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Treating diseases is like putting out a fire; one must have well-prepared instruments, work with united hearts and efforts, and handle the situation properly. Success will naturally follow, depending entirely on the physician. Those who fail to achieve this likely suffer from ten major deficiencies, which are listed below.

First is "lack of differentiation." Yin and Yang, Qi and Blood, Exterior and Interior, Deficiency and Excess, Cold and Heat—these ten characters constitute the guideline for physicians. External pathogens such as Wind, Cold, Summerheat, Dampness, Dryness, and Fire (Six Evils), as well as internal injuries caused by overwork, diet, and the Seven Emotions, must be analyzed precisely for treatment to be effective. If one is confused in mind, treating only the headache when the head hurts, or only the sore legs when the legs ache, this is indeed unworthy of mention among crude practitioners.

Second is "imprecise differentiation." Regarding the Six Evils, although one knows it is an external contraction, one may not clearly distinguish which pathogenic factor has injured the body and which meridian has been affected. For instance, knowing that headache and aversion to cold indicate a common cold (Ganmao), one might fail to recognize that latent pathogens manifesting without typical exterior symptoms should still be treated by inducing sweating to disperse them. Such cases are too numerous to enumerate. Failure to differentiate accurately is no different from having no differentiation at all.

Third is "excessive caution." Sun Simiao stated, "Be cautious yet bold." This is sound advice, as both qualities are complementary and inseparable. However, being overly cautious can also lead to errors. For example, if excess heat requires clearing, a cup of water cannot extinguish the fire on a cartload of firewood; if interior urgency requires purging, a weak crossbow cannot shoot down a high-flying goose. Some physicians, seeing that water cannot control fire, conclude there is no fire; seeing that arrows miss birds, they assume the target is too far away. Consequently, they change their approach, losing previously gained therapeutic effects, which is truly lamentable.

Fourth is "carelessness and boldness." Due to a lack of study in ordinary times, physicians forget the root when dealing with symptoms. A physician once treated a case in early summer where the patient presented with aversion to wind, spontaneous sweating, headache, and a slow pulse. He prescribed Guizhi Tang (Cinnamon Twig Decoction) without hesitation, resulting in the patient's death after ingestion, while claiming this was a clear principle of treating Cold Damage (Shanghan). He failed to realize that between the Frost Descent solar term and the Spring Equinox, latent Summerheat or latent Cold Yang syndromes may present with identical symptoms, let alone those caused by non-seasonal factors.

Fifth is "fabricating terminology." Although diseases vary greatly, they share a unified origin. Regardless of how complex they become, one must trace them to their source. If encountering something difficult to explain through logic, one should honestly admit uncertainty and refer the patient to more capable colleagues, rather than pretending to know what one does not or inventing terms to justify chaotic treatments. Since few patients understand medicine, the physician must not deceive himself.

Sixth is "rigidity and inflexibility." Holding biased views is certainly harmful; even citing appropriate precedents requires considering differences in local climate and seasonal variations. Differences in diet (rich vs. plain food) and constitution mean that rigidly adhering to established formulas often leads to flaws. Therefore, ancient sages compared using fixed prescriptions for current diseases to dismantling old materials to build a new house—it requires skilled craftsmanship. This flexibility is called "round-mindedness" (Yuanji).

Seventh is "impatience leading to failure." In cases of abdominal distension (Peng Zhang), distinctions must be made regarding deficiency/excess, cold/heat, Qi/blood, water retention, and parasites. Among these, deficiency and cold types are the most difficult to treat, requiring multiple doses per day for several days to show improvement. Physicians must explain to impatient patients that fewer doses will be ineffective, but after 20–30 doses, results will appear, earning their trust and facilitating recovery. Physicians must avoid being flexible when they should be firm, or rigid when they should be flexible. When encountering such conditions, lacking true insight and seeking quick results often leads to abandoning tonification for harsh purgatives or vice versa, causing failure. Conditions like stroke, bi-syndrome, and flaccidity syndromes result from gradual accumulation of Zang-Fu deficiency and require slow, steady treatment. Impatience often leads to poor outcomes.

Eighth is "greed damaging virtue." Diseases affect both rich and poor alike. However, those engaged in manual labor are more susceptible to pathogens. For instance, epidemic febrile diseases often arise among those suffering from hunger, cold, and overwork; chronic malaria and dysentery are also common among farmers. As the saying goes, "Where evil gathers, Qi must be deficient." Having practiced medicine for years, I have treated mostly impoverished people whose access to medicine is difficult. Expecting financial回报 from them is unrealistic. Instead, one must ask questions carefully, speak gently, and offer comfort. harboring disgust or neglect towards them damages medical ethics significantly.

Ninth is "arrogantly claiming ability." Sun Simiao, a great master of the Tang Dynasty, would ask detailed questions, sometimes dozens of times, until he fully understood the condition before proceeding. Why do later generations act foolishly, attempting to determine infinite diseases based on the subtle and hard-to-describe pulses of the three positions? Unless one is shallow and ignorant, one must follow the teachings of ancient sages.

Tenth is "wasting spirit and energy." The way of medicine prioritizes preserving life; one cannot establish others if one cannot establish oneself. The chapters on regulating spirit according to the Four Seasons in the *Neijing* emphasize nurturing and cultivation. Therefore, practitioners should远离 alcohol, lust, wealth, and anger, avoiding anything that consumes heart and spirit. By cultivating mental clarity, reading and reflecting in leisure, and approaching clinical practice with sincerity and wisdom, one can focus deeply on difficult cases and strive for success. Only then is it considered a benevolent art. Compared to those distracted by trivial matters and superficial intentions, the difference is vast.