(c). Chills without fever （c）寒战无热
It implies that the patient only has an
它提示了病人只有恶
aversion to cold but no heat sensation or fever,
寒没有热感或发热，这是
which is a sign of the deficiency and cold
虚寒证的征象。
syndrome.
(d) Fever without chills
（d）发热无战
This suggests that the patient with fever has
这提示了病人发热恶
a aversion to heat but not to cold, which pertains
热而不恶寒，属于里热证。
to interior heat syndrome. B. Asking about Perspiration
B.问汗
This is a procedure for the physician to differentiate the conditions of interior and
这是医生区分疾病表
exterior, heat and cold, deficiency and excess
里、寒热、虚实的一个步
of a disease. Asking about perspiration includes
骤。问汗包括出汗的部位、
the presence of sweating, the location of
时间和数量。
sweating, the time of sweating and the amount of sweating.
C. Asking about Diet and Appetite Asking diet and appetite may know the conditions of the spleen and stomach. It includes: thirst and drinking appetite and amount of food taste.
D. Asking about Defecation and Urination
C.问饮食
问饮食可以了解脾胃的状况，包括：渴、饮、胃口和饭量。 D.问二便
This is also a procedure in which the physician 这也是医生了解消化may learn whether the digestion and absorption 吸收和水液代谢是否正常as well as fluid metabolism are normal or not, 的一个程序，可以了解粪and also learn about frequency, time, amount, 便和尿液的次数、时间、quality, color, odor of defecation and urination 数量、质地、颜色、气味and accompanied syndromes. 和伴随症状。 E. Questioning about Pain
E.问痛
(a) Asking about nature of the pain helps tell （a）问疼痛的性质可以帮the cause and pathogenesis; 助了解病因和病机 (b) Asking about locality of the pain helps understand pathological changes of internal organs and meridians; F. Questioning ahout Sleep
It refers to inquiring about insomnia, dreaminess and lethargy to know excess and deficiency of yin and yang.
（b）问疼痛的部位可以帮助了解脏腑经络的病理改变。 F.问睡眠
指的是询问失眠、多梦和昏睡以了解阴阳的虚实。
Besides, chest and abdomen, ears and eyes, 除此之外，还可以询women's diseases， pediatric diseases may be 问胸腹、眼耳、妇科和儿
asked.
4. Pulse-taking and Palpation
科疾病。 4.切
It is the fourth diagnostic methnd, including 这是第四种诊断方pulse-taking and, on the other, palpation of 法，包括切脉和按压身体different parts of the body. The former is a 的其它部位。前者是通过diagnostic procedure by which the physician may 医生的指尖感觉患者桡侧feel the patient's radial arteries with the 腕部动脉以判断脉的状况finger-tips to judge pulse condition, thus 的一个诊断步骤，从而了learning and inferring the condition of illness. 解和推断疾病的状况。后The latter is also a procedure by which the 者也是医生通过触摸、感physician may touch, feel, push and press certain 觉、推和按身体的一定部parts of the body to detect local abnormal 位，检查局部异常改变的changes, thereby determining the location and 一个步骤，因此，可以确nature of the disease. 定疾病的部位和性质。 The location for feeling the pulse at present time is the patient's \\
pulsative place of the radial artery on both 现今按脉的部位是病sides of the wrist, and is divided into three 人的“寸口”，也叫“气regions: cun, guan and chi (inch, bar and cubit), 口”或“脉口”。寸口指which, on the left hand, reflect respectively the 的是双侧腕部桡动脉明显conditions of the heart, liver and kidney and, 搏动的位置，可以分为三on the right hand, the conditions of the lung, 个区域：寸、关、尺，左the spleen, the stomach and the kidney. TCM holds 手单独反应的是心、肝、that each of the six regions for pulse-feeling 肾的状况，右手反应的是corresponds to one of the internal organs and 肺、脾胃和肾的状况。中reveals the pathologic changes of the relevant 医认为切脉的每一个部位organ. For this reason, cunkou pulse-taking is 都与内脏之一相对应，可commonly accepted by practitioners through the 以揭示相关器官的病理变ages and still used today. The pulse is 化。因此，寸口取脉历时differentiated in terms of depth (superficial or 沿用至今，受到临床医师deep), speed ( rapid or slow), strength (forceful 的普遍承认。脉应区分其or weak), shape ( thick or thready, soft or hard) 的沉浮、快慢、强弱、形and rhythm. Different pulse condition indicate 状和节律。不同的脉象提different syndromes. For example, superficial 示不同的证候。例如，浮pulse (fu mai), which is easily felt with gentle 脉轻按则得，提示表证和touch, indicates exterior syndromes and is 表证早期得表现；而沉脉present at the early stage of exogenous diseases; 重按则得，提示里证，等。 while deep pulse( chen mai), which is felt only by heavy pressure, indicates interior syndromes, and so on.
Palpation may be conducted in three 按诊可以通过三个步procedures: touching, stroking and pressing. 骤进行：触、扣、按。触
Touching is used to feel a certain part of the 用于感觉身体得某一部body, like the forehead or limbs with the fingers 位，如通过触摸额、四肢of palms, thereby detecting the body 的指掌，观测体温、燥湿；temperature, dampness or dryness; stroking 扣是指用手检查病人身体refers to examining the patient's some parts of 的一些部位，如扣膨出的the body with the hands, e.g., a swelling, to 部位可以感觉膨出的形状learn the shape, size and sensation of the 和大小；按指的是用手推swelling； pressing means pushing and pressing 和按压身体的一些部位，over some parts of the body with the hands, e. 例如，按压胸腹可以确定g. , the chest or abdomen, to make sure if they 它们是否紧张，有无结块。 are tenderness, or have any cakings when pressed. Inspection, auscultation and olfaction,
望、闻、问、切是了
inquiry and pulse-taking and palpation are the
解病理状况的四种诊断方
four diagnostic methods to understand the
法。它们不能相互分离，
pathological conditions. They can not be
而是相互联系、相互补充
separated, but are related to and complement one
的。临床实践中，只有把
another. In clinical practice only by combining
四诊结合起来，才能综合
the four can a comprehensive and systematic
的、系统的了解疾病的状
understanding of the condition of a disease be
况，从而做出正确的诊断。
gained, thereby, making a correct diagnosis.
DIFFERENTIATlON OF SYNDROMES——THE PRECONDITION FOR TREATMENT
辨证—治疗的前提
Differentiation of syndromes (bian zheng)
中医的辨证是一种
in TCM is a method to analyse and recognize the
分析和认识疾病证候的方
syndrome of disease. In otherwords, it is also
法。换言之，它也是根据四
a process in which the location, nature,
诊收集的临床资料确定疾
occurrence and development of a disease as well
病的位置、性质、发生和发
as the condition of vital qi and pathogenic
展以及邪正状况的一个过
factors are identified according to the clinical
程。从以上可以明显的知道
data obtained from the four diagnostic methods.
辨证是治疗的前提和基础。
From the above it becomes obvious that
正确的辨证和适当的治疗
differentiation of syndromes is the premise and
是取得好的治疗效果的先
foundation of treatment. Correct
决条件。中医有许多辨证的
differentiation and appropriate treatment are
方法，如根据八纲辨证；气
the prerequisite for achieving the hoped-for
血津液辨证；脏腑辨证；六
results. There are a number of methods to
经辨证；卫气营血辨证和三
differentiate syndromes in TCM, such as
焦辨证。每种方法都有自己
differentiation of syndromes according to the
的特点和侧重点，必须准确
eight principles; differentiation of syndromes
灵活的应用才能综合的了
according to the theory of qi, blood and body
解疾病，从而为治疗提供基
fluid; differentiation of syndromes according
础。
to tbe zang-fu theory; differentiation of
syndromes according to the theory of six meridians; differentiation of syndromes according to the theory of wei, qi, ying and xue, and differentiation of syndromes according to the theory of triple energizer. Each method, while having its own features and laying stress They should be applied flexibly and accurately so as to understand a disease comprehensively, thereby providing the basis for treatment.
The eight principal syndromes, also known as \yang, exterior, interior, cold, heat,
deficiency and excess. The differentiation of
syndromes according to the eight principles is 八个证候总纲也称the general guideline of TDS and important “八纲”指的是阴、阳、表、components of TCM diagnostics. Complicated as 里、寒、热、虚和实。八纲the clinical manifestations of diseases may be, 辨证是中医的总的指导，是they are classified under the eight principles. 中医诊断的重要组成部分。
For example, the classification of 虽然疾病的临床表现很复syndromes-yin or yang; the location of 杂，但都可以根据八纲归disease-exterior or interior; the nature of 类。例如，阴证和阳证的归disease-cold or heat; and the preponderance or 类；表病和里病的定位；疾
discomfiture of vital qi and 病的寒热性质；正邪的盛衰
pathogens-deficiency of vital qi or excess of 和虚实。八纲辨证将复杂易
pathogen. Differentiation of syndromes 变的证候归为四对：表里、according to the eight principles generalizes 寒热、虚实和阴阳。因此，the intricate and volatile syndromes into four 在诊断过程中，八纲辨证是pairs: exterior and interior, cold and heat, 必须的。 deficiency and excess, and yin and yang. Therefore, in the diagnostic process, the eight principles can play a role in bring out the
essentials. Although this differentiating method 虽然这种辨证方法将classifies various syndromes into eight 不同的证候分成八类，但是categories, they are interrelated and 它们之间是相互联系、不可inseparable from each other. For instance, the 分离的。例如，表里证和寒exterior syndrome and interior syndrome are 热、虚实证相关；寒热证和related to the cold, heat, deficiency and excess 表里、虚实证相关；虚实证syndromes; the cold syndrome and heat syndrome 和寒热表里证相关。这些病are related to the exterior, interior deficiency 理并不是单独发生，而是表and excess syndromes; the deficiency syndrome 里、寒热、虚实证通常同时and excess syndrome are related to cold, heat, 出现。例如，表里证混杂的
exterior and interior syndromes. These 疾病；虚实夹杂的疾病；寒pathologic changes do not occur singly, the 热夹杂的疾病。在一定条件