察病必须明表里，更详虚实在初分；恶攻喜补人皆信，谁识攻中有补存。
张子和曰∶人身不过表里，血气不过虚实。此言其大略耳。惟庸工之治病，纯补其
虚，不敢治其实，举世皆曰平稳，误人不见其迹。渠亦不自省其过，虽终老而不悔，且
曰∶吾用补药也，何罪焉？病患亦曰，彼以补药补我，彼何罪焉？虽死亦不知觉，此庸
工误人最深。如鲧湮洪水，不知五行之道，夫补者人所喜，攻者人所恶，医者以其逆病患
之心，而不见用，不若顺病患之心，而获利也，岂复计病者之死生乎？盖医有贤愚，人
多谬误，以贤为非，以愚为是，不明标本，妄投药饵，自取危困，徒切感慨。所谓攻者，万
病先须发散外邪，表之义也；外邪既去，而元气自复，即攻中有补存焉，里之义也。然
察其表里虚实，尤在临机权变，毋执一定之规也。
大抵行医片言处，深思浅发要安详；更兼忠浓斯为美，切戒逢人恃己长。
郑端友曰∶医门一业，慈爱为先，尝存救治之心，方集古贤之行。近世医者，诊察
诸疾，未言理疗，訾毁前医，不量病有浅深。效有迟速，亦有阴虚阳实，翕合转移，初
无定论，惟务妒贤嫉能，利己害人，惊谑病家，意图浓赂，尤见不仁之心甚矣。昔神宗
时，钱仲阳为医有声。皇子仪国公病螈 国医莫能治，长公主朝，因言钱乙起草
野，有异能。立召入。进黄土汤而愈。神宗褒谕，问黄土何以愈斯疾状。乙对曰∶以
土胜水，木得其平，则风自止。且诸医所治垂愈，小臣适当其愈。上悦其对，擢太医丞，
赐紫衣金鱼，一旦超然众医之表，岂不贵哉。学人能以仲阳之心为心，则善矣。
诊察疾病必须明确病位在表还是在里，更要详细分辨虚实以作为初步判断的依据；人们普遍相信疾病应当避免攻伐而喜好补益，但谁能认识到在攻伐之中也蕴含着补益的作用呢？
张子和说：人身不过分为表和里，气血不过表现为虚和实。这说的是大概情况罢了。只有平庸的医生治病，只单纯地补其虚损，不敢治疗其实证，世人都说这样平稳，却看不见这种错误对人的伤害。他们也不自我反省过错，即使终老也不后悔，还说：“我使用的是补药，有什么罪过呢？”病人也说：“他用补药来补我，他有什么罪过呢？”即使死了也不知道原因，这是庸医误人最深之处。就像鲧堵塞洪水一样，不懂得五行的道理。补法是病人所喜欢的，攻法是病人所厌恶的，医生因为违背病人的心意而不被任用，不如顺从病人的心意来获取利益，哪里还会考虑病人的生死呢？大概医生有贤能和平庸之分，人们大多产生谬误，把贤能的看作错误的，把平庸的看作正确的，不明白标本关系，胡乱投药，导致自身陷入危险困境，只能徒然感叹。所谓攻法，是指对于万病首先要发散外邪，这是“表”的含义；外邪去除后，元气自然恢复，这就是攻伐中蕴含补益，是“里”的含义。然而观察表里虚实，尤其在于临机应变，不要拘泥于固定的规则。
大体上行医的关键在于言语恰当，深思熟虑后再发表意见要安详稳重；再加上忠诚恳切才算是美好，务必戒除逢人便炫耀自己长处的毛病。
郑端友说：医学这一行当，以慈爱为先，常常存有救治之心，才能聚集古代贤者的德行。近世的医生，诊察各种疾病，还没谈论治疗方法，就诋毁之前的医生，不衡量病情有浅有深，疗效有快有慢，也有阴虚阳实、阴阳翕合转移的情况，起初并没有定论，只是致力于嫉妒贤能，为了私利损害他人，惊吓嘲笑病人家属，意图索取丰厚贿赂，更显示出不仁之心非常严重。从前神宗时期，钱乙（字仲阳）作为医生很有名声。皇子仪国公患抽搐病（螈），国医都不能治愈，长公主上朝时，因此说钱乙出身民间，有特殊才能。神宗立即召他入宫。钱乙进献黄土汤而治好了病。神宗褒奖谕令，询问黄土汤为什么能治好这个病的原理。钱乙回答说：用土来克制水，木气得到平衡，那么风邪自然停止。况且各位医生治疗的病情快要痊愈，我只是恰好赶上它痊愈的时候。皇上对他的回答感到高兴，提拔他为太医丞，赐给紫色官服和金鱼袋，一下子超然于众医生之上，难道不尊贵吗？学习者如果能以钱仲阳的心志为心志，那就很好了。
Diagnosis of disease must clarify whether the pathogen is in the Exterior (Biao, 表) or Interior (Li, 里), and further detail the deficiency (Xu, 虚) or excess (Shi, 实) for initial differentiation; people generally believe that diseases should avoid purgation/attack (Gong, 攻) and prefer tonification (Bu, 补), but who recognizes that tonification exists within attack?
Zhang Zihe said: The human body is merely divided into Exterior and Interior, and Qi and Blood manifest only as Deficiency and Excess. This speaks to the general outline. Only mediocre physicians, when treating disease, purely tonify deficiency and dare not treat excess. The world calls this "steady," yet the harm done to people remains unseen. They do not reflect on their own faults, remaining unrepentant until death, saying, "I used tonifying medicines; what crime have I committed?" Patients also say, "He used tonics to benefit me; what crime has he committed?" Even upon death, they remain unaware of the cause. This is how deeply mediocre physicians mislead people. It is like Gun blocking the floodwaters, ignorant of the Way of the Five Elements (Wu Xing, 五行). Tonification is what patients desire; attack/purgation is what they dislike. Physicians, finding their approach contrary to patients' wishes, are not employed. Instead, they cater to patients' desires to gain profit, showing no concern for the patient's life or death. Generally, there are wise and foolish physicians, yet many people err, regarding the wise as wrong and the foolish as right. Ignorant of the Root (Ben, 本) and Branch (Biao, 标), they recklessly administer drugs, bringing themselves into perilous distress, leaving only room for sighs. What is meant by "attack" is first dispersing external pathogens from all diseases; this is the meaning of "Exterior." Once external pathogens are removed, Yuan Qi (Original Qi, 元气) naturally recovers; thus, tonification exists within attack, which is the meaning of "Interior." However, observing Exterior/Interior and Deficiency/Excess requires flexibility in clinical practice, without adhering to rigid rules.
In general, the key to practicing medicine lies in appropriate speech; deep thought followed by measured expression ensures calmness. Furthermore, sincerity and earnestness constitute beauty; one must strictly avoid boasting of one's strengths to everyone met.
Zheng Duanyou said: In the profession of medicine, compassion comes first. One must constantly harbor a heart of rescue and relief to accumulate the deeds of ancient sages. Modern physicians, when diagnosing various diseases, before discussing therapeutic methods, slander previous doctors, failing to assess that diseases vary in depth and efficacy varies in speed. There are cases of Yin Deficiency with Yang Excess, and shifts in Yin-Yang interaction, where no fixed conclusion exists initially. Yet, they strive to be jealous of the virtuous and capable, harming others for self-interest, startling and mocking patients' families, intending to extract heavy bribes, revealing an extremely uncompassionate heart. In the past, during Emperor Shenzong's reign, Qian Yi (courtesy name Zhongyang) was renowned as a physician. The Imperial Prince, Duke of Yiguo, suffered from convulsions (Chou, 瘛); imperial physicians could not cure him. When the Eldest Princess attended court, she mentioned that Qian Yi, originating from the common folk, possessed unique skills. He was immediately summoned. He prescribed Huangtu Tang (Yellow Earth Decoction, 黄土汤), and the prince recovered. Emperor Shenzong praised him and asked why Huangtu Tang cured this ailment. Qian Yi replied: Using Earth to overcome Water allows Wood to achieve balance, so Wind stops naturally. Moreover, the other physicians' treatments were nearing completion; I merely happened to coincide with the recovery. The Emperor was pleased with his answer, promoted him to Ta Yi Cheng (Director of the Imperial Medical Bureau, 太医丞), bestowed purple robes and gold fish bags, elevating him above other physicians. Is this not honorable? If learners can adopt Zhongyang's mindset as their own, it would be excellent.