徐洄溪先生《医学源流论》云∶治病必得立案。详其何脉何因何症，宜何法治。若是则
方能
用心，可杜肤泛。服剂之后，又当验其如何应效，最为医人真实工夫。予少因多病，弱冠便
喜览方书。后缘老母年高，时有疾恙，益专心向学，尽心调治，渐有所得；因之家人上下，
稍有违和，治之多效。邻朋乡党，渐有知者，邀致必往。即而日有就医，至夏杪三秋，踵门
不绝，皆不论有无，尽心为治，知与不知，俱立一案于方，下次复诊，照方案详问随机圆变
，必中肯綮而后已。今年届甲周，阅历及四十载，不可谓之浅矣；然而所得者十不能五焉，
惟不肯稍涉不知为知，妄语诳人耳！此亦可以自信。
世间德行经济文章学术，立于天地间，表表可观，半由学力，半实天成，即一才一艺，
无不尽
然。子曰∶生而知之者，上也；学而知之者，次也；困而学之，又其次也。夫能困学，即是
其天性，惟赋浅耳。若夫天性，必不能困学。予表兄费某，舅氏必欲其用功举业，延名师，
丰修膳，焚膏继晷，磨琢万方。年逾弱冠，作一破承不能，乃弃去日事手艺。如碧山治银，
元吉治锡，虽时工莫及也。更能刺绣结缨，雕刻竹木，无不精美可观。何于文本之缘，切肤
而不知痛痒；于杂艺一见即能为之，天性有别耳。予旧居对宇有药铺，每薄暮放学，就视药
物，一见能名，续翻本草，并能知其性。时年止八九岁，长嫂病，延俞醒斋先生来治，令予
陪侍。其患崩漏，头重难起，予告俞曰∶长嫂之症，莫非下虚乎？先生问何以知之？答曰∶如
竹稍戴物，必不能举，试易以木则举，强弱之分也。先生曰∶是。后晤相知，极口称道。及
长，乃从事于此。岂非天性使然乎？
徐洄溪先生在《医学源流论》中说：治病必须建立病历档案。详细记录患者的脉象、病因和症状，并确定适宜的治疗法则。如果这样做，医生才能用心诊治，可以避免肤浅和泛泛而谈。服药之后，又应当验证治疗效果如何，这才是医生真正的功夫。我年轻时因为多病，二十岁左右就开始喜欢阅读方书。后来因为母亲年事已高，时常患病，我更加专心向学，尽心调治，逐渐有所心得；因此家人上下，稍有不适，治疗大多有效。邻居朋友乡里乡亲，渐渐有人知晓我的医术，邀请我一定前往诊治。于是每天都有人来求医，直到夏末秋初，登门拜访的人络绎不绝，我都不论对方是否相识，都尽心为他们治疗，无论认识与否，都在药方旁立一案记录，下次复诊时，按照方案详细询问，随机应变，必须切中要害才停止。今年满六十岁，阅历已有四十多年，不能说不浅了；然而所得到的（真知）十中也难有五分，只是不肯稍微把不知道当作知道，妄语欺骗人罢了！这也足以让我自信。
世间德行、经世济民之才、文章学术，立于天地之间，显著可观，一半由学力造就，一半实为天生禀赋，即使是一技一艺，没有不是这样的。孔子说：生来就知道的人是上等的；通过学习才知道的人是次一等的；遇到困难才去学习的人，又是次一等的。能够处于困境而学习，这就是他的天性，只是天赋较浅罢了。至于那些真正具有某种天性的人，必定不会陷入困境才去学习。我的表兄费某，舅舅一定要他用力于科举学业，聘请名师，供给丰盛的饮食，日夜苦读，多方磨练。年过二十，连一篇破题承题的文章都写不出来，于是放弃而去从事手艺。比如碧山制作银器，元吉制作锡器，即使是当时的工匠也比不上他们。更能刺绣结缨，雕刻竹木，无不精美可观。为什么对于文本的缘分，切肤之痛却不知痛痒；而对于杂艺一见就能做，这是天性不同罢了。我旧居对面有药店，每当傍晚放学，就去观看药物，一看就能命名，接着翻阅本草，并能知道它们的药性。当时年仅八九岁，长嫂生病，请俞醒斋先生来诊治，让我陪侍。她的病症是崩漏，头重难以抬起，我告诉俞先生说：长嫂的病，莫非是下虚吗？先生问怎么知道的？回答说：就像竹梢顶着东西，一定不能举起，试着换成木头就能举起，这是强弱之分。先生说：对。后来遇到相知之人，极力称赞。等到长大，便从事于此。这难道不是天性使然吗？
Mr. Xu Huixi stated in *Yixue Yuanliu Lun* (Source and Evolution of Medical Science): "In treating diseases, one must establish a medical record. Detail the pulse, etiology, and symptoms, and determine the appropriate therapeutic method. If this is done, the physician can devote their heart to the treatment, thereby avoiding superficiality and generalization. After administering the dosage, one must verify the efficacy; this constitutes the true skill of a physician. In my youth, due to frequent illnesses, I began to enjoy reading medical texts around the age of twenty. Later, because my mother was advanced in age and often ill, I devoted myself even more diligently to study, treating her with full dedication, and gradually gained insights; consequently, for any minor discomfort among family members, my treatments were largely effective. Neighbors and fellow villagers gradually became aware of this and invited me to treat them. Soon, patients came daily, and through late summer and autumn, visits to my door were unceasing. Regardless of whether they knew me or not, I treated them wholeheartedly, establishing a case record beside each prescription. For subsequent follow-up visits, I would ask detailed questions based on the previous plan and adapt flexibly, stopping only when the treatment hit the mark accurately. This year, I have reached the age of sixty, with over forty years of experience, which cannot be considered shallow; yet, what I have truly mastered accounts for less than half. I simply refuse to pretend to know what I do not know or to deceive others with false words! This gives me confidence."
Virtue, statesmanship, literary works, and academic achievements, standing firm between heaven and earth, are conspicuously admirable; half stems from acquired learning, and half from innate endowment. This applies equally to every talent and skill. Confucius said: "Those who know from birth are the highest; those who know through learning are next; those who learn after encountering difficulties are still lower." The ability to learn amidst difficulties indicates one's nature, albeit with lighter endowment. As for those with strong innate aptitude, they certainly do not need to wait until troubled to learn. My cousin, Mr. Fei, had his uncle insist he focus on the imperial examination curriculum, hiring famous teachers and providing abundant meals, studying day and night with tireless effort. By the time he passed twenty, he could not even write a proper opening paragraph for an essay, so he abandoned it to pursue crafts. For instance, Bishan worked silver, and Yuangi worked tin; even contemporary artisans could not match them. He could also embroider, tie ribbons, and carve bamboo and wood, producing exquisite results. Why was he indifferent to literature, as if feeling no pain despite its closeness to the skin, yet capable of mastering miscellaneous arts at first sight? It is merely a difference in nature. Opposite my former residence was a pharmacy. Every evening after school, I would go there to observe the herbs, naming them upon seeing them once, then consulting the *Bencao* (Materia Medica) to understand their properties. I was only eight or nine years old then. When my eldest sister-in-law fell ill, Mr. Yu Xingzhai was invited to treat her, and I was asked to attend. Her condition was *benglou* (metrorrhagia and metrostaxis), characterized by a heavy head making it difficult to lift. I told Mr. Yu: "Sister-in-law's illness, might it be deficiency in the lower jiao?" The master asked how I knew. I replied: "It is like a bamboo tip bearing weight; it cannot stand upright. Try replacing it with wood, and it will stand; this distinguishes strength from weakness." The master said: "Correct." Later, when meeting acquaintances, they praised me highly. Upon growing up, I engaged in medicine. Is this not caused by nature?