All diseases can be placed into two categories hot diseases and cold diseases. The diagnostic process consists of visual inspection, palpation, and questioning (illustrated on the right side of the second row).
The key items to check in an examination are the five sense organs, urine, sputum, vomit, fees, and blood
Visual inspection includes checking skin color, body shape and size, and other things that the physician can see with the naked eye.
Palpation consists of reading the pulse, feeling the body temperature, and feeling the roughness or smoothness of the skin. The pulse is like a messenger between the physician and the patient. Through experience and knowledge the physician is able read many different pulses.
Questioning is also a useful and informative diagnostic technique. It involves listening to the patient describe symptoms, location of illness, and causative factors. Correct diagnosis requires careful observation, experience, and listening.
Once a diagnosis has been made there are four levels of disease's seriousness with regard to the possibilities of success in treatment: some are easily treatable, some difficult to treat, some with a remote chance of a cure, and some that are incurable or not to be cured for various reasons. For an illness that is easily cured, we simply need a good physician, good medicine, caring nursing, and an obedient patient. Illnesses that are difficult to cure are chronic diseases that need many different methods of treatment over a long period of time. If the patient does not have a good physician and good nursing, the disease will be difficult to cure. For diseases that have a remote chance of a cure, we can see that some patient are diagnosed as incurable, though the patient may remain alive for a long time. This is because, as Buddhists, Tibetans believe that an individual's own lifespan is based on karma. For some people this can be as short as one week and for others as long as a hundred years. Diseases are incurable when the patient is unable to take food and drink, and when there are only skin and bones, no pulse, and no response to any form of treatment. For the physician to with hold treatment the patient would have to be particularly evil someone who would only commit many negative and harmful actions to society if they remained alive.
There are ten ways of taking medicine. If it is a bad-kan disorder, the medicine should be taken on an empty stomach and in the early morning. If the disease is connected with downward-cleansing rlung, the medicine should be taken immediately before lunch. If it is a rlung disorder, medicine must be taken during lunch. If it is pervasive rlung disorder, medicine should taken immediately after lunch or dinner. If it is a life-sustaining rlung disorder, medicine should taken in small does and at the same time as eating food, a little after every alternate mouthful. If it is an upward-moving rlung disorder, medicine should be taken as soon as food has been digested. If the patient has asthma, medicine should be taken in small does and as frequently as possible. If the patient has a weak appetite, medicine is taken food. If the patient suffers from hiccups, medicine should be taken both before and after meals. If the patient has diseases connected to the head, medicine should be taken before dinner and after food has been digested.
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