凡病至根摇本亏。六脉无胃气。二竖入膏肪。即使缓扁复见。亦难措手。何论时名之工哉。
若其形气俱实。偶罹病恙。即不治少待经尽气复。亦当自愈。未有治之而不愈也。即使庸手
妄治。亦无至伤命耳独是人有可生可死之病得治则生。失治则死。对治则生舛治则死。急治
则生。缓治则死者。呼吸关存亡之候。从违操生死之机。如此乃足以别工师之贤愚巧拙。
夫
曰明良。岂真能起死回生哉。但有危急垂死之病。人不能治而已能治。令人全其生。不致枉
死。且能救人死于未病之先。与知病之所从生耳。至所谓名医时医者。治寒以热。治热以寒
。治虚以实。治实以虚。浅病偶中。俗服神奇。固似乎名下无虚士矣一若值有假虚假实假热
假寒之症。病既变幻。见随惶惑。竟昧其所谓从逆反正。通用塞用之法而姑投缓剂。藐无胆
识。且曰王道稳当。病者亦甘心受误始见从前所谓名医者祗虚名耳若夫庸手粗工。不察经书
。不谙脉症。寒热错投。缓急混施。实实虚虚致轻变重。重变笃。笃而死是病本非尽可死之
病而服必死之药安得不死。如此贤愚是在病家慧眼预识。临病慎择之而已矣。
设夫病者既择名手而信从之矣。独其人患非旦夕可愈之病。而欲得乎旦夕必愈之治。于
势难
哉。乃日易数医。贤愚竞进。杂揉伤生。祸福反掌。初非择医不精。特任医不专耳。宋李纲
有云用人如用医。必先知其术业可以已病。乃可使之进药而责成功。今不详究其术业而姑试
之。则虽日易一医。无补于病。徒加疾而已。
凡是疾病发展到根本动摇、本源亏损的地步，六脉之中毫无胃气（指脉搏柔和从容之象），病邪深入膏肓（心尖脂肪与横膈膜之间，喻病位深重），即使华佗、扁鹊再生，也难以施展手脚，更不必说当时的名医了。
如果病人的形体与正气都充实强盛，只是偶然遭受病痛，即便暂时不治疗，等待病程结束、气血恢复，也应当自愈，没有经过治疗反而不好的情况。即使是庸医胡乱治疗，也不会导致死亡。唯独那些有可生可死两种可能的疾病，得到正确治疗就能生存，失去正确治疗就会死亡；对症施治则生，误治则死；紧急救治则生，拖延救治则死者，这些情况是关乎存亡的关键时刻，顺从或违背治疗原则掌握着生死的枢纽。只有在这种情况下，才足以辨别医生师傅的贤良愚笨、技巧拙劣。
所谓“明君良臣”，难道真能起死回生吗？只是对于危急垂死的重病，别人不能治疗而他能治疗，让人保全生命，不至于枉死；并且能在疾病发生之前救人于未然，知晓疾病产生的根源罢了。至于所谓的“名医”、“时医”，用热药治寒证，用寒药治热证，用补法治虚证，用泻法治实证，偶尔治中浅表疾病，被世俗百姓视为神奇，确实似乎名不虚传。然而一旦遇到假虚、假实、假热、假寒的症状，病情变幻莫测，医者见多识广却感到惶惑，竟然不明白什么是顺从病势、什么是逆治病机、什么是纠正偏差、什么是通塞兼用的方法，于是姑且投以缓和的药剂，缺乏胆识，还自夸王道疗法稳妥得当。病人也甘心接受这种误治。这才发现从前所谓的“名医”只是徒有虚名罢了。
至于那些庸手粗工，不考察医经典籍，不熟悉脉象与症状，寒热药物错投，缓急治法混施，导致实证更实、虚证更虚，使轻症变为重症，重症变为危笃，最终致死。这病本来并非完全不可救药的绝症，而是服用了必死无疑的药物，怎么能不死呢？如此看来，医生的贤良与愚笨，在于病人要有慧眼预先识别，在面临疾病时谨慎选择医生罢了。
假设病人已经选择了名医并信任听从他，唯独这个人患的不是朝夕可以痊愈的病，却想要得到朝夕必定痊愈的治疗，这在情势上是很难做到的。于是每天更换几个医生，贤者与愚者竞相进用，杂乱混杂伤害生命，祸福变化只在顷刻之间。起初并不是选择医生不精细，而是任用医生不专一罢了。宋代李纲曾说：“用人如同用医，必须先知他的医术专业能够治愈疾病，然后才可以让他进药并要求成功。”现在如果不详细考究他的医术专长而姑且尝试，那么即使每天换一个医生，对病情也没有帮助，只会加重疾病而已。
When a disease reaches the stage where its root is shaken and its foundation is depleted, and the six pulses (Radial, Carotid, and Jugular arteries on both sides) lack "Stomach Qi" (the gentle and moderate quality of the pulse indicating healthy digestive function), with the pathogen penetrating deep into the Gaohuang (the area between the heart and diaphragm, representing a critical and deep-seated pathological state), even if Hua Tuo or Bian Que were to reappear, they would find it difficult to apply their skills. How much less could contemporary famous physicians manage?
If a patient's physical form and righteous Qi (Vital Energy) are both substantial and solid, and they merely suffer from an occasional ailment, even if left untreated for a short while, waiting for the disease course to complete and Qi to recover, it should heal itself. There is no case where treatment leads to non-healing in such scenarios. Even if incompetent hands treat it recklessly, it will not necessarily lead to death. However, there are diseases that present a possibility of either life or death: correct treatment leads to survival, neglect leads to death; appropriate counter-treatment leads to life, erroneous treatment leads to death; urgent treatment leads to life, delayed treatment leads to death. These situations are critical junctures relating to existence and demise, where compliance or deviation in handling them controls the mechanism of life and death. Only in such cases can one truly distinguish the virtue, wisdom, skill, and clumsiness of physicians.
It is said that "enlightened rulers and capable ministers," do they truly have the power to raise the dead back to life? They simply possess the ability to treat critical, near-fatal conditions that others cannot handle, thereby preserving people's lives and preventing unjust deaths. Furthermore, they can save people from dying before the disease even manifests, by understanding the origins of diseases. As for so-called "famous physicians" or "contemporary physicians," who treat cold with heat, heat with cold, deficiency with excess methods, and excess with deficiency methods, occasionally hitting the mark in treating superficial illnesses, they are regarded as miraculous by the vulgar crowd. Indeed, this seems to live up to their reputation. However, when faced with symptoms of false deficiency, false excess, false heat, or false cold, where the disease presents deceptive changes, these physicians become confused and bewildered. They fail to understand the principles of following the disease trend (Cong), opposing the disease trend (Ni), correcting deviations (Fan Zheng), and using general unblocking or astringent methods (Tong Yong / Sai Yong). Consequently, they tentatively prescribe mild agents, lacking courage and discernment, yet claiming that "Kingly Way" (gentle, balanced therapy) is steady and safe. Patients also willingly accept this misguidance. It is then revealed that the previously mentioned "famous physicians" are but empty names.
As for incompetent practitioners and crude workers, who do not examine medical classics nor understand pulse and symptom patterns, mistakenly administering hot and cold remedies and mixing slow and urgent treatments, cause excess to become more excessive and deficiency to become more deficient. This transforms mild conditions into severe ones, and severe ones into critical ones, leading to death. The disease was not inherently incurable, but the patient took medicines that guaranteed death. How could they not die? Thus, the distinction between the wise and the foolish lies in the patient's insightful judgment to recognize them in advance and carefully select a physician when illness strikes.
Suppose a patient has selected a skilled physician and trusts them completely. If the patient suffers from a disease that cannot be cured in a day or two, yet demands immediate recovery within a day or two, this is contrary to natural tendencies. Consequently, they change doctors daily, allowing both virtuous and foolish practitioners to compete for entry. This chaotic mixture harms life, with fortune and misfortune changing in the blink of an eye. Initially, this is not due to imprecise selection of physicians, but rather a lack of dedicated reliance on a single physician. Li Gang of the Song Dynasty stated: "Employing people is like employing physicians. One must first know that their professional skills can cure the disease before allowing them to administer medicine and demanding success." Now, if one does not thoroughly investigate their professional expertise and merely tries them out, then even if changing a doctor every day, it will benefit the disease not at all, but only add to the illness.