医学人命所关，故《周礼》医师之属，掌于冢宰，岁终必稽其事而制其食。至宋神宗时
，设
内外医学，置教授及诸生，皆分科考察升补。元亦仿而行之。其考试之文，皆有程序，未知
当时得人何如？然其慎重医道之意，未尝异也。故当时立方治病，犹有法度。后世医者，大
概皆读书不就，商贾无资，不得已而为衣食之计。或偶涉猎肆中，剿袭医书，或托名近地时
医门下。始则欲以欺人，久之亦自以医术不过如此。其误相仍，其害无尽，岐黄之精义几绝
矣！若欲斟酌古今考试之法，必访求世之实有师承，学问渊博，品行端方之医。如宋之教授
，令其严考诸医，取其许挂牌行道。既行之后，亦复每月严课，或有学问荒疏，治法廖误者
，小则撤牌读书，大则饬使改业。教授以上，亦如《周礼》医师之有等。其有学问出众，治
效神妙者，候补教授。其考试之法，分为六科。曰针灸，曰大方，曰妇科，曰幼科兼痘科，
曰眼科，曰外科。其能诸科皆通者，曰全科。通一二科者，曰兼科。通一科者，曰专科。其
试题之体有三∶一曰论题，出《灵枢》、《素问》，发明经络脏腑、五运六气、寒热虚实、
补泻逆从之理。二曰解题，出《神农本草》、《伤寒论》、《金匮要略》，考订药性，病变
制方之法。三曰案，自述平日治病之验否，及其所以用此方，治此病之意。如此考察，自然
言必本于圣经，治必遵乎古法，学有渊源，而师承不绝矣。岂可听涉猎杜撰，全无根柢之人
，以人命为儿戏乎！
医学关乎人的性命，因此《周礼》中医师这一类官员，由冢宰（古代官名，掌管宫廷事务及百官）统领，在年终时必定考核他们的工作业绩并据此决定俸禄。到了宋神宗时期，设立了内、外医学机构，设置了教授和诸生（学生），都分科进行考察以决定晋升或补任。元代也效仿这种做法。当时的考试文章都有固定的格式和程序，不知道当时选拔人才的效果如何？然而其慎重对待医道的意图，与之前并无不同。所以当时制定方剂治疗疾病，尚且有法度可循。后世的医者，大都是读书考学不成，经商又缺乏资本，不得已才把行医作为谋生的手段。有的人偶尔在书肆中翻阅，抄袭医书；有的人则托名在近地知名医生门下求学。起初是想欺骗别人，久而久之自己也认为医术不过如此。这种错误相沿成习，危害无穷，岐伯和黄帝（中医始祖）的精微义理几乎断绝了！如果想要斟酌古今的考试方法，必须访求世上那些确实有师承渊源、学问渊博、品行端正的医生。像宋代的教授那样，让他们严格考核各位医生，选取其中允许挂牌行医的人。一旦开始行医之后，也要每月进行严格的考查，如果有学问荒废疏漏、治疗方法谬误错误的，小的撤掉招牌回去读书，大的责令改行。教授以上的职位，也像《周礼》中医师有等级区分一样。那些学问出众、治疗效果神妙的，候补为教授。其考试的方法，分为六科：针灸科、大方科（综合内科）、妇科、儿科兼痘科、眼科、外科。能够精通所有科目的，称为全科。通晓一到两科的，称为兼科。只通晓一科的，称为专科。其试题的体裁有三种：一是论题，出自《灵枢》、《素问》，旨在阐发经络脏腑、五运六气、寒热虚实、补泻逆从的道理。二是解题，出自《神农本草经》、《伤寒论》、《金匮要略》，考查药物性味、病变规律以及制定方剂的方法。三是案卷，让考生自述平日治病是否有效，以及使用此方、治疗此病的用意。通过这样的考察，自然能做到言论必以经典为依据，治疗必遵循古法，学问有渊源，师承不断绝。怎么可以让那些浅尝辄止、凭空杜撰、毫无根基的人，把人的性命当作儿戏呢！
Medicine is closely related to human life; therefore, in the *Rites of Zhou* (Zhou Li), physicians and their subordinates were under the jurisdiction of the Minister of State (Zhongzai). At the end of each year, their performance was reviewed to determine their salary. During the reign of Emperor Shenzong of Song, internal and external medical schools were established, with positions for professors and students, all undergoing examination by specialty for promotion or appointment. The Yuan Dynasty also followed this practice. The examination essays had fixed formats and procedures; it is unknown how successful the selection of talent was at that time. However, the intention to treat the medical profession with caution remained unchanged. Consequently, the formulation of prescriptions and treatment of diseases during that period still adhered to standards. In later generations, most physicians were those who failed in scholarly pursuits, lacked capital for commerce, and resorted to medicine as a means of livelihood. Some casually browsed books in markets, plagiarizing medical texts; others falsely claimed apprenticeship under local renowned doctors. Initially intending to deceive others, they eventually came to believe their own medical skills were mediocre. This error became entrenched, causing endless harm, and the profound essence of Qibo and Huangdi (the legendary founders of Traditional Chinese Medicine) was nearly lost! If one wishes to deliberate upon ancient and modern examination methods, it is essential to seek out physicians who genuinely possess lineage transmission, extensive learning, and upright character. Similar to the Song Dynasty's professors, they should strictly examine other physicians, selecting only those permitted to hang up a sign and practice. Once practicing, monthly rigorous assessments should be conducted. Those whose knowledge becomes dilapidated or whose treatment methods are erroneous shall, in minor cases, have their signs removed to study again, and in major cases, be ordered to change professions. Positions above professor, like the hierarchy of physicians in the *Rites of Zhou*, should have distinct ranks. Those with outstanding scholarship and miraculous therapeutic effects may serve as reserve professors. The examination method is divided into six specialties: Acupuncture and Moxibustion, Internal Medicine (Da Fang), Gynecology, Pediatrics including Smallpox, Ophthalmology, and Surgery. Those proficient in all specialties are called Generalists (Quan Ke); those proficient in one or two are called Dualists (Jian Ke); and those proficient in only one are called Specialists (Zhuan Ke). There are three types of examination questions: First, theoretical topics drawn from the *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions), aiming to elucidate the principles of meridians and zang-fu organs, the Five Movements and Six Qi, cold and heat, deficiency and excess, tonification and sedation, and reversal and compliance. Second, explanatory topics drawn from the *Shennong Bencao Jing* (Divine Farmer's Materia Medica), *Shanghan Lun* (Treatise on Cold Damage), and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), testing knowledge of drug properties, disease variations, and prescription formulation. Third, case reports, where candidates describe the efficacy of their usual treatments and the rationale behind using specific prescriptions for specific diseases. Through such examinations, it is natural that speech will be based on sacred classics, treatment will follow ancient methods, learning will have a source, and lineage transmission will continue. How can we allow those who dabble superficially, fabricate without basis, and lack any foundation to treat human life as a game?