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Fame and profit are the teachers of those who possess unique skills. The laws of life and death in heaven and earth are possessed by everyone; from ancient times to the present, within China and abroad, the subtle utility with which emperors drive the masses, cultivate talents, and transform social customs lies here. Sages, worthies, heroes, and outstanding men may not be moved by profit, but they cannot help but be moved by fame. I fear that the saying "not desiring fame" is not only spoken for people after the Three Dynasties. Confucius said: "Loyalty, trustworthiness, and heavy salaries are used to encourage scholars." The prosperity of Jingxue (Classics Studies) in the Western Han Dynasty was considered by Ban Gu to be caused by profit and salary. As for the Tang Dynasty's prosperity in poetry and fu (rhapsodies), the Song Dynasty's prosperity in Neo-Confucianism and Jingyi (Classics Interpretation), and the Ming Dynasty up to the current dynasty, all selected officials through Bagu (Eight-Legged Essay). Bagu has now become completely useless. But before its abolition, regardless of intelligence or virtue, no one did not exhaust their lifelong energy to enter it, and ultimately, those called divine products, capable products, or renowned masters were countless; those who achieved high positions, amassed great wealth, and received abundant rewards and honors due to it were unknown in number. At that time, there were no Bagu schools; people simply studied on their own. Although academies existed, there were only a few districts per province, and very few outside provinces. Although directors existed, there were only a few examinations per month, and nothing else was asked about outside class. So why was Bagu so prosperous? It is said to be the trend of the times and valued by the rulers. In reality, it was also driven by wealth and honor, and manipulated by fame and profit. This can be borrowed as a prescription for "curing medicine."

Besides Bagu, there were Juanzhe (a type of literary composition), which were even more meaningless than Bagu, yet the prosperity of Juanzhe talents at that time was almost equal to Bagu. Generally, without mastering this, even if one passed the Bagu examination, one could not attain the glory of Zhuangyuan (Top Scholar) or Prime Minister. Thus, scholars across the world competed to become such talents. Each worried about not catching up with such talents. Alas! There were no Juanzhe schools then, yet the prosperity of Juanzhe talents was like that. Ultimately, it was also the trend of the times and valued by the rulers. Was it not also driven by wealth and honor, and manipulated by fame and profit? This can further serve as a prescription for "curing medicine."

The court established medical officials in the Imperial Medical Bureau (Taiyiyuan), with ranks only up to the Third Rank. Salaries varied, mostly over one hundred taels of silver. They were confined to one department and could not circulate or transfer, leading them to die old there. Truly, these are officials not cherished by the state. If officials are treated thus, it is no wonder that the so-called medical practitioners are viewed by the world as minor arts and treated as lowly craftsmen. Those with even slight intelligence and ability would disdain to do it, let alone the wise and virtuous. Although heroes rose and succeeded each other, becoming famous streams, there were only a few in a generation. When their fame was at its peak, hardly a word of praise was heard; after their death, they were merely listed in the Biographies of Artisans (Fangji Zhuan), like Bian Que, Cang Gong, Hua Tuo, and Sun Simiao. Most strangely, someone as sage-like as Zhang Zhongjing has no biography in the *Records of the Grand Historian* (*Shiji*) or *Book of Han* (*Hanshu*), which is particularly baffling. At that time, Bagu and Juanzhe were ladders to wealth and honor, and the crowd flocked to them. Today, new learning and new policies are the shortcut to success, and the crowd flocks to them again. If one says that those who decline honor for humility and wealth for poverty are another kind of talent, such talents can be imagined. These are all causes of the disease in medicine.

Medical Dao is ten-thousandth times more useful than Bagu and Juanzhe; in fact, upon careful inspection, everyone knows this. Bagu and Juanzhe have long been abolishable, while Medical Dao is indispensable until the end of heaven and earth. Yet, what was early abolishable once flourished so greatly, while what was absolutely indispensable has instead decayed so much. I do not know what heart the medical practitioners hold? And what heart do those dealing with medical practitioners hold?

Medical Dao has immense benefits for new policies and new learning, which must be stated clearly, otherwise people will not know. New policies and new learning seem intended to cure the diseases of old policies and old learning. If they are not "cured" well, then even until the end of heaven and earth, they will be of no help. Yet, new policies and new learning are now implemented together, and no one dares to abolish them. Medical Dao's benefit to people of new policies and new learning is still the same: abolished and unable to be raised. I do not know what explanation medical practitioners have? And what explanation do those dealing with medical practitioners have?

Did the court establish medical officials just because the utility of medicine is merely health preservation and disease treatment? Politics has nothing to do with it. How can one know that the Dao of Medicine must integrate the matters of investigating things, extending knowledge, sincerity of will, rectification of mind, self-cultivation, regulating the family, governing the state, and bringing peace to the world into one? Only by connecting heaven, earth, and humanity can it be called Medicine. The so-called good doctors and good ministers, national experts, and even heaven-menders are not empty words, but actual realities and inherent principles. Unfortunately, throughout history and across the world, medical practitioners' thoughts rarely reach this level, their learning never starts from here, and their qualifications fall short. Consequently, those dealing with medical practitioners have grown accustomed to forgetting, neglecting, and despising them, reaching this extreme.

Medicine is not limited to health preservation and disease treatment. Even if regarded solely as such, even ordinary people should absolutely not be negligent and entrust their bodies to mediocre, vile, and inferior hands for experimentation. Especially since the court governs the world to treat the suffering of all regions, ensuring no one is left without grace, leading to the positioning of heaven and earth and the nurturing of all things—this is what is meant by "If the Son of Heaven has joy, the million people rely on him." If the Emperor's body is slightly unwell, he is treated by the Imperial Physicians. The slogans in the capital, essays in the Imperial Academy, imperial processions, guards' spears, and Imperial Physicians' prescriptions can indeed be discussed generally. If efficacy fails, governors and generals of provinces will summon physicians according to edict. I am familiar with Imperial Physicians and group physicians, knowing them well. Frontier officials are not true experts in medicine; how can they judge right and wrong? They merely rely on the court's great fortune or use the opportunity to achieve merit. This cannot be denied as a sporadic ability or temporary luck, but facing major crises, they are likely not true generals. Wang Zi'an and Cheng Yichuan said: "A son must know medicine." I say: "A minister must also know medicine." In truth, anyone being human must know medicine. The so-called "knowing" is not half-understanding, but clear, true knowledge.

Suppose the court reformed the medical official system, placing them on par with frontier governors and cabinet ministers, allowing circulation between them, or specially establishing high ranks and rich salaries for medical officials as advisors. First, an edict would be issued to all scholars: from the beginning of literacy and reading, one must study medicine simultaneously, merging Medical Dao and Governance Dao. Because Medical Dao has nothing that does not connect to Governance Dao, and Governance Dao has nothing that does not connect to Medical Dao. One cannot treat diseases without understanding governance, nor govern a country without mastering medicine. Governing people is like treating disease; a good minister is no different from a good doctor. Using medicine is like using troops; a famous doctor can be a famous general. Promoting benefits and removing harms, correcting biases and saving defects, share the same origin; eliminating violence and comforting the good, driving out evil and nourishing righteousness, follow the same path. Ancient and modern, inside and outside China, dividing them into two leads to those claiming governance not achieving perfect rule, and those called famous doctors not being truly comprehensive. If integrated, everyone can self-govern, govern others, treat diseases, govern states, and command armies. Good ministers and good doctors, famous doctors and famous generals, would be everywhere, creating realms of benevolence and longevity, invincible nations, and the Great Harmony. We would see such a scene. If we still worry that medical talents will not emerge in waves like Bagu and Juanzhe, I do not believe it. Transforming customs depends on the court, but ultimately revolves around the subtle utility of fame and profit. Hence, "Fame and profit are the teachers of unique skills." If this were true, not only would medical schools be unnecessary, but all schools would be redundant. By setting fame and profit as goals and high ranks/rich salaries as bait, people would naturally study on their own, integrating the medical, academic, political, and military spheres. Infinite funds would be saved for rewarding successful students. This is the principle of "One root, myriad branches; myriad branches, one root," embracing unity as the model for the world, not a lofty theory. Medical Dao connects to Governance Dao, yet few great sages and doctors have seen this. Thus, people remain silent, observing broadly and studying carefully. Analyzing quietly and deducing finely, where do ends not connect? Where do principles not interweave? Yet they allow negligence and contempt, mediocrity and vileness, separation for tens of millions of years. No wonder Medical Dao is unclear and unimplemented. Current bias towards Western medicine and talk of Westerners valuing medicine are hearsay and superficial views. Discussing anatomy, experiments, and pharmaceuticals, they may have some merits. Anatomy was also left by our ancestors Yu Fu and Hua Tuo; gains and losses are mixed. Ignorant people haven't researched external texts, which I have detailed. Regarding Qi transformation, they are as confused as current TCM practitioners in a fog. Expecting them to understand governance is entering a thicker fog. How can they discuss Medical Dao?

I pray the Sage sits above, reviving declines of a hundred generations, uplifting achievements of a thousand autumns, connecting the consistent Dao, opening benefits for ten thousand generations, gradually inputting our nation's medical culture into foreign countries, acting as a guide for opening foreigners. Is this not admirable? Furthermore, regarding court governance, nothing is more important or prior than rewards and punishments. Following the bright edict to reform medical officials and revitalize medicine, having set abundant rewards as encouragement, strict punishments must be established as a warning against incompetence. Quack doctors killing people have never been held accountable. Although this stems from the world's negligent and contemptuous habits, making right/wrong and success/failure hard to verify, allowing quacks to escape punishment and fill the world, we must now issue clear edicts reiterating that people must not repeat the habit of neglecting and despising medicine to avoid disaster. Instead, extra respect and reverence should be shown. Establish local medical official titles: Village Doctor, County Doctor, Prefecture Doctor, Provincial Doctor. Order those truly proficient in medicine, capable of becoming National Teachers, to inspect provinces and conduct rigorous exams. Or examine them in the capital. Those passing are recorded and distributed to districts. All expenses are jointly planned by district societies and local officials to provide ample support for doctors' livelihoods, enabling them to assist impoverished medical practitioners. Those not recorded remain as medical practitioners, continuing their studies for future selection, forbidden from practicing immediately. Require district doctors to record cases upon diagnosis, detailing pulse signs, symptom patterns, and treatment methods, keeping records with patients and posting them in public places. Report monthly and annually to officials for verification to determine merit/demerit, serving as basis for rewards/punishments and promotions/demotions, then report to higher authorities and the court. If effective and knowledgeable in governance, promote exceptionally and reward sponsors. If still bad or committing major errors, punish accordingly or execute unexpectedly, holding sponsors liable. Although merit/demerit focuses on right/wrong rather than success/failure, those with true right/wrong will likely succeed more than fail. Although natural talents vary, universal talents are rare. But if everyone follows my prescription to "cure medicine," even if not fully integrating Medical and Governance Dao, good doctors will surely emerge, many understanding governance, washing away past陋习 (bad habits). This is certain. Thus, high rewards are the prelude to "curing medicine," and strict punishments are its backing. This is the court's good prescription for "curing medicine."