夫医也者，近之治身，消患于未兆，远之治人，广惠于无穷。然非研求《灵》、
《素》，得心应手，勿能及也。至于病者听医，犹听神明，然医良而听之，宜也。若学
术未工，则自信不确，而病家疑信居半，尤宜然也。但病有浅深，则效有迟速，倘病在
腠理，而不奏功于附应，诚罪在医术之庸，若势近膏肓，效安期于旦夕，旦不效夕更，
夕不效且更，则虽有神圣，亦不能尽其技矣。故天下不尊医，医亦不自尊，病家急而
求医，医亦急而求术，古之人艺精而试，今之艺试而精，古之人以法治病，今之人以病
合法，古之人因症处方，今之人以方处症，殊不知先贤徒详病情，不设方剂者，盖不欲
以一定之迹，应无穷之变也，因庸下者，苦于莫窥玄奥，证治无从守式，于是汉世以降
方法繁与，如奕之有势，反正逆从势之用
也。运气不济，古今易辙，风土异宜，强弱异禀，贵贱异境，老少异躯，新久异法，内
外异因，局之变也。若执一定之势，以应千变之局，其有不败者几希！故贵学人，熟详
天地阴阳，参透生人原始，如何生发之机无穷，如何化源之机乃绝，如何而诸危症可以
回生，如何而诸轻症得以变重。立定大纲，统其要领，脏腑经络既明，标本虚实识透，
始由至奇至繁至远之文章，终归最平最纯最近之一理，千变万化。《经》所谓一言而终
也。
医学之道，近则调理身体，在祸患尚未显现时予以消除；远则治理人群，将恩惠广布于无穷无尽的未来。然而，如果不深入研究《灵枢》和《素问》，做到心手相应、运用自如，是无法达到这一境界的。
至于病人听从医生的建议，就像听从神明的旨意一样。如果医生医术高明而病人信任他，这是理所当然的。但如果医生的学术水平不够精湛，病人就会缺乏自信且犹豫不决，导致对医生的信任与怀疑各占一半，这也是很自然的事情。
但是，疾病有浅层和深层的区别，疗效也有快慢之分。倘若病邪仅在腠理（皮肤肌肉之间的间隙），却不能在短时间内见效，这确实是医生医术平庸的过错。如果病情已经接近膏肓（指病势深重难治），又怎能期望在早晚之间就见效呢？早上没效晚上换医生，晚上没效接着再换，那么即使有神圣的医生，也无法施展其技艺了。
因此，天下人不尊重医生，医生也不自视尊贵。病人急切地求医，医生也急切地寻求医术。古代的人先精通技艺再行医，现在的人是通过行医来磨练技艺；古代的人依据医理法治病，现在的人却根据病症去凑合方剂；古代的人根据症状开处方，现在的人却用方剂去套用症状。殊不知，先贤们详细记载病情却不设立固定方剂的原因，是因为不想用固定的模式来应对无穷的变化。
由于庸俗低下的医者苦于无法窥探其中的玄妙奥义，辨证治疗没有固定的法式可循，于是从汉代以来，治疗方法变得繁杂多样，就像下棋时的各种局势，讲究正反、顺逆等局势的运用。
运气（五运六气）不济，古今的道路发生了变化，风土环境不同适宜各异，体质强弱禀赋不同，地位贵贱处境不同，年龄老少躯体不同，病程新久治法不同，内外病因各异，这些都是局面的变化。如果执着于固定的局势，来应对千变万化的局面，能不失败的几率是极小的！
所以，重视学问之人，应当熟悉详察天地阴阳的变化，参透生命产生的本源。要明白生机是如何无穷无尽的，化源是如何断绝的，如何让各种危重病症起死回生，如何让各种轻微病症避免加重。确立大纲领，统摄要领，脏腑经络既然明了，标本虚实既然看透，最终就能从极其奇妙、繁杂、深远的理论文章，回归到最平淡、纯粹、切近的根本道理之中，从而应对千变万化的情况。这正是《内经》所说的“一言而终”的道理。
Medicine, in its immediate application, regulates the body and eliminates potential hazards before they manifest; in its distant scope, it governs the populace and extends benefits infinitely. However, without profound study of the *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions), achieving mental and manual proficiency is impossible.
When patients heed their physicians, it is akin to heeding divine will. If the physician is skilled and the patient trusts them, this is appropriate. Yet, if the physician's academic foundation is imperfect, the patient lacks confidence, resulting in half-trust and half-doubt, which is also natural.
However, diseases vary in depth, and efficacy varies in speed. If a pathogen resides only in the *Cou Li* (interstices of skin and muscle) yet fails to respond promptly, this is indeed a fault of mediocre medical skill. Conversely, if the condition approaches *Gao Huang* (the area between the heart and diaphragm, implying a critical or incurable stage), how can one expect recovery within a day or night? Changing doctors because there is no effect by evening, and changing again if there is no effect by the next morning, even a sage-like physician would find their skills exhausted.
Thus, society does not respect physicians, nor do physicians respect themselves. Patients urgently seek doctors, and doctors urgently seek methods. In ancient times, masters refined their skills before practicing; today, people refine their skills through practice. Ancients applied laws of medicine to treat diseases; moderns adapt laws to fit diseases. Ancients prescribed formulas based on symptoms; moderns force symptoms to fit formulas. They fail to realize that the sages of old detailed conditions but did not establish fixed formulas precisely to avoid using rigid patterns to address infinite variations.
Because mediocre practitioners struggle to penetrate the profound mysteries and lack fixed modes for syndrome differentiation and treatment, since the Han Dynasty, methods have become繁复 (complex and numerous), much like the various situations (*Shi*) in chess, involving strategies of reversal, opposition, and compliance.
The influence of *Yun Qi* (Five Movements and Six Qi) has shifted, altering the paths of antiquity and modernity. Local climates differ in suitability, constitutions vary in strength, social statuses differ in circumstances, ages vary in physical states, new versus chronic conditions require different methods, and internal versus external causes differ. These are all changes in the situation. To cling to a fixed situation while responding to thousands of variable scenarios leaves little chance of avoiding failure!
Therefore, those who value learning must thoroughly understand the Yin and Yang of heaven and earth, and penetrate the original source of life. One must know how the mechanism of generation is infinite, how the source of transformation ceases, how to revive critical conditions, and how to prevent mild conditions from worsening. Establishing the general outline and grasping the essentials, once the Zang-Fu organs and meridians are clear, and the root and branch, deficiency and excess are fully understood, one can return from the most wondrous, complex, and distant theories to the simplest, purest, and most proximate principle. Through thousands of changes, this aligns with what the *Classic* (referring to *Huangdi Neijing*) calls "concluding in a single word."