A working intake checklist for Diagnosis by Interrogation. Tick symptoms as the patient reports them; each item shows its usual diagnostic significance. Your ticks are saved in this browser only (nothing is sent anywhere) so you can safely close and reopen this page mid-consultation.
Shows patterns backed by 2 or more ticked symptoms — updates live as you tick, and prints with the form. A single matching symptom is treated as noise and left off; a higher count means more of the ticked symptoms agree on that pattern. Not a diagnosis by itself.
No pattern yet backed by 2 or more ticked symptoms.
Saved in this browser only, same as the rest of the form.
Establishes the state of Spleen and Stomach.
Pick which applies, then tick the specific pattern below.
Pick which applies, then tick the specific pattern below.
One of the simplest clues to a Deficiency pattern — though tiredness is not always Empty in origin. A Full pulse (often Slippery or Wiry) points to Dampness, Phlegm or Qi stagnation as the cause instead.
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Check as many as apply, then tick the specific patterns below.
Check as many as apply, then tick the specific patterns below.
Check as many as apply, then tick the specific patterns below.
Sleep depends on Blood and Yin, especially of Heart (housing the Mind) and Liver (housing the Ethereal Soul).
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Sweating in an exterior (acute) condition always signals that the Upright Qi is somewhat depleted. In an interior condition, distinguish by area of the body, time of day, condition of illness, and quality of the sweat.
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Check as many as apply, then tick the specific patterns below.
Ask with sensitivity — many patients somatize emotional distress into physical complaints instead of naming it directly.
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Ask tactfully, and only if the patient seems willing.
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Limited diagnostic value on the contraceptive pill, with an IUD fitted, or in multiparous women.
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The skin is physiologically related to the Lungs, but also to Blood and, through it, the Liver — not every skin condition is a Lung pattern. Heat in the Blood can also derive from Stomach-Heat, so some skin disease relates to the Stomach as well.
Aims at establishing the state of the Stomach and Spleen. As a general rule, a condition relieved by eating is Empty in nature; one aggravated by eating is Full.
Check as many as apply, then tick the specific patterns below.
Distinguished by onset, time of day, location, character of the pain, and condition (what aggravates or relieves it).