Library

Clinical medical cases are not an ancient tradition. In ancient times, physicians did not write case records when examining patients; they only prescribed herbal formulas and medicines. Since the Song Dynasty established medical subjects and selected physicians through written examinations, choosing those with superior scholarly attainments to enter the Imperial Medical Bureau,

physicians thereafter followed the custom of first writing case records and then prescribing formulas and medicines. However, these records were often discarded immediately after being written, and no one compiled them into books. Figures such as Xu Zhike and Zhang Jiming of the Song Dynasty, Xue Lizhai, Chen Wei Yi, and Sun Wenyuan of the Ming Dynasty, as well as Yu Jiayan and Xu Dachun from the early Qing Dynasty, although they produced collections resembling medical cases, did so only because their treatments yielded effective results, which they then recorded in books. Their writings were essentially historical records, not true clinical consultations. Indeed, given that diseases often change and prescriptions cannot be fixed, authors likely avoided compiling such records for fear of limiting the perspectives of learners, thus treating the matter lightly. Nevertheless, I believe that a physician having treatment plans is akin to legal scholars having precedents or essayists having model examination papers. Prescribing formulas according to diseases and establishing principles based on specific problems, within a brief moment of consultation, the life of the patient hangs in the balance, as does the success or failure of the physician. Although this may not constitute fundamental scholarship, the condition of the patient and the knowledge and thought processes of the physician are fully revealed therein. If one can trace the pulse and symptoms and observe their changes, it is more than just conversing with the patient and physician in the same hall; is it not truly capable of stimulating one's clinical insight? Hence, Ye Tianshi's *Lin Zheng Zhi Nan* (Guide to Clinical Practice) has been widely circulated throughout the country.

However, the language and meaning in Ye's cases are profound and deep, while his prescriptions are often mild. Learners who merely follow his footsteps may not necessarily enter his inner sanctum of wisdom. Because Ye enjoyed great fame during his time, his patients were either wealthy individuals accustomed to rich diets or those with advanced disease and depleted vital energy; there were few poor and low-status patients at the onset of illness. Generally, constitutions differ, and thus methods vary; therefore, few readers could grasp the practical application of his book! I previously obtained two volumes of treatment plans by Mr. Wang Tailin (Wang Xugao) from Wuxi, cherished them, and kept them in my collection. Due to the small number of pages, I did not have them printed. For over twenty years, I sought more but could not find any. One spring, while traveling in Liangxi, I visited my old friend, Mr. Liu Shixiang. Shixiang showed me ten new volumes he had recently acquired from the Li family. I eagerly borrowed them to read at home. His mental agility and superior insight were evident; his style was elegant and refined yet not overly obscure, flexible and adaptive yet adhering to rules. Compared to Ye's cases, they were easier to learn and imitate. Moreover, there were many follow-up visits, allowing for thorough investigation from beginning to end, evaluating successes and failures, which greatly aids learners. Therefore, I combined my collected volumes with these, removed duplicates, and selected and edited them. Wherever sentences were verbose or careless, I made slight deletions and revisions. Organized by category into twenty-six sections, each section includes my humble commentary to briefly elucidate the main ideas. For parts that were particularly insightful or where I felt less satisfied, I pointed them out alongside the cases, offering corrections with due respect, without intending to praise or criticize arbitrarily. The original ten volumes were reduced to approximately half, condensed into four volumes. I instructed my sons to transcribe them. Not wishing to keep this to myself, I entrusted them to the printers to share with fellow scholars.

Preface written in the first month of spring in the Dingyou year (1897) of the Guangxu reign, by Fang Gengxia at the Yiyun Yin Guan."