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The Way of medicine is great, and the responsibility of a physician is heavy. Physicians of middle-to-high caliber are hard to find within a thousand miles or across a century; those of the highest caliber are so rare throughout history and under heaven that they can be counted on one's fingers. How numerous are those in the world who speak of practicing medicine! Those who rely on their cleverness are subjective and arrogant, selecting treatments without precision; although they may succeed occasionally, their failures are also frequent. Those who stick rigidly to their own schools draw boundaries and refuse to enter new realms, blocking their own vital mechanisms; even if they do not cause disaster, they have already erred by delaying treatment. Those skilled in heterodox methods are careless and ignorant, pursuing dangerous and extreme approaches; even if they fall into such techniques by chance, the result is as tragic as being cut by a blade. Patients suffer from physicians gathering in full courts, all claiming to be sages. The shallow succeed; the fraudulent succeed; the slick and worldly succeed, while patients' lives become their testing ground. Physicians suffer because a slight error in diagnosis leads to a thousand-mile deviation, often encountering setbacks. Prescriptions are unreliable; pulse diagnoses are unreliable; teachings from masters are unreliable, yet human lives are used as experiments. Therefore, the harm caused by diseases and afflictions is more widespread than injuries from water, fire, weapons, beasts, or laws during life. And the suffering of hell is more severe than the torments of demons, heretics, hungry ghosts, or animals after death. Because physicians lack clarity of mind and technique, they habitually follow rigid patterns, trapping patients. Thus, the whole world falls into a single rigid pattern, covering the sky and hiding the sun, creating a hell that fills the Iron Ring Mountain realm; its causes and effects are clear as day. Scriptures state that ignorance (Avidyā) is the seed of hell, shrouded in layers of darkness with no way to escape, how sorrowful is this! I, Yu Chang, close my eyes and see only darkness; yet seeing darkness is not devoid of illumination. Fishing lamps on wild banks and fireflies in desolate villages provide a sliver of faint light, which I use to embellish the millennium-long gloom of the medical field, establishing laws as a straightforward path, merely to perform Buddhist deeds. However, if this faint light can awaken the great illumination of Huangdi, Qibo, and Zhang Zhongjing, those with clear vision will find that even building a cart behind closed doors matches the tracks outside, naturally standing without fault. Even with shallow views and limited knowledge, if one understands that karma is unfailing, maintains reverence and caution, and daily expands their understanding, using this to illuminate courage, dispel confusion, and gradually enrich insight, then embracing local scenery and leaning on the balance of truth, how could one remain foolish and unclear? The ancient sage Zhang Zhongjing lived at the end of the Han Dynasty and wrote *Treatise on Cold Damage and Miscellaneous Diseases* (*Shanghan Zabing Lun*). At that time, Buddhism had just been introduced to China, lacking the flourishing branches and leaves seen later, but his spiritual light was already aligned with the Sages of the Three Times, Buddhas, and Patriarchs, walking hand in hand. He is truly the Medicine King Bodhisattva and Medicine Up Bodhisattva of the medical gate. Yet his merit and affinity were less than one hundred-millionth part of Tathagata Buddha's. After a century or two, his transmission gradually faded. Later generations could not trace the source, yet they competed in speculation, displaying varying degrees of insight, which is but a glimpse of the infinite influence of spiritual light. Tathagata Buddha, over countless kalpas, served as the Great Physician King, prescribing formulas according to illness and administering medicine randomly to save all sentient beings. In his final life, he supplemented his complete and perfect nature with eighty-four thousand dharma doors, each thoroughly clear. All sentient beings who caught even a glimmer of light could deeply enter through any one door, achieving Buddhahood. Their lights interpenetrated with the immeasurable Buddhas and Bodhisattvas of the past, future, and present throughout the void and dharma-realm. Regarding the original vows and practices of these Buddhas and Bodhisattvas, and the sutras, mantras, and verses proclaimed over countless kalpas, all subtle meanings were manifested in the light, fully completing Nirvana. Later, Venerable Ananda attained the fruit of non-learning, having knowledge and vision identical to Tathagata Buddha, and thus compiled the Tripitaka and twelve categories of scriptures, serving forever as the eye of humans and devas, a ferry for salvation. The true and ultimate meaning of Buddhas and Bodhisattvas was proclaimed from the Golden Mouth of the Tathagata, collected by the hands of Ananda. If I, Yu Chang, possess innate luminosity, flowing into ink and brush, it is sufficient to reveal to learners. Why not purify oneself, clearing the yin within organs, leisurely sitting, filled with the magnitude that shines like heaven and earth, ancient and modern? Directly merging lights with Huangdi, Qibo, and Zhang Zhongjing, proclaiming profound meanings instantly without deficiency or surplus, yet daily playing with guides, entangling in thorns and vines, comparing strengths and weaknesses with former sages, running fifty or a hundred steps, there is no greater difference in direction than this. The draft for printing was revised ten times, and the printed blocks changed four times, fearing that ordinary knowledge would mix with sage knowledge, patching fine brocade with rotten cotton, yet ultimately unavoidable. As for the six qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and various miscellaneous syndromes, exhausting a lifetime's effort cannot fully address them; even exhausting a thousand lifetimes' efforts cannot fully address them, which can be inferred. Reaching the end of the path and turning back, severing conscious thought, directly returning to Chan (Zen), sweating profusely—how dangerous! How dangerous! How dare I casually speak of different paths leading to the same goal? This major case awaits supplementation when possible.
On the auspicious first day of the first month of the 15th year of Shunzhi, Yu Chang, courtesy name Jiayan, an old man from Nanchang, aged seventy-four, wrote the preface.