客有病痞者。积于其中。伏而不得下。自外至者捍而不得纳。从医而问之。曰。非下之不可。归而
饮其药。既饮而暴下。不终日而向之伏者散而无余。向之捍者柔而不支。焦膈导达。呼吸开利。快
然。若未始有疾者。不数日痞复作。投以故药。其快然也亦如初。自是不逾月。而痞五作而五下。
每下辄愈。然客之气。一语而三引。体不劳而汗。股不步而栗。肤革无所耗于前。而其中柔然莫知
其所来。嗟夫。心痞非下不可已。予从而下之。术未爽也。HT 然独何如。闻楚之南有良医焉。往而
问之。医叹曰。子无怪是HT 然者也。凡子之术固而是HT 然也。坐。吾语汝。且天下之理。有甚快于
吾心者。其末必有伤。求无伤于终者。则初无望其快于吾心。夫阴伏而阳蓄。气与血不运而为痞。
横乎子之胸中者。共累大矣。击而去之。不须臾而除甚大之累。和平之物。不能为也。必将击搏震
挠而后可。夫人之和气。冲然而甚微。汨乎其易危。击搏震挠之功未成。而子之和盖已病矣。由是
观之。则子之痞凡一快者。子之和一伤矣。不终月而快者五。子之和平之气。不既索乎。故体不劳
而汗。股不步而栗。HT 然如不可终日也。且将去子之痞而无害于和也。子归燕居三月。而后与之药
可为也。客归三月。斋戒而后请之。医曰。子之气少复矣。取药而授之曰。服之三月而疾少平。又
三月而少康。终年而复常。且饮药不得亟进。客归而行其说。然其初使人懑（莫困反）然而迟之
。盖三投药而三反之也。然日不见其所攻之效。久较则月异而时不同。盖终岁而疾平。客谒医。再
拜而谢之。坐而问其故。医曰。是医国之说也。岂特医之于疾哉。子独不见秦之治民乎。悍（下罕
反性急悍也）而不听分。堕而不勤事。放而不畏法。令之不听。治之不变。则秦之民尝痞矣。商
君见其痞也。厉以刑法。威而斩伐。悍厉猛
惊。（脂利反）不贷毫发痛 （楚恨反）而力锄之。于是乎秦之政如建（纪偃反）瓴。（户
经反）流通四达。无敢或拒。而秦之痞尝一快矣。自孝公以至二世也。凡几痞而几快矣。顽者已
圯。（部鄙反。段也） 强者已柔。而秦之民无欢心矣。（史商公传。孝公用卫鞅欲变法。孝公曰
。善。卒定变法之令。令民为什五而相守。司连坐。不告奸者腰斩。告奸者与斩敌首同赏。匿奸者
与降敌同罚）故猛政一快者。欢心一亡。积快而不已。而秦之四支枵然。徒具其物而已。民心日
离而君孤立于上。故匹夫大呼。不终日而百疾皆起。秦欲运其手足肩膂。而漠然不我应。故秦之已
者。是好为快者之过也。昔者先王之。民其初亦尝痞矣。先王岂不知砉然击去之以为速也。惟其有
伤于终也。故不敢求快于吾心。优柔而抚存之。教以仁义。导以礼乐。阴解其乱而除去其滞。旁视
而懑然有之矣。然月计之。岁察之。前岁之俗。非今岁之俗也。不击不搏。无所忤逆。是以日去其
戾气而不婴其欢心。于是政成教达。安乐久而无后患矣。是以三代之治。皆更数圣人。历数百年。
而后俗成。则予之药终年而愈疾。盖无足怪也。故曰天下之理。有快于吾心者。其末也必有伤。求
无伤于其终。则初无望其快吾心。虽然。岂独于治天下哉。客再拜而记其说。
有一位客人患有痞证。病邪积聚在体内，潜伏在内无法排出；外来的邪气抗拒，无法被接纳。于是向医生请教，医生说：“非用泻下法不可。”客人回去后服用了药物。服药后突然剧烈腹泻，不到一天时间，之前潜伏的病邪便消散殆尽，之前抗拒的邪气也变得柔弱而无法支撑。胸膈焦躁感消除，气机通畅，呼吸顺畅，感觉非常爽快，好像从未生过病一样。
然而没过几天，痞证又复发了。再次投以原来的药物，那种爽快的感觉也和当初一样。从此以后，不到一个月，痞证发作五次，就泻下五次。每次泻下后症状暂时缓解。但是客人的元气，一说话就多次引动（耗损），身体没有劳累却出汗，大腿没有行走却颤抖。皮肤外表没有消耗，但体内的正气却柔弱无力，不知从何而来（受损）。唉！心痞难道真的非用泻下法不可吗？我顺从病情使用了泻下法，技术并没有失误。然而为什么唯独元气如此受损呢？
听说楚地南部有一位良医，我便前去请教。医生叹息道：“你不要责怪这种元气受损的情况。你之前的治疗手段固然有效且迅速，但请坐，我告诉你。天下的道理，凡是让内心感到特别爽快的事情，其后果必然会有损伤。想要最终不造成损伤，起初就不应期望它能让内心感到痛快。阴邪潜伏，阳气蓄积，气与血运行不畅而形成痞证。横亘在你胸中的这些积滞，积累已经很久了。强行击破去除它们，不需要片刻就能除去巨大的负担，平和温和的药物是做不到的。必须通过猛烈搏击、震荡扰动才能做到。然而人的和平之气（正气），冲淡而微弱，动荡不安，很容易受到危害。在猛烈搏击的功效尚未完成时，你的和平之气就已经生病（受损）了。由此看来，你的痞证每获得一次爽快，你的和平之气就受到一次损伤。不到一个月就爽快五次，你的和平之气，不是已经枯竭了吗？所以身体没有劳累却出汗，大腿没有行走却颤抖，元气受损的样子好像无法度过这一天一样。
如果想要去除你的痞证而不伤害和平之气，你回家静养三个月，然后再用药才可行。”客人回去静养了三个月，斋戒之后再去请求诊治。医生说：“你的元气稍微恢复了一些。”取药交给他说：“服用三个月，疾病会稍微平稳；再服用三个月，会稍微康复；满一年后就能完全恢复正常。而且服药不得急于求成。”客人回去照做。刚开始让人郁闷迟缓，因为三次投药，三次反复（指病情波动或需要调整）。然而每天看不出攻邪的效果，长久比较则每月不同，时节变化也不同。大概经过一年，疾病痊愈。客人拜见医生，拜两次谢恩，坐下询问原因。医生说：“这是治理国家的道理啊，哪里仅仅是治病呢？你难道没看到秦国治理百姓的情况吗？百姓强悍而不听从命令，懒惰而不勤于事务，放纵而不畏惧法律，政令不听，治理不变，那么秦国的百姓曾经处于‘痞’的状态（混乱阻滞）。商鞅看到这种痞塞，就用严酷的刑法来激励，用威严来斩伐。强悍严厉，猛如雷霆，毫不宽恕，痛快地铲除他们。于是秦国的政治像垒起的瓦片一样流通四达，没有人敢抗拒，秦国的痞塞曾经获得了一次极大的爽快。从孝公到二世，究竟经历了多少次痞塞和多少次爽快呢？顽固的人已经被摧毁，强壮的人已经变得柔弱，但秦国的百姓已经没有欢心了。（《史记·商君列传》记载：秦孝公任用卫鞅想要变法。孝公说：‘好。’最终定下了变法的法令。规定百姓五家为一伍，十家为一什，互相守望监督，实行连坐法。不告发奸恶的人腰斩，告发奸恶的人与斩敌首级同样受赏。窝藏奸恶的人与投降敌人同样处罚。）所以猛烈的政令每带来一次爽快，百姓的欢心就丧失一分。积累爽快不停止，秦国的四肢空虚，只剩下空壳罢了。民心日益背离，君主孤立在上。所以一个平民大声呼喊，不到一天各种疾病都起来了。秦国想要运转它的手足肩背，却漠然不响应。所以秦国的灭亡，是好图一时爽快之人的过错。
从前先王治理时，百姓起初也曾处于痞塞状态。先王难道不知道像劈开木头那样猛烈击去以求快速吗？只是因为那会对最终结果造成伤害，所以不敢追求内心的痛快。而是优柔舒缓地安抚保存他们，用仁义教导他们，用礼乐引导他们。暗中化解混乱，除去滞碍。旁边看去似乎郁闷不畅，但如果按月计算，按年考察，前一年的风俗，不同于今年的风俗。不击打不搏斗，没有什么违逆，因此每天去除戾气而不伤害百姓的欢心。于是政教成功，安乐长久而没有后患。所以夏商周三代的治理，都经过了几位圣人，历经数百年，然后风俗养成。那么我的药方用一年才治愈疾病，也就不足为怪了。所以说天下的道理，有让内心感到爽快的，其末节必然有损伤。寻求最终没有损伤，那么起初就不要指望它让内心痛快。虽然如此，难道仅仅适用于治理天下吗？”客人拜两次记下了这番话。
A guest suffered from *pi* syndrome (a condition characterized by abdominal masses or fullness). Pathogenic factors accumulated within, latent and unable to be expelled; external pathogens resisted entry and could not be admitted. He consulted a physician, who said, "It is imperative to use purgation." The guest returned and took the medicine. After ingestion, he experienced sudden severe diarrhea. Within less than a day, the previously latent pathogenic factors dispersed completely, and the previously resistant pathogens became weak and unable to sustain themselves. The burning sensation in the chest and diaphragm was resolved, qi mechanism became unobstructed, breathing became smooth and open, and he felt extremely refreshed, as if he had never been ill.
However, within a few days, the *pi* syndrome recurred. The same medication was administered again, and the feeling of refreshment was identical to the first time. From then on, within less than a month, the *pi* syndrome occurred five times, and purgation was applied five times. Each time purgation was used, symptoms temporarily subsided. Yet the guest's vital qi was repeatedly drawn upon with every word, causing sweating without physical exertion and trembling in the thighs without walking. While the skin and flesh showed no outward depletion, the internal vital qi became weak and deficient, its source unknown. Alas! Was *pi* syndrome truly requiring only purgation? I followed the treatment method, and my technique was not flawed. So why did the vital qi suffer so severely?
I heard there was a skilled physician in the southern region of Chu, so I went to consult him. The physician sighed and said, "Do not blame this state of depleted vital qi. Your previous treatment method was indeed effective and rapid, but please sit, let me explain. In the world, any matter that brings extreme satisfaction to the mind inevitably causes harm at its conclusion. If one seeks to avoid harm at the end, one should not expect initial satisfaction. Yin pathogens are latent, and yang qi is stored; when qi and blood fail to circulate, *pi* syndrome forms. The accumulation obstructing your chest has built up over a long period. To strike it away and remove it requires no more than a moment to eliminate such a heavy burden; gentle and harmonious herbs cannot achieve this. One must employ forceful striking, beating, shaking, and disturbing methods. However, a person's harmonious qi (healthy qi) is subtle and faint, turbulent and easily endangered. Before the effects of forceful striking and beating can be fully realized, your harmonious qi would already be damaged. Thus, for every instance of relief from *pi* syndrome, your harmonious qi suffers one injury. In less than a month, there were five instances of relief; has not your harmonious qi been exhausted? Therefore, you sweat without labor and tremble without walking, appearing as if you cannot endure until the end of the day.
If you wish to remove the *pi* syndrome without harming your harmonious qi, return home and rest quietly for three months before taking medication." The guest returned and rested for three months, observing abstinence, before requesting treatment again. The physician said, "Your qi has slightly recovered." He prepared medicine and handed it to him, saying, "Take this for three months, and the illness will stabilize somewhat. Take it for another three months, and you will recover somewhat. After a full year, you will return to normal. Moreover, medication must not be administered hastily." The guest followed this advice. Initially, the process seemed sluggish and frustrating because the medicine was administered three times, leading to three reversals (fluctuations). However, daily observation revealed no immediate curative effects; yet, comparing month by month and season by season, changes were evident. Ultimately, after a year, the disease was cured. The guest visited the physician, bowed twice in gratitude, and sat down to ask for the reason. The physician said, "This is the principle of governing a state, not merely treating diseases. Have you not observed how Qin governed its people? The people were fierce and disobedient, lazy and neglectful of duties, unrestrained and fearing no law. Orders were ignored, and governance failed to change. Thus, the people of Qin were in a state of 'pi' (obstruction/stagnation). Shang Yang, seeing this obstruction, employed harsh laws and penalties, using authority to execute and punish. Fierce and severe, like thunder, showing no mercy, he ruthlessly eradicated them. Consequently, Qin's administration flowed smoothly in all directions, with no one daring to resist, and the 'pi' of Qin achieved a momentary sense of satisfaction. From Duke Xiao to the Second Emperor, how many times did obstruction occur and how many times was there satisfaction? The stubborn were broken, the strong became soft, but the people of Qin lost their joy. (*Records of the Grand Historian: Biography of Lord Shang*: Duke Xiao of Qin employed Wei Yang to enact reforms. Duke Xiao said, 'Good.' The reform edicts were finalized, establishing mutual surveillance among groups of five and ten households, implementing collective punishment. Those who failed to report crimes faced waist execution, while those who reported criminals received rewards equal to those awarded for enemy heads. Those who hid criminals were punished as if they surrendered to the enemy.) Thus, each instance of harsh policy bringing satisfaction resulted in the loss of public joy. Accumulating satisfaction without limit left Qin's limbs empty, possessing only form. The hearts of the people drifted away day by day, leaving the ruler isolated above. Therefore, when a commoner shouted loudly, various ailments arose within a single day. Qin wished to move its hands, feet, shoulders, and back, but they responded indifferently. Thus, the fall of Qin was the fault of those seeking momentary satisfaction.
In ancient times, during the rule of the Former Kings, the people also initially experienced obstruction. Did the Former Kings not know that striking forcefully, like splitting wood, would bring speed? It was precisely because it would cause harm in the end that they dared not seek satisfaction for their own minds. Instead, they gently and patiently comforted and preserved the people, teaching them benevolence and righteousness, guiding them with ritual and music. They secretly resolved chaos and removed stagnation. At first glance, it might seem frustratingly slow, but calculated monthly and examined annually, the customs of the previous year differed from those of the current year. Without striking or fighting, there was no resistance. Thus, hostile qi was removed daily without hurting the people's joy. Consequently, governance succeeded, education spread, peace lasted long, and there were no subsequent disasters. Therefore, the governance of the Three Dynasties passed through several sages and lasted hundreds of years before customs were established. Thus, it is no wonder that my prescription took a year to cure the disease. Hence it is said: In the world, matters that bring immediate satisfaction to the mind inevitably cause harm at their conclusion. If one seeks to avoid harm at the end, one should not expect initial satisfaction. Although this applies, does it apply only to governing the world?" The guest bowed twice and recorded these words.