TCM and Diagnosing Illness

Preventing Patterns of Disharmony from occurring is the objective of Chinese Medicine. If illness does occur, it is treated through a unique system of diagnosis called the Four Examinations.

A brief description of each follows.

  • Looking Examination—This examination involves the observation of all aspects of the person: complexion, demeanor, manner of walk, body shape, and skin anomalies. The Looking Examination frequently focuses on the tongue. Specific changes in the tongue's color, shape, and coating reflect specific changes in the Vital Substances and/or Internal Organs. For example, a pale, swollen tongue with teeth marks and a thick white coat may indicate a deficiency of Qi.
  • Listening–Smelling Examination—This examination relates specific sounds and smells of an illness to a specific Pattern of Disharmony. For example, a loud barking cough indicates an excess condition, whereas, a weak cough indicates a deficient condition.
  • Asking Examination—The patient is asked a series of questions about sensations of hot and cold, level of thirst, appetite, and bowel movements. The practitioner also asks detailed questions about diet, exercise, lifestyle, work habits, and exposure to Pathogenic Factors. The answers help direct the practitioner to the pathological process occurring.
  • Touching Examination—Areas of pain or discomfort are felt by the practitioner to determine the cause of the dysfunction. The pulse is usually felt. In conventional medicine, the pulse indicates qualities such as speed, strength, and regularity. In Chinese Medicine, the pulse is used as a diagnostic tool. The radial pulse, felt on the wrist, is divided into three different positions and each position has three different levels. Each pulse position is related to a Zang Fu Organ. There are 27 different pulse qualities that supply information. Pulse taking is difficult to learn and takes years to master. An example of a pulse quality is a Wiry pulse, which feels like a guitar string and may indicate that Qi is stagnant.

A Chinese medicine practitioner takes the information from the Four Examinations and determines the underlying Pattern of Disharmony. The appropriate treatment is then chosen.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 01 Jan 2001

Last Modified: 08 Oct 2015