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I advise all practitioners of benevolent arts to turn back promptly, to use broad-mindedness in your analogies and advice. If you cannot become a good prime minister, become a good physician. May you practice universal relief and benevolence, using the meager income gained thereby to sustain your livelihood. First, gradually accumulate hidden merit (Yin Gong), keep in mind what concerns Heaven's principles, and do not merely calculate profit. Zhu Xi (Prime Minister of Xiushui), Qian Ruoshui (Prime Minister of Shanyin), Yan Ne (Minister of Yunnan), and Liao Daonan (Viceroy of Yunnan) are such models.

Pan Ji said: Spreading false rumors to slander others without knowing shame, and exaggerating praises for oneself without knowing embarrassment—this is solely because profit disturbs one's heart, disregarding that ugliness comes from one's own mouth. These are the worst among petty people, and this trait is particularly severe among medical factions. Little do they know that there are clear-eyed observers in the world. False words and grand claims are as visible as seeing one's lungs and liver; before long, many are despised and laughed at by others. What is called slandering others and praising oneself actually ends up praising others and slandering oneself. Mr. Wu Yinzhi said: Those who create rumors are very busy; those who suffer from rumors are very idle. The busy cannot determine the fate of the idle, but the idle can judge the character of the busy. This is indeed a profound saying.

The *Records of the Grand Historian* states: There are six types of illnesses that are untreatable. 1. Arrogance and willfulness, disregarding reason. 2. Neglecting one's health while valuing wealth. 3. Inability to adapt clothing and food properly. 4. Imbalance of Yin and Yang, with unstable Zang-Fu Qi. 5. Emaciation so severe that medication cannot be taken. 6. Believing in shamans but not in physicians.

Qin Guan in the *Record of Encouraging Goodness* says: Nowadays, if someone is injured by boiling water or fire, or mistakenly cut by needles or knives, and their hands and feet ache unbearably, they must cry out for help. When experiencing temporary dizziness, abdominal pain, or even minor ailments, they must call doctors and buy medicines, employing every method to save themselves, cherishing their own bodies so much. Yet towards other living beings, they slaughter them arbitrarily without any compassion. Regardless of Buddhist teachings, which have explicit admonitions, or Heavenly principles, which have explicit retribution, being unkind and unjust, knowing only to cherish "things" (referring to oneself/humans), is not what a gentleman or elder should do. Carefully observe the nature of things and think of all sentient beings. One must not fail to take warning, must not fail to take warning.

Shen Lianchi said: When worldly people fall ill, they sacrifice animals to worship deities to pray for blessings. They fail to consider that their worship of deities is to avoid death and seek life. Killing others' lives to extend my own life is contrary to Heaven and violates reason; nothing is more serious than this. Deities are upright and righteous; would they have selfish motives?

Kou Zongshi said: Although there are specialized departments for treating women, there are also aspects where the methods of the Sages cannot be fully applied. Today, wealthy families live in deep chambers, within curtains, and further cover their arms with silk. Thus, they cannot display the divine skill of observation (Wang), nor exhaust the subtlety of pulse diagnosis (Qie). Two of the Four Diagnostic Methods (Wang, Wen, Wen, Qie) are missing. The Yellow Emperor said: In general, when treating illness, observe the patient's form, Qi, color, and luster. If form and Qi are harmonious, it is called treatable. If color and luster are floating and bright, it is called easily curable. If form and Qi are discordant, it is called difficult to treat. If the complexion is dull and lacks luster, it is called difficult to cure. He also said: The way to diagnose illness is to observe whether the person is brave or timid, and examine their bones, muscles, and skin, understanding their temperament to establish diagnostic methods. If the patient's pulse does not correspond to the disease, and since we cannot see their form, how can a physician rely solely on the pulse to provide medicine? Speaking thus, how can one exhaust medical techniques? This is a common flaw among physicians. Since society cannot change, physicians inevitably question extensively. Patients see the numerous questions and think the physician is incompetent, often refusing to take the medicine after receiving it. Such cases are numerous. Even Bian Que was not trusted when observing the complexion of the Duke of Qi, let alone situations where the face cannot be seen at all. Alas! It can be said to be very difficult.

Wang Haicang said: Ordinary people seeking diagnosis remain silent with hands clasped. If asked to have their pulse taken, they test whether the doctor can know the illness. Pulse reflects the Qi and Blood of the person, attached to the meridians. When Heat dominates, the pulse is rapid; when Cold dominates, the pulse is slow. Excess patterns have strength; Deficiency patterns lack strength. As for the cause of the illness and what was damaged, how can this be known solely by pulse? Therefore, the physician must not fail to ask about the cause, and the patient must not fail to explain the origin. Sun Simiao said: Asking before diagnosing is the most accurate.

Zhu Danxi said: When taking medicine for illness, one must observe taboos. Sun Simiao's *Essential Prescriptions Worth a Thousand Gold* discusses this in detail, but does not explain the reasons for the taboos in detail. I dare to state the basics as a reminder. Stomach Qi is the pure, mild, and harmonious Qi upon which human life depends. If mental labor is excessive, physical movement causes fatigue, desires are unregulated, thoughts are frustrated, diet is improper, or medication violates regulations, all can cause injury. Moreover, after injury, regulation and tonification are required. Ignoring this shamelessly and arbitrarily violating taboos causes old diseases to accumulate day by day. I have seen physicians unable to cope daily, and the damaged Stomach Qi having no hope of complete recovery, drawing near to death.

Gong Tingxian said: In the South, when people fall ill and invite a physician home for diagnosis, they only request one prescription and send someone to buy herbs in the market. Regardless of whether the herbs are genuine or fake, new or old, or whether they have undergone processing (Pao Zhi), they are used immediately. If ineffective, they do not blame themselves but blame the physician for mediocrity. The next day, they switch to another physician. Doing this several times causes the symptoms to increase. The physicians become confused and do not know where the error lies. Alas! Is this the fault of the patient, or the lack of wisdom of the physician?

Wang Haicang said: When patients take medicine, they must select someone who understands decoction procedures to prepare it. It must be done by trustworthy, respectful, honest, and sincere individuals. Decoction vessels must be cleaned of oil, dirt, and foul odors. Fresh, clean, sweet water is best. Measure the amount of water and simmer slowly over low heat. Filter the residue through gauze in portions, and take the clear liquid. There will be no ineffectiveness.

Sun Simiao said: Since ancient times, physicians have been jealous and harmful to each other. Bian Que was harmed by Li Xi, the Imperial Physician of Qin, which is an example. When one physician prescribes, do not allow other physicians to compound it. Otherwise, poison might be secretly added, worsening the illness and leading to distress. Such cases are not few; special caution is required. It is better not to take their medicine and rely on natural vitality than to let foolish, jealous physicians harm human lives, which is deeply sorrowful.

Tao Hongjing said: When princes and nobles prepare medicine, they entrust it entirely to subordinates. Among them, good herbs and expensive minerals are often stolen and replaced. Some even swallow Fluorite (Zi Shi Ying) or Cinnabar (Dan Sha), wash them out later, and sell the same piece repeatedly. Such cunning frauds are endless. Even with supervision, they are ultimately undetected. Using these to treat illness makes immediate efficacy difficult. These issues stem from the greed of herbalists, not the incompetence of physicians.

Gong Tingxian said: In the North, when people fall ill and invite a physician home, regardless of the severity, they expect immediate results. Otherwise, they seek other options, changing sides frequently. They do not realize that human constitution has deficiency and excess, and diseases have depth and superficiality. For colds affecting the interstices (Cou Li), one or two doses may suffice; but for internal injuries and consumptive diseases (Lao Zhai), how can they be cured in one or two doses? This is a custom's flaw, misleading many. Only the wise can discern this.

Kou Zongshi said: Untreatable diseases result from six failures: failure to be prudent, failure to trust, failure to act in time, failure to choose a physician, failure to recognize the disease, and failure to understand the medicine. If any one of these six failures exists, the disease is difficult to treat. It is not only the physician's fault but also the patient's fault. Moreover, if the physician is not benevolent and the patient is suspicious and contemptuous, the two conflicting attitudes benefit neither. Thus, physicians must be benevolent; otherwise, they attract criticism. Patients must not be suspicious; otherwise, they attract disaster. Only the virtuous can thoroughly understand human nature and find peace, which is another perspective on treating illness.

Su Dongpo said: The difficulty of understanding pulses has been a problem since ancient times. Extreme deficiency may present with excess signs, and extreme excess may present with deficiency symptoms. Between these similarities and differences lies the distinction between life and death. Scholars often hide their illness to test the physician's ability, forcing the doctor to guess the cause in obscurity and distinguish deficiency/excess and cold/heat amidst ambiguity. If the physician unfortunately errs, they refuse to admit it, cleverly covering up faults to preserve their reputation. Occasionally, cautious physicians comply with the patient's wishes but also incorporate their own observations, mixing treatments. Throughout my life, I evaluate physicians' skills silently during normal times. When seeking treatment, I inform them completely of my condition so they clearly understand the location of the illness before pulsing. I determine deficiency/excess and cold/heat internally first, so ambiguous pulses cannot confuse me. Thus, even average physicians often cure my illnesses. I only seek recovery; I do not make it my business to trouble physicians.

Chu Cheng said: Using medicine is like using troops; using a physician is like using a general. A skilled commander utilizes infantry as effectively as chariots. A skilled prescriber uses Ginger (Jiang) as effectively as Cinnamon Twig (Gui Zhi). Knowing their talent, entrust the army to them—that is the way to use a general. Knowing their medical skills, entrust your life to them—that is the way to use a physician. There are no incurable diseases in the world, only physicians who are bad at treating. There are no irreplaceable herbs, only people who are bad at substituting. If life is cut short not by destiny, it can be understood from this.

The *Suwen* states: Those constrained by ghosts and spirits cannot be spoken to regarding the highest virtue. Those who dislike acupuncture and moxibustion cannot be spoken to regarding supreme skill. If the patient refuses treatment, the illness will certainly not be cured, and treatment will yield no merit.

Wang Fu in the *Qianfu Lun* says: Abandoning medicine and drugs to serve spirits leads to death. Not realizing they have been deceived by shamans, they instead regret serving them too late. This is the greatest bewitchment of the common people.