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Human beings live in the intersection of Qi (vital energy) between Heaven and Earth. All breaths, inhalations, and exhalations are the primal Qi (original energy) of Heaven and Earth. When confronted by violent winds and heavy rains, extreme cold and muggy heat, mountain miasmas and pestilential vapors that clash with the body, as well as self-inflicted harm from emotional states, injuries from irregular diet and overwork, or sudden abrupt changes, if the Primal Qi is damaged by these factors, disease arises. The pathogen enters internally into the Zang-Fu organs and manifests externally on the limbs and extremities. Consequently, practitioners have divided treatment into distinct internal and external categories. Decoctions (liquid herbal medicine) are used for internal treatment, while external treatment mostly employs plasters (topical pastes). There are indeed cases where external treatment is used exclusively, abandoning decoctions. Heaven does not withhold the Dao (Way/Principles), yet Mr. Wu Shangxian of Qiantang was the first to specialize exclusively in using plasters to treat internal diseases, a practice unprecedented since ancient times.

Mr. Wu possessed the ambition to save the world but rarely displayed his skills in medicine. In recent years, he opened land in the northeast township of Hailing to administer plasters to patients, often achieving perfect cures within the medical community (Apricot Grove). Thus, like the peach and plum trees that attract people without speaking, his reputation spread naturally. However, some harbor doubts, questioning how internal treatments can be effective through external application. They fail to realize that this also relies on the manipulation of Qi. For instance, bathing in the wind allows cold Qi to enter; walking under the sun allows hot Qi to enter. What enters is internal, but what facilitates entry is external, not internal per se. The human body possesses 84,000 hair pores (a metaphor for all skin pores), which are pathways for Qi to enter and exit, not limited merely to the mouth and nose. Visible phenomena include the expulsion of Qi via sweat when feverish, and conversely, the entry of Qi when sweating. The essence of herbs boiled into decoctions—whether one takes their flavor or their Qi? It is solely taking their Qi. When Qi interacts with the pathogen, internal treatment leaves no room for other methods. Transforming decoctions into plasters allows them to enter through the hair pores, relying again on the interaction of Qi with the pathogen. What is there to doubt?

Nevertheless, Mr. Wu’s scholarship never taught people to rely solely on external acquisition. Occasionally, he showed me his work, *Li Yue Pian Wen* (Parallel Prose on External Therapy). Upon reading it, I saw that he extensively collected and concisely selected materials from the *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions) down to later texts, leaving nothing out, unlike vulgar scholars who merely value superficial meanings. Yet why did he firmly insist on external treatment? He believed that those who read his book and gain insight would find external treatment either easily acquired or easily convertible to decoction therapy, whichever they preferred. If they gained no insight, they could temporarily use his method as treatment. There would be no failure in efficacy, no difficulty in application. This way, one could reap the benefits of decoction therapy without its drawbacks. Mr. Wu’s intention can be described as both benevolent and wise.

I am foolish and ignorant of medicine. Mr. Wu deigned not to despise me and entrusted me with writing the preface. Therefore, I elucidate the principle that external and internal treatments are consistent, ultimately attributing it to Qi. Perhaps some will laugh at my folly.

Written by Xu Mei of Haining in the month of Ju You Huang Hua (Fourth Lunar Month) of the Third Year of Tongzhi (1864), at the Cuihui Studio during his stay in Nantong Prefecture.