，共相夸奖，使病家深信而不疑，遂慨然先出财，后受药。孰知药与前医相反，人即与世相违矣。此皆骗财杀命，罪不容诛者也。又有一种骗法，凡治一病即要病人合丸药，以丸药无从辨认，可任其欺哄故也。病人索方，则云此祖传密妙，从不传方；且多珍贵之物，即与方，亦无从觅药，惟议价代制。富者索以数十金，贫者亦勒以七八金。得财到手，仅以钱数一斤药应之。愚人多坠其术中，待悟破时人与财已两亡矣。然后怨恨而吐骂之，有何益乎？又有一种以丸药骗人者，不论病之轻重，只论药之贵贱。定例上料几两，中料几两，下料几两。富人则锘以用上料；贫人亦劝以用中料，必不能，亦必勒以用下料。世岂有富病恰当用贵料药，贫病恰当用贱药者乎？其如妇人女子，不明此理，多为所哄，遂多伤命。各种骗法，有身受而切恨者，有旁观而窃笑者，而骗人之医恬然不觉也。余非敢悬照孽镜，预使奸恶无遁形；第愿燃昏衢灯，欲使沉迷登觉路己而。极知此一种病，最为难医，然非必不可医。释氏云：放下屠刀，立地成佛。乃知佛不难成，惟屠刀难放下耳。苟能刮骨涤肠，痛自攻治，放下欺哄诈骗之心，立便为端方诚笃之品。品高者道自高。能见重于人，必无亏于己。又何俟日夕劳劳，弄巧反成拙哉！妙药妙方，和盘托出。如讳疾忌医。不谅婆心，但嗔苦口，狂言吐骂，掷地咆哮。则当正告曰：人事昏乱，深入膏腴。纵有灵丹，不能下咽矣！请辞。
Among physicians, there exists a type of individual whose moral character is extremely low and whose malady is so profound that it is incurable: deception, fraud, and swindling. The Way of Medicine values sincerity, steadfastness, integrity, and uprightness. How can there be those who make deception their practice and fraud their intent? Tracing the root of such individuals, it is because their Dao (moral cultivation and medical skill) is insufficient to save lives, leading others to abandon them. With an empty door and pressing needs for food and clothing, they devise myriad schemes to seek profit. When legitimate profit is unattainable, they resort to methods of deception. To deceive, one must inevitably cheat, bluff, and swindle; thus, cheating, bluffing, and swindling are merely means to facilitate deception.
Those suffering from this "illness" (referring to unethical medical conduct) are like those with paralysis, leprosy, or carbuncles—extremely foul and vile. Though not common, they do exist. Let us speak from personal observation: In cases where the disease is mild and would heal spontaneously without medication, certain physicians deliberately use terrifying language to instill fear of death in the patient, making them eager for treatment. They boast of unique, unparalleled skills unknown to the world, fostering the patient's joy and exclusive reliance. Consequently, they agree on exorbitant fees, claim credit after a single dose cures the ailment, and depart with the money. Although these tactics are sinister, no life is taken, and the guilt is relatively light.
However, in critical cases where death is imminent and even immortals cannot help, while other physicians decline to treat, one physician may take sole responsibility. He vigorously guarantees a cure, offering penalties if he fails. Overjoyed, the family spares no expense. Once the fraudster obtains the money, a single dose kills the patient. Since the patient was destined to die regardless, this is not intentional homicide; although shameless, the guilt is somewhat forgivable.
In situations hanging by a thread, where life depends entirely on appropriate medication, some physicians ignore the condition and consequences, casually promising cures. Using bewitching words, they negotiate fees, demanding half upfront. Then, speaking boldly and recklessly administering drugs, they cause patients who could have lived to perish. This is truly deceiving for wealth and killing for life.
Furthermore, when another physician’s treatment is effective and nearing success, or when a patient has recovered but experiences a slight relapse, such fraudulent doctors use clever rhetoric to steal the patient. They might claim previous medicines should not be continued as they are harmful, or that prior tonification was premature and requires clearing before further tonification, or that excessive ginseng intake will trigger adverse reactions requiring antidotes, or that previous warm-tonifying herbs caused internal heat, necessitating simultaneous clearing and tonifying. Through various sophistries, they induce doubt and fear in the patient, causing them to abandon the former doctor and follow the new one, turning life into death. Secretly inciting others to praise them, sharing the profits, and gaining the family's absolute trust, the patient pays first and receives medicine later. Unaware that the new medicine contradicts the previous treatment, the patient moves away from health. These acts of defrauding wealth and taking lives are unpardonable.
Another method of deception involves prescribing pills for every condition, as pills are difficult to verify, allowing for unchecked fraud. When patients request prescriptions, the doctor claims it is a secret ancestral formula never disclosed. Citing the rarity of ingredients, even providing a prescription would not allow sourcing the herbs, so they offer to manufacture them at a negotiated price. They extort dozens of taels of silver from the rich and seven or eight taels from the poor. Upon receiving payment, they use mere coins to buy a pound of crude herbs to fulfill the order. Many fools fall into this trap; by the time they realize the truth, both person and wealth are lost. What good is cursing afterwards?
Yet another pill-based scam ignores the severity of the illness and focuses solely on the cost of ingredients. Standard recipes specify amounts for premium, medium, and inferior grades. For the wealthy, they insist on premium ingredients; for the poor, they persuade them to use medium grade, or if refused, coerce them into using inferior grade. Is it true that wealthy patients always require expensive herbs while poor patients always suit cheap ones? Women and girls, lacking understanding, are often deceived, resulting in many deaths.
Various deceptive practices evoke deep hatred from victims and silent laughter from bystanders, yet the deceiving physician remains oblivious. I do not dare to hang a Mirror of Retribution to expose evil; rather, I wish to light a lamp in the dark path to awaken the deluded. I know this "disease" is hardest to cure, yet not impossible. As Buddhism says, "Put down the butcher's knife, and become a Buddha instantly." Becoming a Buddha is not hard; putting down the knife is. If one can undergo painful self-examination, purge deceitful intentions, and immediately become sincere and upright, high moral character naturally elevates one's Dao. Being respected by others ensures no self-harm. Why toil day and night only to succeed through clumsiness?
Here, the miraculous medicine and formula are fully revealed. If one hides their illness and avoids treatment, misunderstanding my earnest advice, complaining about bitter medicine, and responding with wild curses and roaring anger, I must solemnly declare: Your conduct is chaotic, and your illness has penetrated deep into the viscera. Even with spiritual elixirs, they cannot be swallowed. I resign.
Note: Hereby, I publicly share Mr. Wu Chutianshi's "Ten Diseases of Physicians" with colleagues, firstly to warn myself, and secondly to instruct students, preventing them from cycling endlessly within the wrong paths of medical practice. Written by Zhao Zixian in (Hei).