胆欲大而心欲小,此孙真人祝医最确之语也。窃谓治初起之轻证,必须细心,当辨其孰为风而用疏,孰
为寒而用温,孰为暑而用清,孰为湿而用利,孰为燥而用润,孰为火而用泻。尤当审其体之虚实,病之新久,
在女子兼询经期,妇人兼详胎产,如是者,则用药庶无差忒矣。倘粗心而不细者,大意茫茫,不分六气所
感何气,动手便用荆、防,病家告之有痰,遂投陈、夏,
有食遂用神、楂,问其何病,指鹿为马,问其轻重,总说无妨,往
往使轻浅之病,日渐延深,是谁之过欤?圣人云∶不忽于细,必谨于微。其可略乎!至若垂危之重证,必
须大胆,见心包邪窜者,当宣则宣;肝风内动者,当平则平;脾虚气陷者,当培则培,肺气欲绝者,当补
则补;肾液欲涸者,当滋则滋。更有危险之虚证,速宜用参、 之属;实证用硝、黄之属,寒证用姜、桂之
属,热证用犀、羚之属,勿宜迟缓,亟亟煎尝,如是者,则沉 庶有挽救矣。倘胆小而不大者,当用而不敢
用,或用而不敢重,重用恐其增变,变证恐其归怨,往往姑息养奸,坐观其败,是谁之过欤?古人云不入
虎穴,焉得虎子。其可惧乎!若果轻浅之证,过于胆大立方,不啻小题大做;沉重之证,过于小心慎药,
无异杯水车薪。其实胆大而不细心,所谓暴虎冯河者,误事也;细心而不大胆,所谓狐疑鼠
首者,亦误事也。诚哉孙氏之言,足为千古之医训矣!
"The gallbladder should be bold, but the heart [mind] should be cautious." This is Sun Simiao (Sun Zhenren)'s most accurate statement regarding medical practice. I hold that in treating mild conditions at their onset, one must be meticulous. One must distinguish whether the pathogen is Wind and use dispersing methods; Cold and use warming methods; Summerheat and using clearing methods; Dampness and using draining/diaphoretic methods for dampness; Dryness and using moistening methods; or Fire and using purging methods. Furthermore, it is crucial to examine the patient's constitution (deficiency or excess) and the duration of the disease (new or old). For women, inquire about the menstrual cycle; for married women, detail pregnancy and childbirth history. By doing so, medication will likely avoid errors. However, if one is careless rather than meticulous, vague and indifferent, failing to distinguish which of the Six Qi (Six Pathogenic Factors) has affected the body, and immediately prescribing Jingjie (Schizonepetae Herba) and Fangfeng (Saposhnikoviae Radix); if the family reports phlegm, then administering Chenpi (Citri Reticulatae Pericarpium) and Banxia (Pinelliae Rhizoma); if there is food stagnation, using Shenqu (Massae Fermentatae Medicinalis) and Shanzha (Crataegi Fructus); when asked about the disease, confusing right and wrong (pointing at a deer and calling it a horse); when asked about severity, claiming it is harmless—this often causes mild, superficial diseases to deepen day by day. Whose fault is this? The Sages said, "Do not neglect the subtle, but be cautious in the minute." Can this be overlooked! As for critical, severe conditions approaching death, one must be bold. If the Pericardium (Xinbao) is invaded by pathogens, one must unblock when appropriate; if Liver Wind is stirring internally, one must pacify when appropriate; if Spleen deficiency leads to Qi sinking, one must tonify when appropriate; if Lung Qi is on the verge of collapse, one must supplement when appropriate; if Kidney fluids are about to dry up, one must nourish when appropriate. In cases of dangerous deficiency syndromes, quickly use herbs like Renshen (Ginseng Radix et Rhizoma); in excess syndromes, use Xiaoshi (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma); in cold syndromes, use Jiang (Zingiberis Rhizoma) and Guizhi (Cinnamomi Ramulus); in heat syndromes, use Xijiao (Rhinocerotis Cornu) and Lingyangjiao (Saigae Tataricae Cornu). Do not delay; hastily decoct and administer. By doing so, even deep-seated illnesses may have hope of rescue. However, if one is timid rather than bold, afraid to use necessary treatments, or afraid to use heavy doses, fearing that heavy doses will cause adverse changes, and fearing that adverse changes will lead to blame, one often indulges the disease (tolerating evil), sitting idly by watching defeat. Whose fault is this? The ancients said, "If you do not enter the tiger's lair, how can you get the tiger's cub?" Is there any reason to fear? If a mild condition is treated with excessive boldness in prescription formulation, it is akin to making a mountain out of a molehill; if a severe condition is treated with excessive caution in medication, it is akin to pouring a cup of water onto a cartload of burning firewood. In reality, being bold without being meticulous is like "fighting a tiger bare-handed and crossing a river without a boat" (acting rashly), which leads to failure; being meticulous without being bold is like "being as suspicious as a fox and hesitating like a mouse," which also leads to failure. Indeed, Sun's words are true and serve as an eternal medical maxim!