1. The Concept and Evolution of Chinese Medical Diagnosis
The discipline diagnosing a disease in line with the theories of traditional Chinese medicine consists of two parts.
1.1. The examination by the "four methods of diagnosis" is a means of observing the manifestations of a disease and examining the pathological conditions of the disease.
1.2. The determination, or differentiation, is a process of thinking used to analyze or determine the disease based on the data obtained from the "four methods of diagnosis." Therefore, Chinese medical diagnosis is a branch of science which investigates the pathological conditions in order to differentiate the syndromes and to provide the scientific basis for the prevention and treatment of diseases in the light of the theories of traditional Chinese medicine. It is also the foundation for learning various clinical disciplines.

2. The Basic Concepts of Chinese Medical Diagnosis
The Chinese medical diagnosis encompasses the four methods of diagnosis ( inspection, auscultation and olfaction, interrogation, and pulse feeling and palpation), and various kinds of differentiation, such as differentiation according to the eight principles, differentiation according to the theory of zang-fu organs, differentiation according to the theory of six meridians, etc. In addition, the application of the diagnostic methods and the writing of case reports are also involved.
The four main methods of diagnosis are a means to detect a disease and to observe its manifestations. The differentiation according to the eight principles and the rest of the differentiation methods are used to analyze and detect pathological conditions, and to find out the nature of the disease. The application of the diagnostic methods will show how to use the four methods of diagnosis and the differentiation methods to diagnose the disease flexibly and correctly in clinical practice. The writing of a case reports tells us briefly the significance, the specific requirements, and the forms in recording a disease. Each of these will be discussed separately in related chapters of this book.

3. The Characteristics and Principles of Chinese Medical Diagnosis
The theoretical system of diagnosis in traditional Chinese medicine begins with an examination of the various parts of the human body as an organic whole, and determines the treatment on the basis of the differentiation of syndromes. In diagnosing a disease, first, the four methods of diagnosis must be used to make a thorough observation of the body so as to have a correct understanding of the disease. This is actually a concrete application of the concept of viewing the body as an organic whole. Second, various differentiation methods should be applied to analyze the pathological conditions, to seek the causative factors through the differentiation, and to determine the treatment according to etiology. This is known as determining treatment on the basis of the differentiation of syndromes. Therefore, the following principles must be observed in diagnosing a disease.
3.1. To observe both the interior and exterior of the body
Interior refers to the inside of the human body, or the internal environment of the body, while exterior implies the body surface or the natural environment upon which the human being is dependent. A human being is an organic whole and is closely related to the natural world. Whenever a man is ill, the disease must be closely related to the functional derangement of the zang-fu organs, qi and blood, as well as meridians and collaterals. Any pathological changes inside the body manifest themselves on the body surface. Therefore, in diagnosing a disease, the internal changes can be deduced by viewing the outside appearance and the systematic changes can be found by observing a local area; internal pathological changes of the zang-fu organs, qi, and blood can be detected by studying the exterior symptoms. For example, when observing red, swollen, and painful eyes caused by the flaring-up of liver fire, attention must be paid during the diagnosis to such manifestations as flushed face, taut pulse, bitter taste in the mouth, and yellow tongue coating, that is, one must connect the local changes with the systematic changes and find out the nature of the disease from its exterior symptoms. On the other hand, the occurrence of a disease is often influenced by the natural environment, such as abnormal changes in the climate, sudden cold, or sudden beat attacking the body and leading to disease. Therefore, attention must be also paid to the interrelations between the internal environment and the external environment.
3.2. To seek the causative factors from differentiation and to determine treatment according to etiology
This principle is a reflection of the characteristics of determining treatment on the basis of the differentiation of syndromes. This can be explained from the following two aspects.
a) The concept of symptom, syndrome, and disease
Symptom: various abnormal manifestations of a disease such as headache, fever, sweating, and thirst.
Syndrome: a generalization of various symptoms and signs occurring in a certain stage of a disease, or the pathological, comprehensive manifestations formed by the pathogenesis, the location of the disease, the nature of the disease, and the relations between the pathogenic factors and the anti-pathogenic qi. Syndrome reflects the nature of a disease in an overall way. Take the exterior wind-heat syndrome caused by the exogenous pathogenic factors as an example. The syndrome here reveals that the pathogenesis of the disease is the invasion by the exogenous pathogenic wind-heat, the location of the disease is in the exterior, and the nature of the disease belongs to exterior heat.
Disease: the name of an illness, such as dysentery, measles, or asthma. Sometimes the names of certain diseases in traditional Chinese medicine are the same as those of the syndromes. Usually, there are syndromes in the disease and symptoms in the syndrome.
The syndrome can explain the different manifestations at various stages of a disease and the symptoms are the basis of the syndrome.
b) The combination of differentiation of a Disease and differentiation of a Syndrome
In the process of diagnosing a disease, one must not only distinguish the disease, but also differentiate the syndromes. Only by basing one's decisions on the results of diagnosing the disease and differentiating the syndromes can appropriate treatment be established. Therefore, the determination of treatment based on differentiation of syndromes is the key link in diagnosing and treating a disease.
To sum up, the word "etiology" means not only the causative factors, but also the understanding of the nature of a disease. Therefore, the importance of the principle "to search for the root cause of the disease in the treatment,, is also proven.
3.3. Comprehensive analysis of the data obtained from the four Methods of diagnosis
The reliability of the data obtained from the four methods of diagnosis, which serves as the foundation of the differentiation, will exert a direct influence on the accuracy of differentiation. Since the pathological changes of a disease are complicated and varied, careful observation and investigation are essential. Comprehensive analysis must be employed because the pathological conditions of the disease can be detected from different angles by means of observation, auscultation and olfaction, interrogation, and pulse feeling and palpation. If only pulse feeling or tongue observation is stressed but the rest are neglected, the problem of one-sidedness can hardly be avoided. Therefore, an overall observation of the pathological conditions of a disease is extremely essential and significant, and one-sided views must be avoided. Meanwhile, accurate understanding of a disease can also provide a dependable basis for the implementation of differentiation. It is generally acknowledged that a brilliant doctor who is able to give perfect diagnosis must have a very excellent command of the four methods of diagnosis. This also shows the importance of comprehensive analysis of the data obtained from the four methods of diagnosis.

4. The method of learning the diagnosis of traditional Chinese medicine
Generally, the study of Chinese medical diagnosis should follow the learning of The Basic Theories of Traditional Chinese Medicine. In this way, some basic knowledge of traditional Chinese medicine is 11rst mastered, which then allows quicker and better understanding of the basic techniques of Chinese medical diagnosis. Consequently, the following three steps are further undertaken.
a) To understand and become familiar with the theory and mechanism of Chinese medical diagnosis. Only when the principles and contents of Chinese medical diagnosis are fully understood and the theory is properly mastered can they be further applied in clinical practice.
b) To grasp the key and difficult points
The key points of the four methods of diagnosis are the observation of the mental state and facial expression, tongue observation, and the methods and contents of interrogation and palpation. The difficult points are the various manifestations of the tongue pictures and pulse conditions and their indications. The main points for differentiation are differentiation according to the theory of zang-fu organs, differentiation according to the theory of qi, blood, and body fluids, and the application of the diagnostic methods. The difficult points lie in various kinds of "manifestations of the syndromes.'' The important points should be learned by heart and the difficult points should be mastered as much as possible.
c) To practice the basic skills diligently
The key point of having a good command of Chinese medical diagnosis is to combine theory with practice. Whenever conditions allow, try to see more and practice more. This is a quicker and better way to master the basic skills of traditional Chinese medical diagnosis.

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