Inquiry in TCM Diagnosis

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Inquiry of fever and cold in TCM diagnosis
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Inquiry of fever and cold means asking the patient whether he or she has the sensation of fever and aversion to cold. Fever and cold are the common symptoms seen in the course of a disease and are the evidences for differentiating the nature of pathogenic factors and the states of yin and yang in the body.
      
Aversion to cold is a subjective sensation, including disliking cold and fearing cold. If the patient feels cold and such sensation cannot be relieved after putting on more clothes and quilt or staying near fire, it is called disliking cold; if the patient feels cold and such sensation can be relieved after putting on more clothes and quilt or staying near fire, it is called fearing cold. Fever means that the body temperature is higher than usual, also including subjective sensation of general or local fever like feverish sensation over the five centers (palms, soles and chest) which does not necessarily mean the increase of body temperature. The occurrence of fever and cold lies in the nature of pathogenic factors as well as decline and predomination of yin and yang in the body, reflecting or signifying the result of the struggle between healthy qi and pathogenic factors as well as the changes of yin and yang.

Generally speaking, in the disease due to pathogenic factors, pathogenic cold leads to disliking of cold and pathogenic heat leads to fever; in the cold and fever caused by the predomination and decline of yin and yang in the body, exuberance of yang leads to fever and superabundance of yin leads to cold, asthenia of yin brings about fever and asthenia of yang results in cold. So inquiry of cold and fever is helpful for understanding the nature of pathogenic factors and differentiating the states of yin and yang in the body.
 
In inquiring fever and cold, the doctor should make sure whether there is cold and fever or not, whether cold and fever appear simultaneously, whether fever and cold is serious or mild, what time it appears and how it lasts as well as other complications. Clinically the types of cold and fever include aversion to cold and fever, cold sensation without fever, fever without cold sensation, and alternate cold and fever.


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