大便之利不利,关乎里之虚实也。闭者为实,若内外并无热证,则为阴结便闭也。通者为虚,若内外并
无寒证,则为阳实热利也。小便之红与白,主乎里之寒热也。红者为热,若平素浅红淡黄,则为阴虚也。
白者为寒,若平素白浑如米泔,则为湿热所化也。
一问寒热二问汗,
问其寒热多寡,以审阴阳,以辨真假。问其汗之有无,以辨风寒,以别虚实。
三问头身四问便,
问其头痛为邪甚,不痛为正虚。暴眩为风火与痰,渐眩为土虚气陷。问其身之部位,以审经络。亦以一
身重痛为邪甚,软弱为正虚。问其小便红白、多少,大便秘溏,清谷、清水以辨寒热虚实。
五问饮食六问胸,
问饮食以察其胃气之强弱。问胸者,该胃口而言也。浊气上干,则胸满痛为结,胸不痛而胀连心下
为痞气。
七聋八渴俱当辨,
问聋者,伤寒以辨其在少阳与厥阴,杂病以聋为重,不聋为轻也。问渴者,以寒热虚实俱有渴,大抵以
口中和,索水不欲饮者为寒;口中热,引饮不休者为热;大渴谵语,不大便者为实;时欲饮水,饮亦不多,二
便通利者为虚。
九问旧病十问因,
问旧病以知其有素病与否,问其致病之因,以为用药之准。
再将服药参机变。
表里寒热补泻之中,自有神机变化之妙。
妇人尤必问经期,迟速闭崩皆可见。
妇人以经为主,问其有无迟速,以探病情,兼察有孕与否。
再添短语告儿科,天花麻疹全占验。
小儿欲作痘疹,与外感同,宜辨其手中指、足胫、耳后筋色为据。
The patency or impaction of bowel movements relates to the deficiency or excess in the interior (Li). Impaction indicates an Excess pattern; if there are no heat signs internally or externally, it is Yin-Jie constipation (constipation due to Yin-cold accumulation). Frequent loose stools indicate a Deficiency pattern; if there are no cold signs internally or externally, it is Yang-Shi hot diarrhea (diarrhea due to internal heat and excess). The redness or whiteness of urine primarily reflects cold or heat in the interior. Red urine indicates Heat; if the urine is normally pale red and light yellow, it indicates Yin Deficiency. White urine indicates Cold; if the urine is turbid like rice washings, it is transformed by Damp-Heat.
First, inquire about Chills and Fever; second, about Sweating.
Inquire about the degree and frequency of chills and fever to examine Yin and Yang, and to distinguish between true and false patterns. Inquire about the presence or absence of sweating to differentiate between Wind-Cold and other pathogens, and to distinguish between Deficiency and Excess.
Third, inquire about Head and Body sensations; fourth, about Bowel and Urine movements.
Inquire about headache: it indicates severe pathogenic factors; absence of pain indicates righteous Qi deficiency. Sudden dizziness is caused by Wind-Fire and Phlegm; gradual dizziness is caused by Earth (Spleen) deficiency and Qi sinking. Inquire about the specific locations of body pain to examine the Meridians. Similarly, heavy and painful body indicates severe pathogens; weakness indicates righteous Qi deficiency. Inquire about the color (red/white) and volume of urine, and whether stool is constipated or loose, undigested food, or clear water, to differentiate Cold, Heat, Deficiency, and Excess.
Fifth, inquire about Diet; sixth, about the Chest.
Inquire about diet to observe the strength of Stomach Qi. Inquiry about the chest includes the epigastric region. When turbid Qi rises to interfere, fullness and pain in the chest indicate a Knotting (Jie) pattern; distension without pain extending to the heart area below indicates Pi-Qi (Stagnation) pattern.
Seventh, Deafness; Eighth, Thirst, both must be differentiated.
Inquiry about deafness: in Shanghan (Cold Damage), it distinguishes between Shaoyang and Jueyin meridians; in miscellaneous diseases, deafness is considered severe, while absence is mild. Inquiry about thirst: since thirst can occur in Cold, Heat, Deficiency, and Excess patterns generally, the rule is: normal mouth sensation with desire for water but refusal to drink indicates Cold; hot sensation in the mouth with incessant drinking indicates Heat; extreme thirst with delirium and constipation indicates Excess; occasional desire to drink, small amounts consumed, with free urination and defecation indicates Deficiency.
Ninth, Past Illnesses; Tenth, Etiology.
Inquire about past illnesses to know if there is a pre-existing condition; inquire about the cause of disease to serve as a guide for medication.
Furthermore, consider changes based on response to medication.
Within the principles of Exterior/Interior, Cold/Heat, Tonification/Drainage, there are miraculous variations of divine mechanism.
For women, menstruation must especially be inquired about; delays, accelerations, amenorrhea, and flooding all reveal the condition.
Women's health centers on menstruation; inquiring about its presence and timing helps probe the condition and check for pregnancy.
Add a few words for pediatrics: Smallpox and Measles diagnosis relies entirely on these inquiries.
When children are about to develop variola (smallpox) or rubeola (measles), similar to exterior syndromes, one should use the color of the tendons in the middle finger, lower legs, and behind the ears as evidence.