典藏书目

Discourse states: Generally, those who are dull in nature and malicious in intent should not learn to be physicians. If one does not choose goodness but commits evil, disaster is hard to escape. Those who are timid by disposition, straightforward in action but weak in character, also should not discuss the use of medicine. The *Suwen* (Basic Questions) states: "Humans are like boats, and medicines are like water." Water can float a boat, but it can also capsize it. If a pill or powder is correctly indicated and achieves perfect results, rescuing the critically ill from danger, this is not surprising. However, if harm occurs due to profit-seeking or the condition deteriorates, the fault lies with you. Your wisdom is clumsy and dull; it is not the medicine's fault. Students of medicine should study classics, explore their purity and subtlety, apply meticulous research, and strive for efficacy, thereby conforming to rules. What cannot be verbally described belongs to the realm of excellent physicians.

Ancients said that physicians using medicine is like generals using troops. For instance, a skilled physician who clearly diagnoses corresponds to a capable general who obtains correct strategies; medicine conquers disease just as soldiers defend the city. If a general has no strategy, and a physician faces syndromes and pathogens, how can diseases be cured? How can cities be secured? Nowadays, people know how to prescribe drugs but fail to investigate thoroughly. Regarding exterior and interior, zang-fu organs, deficiency and excess, cold and heat, meridians, and Ying-Wei (Nutritive and Defensive Qi), inappropriate administration may cause other harms. One must not rigidly stick to a single formula or herb. Even formulas such as Siwei Lizhong Wan (Four-Ingredient Spleen-Warming Pill) and Xiaochaihu Tang (Minor Bupleurum Decoction) are adult dosages. It is said that "when intention reaches and symptoms appear, medicines are invariably effective," which only capable persons can achieve. The principle is that although various texts record syndromes, formulas, and herbs that should theoretically be effective, few truly reach the ultimate perfection. Is it due to excessive attack? Or is it because one delves into heterodox teachings, has miscellaneous knowledge without focus, and acts recklessly and simplistically? Indeed, one must reflect deeply on this.

Discourse states: The intent of medical treatment and nursing care differs slightly, but both require examining the appropriateness of deficiency and excess, and thoroughly understanding the principles of urgency and slowness. If one understands the severity of the disease, one must observe whether the illness is recent or chronic. Based on the patient's condition, if symptoms are slightly severe and the course is slightly adverse, directly seeking efficacy while preserving therapeutic outcomes is the method of an excellent physician supporting the patient. One should explain the pros and cons according to the syndrome, administer medications in a relaxed sequence, promote recovery, prevent aggravation, and aim for early convalescence. This is being good at regulation and treatment.

For example, water flows downward; rapid or slow currents, clarity brings self-purification, depth brings self-nourishment, narrow channels become turbulent, banks allow drainage, eddies pool, and rapids rush—all occur naturally and cannot be forced. The circulation of pulse qi, when encountering cold, heat, chill, coolness, wind, warmth, dryness, and dampness, also flows naturally like water to low places. "Regulation" (Tiao) refers to the stage where the disease has manifested but not yet transmitted, and Qi circulation is still weak; changes then follow established laws. If Qi is weak, support it slowly. Thus, "Tiao" means observing limits, and "Li" (Reason/Order) means having order. "Limits" mean neither excess nor deficiency; "Order" means attaining the appropriate position. Only then is it called "Li." Without excess or deficiency, it can be called "Tiao." "Tiao" implies measure; knowing the measure lies in description. "Li" must be imitable; correct law fully conforms to rules. This is like silk without a head or hair that cannot be combed—this is chaos. Combing silk seeks straightness; combing hair resolves tangles without leaving any strand behind, bringing pure joy. This is indeed the skill of regulation and treatment.

If urgent methods are used for critical conditions, and slow methods are used when improvement is seen, this is excessive. One must deliberate and weigh, avoiding narrow bias. First, estimate the severity, observe the progression and regression of the disease. Medicines should correspond to the disease's momentum, and the disease should match the pills and powders. Physicians must design with intent, aligning wisdom with medical expertise, harmonizing medicine with pathology. When the disease matches the medication, use it without negligence. Why worry about the disease not healing? Alas! Students of pediatrics should not rely on self-confidence or hold prejudices. Recognize strengths, seek prior learning, and devote oneself completely before stopping.