Inquiry (Wen, 问诊)

The practitioner will document certain answers of the patient to specific organized questions. Traditionally, these questions were organized into 12 categories of topics, referred to as the “ten-plus-two questions.” In modern TCM, the inquiry portion also includes questions about general data such as age, sex, occupation, marital status, lifestyle, diet, the patient’s medical history, medication, and other treatments. Unfortunately, a lot of practitioners limit their assessment to this aspect of the four pillars of diagnosis. The validity of the information that is derived from inquiry depends on the accuracy of the patient’s answers and the patient’s ability to clearly understand the questions. The experienced practitioner will conduct the inquiry in a tactful and sensitive way, and formulate the questions so that the patient feels at ease and is not embarrassed.

The ten traditional topics for questioning are for every patient, and the two additional questions cover women’s medical issues and pediatric information.

  (1) Cold and Fever (Fever and Chills). The practitioner will investigate how the patient describes the feeling of cold or heat in terms of aversion to heat or cold. The subjective feeling of heat (fever) or cold with or without shivering that the patient experiences is equally important to the real observations obtained from measuring temperature with a thermometer or by palpation. This information is useful for differentiating between full and empty, interior and exterior, and hot and cold conditions.
  (2) Transpiration. Questions about transpiration will investigate the location of transpiration; which part of the body is affected; the time of day or night that the transpiration happens; the circumstances, such as activity or lack thereof; and the quality, quantity, and consistency of the sweat.
  (3) Head and body. This includes questions related to signs and symptoms manifesting in or on the head and body, such as headaches, dizziness, pain, and pathological changes.
  (4) Chest and abdomen. The questions are about pain or abnormal sensations in the chest or abdomen.
  (5) Appetite, diet, and taste.
  (6) Stools and urine. Questions about excretions investigate frequency, consistency, odor, and any information that was not obtained from the olfaction–observation part of the diagnostic procedure. The practitioner may also need to ask questions about sensations before, during, or after defecation or urination.
  (7) Sleep. This includes questions about insomnia or lethargy and the circumstances surrounding these conditions. The practitioner may also ask questions about the quality and quantity of sleep.
  (8) Ears and eyes. This includes questions about the quality of hearing and vision, but also about unusual sensations in the ears and eyes.
  (9) Thirst.
(10) Pain. General questions about the onset, circumstances, quality, or quantity of pain. The use of pain scales is often a handy tool for gathering valuable information about pain.

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