吴云。征。证也。篇内。证作医四失。故以名篇。志云。征者。惩创医之四失。
言以杂合耶 吴云。谓杂采众说。而合之己意也。张云。杂合众说。而不能独断也。
外内相失 吴云。外之病情。内之神志。两者相失。张云。以彼我之神不交。心手之用不应也。故
时有疑惑。致乎危殆。
妄作离术 宋本。离。作杂。马志高本同。吴云。离术。别术也。张同。简按今从宋本。
坐之浓薄 张云。坐。处也。志云。薄浓。谓肌肉之浓薄。高本。坐。作土。注云。土。旧本作坐。
今改。简按高本近是。
不明尺寸之论诊 诸注。诊字接下句。是。吴云。千里之外。言其远也。尺寸人事。言其近也。谓世
人求道于远。常驰骛于千里之外。不明尺寸之近。无遑人事之浅也。志云。言世人多夸大其语。而不明寸尺之
微。失寸尺之毫厘。而有千里之谬。盖人之日用事物。饮食起居。莫不有理。如失其和平。皆能为病。诊无人
事之审。是忽近而图远也。
无人事 张云。即前篇贵贱贫富。守数据治之谓。高云。谓昧昧以诊。不知人之病情也。
从容之葆 志云。葆。宝同。言治诊之道。惟天理人事之为葆也。简按脉要精微论。虚静为保。甲乙。
保。作宝。史记留侯世家注。史记珍宝字作葆。志注有所据。王训平。未详所本。马云。保同。吴云。草木丛
生谓葆。（见燕世家注。）盖生机之不可遏者也。张云。葆。韬藏也。（庄子。齐物论。葆光之葆。）并于经
旨未允当。今从志。
坐持寸口 吴云。居然持寸口之脉。张云。若理数未明。而徒持寸口。则五脏之脉。且不能中。志删
坐字。高云。坐。犹定也。持。即诊也。简按张释坐为徒。于文义为是。
诊不中五脉 吴云。诊不中于五脏。百病所起始。以诊字以下十字为一句。张云。五脏之脉。且不能
中。又焉知百病之所起。乃始知自怨其无术。而归咎于师传之未尽。简按张注为是。经脉别论。五脉气少。胃
气不平。王注。五脏脉少。
汝不知道之谕受以明为晦 马志高。并受下句。志云。如不受师之传谕。不明道之体原。是以天道之
明。而为晦矣。
吴云：征，即证。篇中“证”作“医四失”，因此以之名篇。张志云：征，意为惩戒医生犯下的四种过失。
（原文）言以杂合耶
吴云：指杂采众家学说，而融合进自己的见解。张云：杂合众家学说，却不能独立决断。
（原文）外内相失
吴云：外在的病情与内在的神志，两者不相协调。张云：因为彼此神气不交感，心与手的作用不相呼应。所以时常产生疑惑，导致危险困顿。
（原文）妄作离术
宋本中，“离”字作“杂”。马志高本同此。吴云：离术，即别术（其他的医术）。张注相同。简按：现在遵从宋本。
（原文）坐之浓薄
张云：坐，处也。志云：浓薄，指肌肉的厚薄。高本中，“坐”作“土”，注云：“土”旧本作“坐”，今改为“土”。简按：高本接近正确。
（原文）不明尺寸之论诊
诸家注释认为，“诊”字属下句读，这是正确的。吴云：“千里之外”是说距离远；“尺寸人事”是说距离近。意指世人向远处求道，常常驰骋于千里之外，却不明白近在咫尺的道理，无暇顾及浅近的人事。志云：意指世人多夸大其辞，而不明白寸尺之间的细微之处。失之寸尺毫厘，却造成千里的谬误。大概人们日常的事物，饮食起居，无不含有道理。如果失去了平和，都能成为疾病。诊断时缺乏对人事的审察，这就是忽视近处而图谋远处。
（原文）无人事
张云：即前篇所说的贵贱贫富，坚守数据进行治疗的说法。高云：指盲目地进行诊断，不了解病人的具体情况。
（原文）从容之葆
志云：葆，通“宝”。意思是诊治之道，只以天理人事为珍宝。简按：《脉要精微论》中说“虚静为保”，《甲乙经》中“保”作“宝”。《史记·留侯世家》注中，《史记》里珍宝的字写作“葆”。志注有所依据。王训平的解释不详其本源。马云：保同。吴云：草木丛生称为葆。（见《燕世家》注。）大概是生机不可遏制的意思。张云：葆，韬藏之意。（《庄子·齐物论》中有“葆光”之“葆”。）这些解释对于经文旨意都不够妥当。现在遵从志注。
（原文）坐持寸口
吴云：竟然只持守寸口脉。张云：如果理数尚未明了，而仅仅持守寸口脉，那么五脏的脉象尚且不能切中，（更不用说其他了）。张志删去了“坐”字。高云：坐，犹定也。持，即诊也。简按：张氏将“坐”解释为“徒”（空、仅），在文义上是正确的。
（原文）诊不中五脉
吴云：诊断未能切中五脏百病起始的根本。将“诊”字以下十字作为一句。张云：五脏的脉象尚且不能切中，又怎么知道百病所起的原因呢？这才开始怨恨自己没有技术，而归咎于师传未尽善。简按：张注是正确的。《经脉别论》中提到“五脉气少，胃气不平”，王注云：五脏脉气少。
（原文）汝不知道之谕受以明为晦
马志高将“受”字属下句。志云：如果不接受老师的传授教诲，不明白道的本体根源，那么就将天道的明亮视为昏暗了。
Wu Yun: "Zheng" (征) means "Zheng" (证, evidence/proof). In this chapter, "Zheng" is used as "Four Errors of Physicians," hence the chapter title. Zhang Zhiyun: "Zheng" implies admonishing or penalizing physicians for their four errors.
(Text) Yan yi za he ye (Is it speaking of mixing and combining?)
Wu Yun: It refers to eclectically adopting various theories and integrating them into one's own understanding. Zhang Yun: Mixing various theories but lacking the ability to make independent judgments.
(Text) Wai nei xiang shi (External and internal are out of alignment)
Wu Yun: The external clinical condition and the internal mental state are not in harmony. Zhang Yun: Because the spirit and qi of self and other do not interact, and the functions of mind and hand do not correspond. Thus, doubts frequently arise, leading to danger and peril.
(Text) Wang zuo li shu (Carelessly employing separate techniques)
In the Song edition, the character "Li" (离) is written as "Za" (杂). Ma Zhigao's edition agrees. Wu Yun: "Li shu" means separate or alternative techniques. Zhang's note is identical. Jian An [the author]: I now follow the Song edition.
(Text) Zuo zhi nong bo (The thickness at the location)
Zhang Yun: "Zuo" (坐) means location/place. Zhi Yun: "Nong bo" (thick and thin) refers to the thickness of muscles. In Gao Ben, "Zuo" is written as "Tu" (土), with a note stating: "'Tu' was 'Zuo' in old editions, now corrected." Jian An: Gao Ben is closer to being correct.
(Text) Bu ming chi cun zhi lun zhen (Not understanding the discourse on chi and cun regarding diagnosis)
Various commentators suggest that the character "Zhen" (诊, diagnosis) belongs to the following sentence, which is correct. Wu Yun: "A thousand li away" indicates distance far; "Chi cun ren shi" (chi/cun human affairs) indicates proximity near. It means that people seeking the Dao often gallop a thousand li away, failing to understand what is close at hand, and neglecting the superficial aspects of human affairs. Zhi Yun: This implies that people tend to exaggerate and fail to comprehend the subtleties within inches and feet. A deviation of a hair's breadth in measurement can lead to an error of a thousand li. Generally, daily matters such as diet and起居 (living habits) all contain principles. If peace and harmony are lost, they can cause disease. Failing to examine human affairs during diagnosis is ignoring the near to pursue the distant.
(Text) Wu ren shi (Lack of human affairs/context)
Zhang Yun: This refers to the discussion in the previous chapter regarding status (noble/poor) and wealth, adhering to data-based treatment. Gao Yun: It refers to diagnosing blindly without understanding the patient's specific condition.
(Text) Cong rong zhi bao (The treasure of composure)
Zhi Yun: "Bao" (葆) is synonymous with "Bao" (宝, treasure). It means that the way of treatment and diagnosis treasures only Heavenly principles and human affairs. Jian An: *Mai Yao Jing Wei Lun* states "Xu jing wei bao" (emptiness and stillness are preservation); *Jia Yi Jing* writes "Bao" as "Bao" (treasure). The commentary on *Shi Ji: Liuhou Shijia* notes that *Shi Ji* uses "Bao" (葆) for treasure. Zhi's note has basis. Wang Xunping's explanation is unclear. Ma Yun: Bao is the same. Wu Yun: Lush vegetation is called "Bao" (see commentary on *Yan Shijia*). It represents unstoppable vitality. Zhang Yun: "Bao" means concealment (from *Zhuangzi: Qi Wu Lun*, "Bao Guang"). These interpretations are not entirely appropriate for the scriptural intent. I now follow Zhi's note.
(Text) Zuo chi cun kou (Merely holding the Cun Kou pulse)
Wu Yun: Simply holding the Cun Kou pulse. Zhang Yun: If the principles and numbers are not understood, and one merely holds the Cun Kou pulse, then even the pulses of the five Zang organs cannot be accurately assessed. Zhang Zhi deleted the character "Zuo". Gao Yun: "Zuo" means fixed/steady; "Chi" means diagnosis. Jian An: Zhang's interpretation of "Zuo" as "Tu" (merely/in vain) makes sense in context.
(Text) Zhen bu zhong wu mai (Diagnosis does not hit the five pulses)
Wu Yun: Diagnosis fails to hit the origin of diseases arising from the five Zang organs. He treats the ten characters from "Zhen" onwards as one sentence. Zhang Yun: If one cannot even assess the pulses of the five Zang organs, how can one know the origin of hundred diseases? Only then does one begin to complain of one's lack of skill and blame the teacher's transmission for being incomplete. Jian An: Zhang's note is correct. *Jing Mai Bie Lun* mentions "Wu mai qi shao, Wei qi bu ping" (Qi of five pulses is scant, Stomach Qi is unbalanced); Wang Bing's commentary states: Scant pulse of the five Zang organs.
(Text) Ru bu zhi dao zhi yu shou yi ming wei hui (You do not understand the instruction of the Dao; accepting it turns brightness into darkness)
Ma Zhigao attaches "Shou" (receive) to the following sentence. Zhi Yun: If one does not accept the master's transmission and instructions, nor understands the original substance of the Dao, then one treats the brightness of Heavenly Dao as darkness.