言微言厉盛衰根，谵语实邪（胃有燥屎，）错语（首尾不相顾而错乱为神） ，虚呃痰鸣非吉兆
，声音变旧恐离魂。
肝怒声呼心喜笑，脾为思念发为歌，肺金忧虑形为哭，肾主呻吟恐亦多。
问证是医家第一要事，李士材三书言之详矣，兹集隘不能多登，止取张景岳“十问”而
(出《景岳全书》，张心在改订)
一问寒热二问汗（问其寒热多寡，以审阴阳，细辨真假，问其汗之有无，以辨虚寒，以别
虚实，）三问头身四问便，（问其头痛为邪甚，不痛为正虚，暴眩为风火与痰、渐眩为上虚气陷
。问其身之部位以审经络，亦以一身重痛为邪甚，软弱为正虚。问其小便红白多少，大便秘
溏、清谷、清水，以别寒热虚实，）五问饮食六问胸（问饮食以察其胃气之强弱，问胸者兹胃口而言也
。浊气上干，则胸满痛为结胸，不痛而胀连心下为痞气，七聋八渴俱当辨，（问聋者，伤寒以辨
其在少阳与厥阴，杂病以聋为重，不聋为轻也。问渴者，以寒热虚实俱有渴。大抵以口中和
，索水不欲饮者为寒，口中热，引饮不休者为热，大渴谵语不大便者为实，时欲饮水，饮亦
不多，二便通利者为虚证，）九问旧病十问因，）问旧病以知其有夙疾与否，问其致病之因以为用药之
准，）再兼服药参机变（表、里、寒、热，补泻之中自有神机变化之妙。）妇人尤必问经期，迟速
闭崩皆可见（妇人以经为主，问其有无迟速，以探病情，兼察有孕与否。）再添短语告儿科，天
花麻疹全占验（小儿欲作痘疹与外感同，宜辨其手中指，足胫，耳后筋色为据。
言语细微而严厉，是盛衰的根本；谵语（神志不清，胡言乱语）多因实邪（如胃中有燥屎），错语（神志恍惚，前后言语不相顾盼而错乱）多属虚证，呃逆声低微且伴有痰鸣并非吉兆，声音改变或旧病复发恐怕是离魂之象。
肝气愤怒则发出呼喊声，心气喜悦则发出笑声，脾主思虑则发出歌声，肺金主忧悲则表现为哭泣，肾主呻吟恐怕也较多见。
询问症状是医家的第一要务，李士材在《三书》中论述得很详细了，这里篇幅有限不能多收录，只选取张景岳的“十问”并加以注释：
一问寒热与二问汗（询问其恶寒发热的多少，以审察阴阳，仔细辨别真假；询问其出汗的有无，以辨别虚寒，区分虚实。）
三问头身与四问二便（询问头痛是因为邪气盛重，不痛则是正气虚弱，突然眩晕是风火与痰所致，逐渐眩晕则是上虚气陷。询问身体疼痛的部位以审察经络，全身沉重疼痛为邪气盛重，软弱无力为正气虚弱。询问小便颜色红白及多少，大便干结或溏泄、完谷不化或清水样便，以此辨别寒热虚实。）
五问饮食与六问胸脘（询问饮食情况以观察胃气的强弱。询问胸脘是指胃口而言。浊气上犯，则胸满痛为结胸证，不痛但胀闷连及心下为痞气证。）
七问耳聋与八问口渴（询问耳聋，伤寒病用以辨别病在少阳经还是厥阴经，杂病中以耳聋为重证，不聋为轻证。询问口渴，因为寒热虚实都可能出现口渴。大致来说，口中平和，想喝水但不欲饮的为寒证；口中发热，引水饮用不止的为热证；大渴、谵语、不大便的为实证；时常想喝水，但喝得不多，大小便通利的为虚证。）
九问旧病与十问病因（询问旧病以知道是否有宿疾，询问致病原因作为用药的依据。）
再兼看服药后的反应以参悟机变（表里、寒热、补泻之中自有神妙变化的机理。）
妇人尤其必须询问月经情况，周期迟速、闭经或崩漏都能反映病情（妇人以经血为主，询问其有无、迟速，以探知病情，兼察是否怀孕。）
再添几句短话告知儿科医生，天花和麻疹的诊断全凭占验（小儿即将出痘疹时与外感病相似，宜以手中指、足胫、耳后筋络的颜色为依据进行辨别。）
Subtle yet stern speech indicates the root of decline or prosperity; delirium (incoherent and confused speech due to loss of consciousness) stems from excess pathogenic factors (such as dry feces in the stomach), while misstatement (confused speech where words do not correspond to thoughts, indicating mental disarray) suggests deficiency. Low-pitched hiccups accompanied by phlegm rales are not auspicious signs, and changes in voice or recurrence of old symptoms may fearably indicate "separation of the soul."
Anger of the Liver manifests as shouting; joy of the Heart manifests as laughing; thinking of the Spleen manifests as singing; sorrow of the Lung Metal manifests as crying; groaning associated with the Kidney is also likely frequent.
Inquiring about symptoms is the primary duty of a physician. Li Shicai discussed this in detail in his *Three Books*. Due to space limitations here, we cannot include much, so we only adopt Zhang Jingyue's "Ten Questions" with annotations:
First, inquire about chills and fever, and second, about sweating (Ask about the degree of chills and fever to examine Yin and Yang, carefully distinguishing true from false patterns; ask about the presence or absence of sweating to distinguish deficiency-cold and differentiate between excess and deficiency.)
Third, inquire about the head and body, and fourth, about urination and defecation (Ask if headache indicates severe pathogenic factors or if lack of pain indicates deficiency of healthy Qi. Sudden dizziness is due to wind-fire and phlegm; gradual dizziness is due to deficiency of upper Qi sinking. Ask about the location of body pain to examine meridians; general heaviness and pain indicate severe pathogens, while weakness indicates deficiency of healthy Qi. Ask about the color and volume of urine, and whether stool is constipated, loose, contains undigested food, or is watery, to differentiate cold-heat and excess-deficiency.)
Fifth, inquire about diet, and sixth, about the chest and epigastrium (Ask about diet to observe the strength of Stomach Qi. Asking about the chest refers to the epigastric region. If turbid Qi rises to interfere, fullness and pain in the chest indicate *Jie Xiong* [Chest Binding]; distension without pain extending to the epigastrium indicates *Pi Qi* [Pi Syndrome].)
Seventh, deafness, and eighth, thirst (Ask about deafness: in Shaoyang diseases, it helps distinguish involvement of the Shaoyang or Jueyin meridians; in miscellaneous diseases, deafness is a heavy sign, while non-deafness is light. Ask about thirst, as it occurs in cold, heat, excess, and deficiency patterns. Generally, if the mouth feels neutral and the patient desires water but does not want to drink, it is cold; if the mouth feels hot and the patient drinks continuously, it is heat; extreme thirst with delirium and constipation indicates excess; occasional desire to drink small amounts with free urination and defecation indicates deficiency.)
Ninth, old diseases, and tenth, causes (Ask about past illnesses to know if there are chronic conditions; ask about the etiology of the current illness to guide medication.)
Additionally, consider the effects of previous medications to understand subtle variations (Within the treatments for exterior/interior, cold/heat, tonification/reduction, there are divine mechanisms of change.)
For women, menstruation must specifically be asked about; delays, rapidity, amenorrhea, or metrorrhagia can all be observed (Women are governed by menses; asking about their presence, timing, and flow helps probe the condition and check for pregnancy.)
Add a few short phrases for pediatrics: diagnosis of smallpox and measles relies entirely on observation (When children are about to erupt with pox/measles, it resembles external contraction; one should use the color of the tendons in the middle finger, lower legs, and behind the ears as evidence for differentiation.)