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(When *Bencao Sibian Lu* (Speculative Records of Materia Medica) was just printed, a guest happened to inform me of recent medical affairs in the capital. Presuming upon my limited ability, I took this opportunity to expound upon these matters. Issues I had long wished to clarify but failed to do so were now freely discussed. Titled "Preliminary Remarks" (Xu Shuo), it is placed at the beginning of the volume, hoping that students of medicine will learn to examine carefully and direct their efforts correctly.)

Although medicine is an art, reaching profound mastery is extremely difficult. Western medicine relies on morphological theories and looks down upon our Traditional Chinese Medicine (TCM). Meanwhile, those among TCM practitioners who find it too arduous hear Western theories with great joy, mutually elevating Western medicine while suppressing TCM. They fail to realize that the Qi transformation (Qi Hua) theory demonstrated by ancient sages actually stems from a thorough understanding of morphology; conversely, how can Western anatomy, which observes morphology, possibly perceive Qi transformation? Therefore, among Western medicine in China, those capable of treating internal complex diseases and achieving widespread acclaim are rarely seen. Yet, patients do not flock to Western medicine, while practitioners wish to abandon their own learning. Now, a wild surge has arisen where people slander the *Huangdi Neijing* (Yellow Emperor's Inner Canon), *Shennong Bencao Jing* (Divine Farmer's Materia Medica), Zhang Zhongjing’s *Shanghan Lun* (Treatise on Cold Damage), and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), calling them erroneous, absurd, and baseless. How can such reckless talk shake the sacred classics that have hung like the sun and moon for thousands of years without change? The nine volumes of *Suwen* (Basic Questions) include one volume supplemented by Wang Bing (Wang Taipu). The *Lingshu* (Spiritual Pivot) is suspected by some to be fabricated by Wang Bing stealing content from *Suwen*. The modern scholar He Xichi once sat quietly counting his breaths, obtaining approximately 240 breaths per quarter-hour, arguing that the *Lingshu*'s record of 13,500 breaths per day is unreasonable. While such contents may occasionally be spurious, with *Lingshu* being inferior to *Suwen*, and *Nanjing* (Classic of Difficult Issues) inferior to both, the key lies in distinguishing them. However, the profound principles within are inconceivable, and personal verification proves them infallible. They have been revered as standards for millennia. Is this merely a peculiar obsession, or is there another hope? It is not that others are foolish while I alone am wise; this is clearly evident. Instead of discussing deepening research, we blindly follow trends and commit acts of madness. This is indeed a hidden worry for the world, worthy of deep sighs.

*Shanghan Lun* and *Jingui Yaolue* can be compared directly to the sacred classics and should not be discussed on par with other medical texts. Medical books are numerous enough to fill carts and pile up to ox-height. Roughly, 70% are inferior, 20% are medium, and 10% are superior. Superior and medium books all stem from rigorous study of the *Neijing* and Zhang Zhongjing’s works. Today, TCM is despised while Western medicine is prized, yet treatment still relies on TCM. If the superior and medium books are discarded by them, how can progress be sought in inferior books? It is impossible.

It is a habit of physicians to criticize predecessors' errors, yet they themselves cannot be without error. However, these arise from courage to defend the Way, overcorrection, or differing views on obscure meanings. There are none who, lacking scholarship and belonging to the class of wandering doctors, seeing viscera through dissection, claim the Way lies therein, daring to use irrational accusations to insult ancient emperors and sages, like Wang Qingren who wrote *Yilin Gaicuo* (Correction of Errors in the Forest of Medicine). Such behavior is supremely absurd. Let us list his arguments:

In Chapter One, "Record of Viscera," he begins by mixing Song and Yuan dynasty visceral diagrams with the *Neijing*. These diagrams are unworthy, yet citing them alongside the *Neijing* and attributing them generally to ancients shows he lacks discernment. He claims many ancient errors without explaining why. He suddenly cites *Lingshu*: "Hand Shaoyin Sanjiao governs the upper, Foot Taiyang Sanjiao governs the lower," whereas *Lingshu* contains no such text. Even more laughable is his claim that the Yellow Emperor, worried about people's suffering, asked Qibo and Gui Yuzhou questions based on *Lingshu*, hence the name *Suwen*. Most infuriating is his assertion that if these two masters knew accurately, they could tell the ruler; if unsure, they must wait for reference, rather than answering rashly and harming future generations. Zhuangzi said, "There is no greater sorrow than the death of the heart." Does this describe those whose hearts died before speaking?

Chapter Two, "Record of Epiglottis, Left Air Gate, Right Air Guard, General Manager, Nutrient Manager, Qi Bowel, Blood Bowel," records his observations in detail. He claims exhalation, inhalation, expectoration of phlegm-fluids, saliva, and fluids have nothing to do with the Lung, and ancients wrongly attributed coughs to lung disease. He describes left and right air gates beside the lung tube merging into one entering the heart, descending from the heart's left rear to the left lung, passing through to the spine, then down to the "Guard General Manager." This manager has tubes opposite the back, waist, below waist, and eleven short tubes opposite the spine above the waist. Phlegm-fluids travel in these tubes, driven upward by gas past the heart, exiting via lung tubes to the air gates, connecting to the Guard General Manager. With so many tubes, which ones carry phlegm to the air gates, which exit left or right? His silence indicates ignorance. He calls the Guard General Manager the "Waist Tube," claiming two tubes grow above the waist: one connects to the Qi Bowel, which wraps the Small Intestine to preserve Yuan Qi (Original Qi). Yuan Qi is fire; sufficient Yuan Qi aids digestion, deficiency hinders it. Thus, Yuan Qi outside the Small Intestine digests food inside. Tubes are outside the Lung, so the Lung cannot digest phlegm-fluids inside the tubes—is this logical? The Classics state Zang organs store essence and do not drain. Only the Lung tube is clear and empty, thus able to transport external phlegm-fluids; otherwise, the tube would be blocked. Wang Qingren ignores this, treating the Lung as a useless dead organ.

Chapter Three, "Record of Jinmen, Jin Tube, Food Cover, General Lift, Long Tube, Water Channel," continues from Chapter One's section on feces formation in the Small Intestine and should be merged. It relates to Chapter Four, "Brain Marrow Theory," which I discuss below.

Chapter Five, "Theory of Qi and Blood Combined Pulse," states that pulses and their diagnostic value are strictly defined in the *Neijing* and *Nanjing*. Wang Qingren claims the body's Qi tubes exhale Qi, Blood vessels store Blood. Pulses derive from Qi, unrelated to Blood. Thick wrist flesh means short pulse, thin means long. Large/small indicate excess/deficiency, rapid/slow indicate cold/heat. Ignoring that Qi and Blood must interpenetrate, else humans are inert objects; if pulses are hard to understand without fingers, everyone would know medicine. He says he won't deeply explain the ancients' 27 characters on pulses, not because ancients lack space, but to prevent later generations from having no words on pulses when facing syndromes. This hides his weakness while exposing it; indeed, none of the dozens of case treatments mention pulses.

Chapter Six, "Theory of Heart Without Blood," notes Western medicine describes four chambers in the heart with openings for generating and returning blood, aligning with the *Neijing*. Wang Qingren argues the heart is a path for Qi entry/exit, containing no blood. He claims piercing a pig heart lets blood flow in, but un-pierced hearts contain no blood, comparing the heart to a vessel holding water. The heart is not a Fu organ, how can it hold blood? In his diagram, he notes under the Liver "Absolutely Cannot Store Blood." Can ancient texts be read so rigidly? The *Neijing* calls the Spleen "flesh"; Wang Qingren would surely be shocked. The appendix discusses sources of prescription efficacy and errors in *Neijing*, specifically the error of blood transforming into sweat. Wang modifies Zhang Zhongjing's formulas: Ma Huang Tang treats headache, body pain, neck stiffness, fever, aversion to cold, dry retching, and absence of sweating; Gui Zhi Tang treats similar symptoms but with sweating. He argues initial cold damage involves head/body/neck pain, fever, aversion to cold, but never excludes arms/hands from pain/fever/cold. Using Ma Huang Tang without affecting arms/hands proves the formula works but meridians are wrong. Modifying Zhang's text and blaming him is convenient. Neck stiffness is Yangming disease, limb pain is Taiyin disease; they don't co-occur initially unless in epidemic diseases. Formulas sometimes work despite mismatched indications. Quackery thrives here, as does self-praise. Zhang Zhongjing sets laws for posterity, not for quacks' coincidences. Claiming sweating indicates Wind Strike, yet Gui Zhi Tang never cures anyone. Does Wind Strike always involve sweating? Many modern doctors claim Gui Zhi Tang fails for Wind Strike due to incompetence. Wang claims Gui Zhi Tang fails because headache, body pain, fever, sweating are not Wind Strike. This contradicts the *Shanghan Lun* clause: "Headache, fever, sweating, aversion to wind—Gui Zhi Tang governs." Zhang omits pulse because Taiyang syndrome with sweating/aversion to wind naturally presents with floating pulse. Was it truly Taiyang? Floating pulse? Aversion to wind? Omission of body pain implies Taiyang with headache/fever/sweating/aversion to wind plus body pain requires modification of Gui Zhi Tang. Why not modify? Blaming Gui Zhi Tang without scrutiny is unjust. Worse, Wang uses Gui Zhi Tang without knowing the syndrome, claiming it's Wu Keyi's Plague, not Cold Damage. He advises his nephew to read Wu Keyi to understand Cold Damage, proving he read Wu's book. Wu wrote *Wenyi Lun* because contemporary doctors misused Cold Damage methods during epidemics. Why did Wang use Gui Zhi Tang for plague? Plagues differ. Perhaps Wu's method failed, so he used Zhang's, which also failed, reverting to Wu's? Then all attempts fail. Claiming eye pain, nasal dryness, insomnia are heat attacking the head, treated by Zhang with Ge Gen Tang, is cited as proof of formula efficacy but *Neijing* error. *Shanghan Lun* Ge Gen Tang indications do not match. *Neijing* states Yangming governs flesh, its meridian loops nose and connects to eyes, causing fever, eye pain, nasal dryness, insomnia. *Huoren Shu* agrees, neither suggesting Ge Gen Tang. Ge Gen Tang for this syndrome appears in Tao Jie'an's *Quansheng Ji*, adding Bai Zhi and Sheng Ma, describing fever, headache, slight aversion to cold, no sweat, slightly flooding pulse. Wang, ignorant of Yangming pulse/syndrome, misattributes and slanders Zhang, displaying unparalleled confusion. He claims Qi tubes connect to skin with pores for sweating, Blood vessels connect to skin without pores, preventing sweating. Thus, sweat is not transformed from blood, nor is it blood. Sweat is Heart fluid, steamed from heat in blood. Depriving sweat deprives blood; depriving blood deprives sweat. Verified always. Since blood steams to sweat, it moves from static to dynamic, penetrating pores. If sweat and blood exit together, or blood exits without sweat, blood is not static, failing to guard Yang. These principles are in the *Neijing*; how could Wang know?

Western arts exhaust intelligence tirelessly, never abandoning halfway. Though Western medicine lacks expertise in internal complex diseases, integrating Chinese classics to explore origins could reach peaks like ancient Chinese masters Lu Bian. Chinese physicians lack perseverance; reading a book, failing to grasp its purport, they doubt and fear, leading to loss of ancient texts. Internal medicine instruments are unheard of, though ancient ones existed. During Song Dynasty's emphasis on medicine, *Siku Quanshu Tiyao* cites Zhou Mi's *Qidong Yeyu*: Uncle Zhang Shugong mentioned acquiring a bronze man for acupuncture testing in Xiangzhou. Made of fine copper, complete with viscera. Acupoints marked with gold inlay. Front and back halves fit perfectly. Used to test doctors: coated externally with yellow wax, filled internally with water. Practitioners punctured points according to measurements; correct point allowed needle entry and water outflow; incorrect points blocked the needle. Ingenious. Later returned to the imperial treasury by Zhao Zhongnan; Zhang drew two diagrams for printing. Now lost. Western wax models only show form; this included acupuncture methods, rivaling Western ingenuity. Though lost, modern Chinese scholars create strange devices. Restoring the bronze man's craft for diagnosis/treatment would benefit medicine greatly, not just the profession.

Tang Rongchuan's *Zhongxi Huitong Yijing Jingyi* (Refined Meaning of Medical Classics in East-West Integration) balances East and West, revealing creation's secrets, benefiting medicine significantly. Reading these texts yielded insights aiding Tang's work. "Yin stores essence and rises urgently." Kidney essence gathers upwards; upper is end, lower is root. Westerners say brain governs perception, heart does not, seeing only upper essence, ignoring lower accumulation. They ignore Yin guarding Yang, Yang serving Yin. We TCM practitioners cannot fully fathom Yin-Yang dynamics, fortunately possessing sacred classics. Medicine today is comfortable. Western anatomy dates to King Lie of Zhou, analyzing to microns, yet remains superficial. Internal medicine theory states: careful attention clarifies perception. Those attentive see clearly and remember easily. Not "retain in brain" but "retain in heart," showing heart holds sovereignty. Another text says brain nerves come from cardiac plexus, formed by spinal cord knots. Brain roots in cardiac plexus, implying heart governs perception, brain obeys. Like wires: heart generates electricity, spine conducts, brain receives. Kidney generates essence/marrow, transports to brain; heart, as Yang, serves Kidney. Insisting on physical evidence makes "Bronze Mountain collapses, Luo bells ring" sound absurd to Westerners. Food enters stomach, separates clear/turbid paths; intermediate separation is essential. Tang cites Western view: water enters stomach, disperses in membranes, proving water doesn't enter Small Intestine. But isn't Small Intestine for grains? *Quanti Tongkao* on Stomach/Small Intestine mentions "gruel inside," indicating mixed water/grain, steamed by ministerial fire, a better explanation. Yet it omits input/output/separation mechanisms, showing confusion. We must judge by our classics: "Five grains enter stomach, dregs, fluids, and Zong Qi divide into three tunnels." Also: "Middle Jiao exits after Upper Jiao... receiving Qi, separating dregs, steaming fluids, refining essence, sending up to Lung." Separation in Middle Jiao corresponds to Western mesentery or Wang Qingren's Jinmen. Water doesn't fully disperse in membranes because it divides into three tunnels. After gastric/intestinal steaming, remaining waste shouldn't pass straight down; clear/turbid differ, requiring separation. Classics confirm: "Water/grain reside in stomach, become dregs, descend to Large Intestine, assist separation juice, circulate Lower Jiao, seep in." Yang Shangshan notes: Lower Jiao below navel, at bladder opening, governs separation, does not receive. Physicians never speak of two separations, yet Classics do, logically sound. Where is Lower Jiao separation? Westerners say kidneys produce urine, dissecting vertically showing funnel calyces, ureters, no inlet. Urine comes from kidneys. Doubts remain: More drinking yields more urine, less yields less; urine comes from drink (1). If water doesn't transform to urine, edema/diarrhea occur (2). Waiting for kidney generation causes insufficiency (3). Kidney generates then excretes immediately, useless (4). Western error is inexplicable. Tang says renal pedicles pierce spine, connect Sanjiao, two tubes join bladder. Thus water from Middle/Lower Jiao passes renal pedicles to bladder; pedicles are separation sites. Classics: Shaoyang belongs to Kidney, Kidney connects to Lung, combining Sanjiao/Lung power for skill. Separation here is crucial. Internal theory: Lung/skin exhalation high → urine low; exhalation low → urine high. Matches *Neijing* Qi transformation. Bladder lacks upper opening, requiring Qi transformation for urination. Westerners say upper opening exists; Wang Qingren verified no upper opening. Perhaps the upper opening is in the...

Since Western theory of brain governing perception spread in China, accepted uncritically, let us discuss further. Kidney essence generates marrow, enters brain via spine, like fruit on tree tops. Westerners say nerves come from below, reversing root/end, causing error. Questioning their logic corrects them. Kidneys have medullary substance, unique to kidneys; nuclear structures near kidneys suggest abundant nerves, implying marrow generates from kidney. TCM says Heart connection pierces spine to Kidney; Westerners say cardiac plexus forms from spinal knots, implying Heart-Brain connection. Westerners describe transparent brain matter; atrial lining is thin/smooth/transparent, implying brain clarity roots in heart clarity (*Quanti Tongkao*). Internal theory: Back spinal cord disconnected from brain marrow results in unconsciousness, implicitly denying brain sole governance of perception. Westerners excel in chemistry; their medicine is chemistry. Ask about Yin-Yang, Five Elements, twelve meridians, eight extraordinary vessels, Ying-Wei circulation, and they are ignorant. Even if told...

De Zhen's preface in *Quanti Tongkao* calls TCM conservative and arbitrary. This is frog-in-a-well thinking. True conservators uphold unchangeable Heavenly Dao; strict adherence yields new insights. Modern TCM abandons old traditions, leading to arbitrariness—not what De Zhen meant. I lament Western wisdom clinging to anatomy! Anatomy reveals form, but misses the invisible. Qi commands Blood like ruler commands subject, husband wife. This logic is indisputable. De Zhen denies it, suspecting Qi-commanding-Blood is void. Dissecting chest shows only chest, abdomen shows only abdomen; fixation on morphology leads here. Preface also attacks TCM's "Spleen moves to grind Stomach." Spleen moving is TCM error, not from classics. Spleen injury causing failure to grind is true...