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[Scriptural Principles]
Those who are constrained by ghosts and spirits cannot be spoken to regarding the highest virtue; those who detest needles and stones cannot be spoken to regarding the highest skill. If a patient does not permit treatment, the illness will certainly not be cured, and any attempt at treatment will yield no merit. (From *Suwen*)
What the Master was cautious about were: fasting, war, and disease. (From *Analects*)

[Philosophical Sayings]
Humans inherit their physical form from their ancestors, possessing an eight-foot body, yet if they do not understand medical affairs, they are merely wandering souls! Although they may have hearts of loyalty and filial piety, and natures of kindness and compassion, they have no means to save themselves. (Huang Fumi)
Master Cheng said: "To lie sick in bed and entrust one's life to mediocre doctors is equivalent to being unfilial and unkind. Those who serve their parents must know medicine." (From *Zhu Xi's Remnant Writings*)
The heart to care for the young is easily aroused by people; the heart to respect the old is sometimes obscured by them. If one loves parents as one loves children, then everyone would be like Zeng Shen (a famous filial son). (Han Feixia)
When I am ill, I must tell the doctor everything, so that he understands clearly in his mind, and then verify with pulse diagnosis. Nowadays, some people use pulse diagnosis to test doctors, which is like testing medicine on one's own body. (Su Dongpo)
Ban Gu said: "Having an illness but not treating it is considered medium-level handling. If a mistake is made with even one herb, regret will come too late. The ancients said: 'A clumsy doctor treating an illness is better than no treatment.' This shares the same meaning." (From *Medical Beginner*)
Medicines are both great benefits and great harms to human life. If one does not encounter a good doctor, it is better not to take medicine. Regret from error without medicine is small; regret from error with medicine is large. ○ What patients should avoid, besides wine, sex, labor, diet, and all routine prohibitions, are two major taboos: first, mistaking false illness for real illness and being anxious all day long; second, seeking quick effects and lightly using medicines. I strictly observed these warnings during my illness, but failed only in these two aspects, which is why my illness lasted long. Be cautious! (From *Records of Broken Arm*)

There are six types of illnesses that are difficult to cure (Six Untreatables): Arrogance and indulgence without regard for reason, this is the first untreatable; Lightly valuing the body and heavily valuing wealth, this is the second; Inability to adapt clothing and food, this is the third; Yin and Yang are disordered and organ Qi is unstable, this is the fourth; The body is emaciated and unable to take medicine, this is the fifth; Believing in shamans but not in doctors, this is the sixth. If any one of these exists, the illness is heavy and difficult to treat. (From *Records of the Grand Historian*)

1. Generating excessive worries, lightly valuing the body and heavily valuing wealth; 2. Indulging in diet, not observing medical advice; 3. Listening to gossip, excessively seeking quick effects; 4. Only demanding prescriptions, arbitrarily adding or subtracting herbs, using poor quality herbs, and incorrect methods for decocting or making pills; 5. Relying solely on prayers and sacrifices, mixing doctors and shamans, failing to recognize the illness and failing to choose a doctor; 6. Negligent diagnosis, medication not matching the illness, concealing illness and avoiding doctors, confusing tonification and purgation; 7. Capricious and inconsistent, changing doctors frequently, experimenting with drugs to cleanse the intestines and stomach; 8. Family members creating noise and obstacles, and when the condition deteriorates, blaming others with slander; 9. Treating life-threatening conditions as trivial, daring not to consume heavy doses that could save lives; 10. Failing to investigate the root of the illness, loving cooling substances, making arbitrary judgments, and delaying time. (Luo Fengshi)

One common saying: "I have a 'Fire Constitution' and absolutely cannot use tonics." This saying has caused many deaths. One has only heard of Feng Shui masters distinguishing forms of Metal, Wood, Water, Fire, and Earth, but never heard of patients distinguishing constitutions of Metal, Wood, Water, Fire, and Earth. Moreover, there is no mention of people having Metal, Wood, Water, or Earth constitutions; how can there be exclusively a "Fire Constitution"? The organs in the human body each correspond to Yin-Yang and the Five Elements. How can there be a constitution dedicated solely to Fire? I hope patients and doctors carefully examine the logic and do not stick to vulgar sayings, thereby harming themselves and others. ○ Another vulgar saying: "Although the syndrome is deficiency, it cannot be tonified." Patients believe this deeply, unaware that the statement is self-contradictory and ridiculous. If the illness is not deficiency, fine; since it is deficiency, it should be tonified. How can it be said that it cannot be tonified? It is like someone suffering from hunger and cold; naturally, warmth and food should be provided. To say one is hungry and cold but cannot be warmed or fed—does such logic exist? Presumably, the intent is that deficiency accompanied by fire means tonification is forbidden. However, deficiency with fire is indeed deficient fire, and tonification is precisely indicated. Tonifying restores deficiency, and the fire naturally subsides. Danxi said: "Excess fire can be drained, using herbs like Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian); deficient fire can be tonified, using herbs like Ginseng Radix et Rhizoma (Renshen) and Cinnamomi Ramulus (Guizhi)." I hope physicians first examine the illness, then prescribe medication. Once confirmed as a deficiency illness, they should confidently use tonification. Whether there is fire or not, tonification is required; one only discusses deficiency, not fire. Tonifying the deficiency causes the fire to recede. Why do doctors fail to examine deficiency and excess, clinging to the three words "cannot be tonified," much like the fabricated charge of "perhaps there is," thus convicting deficiency patients and letting them die in prison without rescue? This is truly pitiable. ○ Yet another vulgar saying: "Children possess pure Yang and must not be tonified." Adhering to this vulgar saying has killed countless people. Medication should be based on syndromes, not age. If excess syndromes do not require tonification, even an eighty-year-old should not receive it; if deficiency syndromes require tonification, even a half-year-old infant should receive it. Furthermore, infants have fragile constitutions and easily become deficient. Mr. Xue Lizhai said: "Infants are prone to both deficiency and excess." These four words are excellent. For example, slightly overeating leads to internal injury, and touching wind-cold leads to external contraction; this is prone to excess. Slightly overusing digestive herbs weakens the Spleen, and neglecting sweating leads to incessant perspiration; this is prone to deficiency. Generally, infants' Qi is not full, Blood is not vigorous, bones are not solid, and flesh is not filled. Their Spleen and Stomach are weak, and Zang-Fu organs are empty. It is like fruits before maturity: the pits are soft, and the kernels inside are like liquid. Or like an old tree trunk, which is hard to damage with an axe; but a new tender branch breaks easily with a slight touch. Who is excess and who is deficiency is clearly distinguishable. Alas, ignoring this fragility and arbitrarily using clearing or dispersing methods leads to extreme deficiency, causing fever, phlegm surging, vomiting, and diarrhea, gradually forming Slow Spleen Wind. With Spleen Qi scattering and nearly extinguished, using herbs like Calculus Bovis (Niuhuang) and Zi Xue San to drain and suppress—can there still be vitality? ○ Another vulgar saying: "Fuzi (Aconiti Lateralis Radix Praeparata) is toxic and cannot be used." Do you not know that all attacking medicines are toxic, not just Fuzi. *Zhou Li* records collecting toxic medicines on the Winter Solstice to attack diseases. *Neijing* discusses treating diseases with great toxicity, common toxicity, and slight toxicity. Bian Que said: "I save people with toxic medicines." Essentially, non-toxic items cannot attack diseases; only those with toxicity possess great power. For deep-seated cold and chronic cold, or Taiyang Cold Damage involving Yin syndromes, only Fuzi can drive out Yin and restore Yang. Thus, *Bencao* praises its ability to break through gates and capture generals, and its merit of retrieving the soul. Today, people forbid its use simply because of the word "toxic," leaving patients with Yin-cold syndromes without hope for recovery. Moreover, when ill, the disease absorbs the medicine, and there is no surplus property to act as poison elsewhere. Even if toxic, it allows life; is it not better to live with toxicity than to die without it? ○ Another vulgar saying: "In summer, one must avoid Gui Zhi (Cinnamomi Ramulus), Fu Zi (Aconiti Lateralis Radix Praeparata), and other acrid-hot medicines." If this were true, treating illness would not require examining syndromes, only the seasons. In summer heat, use cold-cool medicines; in winter cold, use warm-hot medicines; in spring and autumn, use neutral medicines. Is this logical?
For instance, in deep winter, if Cold Damage transmits to Yin syndromes, treatment uses Shigypsum (Shigypsum), Dahuang (Rhei Radix et Rhizoma), and Chengqi Tang. Would one avoid cold-cool medicines just because it is winter? Summer inherently contains hidden Yin within, and people often eat cold foods, bathe in cold water, or expose themselves to coolness to seek relief. Therefore, Yin-cold syndromes are more common in summer. Should we avoid warm-hot medicines for summer Yin-cold syndromes and watch them die? Summer malaria and dysentery often involve mixed Yin syndromes, requiring the same treatment as Cold Damage Yin syndromes; only warm-tonification can save them. How much more so for direct invasion of the Yin meridians? Without Gui Zhi and Fu Zi, what else can be relied upon? People simply cannot distinguish, so they only know to avoid warm-hot medicines. They do not realize that cold-cool medicines kill as easily as turning a hand. Often, treating mixed Yin malaria/dysentery follows the method for pathogenic malaria/hot dysentery, directly killing the patient with Huangqin, Huanglian, and Dahuang. Encountering central Yin-cold syndromes, instead of recognizing summerheat, they claim heat reception, directly killing with Baihu Tang or Xiangru Yin. Acrid-hot medicines should indeed be avoided, but should cold-cool medicines also be avoided since they kill? ○ Another vulgar saying: "Treating severe illness requires probing with medicine first, showing boldness and carefulness." I argue this is neither bold nor careful, but blind. Consider a blind beggar tapping the ground with a bamboo stick to find the path, or feeling walls to find doors. Even if they find the path, they don't know if it's a pit or a ridge; even if they find a door, they don't know if it's a temple or a house. How does this compare to someone with eyesight, who sees clearly at a glance without effort? Therefore, using a probing method for illness: if probing fails, fine; if it succeeds, it is still unclear. Moreover, severe illnesses are always deceptive: great excess resembles deficiency, great deficiency resembles excess, great cold resembles heat, great heat resembles cold. Probing similarities leads to opposites of truth. Waiting to probe the truth, the previous counter-medicines are already irrecoverable. Only a physician with insight can see the patient's true condition at a glance, either purging excess greatly or tonifying deficiency greatly, hitting the target immediately, bringing immediate effect to chronic illness and immediate peace to critical illness. Is this not straightforward and satisfying? Why grope around like a blind person? Can critical conditions wait for your leisurely probing? ○ Another vulgar saying: "After childbirth, Ren Shen (Ginseng Radix et Rhizoma) cannot be taken." This is extremely illogical. From which book does it come? What evidence supports this error that misleads people? It has become common knowledge. Seeing anyone use Ren Shen to save a postpartum woman, crowds oppose it, watching her die until the end. They say Ren Shen cannot be taken postpartum because it might tonify and trap lochia, preventing its discharge. Do they not know that when Qi moves, Blood moves; when Qi stagnates, Blood stagnates. The reason for Qi stagnation is Qi deficiency; the reason for Qi movement is Qi prosperity. Therefore, Ren Shen must be used to tonify Qi. When Qi is prosperous, Qi moves, and lochia flows naturally. There is no logic that it will be trapped. Moreover, postpartum deficiency syndromes are numerous. The key point is not solely moving lochia; how can one ignore life for the sake of lochia? Danxi said: "Postpartum should focus primarily on greatly tonifying Qi and Blood; all miscellaneous syndromes are treated as secondary." If those with miscellaneous syndromes prioritize tonifying Qi and Blood, how much more so those with pure deficiency? Also, in *Zhengzhi Zhunsheng · Postpartum Section*, the first prescription is Danshen Tang (Single Ginseng Decoction), indicated for postpartum dizziness. Why do modern people prefer death over life, allowing postpartum women to suffer chills, fever, sweating, diarrhea, confusion, chaotic Qi, and myriad deficiency symptoms, gasping for breath, yet refusing to use Ren Shen for rescue? They favor specialized gynecologists who diagnose "Postpartum Convulsions," adding Gouteng (Uncariae Ramulus cum Uncis), Jiangcan (Bombyx Batryticatus), Qinjiao (Gentianae Macrophyllae Radix), and Tianma (Gastrodiae Rhizoma) to standard herbs like Yimucao (Leonuri Fructus) and Zelan (Lycopus Herba), making the postpartum woman more deficient. Though she wishes not to die, it is impossible. ○ Another vulgar saying: "In hematemesis, Ren Shen cannot be taken." Upon seeing blood syndromes, one immediately claims it is Fire. While one cannot say this syndrome definitely lacks Fire, one also cannot say it is entirely Fire. For laborers or those indulging in alcohol and heat, initially clearing is appropriate. After a while, with significant blood loss, deficiency arises, and it can no longer be called Fire. For delicate children of wealthy families or frail women in inner chambers, deficiency exists even before hematemesis, leading to bleeding due to deficiency. When Qi dissipates, Blood exits; when Qi is secured, Blood stops. Qi deficiency fails to control Blood, causing leakage and spurting from the mouth. Qi deficiency fails to guide Blood into collaterals, causing seepage and coughing up of blood. Therefore, not only after blood loss should one tonify Qi to generate Blood and restore what is inherent; even while blood has not stopped, one must urgently secure Qi. As stated, "In blood collapse, one must first tonify Qi." It is also said: "Formative Blood cannot be generated suddenly; Formless Qi should be urgently secured." Modern physicians treating this always claim "there is Fire." Cooling fails to stop bleeding, so they claim Lung Fire; moistening fails, so they claim Deficient Fire; nourishing fails, so they claim Qi rebellion; descending fails, so they claim removing stasis and generating new; cleansing fails, so they claim protecting the Lung and clearing Metal; protecting and clearing fail. Some claim urgent hemostasis is needed, but stopping fails and bleeding worsens. Some use great cold to ice it down, further depleting Yuan Qi and worsening bleeding. Why? Because they never obtain the method of tonifying Qi and securing Blood. Thus, people say Ren Shen cannot be used for hematemesis; I say Ren Shen must be used. People say Ren Shen should be used only after bleeding stops; I say without Ren Shen, bleeding will never stop. Waiting until bleeding ceases to discuss tonification is too late. Blood is exhausted and hard to regenerate; Qi is empty and hard to recover. Consumption syndromes form, and there is no rescue. ○ Another vulgar saying: "So-and-so's medication is stable/safe, so-and-so's illness takes medicine peacefully." Generally, medication values hitting the target, and taking medicine values efficacy. If one does not seek hitting the target but only calls it "stable," drinking soup is more stable. If one does not seek efficacy but only calls it "peaceful," drinking water is more peaceful. True stability lies in appropriate weightiness, correct tonification and purgation, appearing formidable but achieving results upon ingestion. This is true stability. True peace means severe illness reduces instantly, mild illness disappears immediately. "Peace" means the illness retreats and returns to health. This is true peace. Now it is not so. Medicines are floating and light, dosages minimal, prescriptions unstartling, and accidental ingestion harmless. This is modern "stability." I fear that nurturing goiters without itching or pain, though not harming now, will bring disaster later. People rejoice in this stability, unaware that the greatest instability lies dormant within it. Similarly, patients taking medicine experience no increase or decrease, no right or wrong, no offensive taste, no merit or fault in the abdomen. This is modern "peace." I fear that prolonged inertia allows pathogenic Qi to advance daily if not retreated, and Healthy Qi to diminish daily if not grown. People rejoice in this peace, unaware that the greatest unrest follows. ○ Another vulgar saying: "When using tonics, one must keep the thief-pathogen inside." This phrase is most persuasive and most harmful. For fresh food stagnation, Yang syndromes of Cold Damage, transmitted heat pathogens, seasonal malaria, or heat-binding dysentery, there is naturally no reason to tonify, nor will anyone recklessly tonify. The discussion here concerns not these excess pathogen syndromes, but rather Yin-excess/Yang-deficiency, Healthy-deficiency/Pathogen-encroachment, where tonification is definitely required and urgently required, without hesitation or delay. For Yin syndromes of Cold Damage, Yin-cold diarrhea, cold malaria, Three-Yin malaria, mixed-Yin dysentery, Spleen-deficiency distension, Organ-cold fullness, vomiting/diarrhea with collapse, etc., warm-tonification should be primary. When Healthy Qi is prosperous, Pathogenic Qi removes itself; when Yang Qi returns, Yin Pathogens recede. All require urgent tonification, fearing only that tonification is not early enough. A slight delay allows Pathogens to flourish and Healthy Qi to decline, Yin to congeal and Yang to extinguish, endangering life. Yet, using "keeping the thief-pathogen inside" as an excuse confuses patients, leading to death. Such vulgar sayings are truly thief-pathogens; I wish physicians would cut them with the sword of wisdom. (From *Medical Verification Records*)

[Mistakes of the Patient]
Patient mistakes: Premature planning. Initially dismissing illness, the person grows weaker daily while the illness grows stronger. Even a skilled doctor finds it exhausting.
Patient mistakes: Not speaking frankly. Concealing illness to test the doctor's skill. Only the patient knows the harm done; even famous doctors cannot guess.
Patient mistakes: Impatience. When the illness has a chance to recover, medicine must be taken. If the medicine suits, the illness clears. Changing doctors morning and night is unnecessary.
Patient mistakes: Taking medicine incorrectly. There are subtleties in taking medicine. Temperature (cold/hot) must be clear, and timing (before/after meals) has its way.
Patient mistakes: Anger. Qi rebels and rushes to the chest, yet still does not realize. Does one not know Liver Wood overacts on Spleen Earth? I wish you to nurture your nature and protect yourself.
Patient mistakes: Worry and thought. Where does depression lead? Often compare oneself to those worse off. Knowing strength, yet choosing to remain yielding.
Patient mistakes: Excessive talking. Talking damages Qi, making recovery hardest. I advise silence and sitting like a deity, preserving True Qi and nourishing True Yuan.
Patient mistakes: Contracting Wind-Cold. Wind-Cold scatters and returns. Like an incomplete city wall, how can it withstand further destruction by thieves?
Patient mistakes: Not guarding the mouth. The mouth and belly harm people everywhere. Suitable food and drink harmonize Middle Qi, allowing one to enjoy longevity like Heaven and Earth.
Patient mistakes: Lack of caution. Ignoring life in the bedroom. When life reaches peril, what can be done? Let lustful men be your mirror. (Cheng Zhongling)