天下之事，惟以口舌争，而无从考其信否者，则是非难定。若夫医则有效验之可征，知
之最
易。而为医者，自审其工拙亦最易。然而世之择医者与为医者，皆愦愦而莫之辨，何也？古
人用药，苟非宿病痼疾，其效甚速。《内经》云∶一剂知，二剂已。又云∶复杯而卧。《伤
寒论》云∶一服愈者，不必尽剂。可见古人审病精而用药当，未有不一二剂而效者。故治病之
法，必宜先立医案，指为何病，所本何方，方中用某药专治某症，其论说本之何书。服此药
后，于何时减去所患之何病；倘或不验，必求所以不验之故，而更思必效之法。或所期之效
不应，反有他效，必求其所以致他效之故；又或反增他症，或病反重，则必求所以致害之故
。而自痛惩焉。更复博考医书，期于必愈而止。若其病本不能速效，或其病只可小效，或竟
不可治，亦必预立医案，明着其说，然后立方，不得冒昧施治。如此自考，自然有过必知，
加以渚心好学，其道日进矣。今之医者，事事反此，惟记方数首，择时这药数种，不论何病
何证，总以此塞责，偶尔得效，自以为功；其或无效，或至于死，亦诿于病势之常，病家亦
相循为固然，全不一怪。间有病家于未服药之前，问医者服此药之后，效验若何，医者答云
∶且看服后何如，岂有预期之理？病家亦唯唯自以为失言，何其愚也！若医者能以此法自考，
必成良医；病家以此法考医者，必不为庸医之所误，两有所益也。
天下的事情，如果仅凭口舌争辩，而无法考证其真假，那么是非就很难判定。至于医学，则有疗效可以作为验证，因此最容易知晓真伪。对于医生来说，自我审视医术的高下也最容易。然而，世上选择医生的患者和行医的医生，都糊涂昏昧而不能辨别，这是为什么呢？古人用药，如果不是陈年旧疾或顽固重病，其见效非常迅速。《黄帝内经》说：服一剂药后病情好转，服两剂药后病愈。又说：喝完药放下杯子就能安睡（形容见效极快）。《伤寒论》说：服一次药就好了，不必把整副药都喝完。由此可见，古人诊病精准且用药得当，没有一二剂药就不见效的情况。所以治病的方法，必须先建立医案，指明是什么病，依据哪个方剂，方中用某味药专门治疗什么症状，其理论依据出自哪本书。服用此药后，在何时减去所患的何种病症；如果不灵验，必须探究不灵验的原因，并重新思考必定有效的办法。或者预期的疗效没有出现，反而产生了其他效果，必须探究产生其他效果的原因；又或者反而增加了其他症状，或者病情反而加重，则必须探究导致危害的原因，并从中深刻吸取教训。然后再广泛查阅医书，直到确保痊愈为止。如果疾病本来就不能快速见效，或者只能取得轻微疗效，或者竟然无法治愈，也必须预先建立医案，明确阐述这些情况，然后才开立方剂，不得冒昧施治。这样自我考核，自然能发现过错，加上专心好学，医术就会日益进步。现在的医生，事事与此相反，只记住几首方子，挑选几种药材，不论什么病什么证，总是用这些来敷衍塞责，偶尔得到疗效，就自认为是功劳；如果无效，甚至导致死亡，也推卸说是病势的正常发展，病人家属也沿袭这种观念认为理所当然，完全不感到奇怪。间或有病人在未服药之前，询问医生服用此药后的疗效如何，医生回答说：暂且看看服药后怎么样，哪有预先承诺的道理？病人家属也唯唯诺诺，自认为失言，多么愚蠢啊！如果医生能用这种方法自我考核，必然成为良医；病人家属用这种方法考察医生，必然不会被庸医所误导，双方都有益处。
In the world, matters that are debated solely through words and lack a means to verify their truthfulness make it difficult to determine right from wrong. However, in medicine, there are therapeutic effects that can serve as evidence, making it easiest to discern the true from the false. For practitioners, self-assessment of their skill level is also most straightforward. Yet, both those seeking medical care and the practitioners themselves remain confused and fail to distinguish between them. Why is this? In ancient times, when herbs were administered, unless dealing with chronic or entrenched diseases, the effects were very rapid. The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "One dose brings improvement, two doses bring cure." It also says: "Sleep is achieved as soon as the cup is put down," indicating extremely swift efficacy. The *Shanghan Lun* (Treatise on Cold Damage Disorders) states: "If cured after one administration, there is no need to finish the entire decoction." This shows that ancient physicians diagnosed diseases precisely and prescribed medications appropriately; there were no cases where effectiveness was not seen within one or two doses. Therefore, the method of treating disease must begin by establishing a medical record (Yi An), specifying the diagnosis, the source formula, which herb in the formula specifically treats which symptom, and which classic text serves as the theoretical basis. After taking this medication, one should note at what time specific symptoms subside; if there is no effect, one must seek the reason for the ineffectiveness and reconsider methods that will surely work. If the expected effect does not occur but other effects arise, one must investigate the cause of these other effects; or if new symptoms appear or the condition worsens, one must investigate the cause of the harm and learn from it deeply. Then, one should extensively consult medical texts until a complete cure is ensured. If the disease inherently cannot be cured quickly, or only allows for minor improvement, or is incurable, a medical record must still be established in advance, clearly stating these conditions, before prescribing a formula. One must not treat recklessly. Through such self-examination, errors will naturally be known; coupled with diligent study, one's medical skill will improve daily. Modern practitioners do the exact opposite. They memorize only a few formulas and select only a few herbs, applying them indiscriminately to any disease or syndrome to shirk responsibility. If they occasionally achieve an effect, they claim credit; if ineffective or fatal, they blame the natural progression of the disease. Patients' families accept this as normal custom without question. Occasionally, patients ask practitioners before taking medication what the expected outcome will be. The practitioner replies, "Let us see how it goes after administration; how could one predict in advance?" The patient's family accepts this meekly, considering themselves foolish for asking. How ignorant! If practitioners used this method for self-reflection, they would certainly become good doctors; if patients used this method to evaluate practitioners, they would certainly not be misled by incompetent doctors. Both parties would benefit.