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The Imperially Commissioned Golden Mirror of the Orthodox Lineage of Medicine (Yuzuan yizong jinjian 御纂醫宗金鑑), first printed in 1742, was one of the most important and widely circulating works on medicine in late imperial China. This paper analyzes a group of twenty-three medical manuscripts from the nineteenth and early twentieth century that include parts of the Golden Mirror. The findings suggest that most of the manuscripts should not be considered mere copies, but as deliberate selections. They served didactic as well as epistemic functions that differ from, or go beyond, those that could be fulfilled by the printed Golden Mirror (or a faithful manuscript copy alone). This is indicated not only by different content type selections (verse form for memorization or recitation; prose form for study or consultation) and the combination with medical knowledge from other sources, but also by the ways in which these contents were formatted, usually to facilitate reading and navigation. Adjustment, updating or supplementation of Golden Mirror contents likewise functioned epistemically, integrating previous medical knowledge into the medical discourse of the time. Hence, the findings of the present study help to clarify the lasting importance of manuscripts in the age of print, for which possibilities of adapting knowledge to personal interests and requirements seem to have been decisive factors. [ABSTRACT FROM AUTHOR]