胆欲大而心欲小，此孙真人祝医最确之语也。窃谓治初起之轻证，必须细心，当辨其孰为风而用疏，孰
为寒而用温，孰为暑而用清，孰为湿而用利，孰为燥而用润，孰为火而用泻。尤当审其体之虚实，病之新久，
在女子兼询经期，妇人兼详胎产，如是者，则用药庶无差忒矣。倘粗心而不细者，大意茫茫，不分六气所
感何气，动手便用荆、防，病家告之有痰，遂投陈、夏，
有食遂用神、楂，问其何病，指鹿为马，问其轻重，总说无妨，往
往使轻浅之病，日渐延深，是谁之过欤？圣人云∶不忽于细，必谨于微。其可略乎！至若垂危之重证，必
须大胆，见心包邪窜者，当宣则宣；肝风内动者，当平则平；脾虚气陷者，当培则培，肺气欲绝者，当补
则补；肾液欲涸者，当滋则滋。更有危险之虚证，速宜用参、 之属；实证用硝、黄之属，寒证用姜、桂之
属，热证用犀、羚之属，勿宜迟缓，亟亟煎尝，如是者，则沉 庶有挽救矣。倘胆小而不大者，当用而不敢
用，或用而不敢重，重用恐其增变，变证恐其归怨，往往姑息养奸，坐观其败，是谁之过欤？古人云不入
虎穴，焉得虎子。其可惧乎！若果轻浅之证，过于胆大立方，不啻小题大做；沉重之证，过于小心慎药，
无异杯水车薪。其实胆大而不细心，所谓暴虎冯河者，误事也；细心而不大胆，所谓狐疑鼠
首者，亦误事也。诚哉孙氏之言，足为千古之医训矣！
“胆欲大而心欲小”，这是孙思邈（孙真人）关于行医准则最为确切的论述。我认为，治疗初起阶段的轻证，必须细心，应当辨别是风邪所致而用疏风法，是寒邪所致而用温散法，是暑邪所致而用清暑法，是湿邪所致而用利湿法，是燥邪所致而用润燥法，是火邪所致而用泻火法。尤其要审察患者体质的虚实、病程的新久，对女子需兼问月经情况，对妇人需详查胎产状况，像这样用药，才可能没有差错。如果粗心而不细致，大意茫茫，不分感受的是六淫中的哪一种邪气，动手便用荆芥、防风；病人告知有痰，就投用陈皮、半夏；有食积就用神曲、山楂。问是什么病，指鹿为马；问病情轻重，总说无妨。往往使轻浅的疾病日渐深入，这是谁的过错呢？圣人说：“不忽视细微之处，务必谨慎于微小。”这可以忽略吗！至于到了垂危的重证，必须大胆，见到心包络受邪窜扰的，该宣通时就宣通；肝风内动的，该平熄时就平熄；脾虚气陷的，该培补时就培补；肺气欲绝的，该补益时就补益；肾液欲枯竭的，该滋养时就滋养。更有危险的虚证，速宜用人参、[党参/黄芪等补气药]之类的药物；实证用芒硝、大黄之类的药物；寒证用干姜、肉桂之类的药物；热证用水牛角、羚羊角之类的药物，不宜迟缓，急切地煎煮服用，像这样，那么沉疴或许就有挽救的希望了。如果胆小而不大胆，该用而不敢用，或者用了而不敢重用，重用恐怕增加变证，变证又恐怕归咎于医生，往往姑息养奸，坐视其败亡，这是谁的过错呢？古人说：“不入虎穴，焉得虎子。”这有什么可恐惧的呢！如果是轻浅的病证，过于胆大立方，无异于小题大做；如果是沉重的病证，过于小心慎药，无异于杯水车薪。其实，胆大而不细心，就是所谓的“暴虎冯河”（徒手搏虎，徒步渡河），是误事；细心而不大胆，就是所谓的“狐疑鼠首”（像狐狸一样多疑，像老鼠一样首鼠两端），也是误事。孙氏的话确实正确，足以成为千古以来的行医训诫啊！
"The gallbladder should be bold, but the heart [mind] should be cautious." This is Sun Simiao (Sun Zhenren)'s most accurate statement regarding medical practice. I hold that in treating mild conditions at their onset, one must be meticulous. One must distinguish whether the pathogen is Wind and use dispersing methods; Cold and use warming methods; Summerheat and using clearing methods; Dampness and using draining/diaphoretic methods for dampness; Dryness and using moistening methods; or Fire and using purging methods. Furthermore, it is crucial to examine the patient's constitution (deficiency or excess) and the duration of the disease (new or old). For women, inquire about the menstrual cycle; for married women, detail pregnancy and childbirth history. By doing so, medication will likely avoid errors. However, if one is careless rather than meticulous, vague and indifferent, failing to distinguish which of the Six Qi (Six Pathogenic Factors) has affected the body, and immediately prescribing Jingjie (Schizonepetae Herba) and Fangfeng (Saposhnikoviae Radix); if the family reports phlegm, then administering Chenpi (Citri Reticulatae Pericarpium) and Banxia (Pinelliae Rhizoma); if there is food stagnation, using Shenqu (Massae Fermentatae Medicinalis) and Shanzha (Crataegi Fructus); when asked about the disease, confusing right and wrong (pointing at a deer and calling it a horse); when asked about severity, claiming it is harmless—this often causes mild, superficial diseases to deepen day by day. Whose fault is this? The Sages said, "Do not neglect the subtle, but be cautious in the minute." Can this be overlooked! As for critical, severe conditions approaching death, one must be bold. If the Pericardium (Xinbao) is invaded by pathogens, one must unblock when appropriate; if Liver Wind is stirring internally, one must pacify when appropriate; if Spleen deficiency leads to Qi sinking, one must tonify when appropriate; if Lung Qi is on the verge of collapse, one must supplement when appropriate; if Kidney fluids are about to dry up, one must nourish when appropriate. In cases of dangerous deficiency syndromes, quickly use herbs like Renshen (Ginseng Radix et Rhizoma); in excess syndromes, use Xiaoshi (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma); in cold syndromes, use Jiang (Zingiberis Rhizoma) and Guizhi (Cinnamomi Ramulus); in heat syndromes, use Xijiao (Rhinocerotis Cornu) and Lingyangjiao (Saigae Tataricae Cornu). Do not delay; hastily decoct and administer. By doing so, even deep-seated illnesses may have hope of rescue. However, if one is timid rather than bold, afraid to use necessary treatments, or afraid to use heavy doses, fearing that heavy doses will cause adverse changes, and fearing that adverse changes will lead to blame, one often indulges the disease (tolerating evil), sitting idly by watching defeat. Whose fault is this? The ancients said, "If you do not enter the tiger's lair, how can you get the tiger's cub?" Is there any reason to fear? If a mild condition is treated with excessive boldness in prescription formulation, it is akin to making a mountain out of a molehill; if a severe condition is treated with excessive caution in medication, it is akin to pouring a cup of water onto a cartload of burning firewood. In reality, being bold without being meticulous is like "fighting a tiger bare-handed and crossing a river without a boat" (acting rashly), which leads to failure; being meticulous without being bold is like "being as suspicious as a fox and hesitating like a mouse," which also leads to failure. Indeed, Sun's words are true and serve as an eternal medical maxim!