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In the autumn of the Bingchen year, the second son of a merchant named Jia in Chuqiu County, aged twenty-seven, suffered from fatigue and heaviness in the four limbs, irritability with spontaneous heat and sweating, shortness of breath, reduced appetite, coughing with phlegm-saliva, discomfort in the chest and diaphragm, constipation, and emaciation. Over the course of a year, he was treated by several physicians without recovery. Some said, "A 'Fortunate Doctor' is superior to a 'Clear-Sighted Doctor.'" There was a physician in a certain place who, although not proficient in formularies or pulse diagnosis, had seen many cases and achieved success in all treatments; people called him a "Fortunate Doctor." A proverb goes: "No matter how much you read Wang Shuhe (author of *Mai Jing*), it is not as good as having seen many diseases." This seemed quite credible. Thus, they tried to have him treat the patient.

Upon arrival, the physician examined the pulse and said, "I am well acquainted with this disease; treatment will certainly be effective." He applied moxibustion, thirty-seven moxa cones (21 cones) on each of the Feishu (BL13) acupoints, and administered Juan Yin Zhi Shi Wan (Phlegm-Dispelling Aurantium Pill) to resolve phlegm and guide out stagnation. After just a few doses, the patient experienced profuse loose stools, abdominal pain, inability to eat, and his condition became increasingly critical. His son said to his father, "The patient has been ill for a long time, is thin and weak, and cannot tolerate such medication. The disease worsened, and he eventually died."

In winter, upon returning from military service, Mr. Jia told me about this incident. I said, "Reflecting on the words of the *Neijing* (Inner Canon): 'When both physical constitution and vital energy are insufficient, and the pathogenic factor is also insufficient, this indicates a deficiency of both Yin and Yang.' If one applies purgative methods, it leads to double deficiency, causing exhaustion of Yin and Yang, depletion of blood and Qi, emptiness of the five zang organs, and withering of sinews, bones, and marrow. The elderly may perish, and even the vigorous may not recover. Therefore, it is stated that deficiency should be tonified. This is the principle. Your son's prolonged illness and emaciation indicate a deficiency of physical form; shortness of breath indicates a deficiency of Qi; lethargy during episodes, heaviness in the limbs, and reluctance to speak indicate a deficiency of both Blood and Qi. One should tonify, fearing insufficiency, yet instead, toxic agents were used to purge, making the deficient more deficient and the damaged more damaged. How could he not die?" Mr. Jia sighed and left.

Moved by this event, I briefly expound on its rationale. A skilled physician, before curing an illness, first examines the climatic influences of excess or deficiency in the seasons, observes differences in individuals' blood, Qi, diet, courage, and timidity. Diseases differ in excess or deficiency, superficiality or depth, involvement of meridians or zang organs. Medicines follow the principles of sovereign, minister, assistant, and courier roles, size, and odd/even formulations. Treatments adhere to principles of slowness or urgency, following indications, guiding mechanisms, and restoring correctness. Sun Simiao said, "Anyone serving as a Grand Physician must be proficient in the *Jia Yi Jing*, *Su Wen*, *Huangdi Zhenjing*, *Mingtang Liuzhu*, twelve meridians, three positions and nine inspections, five zang and six fu organs, interior-exterior acupoints, Materia Medica, drug pairs, and the classical formulas of Zhang Zhongjing and Wang Shuhe. Furthermore, one must master the Five Elements and Yin-Yang, and be familiar with the *Zhouyi*. Only then can one serve as a Grand Physician. Otherwise, it is like wandering at night without eyes, inevitably leading to disaster. Just as those who correct the five tones must take Shi Kuang's pitch pipes as standard to rectify the tones, and those who make squares and circles must take Gongshu Ban's compass and square to form them, these are merely minor skills, yet still require experts. How much more so medicine, which governs human life, ranks among the four disciplines, and is not comparable to tones or shapes? Without mastering medicine, understanding pulses, studying classics and materia medica, but relying merely on luck to claim the title of 'Fortunate Doctor,' and letting patients entrust their lives to incompetent hands—is this not painful? Alas! A doctor's 'fortune' lies in his own fate. How can his personal fortune eliminate the patient's calamity? People who fail to understand this principle and entrust their lives to 'Fortunate Doctors,' resulting in injury and death, never waking from this delusion. This is extreme confusion. How sorrowful."