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Chai Hu (Bupleuri Radix) and Huang Qin (Scutellariae Radix) appear similar in efficacy. Whether the fever stems from external contraction, internal injury, yin deficiency, or middle cold is not investigated; it is merely stated that these are symptomatic antipyretic herbs.
Just as for headache, Chuan Xiong (Ligustici Chuanxiong Rhizoma) and Ben Cao (Ligustici Sinensis Rhizoma) are used due to their apparent similarity. Whether the pain is caused by wind-cold, blood deficiency, floating yang ascending to the top, or severe headache of yin syndrome is not investigated; it is merely stated that these are symptomatic analgesic herbs.
For example, for abdominal distension, Zhi Ke (Aurantii Fructus) and Hou Po (Magnoliae Officinalis Cortex) are used due to their apparent similarity. Whether the distension is due to food stagnation, spleen deficiency, cold coagulation with qi binding, or drum-like distension due to yin water accumulation is not investigated; it is merely stated that these are symptomatic distension-relieving herbs.
Similarly, for thirst, Mai Dong (Ophiopogonis Radix) and Hua Fen (Trichosanthis Radix) are used due to their apparent similarity. Whether the thirst is caused by excess heat, deficient fire, yang pathogen entering the stomach, yin pathogen entering the kidney, or qi deficiency with lack of fluids, kidney deficiency with failure of water to ascend, is not investigated; it is merely stated that these are symptomatic thirst-treating herbs.
Such examples are too numerous to enumerate. How can one know that ancient physicians employed varied methods in prescribing? There are cases where a prescription appears mismatched but is actually appropriate, going beyond mere superficial resemblance. For instance, treating upper diseases by targeting the lower, or lower diseases by targeting the upper: if one uses upper-body herbs for upper diseases and lower-body herbs for lower diseases, it is merely superficially correct but fundamentally flawed. There are cases of treating yin through yang, or yang through yin: if one uses yang-tonifying herbs for yang syndromes and yin-nourishing herbs for yin syndromes, it is again superficially correct but fundamentally flawed. There are cases of "treating obstruction with unblocking agents" (Tong Yin Yong Tong) and "treating retention with astringent agents" (Sai Yin Sai Yong): if one uses purgatives for constipation and astringents for diarrhea, it is even more superficially correct but fundamentally flawed. Regrettably, many practitioners do not seek the truth but only pursue superficial similarity, because the truth is unknown to people, while superficiality is easily understood. Thus, once they achieve this superficial correctness, doctors pride themselves on their acumen, patients believe firmly in their efficacy, bystanders cannot see the error, and other physicians cannot point out the mistake. This concept of "similarity" deceases easily, confuses the world, caters to vulgarity, and steals reputation. Who would realize that when herbs have no relation to the disease, this is a form of "similarity"; when herbs are contrary to the disease, this is another form; when herbs fail to cure the disease but exacerbate it, this is yet another form; when herbs intended to save life instead hasten death, this is also a form. The harm caused by such "similarity" is incalculable! This situation regarding drugs appearing to match symptoms requires urgent medical attention.

One physician treated diseases by curving to accommodate human sentiments. A physician may be favored by patients, praised by bystanders, and warmly received by fellow doctors, yet this is actually a major malpractice in medicine: accommodating human sentiments. Patients hardly understand medicine; upon falling ill, they suspect wind or fire. How should patients know drug properties? They tell the doctor that dispersing or clearing methods are suitable. To win the patient's favor, the doctor accepts what is not necessarily correct as correct, and what is not necessarily suitable as suitable. This is accommodating the patient's sentiment. When relatives or friends visit to inquire about the condition, they often boast of their medical knowledge and offer opinions. The doctor then praises their brilliance excessively, humbly consulting before prescribing, and modifying the prescription according to their commands after prescribing. This is accommodating the bystander's sentiment. Recent physicians regard drifting with the tide as a good method and conforming to corruption as being timely. They do not seek actual effectiveness for the patient's family but only wish to avoid criticism from other doctors. This is accommodating the professional community's sentiment. Why do they accommodate the sentiments of patients, bystanders, and colleagues? Essentially, the doctor seeks financial gain from the patient. If they offend the patient's sentiment, the patient will claim the doctor is stubborn and inflexible, leading to alienation. The doctor relies on bystanders' recommendations for promotion. If they offend bystanders, they will be labeled as biased and arrogant, refusing to recommend them. Doctors also seek mutual endorsement. If they offend peers, they will be hated for exposing others' faults and highlighting their own strengths, leading to slander, loss of reputation, and loss of profit. Hence, they must accommodate human sentiments. However, I advise practitioners: if your knowledge is profound, principles clear, diagnosis accurate, and prescriptions appropriate, truly capable of reviving the dying and saving critical lives, why not stand firm? Each prescription and herb should be unwavering like a mountain. Follow the usage for life, deviate for death. Patients will express endless gratitude, bystanders will sigh in admiration, and even jealous colleagues will find no grounds for slander. Why compromise and maneuver to secure clients, seek recommendations, and avoid slander? Unfortunately, many doctors lack卓越 insights and fear offending others. Seeking self-interest, they drift with the wind, flatter, and comply, merely imitating the ways of worldly women. This pathology of accommodating human sentiments requires urgent correction. (From *Yi Yan Lu*)

Being a physician is difficult, but being a famous physician is even harder. Why? Famous physicians command high reputations and fees, making them hard to engage. Even if one has the means to hire them, there is a risk of missing the opportunity or finding them residing far away, inaccessible day or night. Therefore, minor illnesses are neglected initially. Only when the disease becomes critical, prolonged, and after multiple failed treatments by various doctors, resulting in irreversible damage, do patients seek out famous physicians. Do these famous physicians truly possess the art of bringing the dead back to life? Families ignorant of this logic assume that such great fame implies miraculous powers. If they were helpless like ordinary doctors, how would they differ from anyone else? Consequently, expectations rise, and demands become heavier. If the disease is inevitably fatal, the physician clearly states the reasons for incurability and predicts the time of death, leaving quietly to avoid blame. If there is a sliver of hope amidst certain death, using mild remedies to shirk responsibility causes inner unease; using heavy remedies for a last-ditch battle risks adverse reactions, triggering waves of criticism where all blame for previous errors falls on the current physician. Although the physician explains this clearly when prescribing, public opinion judges right and wrong by success or failure. Having died after taking the prescribed medicine, the blame cannot be shifted! Furthermore, after recovery from severe illness, vital energy is depleted, and residual pathogens remain hidden. Post-recovery care requires deep study. Families unaware of proper recuperation may suffer relapse, still blaming the doctor for inadequate follow-up. Such cases are numerous. Thus, famous physicians face twice the difficulty of ordinary ones. Knowing this difficulty, one must be extremely cautious. Patients and bystanders should also show understanding. However, there are also contemporary physicians who gain empty reputations and err everywhere, yet patients say, "This person could not cure me; it is fate." There is the reality of causing harm without the reputation of killing. This implies some hidden, cunning methods at play, outside normal circumstances. (Xu Lingtai)

I have seen a physician prescribe "Xiao Cao" (Herba Polygalae), which pharmacists did not recognize as the seedling of Yuan Zhi (Polygalae Radix), but rather used the small part of Gan Cao (Glycyrrhizae Radix). Another physician prescribed "Shu Qi" (Ramulus Daphnes Genkwa), which pharmacists did not recognize as the seedling of Chang Shan (Daphnes Genkwa Cortex), but added Gan Qi (Dry Lacquer). Examples include writing Yu Zhu (Polygonati Odorati Rhizoma) as Wei Rui, Ru Xiang (Olibanum) as Xun Lu, Tian Ma (Gastrodiae Rhizoma) as Du Yao Cao, Human Milk as Pan Tao Jiu, Pigeon Droppings as Zuo Pan Long, and Zao Xin Tu (Caulis Argillae Rubra) as Fu Long Gan. These are too numerous to list. Although classical texts use ancient names, practical usage should be common. If one seeks novelty and eccentricity, causing confusion among others, errors are inevitable in emergencies. Additionally, some physicians excel in cursive script. While illegible case notes may not cause serious issues, illegible herb names pose problems. Pharmacists cannot all read cursive script. Rash individuals may approximate the names and cause delays; careful individuals may ask repeatedly, causing further postponement. Is it possible to agree among colleagues that prescriptions should be written clearly, and herb names universally understood? (From *Wu Yi Hui Jiang*)