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Human life is of paramount importance. Those who harm human life invariably face immediate retribution. Yet today, so-called famous physicians often lack learning and formal training, possess corrupt intentions, deceive the world to steal fame, and have caused countless deaths. They ought to suffer heavenly punishment to manifest their crimes. However, they often enjoy longevity, wealth, and prosperous descendants, suffering no calamity whatsoever. I find this deeply incomprehensible.

Through daily interaction with patients, I later came to understand that death due to medicinal error is half attributable to Heavenly Mandate (Tianming, 天命) and half to the patient's family (Bingjia, 病家). The physician merely facilitates death by following or opposing the natural course of fate; they are not the instigators of murder. Therefore, physicians do not bear the guilt of killing. Why is this?

The proficiency of medical practice has a definite standard of high and low quality. Yet patients often distrust skilled physicians while placing blind faith in incompetent ones. They regard those who prescribe tonics as skilled, and those who prescribe purgatives or dispersants as mediocre; they view warm-hot therapies as beneficial and cool-cold therapies as life-damaging. Surrounded by conflicting opinions from others, or when patients alter prescriptions themselves, physicians, desiring their methods to be accepted, inevitably compromise to suit the patient's wishes. The patient delights in this compliance; if recovery occurs by chance, the physician claims credit; if death occurs, the physician bears no blame. The patient also takes responsibility, conceals their own errors, and ceases to blame the physician. Thus, for the physician, compromising to please the patient is an excellent strategy to claim merit and avoid blame.

After death, rumors circulate: "Person X died because they took medicine prescribed by Doctor Y," serving as a warning. Yet when one falls ill oneself, the same behavior repeats. Even more strikingly, a person may hold a highly respected skilled physician in high esteem, but upon falling ill, trust a physician they usually despise, leading to their death. This must be orchestrated by spirits or deities; this is what is called Fate (Ming, 命).

Life and death have fixed numbers. If everyone were to die only of old age, the world would consist entirely of long-lived individuals, rendering Fate powerless. Therefore, diseases arise to prevent people from living out their full lifespan. However, the severity of diseases varies. If an individual protects themselves well, the influence of the Six Evils (Liuyin, 六淫 - Wind, Cold, Summerheat, Dampness, Dryness, Fire) and Seven Emotions (Qiqing, 七情 - Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright) is minimal. If Fate decrees death, but the illness is too mild to cause it, Fate again loses its power. Consequently, Heaven produces such physicians and distributes them throughout the world. For those destined to die, even a minor ailment can be exacerbated by these physicians, turning mild cases severe and severe cases fatal. Thus, the authority of Fate is restored. In this sense, when a physician causes death, they are secretly executing Heaven's orders to administer punishment. They commit no crime and even perform a minor service to cosmic order; therefore, they incur no retribution.

However, there exist those with malicious intent who deceive, show off cleverness, manufacture fake medicines, and use fear to extort money. These are acts of intentional evil, distinct from the physicians discussed above. Their disasters arrive immediately, and I have witnessed many such cases. I urge all people to reflect carefully on this. It is firmly grounded in evidence, not mere wild talk.