（张介宾着）
一曰病患之情。所谓病患之情者，有素禀之情，如五脏各有所偏，七情各有所
胜。阳脏者，偏宜于凉。阴脏者，偏宜于热。耐毒者，缓之无功。不耐毒者，峻之
为害。此脏气之有不同也。有好恶之情者，不惟饮食有憎爱，抑且举动皆关心。性
好吉者，危言见非。意多忧者，慰安云伪。未信者，忠告难行。善疑者，深言则忌。
此情性之有不同也。有富贵之情者，富多任性，贵多自尊。任性者，自是其是。真
是者，反成非是。自尊者，遇士或慢。自重者，安肯自轻。此交际之有不同也。有
贫贱之情者，贫者衣食不能周，况乎药饵。贱者焦劳不能释，怀抱可知。此调摄之
有不同也。又若有良言甫信，谬说更新，多岐亡羊，终成画饼，此中无主而易乱者
之为害也。有最畏出奇，惟求稳当，车薪杯水，宁甘败亡，此内多惧而过慎者之为
害也。有以富贵而贫贱，或深情而挂牵，戚戚于心，心病焉能心药，此得失之情为
害也。有以急性而遭迟病，以更医而致杂投，惶惶求速，速变所以速亡，此缓急之
情为害也。有偏执者，曰吾乡不宜补，则虚者受其祸。曰吾乡不宜泻，则实者被其
伤。夫十室且有忠信，一乡焉能皆符，此习俗之情为害也。有参、术入唇，惧补心
先痞塞。硝、黄沾口，畏攻神即飘扬。夫杯影亦能为祟，多疑岂法之良，此成心之
情为害也。有讳疾而不肯言者，终当自误。有隐情而不敢露者，安得其详。然尚有
故隐病情，试医以脉者。使其言而偶中，则信为明良。言有弗合，则目为庸劣。抑
孰知脉之常体，仅二十四，病之变象，何啻百千。是以一脉所主非一病，一病所见
非一脉。脉病相应者，如某病得某脉则吉。脉病相逆者，某脉值某病则凶。然则理
之吉凶，虽融会在心，而病之变态，又安能以脉尽言哉。故知一、知二、知三，神
圣谆谆于参伍。曰工、曰神、曰明，精详岂独于指端。彼俗人之浅见，固无足怪；
而士夫之明慧，亦每有蹈此弊者。故忌望闻者，诊无声色之可辨。恶详问者，医避
多言之自惭。是于望、闻、问、切，已舍三而取一，且多有并一未明。而欲得夫病
情者，吾知其必不能也。所以志意未通，医不免为病困。而朦胧猜疑，病不多为医
困乎？凡此皆病患之情，不可不察也。
二曰旁人之情。所谓旁人之情者，如浮言为利害所关，而人多不知检。故或为
自负之狂言，则医中有神理，岂其能测。或执有据之凿论，而病情多亥豕，最所难
知。或操是非之柄，则同于我者是之，异于我者非之，而真是真非，不是真人不识。
或执见在之见，则头疼者云救头，脚疼者云救脚，而本标纲目，反为迂远庸谈。或
议论于贵贱之间，而尊贵执言，孰堪违抗，故明哲保身之士，宁为好好先生。或辨
析于亲疏之际，而亲者主持，牢不可拔，虽真才实学之师，亦当唯唯而退。又若荐
医，为死生之攸系，而人多不知慎。有或见轻浅之偶中而为之荐者，有意气之私浓
而为之荐者，有信其便便之谈而为之荐者，有见其外饰之貌而为之荐者，皆非知之
真者也。又或有贪得而荐者，阴利其酬。关情而荐者，别图冀望。甚有斗筲之辈者，
妄自骄矜，好人趋奉，薰莸不辨，擅肆品评。誉之则盗跖即尧舜，毁之则鸾凤亦鸱
，洗垢索瘢，无所不至。而怀真抱德之士，必其不侔。若此流者，虽其发言容易，
欣戚无关，其于淆乱人情，莫此为甚。多致明医有掣肘之去，病家起刻骨之疑。此
所以千古是非之不明，总为庸人扰之耳。故竭力为人任事者，岂不岌岌其危哉。凡
此皆旁人之情，不可不察也。
三曰同道人之情。所谓同道人之情者，尤为闪灼，更多隐微。如管窥蠡测，醯
鸡笑天者，固不足道；而见偏性拗，必不可移者，又安足论。有专恃口给者，牵合
支吾，无稽信口。或为套语以诳人，或为甘言以悦人，或为强辩以欺人，或为危词
以吓人，俨然格物君子，此便佞之流也。有专务人事者，典籍经书，不知何物，道
听途说，拾人唾余，然而终日营营，绰风求售，不邀自赴，儇媚取容，偏投好者之
心，此阿谄之流也。有专务奇异者，腹无藏墨，眼不识丁，乃诡言神授，伪托秘传，
或假脉以言祸福，或弄巧以乱经常，最觉新奇，动人甚易，此诈欺之流也。有务饰
外观者，夸张侈口，羊质虎皮。不望色，不闻声，不详问，一诊而药，若谓人浅我
深，我明人昧，此粗疏孟浪之流也。有专务排挤者，阳若同心，阴为浸润。夫是曰
是，非曰非，犹避隐恶之嫌，第以死生之际，有不得不辨者，固未失为真诚之君子。
若以非为是，以是为非，颠倒阴阳，掀翻祸福，不知而然，庸庸不免，知而故言，
此其良心已丧，谗妒之小人也。有贪得无知，藐人性命者。如事已疑难，死生反掌，
斯时也，虽在神良，未必其活。故一药不敢苟，一着不敢乱，而仅仅冀于挽回。忽
遭若辈，求速贪功，谬妄一投，中流失楫，以致必不可救。因而嫁谤自文，极口反
噬。虽朱紫或被混淆，而苍赤何辜受害，此贪幸无知之流也。有道不同不相为谋者，
意见各持，异同不决。夫轻者不妨少谬，重者难以略瘥。故凡非常之病，非非常之
医不能察。用非常之治，又岂常人之所知。故独闻者，不侔于众；独见者，不合于
人。大都行高者谤多，曲高者和寡，所以一齐之傅，何当众楚之咻。直至于败，而
后群然退散，什之一人，则事已无及矣，此庸庸不揣之流也。又有久习成风，苟且
应命者。病不关心，些须惟利。盖病家既不识医，则倏赵倏钱；医家莫肯任怨，则
惟苓惟梗。或延医务多，则互为观望。或利害攸系，则彼此避嫌。故爬之不痒，挝
之不痛。医称稳当，诚然得矣。其于坐失机宜，奚堪耽误乎？此无他，亦惟知医者
不真，而任医者不专耳。诗云∶发言盈庭，谁执其咎？筑室于道，不溃于成。此病
家、医家近日之通弊也，尚多难尽。必期不失，未免迁就。但迁就，则碍于病情。
不迁就，则碍于人情。有必不可迁就之病情，而复有不得不迁就之人情，其将奈之
何哉。当局者，能详察斯言，而各为儆省。非惟病患之情，旁人之情，同道人之情，
不难于不失，而相与共保天年，同登寿域之地，端从此始，惟明者鉴之。
陶弘景曰∶凡煮汤欲微火，令小沸。其水根据方。大略二十四药，用水一斗，煮
取四升，以此为推。然利汤欲生，少水而多取汁。补汤欲熟，多水而少取汁，不得令水多少。用新
布两人一尺木绞之，澄去 浊，纸覆令密。温汤勿用铁器服。汤宁小沸，热则易下，冷则呕涌。
李时珍曰∶陶氏所说乃古法也。今之小小汤剂，每一两，用水二瓯为准。多则
加，少则减之。如剂多水少，则药味不出。剂少水多，又煎耗药力也。凡煎药，并
忌铜、铁器，宜用银器、瓦罐，洗净封固，令小心者看守。须识火候，不可太过、
不及。火用木炭、芦苇为佳。其水须新汲味甘者。流水、井水、沸汤等各根据方法。
若发汗药，必用紧火热服。攻下药，亦用紧火煎熟，下硝黄再煎，温服。补中药宜慢火，温服。
阴寒急病，亦宜紧火急煎服之。又有阴寒烦躁，及暑月伏阴在内者，宜水中沉冷服。
孙真人曰∶夫百病之本，有中风、伤寒、寒热、温疟、中恶、霍乱、大腹水肿、
肠、下利、大小便不通、贲豚、上气、咳逆、呕吐、黄胆、消渴、留饮、癖食、
坚积、 瘕、惊邪、癫痫、鬼疰、喉痹、齿痛、耳聋、目盲、金疮、 折、痈肿、
恶疮、痔 、瘤瘿、男子五劳七伤、虚乏羸瘦、女子带下、崩中、血闭、阴蚀、蛊
蛇蛊毒。此皆大略宗兆，其间变动枝叶，各根据端绪以取之。又有冷热劳损、伤饱、
房劳、惊悸、恐惧、忧恚、怵惕，又有产乳、落胎、堕下、瘀血，又有贪饵五石，
以求房中之乐，此皆病之根源，为患生诸枝叶也，不可不知其本末。但向医说，
男女长幼之病，有半与病源相附会者，便可服药也。男子者，众阳所归，常居于燥。
阳气游动，强力施泄，便成劳损。损伤之病，亦以众矣。若比之女人，则十倍易治。
凡女子十四以上，则有月事，月事来日，得风冷湿热，四时之病相协者，皆自说之。
不尔，与治误相触动，更增困也。处方者，亦应问之。
孙真人曰∶比来田野下里家，因市得药，随便市上雇人捣合，非止诸不如法，
至于石斛、菟丝子等难捣之药，费人功力，赁作捣者，隐主悉盗弃之。又为尘埃秽
气入药中，罗筛粗恶，随风飘扬。众口尝之，众鼻嗅之。药之精气，一切都尽，与
朽木不殊。又复服饵不能尽如法。服尽之后，反加虚损，遂谤医者处方不效。夫如
此者，非医之咎。自缘发意甚误，宜熟思之。
玉华子云∶知邪思者，觉也。断邪思者，不续也。人之有疾，必有所因。及知
其因，则谨于未因，及去其因，勿复其因，此愈疾之功也。断念之觉，由于不续。
每觉每去，勿续则已。故曰∶瞥求是病，不续是药。
张大复曰∶杀物以疗病，不若全物以疗之之善也。昔予舅氏之病疹也。外大父
将求鹳卵而疗焉。既得之矣，鹳且逐卵而仆于地。大父伤之曰∶有死子而求生之，
有生卵而必伤之，何见之舛也。遂舍之。夜半疹愈。夫使食卵而愈，未有不以为卵
验矣。鹳有其卵而子得生，亦非鹳之能生之也。然而生非卵验也，因是可以解世人
之惑。余常病悸。有医者教之食鳖。曰∶食鳖则血滋，血滋则悸去。从之期月而悸
自如也。一夕梦群鳖来嘬余，自颈以及于臂，肤无完者。觉而心怦怦焉，悸乃益甚。
嗟乎！固有以杀而病甚者也。
（张介宾著）
一是病患的情状。所谓病患的情状，有先天禀赋的情状，如五脏各有偏颇，七情各有相胜。阳脏之人，偏宜于凉性；阴脏之人，偏宜于热性。耐毒性者，用药缓和则无效；不耐毒性者，用药峻猛则有害。这是脏气不同所致。有好恶之情者，不仅饮食有憎爱，连日常举动也都牵动心神。喜好吉利者，危言耸听会被视为非议；多忧疑者，安慰之言被视为虚伪。未信任者，忠告难以施行；善怀疑者，深切的言论会招致忌讳。这是性情不同所致。有富贵之情者，富人大多任性，贵人大多自尊。任性者，自以为是；真正正确的事，反而被当成错误。自尊者，遇到士人或许傲慢；自重者，怎肯自轻？这是交际方式不同所致。有贫贱之情者，穷人衣食尚且不能周全，何况药物；贱者劳苦忧愁无法排解，其心境可知。这是调养护理不同所致。又有刚相信良言，又更新谬说，像歧路亡羊一样迷失方向，最终成画饼充饥，这是心中无主而容易混乱带来的危害。有最畏惧出奇制胜，只求稳妥，如同杯水车薪，宁可甘愿失败灭亡，这是内心多恐惧而过分谨慎带来的危害。有因富贵转为贫贱，或深情牵挂亲人，心中愁苦，心病岂能用心药治愈，这是得失之情带来的危害。有因急性病却遭遇迟缓治疗，或因频繁换医导致杂药乱投，惶惶不安求速效，结果速变导致速亡，这是缓急之情带来的危害。有偏执者，说我们家乡不宜进补，则虚证患者受其祸害；说我们家乡不宜攻下，则实证患者受其伤害。十户人家尚且有忠信之士，一乡之人怎能都符合习俗，这是习俗之情带来的危害。有人见人参、白术入口，担心补益会导致心先痞塞；见硝石、大黄沾口，畏惧攻伐会使精神立即飘散。杯弓蛇影亦能为祟，多疑岂是良好的法度，这是成见之情带来的危害。有隐瞒疾病不肯说的，最终当自误；有隐藏实情不敢表露的，怎能得到详细病情？然而还有故意隐瞒病情，用脉象试探医生的。如果医生言中偶合，则相信其为明医良才；言语不合，则目为庸劣之辈。殊不知脉象常体仅有二十四种，病变之象何止百千。因此一脉所主并非一种病，一病所见并非一脉。脉与病相应者，如某病得某脉则吉；脉与病相逆者，某脉值某病则凶。然而道理之吉凶，虽融会于心，但病的变态，又怎能仅凭脉象尽言呢？所以知一、知二、知三，圣人谆谆教导要参伍比较。曰工、曰神、曰明，精详岂独在于指端？那些俗人的浅见，固不足怪；而士大夫的明慧，也常有蹈此弊病的人。所以忌讳望闻问切中的望、闻，是因为诊断没有声色可辨；厌恶详细问诊，是医生避免多言自惭。这样对于望、闻、问、切，已舍弃三项只取一项，且多有连一项都未弄明白，就想了解病情，我知道这一定不能做到。所以意志未通，医生不免被病人困扰；而朦胧猜疑，病人不也多困扰医生吗？凡此皆病患的情状，不可不考察。
二是旁人的情状。所谓旁人的情状，如浮言关乎利害，而人多不知检点。所以或有自负的狂言，说医中有神理，岂能测度？或执有据的凿论，而病情多有错讹，最难知晓。或操持是非之柄，同于我的就说是，异于我的就说非，而真正的真与非，不是真人不识。或执着眼前的见解，头疼者说救头，脚疼者说救脚，而本标纲目，反被视为迂腐庸谈。或在贵贱之间议论，而尊贵者执言，谁敢违抗，所以明哲保身之士，宁愿做好好先生。或在亲疏之际辨析，而亲近者主持，牢不可拔，虽是真才实学之师，也当唯唯诺诺退下。又有推荐医生，关乎死生，而人多不知慎重。有的因见轻浅之症偶合而推荐，有的因意气私浓而推荐，有的信其滔滔不绝之谈而推荐，有的见其外表修饰之貌而推荐，都不是真正了解的人。又有因贪得而推荐的，暗中图谋酬金；因关情而推荐的，别图冀望。甚至有见识短浅之辈，妄自骄矜，喜欢别人趋炎附势，薰莸不辨，擅肆品评。赞誉则盗跖即尧舜，诋毁则鸾凤亦鸱枭，洗垢索瘢，无所不至。而怀真抱德之士，必然不相容。像这类人，虽然发言容易，欣戚无关，其对淆乱人情，没有比这更严重的了。多导致明医有掣肘而去，病家起刻骨之疑。这就是千古是非不明，总为庸人扰乱罢了。所以竭力为人任事者，岂不岌岌可危吗？凡此皆旁人的情状，不可不考察。
三是同道人的情状。所谓同道人之情状，尤为闪烁，更多隐微。如管窥蠡测、醯鸡笑天者，固不足道；而见解偏执拗硬，必不可移者，又安足论。有专恃口才者，牵强支吾，无稽信口。或用套语欺骗人，或用甜言蜜语取悦人，或用强辩欺瞒人，或用危词吓唬人，俨然格物君子，这是便佞之流。有专务人事者，典籍经书，不知何物，道听途说，拾人唾余，然而终日营营，招摇撞骗，不邀自赴，谄媚取容，偏投好者之心，这是阿谄之流。有专务奇异者，腹无藏墨，眼不识丁，乃诡言神授，伪托秘传，或假借脉象预言祸福，或弄巧以乱经常，最觉新奇，动人甚易，这是诈欺之流。有务饰外观者，夸张侈口，羊质虎皮。不看色，不听声，不详问，一诊开药，若谓人浅我深，我明人昧，这是粗疏孟浪之流。有专务排挤者，表面若同心，暗中进谗言。是曰是，非曰非，犹避隐恶之嫌，只在生死之际，有不得不辨者，固未失为真诚之君子。若以非为是，以是为非，颠倒阴阳，掀翻祸福，不知而然，庸庸不免，知而故言，这是良心已丧，谗妒之小人。有贪得无知，藐视人性命者。如事已疑难，死生反掌，此时即使神医良才，未必能活。所以一药不敢苟且，一着不敢乱来，仅仅希望挽回。忽遭若辈，求速贪功，谬妄一投，中流失楫，以致必不可救。因而嫁谤自文，极口反噬。虽朱紫或被混淆，而苍赤何辜受害，这是贪幸无知之流。有道不同不相为谋者，意见各持，异同不决。轻者不妨少谬，重者难以略瘥。所以非常之病，非非常之医不能察。用非常之治，又岂常人之所知。所以独闻者，不侔于众；独见者，不合于人。大都行高者谤多，曲高者和寡，所以一齐之傅，何当众楚之咻。直至于败，而后群然退散，什之一人，则事已无及矣，这是庸庸不揣之流。又有久习成风，苟且应命者。病不关心，些须惟利。盖病家既不识医，则倏赵倏钱；医家莫肯任怨，则惟苓惟梗。或延医务多，则互为观望。或利害攸系，则彼此避嫌。故爬之不痒，挝之不痛。医称稳当，诚然得矣。其于坐失机宜，奚堪耽误乎？此无他，亦惟知医者不真，而任医者不专耳。诗云∶发言盈庭，谁执其咎？筑室于道，不溃于成。这是病家、医家近日之通弊也，尚多难尽。必期不失，未免迁就。但迁就，则碍于病情。不迁就，则碍于人情。有必不可迁就之病情，而复有不得不迁就之人情，其将奈之何哉。当局者，能详察斯言，而各为儆省。非惟病患之情，旁人之情，同道人之情，不难于不失，而相与共保天年，同登寿域之地，端从此始，惟明者鉴之。
陶弘景说∶凡是煮汤，要用微火，令小沸。水量根据方剂。大略二十四味药，用水一斗，煮取四升，以此类推。然而利水之汤欲生，少水而多取汁。补益之汤欲熟，多水而少取汁，不得令水多少不当。用新布，两人一尺木绞之，澄清去浊，纸覆令密。温汤勿用铁器服用。汤宁小沸，热则易下，冷则呕涌。
李时珍说∶陶氏所说乃是古法。如今小小汤剂，每一两，用水二瓯为准。多则加，少则减之。如剂多水少，则药味不出。剂少水多，又煎耗药力也。凡煎药，并忌铜、铁器，宜用银器、瓦罐，洗净封固，令小心者看守。须识火候，不可太过、不及。火用木炭、芦苇为佳。其水须新汲味甘者。流水、井水、沸汤等各根据方法。若发汗药，必用紧火热服。攻下药，亦用紧火煎熟，下硝黄再煎，温服。补中药宜慢火，温服。阴寒急病，亦宜紧火急煎服之。又有阴寒烦躁，及暑月伏阴在内者，宜水中沉冷服。
孙真人说∶夫百病之本，有中风、伤寒、寒热、温疟、中恶、霍乱、大腹水肿、肠澼、下利、大小便不通、贲豚、上气、咳逆、呕吐、黄疸、消渴、留饮、癖食、坚积、癥瘕、惊邪、癫痫、鬼疰、喉痹、齿痛、耳聋、目盲、金疮、骨折、痈肿、恶疮、痔、瘤瘿、男子五劳七伤、虚乏羸瘦、女子带下、崩中、血闭、阴蚀、蛊蛇蛊毒。此皆大略宗兆，其间变动枝叶，各根据端绪以取之。又有冷热劳损、伤饱、房劳、惊悸、恐惧、忧恚、怵惕，又有产乳、落胎、堕下、瘀血，又有贪饵五石，以求房中之乐，此皆病之根源，为患生诸枝叶也，不可不知其本末。但向医说，男女长幼之病，有半与病源相附会者，便可服药也。男子者，众阳所归，常居于燥。阳气游动，强力施泄，便成劳损。损伤之病，亦以众矣。若比之女人，则十倍易治。凡女子十四以上，则有月事，月事来日，得风冷湿热，四时之病相协者，皆自说之。不尔，与治误相触动，更增困也。处方者，亦应问之。
孙真人说∶近来田野下里家，因市得药，随便市上雇人捣合，非止诸不如法，至于石斛、菟丝子等难捣之药，费人功力，赁作捣者，隐主悉盗弃之。又为尘埃秽气入药中，罗筛粗恶，随风飘扬。众口尝之，众鼻嗅之。药之精气，一切都尽，与朽木不殊。又复服饵不能尽如法。服尽之后，反加虚损，遂谤医者处方不效。夫如此者，非医之咎。自缘发意甚误，宜熟思之。
玉华子说∶知邪思者，觉也。断邪思者，不续也。人之有疾，必有所因。及知其因，则谨于未因，及去其因，勿复其因，此愈疾之功也。断念之觉，由于不续。每觉每去，勿续则已。故曰∶瞥求是病，不续是药。
张大复说∶杀物以疗病，不若全物以疗之之善也。昔予舅氏之病疹也。外大父将求鹳卵而疗焉。既得之矣，鹳且逐卵而仆于地。大父伤之曰∶有死子而求生之，有生卵而必伤之，何见之舛也。遂舍之。夜半疹愈。夫使食卵而愈，未有不以为卵验矣。鹳有其卵而子得生，亦非鹳之能生之也。然而生非卵验也，因是可以解世人之惑。余常病悸。有医者教之食鳖。曰∶食鳖则血滋，血滋则悸去。从之期月而悸自如也。一夕梦群鳖来嘬余，自颈以及于臂，肤无完者。觉而心怦怦焉，悸乃益甚。嗟乎！固有以杀而病甚者也。
(Zhang Jiebin wrote)
First is the condition of the patient. What is meant by the condition of the patient includes the constitution, such as each of the Zang organs having its own bias, and each of the Seven Emotions having its own overcoming relationship. Those with a Yang constitution are predisposed to favor coolness; those with a Yin constitution are predisposed to favor heat. For those tolerant of toxicity, mild treatment yields no effect; for those intolerant of toxicity, harsh treatment causes harm. This is due to differences in Zang Qi (Visceral Qi). There are those with preferences and aversions, whose dietary likes and dislikes not only extend to food but also affect their daily actions. Those who favor auspiciousness may reject alarming words; those prone to worry may view comfort as false. For the untrusting, sincere advice is hard to accept; for the suspicious, profound words invite resentment. These are differences in temperament. There are those from wealthy and noble backgrounds: the rich often act willfully, the noble often value their status. The willful consider themselves always right; true correctness may be seen as wrong. The self-important may treat scholars with disdain; those who value themselves would never demean themselves. These are differences in social interaction. There are those from poor and humble backgrounds: the poor cannot even ensure basic food and clothing, let alone medicine; the humble are burdened with anxiety and labor, making their state of mind understandable. These are differences in care and nursing. Furthermore, some may initially trust good advice but then adopt new fallacies, like losing sheep on many paths, ultimately achieving nothing—this is the harm caused by being leaderless and easily confused. Some fear unconventional methods, seeking only stability, like trying to extinguish a burning cart with a cup of water, preferring failure over risk—this is the harm caused by excessive caution due to inner fear. Some suffer from changes in fortune or deep emotional attachments, causing mental distress where mental illness cannot be cured by mental remedies—this is the harm caused by gains and losses. Some suffer from acute illnesses treated too slowly, or from frequent doctor changes leading to mixed medications, anxiously seeking speed which leads to rapid deterioration and death—this is the harm caused by urgency and slowness. Some are dogmatic, claiming their region does not benefit from tonification, thus harming those with deficiency; claiming their region does not benefit from purgation, thus harming those with excess. Even in ten households there are loyal and trustworthy people, so how can an entire village conform to custom? This is the harm caused by local customs. Some fear that entering Ren Shen (Radix Ginseng) or Bai Zhu (Rhizoma Atractylodis Macrocephalae) will cause chest stuffiness from tonification; they fear that touching Xiao Shi (Natrii Sulfas) or Da Huang (Radix et Rhizoma Rhei) will scatter their spirit from purgation. Like seeing a bow's reflection in a cup and fearing it is a snake, excessive suspicion is not a good method—this is the harm caused by preconceived notions. Some hide their illness and refuse to speak, eventually harming themselves; some hide their true feelings and dare not reveal them, making it impossible to obtain detailed information. However, some deliberately conceal their condition to test the doctor via pulse diagnosis. If the doctor happens to be correct, they are believed to be wise and capable; if incorrect, they are deemed mediocre. Who knows that there are only twenty-four common pulse types, while disease manifestations number in the hundreds or thousands? Therefore, one pulse does not correspond to only one disease, and one disease does not present with only one pulse. When pulse and disease correspond, such as a specific disease presenting with a specific pulse, it is auspicious; when they contradict, such as a specific pulse appearing with a specific disease, it is ominous. Although the principles of auspiciousness and ominousness reside in the heart, how can the variations of disease be fully described by pulse alone? Thus, knowing one, two, three, the sages earnestly taught the method of "San Wu" (interweaving and comparing). Being skilled, divine, and bright requires precision not just at the fingertips. The shallow views of laypeople are hardly surprising; yet even intelligent scholars often fall into this trap. Those who avoid inspection and listening find no color or sound to distinguish; those who dislike detailed questioning avoid speaking to prevent shame. By abandoning three of the Four Diagnostic Methods (Inspection, Auscultation-Olfaction, Inquiry, Palpation) for just one, and often failing to master even that one, it is impossible to understand the patient's condition. Thus, if communication is not established, the doctor is troubled by the patient; and if confusion and suspicion prevail, the patient troubles the doctor. All these are conditions of the patient that must be examined.
Second is the condition of bystanders. Bystander conditions involve rumors related to benefits and harms, where people often fail to restrain themselves. Some make arrogant claims that medical principles are mysterious and unfathomable. Others insist on seemingly evidence-based arguments, yet the actual condition is often erroneous and difficult to know. Some wield the power of right and wrong, agreeing with those like themselves and disagreeing with others, leaving true truth unknown to anyone. Some cling to superficial views, suggesting treating head pain by saving the head and foot pain by saving the foot, ignoring root and branch relationships as pedantic talk. In discussions between nobles and commoners, the noble's word prevails, forcing wise men to become yes-men. Among relatives and strangers, the relative's opinion dominates, forcing even competent doctors to retreat silently. Regarding doctor recommendations, which determine life and death, people are often careless. Some recommend based on minor coincidences, some out of personal favoritism, some swayed by eloquent speech, some by outward appearance—all lacking true understanding. Some recommend for greed, secretly seeking rewards; some out of personal connection, seeking other hopes. Some petty individuals, arrogant and flattering, cannot distinguish good from bad, praising thieves as saints and destroying phoenixes as owls, finding fault endlessly. True virtuous scholars are incompatible with such people. Though these individuals speak lightly without caring about joy or sorrow, their confusion of human sentiments is unparalleled. This often drives away skilled doctors and creates deep suspicion in patients' families. This is why right and wrong remain unclear for millennia, disturbed by mediocrities. Thus, those striving to handle affairs for others face great danger. All these are conditions of bystanders that must be examined.
Third is the condition of colleagues. Colleague conditions are particularly elusive and subtle. Those with narrow views are unworthy of mention; those with stubborn biases are not worth discussing. Some rely solely on eloquence, making baseless claims. They use clichés to deceive, sweet words to please, strong arguments to trick, or frightening words to scare, posing as gentlemen of investigation—these are the flatterers. Some focus on social connections, ignorant of classics, spreading hearsay, busy all day to sell themselves, flattering to please others—these are the sycophants. Some pursue novelty, ignorant yet claiming divine revelation or secret transmission, faking pulse readings to predict fortune, or playing tricks to disrupt norms—these are the frauds. Some focus on outward appearance, exaggerating, looking impressive but empty inside. Without inspecting color, listening to sound, or asking details, they prescribe after one pulse, claiming depth and clarity others lack—these are the reckless and careless. Some specialize in exclusion, pretending unity while plotting behind the scenes. While distinguishing right from wrong avoids hiding faults, especially in life-and-death matters, sincerity remains. But confusing right with wrong, overturning yin and yang, and fabricating misfortune out of ignorance or malice indicates lost conscience and jealousy—these are slanderous villains. Some are greedy and ignorant, despising human life. In critical cases, even gods might fail. One must not take rash risks, hoping only for recovery. Suddenly encountering such people who seek quick success through reckless prescriptions leads to disaster beyond repair. They then shift blame and attack verbally. Though colors may be confused, why should the innocent suffer? These are the greedy and ignorant. Those with different paths do not plan together, holding divergent opinions. Minor errors may be tolerated in light cases, but serious cases require precise treatment. Extraordinary diseases require extraordinary doctors; extraordinary treatments are unknown to ordinary people. Those who hear uniquely differ from the crowd; those who see uniquely do not fit in. High conduct invites much slander; high songs have few singers. Hence, one teacher cannot withstand the noise of Chu. Only when failure occurs do they disperse, too late for the few who remained. These are the presumptuous mediocrities. Some have grown accustomed to perfunctory compliance. They care little for the disease, focusing only on profit. Since patients don't understand medicine, they switch doctors frequently; since doctors refuse to bear responsibility, they use bland herbs like Ling Cao (Radix Glycyrrhizae) and Jie Geng (Radix Platycodi). When extending treatment costs, they watch each other; when interests conflict, they avoid suspicion. Thus, scratching doesn't relieve itch, beating doesn't cause pain. Doctors claim stability, which is indeed achieved, but at the cost of missing opportunities. This is because patients don't truly understand doctors, and doctors aren't fully trusted. As the poem says: "Words fill the courtyard, who takes the blame? Building a house by the road, it never gets done." These are common faults of patients and doctors today, too numerous to list. Striving for perfection leads to compromise. Compromise hinders treatment; non-compromise hinders human relations. How to handle situations where neither compromise nor non-compromise works? Those involved should examine these words and warn themselves. Not only will patient, bystander, and colleague conditions be managed without error, but preserving natural lifespan and reaching the realm of longevity will begin here. Only the wise will reflect on this.
Tao Hongjing said: When decocting soup, use low fire to keep it gently boiling. Water quantity follows the prescription. Generally, for twenty-four herbs, use one dou of water to boil down to four sheng, extrapolating from this. For purgative soups, keep them raw (light decoction), using less water to extract more juice. For tonic soups, cook them thoroughly, using more water to extract less juice, ensuring water amounts are appropriate. Use fresh cloth and a wooden roller operated by two people to squeeze, clarify to remove turbidity, cover with paper tightly. Do not use iron vessels for warm soup. Soup should be gently boiling; hot is easy to swallow, cold causes vomiting.
Li Shizhen said: Tao's description is ancient method. Modern small prescriptions use two ou of water per liang of herb. Add if needed, reduce if less. Too much herb with little water prevents extraction; too little herb with much water dissipates medicinal power. When decocting, avoid copper and iron vessels; use silver or clay pots, clean and sealed, watched carefully. Master the fire, neither too strong nor too weak. Wood charcoal or reeds are best for fuel. Water should be freshly drawn and sweet-tasting. Running water, well water, or boiled water follow specific methods. For diaphoretic medicines, use strong fire and serve hot. For purgatives, use strong fire to boil, add Xiao Shi (Natrii Sulfas) and Da Huang (Radix et Rhizoma Rhei), then boil again and serve warm. Tonics should be slow-decocted and served warm. Acute cold-yin diseases should also be fast-decocted with strong fire. For cold-dysphoria or summer internal cold, serve chilled by sinking in cold water.
Sun Simiao said: The roots of hundred diseases include Wind Stroke, Cold Damage, Cold-Heat, Warm Malaria, Evil Strike, Cholera, Abdominal Edema, Intestinal Discharge, Diarrhea, Urinary/Fecal Obstruction, Rebellious Qi, Cough/Reverse Qi, Vomiting, Jaundice, Wasting-Thirst, Retained Fluids, Accumulated Food, Hard Accumulations, Masses, Startling Evil, Epilepsy, Ghost Tethering, Throat Bi, Toothache, Deafness, Blindness, Metal Wounds, Fractures, Carbuncles, Malignant Sores, Hemorrhoids, Tumors/Cysts, Men's Five Exhaustions and Seven Injuries, Deficiency and Emaciation, Women's Leukorrhea, Metrorrhagia, Blood Obstruction, Genital Erosion, Gu Poison/Snake Venom. These are general categories; variations depend on specific clues. Also included are Cold-Heat Exhaustion, Overeating, Sexual Exhaustion, Palpitations, Fear, Anxiety, Alarm, Childbirth, Miscarriage, Postpartum Stasis, and indulgence in Five Minerals for sexual pleasure. These are root causes generating branch symptoms; one must know origin and outcome. When consulting doctors, half of descriptions by men, women, young, and old may conflate with disease sources, yet medication is prescribed. Men are gathering places of Yang, often dry. Yang qi moves freely; forceful release causes exhaustion. Injury diseases are numerous. Compared to women, they are ten times harder to treat. Women above fourteen have menstruation. On menstrual days, exposure to wind, cold, damp, heat, or seasonal pathogens causes illness; they should describe it themselves. Otherwise, treatment errors increase suffering. Prescribers should ask.
Sun Simiao said: Recently, rural families buy herbs and hire millers, often improperly. For hard-to-pulverize herbs like Shi Hu (Dendrobii Caulis) and Tu Si Zi (Cuscutae Semen), millers steal and discard parts to save effort. Dust and foul air enter the powder, which is sifted roughly and blown away. Tasted by many, smelled by many, the essence is lost, resembling rotten wood. Patients then fail to take them correctly, worsening deficiency, and blame doctors for ineffectiveness. This is not the doctor's fault but the patient's misguided intent; reflect carefully.
Yu Huazi said: Knowing evil thoughts is awareness. Cutting off evil thoughts is non-continuation. Illness has causes. Knowing the cause, guard against it before it arises; removing the cause prevents recurrence, which is the merit of healing. Awareness of cutting thoughts comes from non-continuation. Each time aware, each time removed; if not continued, it ends. Thus: fleeting desire is disease; non-continuation is medicine.
Zhang Dafu said: Killing things to cure disease is inferior to preserving life to cure. My uncle had measles. My grandfather sought stork eggs to treat it. Getting them, the stork chased its egg and fell dead. Grandfather mourned: "Seeking life through dead offspring, but harming living eggs—how contradictory!" He abandoned it. By midnight, measles healed. If eating eggs cured it, people would credit the egg. The stork's egg hatching isn't the stork's doing, but life isn't proven by eggs; this solves worldly confusion. I often suffered palpitations. A doctor advised eating soft-shelled turtle, saying blood nourishment cures palpitations. After a month, palpitations persisted. One night, I dreamed turtles biting me from neck to arm, skin torn. Waking with pounding heart, palpitations worsened. Alas! Some kill to worsen disease.