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When diagnosing any disease, one must first ask who the patient is: male or female, elderly or young. Next, inquire about the day the illness began, the cause of the disease, and the status of dietary intake and Stomach Qi (Stomach energy). Ask about the condition of urination and defecation, what medicines have been taken previously, how the patient feels during the day, and how they sleep at night. Also, ask if there is any distension or fullness in the chest and diaphragm. If the patient does not answer when asked, it is likely due to deafness. One must consult with those around the patient regarding their usual state. Otherwise, deafness resulting from prolonged illness or excessive sweating and purging that damages healthy Qi may be overlooked. If the patient is reluctant to answer or merely nods, it indicates deficiency of Middle Jiao Qi (Qi of the middle burner). Confusion and loss of consciousness are either due to sudden Jue syndrome (sudden collapse of Yang or Yin leading to loss of consciousness) or a prolonged illness; women often suffer from disorders of Middle Qi (Spleen/Stomach Qi). When examining women, one must ask about their menstrual cycle. Widows, whose Blood and Qi tend to stagnate, often present with slippery pulses at both Chi positions (pulse positions corresponding to Kidneys/Lower Jiao), which should not be mistaken for pregnancy; this also applies to unmarried women. For abdominal distension and pain, one must determine whether it is acute or chronic. In all diagnoses, one must ask about the patient's taste preferences and food choices—whether they prefer meat or vegetables, and whether they indulge in tea or alcohol. A preference for sweet flavors suggests Spleen weakness; a preference for sour flavors suggests Liver deficiency. For pain in the head, body, arms, and elbows, one must ask if they have ever suffered from malignant sores or taken specific medications. Upon clinical examination, one must assess the patient's physical constitution and mental state: whether they are physically idle but mentally overworked, physically overworked but mentally distressed, depressed causing injury to the Middle Jiao, or formerly noble but now stripped of power, leading to internal disease known as Tuo Ying (Depletion of Ying/Nutritive Qi, meaning consumption of nutritive essence). Those who were once rich but became poor, harboring sorrow and grief internally, suffer from Shi Jing (Loss of Jing/Essence, meaning loss of spirit and vitality). Symptoms include dry skin, contracted sinews, flaccidity, bi-syndrome (painful obstruction), and spasms, caused by external depletion of Wei (Defensive) Qi and internal exhaustion of Ying (Nutritive) Qi. An expert physician will understand the nature of the disease upon diagnosis. Furthermore, inquire about diet and living conditions, sudden joy or sudden suffering, and transitions from joy to suffering. Sudden anger injures Yin; sudden joy injures Yang. The physical form becomes ruined and dejected, vital essence daily depletes, and pathogenic factors merge internally (meaning pathogens take advantage of deficiency to invade). Therefore, the sages, when treating diseases, must observe the Yin and Yang of Heaven and Earth, the regulations of the four seasons; the relationships of Yin-Yang, exterior-interior among the Five Zang and Six Fu organs; the indications for acupuncture, moxibustion, bian stone, and herbal drugs; calmly investigate human affairs to clarify medical principles; recognize that nobility and poverty, wealth and destitution, have different physiological and pathological patterns; ask about age and temperament (bravery or timidity); examine the affected parts to know the origin and beginning of the disease; through the Seven Diagnoses and Nine Pulse Positions, symptoms will correspond accurately.