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Chapter 1 Introduction 1

Section 1 The Main Contents of Diagnostics of TCM 2

I. Diagnostic Method 2

II. Syndrome Differentiation 4

Section 2 The Principles of Diagnosis in TCM 5

I.Holism 5

II.Applying Four Diagnostic Methods in Combination 7

III.Differentiating the Syndrome of a Disease 8

Section 3 The Brief History of TCM Diagnostics 9

Chapter 2 Observation 17

Section 1 Observing Vitality, Color, Figure and Posture 17

I.Vitality 18

II.Color 22

III.Figure 29

IV.Posture 32

Section 2 Local Observation 33

I.Head Observation 33

II.Face Observation 34

III.Hair Observation 34

IV.Eye Observation 35

V.Ear Observation 38

VI.Nose Observation 38

VII.Lip Observation 39

VIII.Tooth and Gum Observation 39

IX.Throat Observation 40

X.Neck Observation 40

XI.Chest and Abdomen Observation 41

XII.Lumbus and Back Observation 42

XIII.Limb Observation 42

XIV.Genital and Anus Observation 45

XV.Skin Observation 46

Section 3 Observation of Excreta 50

I.Observing sputum, Saliva, Nasal Discharge and Spittle 50

II.Observing Vomitus 51

Section 4 Tongue Observation 51

I.The Relation Between Tongue and Viscera 52

II.Significance of Tongue Inspection 52

III.Special Attentions on Tongue Observation 54

IV.Concrete Contents of Tongue Diagnosis 55

1 Tongue Texture 56

2 Tongue Coating 64

3 Combining Consideration of Tongue Texture and Coating 72

4 Tongue Picture in Critical Conditions 76

I.Facial Color Observation 77

Section 5 Modern Research on Observation 77

II.Eye Observation 78

III.Ear Observation 79

IV.Nose Examination 80

V.Mouth and Lip Observation 80

VI.Tongue Examination 81

VII.Hand Examination 84

VIII.Acupoint Examination 84

Chapter 3 Auscultation and Olfaction 86

Section 1 Auscultation 86

I.Voice 86

II.Speech 88

III.Respiration 89

IV.Cough 90

V.Vomiting 91

VII.Belching 92

VIII.Sigh 92

VI.Hiccup 92

IX.Sneeze 93

X.Bowel Rumbling 93

Section 2 Olfaction 94

I.Sputum and Nasal Discharge 94

II.Odor of Mouth 94

III.Sweat 94

IV.Odor of Body 95

V.Menstrual Blood and Vaginal Discharge 95

VI.Stool and Urine 95

VII.Vomit 95

VIII.Odor of Ward 95

Chapter 4 Interrogation 96

Section 1 The Purpose and Method of Interrogation 96

I.The Purpose of Interrogation 96

Section 2 The Contents of Interrogation 97

II.The Method of Interrogation 97

I.General Data 98

II.Life Style and Process 98

III.Family History and Anamnesis 100

IV.Chief Complaint 100

V.History of Present Disease 101

Chapter 5 Palpation 135

Section 1 Pulse Examination 135

I.Location for Pulse Examination 137

II.The Method of Pulse-Reading 143

III.Normal Pulse 146

IV.Morbid Pulse 149

V.Key Points for Pulse-taking and Distinguishing among Morbid Pulses 169

VI.Female Pulse and Infant Pulse 172

VII.Compound Pulse and Solitary Pulse 174

VIII.Between Pulse and Symptoms 175

Section 2 Body Palpation 178

I.Method of Body Pressing 178

II.The Main Content 179

Section 3 The Modern Research On Pulse-Reading 188

I.Objectifying of Pulse-Reading 188

II.Analysis Method of Sphygmograph 189

III.Mechanism of Pulse Formation 190

IV.Clinical Research of Pulse 190

Chapter 6 The Eight Principle Syndrome Differentiation 192

Section 1 Syndrome Differentiation on the Yin and Yang 193

I.Yin Syndrome and Yang Syndrome 193

II.Yin Deficiency and Yang Deficiency 195

III.Yang Depletion and Yin Depletion 196

IV.Yin Rebellion and Yang Rebellion 198

I.Exterior Syndrome and Interior Syndrome 199

Section 2 Syndrome Differentiation on Exterior and Interior 199

II.Syndrome of Both Exterior and Interior 201

III.Entering and Exiting 202

Section 3 Syndrome Differentiation on Cold and Heat 203

I.Cold Syndrome and Heat Syndrome 204

II.Coexistence of Cold and Heat 207

III.Inter-Transformation Between Cold and Heat 207

IV.True and False of the Cold and Heat 208

Section 4 Syndrome Differentiation on Deficiency and Excess 209

I.Deficiency and Excess Syndromes 210

II.Coexistence of Deficiency and Excess 213

III.Inter-Transformation Between Deficiency and Excess 213

IV.True and False of the Deficiency and Excess 214

Section 5 The Modern Research on the Eight Principle Syndrome Differentiation 216

Chapter 7 Etiological Syndrome Differentiation 217

Section 1 Six Evils 217

I.Wind Syndrome 218

II.Cold Syndrome 220

III.Summer-Heat Syndrome 221

IV.Dampness Syndrome 223

V.Dryness Syndrome 224

VI.Fire Syndrome 225

Section 2 Pestilential Evils 226

Section 3 Seven Emotions 228

Section 4 Improper Diet and Overwork 230

I.Food-Retention 230

II.Overwork 231

Section 5 Parasites and Surgical Trauma 232

I.Parasites 232

II.Trauma 233

I.Deficiency of Qi 234

Chapter 8 Qi, Blood and Body-Fluid Syndrome Differentiation 234

Section 1 Qi Syndrome Differentiation 234

II.Qi Sinking 235

III.Stagnation of Qi 235

IV.Rebellion of Qi 236

Section 2 Blood Syndrome Differentiation 236

I.Deficiency of Blood 237

II.Bleeding Syndrome 237

III.Blood-Heat Syndrome 238

IV.Blood Stasis Syndrome 238

V.Blood-Cold Syndrome 239

Section 3 Syndrome Differentiation of Both Qi and Blood 239

I.Qi Deficiency and Blood Stasis 239

IV.Failure of Qi to Control Blood 240

V.Qi Depletion Resulting from Hemorrhage 240

III.Deficiency of Both Qi and Blood 240

II.Qi Stagnation and Blood Stasis 240

Section 4 Syndrome Differentiation of Body Fluid 241

I.Deficiency of Body Fluid 241

II.Retention of Body Fluid 242

Section 5 Modern Research on Qi, Blood and Body-Fluid Syndrome Differentiation 246

Chapter 9 Visceral Syndrome Differentiation 248

Section 1 Syndrome Differentiation on Liver and Gallbladder 249

I.Liver Qi Stagnation and Liver Qi Transverse Invasion 252

II.Liver Fire Flaming Up (Excess Fire in the Liver and Gallbladder) 253

III.Ascending Hyperactivity of Liver Yang 254

IV.Liver Blood Deficiency 255

V.Liver Yin Deficiency 255

VI.Liver Wind Stirring Internally 256

VII.Retention of Cold in Liver Meridian 258

VIII.Liver Qi Deficiency and Liver Yang Deficiency 259

IX.Damp-Heat in Liver and Gallbladder 260

X.Gallbladder Stagnation due to Phlegm Disturbance 261

Section 2 Syndrome Differentiation on Heart and Small Intestine 263

I.Heart Qi Deficiency, Heart Yang Deficiency and Loss of Heart Yang 264

II.Heart Blood Deficiency 265

III.Heart Yin Deficiency 266

IV.Blood Stasis in Heart 266

V.Fire Blazing in Heart 268

VI.Heart Disturbed by Phlegm-Fire 268

VII.Phlegm Covering Heart Orifices 269

Section 3 Syndrome Differentiation on Spleen and Stomach 270

II.Spleen Qi Sinking 272

III.Failure of Spleen to Control Blood 273

IV.Spleen Yang Defi?ncy 274

V.Spleen Encumbered by Cold-Dampness 275

VI.Stomach Cold 276

VII.Damp-Heat in Spleen and Stomach 277

VIII.Stomach Heat 278

IX.Stomach Yin Deficiency 278

X.Spleen Yin Deficiency 279

XI.Food-Retention in Stomach 280

XII.Blood Stasis in Stomach 281

Section 4 Syndrome Differentiation on Lung and Large Intestine 281

I.Lung Qi Deficiency 282

II.Lung Yin Deficiency 283

III.Wind-Cold Attacking Lung 284

IV.Cold in Lung 284

V.Phlegm and Fluid-Retention in Lung 285

VI.Wind-Heat in Lung 286

VII.Lung Clogged with Heat 286

VIII.Dryness in Lung 287

IX.Damp-Heat in Large Intestine 288

X.Deficiency-Cold of Large Intestine 289

XI.Loss of Large Intestine Fluid 289

Section 5 Syndrome Differentiation on Kidney and Urinary Bladder 290

I.Kidney Yang Deficiency 291

II.Kidney Yin Deficiency 292

III.Kidney Essence Insufficiency 293

IV.Unconsolidation of Kidney Qi 294

V.Failure of Kidney to Receive Qi 294

VI.Damp-Heat in Urinary Bladder 296

Section 6 Syndrome Differentiation on Compound Visceral Syndromes 297

I.Qi Deficiency of Both Heart and Lung 297

II.Deficiency of Both Heart and Spleen 298

III.Blood Deficiency in Both Heart and Liver 299

IV.Yang Deficiency of Both Heart and Kidney 299

V.Disharmony Between Heart and Kidney 300

VI.Qi Deficiency of Both Lung and Spleen 301

VIII.Yin Deficiency of Both Lung and Kidney 302

VII.Aggression on Lung by Liver Fire 302

IX.Yang Deficiency of Both Spleen and Kidney 303

X.Disharmony Between Liver and Spleen 304

XI.Disharmony Between Liver and Stomach 305

XII.Liver and Kidney Yin Deficiency 306

Section 7 The Modern Research on Visceral Syndrome Differentiation 306

Chapter 10 Meridian Syndrome Differentiation 309

Section 1 Syndromes of the Twelve Regular Meridians 310

I.Syndrome of Lung Meridian of Hand-Taiyin 313

II.Syndrome of Large Intestine Meridian of Hand-Yangming 313

III.Syndrome of Stomach Meridian of Foot-Yangming 314

IV.Syndrome of Spleen Meridian of Foot-Taiyin 314

V.Syndrome of Heart Meridian of Hand-shaoyin 315

VI.Syndrome of Small Intestine Meridian of Hand-Taiyang 315

VIII.Syndrome of Kidney Meridian of Foot-shaoyin 316

VII.Syndrome of Urinary Bladder Meridian of Foot-Taiyang 316

IX.Syndrome of Pericardium Meridian of Hand-Jueyin 317

X.Syndrome of Triple-Jiao Meridian of Hand-Shaoyang 317

XI.Syndrome of Gallbladder Meridian of Foot-Shaoyang 318

XII.Syndrome of Liver Meridian of Foot-Jueyin 318

Section 2 Syndromes of the Eight Extra Meridians 319

I.Syndrome of Du (Governor) Meridian 319

II.Syndrome of Ren (Conception) Meridian 320

III.Syndrome of Chong Meridian 321

IV.Syndrome of Dai Meridian 321

V.Syndrome of Yangwei and Yinwei Meridian 322

VI.Syndrome of Yangqiao and Yinqiao Meridian 323

Chapter 11 Syndrome Differentiation of Exogenous Diseases 328

Section 1 The Six Meridian Syndrome Differentiation 331

I.Taiyang Syndrome 332

II.Shaoyang Synjdrome 336

III.Yangming Syndrome 337

IV.Taiyin Syndrome 338

V.Shaoyin Syndrome 339

VI.Jueyin Syndrome 341

Section 2 Wei-Qi-Ying-Xue (Defence-Qi-Nutrient-Blood) Syndrome Differentiation 344

I.Wei Phase Syndrome 346

II.Qi Phase Syndrome 346

III.Ying Phase Syndrome 348

IV.Xue Phase Syndrome 349

Appendix:Modern Researches on Wei-Qi-Ying-Xue Syndrome Differentiation 350

Section 3 Triple-Jiao Syndrome Differentiation 352

I.Upper-Jiao Syndrome 353

II.Middle-Jiao Syndrome 354

III.Lower-Jiao Syndrome 355

Chapter 12 Medical Record 359

Section 1 The Attentive Items for Writing Medical Record 359

Section 2 The Content of Medical Record 360

第一章 绪论 375

第一节 中医诊断学的基本内容 375

一、诊法 375

二、辨证 376

第二节 中医诊断疾病的基本原则 377

一、整体观念 377

二、四诊合参 377

三、辨别病证 378

第三节 中医诊断学简史 378

第一节 望神色形态 382

一、望神 382

第二章 望诊 382

二、望色 384

三、望形体 387

四、望姿态 388

第二节 望局部 388

第三节 望排出物 395

第四节 望舌 395

一、舌与脏腑的关系 396

二、舌诊的临床意义 396

三、舌诊时的注意事项 397

四、舌诊的内容 397

(一)望舌质 397

(二)望舌苔 401

(三)望舌质合舌苔 404

一、面部色诊 406

(四)危重舌象 406

第五节 望诊的现代研究进展 406

二、目诊 407

三、耳诊 407

四、鼻诊 407

五、望口、唇 407

六、舌诊 408

七、手诊 409

八、穴位诊 409

第三章 闻诊 411

第一节 听声音 411

一、声音 411

二、语言 412

三、呼吸 412

七、嗳气 413

六、呃逆 413

八、太息 413

五、呕吐 413

四、咳嗽 413

九、喷嚏 414

十、肠鸣 414

第二节 嗅气味 414

一、痰与涕 414

二、口气 414

三、汗 414

四、身 414

五、经带 414

六、二便 414

七、呕吐物 415

八、病室气味 415

二、问诊的方法 416

一、问诊之目的 416

第四章 问诊 416

第一节 问诊之目的与方法 416

第二节 问诊的内容 417

一、一般情况 417

二、生活史 417

三、家族史与既往史 418

四、主症 418

五、现病史 418

第一节 脉诊 433

第五章 切诊 433

一、诊脉部位 434

二、诊脉方法 437

三、正常脉象 438

四、病脉与主病 440

五、诊脉要点与鉴别 450

六、诊妇女与小儿脉 452

八、脉与症的关系 453

七、相兼脉象与独异脉象主病 453

第二节 按诊 455

二、按诊的方法 455

二、按诊的内容 456

第三节 切诊的现代研究进展 460

一、脉诊客观化的研究 460

二、脉图分析方法的建立 460

三、脉象形成机理的研究 460

四、脉诊的临床研究 461

第六章 八纲辨证 462

第一节 阴阳辨证 462

一、阴证与阳证 462

二、阴虚证与阳虚证 463

三、亡阴与亡阳 464

一、表证与里证 465

第二节 表里辨证 465

四、阴厥与阳厥 465

二、表里同病 466

三、表里出入 467

第三节 寒热辨证 467

一、寒证与热证 468

二、寒热错杂 469

三、寒热转化 470

四、寒热真假 470

第四节 虚实辨证 471

一、虚证与实证 472

二、虚实错杂 473

三、虚实转化 473

四、虚实真假 473

第五节 八纲辨证的现代研究进展 474

第一节 六淫 476

一、风证 476

第七章 病因辨证 476

二、寒证 477

三、暑证 478

四、湿证 479

五、燥证 480

六、火证 480

第二节 疫疠 481

第三节 七情 482

第四节 饮食劳倦 483

一、食积 483

二、劳倦 484

一、虫证 485

二、外伤 485

第五节 虫证、外伤 485

第八章 气血津液辨证 486

第一节 气病辨证 486

一、气虚证 486

二、气陷证 486

三、气滞证 487

四、气逆证 487

第二节 血病辨证 488

一、血虚证 488

二、失血证 488

三、血热证 488

四、瘀血证 489

五、血寒证 489

第三节 气血同病辨证 489

四、气不摄血证 490

三、气血两虚证 490

五、气随血脱证 490

一、气虚血瘀证 490

二、气滞血瘀证 490

第四节 津液病辨证 491

一、津液不足证 491

二、津液不化证 491

第五节 气血津液辨证的现代研究进展 494

第九章 脏腑辨证 496

第一节 肝与胆病辨证 496

三、肝阳上亢证 498

一、肝气郁结与肝气横逆证 498

二、肝火上炎证 498

四、肝血虚证 499

五、肝阴虚证 499

六、肝风内动证 499

七、寒滞肝脉证 500

八、肝气虚与肝阳虚证 500

十、胆郁痰扰证 501

九、肝胆湿热证 501

第二节 心与小肠病辨证 502

一、心气虚、心阳虚与心阳暴脱证 503

二、心血虚证 503

三、心阴虚证 504

四、心血瘀阻证 504

五、心火亢盛证 505

六、痰火扰心证 505

七、痰迷心窍证 506

第三节 脾与胃病辨证 506

一、脾气虚证 507

二、脾气下陷证 507

三、脾不统血证 508

四、脾阳虚证 508

五、寒热困脾证 508

七、脾胃湿热证 509

六、胃寒证 509

九、胃阴虚证 510

十、脾阴虚证 510

八、胃热证 510

十一、食滞胃脘证 511

十二、血瘀胃脘证 511

第四节 肺与大肠病辨证 511

一、肺气虚证 512

二、肺阴虚证 512

三、风寒束肺证 512

四、寒邪客肺证 513

五、痰饮停肺证 513

六、风热犯肺证 514

七、热邪壅肺证 514

八、燥邪犯肺证 514

十一、大肠液亏证 515

第五节 肾与膀胱病辨证 515

十、大肠虚寒证 515

九、大肠湿热证 515

一、肾阳虚证 516

二、肾阴虚证 517

三、肾精不足证 517

四、肾气不固证 517

五、肾不纳气证 518

六、膀胱湿热证 518

第六节 脏腑兼病辨证 519

一、心肺气虚证 519

二、心脾两虚证 519

三、心肝血虚证 520

四、心肾阳虚证 520

五、心肾不交证 520

九、脾肾阳虚证 521

八、肺肾阴虚证 521

六、肺脾气虚证 521

七、肝火犯肺证 521

十、肝脾不调证 522

十一、肝胃不和证 522

十二、肝肾阴虚证 522

第七节 脏腑辨证的现代研究进展 523

第十章 经络辨证 525

第一节 十二经脉病证 525

第二节 奇经八脉病证 531

第十一章 外感病辨证 534

第一节 六经辨证 535

一、太阳病证 535

二、少阳病证 537

三、阳明病证 537

五、少阴病证 538

四、太阴病证 538

六、厥阴病证 539

第二节 卫气营血辨证 539

一、卫分证 540

二、气分证 540

三、营分证 541

四、血分证 541

附：卫气营血辨证的现代研究进展 542

第三节 三焦辨证 543

一、上焦病证 543

二、中焦病证 544

三、下焦病证 544

第十二章 病案 547

第一节 书写病案的注意事项 547

第二节 病案书写的内容 547