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Recommending physicians is a matter of life and death. As the saying goes, virtuous people do not readily recommend physicians; this indeed reflects the gravity of such an action. However, I believe that virtuous people are not those who never recommend physicians, but rather those who do not recommend unvirtuous ones.

Zhang Jingyue stated: Some are recommended because they occasionally hit upon a cure for a mild or superficial condition; some are recommended due to deep personal affection; some are recommended based on their eloquent speech; some are recommended because they are deceived by their outward appearance; others are recommended out of greed for profit, secretly seeking remuneration; still others are recommended out of personal favor, with ulterior motives. Even worse, there are those of narrow mind and small capacity who are arrogantly conceited, enjoy flattery, cannot distinguish between fragrant herbs and stinking weeds (Xun You, 熏犹), yet arbitrarily pass judgment on others. When praising, they portray Robber Zhi (Daozhi, 盗跖) as sage-like Yao and Shun (Yao Shun, 尧舜); when denigrating, they liken auspicious birds like Luan and Feng (Luan Feng, 鸾凤) to owls (Chi, 鸱). They scrutinize flaws without limit, while men of true talent and virtue inevitably clash with them. Such individuals, though speaking lightly and having no stake in others' fortunes or misfortunes, cause the greatest confusion in human affairs and sentiments. This often leads to wise and capable physicians being hindered, causing patients' families to harbor deep-seated doubts. The lack of clarity regarding right and wrong is entirely due to the disturbance caused by mediocre people. The implications of recommending physicians must be carefully examined.

There exists a class of half-knowledgeable individuals who do not understand the principles of deficiency/excess (Xu Shi, 虚实) and tonification/reduction (Bu Xie, 补泻). Having read one or two medical books, they believe that knowing which formula treats which disease and which herb treats which formula constitutes the entirety of medical practice. Others, having once been ill themselves and discussed treatment with physicians, merely grasp basic formulas and herbs, yet dare to diagnose pulses for others. Upon seeing a floating pulse (Fu Mai, 浮脉), they declare it harmless; upon feeling a deep pulse (Chen Mai, 沉脉), they claim there is no pulse. They shake their heads and click their tongues, causing alarm, which is truly laughable. Alas! Quack doctors harming people is already unbearable; such half-knowledgeable charlatans are even more erroneous and absurd. They dictate opinions among relatives and friends, debate between the wise and the foolish, overturning right and wrong, and recklessly predicting fortune and disaster. Consequently, low-character individuals adopt an ambiguous stance to seek acceptance, while enlightened scholars, holding unique insights, remain isolated. Like building a house amidst many voices (San Ren Cheng Hu, 三人成虎 - idiom for rumors gaining traction through repetition), they hinder the virtuous. The harm caused by such "half-knowledge" is indeed perilous.

Medicine is the study of life and destiny, the master of generation and survival. Its Dao is vast, and its responsibility immense. Since the *Book of Tang* categorized it under "Technical Arts" (Fang Ji, 方技), literati and famous scholars have often ceased discussing it. Lin Yi, Grand Guardian of the Song Dynasty, said, "Entrusting the most subtle and profound principles to those of the lowest status makes it rare to find someone capable of curing diseases." Thus, as society declined, medical skills became scarcer, mostly practiced by market ruffians and defrocked monks who could barely read and were skilled in persuasive speech. This is a disgrace to humanity, not to medicine itself. These individuals begin learning medicine by memorizing the *Pulse Rhymes* (Mai Jue, 脉诀) and *Formulas for Decoctions* (Tang Tou Ge Kuo, 汤头歌括). They then apprentice under quacks with false reputations, treating them as illustrious masters. After briefly understanding the four major pulse categories (Floating, Deep, Slow, Rapid - Fu Chen Chi Shu, 浮沉迟数) and the properties of warming, cooling, cold, and hot herbs, taking anywhere from six months to a year, they believe their knowledge is complete and superior. They open shops, hang large signs claiming secret transmissions or heart-to-heart teachings, deviating from classics and opposing orthodoxy. They apply fixed formulas to diseases, achieving occasional success with mild conditions, and pride themselves on their miraculous skills. Obsessed with monopolizing profits and calculating petty gains, their desire to climb social ladders arises. They think, "Without flattering a few nobles to promote me, how can my fame spread?" Anticipating that high officials will need doctors upon taking office, they bribe clerks and runners to spread recommendations. When officials request a doctor, unable to discern wisdom from folly, they accept these recommendations blindly. Unaware that these schemers coordinate with palace servants to learn the patient's identity and symptoms beforehand, ensuring their diagnosis matches the pre-learned pathology. Once diagnosed, their words align perfectly, and prescriptions may yield results, leading everyone to admire them as genuinely skilled. Initially using low-ranking clerks as stepping stones, they now flatter high officials for promotion, hoping to receive honorary plaques displayed outside. Passersby follow the trend, spreading rumors that "he is a famous physician." Even wise scholars fall into this trap, encountering difficult cases where many die unjustly at their hands. Only when an expert pierces through the deception do their lies fail and flaws appear. Alas! Competing in such corrupt streams, hearts muddy as black and green mixed together, fingers sharp as blades, what couldn't they achieve if they acted properly? Yet they recklessly pose as doctors, killing countless people. This is a universal flaw throughout history. Consider the words of Liu Bowen: "In Hangzhou, there was a fruit seller who preserved citrus fruits so well that they remained fresh through seasons, shining like jade and gold. Sold at ten times the price, people competed to buy them. I bought one, cut it open, and smoke hit my nose; inside, it was dry and rotten like broken cotton. I asked him, 'Do you sell this to fill ritual vessels, offer sacrifices, or entertain guests? Or do you deceive the ignorant with its appearance?' His deception is extreme!" The seller laughed, "I have done this for years; it feeds me. People buy it, no one complains. It just doesn't satisfy you. There are many deceivers in the world, am I the only one?" These were Liu Bowen's words expressing indignation against worldly evil. Today, since doctors deceive externally like selling fake citrus, can patients be allowed to suffer slaughter like the deceived?