Visual diagnosis: General appearance, tongue,eyes,ears, nose, stool, urine, ski complexion, colon (large intestine) and texture of blood, nail colour and shine.

1. What has caused the problem - what is the primary cause?
2. How does the patient experience the discomfort (symptoms) - can he tell if it is more HOT or COLD?
3. Where on the body is discomfort experienced?  Upper, middle or lower body?
4. Is it possible to see the abnormality?  Establish condition of 5 vital/vessel organs.
5. Where (geographically) did the patient contract the condition. E.g. mountain, plain etc.
6. During which part of the day does the patient experience discomfort most?  Morning, noon, evening?
Location of problem, location of patients' dwelling. Time of day.   Study all 10 phenomena for use in interrogation and conclusion of problem.

Factors in course of disease - accumulation, manifestation, subsidence
Causes - Primary, Immediate, Location, Passage of disease.  Character of different ailments.
Don't just listen to how patient feels, look at pulse, urine, appearance etc. 
Visualization - 50 factors,  Palpitation 27 factors,   Interrogation - 10 factors: 87 total
  

Diagnosis: 
Types are ascertained by :
Physical appearance: Body shape, height, frame size, weight.
Skin texture ó smooth, rough, oily, dry
Complexion radiance ó high colour, pale and even, pale and uneven in texture and colouring
Eyes, nails ó colour, e.g. yelllowish ó liver, nails ó dry, oily, colour or pale
Skin temperature ó cool and slippery, cool and rough, warm and hot
Hair colour/texture ó brown to reddish/hot, pale, fairish/cool. Dry, oily, thick,thin
Speech/movements ó careful, slow, quick, jerky, nervous gestures, nailbiting etc.
Pulse
Urine
Interrogation ó which foods preferred? Light or heavy sleep? Calm or short-tempered? Good appetite and can hunger be tolerated ó can they miss a meal? Where on body is discomfort experienced? 
Time of day? Season?
 

TREATMENT OF PATIENT:

1.  Attitude should be like 'carrying lamp over high, thin wall.'  Merry-making going on below - person who walked over wall has seen nothing.  All on's attention should be on the patient, like the man who walked over the wall.  Immeasurable love and compassion must be generated towards patient.  The Dali Lama stresses this in meeting with new doctors.
Love can outweigh knowledge when curing people.
Calm and gentle way of speaking to patient.

2.  Some people accept what physician tells them about their way of living, e.g. change, some do not.  Some people are stubborn and will not accept. Try to cultivate patients' positive attitude towards the treatment - medicine will then work better.

3.  Has patient has had any other treatment for the problem?  Treatment given - was it hot nature for a cold problem etc.  Some people see lots of different doctors.  Was the treatment suitable or not?   If treatment was right for his illness - what degree of treatment given - mild, strong etc.  Responsibility lies with patient, as much as doctor, to carry out the treatment.  Previous treatment may not havew been carried out by patient - check this.

Life is like the palm of the hand - dirty, then wash, clean, but will get dirty again.
'Tonglen' is helpful in a difficult illness.
Intensity - too little, too much - adverse effect.  Right medicine, too little, disorder increases.  Too much, can reduce effectiveness.

4.  Hot treatment.  Could be given for hot disease due to misconception on part of doctor.  Differentiate between cold and hot nature.
Lung symptoms - could have an innate obstructive nalture - fever could cause insomnia, pain in joints, shivering (cold).   Lung symptoms, but not Lung.
Talkativenss could be high fever, not Lung.  One should check urine analysis, pulse, tongue, interrogation - time of day patient experiences discomfort etc.
Headache - dryness of mouth, thirstiness.  Backache - hot temperament - Tipa.   Too much disturbance of Lung, dryness of mouth, thrist, backache.
Headache - Lung: giddiness, tinnitus
Headache - Tipa: hot,  no giddiness.        Yellowness, bile, could be other?

General Signs and Symptoms:  Oral Tantra has chapter about misconception of nature of disease.

5. Diet.  Right diet and behaviour - according to the season and type.  Right diet and behaviour supports medicine, hastens recovery.

6.  Go on dealing with symptoms not cause is like person treating leaves of poison tree and not the trunk -  one should try to uproot the tree.
Look for the root cause of treatment. - 3rd chapter of Oral Tantra.
FOMENTATION - does not treat  root cause, but gives patient ease along the way.  See Fomentation in Acessory Therapy section.

Oral Tantra -Indigestion is root cause of dropsy (unusually watery state of the tissues of the body) Leakage of the fluid part of the blood into the flesh/vessels of the body, causing swelling due to obstruction in that area.  Controlled by the lymphatic glands.  SWELLING is the outward sign of this disorder. Give medicine first for dropsy, cure disbalance of digestion.  Give medicine for the digestive power then specifically for symptoms presenting.

7.  Problems -in spite of the right treatment from patient's point of view, problem gets worse.  Could be due to obstructive nature of the ailment.  Could be some  aggravation of the problem such as 'hidden fever'.   Like homeopathy - get problem to show itself, e.g. increase fever with purgatives, stimulate nature of ailment.   Misconception of incompatability of treatment - time factor invovlved, may take longer than patient expects to feel better.  Strong stream, want to dam, very strong may be difficult, but as speed slows, then work will suceed.  Patient feels treatment is no good, will not help, although treatment is right.
Don't just listen to how patient feels, look at pulse, urine, appearance etc. 

Easy way to find out what is wrong is to give long treatment.  Patient complains at not getting results - STOP treatment for a few days, patient may feel worse again.
Correlate all the factors before drawing a conclusion.