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Shortness of breath and insufficient respiration indicate extreme deficiency (Xu), where Qi lacks the strength to respond to respiratory demands.

In a healthy person without fever or aversion to cold, shortness of breath and insufficient respiration indicate excess (Shi). This is often due to obstruction in the Middle Jiao (Middle Burner) or the presence of Phlegm-Fire.

If inhalation is slightly rapid, the disease is located in the Middle Jiao and is an excess pattern; it should be treated with purgation (Xia Fa), leading to recovery. This occurs because middle-jiao excess obstructs deep inhalation, causing exhalation followed by immediate re-inhalation, resulting in slight but rapid breathing. If it is a deficiency pattern, it is difficult to treat; if it is an excess pattern, it can be treated with purgation.

If the Middle Jiao is deficient, inhalation fails to reach its depth and is slightly rapid, indicating that Liver-Kidney Qi is nearing exhaustion. When the disease is in the Upper Jiao, inhalation is short and hurried; when in the Lower Jiao, inhalation is deep and distant. These are all difficult-to-treat conditions. If the patient trembles during respiration, it indicates that Qi cannot support the body form.

For diseases in the Upper Jiao, Qi flow should be unobstructed; for diseases in the Lower Jiao, Qi flow should ascend. Only when Upper and Lower Jiao Qi communicate can the disease be cured. Currently, the Upper Jiao has short, hurried inhalation that cannot descend, and the Lower Jiao has deep, distant inhalation that cannot ascend. Without this communication, how can the disease be easily cured? Trembling indicates that Qi fails to bear the body.

Generally, when diagnosing illness, one must first ask who the patient is: male or female, old or young, child servant or maid, or relative. Secondly, ask about the onset date, etiology, dietary habits, Stomach Qi status, bowel/bladder function, previous medications, day vs. night symptom variations, sleep patterns, and any areas of distension, fullness, or pain.

If the patient does not answer, they are likely deaf; inquire whether they were congenitally deaf or if hearing loss resulted from prolonged illness or excessive sweating/purging causing Qi deficiency.

If the patient is reluctant to speak and only nods, it indicates Spleen-Stomach Qi deficiency (Zhong Qi Xu).

If the patient is confused and unaware, determine if it is sudden Jue syndrome (Fainting/Coma) or chronic illness.

Women presenting with rigidity and fainting often suffer from Middle Qi damage; inquire if they experienced severe anger.

Women must be asked about their menstruation. Widows have stagnant Qi and Blood, often showing slippery pulses at the Chi position; do not misdiagnose this as pregnancy. Virgins are similar.

For epigastric and abdominal distension and pain, determine if it is a recurrence of an old disease or a new onset.

Ask about taste preferences and food cravings. Lovers of alcohol or vegetarian diets, those preferring sour tastes indicate Liver deficiency; those preferring sweet tastes indicate Spleen deficiency. Other tastes follow this logic.

For pain in the head, body, or arms, inquire about history of malignant sores. Examine the patient's physique and mental state: physical labor with mental distress, depression injuring the Middle Jiao, loss of status causing lingering attachment, or former wealth turned to poverty causing sorrow and grief internalized, termed "Loss of Jing" (Spirit/Essence depletion). These lead to dry skin, contracted sinews, flaccidity, bi-syndrome, and spasms, due to external consumption of Wei Qi (Defensive Qi) and internal depletion of Ying Qi (Nutritive Qi). Skilled physicians must understand the condition, then inquire about diet and lifestyle. Sudden joy or suffering, joy turning to suffering, sudden anger injuring Yin, sudden joy injuring Yang, physical deterioration, daily loss of essence, and pathogenic factors invading due to deficiency.