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  • Difficulty falling asleep (HT Blood or Yin deficiency), excessive dreaming (GB/HT disturbance), early waking (LR Yin Deficiency)

  • Sleeping too much (Damp), insomnia (Shen disturbance)

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Reflects Heart, Liver, Spleen, Kidney, and Shen balance

Sleep
(睡眠)

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  • Mood fluctuations, anxiety, irritability, depression, worry

  • Sudden emotional changes, history of trauma or emotional suppression

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Essential for understanding Liver Qi, Heart Shen, Spleen overthinking, Kidney fear, and emotional aetiology of disease

Emotions and Mental State
(情志)

  • Appetite level, food cravings, aversions

  • Thirst (excessive = Heat; lack = Cold), taste in mouth (bitter = LR/GB Heat)

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Key for diagnosing Middle Jiao, ST Heat, SP Dampness, Yin Deficiency

Appetite, Thirst, Taste
(饮食口味)

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  • Chest oppression (LU or HT), epigastric pain (ST), distension (Qi stagnation), hypochondriac pain (LR)

  • Palpitations (HT), rib-side pain (LR Qi stagnation), bloating (SP deficiency)

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Indicates involvement of Zang-Fu, Qi movement, Blood stasis, Phlegm

Thoracic and Abdominal Symptoms
(胸腹)

  • Do you feel hot or cold?

  • Are you more sensitive to warmth or cold?

  • Do you have chills, fever, night sweats, spontaneous sweating?

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Helps identify Yin/Yang, Interior/Exterior, Cold/Heat, Deficiency/Excess.

Cold and Heat
(寒热)

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  • Presence, absence, timing, quality of sweat

  • Spontaneous (Qi deficiency), night sweats (Yin deficiency), profuse (Heat), lack of sweating (Cold)

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Related to Wei Qi, Yin-Yang balance, Lung and Heart function.

Sweating (汗)

Asking

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Asking (问诊 wèn zhěn) is a vital component of the Four Diagnostic Methods (四诊 sì zhěn), alongside Looking (望), Listening/Smelling (闻), and Palpation (切). The role of Asking is to gather subjective information directly from the patient, helping the practitioner understand what the patient feels and experiences, which cannot be seen or heard externally. It allows for the deepest insight into internal patterns and the most complete understanding of the nature, location, and cause of disease. Purpose and Importance of Asking in TCM Diagnosis include:

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  • Clarifies the patient’s experience: sensations, habits, symptoms

  • Identifies internal conditions that may not manifest externally

  • Reveals the root of imbalance: organ dysfunction, Qi-Blood status, emotional causes

  • Guides pattern differentiation (辨证): matches signs with one or more diagnostic frameworks

  • Helps track disease progression, treatment response, and prognosis

 

Unlike visual or tactile signs, asking brings out nuanced details about the patient’s constitution, lifestyle, emotional state, and functional complaints, which are indispensable for accurate diagnosis.

  • Type, location, nature, timing of pain

  • Headache: location (Tai Yang, Shao Yang, etc.), sharp/dull, worse with cold/heat

  • Body pain: soreness (deficiency), fixed pain (Blood stasis), migrating (Wind)

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Relates to meridian blockage, Qi-Blood, Wind-Cold-Damp invasion

Head and Body Pain (头身痛)

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  • Frequency, colour, texture, urgency

  • Diarrhea (SP/KI Yang Xu), constipation (Heat or Yin Xu), dark/burning urine (Damp-Heat), enuresis (KI Qi Xu)

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Direct insight into SP/ST, KI/BL, LI functions, Damp, Heat, Qi flow

Urine and Stool
(二便)

  • Menstrual cycle: length, flow, colour, pain, clots, PMS

  • Fertility, libido, pregnancy history

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Diagnoses Chong/Ren dysfunction, Blood/Yin deficiency, Qi/Blood stagnation, Damp-Heat

Gynaecological or Reproductive Health (妇科)

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  • Developmental milestones, feeding, crying, sleep, vein examination

  • Inquiry about skin, hearing, vision, tongue sensation, body temperature patterns

Paediatric and Other Special Questions

Asking in TCM works hand-in-hand with Looking: to confirm visual signs (e.g. fatigue and pale complexion = Qi/Blood Xu), Listening/Smelling: to identify additional clues (e.g. cough, breath odour) and Palpation: particularly pulse diagnosis, which often validates patient-reported symptoms. Together, these methods create a full pattern differentiation (辨证论治) that guides the treatment plan.
 

Asking is the most direct way to understand the patient's experience. It helps differentiate internal vs external, Cold vs Heat, Excess vs Deficiency, Qi, Blood, or organ pathology. Covering a wide spectrum: digestion, urination, defecation, emotions, menstruation, sleep, pain, it is essential for identifying Zang-Fu organ patterns, emotional causes, constitution, and lifestyle triggers. It’s a deeply personalized diagnostic tool, requiring empathy, active listening, and pattern recognition from the practitioner.

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