On Conduct Square, Wisdom Round, Heart Small, Gall Great
Sun Simiao counseled the physician: Let conduct be square and wisdom be round; let the heart be small and the gall be great. Alas — the physician's spirit and skill are entirely in these.
Conduct square. Settle the heart in plainness and care; act in calm and harmony; speak no light word, look on no chaotic sight; let no jealous heart arise, no covetous thought be born; do not flinch from weariness; carefully study the medical canon; pity those who suffer. This is conduct square.
Wisdom round. Constitutions vary thick or thin; ages vary old or young; bodies vary fat or thin; tempers vary urgent or easy; circumstances vary noble or base; weather varies harsh or gentle; seasons vary cold or hot; day and night vary heavy or light; complexions vary auspicious or fatal; voice varies high or low; the case may be new or old; qi-fortunes may go beyond or fall short. Know the constant, know the change; bring spirit and clarity to bear. This is wisdom round.
Heart small. Inspection, listening, asking, palpation should be detailed; supplementing, draining, cooling, warming must be distinguished. Always think: a life is most precious, the dark reckoning hard to escape; a single slip — endless ages cannot atone for it. How can one not be careful? This is heart small.
Gall great. Supplement when one should supplement, drain when one should drain, heat when one should heat, cool when one should cool. Didang Tang and Chengqi Tang, used in season, can return spring; jiang, fu, Lizhong — invariably they lift the dying. Make the reasoning clear; do not hold to two equal possibilities. This is gall great.
These four seem distinct but in fact are one. There has never been a careful, faithful physician who, sticking to method, harmed a patient; never a clever, supple physician who, ruined in name and conduct, has harmed himself. Where conduct is square, wisdom is necessarily round. Where the heart is small, fearing the slightest miss; where the gall is great, the drug matches the pattern — perhaps a great attack, perhaps a great supplement — seemingly great gall: not so. Without it the illness will not resolve — the great gall is exactly the exercise of the small heart. So heart small and gall great — together they make wisdom round; heart small, gall great, wisdom round — together they make conduct square. The world doubts that square does not obstruct round, or that small impedes great. Hence I bring it out.
Selected from Yizong Bidu.