Chapter Seventy: A Preliminary Discussion on the Medical System of the Great Tang

Li Yi smiled faintly, showing no sign of impatience. In fact, a new idea had just dawned on him. He believed that with this guarantee, it would no longer be he who begged Sun Simiao to stay, but rather Sun Simiao who would come seeking him.

“Master Sun, I have a question for you. May I ask, how many people can you treat in a year?”

Sun Simiao was taken aback. “Well… I have never really calculated that before.”

“Very well, allow me to do the math for you. Suppose you can treat ten people a day, and spend twenty days a month seeing patients. That would mean you cure two thousand four hundred people in a year. Am I correct?”

Sun Simiao shook his head. “Not nearly so many. I am but one man. Even if I had the energy, which I don’t, I simply wouldn’t encounter so many patients. That number should be at least halved.”

“Very well, let’s halve it. Suppose you treat one thousand two hundred people a year. But do you know how many fall ill in the Tang Empire each year? Our population exceeds ten million—let’s call it ten million for simplicity. Even if only two million among them fall ill each year, and if each falls ill five times, that’s ten million cases a year. Subtract the two thousand four hundred you might treat, and you are left with nine million nine hundred ninety-eight thousand eight hundred patients. The empire has three hundred and sixty prefectures—suppose each has ten physicians, and each treats five hundred cases a year. That’s one hundred and eighty thousand cases, still leaving one million nine hundred eighty-eight thousand eight hundred people untreated.”

“This… this…” Sun Simiao and Yuan Tiangang were struck speechless. They had always known there were many sick and few physicians, but never imagined the situation was so dire. Over a hundred thousand people—no, nearly two million—left without care! The impact of precise numbers far outweighed vague impressions. Sometimes, numbers are cruel in their simplicity, laying bare the bloody truth with nothing but a handful of digits.

Li Yi took a sip of tea and continued, “You must also know that, given the current state of public health in the Tang, the number of patients is surely higher, and the number of physicians much lower, with their skills being far from adequate. Add to that quacks misdiagnosing, unscrupulous doctors preying on the sick, and the poor unable to afford treatment, and this number multiplies several times over. Do you still believe that wandering the land year after year, treating people one by one, truly makes a difference?”

Sun Simiao gave a bitter smile. “What else can I do? I am but one man, unable to be in two places at once. All I can do is give my all.”

“That is a grave mistake!” Li Yi stood, striding to the center of the hall, speaking with conviction. “That is the thinking of an ordinary man. If you were just another physician, I would not trouble to say so much. But you are the Medicine King, a master of your age, a rare sage of the healing arts. A true master must act with the vision of a master, doing what ordinary men cannot. I have always believed that when facing hardship, one should perfect oneself; but when blessed with fortune, one should serve the world. Your duty is to pass your knowledge to thousands, to let medicine blossom across the Tang. That is what you should aspire to—not wandering the land year after year, relying on your own hands to heal, leaving behind a single book as your legacy. If that were sufficient, the Green Satchel Classic of Hua Tuo would never have been lost. You must shoulder this responsibility, for not every age is blessed with a Sun Simiao!”

Li Yi’s words struck Sun Simiao like a thunderbolt of clarity. He suddenly realized how narrow his actions had been. Perhaps Li Yi was right—a true master is one who changes the world, not one who merely adapts to it.

Sun Simiao’s mind expanded in an instant, but his eyes quickly dimmed again. “It is easy to say, but where does one even begin?”

Li Yi lifted his teacup, drank deeply, and moistened his throat. “In fact, it is quite simple. To spread a culture, the fastest, most effective method is to systematize it. In plain terms, you must compile all your medical knowledge, categorizing it according to your experience. For example, diseases fall into a few main types: internal ailments, external injuries, cold syndromes, heat syndromes, and so on. You can use these as main categories, then gradually refine them. For instance, under external injuries—what types are there? What symptoms? How should they be treated? Are there exceptions? Once this book is complete, other physicians can use it as a reference—if someone catches a cold, they consult the cold syndromes section, find the relevant entry, and follow the treatment methods. Everything becomes clear at a glance.”

“Systematize…it… That’s it! What a brilliant idea! Systematization!” Sun Simiao repeated the word like an incantation, his eyes growing brighter and brighter.

Li Yi paused to let Sun Simiao reflect, then continued, “That is only the first step. Even with the book completed, errors are inevitable—after all, diseases are ever-changing, and in medicine, blind reliance on books is worse than having none at all. The key is to treat according to the patient. Therefore, the next step is to establish a medical academy and teach systematically, thus quickly producing a group of competent physicians. At this point, half the task will be done. The rest is to address the problems of unscrupulous doctors, and the poor being unable to afford treatment. The best way is to establish hospitals across the empire, integrating all physicians into a system. This way, from medical knowledge to physicians to patients, everything is organized. The ultimate goal is to build a complete medical system—that is the true solution to our problems!”

Sun Simiao was stirred to his very core, his face flushing with excitement. He yearned to begin compiling the book at once, but after a lifetime of experience, he retained enough composure to say, “Young friend, your vision is admirable, but I am just one man. How can I accomplish so great a work, let alone establish academies and hospitals?”

Li Yi chuckled. “That is easily solved! As for compiling the book, I can ask His Majesty for help—the Imperial Medical Academy is full of physicians with little to do; they may as well put their skills to good use. As for the academy and hospitals, perhaps you do not know, but soon there will be a new institution in the Tang called the Charity Foundation. Charity, simply put, means giving with a generous heart. The Foundation will collect funds from all corners, and use them for worthy causes—building bridges, paving roads, caring for the old and young, developing towns, and so on. Its mission is to serve the people wholeheartedly, to be loyal and patriotic. Since hospitals and the academy serve the common good, you can apply to the Charity Foundation for support. As long as they agree, all your problems will be solved!”