Eight Principles Diagnosis is a comprehensive framework, as each disease has its unique causes. The core of diagnosis lies in the differentiation of the organs and the clear distinction of Qi (vital energy), Blood, and Jin Ye (body fluids).
For external febrile diseases, the levels of differentiation are crucial in determining the type of disease and its symptoms.
Eight Principles Diagnosis
Exterior Syndrome: Exterior syndrome occurs when pathogenic factors invade the skin and muscles, presenting with nasal congestion, runny nose, headache, and body aches. Symptoms may include chills, fever, absence of sweating, and a cough with a white coating and floating pulse.
Interior Syndrome: Interior syndrome can arise from the transmission of exterior pathogens or from internal factors, indicating that the disease is located deeper within the body. Conditions affecting the organs, Qi, and Blood are classified as interior syndromes, encompassing all non-exterior syndromes.
Cold Syndrome: Cold syndrome results from the invasion of cold pathogens, often associated with Yang deficiency and excessive Yin. Symptoms include aversion to cold, preference for warmth, cold limbs, pale complexion, loose stools, lack of thirst, and a white, slippery, tight tongue coating.
Heat Syndrome: Heat syndrome arises from the invasion of heat pathogens or from excessive Yang and deficient Yin. Symptoms include irritability, thirst for cold drinks, fever, preference for coolness, red face, constipation, and a red tongue with a yellow coating and rapid pulse.
Deficiency Syndrome: Deficiency syndrome indicates insufficient Zheng Qi (correct Qi), leading to a weakened ability to resist disease. Symptoms include thin physique, fatigue, shortness of breath, palpitations, spontaneous sweating, loose stools, pale tongue, and thin, weak pulse.
Excess Syndrome: Excess syndrome indicates an abundance of pathogenic Qi, with Zheng Qi still capable of resisting. Symptoms include coarse breathing, prolonged speech, chest and abdominal distension, pain upon pressure, irritability, constipation, and a thick, old tongue coating with a strong pulse.
Yin Syndrome: Yin syndrome is characterized by aversion to light, quietness, and a weak voice. Symptoms include preference for warmth, cold limbs, spontaneous diarrhea, clear urination, pale tongue, white coating, and a slow, weak pulse, indicating Yang deficiency and excessive cold.
Yang Syndrome: Yang syndrome is characterized by a desire for light, restlessness, and a strong voice. Symptoms include fever, aversion to cold, thirst for cold drinks, constipation, red face, red tongue with yellow coating, and a rapid pulse, indicating excessive Yang and heat.
Yin Deficiency Syndrome: Yin deficiency syndrome presents with thin physique, dizziness, insomnia, dry mouth, and five-center heat. Symptoms include red cheeks, red lips, tidal fever, and a thin, rapid pulse.
Yang Deficiency Syndrome: Yang deficiency syndrome presents with fatigue, cold limbs, and a preference for warmth. Symptoms include pale complexion, pale tongue, and a slow, weak pulse.
Yin Collapse: Yin collapse indicates severe depletion of Yin fluids, with symptoms including excessive sweating, warm hands and feet, thirst for cold drinks, and a red, dry tongue with a thin, rapid pulse.
Yang Collapse: Yang collapse indicates severe depletion of Yang Qi, with symptoms including excessive sweating, cold limbs, weak voice, pale tongue, and a weak pulse.
Diagnosis Based on EtiologySix External Pathogenic Factors
Wind-cold syndrome presents with fever, aversion to wind, sore throat, cough, and headache.
Wind-cold syndrome: pale tongue with thin white coating and floating pulse, with symptoms of skin itching and joint pain.
Cold syndrome: presents with fever, aversion to cold, and absence of sweating, with headache and body aches. Tongue coating is thin white with a tight pulse, and may include vomiting and abdominal pain.
Heat syndrome: (1) Summer heat presents with high fever, thirst, and sweating, with headache and shortness of breath. Tongue is red with yellow coating and rapid pulse, possibly leading to fatigue or convulsions.(2) Heat stroke presents with sudden onset of dizziness and headache, chest tightness, nausea, and dry mouth. Severe cases may lead to fainting, high fever, and excessive sweating.Moisture syndrome:
Moisture invasion presents with heaviness in the head and limbs, with poor urination and a bland taste in the mouth. Symptoms include chest tightness, poor appetite, abdominal distension, and joint pain, with a white, greasy tongue coating and a slow pulse.
Dryness syndrome:
(1) Cool dryness presents with aversion to cold, fever, and absence of sweating, with headache and dry mouth. Tongue is pale with white coating and floating pulse, with nasal congestion and minimal phlegm.
(2) Warm dryness presents with fever, slight aversion to cold, and dryness in the nose and throat. Tongue is red with yellow coating and rapid pulse, with dry cough and thick phlegm.
Fire syndrome presents with high fever, irritability, thirst, and red urine. Tongue is red with yellow coating and rapid pulse, with symptoms of vomiting blood and skin rashes.
Emotional Disturbance Diagnosis
Joy injury: Excessive joy can disperse Qi, leading to confusion and disorientation. Symptoms include mental confusion, erratic behavior, and a weak pulse.
Anger injury: Excessive anger can cause Qi to rise, leading to dizziness and a red face. Severe cases may lead to fainting or vomiting blood, with symptoms of chest and rib distension and a wiry pulse.
Worry injury: Excessive worry can damage the lungs and spleen, leading to fatigue and poor appetite. Symptoms include shortness of breath, cough, and a weak pulse.
Overthinking injury: Overthinking can cause Qi stagnation, leading to poor appetite and fatigue. Symptoms include insomnia, forgetfulness, and a weak pulse.
Sadness injury: Excessive sadness can deplete Qi and damage the heart and lungs, leading to low energy and frequent crying. Symptoms include pale complexion and a weak pulse.
Fear injury: Excessive fear can cause Qi to descend, leading to anxiety and incontinence. Symptoms include a weak pulse and a sense of unease.
Shock injury: Shock can disrupt Qi, leading to confusion and erratic behavior. Symptoms include disorientation and a chaotic pulse.
Organ Diagnosis
Heart Yin Deficiency: Symptoms include palpitations, irritability, insomnia, and excessive dreaming. Tongue is red with little moisture and a thin, rapid pulse.
Heart Blood Deficiency: Symptoms include palpitations, insomnia, forgetfulness, and dizziness. Tongue is pale with a thin, weak pulse.
Heart Qi Deficiency: Symptoms include palpitations, fatigue, and spontaneous sweating. Tongue is pale with a weak pulse.
Heart Yang Deficiency: Symptoms include palpitations, cold limbs, and spontaneous sweating. Tongue is pale with a weak pulse.
Heart Fire: Symptoms include palpitations, irritability, and mouth ulcers. Tongue is red with a yellow coating and a rapid pulse.
Heart Blood Stasis: Symptoms include palpitations and severe pain. Tongue is dark with purple spots and a thin, choppy pulse.
Phlegm Obstructing the Heart: Symptoms include confusion and mental dullness. Tongue is pale with a white coating and a slippery pulse.
Phlegm Fire Disturbing the Heart: Symptoms include agitation and erratic behavior. Tongue is red with a yellow coating and a rapid pulse.
Small Intestine Heat: Symptoms include irritability and red face. Tongue is red with a yellow coating and a rapid pulse.
Small Intestine Qi Pain: Symptoms include abdominal pain and distension. Tongue is pale with a thin coating and a wiry pulse.
Liver Qi Stagnation: Symptoms include chest and rib distension. Tongue is pale with a wiry pulse.
Liver Fire: Symptoms include red eyes and irritability. Tongue is red with a yellow coating and a rapid pulse.
Liver Yin Deficiency: Symptoms include dry eyes and irritability. Tongue is red with little moisture and a thin, rapid pulse.
Liver Blood Deficiency: Symptoms include dizziness and pale complexion. Tongue is pale with a thin, weak pulse.
Liver Yang Rising: Symptoms include irritability and headaches. Tongue is red with a thin coating and a rapid pulse.
Liver Wind: Symptoms include dizziness and tremors. Tongue is pale with a thin coating and a wiry pulse.
Spleen Qi Deficiency: Symptoms include fatigue and poor appetite. Tongue is pale with a thin coating and a weak pulse.
Spleen Yang Deficiency: Symptoms include cold limbs and loose stools. Tongue is pale with a white coating and a slow pulse.
Spleen Yin Deficiency: Symptoms include dry mouth and poor appetite. Tongue is red with little moisture and a thin, rapid pulse.
Cold Dampness Obstructing the Spleen: Symptoms include abdominal distension and poor appetite. Tongue is pale with a white, greasy coating and a slow pulse.
Heat Dampness Accumulating in the Spleen: Symptoms include abdominal distension and poor appetite. Tongue is red with a yellow, greasy coating and a rapid pulse.
Stomach Yin Deficiency: Symptoms include dry mouth and stomach pain. Tongue is red with little moisture and a thin, rapid pulse.
Food Stagnation in the Stomach: Symptoms include abdominal pain and foul belching. Tongue is thick with a greasy coating and a slippery pulse.
Cold Invasion of the Stomach: Symptoms include acute abdominal pain and aversion to cold. Tongue is pale with a thin coating and a tight pulse.
Stomach Fire: Symptoms include irritability and thirst. Tongue is red with a yellow coating and a rapid pulse.
Lung Qi Deficiency: Symptoms include weak voice and cough. Tongue is pale with a thin coating and a weak pulse.
Lung Yin Deficiency: Symptoms include dry cough and night sweats. Tongue is red with little moisture and a thin, rapid pulse.
Wind Cold Invading the Lungs: Symptoms include cough and aversion to cold. Tongue is pale with a thin coating and a tight pulse.
Wind Heat Invading the Lungs: Symptoms include cough and fever. Tongue is red with a yellow coating and a rapid pulse.
Lung Dryness: Symptoms include dry cough and dry throat. Tongue is red with little moisture and a thin, rapid pulse.
Heat Obstructing the Lungs: Symptoms include cough and chest pain. Tongue is red with a yellow coating and a rapid pulse.
Phlegm Obstructing the Lungs: Symptoms include cough and phlegm. Tongue is pale with a white coating and a slippery pulse.
Large Intestine Cold Dampness: Symptoms include abdominal pain and diarrhea. Tongue is pale with a white coating and a slow pulse.
Large Intestine Heat Dampness: Symptoms include abdominal pain and diarrhea. Tongue is red with a yellow coating and a rapid pulse.
Intestinal Abscess: Symptoms include abdominal pain and fever. Tongue is red with a yellow coating and a rapid pulse.
Kidney Yin Deficiency: Symptoms include weakness in the lower back and dizziness. Tongue is red with little moisture and a thin, rapid pulse.
Kidney Yang Deficiency: Symptoms include cold limbs and fatigue. Tongue is pale with a white coating and a slow pulse.
Kidney Qi Deficiency: Symptoms include weakness in the lower back and frequent urination. Tongue is pale with a thin coating and a weak pulse.
Kidney Not Receiving Qi: Symptoms include weakness in the lower back and shortness of breath. Tongue is pale with a thin coating and a weak pulse.
Kidney Deficiency with Water Overflow: Symptoms include weakness in the lower back and edema. Tongue is pale with a white coating and a slow pulse.
Kidney Essence Deficiency: Symptoms include weakness in the lower back and developmental delays. Tongue is pale with a thin coating and a weak pulse.
Bladder Yang Deficiency: Symptoms include cold limbs and frequent urination. Tongue is pale with a white coating and a slow pulse.
Bladder Heat Dampness: Symptoms include burning urination and frequent urination. Tongue is red with a yellow coating and a rapid pulse.
Qi, Blood, Jin Ye Diagnosis
Qi Deficiency: Symptoms include fatigue and dizziness. Tongue is pale with a thin coating and a weak pulse.
Qi Sinking: Symptoms include fatigue and abdominal distension. Tongue is pale with a weak pulse.
Qi Stagnation: Symptoms include distension and pain. Tongue is pale with a thin coating and a wiry pulse.
Qi Reversal: Symptoms include nausea and vomiting. Tongue is pale with a thin coating and a weak pulse.
Blood Deficiency: Symptoms include numbness and palpitations. Tongue is pale with a thin coating and a weak pulse.
Blood Stasis: Symptoms include localized swelling and pain. Tongue is dark with purple spots and a thin, choppy pulse.
Blood Heat: Symptoms include fever and irritability. Tongue is red with a yellow coating and a rapid pulse.
Fluid Deficiency: Symptoms include dry skin and constipation. Tongue is pale with a thin coating and a weak pulse.
Fluid Stagnation
(1) Wind Phlegm: Symptoms include dizziness and nausea. Tongue is pale with a white coating and a slippery pulse.
(2) Heat Phlegm: Symptoms include cough and fever. Tongue is red with a yellow coating and a rapid pulse.
(3) Cold Phlegm: Symptoms include cough and clear phlegm. Tongue is pale with a thin coating and a slow pulse.
(4) Dry Phlegm: Symptoms include dry cough and chest pain. Tongue is red with little moisture and a thin, rapid pulse.
(5) Damp Phlegm: Symptoms include cough and chest fullness. Tongue is pale with a white coating and a slippery pulse.
(6) Phlegm Fluid: Symptoms include cough and shortness of breath. Tongue is pale with a white coating and a slippery pulse.
(7) Suspended Fluid: Symptoms include cough and chest pain. Tongue is pale with a thin coating and a slow pulse.
(8) Overflowing Fluid: Symptoms include cough and edema. Tongue is pale with a white coating and a slow pulse.
(9) Stagnant Fluid: Symptoms include cough and chest fullness. Tongue is pale with a white coating and a slow pulse.
Summary of Differentiation Levels
For external febrile diseases, the differentiation of levels is crucial. The initial stage presents with external symptoms, while unresolved cases may progress inward.
Both fever and heat transformation indicate Yin damage, and the severity of the disease can be categorized into three levels: external, internal, and intermediate.
Summary of External Symptoms
Initial external symptoms indicate superficial disease, with pathogenic factors invading and Zheng Qi resisting. Different causes lead to different symptoms, categorized into wind, heat, dampness, dryness, and cold.
(1) Wind Cold Syndrome: Symptoms include aversion to cold, fever, and absence of sweating. Tongue is pale with a thin coating and a floating pulse.
(2) Wind Heat Syndrome: Symptoms include fever and aversion to cold. Tongue is red with a thin coating and a rapid pulse.
(3) Cold Dampness Syndrome: Symptoms include fever and body aches. Tongue is pale with a white coating and a slow pulse.
(4) Summer Heat Dampness Syndrome: Symptoms include fever and yellow urine. Tongue is red with a yellow coating and a rapid pulse.
(5) Dryness Syndrome: Symptoms include fever and dry throat. Tongue is red with little moisture and a thin, rapid pulse.
Summary of Intermediate Symptoms
Intermediate symptoms indicate a deeper invasion of pathogens, with symptoms of alternating chills and fever, nausea, and poor appetite.
(1) Intermediate Syndrome: Symptoms include alternating chills and fever, nausea, and poor appetite. Tongue is pale with a thin coating and a weak pulse.
(2) Internal Heat: Symptoms include fever and irritability. Tongue is red with a yellow coating and a rapid pulse.
(3) Internal Cold: Symptoms include cold limbs and abdominal pain. Tongue is pale with a thin coating and a slow pulse.
Summary of Internal Symptoms
Internal symptoms indicate a full invasion of pathogens, with severe symptoms and potential complications.
(1) Internal Heat: Symptoms include high fever and irritability. Tongue is red with a yellow coating and a rapid pulse.
(2) Internal Cold: Symptoms include severe abdominal pain and cold limbs. Tongue is pale with a thin coating and a slow pulse.
(3) Internal Dampness: Symptoms include abdominal distension and poor appetite. Tongue is pale with a white coating and a slow pulse.
(4) Internal Dryness: Symptoms include dry skin and constipation. Tongue is pale with a thin coating and a weak pulse.
(5) Internal Phlegm: Symptoms include cough and chest fullness. Tongue is pale with a white coating and a slippery pulse.
(6) Internal Blood Stasis: Symptoms include severe pain and dark complexion. Tongue is dark with purple spots and a thin, choppy pulse.
(7) Internal Qi Stagnation: Symptoms include distension and pain. Tongue is pale with a thin coating and a wiry pulse.
(8) Internal Qi Deficiency: Symptoms include fatigue and dizziness. Tongue is pale with a thin coating and a weak pulse.
(9) Internal Yin Deficiency: Symptoms include dry mouth and insomnia. Tongue is red with little moisture and a thin, rapid pulse.
(10) Internal Yang Deficiency: Symptoms include cold limbs and fatigue. Tongue is pale with a white coating and a slow pulse.
(11) Internal Yang Collapse: Symptoms include cold limbs and fainting. Tongue is pale with a thin coating and a weak pulse.
(12) Internal Yin Collapse: Symptoms include high fever and irritability. Tongue is red with a yellow coating and a rapid pulse.
(13) Internal Blood Heat: Symptoms include high fever and irritability. Tongue is red with a yellow coating and a rapid pulse.
(14) Internal Blood Stasis: Symptoms include severe pain and dark complexion. Tongue is dark with purple spots and a thin, choppy pulse.
(15) Internal Qi Stagnation: Symptoms include distension and pain. Tongue is pale with a thin coating and a wiry pulse.
(16) Internal Qi Deficiency: Symptoms include fatigue and dizziness. Tongue is pale with a thin coating and a weak pulse.
(17) Internal Yin Deficiency: Symptoms include dry mouth and insomnia. Tongue is red with little moisture and a thin, rapid pulse.
(18) Internal Yang Deficiency: Symptoms include cold limbs and fatigue. Tongue is pale with a white coating and a slow pulse.
(19) Internal Yang Collapse: Symptoms include cold limbs and fainting. Tongue is pale with a thin coating and a weak pulse.
(20) Internal Yin Collapse: Symptoms include high fever and irritability. Tongue is red with a yellow coating and a rapid pulse.
