What are the basic methods and principles of the Four Diagnostic Methods?

The Four Diagnostic Methods are the four basic methods of diagnosing diseases summarized by Bian Magpie, a famous doctor during the Warring States period in ancient times, based on his experience in folklore and his own medical practice for many years, namely, looking, smelling, questioning and cutting, which are collectively known as the Four Diagnostic Methods, and were called the Four Diagnostic Methods in ancient times. "

The four basic methods of diagnosing diseases are summarized in this article.

The basic principle of the four diagnostic methods is based on the concept of the whole and the concept of constant movement, and is the specific application of the basic theories of yin and yang, five elements, the hidden image of the meridians and collaterals, and the etiology of disease. It has been continuously developed and perfected since its creation, and is a treasure of China's traditional medical culture.

Bian Magpie, a folk doctor in the Spring and Autumn and Warring States Periods, had made great contributions to the formation and establishment of the Four Diagnostic Methods.

The Records of the Grand Historian (史记-扁鹊传传)recorded that once Bian Magpie traveled to the state of Jin to practice medicine, he met Zhao Jianzi, who was gravely ill and had been in a coma for five days, unconscious. His relatives and staff were very worried and asked Bian Magpie to come to cure Zhao Jianzi.

Bian Magpie noticed that Zhao Jianzi's heart was still beating slightly by cutting his pulse, and realized that the political struggle in Jin was very fierce at that time by asking questions, so he concluded that Zhao Jianzi was in a coma for a while due to over-exertion of his brain in the political struggle and did not die.

After careful treatment by Bian Magpie, Zhao Jianzi was cured within 3 days. This shows that Bian Magpie was very proficient in the Four Diagnostic Methods of Looking, Smelling, Questioning and Cutting. For thousands of years, the Four Diagnostic Methods have become the basic method of diagnosing illnesses in Chinese medicine.

Looking is a diagnostic method based on the theory of internal organs and meridians. The human body outside and the five viscera and six viscera close relationship, if the human body viscera and six viscera functional activity has changed, will inevitably be reflected in the human body outside and manifested as God, color, shape, attitude and other aspects of the changes. Therefore, the observation of the body surface and the five senses morphology and function of the signs of change, can be inferred from the internal organs of the changes.

In terms of specific steps, diagnosis by looking can be divided into looking at God, looking at the color of the face, looking at the form, looking at the head and neck, looking at the five senses, looking at the skin, looking at the veins, looking at the discharges, and so on. The focus of the diagnosis is on the look at God, look at the color of the face and tongue diagnosis. Because of the face, tongue of the various manifestations, can be reflected in a considerable degree of visceral function changes.

Smell diagnosis is a doctor to use their sense of hearing and smell, through the sound of the patient and the body of the excreta emitted a variety of odors to deduce the diagnosis of disease. Through listening to the sound, not only can diagnosis and pronunciation related organ lesions, but also according to the changes in the sound, diagnosis of the internal organs of the changes.

Listening to the voice includes: speech, breathing, coughing, uh-oh, belching and so on.

Odor is divided into two kinds of odor: the odor of the sick body and the odor of the sick room. Among them, the odor of the sick body is mainly due to the evil venom to make the human organs, blood, fluid to produce defeat, from the body orifices and discharges issued; the odor of the sick room is emitted by the sick body and its excreta, such as the plague patients will make the moldy and rotten stench filled with indoor.

An inquiry is a method of diagnosis in which the doctor uses conversation to inquire of the patient and his or her informants about the onset and development of the disease, its present symptoms, and the course of treatment.

An inquiry is mainly for the objective difficult to detect the disease, such as in the lack of signs of disease or not obvious, to find the diagnosis of the condition of the information, or to provide clues for further examination; at the same time, a comprehensive grasp of all the circumstances related to the disease, including the patient's daily life, working environment, dietary preferences, marital status, and so on.

The basic content of the inquiry includes the patient's general condition, complaints, history of present illness, present symptoms, past medical history, personal history, family history and so on. Among them, the inquiry of the present symptoms is mainly: asking about cold and heat, asking about sleep, asking about mood, asking about the two stools, and so on.

Cutting diagnosis is the doctor's hand on the patient's body surface to touch, press the diagnosis. Diagnosis includes pulse diagnosis and diagnosis of two parts. Pulse diagnosis, also known as pulse cutting, pulse diagnosis, is through the pulse changes in the physical observation, understanding of the body lesions diagnostic methods. Press diagnosis, is to use the hand to touch and press the patient's body surface parts, in order to understand the local abnormal changes, so as to deduce the nature of the lesion site and the severity of the condition of the diagnostic method.

The above four methods of diagnosing diseases are not isolated from each other, but are interconnected. It is necessary to collect the condition of the four diagnostic, comprehensive analysis, remove the rough and extract the essence, remove the false and keep the true, in order to make a comprehensive scientific judgment from the surface to the inside.

The "Four Diagnostic Methods" summarized by the magpie are fully in line with the theories of the holistic approach, systematic approach and dialectical approach of modern science, which cannot but be admired. Magpie is also known in the medical field as the "pulse". For thousands of years, China's "pulse science" has been in a hundred schools of thought in the forward.

Wang Shuhe, a medical doctor in the Jin Dynasty, wrote the Pulse Classic, which is the earliest surviving monograph that systematically discusses pulse science in China.

This book is a systematic summary of pulse science before the 3rd century,*** 10 volumes, excerpts from the "Neijing", "Nanking", "Typhoid Fever", "The Essentials of the Golden Quarter" and the relevant treatises of Bianqi, Hua Tuo, etc., to expound on and analyze the pulse theory and method, and put forward their own insights.

In the book "Pulse Classic", Wang Shuhe first summarized the pulse into 24 types: floating, hollow, flooding, slippery, counting, urging, stringing, tightening, sinking, volatile, leathery, solid, micro, astringent, fine, soft, weak, weak, weak, scattered, slow, late, knotting, generation, and movement, and made specific descriptions of each type of pulse, such as image and under-finger sensation, and pointed out the differences between some similar pulses.

Arranged in 8 groups for comparison, it initially affirmed the positioning diagnosis of the pulse of the inch and foot in the left hand as the main heart and the small intestine, and the liver and the gallbladder in the off hand; the pulse of the inch in the right hand as the main lung and the large intestine, and the spleen and the stomach in the off hand; and the pulse of the inch, off and foot in the ruler's part of the two hands as the main kidneys and bladders, etc., which has laid down an important foundation for the development of pulse science of traditional Chinese medicine in the later generations.

In 1241, Shi Fa, a medical doctor of the Song Dynasty, wrote a book entitled "Guide to Detecting Diseases", which mainly expounded on pulse science and attached diagnostic methods such as listening to the voice, detecting the color, and examining the taste, and it is an early and systematic diagnostic monograph existing in China.

The Guide to Detecting Diseases mainly deals with pulse, and the principles of flat pulse, diseased pulse, and pulse diagnosis are all based on the legacy of ancient sages, which are popularized and supplemented. What is worth mentioning in particular is that the book uses the phenomenon of pulsation to create 33 kinds of pulse diagrams to show the pulse, which is a vivid and unique image. This chart is more than 700 years ago, is the world's earliest existing pulse chart.

China's "pulse science" developed to the Ming Dynasty, and a new breakthrough. Li Shizhen, a medicine man of the Ming Dynasty, compiled the "Pulse of the Lake", "eight veins of the Qi Jing Kao", "Pulse Kao Zheng", are related to the "pulse" of the treatise.

The "Pulse Study at the Lake" is the author's research on "pulse science". Based on the essence of various schools of pulse theory, he listed 27 kinds of pulse, comprehensively describing various issues related to "pulse science". Among them, the identification points of the same kind of different pulse and the corresponding illnesses of each kind of elephant are compiled into songs and bowels to help recite and memorize.

The examination of the eight veins of the odd meridians is the study of the "eight veins of the odd meridians" of the monograph. This book not only describes in detail the circulation route of the "odd meridians and veins", but also combined with the main disease, the corresponding treatment. At the same time, it is also a basis for diagnosing diseases based on the pulse, which is of reference value to the study and research of "pulse science".

The "Pulse Recordings" collects and records the different opinions of various schools on "pulse science" before the Ming Dynasty, and combines the author's own opinions to discuss the practical problems of "pulse science", which plays a role in the argumentation and verification of the study of "pulse science". "The author's own opinions, combined with the discussion of the actual problems of pulse science, play a role in the study of pulse science to argue and resolve some of the doubts.