Diagnosis Through Asking

Diagnosis through asking various questions will help you to know where and what the actual or potential problem is. by doing so, you are able to treat an existing disharmony, or to maintain your health at its present level.

We have listed some questions here. You may well find that you need to add new information or refine your answers as you work through them over time. Therefore, you may want to make several photocopies of the questionnaire to fill in.

The self-diagnosis questionnaire

1. What would you say is your main health problem?

2. Do you have a diagnosis from your doctor?

3. If there is more than one problem, repeat the questions for each:

  • When did the problem first start?
  • Where do the symptoms occur?
  • Describe the main symptoms.
  • Does anything make the symptoms worse?
  • Does anything make the symptoms better?
  • What treatment, if any, have you had for this problem?
  • Does this problem relate to another health issue?
  • In what way are they affected by each other?


  • Describe your usual thirst level.
  • How much fluid do you drink in a day?
  • Do you generally prefer hot drinks or cold drinks?
  • How many times do you usually pass water in a day?
  • How many times do you usually pass water at night?
  • What are the colour and volume?
  • Do you get any discomfort, difficulty or burning with urination?


  • Describe how you feel most of the time.
  • When are you most aware of feeling tired?
  • How do you feel when you wake in the morning?


  • Describe your appetite.
  • Do you get acidity? What causes it?
  • Do you get bloating? What causes it?
  • Do you get nausea? What causes it?
  • Do you have any food intolerance? Specify which.
  • Do you get food cravings? Specify which.

7. BOWEL MOVEMENTS Are your bowel movements:

  • Daily? (How many times?)
  • If not, how often? (Every _ days.)
  • Formed? Describe.
  • Loose? Describe.
  • Hard?
  • Alternating between constipation and diarrhoea?

Is there any:

  • Pain?
  • Blood?
  • Mucus?
  • Wind?
  • Straining?


  • How many times a day do you have a full meal?
  • Do you snack?
  • Do you regularly skip meals?
  • Have you regularly been on a weight loss diet? (Specify which.)
  • Do you tend to gain or lose weight more easily?
  • Do you often eat at different times every day, or very late at night?
  • Describe a typical breakfast.
  • Describe a typical lunch.
  • Describe a typical supper.
  • What snacks or treats do you eat?
  • Do you often need to rush, work or do something else during one of these meals?
  • Note any foods that you know will probably bring on a particular symptom and describe the symptom.


  • Do you regularly get pain anywhere? (Specify where.)
  • Describe the pain.
  • Does it travel to any other location?
  • What brings the pain on?
  • What eases it?


  • How old were you when you had your first period?
  • What was it like when it started?
  • What is the average time between periods now?
  • If they are irregular, give the shortest and longest cycles.
  • How long do your periods last?
  • Which is the heaviest day(s)?
  • Is there any pain?
  • How severe is it?
  • Describe the flow and how it changes (fresh, dark, clots, spotting, thin).
  • Does your mood change before your period?
  • Describe the mood changes.
  • How long before your period do they start?
  • Do you get any physical symptoms before your period begins?
  • Have you ever been pregnant? If so, do you have any children?
  • What were your pregnancies and labour like?
  • What forms of contraception have you used?
  • If you have been through the menopause, describe what it was like for you.


  • What word or phrase would you use to describe your mental and emotional states?
  • Have you ever suffered from anxiety or depression?
  • Do you regularly experience a particular type of uncontrollable emotion?
  • What are your concentration and memory like?
  • Do you have any problems getting to sleep?
  • Do you wake at night?
  • Do you have dreams that disturb your sleep?


  • Do you feel more sensitive to certain temperatures or weather? Specify.
  • Do you get hot or sweat abnormally?
  • Do you have any particular problems with your ears, eyes or nose? Describe.
  • Describe any previous history of illness.
  • Are there any hereditary diseases which run in your family? Specify which.
  • Note down any medication or supplements that you take on a regular basis.

Return from Diagnosis through Asking to Chinese Medicine Diagnosis

Web www.acupuncture-and-chinese-medicine.com

Share this page: