Bian Que's Six Incurable Conditions (六不治)

Overview

Ancient Chinese medical diagnostic framework identifying six categories of patients who cannot be successfully treated. Used by the legendary physician Bian Que.

The Six Conditions

1. 骄恣不论於理

• Translation: Arrogant and unreasonable
• Signs: Patient refuses to listen to reason, dismisses medical advice
• Prognosis: Cannot be treated

2. 轻身重财

• Translation: Values wealth over health
• Signs: Unwilling to spend money on treatment, prioritizes possessions
• Prognosis: Cannot be treated

3. 衣食不能適

• Translation: Cannot properly manage clothing and food
• Signs: Poor self-care, inappropriate diet, improper clothing for conditions
• Prognosis: Cannot be treated

4. 阴阳并，藏气不定

• Translation: Yin-yang chaotic, organ qi unstable
• Signs: Severe internal imbalance, erratic vital signs
• Prognosis: Cannot be treated

5. 形羸不能服药

• Translation: Body too weak to take medicine
• Signs: Cannot digest or absorb treatment, extreme emaciation
• Prognosis: Cannot be treated

6. 信巫不信医

• Translation: Trusts shamans, not physicians
• Signs: Relies on supernatural rather than medical treatment
• Prognosis: Cannot be treated

Decision Framework

IF patient exhibits ANY of the six conditions:
  → Decline treatment or set expectations appropriately
  → Document the incurable condition
ELSE:
  → Proceed with standard diagnosis and treatment

Clinical Application

• Use as initial screening before committing resources
• Helps physician focus efforts on treatable cases
• Protects reputation by avoiding guaranteed failures

Verification

1. Confirm that each of the six conditions has been explicitly assessed during initial patient screening before deciding to treat or decline.
2. Validate that the incurable condition, if present, has been documented with specific observed signs (not assumptions).
3. Ensure expectations have been set appropriately with the patient or their family when any of the six conditions is identified.