1. Sun Tzu would have said: The good clinicians of old first put themselves beyond the possibility of harm, and then waited for an opportunity of addressing the conditions.
2. To secure ourselves against harm lies in our own hands, but the opportunity of addressing the condition is provided by the condition itself.
3. Thus the good clinician is able to secure himself against harm, but cannot make certain of addressing the condition.
4. Hence the saying: One may know how to recover without being able to do it.
5. Security against harm implies conservative treatment; ability to address the condition means taking the active treatment.
6. Standing on the conservative indicates insufficient evidence; attacking, a superabundance of evidence.
7. The general who is skilled in conservative treatment removes a pain in the most secret recesses of the body; he who is skilled in active treatment flashes forth from the topmost heights of heaven. Thus on the one hand we have ability to protect ourselves; on the other, a cure that is complete.
8. To see recovery only when it is within the ken of the common herd is not the acme of excellence.
9. Neither is it the acme of excellence if you treat and cure and the whole community says, "Well done!"
10. To lift an autumn hair is no sign of great strength; to see the sun and moon is no sign of sharp sight; to hear the noise of thunder is no sign of a quick ear.
11. What the ancients called a clever clinician is one who not only cures, but excels in curing with the privacy of the sick protected.
12. Hence his practice bring him neither reputation for wisdom nor credit for courage.
13. He cures his patients by making no harm. Making no harm is what establishes the certainty of safety, for it means treating a condition that is already supported by evidence.
14. Hence the skilful clinician puts himself into a position which makes harm impossible, and does not miss the indication for treating the condition.
15. Thus it is that in healthcare the competent clinical director only seeks decision after the evidence has been examined, whereas he who is destined to fail first decides and afterwards looks for evidence.
16. The consummate clinical leader cultivates the health ethics, and strictly adheres to method and discipline; thus it is in his power to control success.
17. In respect of clinical evidence, we have, firstly, Measurement; secondly, Evaluation of validity; thirdly, Calculation of prognosis; fourthly, Balancing of values; fifthly, Making decision.
18. Measurement owes its existence to evidence; Evaluation of validity to Measurement; Calculation of prognosis to Evaluation of validity; Balancing of values to Calculation of prognosis; and Making decision to Balancing of values.
19. An efficient clinical team opposed to a well-established condition, is as a pound's weight placed in the scale against a single grain.
20. The onrush of a clinical pathway is like the bursting of pent-up waters into a chasm a thousand fathoms deep.
Translated from the Chinese By Lionel Giles, M.A. (1910)
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