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The difficulty of pulse diagnosis has been a concern for people since ancient times. Extreme deficiency may present with excess-like symptoms, and extreme excess may present with deficiency-like appearances. A discrepancy of mere hair's breadth in such ambiguous situations can lead to vastly different outcomes regarding life and death, fortune and misfortune; this is a universal concern throughout history. When ill, one cannot but seek medical help, yet physicians who are proficient in pulse diagnosis are few, numbering perhaps only one or two in the world. Fine horses do not appear constantly, yet people do not walk everywhere on foot; He Qi (Bian Que) and Qin Yueren do not emerge every generation, yet patients do not simply die without recourse, for they rely on utilizing their physicians' strengths to compensate for weaknesses. Scholars and officials often conceal their ailments to solicit diagnoses, thereby testing the physician's competence. This is akin to searching for the disease in obscurity and distinguishing between deficiency/excess and cold/heat amidst ambiguity. If a physician unfortunately makes an error, they are reluctant to admit it at the end. Instead, they employ clever rhetoric to cover up faults and preserve their reputation, until the condition becomes incurable, at which point they claim, "This was inherently difficult to treat." Occasionally, there are cautious and honest physicians who, although relying partly on the patient's account, also incorporate their own observations. By maintaining both perspectives and treating with mixed methods, the medicine often fails to be effective. This is a common malady of the world, yet no one realizes it. In my lifelong experience of seeking medical care, I generally assess a physician's skill quietly during ordinary times. When illness strikes and treatment is sought, I first inform the physician completely of my symptoms before allowing them to take my pulse, so that the physician clearly knows where the ailment lies. Only then do I request pulse diagnosis; with the determination of deficiency/excess and cold/heat already established in my mind, doubts arising from the pulse cannot confuse me. Thus, even average physicians often cure my illnesses when I seek them out. My sole aim is recovery; I have no intention of making things difficult for the physician!

Among medicines, none is as inexpensive yet so essential for worldly use as Xanthium sibiricum (Cang'er). Other cheap medicines may not be produced in certain regions. However, this herb grows regardless of whether the location is north or south, among Han or Yi peoples, in mountains, marshes, saline-alkali lands, mud, sand, or rocks; wherever there is land, it grows. Its flowers, leaves, roots, and fruits are all edible. It can be eaten like vegetables and treats diseases without toxicity. Whether prepared raw or cooked, in pills or powders, there is no unsuitable application; consuming more yields better results. Long-term consumption fills the marrow, makes the skin texture like jade, and serves as a longevity drug. It is used extensively for miscellaneous treatments of wind-bi paralysis, strangury, malaria, sores, and itching, too numerous to mention. It is particularly effective for goiter and metallic wounds. Also known as Shuniuzi (Arctii Fructus), Yangfucai, referred to as Juan'er in the *Classic of Poetry*, as Er in botanical texts, and commonly called Daoren Tou (Daoist's Head). In Hainan, where medicinal herbs are scarce, this herb grows abundantly around houses, often among thorns and brambles, which is fortunate for exiled scholars. Written on the fifteenth day of the second month in the Jiyao year.