名利者,绝技之师,天地生死,人人之具,古今中外,帝王驱遣群伦,培养人才,而转移风俗之妙用也。圣
贤豪杰,或不为利动,而不能不为名动,唯恐不好名之说,不只为三代以下言也。孔子曰∶忠信重禄,所以劝士
,西汉经学之盛,班孟坚谓是利禄使然。至于唐以诗赋盛,宋以理学经义盛,有明以迄国朝,皆以八
股取士。八股至今,至无用当也。而当未废之前,毋论智愚贤否,莫不竭尽毕生精力以入其
中而卒之,以此称神品,称能品,号大家名家者不可胜数,以之致大位,拥大富,膺懋赏殊
荣者不知几何。当时未闻有八股学堂也,不过人自为学而已,虽有书院之名,每省不过数
区,省外则无几矣。虽有院长之号,每月不过数课,课外不他问矣。而何以八股之盛于斯
也?所谓风会之所趋,而当王者贵也。又实为富与贵之所驱,名与利之所使也,是可藉为医
医之方也。
八股之外又有卷折,其 八股,尤为无谓,而当时卷折人才之盛,亦几与八股相埒,
盖非工此,虽八股入彀,仍不得与于状元宰相之荣,于是天下士夫咸相率而成此种人才。各
相虑而唯恐不及此种人才。呜呼,时亦未闻有卷折学堂也,而卷折人才之盛又如彼,要亦风
会之所趋而当王者贵也。又何莫非富与贵之所驱,名与利之所使哉?是更可为医医之方
也。朝廷医官置太医院,位仅三品,有差俸只百金以外,而又囿于一部,不能流通转用,以
至老死,真所谓不甚爱惜之官也。官犹如此,则所谓医士医生者,更无怪世人小道目之,贱
工待之矣。稍有聪明才力者,且不屑为,而谓贤智为之乎?虽有豪杰崛起代兴,自成名流,
而一代不过数人,当其盛名鼎鼎,曾不数闻一字之褒,及其既也,要亦不过列入方技传中,
如扁鹊、仓公、华佗、思邈而已。最可怪者,圣如仲景,史汉并无一传,尤令人索解不得。当
时八股卷折为富贵之阶梯,群既趋于彼矣。今日新学新政为终南之快捷方式,群又趋于此矣。而
谓辞尊居卑,辞富居贫,别有人才,其人才亦可想见,是皆所以致医之病也。
医道较有用于八股卷折万万一,实按之则尽人知之矣,八股卷折早已可废,医道则虽
终天地不可废,乃以早可废者而曾见其隆盛如彼,以万不可废者而转任其腐败若此。不知
医者自存何心?对待于医者又何心也?
医道殊有济于新政新学亦万万,非切言之,则人莫或知也。新政新学似欲以医旧政旧
学之病,非善医之则虽终天地而仍无济,乃新政新学今则并举,而莫敢废矣。医道之有济于
新政新学人,今乃犹是,废莫能举焉,不知医者自有何说?对待于医者又何说?
朝廷之置医官也,岂不以医之为用卫生治疾已耳。政治无与,焉不知医之为道,必合
格致诚正修齐治平之事而一之,通天地人而贯之,然后可谓之医。所谓良医良相,所谓国
手,更所谓补天手者,非虚拟之词,实当然之事,而固有之道也。惜古今中外,医者思想多
不到此,学问向不由此,资格都不及此,遂致对待于医者,相习而忘之,相忽而轻之,一至
于此。
医不止于卫生治疾已也,即只以为卫生治疾计,虽在常人,亦万不宜苟且轻忽而托之
于庸恶陋劣之手以尝试。况朝廷之莅天下也,将以治万方之疾苦,使无一夫不被其泽,循至
天地位而万物育,所谓一人有庆,兆民赖之。圣躬偶然违和,即属治于太医,京师口号国子
监之文章銮舆,卫之刀枪,太医之药方诚有概乎言之也,一有不效,则各直省督抚将军应诏
以进群医,太医群医,吾皆闻之熟矣,知之稔矣,封疆大吏又皆非真知医者,乌得有真是
非?亦唯荷朝廷洪福,或借手以奏功,不可谓非一得之能,一时之幸,然而临大敌则恐非真
将军矣。王子安与程伊芳川曰∶为人子者,不可不知医。愚则曰∶为人臣者,亦不可不知医。实
则凡为人者,皆不可不知医。所谓知者,又非一知半解之知,必灼见真知之知,乃为知也。
设使朝廷变通医官,或与封疆台阁并重并用,或与台阁封疆流通转用,或特设高爵浓
禄以寓医官,专为顾问,天下利病先诏天下学人,凡识字读书之始,必兼习医,使医道治道
合而为一。盖医道无一不通于治道,治道亦无一不通于医道,未有不谙治道而能医病者,亦
未有不精医道而能治国者。治民如治病,良相无异于良医;用药如用兵,名医即可为名将。
兴利除害,补偏救弊,理本一源;锄暴安良,驱邪养正,道原一贯。古今中外,歧而为二,其称
治者,尚非郅治,所号名医,仍非通医,诚能贯而通之,则人人皆能自治,皆能治人,皆能治
疾,皆能治国,皆能治兵。所谓良相良医,名医名将,所在皆是仁寿之宇,无敌之国,大同之
世,且将见之如此,而犹虑医界之人才不辈出,如八股卷折之盛,吾不信也。转移风气,端
在朝廷,然总不越乎名与利二者之妙用,故曰∶名利者,绝技之师。诚如是也,不特医学堂
无事开办,即各学堂亦不必设立。只悬名利以为鹄,而高爵浓禄以为招,则人莫不自为学,
且将合医界、学界、政界、兵界而一以贯之,截留无限经费,以待学成者之懋赏,此一本万
殊,万殊一本,抱一而为天下式之理,非故为高论也。医道无一不通于治道,虽古今中外大
儒名医未尝几见及此,故世多墨墨诚诚,纵观而博考之,静按而细绎之,何一端不相通,何
一理不相贯,而乃任其苟且轻贱,庸恶陋劣,各相隔阂几千万年,无惑乎医道之不明不行
也,今之偏重西医,与言西人之重医,皆属耳食目论,若徒论其解剖、实验、制药,良不无一
得之长,然解剖亦为吾国先代俞跗、华佗辈所遗,其中得失参半,昧者未尝索考外篇,已为
缕晰言之,若论气化,则仍如今之中医茫然如堕五里雾中,若复望其通治化则更堕百里雾
中矣。又安能语于医道。伏愿圣人在上,起百代之衰,振千秋之业,通一贯之道,开万世之
利,渐以吾国医道之衣冠文物输入列邦,而为开通外人之导线,岂不懿欤!尤有进者,朝廷治化,
莫要于赏罚,亦莫先于赏罚。如承明诏,变通医官,振兴医学,既悬懋赏,以为鼓励之方。即
订。严刑以为滥竽之戒,庸医杀人,向不论抵此,虽世人苟且轻贱之习有以自召,以致是非
成败,难于稽核,久使庸医漏网,乃复充斥人间。今必。明谕重申,先令世界之人毋得仍蹈
苟且轻贱于医之习,以自取祸,且当格外隆重以致敬礼,再于地方为立乡医、县医、府医、省
医各等医官名目,而令真能通医可为国师者,按临各省,认真考试,或令试于京师,如中式
者即录之而分布各区,一切经费悉由各区社会及地方官合筹分给各医,总以优裕足赡医
之身家,使得借以资医穷乏。其不录者,仍自归为医士,加功探讨,以待后日续选,不许即
妄与人延医。更令各区之医遇证立案,将脉相、证相、治否方法逐一详列,存之病家,并榜
诸通衢,按月分年,报官核验,以定是非功过,而为赏罚黜陟,然后上之大府,奏之朝廷。若
果成效多着,而又能通治道者,即行破格录用,不次超迁举主,并予上赏。若仍恶劣如前,
以及大不韪者,则即治以应得之罪,或更予以不测之诛,并将举主连坐,虽功过只论是非,
难论成败,然有真是非者,自必多成鲜败,虽
天之降才各殊,通才谈何容易。然能悉照愚方以医医,即不能人人合医道治道为一贯,亦必
良医辈出,多谙治道,一洗前习之陋,是可决也。故上赏者为医医之先声,而严罚者又医医
之后盾也。此者朝廷医医之良方也。
名利,是掌握绝技之人的老师。天地间的生死规律,人人皆具备;从古至今、中国外国,帝王驱使大众、培养人才以及转移社会风俗的奥妙作用,都在于此。圣贤豪杰,有的人不被利益所动摇,但不能不被名声所打动。我唯恐“不好名”的说法,不仅仅是针对夏商周三代以后的人而言的。孔子说:“忠诚守信并加重俸禄,是用来鼓励士人的。”西汉经学的兴盛,班固认为是由于利禄驱动的。至于唐代以诗赋兴盛,宋代以理学和经义兴盛,明代直到本朝,都以八股文取士。八股文到现在,确实已经毫无用处了。但在废除之前,不论聪明愚笨、贤良与否,没有人不耗尽毕生精力投身其中,最终因此被称为神品、能品,号称大家名家的不可胜数;凭借它获得高位、拥有巨富、承受丰厚赏赐和殊荣的不知有多少。当时并没有听说有八股学堂,不过是人们各自自学罢了。虽然设有书院之名,每省不过几个区域,省外则几乎没有。虽然有院长之称,每月不过几次考试,课外不再过问其他事务。那为什么八股文会如此兴盛呢?这大概是风气趋势所在,且被当权者所看重。其实也是被富贵所驱使,被名声与利益所利用。这可以借用来作为“医治医学”的药方。
除了八股文之外还有卷折(一种文体),其比八股文更为无谓,但当时卷折人才的兴盛,也几乎与八股文相当。大概如果不精通此项,即使八股文考中,仍然不能获得状元宰相的荣耀,于是天下的士大夫都争相成为这种人才。每个人都担心自己赶不上这种人才。唉!那时也没听说有卷折学堂,但卷折人才的兴盛却像那样,归根结底也是风气趋势所在,且被当权者所看重。这又何尝不是被富贵所驱使,被名声与利益所利用呢?这更可以作为“医治医学”的药方。
朝廷设置医官,置于太医院,职位仅三品,有差别等级的俸禄只有一百金以上,而且局限于一部之内,不能流通转用,以至于老死于此,真可谓是不甚爱惜的官职。官员尚且如此,那么所谓的医士、医生,世人把他们看作小道、当作低贱工匠对待,也就不足为怪了。稍有聪明才智的人,尚且不屑于去做,何况贤能智慧之人呢?虽然也有豪杰崛起、代代兴起,自成名流,但一代也不过几个人。当他们盛名远扬时,甚至听不到一个字的好评;等到他们死后,也只不过被列入《方技传》中,如同扁鹊、仓公、华佗、孙思邈而已。最奇怪的是,像仲景这样圣明的人物,《史记》和《汉书》都没有为他立传,尤其令人难以理解。当时八股文和卷折是通往富贵的阶梯,大众都趋向于此。如今新学新政是通往终南山的快捷方式,大众又趋向于此。如果说辞谢尊贵而居于卑位、辞谢富有而居于贫寒,另有人才,那么这类人才也是可以想象得到的,这些都是导致医学弊病的原因。
医道相对于八股文和卷折,有用之处万分之一,实际上仔细考察人人都知道。八股文和卷折早已可以废除,医道则是即便到天地终结也不可废除。竟然让早该废除的东西曾经那样隆盛,让万万不可废除的东西反而如此腐败。不知道医者自己存的是什么心?对待医者的人又存的是什么心?
医道对于新政和新学,也有万万不可忽视的帮助,如果不切切实实地说明,人们就不会知道。新政和新学似乎想要医治旧政旧学的弊病,如果不能很好地“医治”它们,那么即便到天地终结也无济于事。然而新政和新学现在同时并举,没有人敢废除。医道对于新政和新学的人,现在还是这样,废弃而不能举起,不知道医者自己有什么说法?对待医者的人又有什么说法?
朝廷设置医官,难道不是因为医学的作用仅仅是卫生保健和治疗疾病吗?政治与此无关。哪里知道医学之道,必须将格物、致知、诚意、正心、修身、齐家、治国、平天下这些事合而为一,贯通天、地、人,然后才可以称为医。所谓良医良相,所谓国手,更所谓补天手,不是虚拟的词藻,而是实际应当存在的事情,也是固有的道理。可惜古今中外,医者的思想大多达不到这个境界,学问向来不由此出发,资格都不及此,导致对待医者的人,习以为常而忘记,疏忽轻视,以至于到了这种地步。
医学不止于卫生保健和治疗疾病。即使只把它当作卫生保健和治疗疾病来考虑,即使是普通人,也万万不应该苟且轻忽,把身体托付给庸俗恶劣低劣的人手中去尝试。何况朝廷治理天下,旨在治疗万方百姓的疾苦,使没有一个人不被恩泽覆盖,进而达到天地定位、万物生长的境界,这就是所说的“君主一人有喜庆,亿万民众依赖他”。皇帝身体偶然不适,就交由太医治疗。京城的口号、国子监的文章、皇帝的仪仗、护卫的刀枪、太医的药方,确实可以说是一概而论的。一旦疗效不佳,各直省的督抚将军就会应诏召集群医。太医和群医,我都听熟了,了解得很透彻。封疆大吏都不是真正懂医的人,哪里有真正的对错判断?也只是仰仗朝廷洪福,或者借机建立功劳,不能说不是一种偶然的才能、一时的幸运。然而面对重大危机时,恐怕就不是真正的将军了。王子安和程伊川说:“做儿子的,不可以不懂医。”我说:“做臣子的,也不可以不懂医。”实际上凡是为人者,都不可以不懂医。所谓懂,又不是半知半解的懂,必须是透彻看清、真正知道的懂,才叫懂。
假使朝廷变通医官制度,或与封疆大吏、内阁重臣并重并用,或与台阁封疆流通转用,或特别设立高官厚禄来安置医官,专门作为顾问。先向天下颁布诏令,天下学人凡识字读书之初,必须兼习医学,使医道与治道合而为一。因为医道没有不通向治道的,治道也没有不通向医道的。没有不熟悉治道却能治病的人,也没有不精通医道却能治国的人。治理百姓如同治疗疾病,优秀的宰相无异于优秀的医生;用药如同用兵,名医即可成为名将。兴利除害、纠正偏差挽救弊端,道理本源相同;铲除暴虐安抚善良、驱除邪气培养正气,道原本一贯。古今中外,将其分为两途,那些自称善于治理的,还谈不上至治;那些号称名医的,仍不是通达的医。如果能贯通它们,那么人人都能自治,都能治人,都能治病,都能治国,都能治军。所谓良相良医、名医名将,到处都是仁寿之域、无敌之国、大同之世,并且将会见到这样的景象。如果还担心医学界的人才不能像八股文和卷折那样兴盛辈出,我不相信。转移风气,关键在于朝廷,但总离不开名与利二者的奥妙作用,所以说:“名利是绝技的老师。”如果真的这样,不仅医学堂不需要开办,就连各个学堂也不必设立。只要悬挂名利作为目标,以高官厚禄作为招揽,那么人们自然各自求学,并且将将医学界、学术界、政界、兵界贯通为一,截留无限经费,用来等待学业有成者的丰厚赏赐。这是一本万殊、万殊一本、抱一而为天下楷模的道理,并非故意发表高论。医道没有不通向治道的,虽然古今中外的大儒名医未曾几见有人达到这个境界,所以世人大多默默无言,真诚地纵观并广泛考证,安静地按察并细致推演,哪一端不相通,哪一理不相贯,却任由其苟且轻贱,庸俗恶劣低劣,彼此隔绝几千万年,难怪医道不明朗、不推行啊。现在偏重西医,以及谈论西方人重视医学,都属于耳食目论(道听途说、片面之词)。如果只谈论他们的解剖、实验、制药,确实可能有一些长处,但解剖也是我国古代俞跗、华佗等人所遗留的,其中的得失参半,愚昧的人不曾索求考查外篇,我已经详细说过。如果谈论气化,则仍然像现在的中医一样茫然如堕五里雾中,如果再指望他们通晓治化,那就更是堕入百里雾中了。又怎么能谈论医道呢?
伏愿圣人在上位,振兴百代的衰微,振作千秋的事业,贯通一贯之道,开启万世的利益,逐渐将我国的医道衣冠文物输入列国,作为开通外国人的导线,岂不美好!更有进言的是,朝廷的治理教化,没有比赏罚更重要的,也没有比赏罚更优先的。如果秉承明诏,变通医官,振兴医学,既然悬挂丰厚赏赐作为鼓励的方法,就应制定严刑作为滥竽充数的警戒。庸医杀人,向来不论抵命,这虽然是世人苟且轻贱的风气自我招致的,导致是非成败难以稽核,长久以来让庸医漏网,充斥人间。现在必须明确谕令重申,首先让世间之人不要再蹈苟且轻贱医学的覆辙,以免自取祸患,并且应当格外隆重以致敬礼。再在地方上设立乡医、县医、府医、省医等各等医官名目,并命令真正通晓医学、可以成为国师的人,巡视各省,认真考试。或者令其在京师考试,如果考中即录取并分布到各区。一切经费全部由各区社会及地方官共同筹划分发给各位医生,总要以优裕充足供养医生的身家,使他们能够借此资助贫困的医者。没有被录取的,仍自归为医士,加功探讨,等待日后续选,不许立即妄自给人延医。再令各区的医生遇到病症立案,将脉象、证候、治疗方法逐一详细列出,保存在病家,并张贴在交通要道,按月分年,上报官府核验,以确定是非功过,作为赏罚升降的依据,然后上报大府,奏请朝廷。如果果然成效显著,而又能通晓治道的人,就破格录用,越级提拔举荐人,并给予上等赏赐。如果仍然恶劣如前,以及犯有大错的人,就立即治以应得的罪,或更予以意想不到的诛杀,并将举荐人连坐。虽然功过只论是非,难论成败,但有真正是非的人,自然必然多成少败。虽然上天降下的才能各不相同,通才谈何容易。但如果能完全按照我的方案来“医治医学”,即使不能人人都将医道治道合而为一,也必定良医辈出,多通晓治道,彻底洗刷前习的陋习,这是可以断定的。所以上等奖赏者是“医治医学”的先声,而严厉惩罚者又是“医治医学”的后盾。这是朝廷“医治医学”的良好药方。
Fame and profit are the teachers of those who possess unique skills. The laws of life and death in heaven and earth are possessed by everyone; from ancient times to the present, within China and abroad, the subtle utility with which emperors drive the masses, cultivate talents, and transform social customs lies here. Sages, worthies, heroes, and outstanding men may not be moved by profit, but they cannot help but be moved by fame. I fear that the saying "not desiring fame" is not only spoken for people after the Three Dynasties. Confucius said: "Loyalty, trustworthiness, and heavy salaries are used to encourage scholars." The prosperity of Jingxue (Classics Studies) in the Western Han Dynasty was considered by Ban Gu to be caused by profit and salary. As for the Tang Dynasty's prosperity in poetry and fu (rhapsodies), the Song Dynasty's prosperity in Neo-Confucianism and Jingyi (Classics Interpretation), and the Ming Dynasty up to the current dynasty, all selected officials through Bagu (Eight-Legged Essay). Bagu has now become completely useless. But before its abolition, regardless of intelligence or virtue, no one did not exhaust their lifelong energy to enter it, and ultimately, those called divine products, capable products, or renowned masters were countless; those who achieved high positions, amassed great wealth, and received abundant rewards and honors due to it were unknown in number. At that time, there were no Bagu schools; people simply studied on their own. Although academies existed, there were only a few districts per province, and very few outside provinces. Although directors existed, there were only a few examinations per month, and nothing else was asked about outside class. So why was Bagu so prosperous? It is said to be the trend of the times and valued by the rulers. In reality, it was also driven by wealth and honor, and manipulated by fame and profit. This can be borrowed as a prescription for "curing medicine."
Besides Bagu, there were Juanzhe (a type of literary composition), which were even more meaningless than Bagu, yet the prosperity of Juanzhe talents at that time was almost equal to Bagu. Generally, without mastering this, even if one passed the Bagu examination, one could not attain the glory of Zhuangyuan (Top Scholar) or Prime Minister. Thus, scholars across the world competed to become such talents. Each worried about not catching up with such talents. Alas! There were no Juanzhe schools then, yet the prosperity of Juanzhe talents was like that. Ultimately, it was also the trend of the times and valued by the rulers. Was it not also driven by wealth and honor, and manipulated by fame and profit? This can further serve as a prescription for "curing medicine."
The court established medical officials in the Imperial Medical Bureau (Taiyiyuan), with ranks only up to the Third Rank. Salaries varied, mostly over one hundred taels of silver. They were confined to one department and could not circulate or transfer, leading them to die old there. Truly, these are officials not cherished by the state. If officials are treated thus, it is no wonder that the so-called medical practitioners are viewed by the world as minor arts and treated as lowly craftsmen. Those with even slight intelligence and ability would disdain to do it, let alone the wise and virtuous. Although heroes rose and succeeded each other, becoming famous streams, there were only a few in a generation. When their fame was at its peak, hardly a word of praise was heard; after their death, they were merely listed in the Biographies of Artisans (Fangji Zhuan), like Bian Que, Cang Gong, Hua Tuo, and Sun Simiao. Most strangely, someone as sage-like as Zhang Zhongjing has no biography in the *Records of the Grand Historian* (*Shiji*) or *Book of Han* (*Hanshu*), which is particularly baffling. At that time, Bagu and Juanzhe were ladders to wealth and honor, and the crowd flocked to them. Today, new learning and new policies are the shortcut to success, and the crowd flocks to them again. If one says that those who decline honor for humility and wealth for poverty are another kind of talent, such talents can be imagined. These are all causes of the disease in medicine.
Medical Dao is ten-thousandth times more useful than Bagu and Juanzhe; in fact, upon careful inspection, everyone knows this. Bagu and Juanzhe have long been abolishable, while Medical Dao is indispensable until the end of heaven and earth. Yet, what was early abolishable once flourished so greatly, while what was absolutely indispensable has instead decayed so much. I do not know what heart the medical practitioners hold? And what heart do those dealing with medical practitioners hold?
Medical Dao has immense benefits for new policies and new learning, which must be stated clearly, otherwise people will not know. New policies and new learning seem intended to cure the diseases of old policies and old learning. If they are not "cured" well, then even until the end of heaven and earth, they will be of no help. Yet, new policies and new learning are now implemented together, and no one dares to abolish them. Medical Dao's benefit to people of new policies and new learning is still the same: abolished and unable to be raised. I do not know what explanation medical practitioners have? And what explanation do those dealing with medical practitioners have?
Did the court establish medical officials just because the utility of medicine is merely health preservation and disease treatment? Politics has nothing to do with it. How can one know that the Dao of Medicine must integrate the matters of investigating things, extending knowledge, sincerity of will, rectification of mind, self-cultivation, regulating the family, governing the state, and bringing peace to the world into one? Only by connecting heaven, earth, and humanity can it be called Medicine. The so-called good doctors and good ministers, national experts, and even heaven-menders are not empty words, but actual realities and inherent principles. Unfortunately, throughout history and across the world, medical practitioners' thoughts rarely reach this level, their learning never starts from here, and their qualifications fall short. Consequently, those dealing with medical practitioners have grown accustomed to forgetting, neglecting, and despising them, reaching this extreme.
Medicine is not limited to health preservation and disease treatment. Even if regarded solely as such, even ordinary people should absolutely not be negligent and entrust their bodies to mediocre, vile, and inferior hands for experimentation. Especially since the court governs the world to treat the suffering of all regions, ensuring no one is left without grace, leading to the positioning of heaven and earth and the nurturing of all things—this is what is meant by "If the Son of Heaven has joy, the million people rely on him." If the Emperor's body is slightly unwell, he is treated by the Imperial Physicians. The slogans in the capital, essays in the Imperial Academy, imperial processions, guards' spears, and Imperial Physicians' prescriptions can indeed be discussed generally. If efficacy fails, governors and generals of provinces will summon physicians according to edict. I am familiar with Imperial Physicians and group physicians, knowing them well. Frontier officials are not true experts in medicine; how can they judge right and wrong? They merely rely on the court's great fortune or use the opportunity to achieve merit. This cannot be denied as a sporadic ability or temporary luck, but facing major crises, they are likely not true generals. Wang Zi'an and Cheng Yichuan said: "A son must know medicine." I say: "A minister must also know medicine." In truth, anyone being human must know medicine. The so-called "knowing" is not half-understanding, but clear, true knowledge.
Suppose the court reformed the medical official system, placing them on par with frontier governors and cabinet ministers, allowing circulation between them, or specially establishing high ranks and rich salaries for medical officials as advisors. First, an edict would be issued to all scholars: from the beginning of literacy and reading, one must study medicine simultaneously, merging Medical Dao and Governance Dao. Because Medical Dao has nothing that does not connect to Governance Dao, and Governance Dao has nothing that does not connect to Medical Dao. One cannot treat diseases without understanding governance, nor govern a country without mastering medicine. Governing people is like treating disease; a good minister is no different from a good doctor. Using medicine is like using troops; a famous doctor can be a famous general. Promoting benefits and removing harms, correcting biases and saving defects, share the same origin; eliminating violence and comforting the good, driving out evil and nourishing righteousness, follow the same path. Ancient and modern, inside and outside China, dividing them into two leads to those claiming governance not achieving perfect rule, and those called famous doctors not being truly comprehensive. If integrated, everyone can self-govern, govern others, treat diseases, govern states, and command armies. Good ministers and good doctors, famous doctors and famous generals, would be everywhere, creating realms of benevolence and longevity, invincible nations, and the Great Harmony. We would see such a scene. If we still worry that medical talents will not emerge in waves like Bagu and Juanzhe, I do not believe it. Transforming customs depends on the court, but ultimately revolves around the subtle utility of fame and profit. Hence, "Fame and profit are the teachers of unique skills." If this were true, not only would medical schools be unnecessary, but all schools would be redundant. By setting fame and profit as goals and high ranks/rich salaries as bait, people would naturally study on their own, integrating the medical, academic, political, and military spheres. Infinite funds would be saved for rewarding successful students. This is the principle of "One root, myriad branches; myriad branches, one root," embracing unity as the model for the world, not a lofty theory. Medical Dao connects to Governance Dao, yet few great sages and doctors have seen this. Thus, people remain silent, observing broadly and studying carefully. Analyzing quietly and deducing finely, where do ends not connect? Where do principles not interweave? Yet they allow negligence and contempt, mediocrity and vileness, separation for tens of millions of years. No wonder Medical Dao is unclear and unimplemented. Current bias towards Western medicine and talk of Westerners valuing medicine are hearsay and superficial views. Discussing anatomy, experiments, and pharmaceuticals, they may have some merits. Anatomy was also left by our ancestors Yu Fu and Hua Tuo; gains and losses are mixed. Ignorant people haven't researched external texts, which I have detailed. Regarding Qi transformation, they are as confused as current TCM practitioners in a fog. Expecting them to understand governance is entering a thicker fog. How can they discuss Medical Dao?
I pray the Sage sits above, reviving declines of a hundred generations, uplifting achievements of a thousand autumns, connecting the consistent Dao, opening benefits for ten thousand generations, gradually inputting our nation's medical culture into foreign countries, acting as a guide for opening foreigners. Is this not admirable? Furthermore, regarding court governance, nothing is more important or prior than rewards and punishments. Following the bright edict to reform medical officials and revitalize medicine, having set abundant rewards as encouragement, strict punishments must be established as a warning against incompetence. Quack doctors killing people have never been held accountable. Although this stems from the world's negligent and contemptuous habits, making right/wrong and success/failure hard to verify, allowing quacks to escape punishment and fill the world, we must now issue clear edicts reiterating that people must not repeat the habit of neglecting and despising medicine to avoid disaster. Instead, extra respect and reverence should be shown. Establish local medical official titles: Village Doctor, County Doctor, Prefecture Doctor, Provincial Doctor. Order those truly proficient in medicine, capable of becoming National Teachers, to inspect provinces and conduct rigorous exams. Or examine them in the capital. Those passing are recorded and distributed to districts. All expenses are jointly planned by district societies and local officials to provide ample support for doctors' livelihoods, enabling them to assist impoverished medical practitioners. Those not recorded remain as medical practitioners, continuing their studies for future selection, forbidden from practicing immediately. Require district doctors to record cases upon diagnosis, detailing pulse signs, symptom patterns, and treatment methods, keeping records with patients and posting them in public places. Report monthly and annually to officials for verification to determine merit/demerit, serving as basis for rewards/punishments and promotions/demotions, then report to higher authorities and the court. If effective and knowledgeable in governance, promote exceptionally and reward sponsors. If still bad or committing major errors, punish accordingly or execute unexpectedly, holding sponsors liable. Although merit/demerit focuses on right/wrong rather than success/failure, those with true right/wrong will likely succeed more than fail. Although natural talents vary, universal talents are rare. But if everyone follows my prescription to "cure medicine," even if not fully integrating Medical and Governance Dao, good doctors will surely emerge, many understanding governance, washing away past陋习 (bad habits). This is certain. Thus, high rewards are the prelude to "curing medicine," and strict punishments are its backing. This is the court's good prescription for "curing medicine."