TCM Diagnostic Method - Inspection
Diagnostic Methods Used in the TCM ExaminationThere are four examination methods: Questioning/history taking, inspection, auscultation (listening) & olfaction (smelling), and palpation. The four methods have their unique clinical functions and cannot be replaced by one another. Sometimes, false manifestations of a disease occur which emphasize the importance of integrating all diagnostic methods.
II. InspectionExamination through inspection entails the physician using visual senses to investigate a patient's condition. This includes observation of the entire body (spirit, color, form, bearing), as well as content derived from areas of the body, the tongue etc. This is a method for TCM physicians to understand and predict the pathological changes of internal organs through observing abnormal changes in the patient's vitality, appearance, secretions and excretions. The Chinese physicians realized the close relationship between the external part of the body, especially the face and tongue, and the organs. Any slight changes that appear reveal the pathological conditions of various parts of the body. Chinese medicine usually focuses on the following:
SpiritSpirit is the outward manifestation of vital activities. By inspecting it, one gains insight into the development of the disease, and can measure the strength or weakness of the disease, and judge the prognosis. If the person behaves normally, is alert and co-operative, the disease is usually mild. But if responses are sluggish or confused, the disease could be serious.
ColourSkin colour varies according to your race. The lustre (or moisture) of the skin reflects the prosperity or decline of the qi (vital energy) and essence. In TCM, skin colours are divided into five colours corresponding to the organs - blue is for the liver, red for the heart, yellow for the spleen, white for the lungs, and black for the kidneys. Changes in skin colour reflect the nature of a disease and various syndromes of different organs. Discolorations are usually seen: purple or green-blue, yellow, red, pale and dark gray.Common discolorations in TCM examination
Discoloration: Associated syndrome(s)Purple, Green-blue: Cold syndrome, painful syndrome, blood stasis or liver diseaseRed: Heat syndromeYellow: Dampness syndrome, syndromes of deficiency (xu) typePale: Cold syndrome of deficiceny (xu) type, blood lossDark gray: Kidney deficiency, cold syndrome, painful syndrome, blood stasis or static fluid syndromes.
FormThe body shape can be described as strong, weak, heavy or skinny. TCM believes overweight people tend to be excessive in phlegm and dampness. A thin person with dry skin indicates insufficiency of blood. Great loss of weight in the course of a long illness indicates exhaustion of essence.
BearingThe patient's movement and posture are outward manifestations of pathological changes. There is a variation of movement and posture in different diseases. For example, the appearance of numbness and impaired movement of the limbs on one side of the body indicates stroke, pain and soreness. Heaviness and numbness in the tendons, bones and muscles accompanied by swelling and restricted movement at the joints appear in rheumatism.
TCM Tongue examinationObservation of the tongue, also known as tongue diagnosis, is an important procedure in TCM examination. It includes observing the tongue and any coating it may have. The tongue body refers to the muscular tissue of the tongue. The tongue coating (fur) refers to a layer of "moss" over the tongue surface, which is produced by the stomach qi. In ancient times, it was established that different parts of the tongue correspond to different internal organs. The tip of the tongue reflects the heart and lungs; the middle part, the spleen and stomach; its root, the kidneys; and both sides of the tongue, liver and gall-bladder.The tongue body and fur together create the tongue sign. Tongue signs are an important factor in diagnosis, as changes in the signs, reflect changes in the condition of the disease. A normal tongue sign is proper size, soft in quality, free in motion, pale red in color and with a thin layer of white coating which is neither dry nor overly moist.
Different diseased tongue signs:
Pale tongue with white and thin coatingPale red tongue with white glossy coatingRed tongue with fissures; and the coating is white, thin and a little rough. Red tongue with yellow, thick and greasy coating. Deep red tongue without any coating. Purple tongue with white, thin and slimy coating.
Disclaimer:All the material presented in this article is for informational purposes only and should not take the place of a consultation from a trained medical professional.