典藏书目

Wu Hegao, whenever he treated a patient, would first write down a medical record (bing'an) before prescribing medication. He claimed that by examining the condition of the disease and establishing the formula theory, pathogenic factors (gui zei) could not discern its form, and upon administration of the medicine, the illness would be cured. Yu Jiayan also had extremely detailed and standardized formats for discussing diseases. In short, one must discuss the disease first and then prescribe medication; with a detailed and clear case format, one can naturally master the situation and act with creative ingenuity. I hereby excerpt this to advise those who are rash and imprudent.

First, record the year, month, location, person, as well as their age, physique, voice, and complexion; second, record their emotional state (joy or distress), etiology, onset date, which time of day (day vs. night) symptoms are worse, whether cold or heat predominates, what they like or dislike, and the pulse characteristics; third, record any medications previously taken, which were effective, and which were ineffective; fourth, cite classical medical principles to determine the disease name, identify which symptoms are the branch (biao) and which are the root (ben), specify which formula requires modification with which herbs, which herbs enter which meridians, and which formulas align with which theoretical meanings, listing everything in detail; finally, record the author as "a junior scholar from [County Name]."

Recording the Heavenly Stems and Earthly Branches of the year and the seasons of the month is to assess the influence of Six Qi (yun qi). Recording the location is to assess regional suitability. Recording age and appearance is to assess youth/old age and the flourishing or declining state of vital energy. Recording joy or distress is to assess the Seven Emotions (qi qing). Recording the onset date is to assess the duration of the illness. Recording day/night variations, cold/heat, and likes/dislikes is to examine Yin-Yang and Zang-Fu organs. Recording pulse characteristics allows for integration with age, physique, and symptoms. Asking sequentially about drug efficacy allows for deliberation on one's own insights. Citing classics and recording symptoms is like a wise judge citing laws to pass sentence; similarly, disease is like rebellion and medicine like troops, so military action must have a just cause. Recording root and branch helps identify urgency and severity. Recording herb properties and formula meanings ensures that knowledgeable individuals will have no doubts after reviewing it. Recording the author's name at the end allows the patient to keep a record, thereby verifying the physician's skill level.

When treating eye diseases for families of renowned and virtuous physicians, one should clear the mind and settle thoughts while writing this case record. This serves three purposes: first, as a mirror for diagnosing the disease; second, to establish the proper conduct of a physician; third, since high moral standing often invites slander, merits and faults can be mutually verified. This achieves three benefits at once and serves as a corrective needle for worldly ears. Those responsible for medicine, and those who listen and think wisely, how can they remain passive? If seeing dozens of patients daily makes it difficult to complete records hastily, or if the family members are illiterate, one may simply record which person, which meridian is affected, which syndrome is present, the etiology, whether the pulse matches the symptoms, and propose treatment based on modifications of specific syndromes and formulas. Although brief and lacking in literary flair, this is still superior to prescribing recklessly. Inferior physicians secretly withhold formulas and forbid questioning, leaving their lineage unknown.

Regarding acupuncture for internal cataracts (nei zhang), detailed explanation is especially necessary. Patients are common everywhere, yet doctors skilled in this area are rare even across provinces. Zhang Jiebin, a famous doctor from Zhejiang who authored *Jingyue Quanshu* (Complete Works of Jingyue), stated directly that internal cataracts are incurable. However, I have heard of skilled practitioners who can insert needles into the eye to dislodge the opacity, though I have never seen such a person myself. This shows that true experts in this field are extremely rare. Beyond the standard case recording mentioned above, additional notes are required. If neither eye violates contraindications, treatment is possible; both eyes may be needled simultaneously. Some cases show immediate improvement in one eye; some patients regain vision immediately upon needle insertion, with no redness or pain after withdrawal, recovering fully without further medication. In other cases, although the opacity appears to have fallen, vision remains impaired. Furthermore, post-acupuncture symptoms can vary widely. With proper care and regulation, vision may return completely within one or two months, or even a year later. The subtle principles involved are such that even an experienced practitioner like Tingjing cannot predict the outcome before needling, nor fully understand the mechanism. It seems to depend on timing, fortune, destiny, and individual merit. In summary, if the disease is curable, it is due to divine assistance for the auspicious; the physician holds the hammer and furnace of creation in hand and acts with creative insight. Thus, both parties should rejoice, and the golden needle will indeed not fail the patient.