临病时，古有望、闻、问、切四法。切脉固为重，望、闻、问尤居先。当细察受病之源，辩其
所现之象。望其色之荣枯，闻其声之勇怯，问其饮食进否，喜冷喜热。探其胸腹有无痛处，便溺秘
利。验其目睛、鼻、舌、气息、蜷卧挺身、向内向外。次诊脉理，明表里虚实，寒热阴阳，有余不
足，与外证相参合不合。酌见病之浅深正变，明辩病之同异真似。追溯病前日如何，又预料病后日
如何。急则治标，缓则治本。或当正治，或当从治。病剧者，再候两足太溪、太冲、冲阳之脉。更
验服过某方某药，着意详审，尽得病情，始拟方立案。在患病者，尤当以自己平日嗜好性情及受病
原由，详细说与医者。倘讳疾忌医，则是助庸医之谬，掣明医之肘，而自贻其祸也。又医者固当熟
透古方，当神契物性。盖药品有阴阳升降、气胜、味胜等之不同，须令洞彻详明，则取用时能不泥
古而不悖古。所谓药不执方，合宜则用。古人方药，但陈大略，原俟后人润色。盖天时有寒燠之不
同；民居有燥湿之不同；人身有老少、强弱、肥瘦、黑白、饮啖多寡之不同；病情有内外虚实，似
虚而实，似实而虚，似寒而热，似热而寒等之不同；其间情态百变，相机时措。古所称神圣工巧，
岂异人任哉？又凡治法用药，有奇险骇俗者，只要见得病真，便可施用，不必顾忌。即如病有临危，
原属有余，失于攻下所致，虽至几微欲绝，犹当攻下取
效。若久泻久痢，至于滑脱不禁，则宜劫止而后调之。如国家以刑治奸盗，以兵却虏寇，不得已而
用权，权不离经，非霸术也，王道也。乃有医谬称王道，一味平补调停，此可施与不足，不可施于
有余。施于有余，则邪气得补而愈盛，是速其毙也。又有遇危难证，如大黄、附子，迥若霄壤，恐
致杀人，而惟用中和之方，无大热大寒，救疗而死，其杀人一也。病家无识，喜其平稳，卒受害而不
觉。悲夫！虽然临病妙用，全系平日之识见，学力明透精熟，岂能徼幸袭取于朝夕哉！
临诊时，古人有观察、听嗅、询问、切脉四种方法。切脉固然重要，但望、闻、问更应放在首位。应当仔细考察致病的原因，辨别其表现出的征象。观察面色是红润还是枯槁，听声音是洪亮还是微弱，询问饮食摄入情况以及喜冷或喜热，探查胸腹部是否有疼痛之处，大小便是否通畅或秘结。检查眼睛、鼻子、舌头、呼吸气息，身体是蜷缩还是挺直，头脚是向内还是向外。其次诊察脉理，明确表里、虚实、寒热、阴阳的盛衰情况，并与外在证候相互参照印证。斟酌判断病情的深浅及正变，明辨疾病的同异与真假相似之处。追溯发病前的状况，又预判发病后的演变。急症则治其标，缓症则治其本。或者采用正治法，或者采用从治法。病情危重者，再候诊两足的太溪、太冲、冲阳穴处的脉象。进一步查验患者曾服用过哪些方剂和药物，着重详细审察，完全掌握病情后，才开始拟定处方并建立病历。患病者，尤其应当将自己平日的嗜好性情及致病原因，详细告知医生。如果隐瞒疾病忌讳就医，那就是助长庸医的错误，阻碍名医施展医术，从而给自己带来灾祸。另外，医生固然应当熟透古代方剂，更要神妙契合药物本性。因为药品有阴阳升降、气偏胜、味偏胜等不同，必须令其透彻明白，那么在取用时就能不拘泥于古法而不违背古法。所谓用药不固执成方，合乎适宜即可使用。古人的方药，只是陈述大概原则，原本就等待后人润色完善。因为天时气候有寒冷和温暖的不同；居住环境有干燥和潮湿的不同；人体有老少、强弱、肥瘦、肤色黑白、饮食多少的不同；病情有内外虚实，似虚而实，似实而虚，似寒而热，似热而寒等的不同；其间情态变化多端，需根据时机灵活处置。古人所称的神圣工巧（指高超的医术），难道是由异人独自承担的吗？另外凡是治疗方法和用药，有奇特危险惊世骇俗的，只要看清了病的真相，就可以施用，不必顾忌。就像有病势危急，原本属于邪气有余，因失于攻下所致，虽然到了极其微弱几乎要断气的地步，仍然应当攻下以求取效。如果是久泻久痢，导致滑脱不禁，则应当用强力止涩的方法然后进行调理。如同国家以刑罚惩治奸盗，以军队抵御虏寇，不得已而使用权变之术，权变不离经义，这不是霸道，而是王道。然而有的医生谬称行王道，一味平和补益调停，这只能施用于正气不足之证，不可施用于邪气有余之证。施用于邪气有余，则邪气得到补益而更加旺盛，这是加速其死亡。又有遇到危难重症，如大黄、附子，差别犹如天地悬殊，恐怕导致杀人，而只用中和的方剂，没有大热大寒的药，结果救疗无效而死，这种杀人的后果是一样的。病人没有见识，喜欢药性平稳，最终受害却不觉悟。可悲啊！虽然如此，临诊的妙用，完全取决于平时的识见，学力必须明透精熟，怎么能指望在朝夕之间侥幸获取呢！
When attending to a patient, the ancients employed four methods: observation (Wang), listening and smelling (Wen), inquiry (Wen), and palpation (Qie). While pulse diagnosis is certainly important, observation, listening/smelling, and inquiry should take precedence. One must carefully investigate the source of the disease and distinguish its manifested signs. Observe whether the complexion is lustrous or withered; listen to whether the voice is robust or feeble; inquire about dietary intake and preference for cold or hot substances; explore whether there are painful areas in the chest and abdomen, and whether urination and defecation are obstructed or free. Examine the eyes, nose, tongue, breath, whether the body is curled up or extended, and whether the head/feet turn inward or outward. Subsequently, diagnose the pulse principles to clarify the exterior and interior, deficiency and excess, cold and heat, yin and yang, and the surplus or insufficiency of qi, correlating these findings with external symptoms to see if they match. Assess the depth and normality or deviation of the disease, clearly distinguishing between similar and truly different conditions. Trace back the condition before the onset of illness, and anticipate the evolution after onset. In acute cases, treat the branch (symptoms); in chronic cases, treat the root (cause). Employ either direct treatment (Zheng Zhi) or contrary treatment (Cong Zhi). For severe illnesses, further palpate the pulses at Taixi (KI3), Taichong (LR3), and Chongyang (ST42) on both feet. Further verify which formulas and herbs have been taken previously, paying close attention to detailed examination. Only after fully grasping the condition should one draft a prescription and record the case. The patient should especially detail their daily habits, temperament, and the cause of the illness to the physician. Concealing illness and avoiding medical help aids the errors of mediocre doctors, hinders skilled physicians, and brings disaster upon oneself. Furthermore, physicians must not only master ancient formulas but also spiritually understand the nature of substances. Medicinal materials differ in yin-yang ascending-descending dynamics, qi dominance, and flavor dominance. These must be thoroughly understood so that when used, one does not rigidly adhere to antiquity while violating its principles. It is said that medication should not be bound by fixed formulas but used when appropriate. Ancient formulas and herbs merely outlined general principles, awaiting refinement by later generations. This is because climatic conditions vary in cold and warmth; dwellings vary in dryness and humidity; human bodies vary in age, strength, obesity, leanness, skin color, and quantity of food and drink; disease conditions vary in exterior-interior, deficiency-excess, appearing deficient yet being excess, appearing excess yet being deficient, appearing cold yet being hot, and appearing hot yet being cold. Among these, manifestations change endlessly, requiring flexible application according to timing. Are the "divine, sacred, skillful, and clever" (Shen Sheng Gong Qiao) qualities attributed to the ancients possessed only by extraordinary individuals? Moreover, regarding treatment methods and medication, even those that seem bizarre, dangerous, or shocking can be applied as long as the true nature of the disease is identified, without hesitation. For instance, in critical conditions where pathogenic factors are excessive due to failure in purging, even if the patient is nearly dead with faint pulse, purgation should still be employed to achieve efficacy. Conversely, in cases of chronic diarrhea or dysentery leading to incontinence, strong astringents should be used first, followed by regulation. Just as a state uses punishment to deal with thieves and soldiers to repel invaders, employing flexibility out of necessity is not hegemony but kingly way (Wang Dao), provided it does not deviate from orthodoxy. However, some physicians falsely claim to follow the kingly way by using only mild tonifying and balancing methods. This is suitable for deficiency patterns but inappropriate for excess patterns. Applying tonics to excess patterns strengthens the pathogen, accelerating death. In critical emergencies, such as when Da Huang (Rhei Radix et Rhizoma) or Fu Zi (Aconiti Lateralis Radix Praeparata) are indicated, though their effects differ vastly like heaven and earth, fear of causing death may lead physicians to use only neutral formulas without extreme hot or cold properties, resulting in failure to save the patient and causing death just as surely. Patients lacking insight prefer stable, mild treatments and suffer harm unknowingly. How sorrowful! Nevertheless, the subtle applications in clinical practice depend entirely on one's prior knowledge and learning. Profound mastery cannot be achieved by chance in a day or two.