In this paper, I aim to discuss the production of medical knowledge in rural Taiwan in light of the adoption and re-creation of prescription divinations (yaoqian), which entails an interrogation of the relation between authority, practice and history. My data are derived from ethnographic fieldwork and the laboriously collected materials of yaoqian from temples. Involved in this production of medical knowledge are local authorities, individual specialists, and the supplicants soliciting yaoqian. The key issues I raise include the following. How has such medical knowledge been historically established as a local practice? How has its healing efficacy been perceived by the faithful? What is thought to endow yaoqian with the power to heal in general? And further, what is the difference in essence between the diverse collections of yaoqian? First of all, I suggested that the healing efficacy in soliciting yaoqian was perceived through a series of standard procedures with self-examination and easy access. Moreover, the solicitation of yaoqian is an act of divination established on the basis of morality and godliness of the worshippers. Among the procedures, the casting of wooden blocks (buabuei in South Fukien) serves as a cultural mechanism crucial for knowing what is unknown and obtaining multiple divine confirmations, which reflects the major logic of the practice. Secondly, by using the ‘lineage’ approach instead of the divine origin ‘system’, I suggested that there exists ‘alienation’ between divine origins and healing power of yaoqian. There is no Dadaogong qian, Wuguwang qian, Lüzuqian or Mazu qian in essence, since most Mazu qian, Dadaogong qian and Lüzu qian were used interchangeably by those temples dedicated to the three Gods of Medicine (yiyao shen) and the Goddess of Heaven (Mazu). Finally, with my lineage analysis I noted that the decision on which collection of yaoqian was to be adopted by an individual temple was influenced by historical ties with its premier temple, as well as the changes in timeline. Moreover, the impact of social factors on the adoption and re-creation of yaoqian collections is of great importance. By tracing the circulation of Efficacious Prescription Divinations from Lüdi (Lüdi xianfang) with many editions published, I highlighted that the influence of printing and the performative mediator of phoenix halls (luantang) have contributed to the production of yaoqian. In particular, the initiated members of phoenix halls and local gentry with textual knowledge administrating luantang are crucial to the transmission and local adaptation of yaoqian knowledge.