医者，意也，其术不尽于药石。故古人有泥丸蓑草，可以济人之语。苏耽橘井，食叶饮
泉即
愈，岂专药石也？此在医者有恒，能真心济世，不逐声利之间，则虽祝由，可以已病。以我
正气，却彼邪气，德行所积，随施随验，固非常理可测。若只专计刀锥之利，己心不正，安
能却邪？虽己试之方，珍异之药，或未必能有神明助乎？其间非可摈之为妄语也！
后汉郭玉谓，疗贵人有四难∶“自用意而不任医，一难也；将身不谨，二难也；骨节安
间，
不能使药，三难也；好逸恶劳，四难也。”余以为此四病，贵人果有之。然贵人之遇医，亦
有四难∶远地相召，素不曾试，一难也；稍涉毒味，不敢轻用，二难也；尊高临之，医不能
尽意三难也；专任仆外家，烹煮失宜，四难也。以此言之，贵人不可轻于致病，尤须慎于服
药，如夫子所谓某未达，不敢尝焉。然后可。
医家乘人之危，古经比之杀人。古经云∶不恤缓急，妄索事分杀人也；不问有无，必欲
多得
，杀人也；懒惰睡眠，轻视人命，杀人也；辨察不明，用药差误，杀人也；见不即治，俄至
增剧，杀人也。有此五失，挟术杀人，甚于挺刃。昔陈景仁妻张氏有微疾，医误投血膈之药
，遂至不起。既死，魂神荡越。一日，因景仁出郊，遂合为一，恍惚如狂，独歌独笑，以
终其身。观此临人疾患，可不慎夫。
医生，靠的是意念（医者的思维判断与直觉），其医术并不完全局限于药物和针石。所以古人有“泥丸蓑草”（指用泥土、蓑衣等简陋之物治病）可以救人的说法。苏耽（汉代仙人苏武之子，传说成仙后以橘叶、泉水救人）的橘井泉香故事，病人吃了橘叶、喝了泉水就能痊愈，这难道仅仅是依靠药物吗？这关键在于医者要有恒心，能真心救济世人，不追逐名声和利益，那么即使是使用祝由术（古代一种通过心理暗示和精神疗法来治病的方法），也可以治愈疾病。凭借我的正气，去抵御邪气，随着德行的积累，施治后立即见效，这本来就不是常理所能测度的。如果只专门算计刀锥之利（微小的利益），内心不正，怎么能抵御邪气呢？即使是自己试用过的方子、珍贵奇异的药物，或许也未必能有神效吧！这其中并不是可以将其摒弃为妄语啊！
后汉时期的郭玉说，治疗贵人有四难：“自以为是而不听从医生的建议，这是第一难；自身生活不谨慎，这是第二难；骨节之间（指身体僵硬或不愿配合治疗），不能使药物发挥作用，这是第三难；喜好安逸厌恶劳动，这是第四难。”我认为这四种毛病，贵人确实存在。然而，贵人求医也有四难：地处偏远被召唤，平时未曾尝试过这位医生，这是第一难；稍微涉及有毒性的药物，不敢轻易使用，这是第二难；地位尊贵高高在上，医生不能完全施展心意（因畏惧而不敢直言或尽技），这是第三难；专门任用仆人或外戚代为管理，煎煮药物不当，这是第四难。从这些方面来说，贵人不可轻易致病，尤其必须慎重服药，就像孔子所说的“我还没弄明白道理，不敢轻易尝试”，这样才可以。
医家利用别人的危难，古经将其比作杀人。古经说：不顾病情的缓急，胡乱索取报酬，是杀人；不问对方是否有钱，一定要多得钱财，是杀人；懒惰嗜睡，轻视人命，是杀人；辨证察理不明确，用药出现差错，是杀人；见到病情不及时治疗，导致病情迅速加重，是杀人。有了这五种过失，凭借医术杀人，比拿着刀剑杀人还要严重。从前陈景仁的妻子张氏有小病，医生误用了破血逐瘀的药物，最终导致死亡。死后，她的魂魄动荡离散。有一天，因为陈景仁出城到郊外，她的魂魄便与他合为一体，神情恍惚如同发狂，独自唱歌独自大笑，直到终身如此。看这个例子，面对他人的疾病，能不谨慎吗？
The physician relies on *Yi* (mental intention and intuitive judgment); their art is not limited solely to herbs and acupuncture needles. Therefore, the ancients spoke of using mud pills and straw cloaks to save people. In the story of Su Dan's orange well and spring water, patients recovered merely by eating orange leaves and drinking spring water; was this exclusively dependent on medicinal substances? This depends on the physician having perseverance and a sincere desire to benefit the world, without chasing fame or profit. In such cases, even *Zhuyou* (a traditional psycho-spiritual healing method) can cure diseases. By relying on one's own righteous Qi (vital energy) to repel pathogenic factors, and with accumulated virtue, treatment yields immediate results. This is indeed beyond the scope of ordinary reasoning. If one only calculates trivial profits, and the heart is not upright, how can one repel pathogens? Even if one uses proven prescriptions or rare and precious medicines, they may not necessarily produce miraculous effects. Thus, these practices should not be dismissed as mere nonsense!
Guo Yu of the Later Han Dynasty stated that there are four difficulties in treating nobles: "Being self-willed and refusing to follow the doctor's advice is the first difficulty; being careless with one's body is the second difficulty; stiffness in the joints preventing effective medication administration is the third difficulty; loving ease and hating labor is the fourth difficulty." I believe these four flaws do exist among nobles. However, there are also four difficulties for nobles in seeking medical care: summoning a doctor from a distant place who has never been tried before is the first difficulty; hesitating to use drugs slightly toxic due to fear is the second difficulty; the noble's high status intimidates the doctor, preventing them from fully expressing their expertise is the third difficulty; entrusting servants or relatives-in-law to manage matters leads to improper decoction preparation is the fourth difficulty. From this perspective, nobles should avoid contracting illnesses lightly and must be extremely cautious when taking medicine, just as Confucius said, "I have not yet understood the principle, so I dare not taste it," which is the proper approach.
Physicians exploiting others' crises were compared to murderers by ancient texts. The ancient texts state: Ignoring the urgency of the condition and arbitrarily demanding payment constitutes murder; demanding excessive wealth regardless of the patient's ability to pay constitutes murder; laziness and sleepiness while disregarding human life constitutes murder; unclear differentiation and diagnosis leading to erroneous medication constitutes murder; failing to treat promptly, allowing the condition to worsen rapidly, constitutes murder. Possessing these five faults, utilizing medical skills to kill is worse than wielding a blade. In the past, Zhang Shi, the wife of Chen Jingren, suffered from a minor ailment. A physician mistakenly administered blood-breaking and stasis-resolving medications, leading to her death. After her death, her soul became agitated and dispersed. One day, while Jingren went out to the suburbs, her spirit merged with him. He became trance-like and mad, singing and laughing alone until his death. Observing this case, when facing another's illness, how can one not be cautious?