Chinese Medicine Diagnosis (Part III): Questioning

Chinese Medicine Diagnosis (Part III): Questioning

Questioning is where the Chinese medicine practitioner collects information about your health and your body through asking questions.

Through the questions the practitioner will ask about your current symptoms, as well as the history of the symptoms, the onset and development of your condition and your treatment history, your family history, lifestyle, living and working environment.

Throughout the consultation the practitioner and the client both need to be patient and spend the time to describe and collect all of the information needed, especially for the initial consultation where around thirty minutes is usually required.

1. What do we ask during questioning?

In this paragraph I will list the common questions that we ask during questioning which are important for diagnosis.

During a consultation your practitioner will not ask you all of these questions and may focus on those which are relevant to your health issue.

(i) Does your body feel hot or cold?
This question is to determine how your body reacts due to environmental factors. such as heat and cold, and also how your body itself feels generally, either more hot or more cold. This information can help us to determine how the Yin and Yang in your body is changing, as well as how the characteristics of pathogenic factors (the cause of disease) have affected your body (eg. cold wind or excess heat).

Some examples for this section include:

a) Cold hands and feet with loose and pale yellow stools: May indicate Spleen Yang or Qi deficiency.

b) Body feels hot while sleeping, thirst, dry skin, constipation or dry stools and lower back pain: May indicate Kidney Yin deficiency.

c) Uncomfortable feeling or pain and cramping in stomach after eating cold food: May indicate Cold or Stagnation in your abdomen area.

d) Body feels hot with perspiration, headache, sneezing and sore throat: May indicate that the body has been attacked by exterior pathogenic heat (commonly associated with the common cold, flu or virus).

(ii) Does your body have abnormal sweating?
Abnormal sweating (perspiration) usually indicates a deficiency or excess of certain organs, and the character or cause of the disease. Some examples for this section include:

a) Body is easy to perspire with movement and general activities, with shortness of breath, palpitations, lack of energy: May indicate Heart Qi or Yang deficiency.

b) Perspiration on the head with a hot body, red face, bad breath, constipation or dry stools and cough: May indicate heat in the Lung and Large Intestine.

c) Body perspires on the palms and underarms with stress, anxiety, insomnia and palpitations: May indicate a Liver and Heart disorder.

(iii) Do you experience symptoms with your head or body?
This information can help the practitioner to determine the location of the problem, and also the relationship or association with certain internal organs and channels. In this section we ask questions about headaches, dizziness, body pain, stiffness, numbness or heaviness, bloating and any other uncomfortable symptoms. Some examples for this section include:

a) Numbness or pain in the little finger: May indicate a blockage in the Heart and Small Intestine channel.

b) Pain or uncomfortable feeling in the hypochondriac area with migraine headache and stress: May indicate a Liver and Gall Bladder disorder.

c) Pain on the forehead with a blocked nose, sneezing and dripping mucous from the nose to the throat: May indicate a Lung disorder and blockage of the Large Intestine, Urinary Bladder and Du channels.

(iv) Do you have abnormal bowel movements or urination?
This section is very important. Through information about your bowel movements and urination the practitioner can determine the cause of your disease. I have written separate articles on bowel movement and urination. If you are interested in further details on this topic please refer to other articles on our website.

(v) Do you have abnormal thirst or dislike drinking fluids?
This section is important to detect changes of Yin and Yang in the body and the character or cause of the disease (pathogenic heat and cold). Some examples for this section include:

a) While you are sick you feel very thirsty, drink a lot of water, the body is hot with a red face and constipation: May indicate an excessive heat condition.

b) Only feel thirsty while sleeping and wake needing to drink water: May indicate Yin deficiency or weakness.

c) While you are sick you dislike to drink water with bloating, heavy sensation in the body, puffy and swollen ankles and legs and sluggish bowel movements: May indicate the body may have stagnation from the fluids (For this issue our experience is that the body needs to get rid of the fluid first, through treatment, before the person will feel like drinking water again).

(vi) Do you have difficulty sleeping?
There are different types of sleep issues with symptoms of difficulty to fall asleep, waking up early, waking up frequently throughout the night or excessive dreaming. They each indicate different internal organ disorders. I have written certain articles about insomnia, so if you are interested in further information please refer to the specific articles on the website.

(vii) Do you have abnormal symptoms with your eating?
In this section we check your digestive system and the other internal organs that are associated with the diet and eating. Usually we will pay attention to the symptoms in the body before or after eating and food preferences or cravings. Some examples for this section include:

a)The body craves sweet foods with sluggish or loose bowel movements, bloating, lack of energy, shortness of breath, heaviness and puffiness in the legs and arms: May indicate Spleen Qi deficiency.

b) Low appetite or discomfort and pain after eating with constipation, burping and bad breath: May indicate Food Stagnation in your digestive system.

(viii) Women’s health issues: Do you have abnormal symptoms?
Chinese medicine believes that women’s bodies have their own unique characteristics. Common problems may affect and cause women’s health issues and vice versa (women’s health issues may cause common problems with other internal organs also).

The questions asked usually include menstruation (cycle, amount and colour of bleeding, blood clots, period pain and location, and premenstrual tension), discharge (colour, amount, odour), pregnancy history and issues, and menopausal symptoms. Some examples for this section include:

a) Period delayed with dark or brownish bleeding or blood clots, period pain (especially on lower abdomen area), breast fullness and tenderness before the period, headaches on each side of the head or on top of the head: May indicate Liver Qi and Blood disorder.

b) Abnormal discharge which is excessive, yellow, sticky and with a strong odour: May indicate Damp and Heat in the lower abdomen and lower back area.

c) Early Menopause with no period or irregular periods, dry skin, hot flushes and sweating, lower back pain, frequent urination at night-time: May indicate a Kidney Yin and Yang disorder.

(ix) Children: Special issues
Chinese medicine considers a child’s constitution and body conditions to be very different to that of an adult. The history of birth, development and diet are important factors to consider in young children. Some examples for this section include:

a) Bedwetting with a pale face, lack of energy, may be slightly behind their peers in class: May indicate Kidney Essence, Yin or Yang deficiency.

(x) Others
For certain cases there are specific questions that need to be asked individually, such as pregnancy issues for men and women.

2. How can you prepare to answer our practitioner’s questions?

(i) If you read this article before your consultation you will be more prepared and understand why the questions are being asked.

(ii) If you haven’t read this article before attending your consultation, it is still not hard for you to answer the questions asked. You simply need to tell us the facts about your body’s signs and symptoms. If you cannot remember or are not sure, you do not need to answer that day, you can take notice before your next appointment and let the practitioner know. It will not affect our diagnosis too much.

(iii) In the case of certain questions you are unable to answer or prefer not to answer, it is ok, and should not affect our diagnosis.

All of our practitioners are very friendly and want you to feel relaxed and comfortable during your consultation. We hope you will enjoy the experience and learn more about your body as well!

Next, learn about Palpation in Chinese medicine diagnosis.

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Dr Ping Wang is the clinic founder and senior practitioner of Ping Ming Health. She has over 30 years of experience in traditional Chinese medicine teaching and practice. Dr Ping especially enjoys sharing her knowledge of Chinese medicine through our popular clinic articles, seminars and clinical training of students and practitioners.