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Su Shi said: The greatest disaster in the world is not knowing the cause yet allowing it to proceed. Not knowing the cause yet allowing it to proceed is equivalent to standing with hands folded, waiting for chaos. Therefore, the wise recognize changes in Qi transformation (气化) before the disease manifests. By the time the disease has formed, the body's deficiency and excess are balanced (虚强半). When the disease first erupts, it is intense, and urgent treatment is required. However, if the pathogenic factor is in the meridians (Jing), one dose can cure it; if it transmits to the Fu organs (Zang-Fu theory), a few prescriptions can bring relief. But once it enters the Zang organs, less than one in a hundred survives. Thus, Hua Tuo excelled in abdominal surgery, while Qin Huan (Bian Que) rarely had the opportunity to use plaster treatments. This is not due to differences in the skill of physicians, but rather the disparity in the depth of the diseases. The Classics state: "If the momentum of the disease has passed, life will be hard to preserve." How can one fail to reflect deeply on this?

When the pathogenesis initially emerges, one should carefully select a physician. If treated incorrectly at the beginning, failure and death will inevitably follow. Let us now discuss Yin and Yang syndromes of Cold Damage (Shanghan) as examples. At the initial stage of a Yang syndrome, symptoms include headache as if splitting, stiffness and tension in the waist and back, body heat like burning, incessant panting and thirst, and frequent episodes of mania and delirium. Who would not be alarmed by such signs? However, if the pulse matches the symptoms, proper treatment leads to recovery. Although the situation is worrying, the disease itself is not fatal, as it only transmits through the meridians and affects the Fu organs, without damaging the Zang organs. Conversely, when a Yin syndrome first appears, the headache is mild, the body heat is low, appetite is irregular, there is slight pain in the umbilical and abdominal regions, loose stools, or vomiting and incontinence. The patient appears weak and lethargic, unaware that the Qi of the Zang organs is already depleted. The pulse shows a hidden Stomach Qi (Wei Qi), significantly different from Yang syndromes. If warm tonifying formulas were administered immediately, how could one perish due to delay? Yet, physicians who do not recognize this condition assume there is no danger, using either diaphoretic methods (Fa Biao) or clearing and resolving methods (Qing Jie). After several days of delay, the disease enters the Zang organs, worsens gradually, and signs of death appear. Even with the skills of Lu Yi (Lu Fu) or Bian Que, nothing can be done. Generally, Yang Qi is rapid, while Yin Qi is slow; Yang nature is rigid, while Yin nature is soft; Yang diseases are external, floating, and easy to detect, whereas Yin diseases are internal, deep, and difficult to perceive. Therefore, people generally exercise caution regarding Yang conditions but neglect Yin conditions. Physicians who fail to distinguish between Yin/Yang and Deficiency/Excess, treating symptoms merely as symptoms, often lead patients to death, an occurrence too numerous to count. Hence, I earnestly advise patients: when selecting a physician at the onset of illness, one must be extremely cautious, for life and death depend on it.

In my commentary: Guo Youfu expressed deep astonishment at those who conceal their illness and fear medical treatment. They clearly fear death, yet also fear others knowing they are dying. They worry that enemies would rejoice upon hearing of their illness, perhaps caused by lustful indulgence, or that relatives would be angered. Thus, even when the illness is severe, they continue to cover it up. They fail to consider that at this stage, why not speak out early? Those who have experienced illness should serve as a warning to others. If one knows of a specific illness cured by a renowned physician, seeking treatment promptly naturally leads to recovery. One must never sacrifice one's own life due to the pleasure or anger of others. As the saying goes: "Conceal your intentions, but reveal your illness." How true this is.