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Is medicine a trivial art? Yet, among those who study medicine, there are many of petty character; it is because of such people that medicine has been slighted for a long time. As for those who suck abscesses and treat hemorrhoids, called *Yang Yi* (Surgical Physicians), they are regarded as the most base and mediocre group. Society holds them in even lower esteem. Although it is said that medical practice is divided into internal and external departments, and symptoms have exterior and interior aspects, how can one fail to know that the skin, hair, muscles, and flesh are all connected to the Zang-Fu organs and the Twelve Meridians, which are the sites where Qi and Blood are infused and nourished? External sores and ulcers arise from internal pathogenic influences; how can they be viewed merely as external matters and disregarded? I often see surgical physicians who disregard the deficiency or excess of Yuan Qi (Original Qi) and the cold-heat nature of the pathological mechanism, stubbornly adhering to established prescriptions and indiscriminately administering cooling agents. For patients whose Yuan Qi, Xing Qi (Formative Qi), and Bing Qi (Pathogenic Qi) are all substantial, this approach may be appropriate. However, if all three are deficient, will it not harm life? If surgical physicians treat external conditions and internal physicians treat internal conditions, one must examine whether the pulse Qi is complete or deficient, thereby avoiding premature death or wrongful demise. The principles elucidated by Zhu Danxi regarding the treatment of carbuncles and sores can illustrate this point.

The above thirteen evaluations of physicians, though offered by my shallow knowledge without fear of ridicule from experts, stem solely from concern for the lives of the people. I specifically expose them based on their moral integrity (righteousness vs. wickedness) and their scholarly wisdom (virtuous vs. foolish), so that patients in the world may choose carefully.

In my youth, accompanied by peers, I traveled through the Yan and Zhao regions, riding side by side and galloping along. I frequently observed animals under the carriage shafts possessing very acute nature. Once saddled and bridled, awaiting riders, upon embarking on the journey, they would follow the main roads without losing their way on diverging paths; encountering small ditches or narrow bypaths, they could navigate with flexibility and curvature. Upon reaching an inn to rest, when the driver arrived, after unloading burdens and removing saddles and stirrups, they would proudly enter the stable to seek food. Day after day, this routine continued. I asked, "Why is this animal so intelligent?" The driver replied, "Raising one mule or donkey serves for thirty years. They travel long distances back and forth at least six or seven times a year. Having trodden these paths continuously over years, they become extremely familiar with the roads and inns, requiring no urging." Ten days later, passing Handan, the price of firewood and rice soared, and news of bandits arrived. I asked again, "Does this animal also know this?" The driver said, "It only knows how to seek food; how could it know prices are soaring? It only knows the road is passable and the stable is available; how could it know of bandit alerts? It regards thieves as humans too; how could it distinguish between good and evil? Objects cannot be compared to humans." I then recalled the "Hidden Dragon" and "Chick Phoenix" (metaphors for reclusive talents like Zhuge Liang). Both are living beings. Why, before emerging from thatched cottages, did they not see as many things as the mules and donkeys, yet still know the affairs of the world? How could they foresee the fluctuations of heavenly fortune, the rise and fall of national dynasties, and the auspiciousness or inauspiciousness of human affairs, escaping no divine calculation? This seemed inexplicable. When discussing this incident, a guest laughed and said, "This suffices as a metaphor for Bright Physicians, Reclusive Physicians, Contemporary Physicians, and Famous Physicians." I replied, "Indeed."