 Second, women were often silent about their issues with doctors and male figures due to the societal expectation of female modesty and the presence of a male figure in the room.Third, the presence of male authority in the sick room and the patriarchal dominated society also caused doctors to reference their women and children patients "the anonymous category of family members ("Jia Ren") or household ("Ju Jia")" in their journals.This anonymity and lack of conversation between the doctor and woman patient led to the inquiry diagnosis of the Four Diagnostic Methods being the most challenging.