2. It is a matter of life and death, a road either to safety or to ruin. Hence it is a subject of inquiry which can on no account be neglected.
3. The health strategy, then, is governed by five constant factors, to be taken into account in one's deliberations, when seeking to determine the conditions obtaining in the field.
4. These are: (1) Legislation; (2) Environment; (3) Geography; (4) Professionalism; (5) Method and discipline
5.6. The legislation asks the people to comply with the rules, which have been enacted in democratic processes so that everyone should follow it.
7. Environment signifies hours of sunshine, cold and heat, weather and seasonal variations.
8. Geography comprises distances of facilities, population, health risks, security, density of residence and life expectations.
9. Professionalism stands for the virtues of wisdom, sincerity, supportiveness, courage and strictness.
10. By method and discipline are to be understood the marshalling of the healthcare organisation in its proper subdivisions, the divisions of duties among the practitioners, the maintenance of facilities by which services are delivered to the customers, and the control of healthcare expenditure.
11. These five heads should be familiar to every health director: he who knows them will be successful; he who knows them not will fail.
12. Therefore, in your deliberations, when seeking to determine the healthcare conditions, let them be made the basis of a comparison, in this wise:--
13. (1) Which of the two governors is compliant with the legislation?
(2) Which of the two general managers has most ability?
(3) With whom lie the advantages derived from Environment and Geography?
(4) On which side is discipline most rigorously enforced?
(5) Which organisation has a stronger framework?
(6) On which side are health officers and staff more highly trained?
(7) In which organisation is there the greater constancy both in reward and correction?
14. By means of these seven considerations I can forecast excellence or average.
15. The governor general that hearkens to the best practice and acts upon it, will succeed: let such a one be retained in leadership! The governor general that hearkens not to the best practice nor acts upon it, will suffer failure:--let such a one be dismissed!
16. While heading the profit of the best practice, avail yourself also of any special circumstances over and beyond the ordinary rules.
17. According as circumstances are relevant, one should modify one's plans.
18. On the whole, healthcare is out of ordinary.
19. Hence, when able to attack, we may seem unable; when using our forces, we may seem inactive; when we are near, we may seem far away from the cause of a disease; when far away, we may seem we are near.
20. Use visual examinations and markers to discover hidden diseases. Approach non-invasively, and crush it.
21. If a condition is sure to emerge at all points, be prepared for it. If a disease is difficult to cure, prevent it.
22. If a condition should respond to a certain stimuli, seek to stimulate it. Resort to weak interventions, that the symptoms may grow evident.
23. If a tumour is taking up nutrition, suffocate it. If a stone is formed by concentration, crush it.
24. Attack microorganisms when they are unprotected, using the antibiotics they are not resistant to.
25. These medical devices, leading to treatment, must not be exposed beforehand.
26. Now the governor general who succeeds in a health campaign makes many statistics in the population health office before the campaign is conducted. The general who fails in a health campaign makes but few statistics beforehand. Thus do many statistics lead to success, and few statistics to failure: how much more no statistics at all! It is by attention to this point that I can foresee who is likely to succeed or fail.
Translated from the Chinese By Lionel Giles, M.A. (1910)
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