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Subtle yet stern speech indicates the root of decline or prosperity; delirium (incoherent and confused speech due to loss of consciousness) stems from excess pathogenic factors (such as dry feces in the stomach), while misstatement (confused speech where words do not correspond to thoughts, indicating mental disarray) suggests deficiency. Low-pitched hiccups accompanied by phlegm rales are not auspicious signs, and changes in voice or recurrence of old symptoms may fearably indicate "separation of the soul."

Anger of the Liver manifests as shouting; joy of the Heart manifests as laughing; thinking of the Spleen manifests as singing; sorrow of the Lung Metal manifests as crying; groaning associated with the Kidney is also likely frequent.

Inquiring about symptoms is the primary duty of a physician. Li Shicai discussed this in detail in his *Three Books*. Due to space limitations here, we cannot include much, so we only adopt Zhang Jingyue's "Ten Questions" with annotations:

First, inquire about chills and fever, and second, about sweating (Ask about the degree of chills and fever to examine Yin and Yang, carefully distinguishing true from false patterns; ask about the presence or absence of sweating to distinguish deficiency-cold and differentiate between excess and deficiency.)

Third, inquire about the head and body, and fourth, about urination and defecation (Ask if headache indicates severe pathogenic factors or if lack of pain indicates deficiency of healthy Qi. Sudden dizziness is due to wind-fire and phlegm; gradual dizziness is due to deficiency of upper Qi sinking. Ask about the location of body pain to examine meridians; general heaviness and pain indicate severe pathogens, while weakness indicates deficiency of healthy Qi. Ask about the color and volume of urine, and whether stool is constipated, loose, contains undigested food, or is watery, to differentiate cold-heat and excess-deficiency.)

Fifth, inquire about diet, and sixth, about the chest and epigastrium (Ask about diet to observe the strength of Stomach Qi. Asking about the chest refers to the epigastric region. If turbid Qi rises to interfere, fullness and pain in the chest indicate *Jie Xiong* [Chest Binding]; distension without pain extending to the epigastrium indicates *Pi Qi* [Pi Syndrome].)

Seventh, deafness, and eighth, thirst (Ask about deafness: in Shaoyang diseases, it helps distinguish involvement of the Shaoyang or Jueyin meridians; in miscellaneous diseases, deafness is a heavy sign, while non-deafness is light. Ask about thirst, as it occurs in cold, heat, excess, and deficiency patterns. Generally, if the mouth feels neutral and the patient desires water but does not want to drink, it is cold; if the mouth feels hot and the patient drinks continuously, it is heat; extreme thirst with delirium and constipation indicates excess; occasional desire to drink small amounts with free urination and defecation indicates deficiency.)

Ninth, old diseases, and tenth, causes (Ask about past illnesses to know if there are chronic conditions; ask about the etiology of the current illness to guide medication.)

Additionally, consider the effects of previous medications to understand subtle variations (Within the treatments for exterior/interior, cold/heat, tonification/reduction, there are divine mechanisms of change.)

For women, menstruation must specifically be asked about; delays, rapidity, amenorrhea, or metrorrhagia can all be observed (Women are governed by menses; asking about their presence, timing, and flow helps probe the condition and check for pregnancy.)

Add a few short phrases for pediatrics: diagnosis of smallpox and measles relies entirely on observation (When children are about to erupt with pox/measles, it resembles external contraction; one should use the color of the tendons in the middle finger, lower legs, and behind the ears as evidence for differentiation.)