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Ancient sage kings personally tasted hundreds of herbs, compiled medical texts, and amidst the myriad duties of governance, refused to indulge in leisure or ease. This was truly because the livelihood of the people is paramount, and medical affairs are of critical importance.

The *Rites of Zhou* (*Zhou Li*) placed medical administration under the Six Ministries to protect the royal body and manage the diseases of the populace. It appointed physicians as teachers, empowering them to issue administrative decrees. Ban Gu, in the *Book of Han* (*Hanshu*), grouped physicians with immortals, indicating that their positions were noble and their Dao profound. Consequently, during that era, miraculous and excellent practitioners emerged in abundance, such as Changsang Jun and Bian Que of the Zhou Dynasty, and Hua Tuo and Zhang Zhongjing of the Han Dynasty, all of whom remained prominent in public memory.

Since then, however, the ruling class viewed physicians merely as attendants for imperial service, while the common people regarded them as mere artisans or entertainers. Scholars and literati largely neglected medical study; only those who failed in their Confucian scholarly pursuits would casually browse medical books and claim to be doctors, using it as a means to enrich their families. The result was treating excess conditions with tonics (Sheng Sheng) and deficiency conditions with purgatives (Xu Xu), thereby bringing premature death upon patients; allowing pathogenic factors to invade and healthy Qi to fail, thus cutting short lives. The decline of medicine has been long-standing.

Although since the Tang and Song dynasties there have been no lack of wise individuals, true masters have been few. Tracing the fault back, it stems from a lack of study. Studying Confucian texts is relatively easy, whereas studying medical texts is difficult. Confucian classics follow fixed principles, while medical literature is diverse and easily dazzling. The Confucian books are those of Confucius and Mencius; everyone knows to read them and dares not violate them. The medical books are those of Yan Huang (the Yellow Emperor and Shennong); everyone claims to read them, yet ultimately does not. Why? Because the language is archaic and elegant, and the principles are profound and deep, making them hard to comprehend. Thus, mediocre and shallow individuals frown at them. Upon seeing books like the *Ode to Drug Properties* (*Yao Xing Fu*) or rhymed prescriptions for symptoms, they revere them as sacred treasures, unaware that an error at the beginning leads to mistakes for both themselves and others. Learning in youth prevents regret in old age; without early study, one suffers in vain later, with no time for repentance.

Conversely, those who pride themselves on high learning often claim to have studied the *Jin Gui Yao Lue* (*Essential Prescriptions of the Golden Cabinet*) and followed Zhang Zhongjing’s methods. Yet they remain rigid and inflexible. In treating diseases and prescribing formulas, they strive for novelty and eccentricity. This type of killing due to arrogant pedantry is equivalent to killing due to mediocrity and ignorance.

Therefore, Zhang Yuansu, Liu Wansu, Li Dongyuan, and Zhu Zhenheng are the Four Great Masters of Medicine. Their writings merely supplemented what predecessors had left incomplete, establishing their own schools of thought. Even when each school made innovations, most served to fill gaps left by earlier authors. As Zhao Xianke stated: "If one reads the *Shanghan Lun* (*Treatise on Cold Damage*) but not Li Dongyuan’s works, internal injury remains unclear, leading to many deaths. If one reads Li Dongyuan but not Zhu Danxi’s works, Yin deficiency remains unclear, leading to many deaths. If one reads Zhu Danxi but not Xue Ji’s medical works, the concepts of True Yin and True Yang remain unclear, also leading to many deaths."

Thus, if a physician does not deeply understand the principles of Confucius and Mencius, nor thoroughly grasp the meanings of Yan Huang, and fails to extensively consult various philosophical schools and百家 (hundred schools of thought), integrating them to treat diseases flexibly, one cannot hope to achieve results as immediate as a drum responding to a mallet, or as thorough as removing a thorn or cleaning dirt, nor can one be called a master of skill or divine. Who says medicine is a minor art that can be treated lightly?

It is heard that Zhang Changsha (Zhang Zhongjing) said: "Scholars of the world do not pay attention to medical arts. They cannot treat rulers and parents above, save the poor and lowly below, or preserve themselves in the middle. Instead, they chase glory and profit, aspiring to the status of the powerful. When unexpected crises occur, they find themselves in mortal danger, entrusting their lifespans to the mediocre. Is this not dangerous?"

Huangfu Mi (Xuan Yan) said: "Humans inherit the bodies of their ancestors, possessing eight chi of flesh and blood, yet if they do not know medical matters, they are merely wandering ghosts. Despite having hearts of loyalty and filial piety, and natures of kindness and compassion, when rulers and fathers are in peril, or infants and people suffer, they have no way to rescue them. This is why sages think profoundly and argue extensively, exhausting the principles [of medicine]."

Moved by the words of these two gentlemen, I recalled the ancient saying: "If one cannot become a good prime minister, one should become a good physician." With a sigh, I considered that medicine allows one to serve the ruler, support parents, benefit the world, preserve life, and achieve fame. Does this not resemble the ethos of Youxiong Shi (the Yellow Emperor)? Therefore, I resolutely spurred myself on. For twenty years, rising early and sleeping late, I exhausted myself exploring the mysteries of Yan Huang and the secrets of Zhang Zhongjing. I plundered medical books and collected medical cases, gaining some illumination.

I then compiled *Ben Cao Bi Yong* (Essential Materia Medica), edited the cumbersome *Mai Fa* (Pulse Methods), illustrated *Nei Jing* (Inner Landscape), summarized the *Ling Shu* and *Su Wen*, gathered maxims, and elucidated symptom-formula relationships. These were divided into sixteen volumes, collectively titled *Ming Yi Jing* (Mirror of Famous Physicians). All are based on the theories of Qibo, Huangdi, and Zhang Zhongjing as the warp, and the hundred schools of thought as the weft. Every sentence collects gold and stone [valuable insights]; every word picks out pearls and gems. It clearly dissects the nature of diseases and fully conforms to the appropriateness of time and place. This allows the mediocre and shallow to comprehend it easily, and prevents the pretentious from employing dangerous or obscure methods.

I further hope that eminent figures of the current generation will use their wisdom to critique and promote these works, helping to reverse the declining trends, so that everyone may enjoy their natural lifespan, not failing the benevolence of the ancient sage kings’ teachings. This would be my greatest joy and the great fortune of the common people.

Gu Jingyuan, courtesy name Song Yuan, from Wu Men (Suzhou)