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Sun Shengshengzi said: A physician is praised for mastering adaptability, whereas adhering rigidly to fixed prescriptions leads to inflexibility. Therefore, a practitioner who can follow the methods of the ancients and carefully discern the timing for their application will grasp the original intent behind the establishment of these laws. Otherwise, merely catching a glimpse of one aspect and criticizing its biases or strengths—even regarding masters like Zhang Zhongjing and Li Dongyuan—would be unjustified criticism. Is this acceptable? Is it acceptable?! Thus, I list below those who established methods according to the times.

Before the Han and Qin dynasties, there were no fixed medical formulas; formulas originated with Zhang Changsha (Zhang Zhongjing). Hence, physicians regard Zhang Changsha as the ancestor of formula literature. Later generations discussing Zhang Changsha generally claim he excelled in treating *Shanghan* (Cold Damage) but was deficient in treating miscellaneous diseases. I believe there is no flaw in Zhang Changsha’s approach. The reason Zhang Changsha prioritized *Shanghan* is that among diseases, none are more severe than *Shanghan*, nor do they present more drastic variations. Life and death are often determined between the seventh day and the thirteenth-fourteenth day, unlike other ailments which allow for leisurely treatment. Observing the urgency of the condition, Zhang Changsha made *Shanghan* his primary concern. If not so, would *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), a text on treating miscellaneous diseases, not also be his work? Additionally, biographical records state: "Zhongjing studied under Zhang Bozu of his native commandery, excelling in treatment and particularly skilled in classical formulas. People of the time believed that even Bian Que and Cang Gong could not surpass him." From this, it is evident that Zhongjing did not specialize solely in *Shanghan*. Liu Zongnong also stated: "I have used Dongyuan's herbs and modeled my prescriptions after Zhongjing." Liu Zongnong was a senior disciple of Danxi; instead of following Danxi, he followed Zhongjing, because Zhongjing is the 'Sub-Sage' of medicine, beyond the reach of Danxi. Following Zhongjing may reflect the principle of aiming high. Future generations should not lightly criticize Changsha.

Zhang Dairen (Zhang Congzheng) possessed a unique and outstanding medical skill. Those who do not investigate his underlying intent criticize his treatments as merely employing attack methods. Even Zhu Danxi, known for his clarity, criticized Zhang as biased in his *Gezhi Yulun*. With Danxi's theory emerging, people became fearful of the sweating, vomiting, and purging methods, dismissing his books entirely. I feel this is an injustice. I argue that disease entering the body is like bandits invading a state; if one does not first drive out the bandits but instead focuses on soothing, one only nourishes the bandits and disturbs the people. Zhang Dairen understood this, thus prioritizing the removal of pathogenic factors before tonification, which is the method of pacifying bandits and stabilizing the people. Were Zhongjing's Mahuang Tang (Ephedra Decoction), Gouti San (Melon Seed Powder), and Dachengqi Tang (Major Order the Qi Decoction) not urgent attack formulas? Using them based on the assessment of urgency is precisely Zhongjing's intent. Generally, diagnosing disease is difficult for physicians, while attacking pathogens or tonifying is not. Zhang Dairen highlighted this difficulty. Danxi cited the *Neijing* saying, "Where evil gathers, qi must be deficient," omitting the subsequent phrase, "If it remains and does not depart, the disease becomes excess." He cited "Loss of essence and qi constitutes deficiency," omitting "Exuberance of evil qi constitutes excess." He cited "Deficiency refers to the deficiency of upright qi," omitting "Excess refers to the excess of evil qi." He collected points to criticize Zhang Dairen while ignoring what Zhang deemed urgent. If Danxi acted thus, how can I blame others? Moreover, Zhang named his book *Rumen Shinqin* (Confucian Practice for Serving Parents). Would a Confucian serve parents by practicing tyranny and harming them? Certainly not. Just as King Wu of Zhou hung King Zhou of Shang at the White Flag before distributing grain, or Emperor Gaozu of Han entered Qin, subdued Ziying, and then established three laws, those who rigidly advocate only tonification while rejecting attack are like governing a state using only rewards and no punishments. In that case, were Shun's campaign against the Four Evils and Confucius's execution of Shao Zhengmao superfluous? I wrote this to vindicate Dairen.

Some say Liu Shouzhen (Liu Wansu) excelled in treating fire syndromes. This statement fails to recognize Liu's true strengths. Liu was profound and agile, unmatched by ordinary practitioners. His treatments focused on "eliminating the old to generate the new, preventing any stagnation, reflecting the continuous renewal of creation. A physician unaware of this lacks skill." These words belong to Wang Haizang, a senior disciple of Dongyuan, whose praise indicates Liu's deep learning. Furthermore, in his *Yuanbing Shi* (Treatise on the Origin of Diseases), Liu elucidated the nineteen pathogenesis clauses from the *Suwen*, five of which relate to fire. He observed that human nature tends toward movement, and all movements belong to fire. Among the Five Elements in the human body, each appears once, but fire has both Ministerial Fire and Sovereign Fire, leading to many pathogeneses relating to fire. *Yuanbing Shi* specifically addresses pathogenesis, hence neglecting other topics. However, his *Baoming Ji* (Collection for Preserving Life), comprising three volumes, treats miscellaneous diseases with exquisite skill. Thus, claiming Liu only excelled in treating fire shows a lack of understanding of his true capabilities.

Physicians commonly discuss Li Dongyuan as excelling in internal injury but lacking in treating deficiency and weakness, citing his view that "tonifying the spleen is superior to tonifying the kidney." I contend that the Kidney governs opening and closing, and the Yuan Qi (Original Qi) in the interspace of the kidneys is the master of life; how could it be considered inferior to the Spleen and Stomach? Perhaps due to the urgency of conditions and the specific historical context, Li prioritized acute cases. During the turmoil of the Jin and Yuan dynasties, people exhausted themselves running for survival, suffering spleen damage from fatigue, worry, and irregular diet. As the *Neijing* states: "The Spleen and Stomach are the root of the granaries and the residence of Ying Qi." It also says: "All five zang and six fu organs receive qi from the Spleen and Stomach; if the Spleen and Stomach are injured, the organs lose their source of qi." Therefore, Li diligently prioritized protecting the Spleen and Stomach. Deficiency injuries affecting Kidney Yin usually stem from idle living and excessive sexual activity, which cannot be compared to the acute spleen injuries of that era. Moreover, works like *Neiwai Shang Bianhuo Lun* (Distinguishing Internal and External Injury and Resolving Doubts), *Waike Jingyi* (Essentials of Surgery), and *Lanshi Micang* (Secrets of the Orchid Chamber) treat miscellaneous diseases, not just internal injuries. This clarifies the matter.

Observing recent physicians, few mastered Neo-Confucianism better than Zhu Danxi. Although he advocated the theory of "Yang is often in excess, Yin is often deficient," his intent was specific. In times of peace, people indulged in alcohol and lust, depleting essence. Depleted essence leads to blazing fire. If one mistakenly uses harsh, drying drugs thinking them to be warming tonics, one quickly suffers from bleeding, internal heat, and emaciation, similar to adding a wick to a lamp when the oil is exhausted. This explains the origin of his theory. Later students, failing to examine this, universally applied his theory. Upon encountering deficiency, they immediately prescribed Yin-nourishing and Fire-descending formulas. By the terminal stage, patients died of hoarseness and diarrhea, yet blamed Danxi's theory. This is the fault of poor learning, not Danxi himself. Danxi was a senior disciple of Xu Wenyi and studied under Zhu Xi (Kao Ting). His diagnosis was accurate, and his prescriptions precise. His treatments of Xu Wenyi's illness and thirteen types of gout demonstrate this. I have long felt it unjust to label him either the chief merit-maker or the primary culprit.

Xunzi liked to make grand theories, which Li Si inherited, bringing disaster to the world, leading to justifications for revenge and robbery. Generally, ancient sages established theories with firm convictions, balancing tradition and flexibility appropriately. Those who cling to formulas without understanding change inadvertently discredit Danxi. Therefore, I do not spare my efforts to defend him.

Reading Sima Qian's *Records of the Grand Historian*, specifically his praise of You Guang and Boyi, I often closed the book sighing at the unacknowledged skill of Hua Brenren (Hua Shou). Brenren was a remarkable scholar of our Ming Dynasty. His technical skill rivaled Danxi's. His literary works, such as *Suwen Chao* (Notes on the Suwen), *Nanjing Zhu* (Annotations on the Nanjing), diagnostic texts like *Shuyao* (Key Principles), and acupuncture works like *Jingluo Fahui* (Elaboration on Meridians and Collaterals) and essays on sores, hemorrhoids, and fistulas, represent a culmination of past sages' achievements. Yet later students only revere *Danxi Xinfa* (Core Methods of Danxi), ignoring the *Lingshu*, *Suwen*, and Hua's collections. Despite his miraculous cures and clear evidence of success, as recorded in official histories, he remains overlooked. Why? Because Danxi was promoted by contemporary scholars and had famous disciples like Dai Yuanli and Liu Zongnong, making Danxi's name famous. Hua, though skilled, was less recognized. He Yiyang once said: Comparing ancient sages, if Qibo and Yu Ren are the Confucius of medicine, then Zhongjing is akin to Yan Hui and Zeng Shen; Hejian (Liu Wansu) and Dongyuan (Li Gao) belong to the ranks of Zai Wo and Zigong. Hua Shou, with refined principles and pure compositions, belongs to the class of You Xia (Ziyou and Zixia). Yanxiu is slightly lower. This argument is sound, yet today few revere Hua. Nor do they revere Dairen or Shouzhen. Thus, the Grand Historian said: "Hermit scholars wishing to establish their reputation must attach themselves to high-ranking officials to spread their fame posthumously." This is true. Therefore, I specially commemorate Brenren.

Shengshengzi said: I write these arguments not to flatter my favorites, but to ensure future generations know: Zhongjing is not only renowned for *Shanghan*; Shouzhen is not only praised for treating fire; Dairen should not be mocked for attack methods; Dongyuan did not build his legacy solely on internal injuries; the discourse on "Yang excess and Yin deficiency" should not be used to slander Danxi; and the skills of Yingsheng (or specialists in this field) will also be immortal alongside these masters. I hope colleagues understand and do not criticize me.