Diagnosis by observation

Diagnosis By Spirit Observation:

observed through the eyes, complexion, breathing, vitality, and aura – describe, either strong or weak

Diagnosis by Body constitution:

wood – tall and slender fire – small pointed head and small hands

metal – broad square shoulders, strongly built and a triangular face

earth – slightly fat, large head belly and thighs, wide jaws

water - round face and body, and a long spine

Diagnosis by Demeanour:

how the person moves should correspond with their constitution

rapid jerky movements (Yang excess, or Heat)

slow or lack of movement (Yin deficiency, or Cold)

Diagnosis of Hair:

falling hair (Blood deficiency) - premature graying (Kidney Essence deficiency) - dull splitting (Lung deficiency)

Face Diagnosis:

clear and moist (Stomach Qi healthy) -

dry and lusterless (Stomach Qi deficiency) -

green (Liver, interior Cold, pain, internal Wind) -

red (whole face – excess Heat, malar – deficiency Heat) -

yellow (Spleen deficiency, Damp) -

bright orange-yellow (Damp/Heat) -

dry yellow (Spleen or Stomach Heat) -

dull pale yellow (Spleen Stomach Damp/Cold) -

white dull (Blood deficiency) -

white bright (Yang deficiency) -

black moist (Cold) -

black dry (Kidney -

black moist (Cold) -

black dry (Kidney Yin deficiency)

***Important to use corresponding facial areas to aid in diagnosis.

Diagnosis of The Eyes:

(there are differing theories, only one will be discussed)

- red inner corners (Heart Fire) - red sclera (Lung Heat) - yellow sclera (Damp/Heat) - whole eye red painful swollen (Wind/Heat, or Liver Fire) - pale white corners and lids (Blood deficiency) - dark or swelling under the eye ‘bags’ (Kidney deficiency)

Diagnosis of The Nose:

green-blue (abdominal pain) - yellow (Damp/Heat) - white (Blood deficiency) - red (Lung Spleen Heat) - grey (impairment of water movement) - dry tip (Stomach or Large Intestine Heat) - dry black (Toxic Fire) - clear discharge (Cold) - yellow discharge (Heat)

Ear Diagnosis

blue-black (pain) - white (Cold) - lobes dry withered black (Kidney deficiency – prognosis bad) - lobes shiny and moist (prognosis good) - lobes long and full (strong Kidneys) - lobes thin and small (weak Kidneys) - infection with pain (Fire in Shaoyang meridians)

Mouth and lips - pale lips (Blood or Yang deficiency) - red dry lips (Spleen Stomach Heat) - purple-bluish lips (Blood Stasis) - mouth always slightly open (deficiency) - breathe though mouth (Lung Qi deficiency) - green around mouth (Liver Blood Stasis, and Wood overact on Earth)

Teeth and gum Diagnosis:

dry teeth (Kidney Yin deficiency, or Yangming Heat) - poor tooth development (Kidney deficiency) - swollen painful gums with possible bleeding (Stomach Heat, if no pain deficiency Heat) - pale gums (Blood deficiency)

Diagnosis of The Throat:

pain, redness, swelling (Wind/Heat, or Stomach Fire)

- sore and dry, not red and swollen (Kidney Yin deficiency Heat)

Diagnosis of the Nails and limbs:

- pale nails (Blood deficiency) - purple-blue (Liver Blood Stasis) - dry lifeless skin around the wrists and ankles (body fluid deficiency)

Diagnosing Children:

The first joint on the index finger is the ‘gate of wind’, the second is the ‘gate of Qi’, and the third is the ‘gate of life’.

- after rubbing the finger towards the body…

- veins appear only beyond the ‘gate of wind’ (mild, exterior invasion)

- veins appear beyond the ‘gate of Qi’ (internal, more serious)

- veins appear beyond the ‘gate of life’ (serious life threatening disease) 

- blue veins (Cold)

- red veins (Heat)

Diagnosing The Skin:

- dry (Blood deficiency)

- itchiness (Wind)

- pitting edema (Kidney Yang deficiency)          - non-pitting edema (Qi stagnation)

- bright clear yellow Yang jaundice (Damp/Heat)

- dull yellow Yin jaundice (Damp/Cold)

Diagnosing The Tongue:

root (Kidney) - middle (Spleen Stomach) - sides (Liver Gallbladder) - tip (Heart) - behind tip (Lungs)

Tongue Body Diagnosis: 

Tongue body colour indicates condition of blood, Ying Qi, and Zang organs

- pale red (normal) - pale (Blood or Yang deficiency) - red (excess or deficient heat) - red spots/papillae (Heat or Blood Stasis) - deep red (more severe Heat) - purple (Blood Stasis) - blue (Cold causing Blood Stasis)

Tongue body shape shows blood and Ying Qi

- thin (blood or Yin deficiency) - swollen (Yang deficiency causing Damp or Damp/Heat) - stiff (internal Wind) - flaccid (body fluid deficiency) - long (Heart Heat) - short (interior Cold or severe Yin deficiency) - cracked (horizontal = Stomach Yin deficiency, midline to tip = Heart, midline shallow wide = Stomach Yin deficiency) - quivering (Spleen Qi deficiency) - tooth-marked (Spleen Qi deficiency)

Tongue Coating Diagnosis  -  Tongue coating shows the Fu organs (in particular the Stomach, the coat is the left over from the digestion)

- thin white (Stomach is digesting normally) - thick (Wind, Cold, Damp, retention of food, Phlegm, Heat, Fire, the thicker the more severe) - no coat (Stomach or Kidney Yin deficiency) - white (Cold) - yellow (excess Heat) - grey or black (severe Cold or Heat depending on the moisture) moisture shows body fluids - dry (Heat has injured the body fluids) - slightly moist (normal) - too wet (Yang Qi deficiency Damp) - sticky or slippery (Damp or Phlegm)

Diagnosis by Meridians:

The following symptoms are signs which apply only to the specific meridian, organ symptoms have been left out. In addition to the following clinical manifestations, any pain, heat or coldness, numbness, stiffness, knots, tingling, aches, redness, or any other sign along the course of a meridian is also an obvious meridian symptom.

Lung Meridian  (hand Taiyin) External pathogenic invasion, accumulation of Lung heat: i.e. fever, aversion to cold, stuffiness of the chest, pain in the clavicle, shoulders and arms.

Large Intestine Meridian  (hand Yangming) Wind/cold/damp blockage, accumulation of heat: i.e. sore throat, toothache, epistaxis (nosebleed), runny nose, swollen and painful gums, swollen eyes

Stomach Meridian (foot Yangming) External pathogenic invasion, Stomach heat rebelling: i.e. pain in the eyes, epistaxis (nosebleed), swelling of neck, facial paralysis, cold legs and feet

Spleen Meridian (foot Taiyin) Wind/cold/damp, heat rebelling: i.e. vaginal discharge, weakness of the leg muscles, tongue stiffness/pain

Heart Meridian (hand Shaoyin) Wind/cold/damp blockage, heat rebelling: i.e. pain in the eyes, pain on the inner side of the arm, pain along the scapula, eye jaundice, tongue ulcers, pyogenic infections

Small Intestine Meridian (hand Taiyang) External pathogenic invasion, heat rebelling: i.e. pain and/or stiffness of the neck and/or elbow, red eyes, sore throat, mandible swelling, ear trouble

Bladder Meridian (foot Taiyang) Wind/cold/damp blockage, heat rebelling: i.e. fever and aversion to cold, headache, stiff neck, pain in lower back and/or eyes, pain in the posterior leg, hard to bend, nosebleed, hemorrhoids

Kidney Meridian (foot Shaoyin) Cold: i.e. pain in lower back and/or sole of foot

Pericardium Meridian (hand Jueyin) Cold, heat, Liver Qi stagnation: i.e. stiff neck, contraction of elbow or hand, Bi and Wei syndromes, armpit swelling, hot palms, chest pain, shaking arms (anger)

San Jiao  Meridian (hand Shaoyang) Wind/cold/damp, heat: i.e. sore throat, scrofula, goiter, axillary swelling, pain in the elbow, alternation of chills and fever, deafness, pain and discharge from the ear, pain at the top of the shoulders

Gallbladder Meridian (foot Shaoyang) Cold stagnation, heat rebelling: i.e. alternation of chills and fever, headache, deafness, pain in hip and lateral side of legs, pain and distension of breasts, difficult leg movements, 4^th and 5^th toe disorders, inner ear pain, migraine, bitter taste

Liver Meridian (foot Jueyin) Cold stagnation, Wind Fire rebelling: i.e. headache, pain and swelling of the eye, leg cramps, pain in side of lower abdomen, hernia, one sided testicle pain radiating to low abdomen, dizziness, blurred vision, eyelid twitching, difficulty swallowing, facial deviation