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In cases where symptoms improve in the morning, it is because at dawn, the Zheng Qi (Upright Qi / Healthy Energy) begins to generate and the Wei Qi (Defensive Qi) begins to circulate, hence the clarity of spirit. In cases where symptoms are stable during the day, it is because at noon, the Zheng Qi grows strong; when strong, it overcomes the Xie Qi (Pathogenic Factor), hence the stability. In cases where symptoms worsen in the evening, it is because at dusk, the Zheng Qi begins to decline and the Xie Qi begins to flourish, hence the worsening. In cases where symptoms are severe at night, it is because at midnight, the Zheng Qi enters the Zang-Fu Organs, leaving the Xie Qi to reside alone in the body, hence the severity. This is the general pattern of waxing and waning in all diseases, reflecting the advance and retreat of Xie Qi and Zheng Qi.

Generally, when a disease manifests with tidal regularity, observing the Shen (Spirit/Mental State) is paramount. If the Shen remains unimpaired upon onset, it indicates that Xie Qi cannot overcome Zheng Qi, signifying excess Zheng Qi. If the Shen becomes fatigued and weak upon onset, it indicates that Zheng Qi cannot overcome Xie Qi, signifying deficiency of Zheng Qi.

In cases where symptoms aggravate during the day accompanied by vexatious heat, while remaining quiet at night, this indicates Yang naturally flourishing in the Yang aspect, denoting a disease of Qi but not Blood. In cases where symptoms aggravate at night accompanied by cold extremities (Han Jue), while remaining quiet during the day, this indicates Yin naturally flourishing in the Yin aspect, denoting a disease of Blood but not Qi. In cases where symptoms aggravate during the day with cold extremities, while remaining quiet at night, this is a pathology of Yin surging upward into the Yang aspect. In cases where symptoms aggravate at night with vexatious heat, while remaining quiet during the day, this is a pathology of Yang sinking downward into the Yin aspect. In cases where cold extremities occur both day and night, this is a pathology of Repeated Yin without Yang. In cases where vexatious heat occurs both day and night, this is a pathology of Repeated Yang without Yin. In cases where there are cold extremities by day and vexatious heat by night, termed "Yin-Yang Interlacing," if food intake ceases, death is ultimately inevitable.

Consuming much food with robust Qi is the normal state. If one consumes much food but has weak Qi, it is either due to Stomach Fire transforming (increasing appetite) or, after recovery from illness, greedily eating before Gu Qi (Grain Qi/Nutritional Energy) has sufficiently recovered. Consuming little food with weak Qi is the normal state. If one consumes little food but has excessive Qi (rapid breathing), it must be due to Stomach disease preventing eating, or Lung disease causing Qi rebellion; this is an error involving both meridians. Those who prefer cold drinks must have Heat in the interior; those who prefer hot drinks must have Cold in the interior. In Deficient Heat, consumption of cold drinks is scanty; in Excess Heat, consumption of cold drinks is abundant. In Deficient Cold, consumption of hot drinks is scanty; in Excess Cold, consumption of hot drinks is abundant. Thus, Cold/Heat and Deficiency/Excess can be distinguished by the quantity of intake. For example, loss of appetite due to Food Retention differs from craving food in miscellaneous diseases: craving food in miscellaneous diseases indicates the presence of Stomach Qi, leading to survival; total absence of desire to eat indicates the absence of Stomach Qi, leading to death.