TCM- Diagnosis in Chinese Medicine (Test 6)

2 Fundamental Diagnosis Principles:

• Inspect the exterior to examine the interior- outward signs and symptoms reflect the condition of the Internal Organs.
• A part reflects the whole- the state of the whole organism can be determined from examination of a part of it.

4 methods of examination:

1. Observation (Looking)
   
2. Auscultation (Hearing and Smelling)
   
3. Interrogation (Asking)
   
4. Palpation (Touching)

2 Important things to keep in mind:

1. Correspondence between an Individual Part and the Whole- One of the principles on which diagnosis by observation is based on is that each single, small part of the body reflect the whole. Important example of this are the face, tongue, pulse, and ear.
2. Observation of Constitutional Traits- Why is it important to observe constitutional traits?
1. a constitutional type indicated the tendency to certain disharmonies and it allows us to forecast, and prevent a possible pathological development.
2. allows for us to put the presenting disharmony into perspective, helping up to gauge its severity

Diagnosis by Observation involves looking at the following aspects:

• nose
  
• ears
• mouth
• teeth
• tongue
• and...

Spirit:

1. In a general sense, it indicates a general state of vitality; if this is thriving, the person has spirit. The presence or absence of spirit can be observed in the complexion, eyes, state of the mind, and the breathing.
1. With spirit----> complexion is healthy, the muscles are firm, the face color is clear, the eyes have glitter and reveal inner vitality, mind is clear and breathing is even.
2. Without spirit----> complexion is dull, muscles are withered, face color is dark, eyes move uncontrollably, show no inner vitality or are not clear, the mind is unclear and breathing is labored or shallow.
2. Spirit of a person also refers to the mental-emotional-spiritual state of the person.
1. Strong spirit----> clear voice that projects outwards well, the eyes and the complexion have luster, expression is lively, mind is clear and alert, person walks with an erect posture and has a naturally optimistic, enthusiastic and mentally strong attitude.

Body:
3 aspects to consider when examining the physical appearance of a patient:

• Constitutional Type
• Long tern changes in physical appearance
• short term changes

Demeanor:
This includes the way that a person moves, and also movement of individual parts of the body, such as eyes, face, mouth, limbs, and fingers.

• General principle:
  
• Excess of movement, or rapid and jerky movements --> Yang, Full, or Hot patterns
• Lack of movement, or slow movements ---> Yin, Empty or Cold patterns

Movements such as tremors or convulsions always indicate the presence of interior Wind of the Liver.


Head and Face:
4 Attributes of a normal complexion:

• Luster
• slightly shiny
• vibrant in color
• Subtle, slightly reddish hue
• reddish hue indicates a good supply of heart blood and a good state of mind
• a 'contained' 'veiled' color
• Moisture

Pathological Colors of Complexion

White:

• Dull White- blood dificiency
• bright white- yang deficiency
• bluish white- yang deficiency with cold

Red:

• Whole face red- full heat
• red cheekbones- empty- heat

Yellow:

• Sallow yellow- ST and SP deficiency or blood deficiency

Green:

• Green face- liver patterns, interior cold, pain or interior wind
• green complexion with red eyes- liver fire
• dark reddish green complexion- stagnant liver qi turning into heat

Blue:

• white bluish - cold, or chronic pain

Black:

• cold, pain or kidney disease usually kidney tin
• black and moist0 cold
• black and dried up, heat

A moist color is a sign of good prognosis , while a dry color is a sign of poor prognosis




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