FIVE COMMANDMENTS AND TEN REQUIREMENTS

1617

The Five Commandments and Ten Requirements of physicians constitute the most comprehensive statement on medical ethics in China. They were written by Chen Shih-kung, an early-seventeenth-century Chinese physician, and appear in his work An Orthodox Manual of Surgery.

Five Commandments

1. Physicians should be ever ready to respond to any calls of patients, high or low, rich or poor. They should treat them equally and care not for financial reward. Thus their profession will become prosperous naturally day by day and conscience will remain intact.
2. Physicians may visit a lady, widow or nun only in the presence of an attendant but not alone. The secret diseases of female patients should be examined with a right attitude, and should not be revealed to anybody, not even to the physician's own wife.
3. Physicians should not ask patients to send pearl, amber or other valuable substances to their home for preparing medicament. If necessary, patients should be instructed how to mix the prescriptions themselves in order to avoid suspicion. It is also not proper to admire things which patients possess.
4. Physicians should not leave the office for excursion and drinking. Patients should be examined punctually and personally. Prescriptions should be made according to the medical formulary, otherwise a dispute may arise.
5. Prostitutes should be treated just like patients from a good family and gratuitous services should not be given to the poor ones. Mocking should not be indulged for this brings loss of dignity. After examination physicians should leave the house immediately. If the case improves, drugs may be sent but physicians should not visit them again for lewd reward

Ten Requirements

1. A physician or surgeon must first know the principles of the learned. He must study all the ancient standard medical books ceaselessly day and night, and understand them thoroughly so that the principles enlighten his eyes and are impressed on his heart. Then he will not make any mistake in the clinic.
2. Drugs must be carefully selected and prepared according to the refining process of Lei Kung. Remedies should be prepared according to the pharmaceutical formulae but may be altered to suit the patient's condition. Decoctions and powders should be freely made. Pills and distilled medicine should be prepared in advance. The older the plaster is the more effective it will be. Tampons become more effective on standing. Don't spare valuable drugs; their use is eventually advantageous.
3. A physician should not be arrogant and insult other physicians in the same district. He should be modest and careful towards his colleagues; respect his seniors, help his juniors, learn from his superiors and yield to the arrogant. Thus there will be no slander and hatred. Harmony will be esteemed by all.
4. The managing of a family is just like the curing of a disease. If the constitution of a man is not well cared for and becomes over-exhausted, diseases will attack him. Mild ones will weaken his physique, while serious ones may result in death. Similarly, if the foundation of the family is not firmly established and extravagance be indulged in, reserves will gradually drain away and poverty will come.
5. Man receives his fate from Heaven. He should not be ungrateful to the Heavenly decree. Professional gains should be approved by the conscience and conform to the Heavenly will. If the gain is made according to the Heavenly will, natural affinity takes place. If not, offspring will be condemned. Is it not better to make light of professional gain in order to avoid the evil retribution?
6. Gifts, except in the case of weddings, funerals and for the consolation of the sick, should be simple. One dish of fish and one of vegetable will suffice for a meal. This is not only to reduce expenses but also to save provisions. The virtue of a man lies not in grasping but rather in economy.
7. Medicine should be given free to the poor. Extra financial help should be extended to the destitute patients, if possible. Without food, medicine alone can not relieve the distress of a patient.
8. Savings should be invested in real estate but not in curios and unnecessary luxuries. The physician should also not join the drinking club and the gambling house which would hinder his practice. Hatred and slander can thus be avoided.
9. Office and dispensary should be fully equipped with necessary apparatus. The physician should improve his knowledge by studying medical books, old and new, and reading current publications. This really is the fundamental duty of a physician.
10. A physician should be ready to respond to the call of government officials with respect and sincerity. He should inform them of the cause of the disease and prescribe accordingly. After healing he should not seek for a complimentary tablet [a wooden board inscribed with complimentary words, hung in the physician's office for propaganda] or plead excuse for another's difficulty. A person who respects the law should not associate with officials.