Questioning or interviewing a patient during intake covers many topics, including:

Identification of TCM patterns is done by using paradigms such as the 8 Principles (Ba Gong), Zang Fu organ diagnosis, Channel diagnosis, as well as other paradigms. Patterns can be identified generally as in the 8 Principles, or more specifically as in Zang Fu diagnosis.

Absence of a sign or symptom may, in some cases, be vital to a correct TCM diagnosis, and absence of symptoms are generally not reported by a patient. For example, absence of thirst may indicate a cold condition. Keep in mind that all relevant information is not usually provided by the patient.

Traditionally, there are ten areas of questioning...

Common areas of Questioning today:

Questions should be relevant to the patients condition, as not all questions are useful in every situation. Additional questions should be asked based on information provided by the patient as well as what is observed by the practitioner.

Chills and Fever

Chills and Fever in Exterior Patterns

Chills and fever in an Exterior Pattern (unless they are alternating), an invasion or attack by exogenous pathogenic factors. It is important to distinguish the presence of chills or fever or both. Chills is not only the feeling of Cold, but also having an aversion to Cold. The patient does not want to go outside into the Cold, does not like drafts, and the chills are not alleviated by covering up with blankets.

Fever, in this context, is a subjective sensation of heat rather than actual body temperature.

The initial stages of an Exterior diseases is an acute condition, like the flu or common cold. When a patient has an aversion to cold and chills, it usually indicates an invasion of exogenous Wind Cold or exogenous Wind Heat. The patient feels cold because the pathogenic factor blocks circulation of the body's Defensive Qi (Wei Qi), which is impaired from circulating and warming the body. The chills and fever occur simultaneously at the beginning stages of an acute disease because the body is trying to expel the pathogen. This is the pathogenic/evil Qi struggling with the antipathogenic/protective Qi.

Wind Cold

Symptoms: chills, aversion to cold, possible fever (especially low grade), usually with body aches, absence of sweating, headache.

Pulse: superficial/floating and tight.

Wind Heat

Symptoms: Predominantly fever, with only slight aversion to cold or mild chills. Also thirst, slight or profuse sweating.

Pulse: superficial/floating and rapid.

Alternating Fever and Chills

This is a half external and half internal condition where there is exterior invasion of Wind-Cold or Wind-Heat, but the pathogen has penetrated to a deeper level (Shaoyang) of the body .

Exterior diseases are generally diagnosed according to two paradigms:

Chills and Fever in Interior Patterns

Interior Excess Heat patterns usually present with a persistent high fever and aversion to heat, but no chills. Other symptoms may include profuse sweating, thirst, and a flooding pulse.

Interior Deficient Heat patterns usually present with tidal fever (fever that comes in 'tides', at specific hours of the day, usually in the evening or night). Other symptoms may include night sweats, 5 palm heat (heat or sweating in the palms of the hands, soles of the feet, and the chest), and a red tongue body.


It is usually beneficial to ask a patient about sweating, even if they don't initially volunteer the information.

Example Questions:

In Exterior Patterns sweating can indicate:

In Interior Patterns sweating is differentiated by:

Time of day

Area of body

Condition of illness

Quality of Sweat

Head and Body

The Head is where all six Yang channels meet. The three Yang channels of the upper limbs end on the face and the three Yang of the lower limbs begin on face. Yang channels bring the clear Yang to the head and orifices, enabling clear vision, hearing, taste, and smell.


Headache is distinguished according to the onset, time, location, nature of the pain, condition.


Time of Day


Nature of Pain



Dizziness can be due to Internal Wind, Fire, Phlegm, or Deficiency of Qi and Blood

Internal Wind from Ascending Liver Fire


Qi and Blood Deficiency

Acute Onset of Dizziness

Gradual Onset or Chronic Dizziness

Pain All Over the Body

Pain in the Joints, Painful Obstruction Syndrome (Bi Syndrome)

Lumbar Pain


Thorax and Abdomen

Areas of the thorax and abdomen can be generally associated with the internal organs

Thorax Heart and Lungs, Upper Jiao
Flanks and Ribcage Liver and Gallbladder
Abdomen Liver, Intestines, Spleen, Kidney, Bladder
Epigastric area Spleen and Stomach
Umbilical area Kidney

Chest Pain

Hypochondriac Pain

Epigastric Pain

Lower Abdominal Pain


Hypogastric Pain

Food and Taste

This gives us information regarding the state of Spleen & Stomach (also the flavors desired give clues to other Organs according to the five element correspondences).

Appetite and Eating

Taste in Mouth


Stools and Urine

A condition alleviated after bowel movement indicates an Excess condition, while a condition worsening after bowel movement indicate a Deficiency condition.



Borborygmus (gurgling in the abdomen)


Urinary Function

Pain associated with urination

Urine Color

Urine Amount


The Heart is the residence of the Shen, and the Blood and Yin nourish the Shen. When Blood and/or Yin is Deficient, the Shen has no residence and can not rest.

Ears and Eyes

The Kidney opens to the ears, but not all ear disorders are related to the Kidney. The Shaoyang channels (GB, SJ) travel to the ears, and some Exterior Heat conditions that affect the Shaoyang can cause ear problems. Dampness and Phlegm can also obstruct rising of Yang to upper orifices which can affect the ears.

Tinnitus (Ringing in the Ears)



Thirst and Drink


Excess conditions causing pain are usually due to Qi circulation in the Channels being obstructed due to stagnation, cold, or heat.

Deficient condition that cause pain are usually due to the channels not being nourished by Yin and Blood. An Excess condition causes more severe pain, while a deficient one causes more dull pain.

Excess Conditions

Deficient Conditions

Gynecological Conditions

Ask about Menstruation, Vaginal Discharge, Pregnancy, and Childbirth. A Woman's menses give a clear idea of the condition of her Qi and Blood.

See also: Amenorrhea, Dysmenorrhea, Early Menses, Extended Menses, Flooding & Trickling Menses, Heavy Menses, Irregular Menses, Late Menses, Scanty Menses, Spotting Menses

Important Questions

Menses - Moon Cycle









Pregnancy and Childbirth