孙思邈祝医者曰∶行欲方而志欲圆，心欲小而胆欲大。甚矣！先生之风范良可想见耳。余特引而伸之，而与
博爱者共勉。夫人襟期浩荡，器宇雍和，口不轻言，心无杂念，正其谊不谋其利，明其道不计其功，倘遇险症，
尔体臣心，存存以诚，而单寒之家愈加矜慎，如是者谓之“行方”；禀赋有浓薄，年纪有老少，情性有缓急，境
遇有贵贱，日月有远近，风土有强弱，病候有沉郁暴悍，运气有太过不及，处常弭变，悉得其情，如是者谓之
“志圆”；望闻问切至再三，苦欲补泻载详载审，名著求为可知，下问惟恐失人，如是者谓之“心小”；硫磺、
桂、附，补则补而热则热，芒硝、连、柏，泻即泻而寒即寒，全不模棱，尚持两可，如是者谓之“胆大”。四者
似分而实合也。故精警之士未常越成法以败德，亦未常囿成法以误事，是行方者志必圆也。灵变之人未有知其然
而不究其所以然，亦未有当如此而不敢决其必如此，是胆大适所以行其心小也。或谓心小、胆大一合而成志圆，
心小、胆大、志圆再合而成行方，则得先生之微意。或谓方则有碍于圆，小未免妨乎大，则失先生之大旨矣。呜
呼！顾安得起思邈于九京，而与夫夫折衷也哉。
从古大勇大知教国治家，总以不徇人情为得，以不近人情为失。医，人鬼之关也。目，阴阳之界也。生民司
命，有
不权衡于斯二者之间，是为不得人情。不得人情，则不得病情矣。得失云乎哉，略为申其三说∶曰病患之情、旁
人之情、医人之情。所谓病患之情者，尽有变端，难以定律。有脏腑偏胜，有运气愆候，有飞灾波累，有内火潜
焦，有眠食不时，有劳苦自若，有缘境未遂，竟日逐逐，有深情牵挂，中霄耿耿，有处事不和，动成荆棘，有流
荡亡返，甘落风尘，有形类惊猿，虽严师益友，忠告善道，禁戒未必恪遵，有心如止水，尝少米无柴，室人交谪，
凌辱大难忍耐，有爱物及乌，或举贤，或自荐，良言甫入而狐媚承欢，曰某劳力，曰某省费，谬说又从，多岐亡
羊，终成蕉鹿。有大床自卧，无礼下人。有一钱如璧，得鱼忘筌，怀真高士，讵肯输诚。有迂腐当证，急暴罔顾
神速，宁图老实，车薪杯水，玉石俱焚。有躁率而病延缠，胆识自嘉，鄙人过慎，长驱锐进，岂无侵犯。有热汤
惧补，未沾唇心先痞满。有攻方畏凉，刚下咽魂即飘扬。再则有讳疾不言，有隐疾莫告，有故隐疾，试医工拙，
有窒泥古书，毁人妙论，有先功后居，有乙误咎甲，有德施怨报，有阳奉阴违。有闺壶害羞，传言差错。有刀针
怯痛，神术不行。此皆病患之情，不可不察也。所谓旁人之情者，欣戚无关，发言容易，或持有据快论，而病源
未必相符。或谓无恐勿慌，而医理何曾梦晤。或面决异同，是己者与之，非己者拒之，更医杂投，以药治药，徒
丧真元。或强作解事，症奇曰邪祟，症凶曰犯煞，铸张为幻，一传再传，多至难挽。或尊贵风威难抗，或密戚阻
挠万千。好谀者，医 之，则不肖亦贤。慷他人之慨，浓其赠予，素悭者病起矣。犹洗垢索瘢，却别人之请，不
放医回，逮至荐医，非有令名，无因至前。不然，或意气之私浓，或庸浅之偶中，或信其利口，或贪其酬谢，或
报其旧德，或修其新好，熏莸
不辨，妄肆品题，信而延之，病其进矣。并有讪诋医药，特荐左道舞鬼说神，破财晦气。此皆旁人之情，不可不
察也。所谓医人之情者，据道则近仁，行来只觉为利，是以便佞者，不巧语悦人，则大言耸听，不强辨相欺，则
危机相恐。阿附者，此浓待伊芳亲，叨护其短，彼小惠近侍，可匿其非。此夤缘攀结，营求汲引，彼浓貌深衷，不
速自赴。诈欺者，胸无成竹假师承，临时翻阅锦囊，目不识丁推秘授，至死不拈笔墨。巾笥偶缺柴胡，充以前胡，
丹丸其实六味，价征八味。惰慢者，生憎寒暑，欲急而缓，俨若知渠淡泊，迟迟吾行。或癖游嗜赌，以重为轻，
不则转央同侪，每致变。陋劣可耻者，始也自高其道，非钱不行，继则隔靴搔痒，自褒稳重，已而耻谈症候，动
辄讲脉∶故为矜持，十时诊脉。道听人言，佯验以脉。夸精太素，风鉴人脉。明见不知，硬争好脉。孟浪不经者，
五轮八廓漫不留心，七方十剂胡乱就用。且谓若钝兹利，人呆我惊，不吉却嫁谤，自文许多饰说。贪污行险者，
闻高华而抱危病，恨不得入局居奇。幸而落手，既热则寒，曾攻决补，峻品重剂，冀为孤注。窃闻夜半脱逃，大
该而属。冒嫉刻薄者，比邻名医在座，心知臭味不投，则多方浸润，洎去而之他，眼见沉 遍起，犹尽情 牾，
其实风行草偃，枉作宵人。外如素昧平生，苟且图名，而仪文不较，萍水相逢，偶然认症，而凯觎到底。穷酸指
大，招牌大书儒医，行动必肩舆仆马，究其所蕴，又不过七十二症，所谓羊质虎皮，虚有其表，浪费民财，残虐
么魔，丰仪确是长者，遇无妄之疾，莫利其赀，反其药饵，致入沉困，殆囊橐既饱，然后徐徐收效，所谓笑中有
刀，柔而害物。一中流失楫，不几谋财故杀。此皆医人之情，不可不察也。若夫品行清高，而见偏性辟，药不济
以刀针继之，法外施刑，绝
人长命。及见人之失，若己之得，见人之得，若己之失，有可利己损人，则从中播弄，以逞一时之快。与夫好吉
者，危言见摈。多忧者慰问为非。信巫蓍者，以医为敌，药石无怪其成仇。惯猜疑者，深言则忌，金兰安望其同
契，甚则病廖意怠，托故妆乔，且得命思财，兄弟 墙，伦常乖戾，怨天尤人，广生懊恼等情，独非人情？而人
情之详，尚多难尽，予以不徇人情，不近人情之得失为戒者，欲令后人思之慎之，弗为陋习所中耳。虽然人情王
道之本，必期不殉，未免拗执，务欲近情，端涉迁就，则迁就固逆乎病情，而拗执决拂于人情，有断宜拗执之病
情，而复有不得不迁就之人情，可奈何！可奈何！呜呼！非常之病，非非常之医不能治。而非常之医，又岂常人
之所知。安得大勇大知，教国治家者，与之商斯事也哉。
孙思邈曾告诫医者说：“行为要端正有原则，志向要灵活圆通，心思要缜密谨慎，胆识要宏大果敢。”先生的风范确实令人敬仰。我特意引申发挥，与各位怀有仁爱之心的人共勉。
所谓“行方”（行为方正）：一个人胸怀宽广，气度雍容平和，不轻易言语，心中没有杂念，坚持正义而不谋取私利，彰明大道而不计较功效；如果遇到危重病症，自身廉洁如臣子般忠诚，以诚心坚守，对贫寒之家更加小心谨慎，像这样的人就叫做“行方”。
所谓“志圆”（志向圆通）：人的禀赋有厚薄之分，年龄有老少之别，性情有缓急之异，境遇有贵贱之差，时间有久暂之异，地域风土有强弱之殊，病情有沉滞暴烈之不同，运气（五运六气）有过盛与不及之变。处理常态并消除变故，都能洞察其情由，像这样的人就叫做“志圆”。
所谓“心小”（心思缜密）：通过望、闻、问、切四诊反复检查，详细审慎地记载补泻之法，追求名声是为了探求可知之理，虚心向他人请教唯恐遗漏病人，像这样的人就叫做“心小”。
所谓“胆大”（胆识宏大）：使用硫磺、桂枝、附子等药，补益则真补，温热则真热；使用芒硝、黄连、黄柏等药，攻下则真下，寒凉则真寒，绝不模棱两可，保持犹豫不决的态度，像这样的人就叫做“胆大”。
这四点看似分开，实则统一。所以精警敏锐的医者从未超越成法而败坏医德，也从未拘泥于成法而耽误事情，这就是“行方者志必圆”。灵动多变之人没有只知其然却不探究其所以然的，也没有在应当如此时不敢坚决断定必须如此的，这就是“胆大”正是为了践行“心小”。有人说，“心小”和“胆大”结合而成“志圆”，“心小”、“胆大”、“志圆”再结合而成“行方”，这就得到了先生的深意。有人说“方”会妨碍“圆”，“小”难免妨害“大”，这就误解了先生的主旨了。唉！哪里能让孙思邈从九泉之下复活，来与大家折衷评判呢？
自古以来，拥有大勇大智、能教化国家治理家庭的人，总以不徇私情为得，以不合人情为失。医学，是人鬼之间的关口；眼睛，是阴阳交界之处。百姓的生命命运，如果不在这两者之间权衡，就是不得人情。不得人情，就无法掌握病情了。这关乎得失啊，略为阐述三种情况：即病患之情、旁人之情、医人之情。
所谓“病患之情”：情况千变万化，难以用固定法则衡量。有的脏腑偏胜，有的运气失常，有的遭遇飞来横祸牵连，有的内火暗中煎熬，有的睡眠饮食不规律，有的劳苦习以为常，有的心愿未遂终日奔波，有的深情牵挂半夜难眠，有的处事不和动辄陷入困境，有的流荡忘返甘愿堕落风尘，有的形体像受惊的猿猴，即使是严师益友忠告善道，也未必严格遵守禁令，有的心如止水，即使缺米少柴、家人责备凌辱也能大难忍耐，有的爱屋及乌或举荐贤才或自我推荐，良言刚入耳便逢迎承欢，说某人出力多，说某人费用省，谬论随之而来，最终歧路亡羊，一场空梦。有的自高自大卧床不起，无礼对待他人。有的视钱财如璧玉，得鱼忘筌，怀藏真知的高士岂肯输诚。有的迂腐固执当证候之急，不顾神速，宁愿图个老实，如同车薪杯水，玉石俱焚。有的急躁草率导致病情拖延，胆识虽佳但鄙人过于谨慎，长驱直入难道没有侵犯吗？有的害怕热汤补剂，未沾唇中心先痞满。有的畏惧攻下方剂，刚下咽魂即飘扬。再有讳疾忌口不言，隐瞒疾病不告，故意隐瞒疾病试探医生技艺高低，死守古书毁弃妙论，居功诿过，乙误咎甲，施恩反怨，阳奉阴违。有的闺房害羞，传言差错。有的惧怕刀针疼痛，神术无法施行。这些都是病患之情，不可不察。
所谓“旁人之情”：悲欢无关己身，发言容易，有的持有确凿快论，但病源未必相符。有的说不要恐慌，但医理何曾梦见。有的当面决断异同，认同自己的就支持，不认同的就拒绝，更换医生杂乱投药，以药治药，徒丧真元。有的强作解事，症状奇特就说邪祟，症状凶险就说犯煞，张皇造幻，一传再传，多至难挽。有的尊贵威风难抗，有的亲密亲戚阻挠万千。喜欢阿谀奉承的人，医生若迎合他，则不肖也被视为贤能。慷他人之慨，丰厚赠予，原本吝啬的人病好后却洗垢索瘢，拒绝别人的请求，不放医生回去，等到再荐医生时，若非有名声，无缘来到面前。不然，或因意气之私浓厚，或因庸浅偶然中症，或因相信其利口，或因贪图酬谢，或因报答旧德，或因修好新交，熏莸不辨，妄加品评，信任并延请，病情反而加重。还有讥讽诋毁医药，特别推荐左道舞鬼说神，破财晦气。这些都是旁人之情，不可不察。
所谓“医人之情”：依据道义则接近仁，行事只为利益，于是巧言令色者，不巧语悦人，就大言耸听，不强辩相欺，就危机相恐。阿谀依附者，对此人浓待其亲，包庇其短；对彼人小惠近侍，隐匿其非。这种攀结营求，那人貌深衷，不速自赴。欺诈者，胸无成竹假借师承，临时翻阅锦囊，目不识丁推托秘授，至死不拈笔墨。巾笥偶缺柴胡，充以前胡，丹丸其实六味，价征八味。懒惰傲慢者，生憎寒暑，欲急而缓，俨若知渠淡泊，迟迟吾行。或癖游嗜赌，以重为轻，不则转央同侪，每致变。陋劣可耻者，始也自高其道，非钱不行，继则隔靴搔痒，自褒稳重，已而耻谈症候，动辄讲脉：故为矜持，十时诊脉。道听人言，佯验以脉。夸精太素，风鉴人脉。明见不知，硬争好脉。孟浪不经者，五轮八廓漫不留心，七方十剂胡乱就用。且谓若钝兹利，人呆我惊，不吉却嫁谤，自文许多饰说。贪污行险者，闻高华而抱危病，恨不得入局居奇。幸而落手，既热则寒，曾攻决补，峻品重剂，冀为孤注。窃闻夜半脱逃，大该而属。冒嫉刻薄者，比邻名医在座，心知臭味不投，则多方浸润，洎去而之他，眼见沉 遍起，犹尽情 牾，其实风行草偃，枉作宵人。外如素昧平生，苟且图名，而仪文不较，萍水相逢，偶然认症，而凯觎到底。穷酸指大，招牌大书儒医，行动必肩舆仆马，究其所蕴，又不过七十二症，所谓羊质虎皮，虚有其表，浪费民财，残虐么魔，丰仪确是长者，遇无妄之疾，莫利其赀，反其药饵，致入沉困，殆囊橐既饱，然后徐徐收效，所谓笑中有刀，柔而害物。一中流失楫，不几谋财故杀。此皆医人之情，不可不察也。若夫品行清高，而见偏性辟，药不济以刀针继之，法外施刑，绝人长命。及见人之失，若己之得，见人之得，若己之失，有可利己损人，则从中播弄，以逞一时之快。与夫好吉者，危言见摈。多忧者慰问为非。信巫蓍者，以医为敌，药石无怪其成仇。惯猜疑者，深言则忌，金兰安望其同契，甚则病廖意怠，托故妆乔，且得命思财，兄弟 墙，伦常乖戾，怨天尤人，广生懊恼等情，独非人情？而人情之详，尚多难尽，予以不徇人情，不近人情之得失为戒者，欲令后人思之慎之，弗为陋习所中耳。虽然人情王道之本，必期不殉，未免拗执，务欲近情，端涉迁就，则迁就固逆乎病情，而拗执决拂于人情，有断宜拗执之病情，而复有不得不迁就之人情，可奈何！可奈何！呜呼！非常之病，非非常之医不能治。而非常之医，又岂常人所所知。安得大勇大知，教国治家者，与之商斯事也哉。
Sun Simiao once advised physicians: "Conduct yourself with integrity and principle, keep your aspirations flexible and comprehensive, maintain a meticulous and cautious mind, and possess bold and resolute courage." The master's demeanor is truly admirable. I hereby extend this teaching and encourage all those who harbor benevolence to strive for it together.
To speak of "Xing Fang" (Upright Conduct): One should have a broad mind and harmonious bearing, speak sparingly, keep the heart free from distracting thoughts, uphold righteousness without seeking profit, illuminate the Way without calculating merit. When encountering critical illnesses, one must be as loyal as a minister, steadfast in sincerity, and particularly cautious when treating poor families. Such a person is said to have "Upright Conduct."
To speak of "Zhi Yuan" (Comprehensive Vision): People differ in constitution (thick or thin), age (young or old), temperament (slow or quick), circumstances (noble or humble), time (long or short), and local climate (strong or weak). Diseases vary in depth and violence, and the movement of Qi and Blood (Yunqi) has excess and deficiency. Handling normal situations and preventing changes by fully understanding these factors constitutes "Comprehensive Vision."
To speak of "Xin Xiao" (Meticulous Mind): Through repeated observation, listening, inquiry, and pulse-taking (Wang Wen Wen Qie), carefully recording methods of tonification and purgation, seeking fame only to understand the truth, and humbly asking others for fear of missing patients, such a person is said to have a "Meticulous Mind."
To speak of "Dan Da" (Bold Courage): Using herbs like Sulfur (Huangqi), Cinnamon Twig (Guizhi), and Prepared Aconite Root (Fuzi), if tonifying, one truly tonifies; if warming, one truly warms. Using substances like Mirabilite (Mangxiao), Coptis Rhizome (Lianhua), and Phellodendron Bark (Baihuangbo), if purging, one truly purges; if cooling, one truly cools. One avoids ambiguity and indecision. Such a person is said to have "Bold Courage."
These four aspects seem separate but are actually unified. Thus, a sharp physician never violates established rules to ruin virtue, nor is he confined by rules to cause mistakes; this means that upright conduct necessitates comprehensive vision. An adaptable person never knows the 'what' without exploring the 'why', nor dares not decide firmly when action is required; this means bold courage serves to execute meticulousness. Some say that "Meticulous Mind" and "Bold Courage" combine to form "Comprehensive Vision," and these three combine to form "Upright Conduct," which captures the master's subtle intent. Others argue that "Uprightness" hinders "Comprehensiveness," and "Smallness" obstructs "Bigness," thus misunderstanding the master's main theme. Alas! How can we bring Sun Simiao back from the nine springs to deliberate with us?
Since ancient times, those with great courage and wisdom who educate the state and govern the family succeed by not pandering to human sentiments and fail by being out of touch with them. Medicine is the threshold between life and death; the eyes are the boundary of Yin and Yang. If one does not weigh these two factors regarding people's lives, one fails to understand human nature. Failing to understand human nature leads to failing to grasp the disease condition. This concerns gain and loss. Let me briefly elaborate on three types of human sentiment: the patient's sentiment, the bystander's sentiment, and the physician's sentiment.
Regarding the "Patient's Sentiment": Changes are endless and hard to standardize. There are cases of organ imbalance, abnormal climatic influences, sudden disasters, hidden internal heat, irregular sleep and diet, habitual labor, unfulfilled desires causing daily anxiety, deep emotional attachments causing sleepless nights, interpersonal conflicts leading to thorns everywhere, wandering and degradation, fearful behavior resisting advice even from good friends, stoic endurance of poverty and abuse, altruism or self-promotion met with flattery, misleading statements leading astray, arrogance and rudeness, stinginess, stubborn adherence to symptoms ignoring urgency, rashness prolonging illness despite courage, fear of warm tonics causing chest fullness, fear of purgatives causing spiritual distress, concealment of disease, testing doctors' skills, rigid adherence to ancient texts rejecting new theories, shifting blame, ingratitude, hypocrisy, shyness leading to miscommunication, fear of needles hindering treatment. These are all patient sentiments that must be observed.
Regarding the "Bystander's Sentiment": Uninvolved parties speak easily. Some offer confident opinions unrelated to the disease source. Some say "don't panic," lacking medical knowledge. Some judge based on personal preference, supporting those who agree and rejecting others, leading to chaotic medication and loss of vital energy. Some fabricate supernatural causes for strange or severe symptoms, spreading rumors until they become incurable. Some yield to noble authority or family obstruction. Flatterers may turn bad doctors into perceived virtuous ones. Generosity from others may lead to excessive gifts, causing stingy patients to reject doctors after recovery. Later recommendations depend on reputation or personal connections, bias, or greed for reward. Confusing good and bad advice, trusting the wrong doctor worsens the disease. Some slander medicine and promote superstition, causing financial loss. These are bystander sentiments that must be observed.
Regarding the "Physician's Sentiment": Those claiming to follow the Dao but acting for profit use flattery, exaggeration, deception, or fear tactics. Sycophants cover up faults for relatives or servants. Climbers seek connections. Fraudsters fake lineage, hide ignorance, substitute inferior herbs (e.g., using Radix Peucedani instead of Radix Bupleuri), and overcharge for formulas. Lazy physicians delay treatment, gamble, or rely on colleagues, causing changes. Shameful physicians demand high fees, scratch the surface while praising stability, avoid discussing symptoms, and focus solely on pulse-taking to appear dignified. They mimic pulse diagnosis based on hearsay, boast of esoteric knowledge, and argue falsely. Reckless physicians ignore the Five Wheels and Eight Corollaries, prescribe randomly, make excuses for failures, and shift blame. Greedy physicians target wealthy critical patients, use harsh drugs for high stakes, and flee at night. Envious physicians undermine neighbors, contradict themselves, and act maliciously. Pretentious physicians seek fame, recognize diseases by chance, and exploit patients. Poor scholars display grand titles but know little, wasting resources. Hypocritical elders charge excessively for minor ailments, delaying effective treatment until their pockets are full, smiling while harming. This is essentially murder for profit. These are physician sentiments that must be observed.
Furthermore, some high-minded physicians have biased views, using acupuncture beyond medicinal limits, effectively sentencing patients to death. Some rejoice at others' failures and grieve at others' successes, manipulating situations for personal gain. Optimists are rejected for alarming words; worriers are criticized for concern. Believers in witchcraft see doctors as enemies; suspicious individuals resent deep insights. Even after recovery, patients may show indifference, make excuses, prioritize wealth over health, fight with brothers, violate ethics, blame heaven and men, and feel regret. Are these not human sentiments? Detailed human sentiments are countless. I warn against both pandering to and ignoring human sentiments, hoping future generations will think carefully and avoid bad habits. However, human sentiment is the foundation of kingship. Refusing to compromise seems stubborn, while trying to accommodate seems yielding. Yielding goes against disease conditions, while stubbornness offends human sentiment. There are diseases requiring stubbornness and sentiments requiring accommodation. What can be done? Alas! Extraordinary diseases require extraordinary physicians, who are rarely known by ordinary people. Where can we find those with great courage and wisdom to discuss this matter?