以治未病。凡脏腑未竭,气血未乱,精神未散者全愈,病已成者半愈,病势已过者危矣。
第一看他神气色,润枯肥瘦起和眠;
肥白人多湿痰,黑瘦人多火热。或形肥色黑,或形瘦色白,临时参证,或从形,或从色,不可泥也。
活润死枯肥是实,瘦为虚弱古今传;谦体即知腰内苦,攒眉头痛与头眩;手不举兮肩背痛,步行艰苦脚间
疼;叉手按胸胸内痛,按中脐腹痛相连;但起不眠痰夹热,贪眠虚冷使之然;面壁身蜷多是冷,仰身舒挺热相
煎;身面目黄脾湿热,唇青面黑冷同前。
五音以应五脏,金声响,土声浊,木声长,水声清,火声燥。如声清,肺气调畅。声如从室中言,中湿也。
言而微,终日乃复言,夺气也。先轻后重,高厉有力,为外感。先重后轻,沉困无力,为内伤。
第二听声清与浊,鉴他真语及狂言;声浊即知痰壅滞,声清寒内是其源;言语真诚非实热,狂言号叫热深
坚;称神说鬼逾墙屋,胸膈停痰证号癫;更有病因循日久,音声遽失命归泉。
试问头身痛不痛,寒热无歇外感明;掌热口不知食味,内伤饮食劳倦形;五心烦热兼有咳,人瘦阴虚火动
情;除此三件见杂症∶如疟如痢必有名;从头至足须详问,证候参差仔细听。
头痛否? 痛无间歇为外感,痛有间歇为内伤。
目红肿否? 或暴红肿,或素疼痛。
耳鸣耳聋否? 或左或右。久聋者,不敢纯用补涩之剂,须兼开关行气之药。
鼻有涕否? 或无涕而燥,或鼻塞,或素流涕不止,或鼻痔,或酒 。
口知味否? 或不食亦能知味,为外感风寒;或食亦不知味,为内伤饮食。
口渴否? 渴饮冷水者为热,渴饮热水者为虚,夏月大渴好饮者为暑。
舌有苔否? 或白,或黄,或黑,或红而裂。
齿痛否? 或上眶,或下眶,或有牙宣。
项强否? 暴强则为风寒,久强则为痰火。
咽痛否? 暴痛多痰热,素惯痛多下虚。
手掌心热否? 手背热为外感,手心热为内伤,手背手心俱热为内伤兼外感。
手指梢冷否? 冷则为感寒,不冷则为伤风,素清冷则为体虚。
手足瘫痪否? 左手足臂膊不举或痛者,属血虚有火;右手足臂膊不举或痛者,属气虚有痰。
肩背痛否? 暴痛为外感,久痛为虚损挟郁。
腰脊痛否? 暴痛亦为外感,久痛为肾虚挟滞。
尻骨痛否? 暴痛为太阳经邪,久痛为太阳经火。
胸膈满否? 已下为结胸,未下为邪入少
阳经分,非结胸也。素惯胸满者,多郁多痰火下虚。
胁痛否? 或左或右,或两胁俱痛,或一点空痛。
腹胀否? 或大腹作胀,或小腹作胀。
腹痛否? 或大腹痛,或脐中痛,或小腹痛,或痛按之即止,或痛按之不止。
腹有痞块否? 或脐上有痞块,或脐下有痞块,或脐左有痞块,或脐右有痞块,或脐中有块,不可妄
用汗吐下及动气凝滞之药,宜兼消导行气之剂。
心痛否? 暴痛属寒,久痛属火属虚。
心烦否? 或只烦躁不宁,或欲吐不吐,谓之嘈杂。或多惊恐,谓之怔忡。
呕吐否? 或湿呕,或干呕,或食罢即呕,或食久乃呕。
大便泄否? 或溏泄,或水泄,或晨泄,或食后即泄,或黄昏时泄,一日共泄几行。
大便秘否? 秘而作渴作胀者为热,秘而不渴不胀者为虚。
小便清利否? 清利为邪在表,赤涩为邪在里,频数窘急为下虚挟火,久病及老人得之危。
小便淋闭否? 渴者为热,不渴为虚。
阴强否? 阴强为有火,阴痿为无火。
素有疝气否? 有疝气,宜兼疏利肝气药,不可妄用升提及动气之剂。
素有便血否?有痔疮否? 有便血痔疮,不敢过用燥药,烁阴伤脏。
有疮疥否? 有疮疥忌发汗,宜兼清热养血祛风。
素有梦遗白浊否? 有遗浊则为精虚,不敢轻易汗下。
有房室否? 男子犯房则气血暴虚,虽有外邪,戒用猛剂。或先补而后攻,可也。
膝酸软否? 暴酸软则为香港脚,或胃弱。久病则为肾虚。
脚肿痛否? 肿而痛者多风湿,不肿胫枯细而痛者为血虚、为湿热下注。
脚掌心热否? 热则下虚火动。脚跟痛者,亦肾虚有热。脚指及掌心冷者为寒。
有寒热否?寒热有间否? 无间为外感,有间为内伤。午寒夜热,则为阴虚火动。
饮食喜冷否? 喜冷则为中热,喜热则为中寒。
饮食运化否? 能食不能化者,为脾寒胃热。
饮食多少否? 能饮食者易治,全不食者难治。惟伤寒不食亦无害。
素饮酒及食煎炒否? 酒客多痰热,煎炒多犯上焦,或流入大肠而为湿热之症。
有汗否? 外感有汗则为伤风,无汗则为伤寒。杂症自汗则为阳虚。
有盗汗否? 睡中出汗,外感则为半表里邪,内伤则为阴虚有火。
浑身骨节疼痛否? 外感则为邪居表分,内伤则为气血不用,身重痛者为挟湿气。
夜重否? 或昼轻夜重为血病,或夜轻昼重为气病。
年纪多少? 壮年病多可耐,老人病杂则元气难当。妇人生产少者,气血犹盛;生产多,年又多,宜补不宜攻。
病经几时? 或几日,或几旬,或经年。
所处顺否? 所处顺,则情性和而气血易调;所处逆,则气血怫郁,须于所服药中,量加开郁行气之剂。
曾误服药否? 误药则气血乱而经络杂,急病随为调解,缓病久病,停一二日后药之,可也。
妇人经调否? 或参前为血热,或参后为血虚。或当经行时有外感,经尽则散,不可妄药,以致有犯血海。
经闭否? 或有潮热,或有咳泄,或有失血,或有白带否?能饮食否?能食,则血易调而诸症自除,食减
渐瘦者,危。
有 瘕否? 有腹痛潮热,而一块结实者,
为瘕。
有孕能动否? 腹中有一块结实能动,而无腹痛潮热等症者,为有孕。腹虚大胀满,按之无一块结实者,
为气病,其经水亦时渗下。
产后有寒热否?有腹痛否,有汗否?有咳喘否?寒热多为外感,腹痛多为瘀血,或食积停滞。有汗单
潮为气血大虚。咳喘为瘀血入肺,难治。
凡初证题目未定,最宜详审,病者不可讳疾忌医,医者必须委曲请问,决无一诊而能悉知其病情也。初学
宜另抄问法一纸,常出以问病。若题目已定,或外感,或内伤,或杂病,自当遵守古法,不可概施发散剂也。
以治疗未病。凡是脏腑功能尚未衰竭,气血运行尚未紊乱,精神尚未耗散的患者,可以完全痊愈;病情已经形成的,可以半愈;病势已经过去(指正气已衰而邪气未尽或正虚为主)的,则处于危险境地。
第一要观察患者的神气与面色,看其润泽还是枯槁,形体肥壮还是消瘦,以及睡眠和起卧状态如何;
形体肥胖、肤色白皙的人多患湿痰证,形体黑瘦的人多患火热证。或者形体肥胖但肤色黑,或者形体消瘦但肤色白,需根据具体症状灵活参详,或从形体判断,或从面色判断,不可拘泥固执。
活润者生,死枯者亡,形体肥大多属实证,形体消瘦多为虚弱,这是古今相传的经验;身体谦弱蜷缩即知腰部内部痛苦,皱眉表示头痛与头晕;手臂不能抬起则肩背疼痛,行走艰难则脚部疼痛;双手交叉按胸表示胸内疼痛,按压中部则腹痛相连;刚起身就失眠多因痰热夹杂,贪睡则是由于虚寒所致;面壁蜷缩身体多属寒证,仰卧伸展身体多属热证煎熬;全身面目发黄为脾经湿热,嘴唇青紫、面色发黑为寒证同前所述。
五音对应五脏,金声清脆,土声浑浊,木声悠长,水声清亮,火声燥急。如果声音清亮,说明肺气调畅。如果声音像是从密室中发出,是中湿的表现。
说话声音微弱,整天才能说一句话,是夺气(元气大伤)的表现。先轻后重,高声厉色有力,属于外感病。先重后轻,低沉困倦无力,属于内伤病。
第二听声音的清浊,鉴别是真语还是狂言;声音浑浊即知痰浊壅滞,声音清亮则寒邪在内是其根源;言语真诚而非实热证,狂言号叫则是热邪深重坚固;称神说鬼、逾墙越屋,胸膈停痰,证候称为癫证;更有病因拖延日久,声音突然丧失,生命终结。
试着询问头部和身体是否疼痛,寒热是否无休止,以此明确是否为外感;手掌发热、口不知食味,是内伤饮食劳倦的表现;五心烦热兼有咳嗽,人瘦阴虚火动的情状;除了这三类,见到杂症:如疟疾、痢疾必有名称;从头到足必须详细询问,证候参差不齐仔细倾听。
头痛吗? 痛无间歇为外感,痛有间歇为内伤。
眼睛红肿吗? 或是突然红肿,或是平时疼痛。
耳鸣耳聋吗? 或左或右。久聋者,不敢纯用补涩之剂,须兼用开关行气之药。
鼻有鼻涕吗? 或无涕而干燥,或鼻塞,或平时流涕不止,或鼻痔,或酒渣鼻。
口能知味吗? 或不进食也能知味,为外感风寒;或进食也不知味,为内伤饮食。
口渴吗? 渴饮冷水者为热证,渴饮热水者为虚证,夏季大渴好饮者为暑证。
舌上有苔吗? 或白,或黄,或黑,或红而裂开。
牙齿痛吗? 或上眶痛,或下眶痛,或有牙宣(牙龈萎缩出血)。
项强吗? 突然强直则为风寒,久强则为痰火。
咽痛吗? 突然痛多痰热,平时惯常痛多下焦虚损。
手掌心热吗? 手背热为外感,手心热为内伤,手背手心俱热为内伤兼外感。
手指梢冷吗? 冷则为感寒,不冷则为伤风,平时清冷则为体虚。
手足瘫痪吗? 左手足臂膊不能举起或痛者,属血虚有火;右手足臂膊不能举起或痛者,属气虚有痰。
肩背痛吗? 突然痛为外感,久痛为虚损挟郁。
腰脊痛吗? 突然痛亦为外感,久痛为肾虚挟滞。
尻骨痛吗? 突然痛为太阳经受邪,久痛为太阳经火。
胸膈满闷吗? 已下法治疗后为结胸,未下法治疗为邪入少阳经分,非结胸也。平时惯常胸满者,多郁多痰火下虚。
胁痛吗? 或左或右,或两胁俱痛,或一点空痛。
腹胀吗? 或大腹作胀,或小腹作胀。
腹痛吗? 或大腹痛,或脐中痛,或小腹痛,或痛按之即止,或痛按之不止。
腹部有痞块吗? 或脐上有痞块,或脐下有痞块,或脐左有痞块,或脐右有痞块,或脐中有块,不可妄用汗吐下及动气凝滞之药,宜兼消导行气之剂。
心痛吗? 突然痛属寒,久痛属火属虚。
心烦吗? 或只烦躁不宁,或欲吐不吐,谓之嘈杂。或多惊恐,谓之怔忡。
呕吐吗? 或湿呕,或干呕,或食罢即呕,或食久乃呕。
大便泄泻吗? 或溏泄,或水泄,或晨泄,或食后即泄,或黄昏时泄,一日共泄几行。
大便秘结吗? 秘而作渴作胀者为热,秘而不渴不胀者为虚。
小便清利吗? 清利为邪在表,赤涩为邪在里,频数窘急为下虚挟火,久病及老人得之危。
小便淋闭吗? 渴者为热,不渴为虚。
阴器勃起吗? 阴强为有火,阴痿为无火。
素有疝气吗? 有疝气,宜兼疏利肝气药,不可妄用升提及动气之剂。
素有便血吗? 有痔疮吗? 有便血痔疮,不敢过用燥药,以免烁阴伤脏。
有疮疥吗? 有疮疥忌发汗,宜兼清热养血祛风。
素有梦遗白浊吗? 有遗浊则为精虚,不敢轻易汗下。
有房室生活吗? 男子犯房则气血暴虚,虽有外邪,戒用猛剂。或先补而后攻,可也。
膝酸软吗? 突然酸软则为香港脚(脚气病),或胃弱。久病则为肾虚。
脚肿痛吗? 肿而痛者多风湿,不肿胫枯细而痛者为血虚、为湿热下注。
脚掌心热吗? 热则下虚火动。脚跟痛者,亦肾虚有热。脚趾及掌心冷者为寒。
有寒热吗? 寒热有间歇吗? 无间为外感,有间为内伤。午寒夜热,则为阴虚火动。
饮食喜冷吗? 喜冷则为中热,喜热则为中寒。
饮食运化吗? 能食不能化者,为脾寒胃热。
饮食多少吗? 能饮食者易治,全不食者难治。惟伤寒不食亦无害。
素饮酒及食煎炒吗? 酒客多痰热,煎炒多犯上焦,或流入大肠而为湿热之症。
有汗吗? 外感有汗则为伤风,无汗则为伤寒。杂症自汗则为阳虚。
有盗汗吗? 睡中出汗,外感则为半表里邪,内伤则为阴虚有火。
浑身骨节疼痛吗? 外感则为邪居表分,内伤则为气血不用,身重痛者为挟湿气。
夜间加重吗? 或昼轻夜重为血病,或夜轻昼重为气病。
年纪多少? 壮年病多可耐,老人病杂则元气难当。妇人生产少者,气血犹盛;生产多,年又多,宜补不宜攻。
病经几时? 或几日,或几旬,或经年。
所处顺否? 所处顺,则情性和而气血易调;所处逆,则气血怫郁,须于所服药中,量加开郁行气之剂。
曾误服药吗? 误药则气血乱而经络杂,急病随为调解,缓病久病,停一二日后药之,可也。
妇人月经调吗? 或参前为血热,或参后为血虚。或当经行时有外感,经尽则散,不可妄药,以致有犯血海。
经闭吗? 或有潮热,或有咳泄,或有失血,或有白带吗?能饮食吗?能食,则血易调而诸症自除,食减渐瘦者,危。
有瘕聚吗? 有腹痛潮热,而一块结实者,为瘕聚。
有孕能动吗? 腹中有一块结实能动,而无腹痛潮热等症者,为有孕。腹虚大胀满,按之无一块结实者,为气病,其经水亦时渗下。
产后有寒热吗?有腹痛吗,有汗吗?有咳喘吗?寒热多为外感,腹痛多为瘀血,或食积停滞。有汗单潮为气血大虚。咳喘为瘀血入肺,难治。
凡初证题目未定,最宜详审,病者不可讳疾忌医,医者必须委曲请问,决无一诊而能悉知其病情也。初学宜另抄问法一纸,常出以问病。若题目已定,或外感,或内伤,或杂病,自当遵守古法,不可概施发散剂也。
To treat disease before it arises. For those whose Zang-Fu organs are not yet exhausted, Qi and Blood are not yet chaotic, and Spirit is not yet scattered, complete recovery is possible; for those where the disease has already formed, half recovery is possible; for those where the pathological trend has passed (indicating deficiency of healthy Qi with lingering pathogenic factors or predominance of deficiency), the condition is critical.
First, observe the patient's Shen (Spirit) and complexion: whether lustrous or withered, fat or thin, and their sleep and waking states.
People who are fat and white-skinned often have Phlegm-Dampness; people who are dark and thin often have Fire-Heat. If one is fat but dark-skinned, or thin but white-skinned, refer to the symptoms at hand; judge from the body shape or from the complexion, do not be dogmatic.
Lustrous indicates life, withered indicates death; fatness suggests Excess, thinness suggests Deficiency—this is a tradition passed down through ancient and modern times. A humble, curled posture indicates pain in the waist and interior; knitting brows indicates headache and dizziness. Inability to raise hands indicates shoulder and back pain; difficulty walking indicates leg pain. Hands crossed over the chest indicate chest pain; pressing the middle indicates abdominal pain. Insomnia upon rising is often due to Phlegm-Heat; excessive sleepiness is caused by Deficiency-Cold. Facing the wall and curling up mostly indicates Cold; lying on the back stretching out indicates Heat torment. Yellowing of the whole body, face, and eyes indicates Spleen Damp-Heat; blue lips and black face indicate Cold as mentioned before.
The five tones correspond to the Five Zang organs: Metal tone is crisp, Earth tone is turbid, Wood tone is long, Water tone is clear, and Fire tone is dry. If the voice is clear, Lung Qi is smooth. If the voice sounds like it comes from a room, it indicates internal Dampness.
Speaking faintly, taking all day to say a few words, indicates Loss of Qi (severe depletion of Yuan Qi). Starting light then becoming heavy, loud and forceful, indicates External Contraction. Starting heavy then becoming light, deep and weak, indicates Internal Injury.
Second, listen to the clarity or turbidity of the voice to distinguish true speech from delirious speech. Turbid voice indicates Phlegm obstruction; clear voice indicates Cold as its source. Sincere speech is not Excess-Heat; delirious shouting indicates Deep and Firm Heat. Calling out to spirits, climbing walls, with Phlegm stagnation in the chest and diaphragm, is classified as Dian (Manic Disorder). If the cause persists for a long time and the voice suddenly disappears, life ends.
Ask if there is head or body pain; if chills and fever are unceasing, it clarifies External Contraction. Hot palms and loss of taste indicate Internal Injury from diet and fatigue. Five-palm heat combined with cough indicates Yin Deficiency with Fire stirring. Besides these three, miscellaneous diseases appear: such as Malaria or Dysentery, which have specific names. Question from head to toe carefully; listen attentively to the varying symptoms.
Is there headache? Uninterrupted pain is External Contraction; intermittent pain is Internal Injury.
Are eyes red and swollen? Or sudden swelling/redness, or chronic pain.
Is there tinnitus or deafness? On the left or right. For chronic deafness, do not use purely tonifying and astringent formulas; must combine with opening and Qi-moving herbs.
Is there nasal discharge? Or no discharge but dryness, or nasal congestion, or chronic runny nose, or nasal polyps, or rhinophyma.
Can you taste food? If you can taste without eating, it is External Wind-Cold; if you cannot taste even when eating, it is Internal Injury from diet.
Are you thirsty? Thirst for cold water indicates Heat; thirst for hot water indicates Deficiency; great thirst in summer indicates Summerheat.
Is there tongue coating? White, yellow, black, or red with cracks.
Do teeth hurt? Upper jaw, lower jaw, or gum recession/bleeding.
Is the neck stiff? Sudden stiffness is Wind-Cold; chronic stiffness is Phlegm-Fire.
Does the throat hurt? Sudden pain is mostly Phlegm-Heat; habitual pain is mostly Lower Jiao Deficiency.
Are palms hot? Back of hand heat is External Contraction; palm heat is Internal Injury; both are Internal Injury plus External Contraction.
Are fingertips cold? Cold indicates Cold invasion; not cold indicates Wind injury; chronically cold indicates Constitution Deficiency.
Is there paralysis of limbs? Left limb/arm inability to lift or pain indicates Blood Deficiency with Fire; right limb/arm inability to lift or pain indicates Qi Deficiency with Phlegm.
Do shoulders/back hurt? Sudden pain is External Contraction; chronic pain is Deficiency with Stagnation.
Do waist/spine hurt? Sudden pain is also External Contraction; chronic pain is Kidney Deficiency with Stasis.
Does the sacrum hurt? Sudden pain is Shaoyang channel pathogen; chronic pain is Shaoyang channel Fire.
Is the chest/diaphragm full? After purgation, it is Jie Xiong (Chest Binding); before purgation, it is pathogen entering Shaoyang channel, not Jie Xiong. Habitual chest fullness indicates Stagnation, Phlegm-Fire, and Lower Deficiency.
Do flanks hurt? Left, right, both, or a single empty pain.
Is abdomen bloated? Large abdomen or small abdomen.
Is there abdominal pain? Large abdomen, umbilicus, or small abdomen; pain stopping upon pressure or continuing despite pressure.
Are there abdominal masses? Above, below, left, right, or center of umbilicus. Do not rashly use sweating, vomiting, or purging methods that move Qi and cause stagnation; should combine resolving and Qi-moving agents.
Is there heart pain? Sudden pain is Cold; chronic pain is Fire or Deficiency.
Is there mental restlessness? Only irritability is Za Cao (Gluttony sensation); wanting to vomit but unable is Za Cao. Frequent fright is Zheng Chong (Palpitations).
Is there vomiting? Wet vomiting, dry vomiting, vomiting immediately after eating, or vomiting after a long time.
Is there diarrhea? Loose stool, watery stool, morning diarrhea, post-prandial diarrhea, or evening diarrhea; how many times per day.
Is there constipation? Constipation with thirst/bloating is Heat; constipation without thirst/bloating is Deficiency.
Is urination clear and free? Clear/free indicates pathogen in Exterior; red/astringent indicates pathogen in Interior; frequent/urgent indicates Lower Deficiency with Fire; dangerous for chronic patients and elderly.
Is there strangury/retention? With thirst is Heat; without thirst is Deficiency.
Is there penile erection? Erection indicates Fire; flaccidity indicates No Fire.
Do you have hernia? If yes, combine liver-soothing herbs; do not rashly use ascending or Qi-moving agents.
Do you have hematochezia? Hemorrhoids? If present, avoid excessive drying herbs to prevent damaging Yin and Zang organs.
Do you have sores/scabies? Sweating is contraindicated; combine clearing Heat, nourishing Blood, and dispelling Wind.
Do you have nocturnal emission or leukorrhea? Emission indicates Essence Deficiency; avoid rash sweating or purging.
Is there sexual activity? Men engaging in sex suffer sudden Qi/Blood deficiency; even with external pathogens, avoid harsh formulas. Tonify first, then attack, is acceptable.
Are knees sore/weak? Sudden soreness is Hong Kong Foot (Gout/Jamming), or weak Stomach. Chronic is Kidney Deficiency.
Are feet swollen/painful? Swollen and painful is mostly Wind-Damp; non-swollen, with withered/thin calves and pain is Blood Deficiency or Damp-Heat pouring downward.
Are soles hot? Heat indicates Lower Deficiency with Fire stirring. Heel pain is also Kidney Deficiency with Heat. Cold toes/soles indicate Cold.
Is there chills/fever? Intermittent? No interval is External Contraction; interval is Internal Injury. Chills noon/fever night is Yin Deficiency with Fire stirring.
Preference for cold food? Cold preference indicates Middle Heat; hot preference indicates Middle Cold.
Digestion ability? Eating but not digesting is Spleen Cold/Stomach Heat.
Amount of food? Able to eat is easy to treat; unable to eat is difficult. Except for Shang Han where anorexia is harmless.
History of alcohol/fried foods? Alcohol drinkers often have Phlegm-Heat; fried foods affect Upper Jiao or Large Intestine causing Damp-Heat.
Is there sweating? External with sweat is Wind Injury; without sweat is Cold Injury. Miscellaneous spontaneous sweating is Yang Deficiency.
Is there night sweats? Sweating during sleep: External is Half-Exterior/Half-Interior pathogen; Internal is Yin Deficiency with Fire.
Is there generalized joint pain? External is pathogen in Exterior; Internal is Qi/Blood dysfunction; heavy pain indicates Dampness.
Worse at night? Light day/heavy night is Blood disease; light night/heavy day is Qi disease.
Age? Young adults tolerate illness better; elderly with mixed diseases struggle with Yuan Qi. Women with few births have strong Qi/Blood; many births + old age requires tonification, not attack.
Duration? Days, weeks, or years.
Environment favorable? Favorable environment leads to harmonious emotions and easy Qi/Blood regulation; unfavorable leads to Qi/Blood depression; add Qi-opening/stagnation-resolving herbs to medication.
Mistaken medication? Mistakes cause Qi/Blood chaos and meridian confusion. Acute cases need immediate adjustment; chronic cases wait 1-2 days before medicating.
Menstruation regular? Referencing previous points: before period is Blood Heat; after is Blood Deficiency. External contraction during menstruation disperses after; do not rashly medicate to avoid violating Blood Sea.
Amenorrhea? With tidal fever, cough/diarrhea, bleeding, or leukorrhea? Able to eat? If able, Blood regulates and symptoms resolve; reduced intake/emaciation is critical.
Have Ju (Masses)? Abdominal pain, tidal fever, and a solid mass indicate Ju.
Pregnancy movement? Solid movable mass in abdomen without pain/tidal fever indicates pregnancy. Empty large distension without solid mass indicates Qi disease, with occasional vaginal bleeding.
Postpartum chills/fever? Pain? Sweat? Cough/wheeze? Chills/fever mostly External; pain mostly Blood Stasis or Food Retention. Single tidal sweating indicates severe Qi/Blood Deficiency. Cough/wheeze indicates Blood Stasis entering Lungs, difficult to treat.
When initial diagnosis is undetermined, careful examination is essential. Patients must not hide illness; doctors must ask comprehensively. No single pulse reading reveals the entire condition. Beginners should copy a questioning sheet and use it frequently. Once diagnosed as External, Internal, or Miscellaneous, follow ancient methods; do not indiscriminately apply dispersing formulas.