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Whenever examining a patient's disease, one must simultaneously observe their complexion and physical form, and then cross-reference these with the pulse and symptoms. If one can truly understand the condition at the beginning, thereby determining the prognosis, there will be almost no errors in a hundred diagnoses.

How is this known? When a Yin syndrome (syndrome characterized by deficiency, cold, or interior pathology) presents with Yang-colored features, such as redness appearing on the cheeks and zygomatic arches; or when a Yang syndrome presents with Yin-colored features, such as cyanosis of the fingernails, both are considered fatal signs.

Additionally, if the body is hot but the pulse is fine/thin, the lips and corners of the mouth turn blue/cyan, and the eyes are fixed/staring straight ahead, this is a sign of death.

If the face looks as if coated with rouge, or has a color resembling yellow earth, with an oily black aura smearing the face, this is a sign of death.

If the lips and tongue are dry and scorched, black soot-like deposits appear in the nostrils, and the spirit/eyes reveal themselves without depth/focus, this is a sign of death.

If the appearance is emaciated and haggard, the spirit is confused and short, and the body shape shrinks, this is a sign of death.

If breathing is panting and coarse, qi is short, the nostrils flare (alae nasi move), the eyes protrude, and speech is delirious/wild, this is a sign of death.

If the patient unconsciously grasps at clothes or bed rails, loses control of urination and defecation, and makes empty grasping movements in the air (picking at empty space), this is a sign of death.

If the head hangs low and the neck is soft/flaccid, the eyes look without spirit, and inhalation is shallow and short, this is a sign of death.

If the skin is broken but no blood flows, the flesh splits and rots into patches, and there is numbness without sensation of pain or itch, this is a sign of death.

If the teeth are yellow like boiled beans, the lips are white with no texture/lines, the ears are black, dry, scorched, and deaf to hearing, the philtrum (area between nose and upper lip) is shortened and flat, the mouth is open with exhaled breath unable to close/recirculate, the nostrils flare accompanying respiration, sweat beads up like pearls and does not disperse, phlegm is sticky and hardens like glue, the blood spat from the mouth is red like the color of the lung, the fingernails are curved and tinged with cyan, the spirit is confused or floating, the spirit is chaotic or detached, black qi covers the entire face, and a grim black aura appears on the forehead (Tian Ting); encountering any of these means loss of life. The diagnostic methods are evaluated within these descriptions.

The "Three Causes" refer to Internal Causes, External Causes, and Non-Internal/External Causes. This theory originates from ancient times, though its meaning has not been fully elaborated.

Internal Causes arise from the accumulation of the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright) inside the body, combined with the consumption of rich flavors and fatty/sweet foods, which steam and damage the Zang-Fu organs. It also includes sexual excess causing labor injury and depleting Yuan Qi (Original Qi). These affect the Five Zang Organs, and diseases arising from this source are common, occurring in nine out of ten cases among the wealthy and obese.

The manifestations of these conditions are often hard and solid, with deep roots. There is irregularity in urination and defecation, reduced food intake, a soft exterior but hard interior, flat depressions without pus, excess at the exterior but deficiency at the interior, and difficulty expelling toxins. These are internal injury syndromes, hence called Internal Causes.

External Causes all originate from the invasion of the Six Excesses (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) in individuals with weak constitutions, such as sleeping outdoors in summer and autumn, cooling off in the wind, or sitting/sleeping on damp ground, leading to Wind-Cold-Dampness invading the meridians. Another scenario is contracting pathogens after sexual intercourse, where Cold-Toxin penetrates deeply into the bone marrow due to deficiency, coagulating with Qi and Blood, which is particularly severe. Or, external Wind pathogen was not fully dispersed through sweating/diffusing therapies, resulting in swelling and pain. These affect muscles, blood vessels, and bones/tendons. Diseases caused by external factors often result from poor self-care, occurring in nine out of ten cases among those suffering from falls/fractures or overwork. Symptoms often include alternating chills and fever, bone and joint pain, difficult walking, flowing toxic phlegm, various wind syndromes leading to paralysis, facial deviation, hemiplegia, Wind-Dampness, Wind-Warmth, and epidemic toxins. These are external contractive diseases, hence called External Causes.

There are also Non-Internal/External Causes. If there is no internal disturbance by the Seven Emotions and no external injury by the Six Excesses, where do the diseases come from? They arise from irregular eating and drinking, overwork and fatigue, inconsistent emotions (excessive joy or anger), improper temperature of food and drink, and excessive labor without regard for one's health. This leads to disharmony of the Zang-Fu organs, unsmooth Ying and Wei (Nutritive and Defensive) Qi, injury to the Spleen and Stomach, and stagnation of the meridians. Consequently, the disease manifests externally without the typical signs of the Six Meridians (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin) and internally without obstruction of urination or defecation. The disease mostly arises between the skin and muscles, resembling conditions such as scrofula (Luo Li), phlegm nodules (Tan Zhu), Qi痞 (Qi Pi), and goiter (Ying Liu). The treatment method should not involve releasing the exterior or purging the interior, but rather nourishing Qi and Blood, regulating meridians, strengthening the Spleen and harmonizing the Middle Jiao, resolving phlegm, and opening depression. This approach is considered the most excellent.