The Main Content of TCM Diagnostics

TCM Diagnostics primarily consists of four major components: diagnostic methods, disease diagnosis, pattern differentiation, and case records.

I. Diagnostic Methods
Diagnostic methods are the techniques for examining the patient and collecting information related to the patient's health. The Four Examinations comprise inspection, listening and smelling, inquiry, and palpation.

According to Chinese medical theory, the human body is an organic whole. Local pathological changes can affect the entire body, and internal pathological changes can be reflected externally. That is to say, external disease manifestations can reveal the essence of internal disease. Therefore, when diagnosing disease, Chinese medicine often infers the patient's internal pathological changes through the patient's subjective sensations and the external manifestations observed by the physician. As stated in the Suwen · Yinyang Yingxiang Da Lun (Basic Questions: Great Treatise on the Correspondences of Yin and Yang): “Knowing the interior from the exterior... in this way, diagnosis will not fail.” This holds that external changes can reflect internal disease. The Lingshu · Wai Chuai (Spiritual Pivot: Inferring from the Exterior) states even more explicitly: “When the five sounds are not clear, and the five colors are not bright, the five zang are in turmoil. In such cases, the internal and the external influence one another, like the drumstick striking the drum, like the echo responding to the sound, like the shadow mirroring the form. Thus, for what is remote, one governs the exterior to infer the interior; for what is close, one governs the interior to infer the exterior.” This holds that changes on the body surface will accurately reflect internal disease. This diagnostic theory of “knowing the interior from the exterior” continues to play a tremendous role in clinical practice to this day.

II. Disease Diagnosis
Disease diagnosis, also called disease differentiation, refers to making a judgment about the type of disease and arriving at a disease name diagnosis. The disease name is a summary and abstraction of the characteristics and patterns of the entire course of a disease. Making a disease name diagnosis is an essential component in clinical specialties such as internal medicine, surgery, gynecology, and pediatrics.

III. Pattern Differentiation
Pattern differentiation is the quintessence of Chinese medicine. To clarify the meaning of pattern differentiation, one must first grasp the concepts of symptom (症), pattern (证), disease (病), and pattern differentiation (辨证).

IV. Case Records
Case records, also called medical records and known in ancient times as diagnostic records (zhenji), are written accounts of relevant clinical diagnostic and therapeutic information. Case records serve as important material for clinical practice, scientific research, and education. Writing case records is a fundamental skill that all clinical practitioners must master; it requires that the patient's detailed disease condition, medical history, diagnosis, treatment, and other relevant information be truthfully recorded.