典藏书目

Ask first about cold and fever, second about sweating, third about the head and body, fourth about urination and defecation, fifth about diet, sixth about the chest and abdomen, seventh about deafness, eighth about thirst; all these should be carefully differentiated. Ninth, observe Yin and Yang through pulse and complexion; tenth, perceive Shen (Spirit) from voice and qi appearance. Although making a diagnosis based on these observations is not difficult, one must remain wise and prudent to avoid resentment.

The aforementioned Ten Questions are the essential guidelines for inviting a physician and the primary task in clinical practice. Understanding these Ten Questions means that the Six Transformations (Yin, Yang, Exterior, Interior, Cold, Heat) are all contained within, and the forms and conditions of myriad diseases are all within my vision. The difficulty in medicine lies in failing to recognize the root of the disease and administering incorrect treatment. Incorrect treatment kills people, and the Way of Heaven is awe-inspiring; correct treatment saves people, and hidden virtue is boundless. Those who wish to master this path must first examine these essentials to establish their understanding and use them as a stepping stone, then consult various books to broaden their knowledge, how could they make mistakes? If one can memorize these in the mind and apply them with ease, it benefits not only others but also oneself significantly. Be cautious and treasure them.

Asking about cold and fever refers to inquiring about internal and external cold and heat, aiming to differentiate whether the pathogen is in the Exterior or the Interior. When humans are injured by Cold pathogens, they develop fever. Therefore, whenever there is body heat, tight pulse, headache, body pain, stiffness without sweating, and the onset is sudden, it must be an External Contraction (Exogenous Disease). Because Cold pathogens are in the meridians, there is headache and body pain; because pathogens block the skin and hair pores, there is stiffness and fever. If a person has no prior illness but suddenly presents with such pulses and symptoms, it is mostly due to External Contraction. Since Cold pathogens are not inherent to the body but appear suddenly, this is an Exterior Syndrome. If there is no Exterior Syndrome but the body heat does not resolve, it mostly belongs to Internal Injury, yet there must be corresponding Internal Symptoms. Examining them together will naturally reveal the truth.

First, if body heat persists for ten days or even a month without resolving, it may still belong to an Exterior Syndrome. This is because initially, Cold pathogens were contracted, causing body heat and headache. If the physician fails to differentiate and mistakenly identifies it as Fire, using Cold-Cooling herbs causes the pathogen to fail to disperse. Or, although dispersal treatment was used, the medicinal power did not reach the disease site, causing the pathogen to linger in the meridians. Such diseases present with more Exterior symptoms than Interior symptoms; this is not an Interior condition, and dispersal treatment should still be applied.

Second, fevers arising from Internal Symptoms mostly belong to Yin Deficiency, or are due to accumulated Heat. However, there must be corresponding Internal Symptoms, and the onset is gradual. Yin Deficiency inevitably injures Jing (Essence); injuring Jing inevitably affects the Zang-Fu organs. If it affects the Lung above, there must be panting, rapid breathing, and coughing; if it affects the Spleen in the middle, there may be impaired appetite, mental restlessness (Ao Nu), or irritability and parched thirst; if it affects the Kidney below, there may be seminal emission, dribbling, or loss of control over urination and defecation. Typically, there are alternating sensations of heat and cold, occurring intermittently, or weak Qi and faint voice. These are all signs of Yin Deficiency.

Third, fevers caused by anger and the Seven Emotions damaging the Liver and Zang-Fu organs generally belong to a deficiency of True Yin, allowing Evil Fire to easily flourish; this is also Yin Deficiency.

Fourth, fevers caused by fatigue and overwork damaging the Spleen occur because Spleen Yin is insufficient, making it susceptible to injury. Once injured, heat arises in the muscle layer; this is also Yin Deficiency.

Fifth, internally damaged accumulated Heat manifests with physical signs in the Qi level and clear indications in the Blood and Qi levels, such as heat in the nine orifices above and below, or heat in the Zang-Fu organs within the San Jiao (Triple Burner). If it is indeed Excess Heat, where Fire damages the形体 (physical form) without involving the True Yuan (Primordial Qi), the patient's physique, Qi, voice, and pulse will naturally appear robust and magnificent, providing ample evidence for examination. This should be treated as Excess Fire.

Sixth, Cold syndromes are particularly obvious. External Cold indicates a deficiency of Yang Qi at the Exterior; Internal Cold indicates a decline of Fire (Mingmen Fire) in the Middle. As described in previous cases. Generally, Heat syndromes are mostly Excess, while Deficient Heat is the most prone to misdiagnosis; Cold syndromes are mostly Deficiency, though Excess Cold occasionally occurs. The differentiation of Cold and Heat in the Exterior versus the Interior must not be overlooked.