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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: One must carefully inquire about the initial onset of the disease and its current manifestation. Then, palpate and trace the pulse in various positions. It also states: One must ask if the patient has experienced a change from high status to low status. Even without external pathogenic factors, diseases can arise internally; this is called "Tuo Ying" (Depletion of Ying/Nutritive Qi). If one was once wealthy but became poor, this condition is called "Shi Jing" (Loss of Jing/Essence). The five visceral qi may linger and stagnate, causing diseases to manifest. When physicians diagnose, if they do not examine the Zang-Fu organs, and the physical form remains unchanged, diagnosis becomes doubtful, and the disease name remains unknown. The body wastes away daily, Qi becomes deficient and Jing is depleted. In deep-seated diseases, Qi is exhausted, manifested by rattling sounds (indicating fluid retention or weak respiration) and frequent fright. The severity of the disease stems from external depletion of Wei Qi (Defensive Qi) and internal exhaustion of Ying Qi (Nutritive Qi). Skilled physicians err because they fail to understand the nature of the pathology.

It further states: There are three common aspects to consider during diagnosis; one must inquire about the patient's social status. For instance, those who have lost their noble rank or aspire to become feudal lords may suffer from psychosomatic illnesses.

It also states: When entering a country, inquire about local customs; when entering a home, ask about taboos; upon entering the hall, ask about etiquette; and when facing a patient, ask about their preferences and conveniences. This demonstrates utmost caution. Furthermore, when diagnosing any illness, one must inquire about diet and daily routine. Sudden extreme joy or sorrow, or a shift from happiness to suffering, all damage True Qi. Additionally, if diagnosis does not first inquire about initial worries, dietary irregularities, excessive living habits, or potential poisoning, and instead hastily palpates the Cun Kou (Radial Artery at the wrist), how can one accurately determine the disease?

Generally, for various diseases, if symptoms worsen during the day and remain quiet at night, it indicates excess Yang, meaning there is a Qi disorder but no Blood disorder. If symptoms worsen at night and remain quiet during the day, it indicates excess Yin, meaning there is a Blood disorder but no Qi disorder.

If one asks and finds fever during the day but quietness at night, it indicates Yang Qi naturally flourishing in the Yang aspect. If quiet during the day but feverish and irritable at night, it indicates Yang Qi sinking into the Yin aspect, a condition named "Re Ru Xue Shi" (Heat Entering the Blood Chamber). If feverish and irritable both day and night, it indicates Extreme Yang with no Yin (Yang Excess without Yin constraint). One should urgently drain the Yang heat and vigorously tonify the Yin.

If one asks and finds aversion to cold during the day but quietness at night, it indicates Yin Blood naturally flourishing in the Yin aspect. If quiet at night but aversion to cold during the day, it indicates Yin Qi overflowing into the Yang aspect. If aversion to cold occurs both day and night, it indicates Extreme Yin with no Yang (Yin Excess without Yang constraint). One should urgently drain the Yin cold and vigorously tonify the Yang.

If there is aversion to cold during the day, irritability at night, and inability to eat, the disease is named "Yin Yang Jiao Bian" (Yin-Yang Interaction/Conflict), which is a fatal prognosis. In such cases, close doors and windows, strike them to startle the patient, and repeatedly inquire about their emotional state, accommodating their will. Those who retain Shen (Spirit) prosper; those who lose Shen perish.

The *Jia Yi Jing* (Classical Text of Jia Yi) states: When asking about the illness, inquire what they think about, fear, desire, and doubt. The key to inquiry lies in examining the deficiency and excess of Yin and Yang, and distinguishing the cold and heat of the Zang-Fu organs. Disease generation revolves around Yin-Yang, Zang-Fu, Cold-Heat, and Deficiency-Excess. Clear distinction leads to error-free treatment.

The *Nan Jing* (Classic of Difficult Issues) states: If a patient desires cold and wishes to see people, the disease is in the Fu organs. If a patient desires warmth and does not wish to see people, the disease is in the Zang organs.

Li Dongyuan, in his *Differentiation of Internal Injury and External Contraction*, discusses: Regarding fever and aversion to cold, if chills and fever alternate, with steaming heat arising from within the muscles, it is an internal injury. If fever and aversion to cold occur simultaneously, with surface heat on the skin and hair, it is an external contraction. Regarding taste and digestion, if one cannot taste food, cannot swallow, has disharmonious limbs, and heat in both hypochondria, it is an internal injury syndrome. If one retains taste, has a harmonious abdomen, normal excretion, but suffers from bone and joint pain, immobility, and requires support to stand, it is an external contraction syndrome. Regarding wind sensitivity, if one lives outdoors in strong winds without feeling afraid, but only fears drafts from window cracks, it is an internal injury syndrome. Regarding nasal discharge and breathing, if there is clear runny nose, headache, spontaneous sweating, shortness of breath, reluctance to speak, it is an internal injury syndrome. Regarding urination and defecation, if there is frequent urination without thirst, initially caused by overwork, with poor appetite, yellow-red urine, difficult stool (constipation or hardness), or loose stools resembling dysentery but not being so, or yellow mushy diarrhea, or alternating constipation and diarrhea, these are all internal injury syndromes. Regarding chest and abdominal discomfort, if there is epigastric fullness or chest oppression with knife-like pain, occurring alternately rather than simultaneously, sometimes with heartburn pain radiating to the hypochondria, limb flaccidity, weakness, lethargy, and drowsiness, these are internal injury syndromes. Regarding the Qi of Minister Fire below the navel rushing up to the chest uncontrollably, causing rapid breathing and severe panting, these are internal injury syndromes. Regarding headache, constant and unceasing pain suggests external contraction. Fixed pain indicates Blood stasis; wandering pain indicates Qi disorder. Pain relieved by pressure indicates deficiency; pain aggravated by pressure indicates excess. Wandering pain indicates Wind; spasms indicate Cold; irritability and thirst indicate Summerheat; heaviness and stiffness indicate Dampness. Other causes include excessive sexual activity, fright, dietary injury, or Summerheat contracted while staying indoors. These are the reasons why inquiry is precious.

In gynecology regarding postpartum care, one must first ask about the ease or difficulty of labor, the amount of lochia, timing of diet, and survival of the infant. Different types of tangible injuries affect Blood differently, requiring distinct methods for tonifying Qi and Blood. Irregular diet requires regulating the Middle Jiao; loss of fetus requires resolving depression. Inquiring about desires helps identify the disease: craving hot foods indicates Cold; craving cold foods indicates Heat; preferring stillness and disliking movement indicates Deficiency; irritability and restlessness indicate Excess. Aversion to food indicates Food Stagnation; aversion to wind indicates Wind Invasion. Craving sweet flavors indicates Spleen Deficiency; craving pungent flavors indicates Lung disease; craving sour flavors indicates Liver disease; craving salty flavors indicates Kidney weakness; craving bitter flavors indicates Heart disease. These are favorable patterns and easy to treat. However, if Heart disease craves salt, Lung disease craves bitterness, Spleen weakness prefers sour, Liver disease likes spicy, and Kidney decline craves sweet, these are adverse signs. Mild illness becomes critical; critical illness leads to death. With correct treatment and preventive medication, life can be saved.

Once, a patient suffered from sore throat, and many physicians failed to cure him. One physician asked about his usual diet and learned he liked eating turtledoves. He deduced that the doves had eaten Banxia (Pinellia Tuber) seedlings, leading to toxicity. The patient was cured using Shengjiang (Fresh Ginger).

Tang Ruzheng treated a child with Wind-Heat. The whole body recovered except for the vertex of the head. Upon inquiry, he learned the wet nurse frequently drank hot wine. He identified this as the source of toxicity transmitted through milk and prescribed doubled doses of Gegen (Puerariae Radix) and Huanglian (Coptidis Rhizoma), resulting in a cure.