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Diagnosis of disease must clarify whether the pathogen is in the Exterior (Biao, 表) or Interior (Li, 里), and further detail the deficiency (Xu, 虚) or excess (Shi, 实) for initial differentiation; people generally believe that diseases should avoid purgation/attack (Gong, 攻) and prefer tonification (Bu, 补), but who recognizes that tonification exists within attack?

Zhang Zihe said: The human body is merely divided into Exterior and Interior, and Qi and Blood manifest only as Deficiency and Excess. This speaks to the general outline. Only mediocre physicians, when treating disease, purely tonify deficiency and dare not treat excess. The world calls this "steady," yet the harm done to people remains unseen. They do not reflect on their own faults, remaining unrepentant until death, saying, "I used tonifying medicines; what crime have I committed?" Patients also say, "He used tonics to benefit me; what crime has he committed?" Even upon death, they remain unaware of the cause. This is how deeply mediocre physicians mislead people. It is like Gun blocking the floodwaters, ignorant of the Way of the Five Elements (Wu Xing, 五行). Tonification is what patients desire; attack/purgation is what they dislike. Physicians, finding their approach contrary to patients' wishes, are not employed. Instead, they cater to patients' desires to gain profit, showing no concern for the patient's life or death. Generally, there are wise and foolish physicians, yet many people err, regarding the wise as wrong and the foolish as right. Ignorant of the Root (Ben, 本) and Branch (Biao, 标), they recklessly administer drugs, bringing themselves into perilous distress, leaving only room for sighs. What is meant by "attack" is first dispersing external pathogens from all diseases; this is the meaning of "Exterior." Once external pathogens are removed, Yuan Qi (Original Qi, 元气) naturally recovers; thus, tonification exists within attack, which is the meaning of "Interior." However, observing Exterior/Interior and Deficiency/Excess requires flexibility in clinical practice, without adhering to rigid rules.

In general, the key to practicing medicine lies in appropriate speech; deep thought followed by measured expression ensures calmness. Furthermore, sincerity and earnestness constitute beauty; one must strictly avoid boasting of one's strengths to everyone met.

Zheng Duanyou said: In the profession of medicine, compassion comes first. One must constantly harbor a heart of rescue and relief to accumulate the deeds of ancient sages. Modern physicians, when diagnosing various diseases, before discussing therapeutic methods, slander previous doctors, failing to assess that diseases vary in depth and efficacy varies in speed. There are cases of Yin Deficiency with Yang Excess, and shifts in Yin-Yang interaction, where no fixed conclusion exists initially. Yet, they strive to be jealous of the virtuous and capable, harming others for self-interest, startling and mocking patients' families, intending to extract heavy bribes, revealing an extremely uncompassionate heart. In the past, during Emperor Shenzong's reign, Qian Yi (courtesy name Zhongyang) was renowned as a physician. The Imperial Prince, Duke of Yiguo, suffered from convulsions (Chou, 瘛); imperial physicians could not cure him. When the Eldest Princess attended court, she mentioned that Qian Yi, originating from the common folk, possessed unique skills. He was immediately summoned. He prescribed Huangtu Tang (Yellow Earth Decoction, 黄土汤), and the prince recovered. Emperor Shenzong praised him and asked why Huangtu Tang cured this ailment. Qian Yi replied: Using Earth to overcome Water allows Wood to achieve balance, so Wind stops naturally. Moreover, the other physicians' treatments were nearing completion; I merely happened to coincide with the recovery. The Emperor was pleased with his answer, promoted him to Ta Yi Cheng (Director of the Imperial Medical Bureau, 太医丞), bestowed purple robes and gold fish bags, elevating him above other physicians. Is this not honorable? If learners can adopt Zhongyang's mindset as their own, it would be excellent.