Abstract: LI Dongyuan was a prominent figure in the Yishui school of medicine. He had written works such as Neiwaishang Bianhuo Lun and Piwei Lun.He analyzed both Waigan and Neishang and strongly advocated the Piwei theory.LI Dongyuan led a life filled with hardships. His medical career experienced through three distinct stages.In his early years, his mother's serious illness was misdiagnosed by an incompetent physician, which motivated him to study medicine.However, his initial goal in studying medicine was to understand medical theory, rather than to become a practicing doctor. Second,due to the wartime chaos, he fled to Bianliang and practiced medicine among the elite.Later, he traveled north to Dongping, where he began practicing medicine as his profession.He was diligent in his thinking and adept at summarizing.By writing books, he corrected the shortcomings of contemporary medicine, thus achieving the ideal of “curing the flaws of medicine”. In his later years, he returned to his hometown, devoted himself to practicing medicine, and taught and mentored disciples. His sole focus was to advance the practice of medicine and achieve the ideal of sincere medical care.There are three key factors behind the sublimation of his medical philosophy.The first is his benevolence, the second is his aptitude for learning and reflection, and the third is his diligence in practice and his courage to question.The transformation of LI Dongyuan's medical realm offers profound insights for contemporary physicians.

Key words: LI Dongyuan, medical practice, realm, transformation, insight