典藏书目

Commentary states: I believe that from newborn infants to young children, their blood and qi are weak, and diseases are often critical and deficient. When a disease is urgent, one must not be panicked; when a physician desires to bring peace (cure), how can they act hastily? By midday (when yang qi is at its peak), treatment may proceed. If the pathology is located at the apex (upper body), one must guard against jue (syncope/cold extremities). Medical practice should adhere to the mean, ensuring that skilled practitioners administer medicines with an emphasis on human adaptability and variation. Practicing medicine requires maintaining intent; if intent is clear, medical affairs are not cumbersome; if functions are flexible, medication is not disordered. "Tongbian" (Adaptability and Variation) serves as the method for achieving the extraordinary, while "Dezhi" (Attaining Intent) leads to subtlety. The ancients said, "Only when the mind is clear can one learn; only when formulas are understood can one become a good physician." I say, "Only through changing intent can one become a good physician." I have compiled this book; although it lacks literary elegance, its content is indeed verbose, yet its intention is solely to enable learners to master "Tongbian." "Tong" refers to broad principles where one understands everything encountered; "Bian" refers to truly understanding the root cause and opening one's mind. If one merely follows ancient methods, applying fixed formulas to modern people without considering diet, rest, hunger, fullness, labor, or leisure, and ignoring heavenly timing and earthly advantages, how is this acceptable? Even phenomena like dog barking and chicken crowing require careful attention. The four seasons—spring, summer, autumn, and winter—have normal and pathogenic commands. Diseases such as vomiting, diarrhea, convulsions, and malnutrition involve transmission among the five zang organs or sudden onset of chronic conditions. It is said, "Advance when appropriate, stop when appropriate." If suitable, proceed; if not, change strategy (the changed strategy is discussed later). This is what is called the way of "Tongbian." The application of wisdom, strategy, and intellectual assessment constitutes the tactics of warfare. Careful examination, pulse palpation, and observation constitute the profession of medicine. Generally, all actions depend on "Tongbian." Only those who strive to save lives more rigorously than military strategy, focusing on adaptability and knowing how to vary, possess the mindset of a skilled artisan. Those who stick to routine without understanding variation are mediocre practitioners. Those who operate normally yet understand adaptation, seeing symptoms to know the disease, predicting life and death in advance, and treating crises without harming the patient, are called superior physicians (Shanggong). When favorable and unfavorable factors mix, how does one adapt? Why does one vary? These are characteristics of inferior practitioners. Alas! Children easily fall ill, and signs change frequently. I adjust treatment based on symptoms and signs, whether mild or severe, adjusting my approach accordingly. Thus ends the discussion on adaptability.

Commentary states: Heaven and earth's yin and yang still have waxing and waning phases. In humans, improper regulation of yin and yang leads to deviation from harmony, where evil and righteous qi interfere, disrupting peace and causing disasters. Pediatrics differs from other fields because the ancients considered it difficult due to its uniqueness. However, illnesses differ between adults and children. Statements regarding difficulty and ease do not refer to yin-yang dominance, differences in transmission, irregular pulses, or organ deficiency/excess. Therefore, describing symptoms is termed "difficult," while misinterpreting signs is termed "easy." One should not treat difficult symptoms lightly as easy, nor should one wrongly judge easy signs as difficult. Mastery over difficulty and ease comes from sincerity, exhausting principles, and fully realizing nature. Medical education models ancient traditions, requiring memorization of various schools' texts and clear comprehension of their essence. One must carefully assess severity and observe children closely. Since children are young and conditions change rapidly, one must not rigidly adhere to ancient ideas nor blindly rely on common sense. Only by thoroughly exploring perfection and ensuring no symptom or sign lingers unresolved can one claim the miraculous ability to succeed ten out of ten times. The ancients said, "Clarity in mind makes pulse diagnosis difficult; pediatric pulse diagnosis is easier; mental effort may sometimes fail." This relates to ignorance; any lack of proficiency ruins previous efforts. Consider that children bear significant stakes; one cannot boast of minor skills. What is there to praise? A family tradition spanning three generations failed to gain fame, likely due to hasty and careless medical practice, leading to gains and losses. Alas! Without deep thought and foresight, how can one gain broad knowledge? Seeking lucky outcomes harms lifelong fortune. Superficial views cannot ensure safety. Life and death are entrusted to you; how can symptoms be treated as trivial? Until symptoms are clear, do not force treatment. Learners, please examine this carefully.