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(Pan Zhiqi, Author)

1. Nourish the Spirit (Shen). The essence and blood of the whole body rely on Qi, and Qi relies on the Spirit (Shen, vital spirit/consciousness). The Spirit is the mother of essence and Qi. The Book of Rites states: When one is ill, both the patient and those caring for them should observe abstinence (Zhai, a state of ritual purity and mental clarity). Abstinence refers to reaching the utmost state of clarity and purity. One should not think arbitrarily with the heart, nor move arbitrarily with the body; will and Qi should correspond, extending to the Spirit, thereby regulating Yin and Yang and welcoming heavenly blessings. The Liver governs Benevolence (Ren), the Heart governs Propriety (Li), the Lungs govern Righteousness (Yi), the Kidneys govern Wisdom (Zhi), and the Spleen governs Trustworthiness (Xin); these are the dwellings of temperament and nature. Therefore, there is a method for dispelling disease called: sitting quietly and contemplating emptiness, perceiving that the Four Elements (Earth, Water, Fire, Wind) are merely temporary aggregations; this is the highest level. It is also said: Often comfort yourself cleverly by comparing yourself to those worse off than you. When facing all matters, regard them through the lens of death. This can lead to a calm mind and settled intent, allowing clear and empty energy to increase day by day. It is also said: Frequently invite knowledgeable friends and relatives to discuss matters that broaden the mind and transcend worldly concerns; this is sufficient to cleanse the troubled chest and inspire aspirations. If sorrow and worry are tangled like threads, the Spirit becomes depressed internally. Depressed inside and unable to emerge, it leads to stagnation and obscurity. Sudden anger attacks like fire, causing Qi to rush upward. Rushing upward and failing to descend, it leads to distension and Jue syndrome (reversal cold/heat). Or perhaps worrying about posthumous affairs, fearing for wife and children, clinging endlessly to everything in front of eyes that is delightful and hard to part with, planning ceaselessly; none will not end up harming life and losing their destiny. Try thinking about when life is harmed and destiny lost: who can bear it for me? What object can I take with me? Su Dongpo said: "Gaining leisure due to illness is not bad; calming the mind is the best medicine." This is truly a cooling powder for patients.

2. Guard against pathogenic factors. Sexual activity without restraint depletes Essence (Jing). Labor without caution depletes strength. Excessive speech without conservation depletes Qi; this is pathogenic influence received from within. Irregular living habits allow wind and dew to invade; improper diet damages the intestines and stomach; this is pathogenic influence entering from outside. Even healthy people cannot avoid illness if they have these behaviors, let alone patients who might add such toxicity. However, patients' temperaments are often indulgent; if slightly dissatisfied, anger arises. Parents and wives, fearing to offend him, indulge him. He may be biased in certain matters and frequently violate rules. Therefore, the patient must not slight his own life, and those attending to the patient must be especially cautious, vigilant, and meticulous in every detail. If one indulges his desires, disaster is inevitable. Be extremely cautious.

3. Do not conceal illness. *The Four Essentials of Medical Practice* states: Observation (Wang), Auscultation and Olfaction (Wen), Inquiry (Wen), and Palpation (Qie) are like the four limbs of a person. If one limb is disabled, one is no longer complete as a human. If one essential method is missing, one is no longer a complete physician. However, Observation and Auscultation must precede Inquiry and Palpation because they are valued more highly than palpation alone. Yet patients do not understand this principle; they often conceal their ailments, waiting for the doctor to speak first, thereby testing the doctor's ability. They do not realize that diseases may present with similar symptoms and identical pulses, yet the actual pathology is vastly different. If the situation is not explained clearly beforehand, how can the doctor accurately diagnose by suddenly palpating the radial artery? In the past, Danxi's great-uncle, aged seventy, suffered from diarrhea with a choppy (Se) and wiry (Xian) pulse. Upon asking what he liked to eat, he replied he enjoyed carp. Danxi used Evodia Fructus (Zhuyu), Tangerine Peel (Chenpi), Ginger (Shengjiang), and brown sugar to induce vomiting of sticky phlegm, stopping the diarrhea. Another neighbor, who usually suffered from chancre (Gchuang), developed diarrhea in early summer with a similarly choppy and wiry pulse. Danxi said: "This is a severe case of lower chancre," and prescribed Danggui Luxiao Wan (Angelica and Wormwood Pill) minus Moschus (Shexiang). After four doses, the diarrhea stopped. These two cases had similar symptoms and pulses but required radically different treatments because the inquiry was detailed and the explanation clear. Furthermore, one must ask about the patient's social changes (noble to humble, poor to rich), sudden shifts in emotion (sudden joy or suffering), and their thoughts, preferences, aversions, desires, doubts, and fears. One must know the initial cause of the disease, where it originated, and how the condition changes daily, as well as whether previous medications were appropriate. Only by explaining these details thoroughly can pulse diagnosis be free of doubt and medication be effective. If one conceals information out of various taboos and silently extends an arm for the doctor to feel the pulse, forcing the doctor to guess like solving a riddle, this is treating life as a game. Wang Haicang said: "Ordinary people seeking diagnosis remain silent and only allow pulse taking. They do not know that Qi and Blood attach to the meridians; heat makes the pulse rapid, cold makes it slow, excess makes it forceful, and deficiency makes it weak. If one knows the cause of the disease and what caused the injury, how can it be known solely by the pulse?" Su Dongpo said: "I must tell my doctor everything completely, so that the doctor understands fully before taking the pulse, preventing confusion from similarities. I only seek recovery, not to perplex the doctor." These two sages had truly insightful views; patients must know this.

4. Attend to minor illnesses. If medication is taken while the illness is minor, it is easy to cure. If treatment begins when the illness is half-developed, only three out of ten will recover. If treatment begins when the illness is seven or eight parts advanced, less than one out of ten will recover. In the past, Pan Manru, the Grand Commandant of Qi, suffered from lower abdominal pain. Cang Gong diagnosed: "This disease resulted from drinking alcohol and engaging in sexual intercourse. The Grand Commandant did not restrain himself sexually. Twenty-eight days later, he will pass blood in urine and die." After twenty-five days, he indeed passed blood in urine and died three days later. Wang Zhongxuan was twenty years old. Zhang Zhongjing told him: "You have a disease; at forty, your eyebrows will fall out, and you will die six months later." He prescribed Wushi Tang (Five Minerals Decoction) for him to take to avoid this. A few days later, Zhang asked again. Wang lied, saying he had taken the decoction. Zhang said: "Your complexion does not match the signs of having taken the decoction; why do you slight your life?" Later, when the time came, it happened exactly as predicted; his eyebrows fell out, and he died. Nowadays, people infected with disease do not cherish themselves, ignore medical advice, and neglect the initial stage. Only when the condition becomes severe do they panic, ultimately dying without hope. Alas! It is too late.

5. Be cautious with medicines. There are three vulgar habits among patients' families. First, believing in shamans and witches, slaughtering animals extensively, praying to ghosts and gods, while delaying medical treatment and entrusting decoction and administration to unqualified persons. Second, lacking understanding of pharmacology, changing doctors morning and night, causing the source and flow of the disease to become unclear, mixing good and bad advice, randomly administering mixed prescriptions, and not knowing whom to follow. Third, claiming to know medicine, sticking rigidly to personal opinions, arbitrarily adding or subtracting ingredients, thus hindering the physician's efforts. With these three malpractices, even Bian Que could not demonstrate his skill. Those who know how to properly nourish themselves will understand this.