Inspection of Shen & Face

Question 1

What is inspection?

Answer 1

• The very first assessment that takes place on meeting a patient
• This includes: the whole body, local areas, an infant’s index finger, inspection of secretions and the tongue
• Spirit, body, movement, sense organs, face, skin, tongue and channels.
• The whole person: what is the spirit of the person? Are they dynamic or energetic? What is there complexion? What is their size? What is there shape?

Question 2

What is Shen?

Answer 2

Shen – spirit which reflects their vitality, consciousness, mental health, emotional balance and cognition.

Question 3

What is a healthy Shen?

Answer 3

A healthy shen: bright eyes, strong vitality, calm demeanour, normal emotional responses, clear speech, good reasoning, radiant complexion and body is flexible / smooth in movement.

Question 4

What are signs and symptoms of Shen?

Answer 4

Anxiety, insomnia, restlessness, mania, delirium, psychosis, hallucinations, listlessness, clouded thoughts, dull eyes, erratic movements, stuttering, inappropriate laughing or crying, palpitations, dream disturbed sleep and irregular breath

Question 5

How can we observe Shen?

Answer 5

• Shen observation: facial expression, mental state, language, speech, reactivity, breathing, physical movement and eyes.

Question 6

What causes deficient Shen?

Answer 6

• Qi and blood can stagnate resulting in blockage
• Shock / trauma can disturb and scatter the Shen
• Heat or Fire can harass the heart
• Deficient Yin fails to nourish and cool the heart
• Phlegm can mist the mind
• Deficient blood can fail to house the shen
• Having spirit (You Shen) healthy shen, sufficient essence, mild illness, good prognosis.
• Fatigued spirit (Shen Pi) deficiency of Heart, Spleen or Kidney Yang

Question 7

What is lack of spirit?

Answer 7

Lack of Spirit (Shao Shen) this is the most severe and what is usually referred to as Shen disturbance. Loss of spirit – exhausted essence, severe illness or poor prognosis. False spirit – a pseudo phenomenon indicating a crisis stage. Spirit disturbance – psychological and emotional disorder due to various causes.

Question 8

What is inspection of complexion?

Answer 8

• Complexion: facial colour – the colour of the actual skin, facial sheen – skin lustre
• Observing the facial colour will help you to differentiate hot and cold, identify the location of disease and judge the condition of the qi, yang, yin and blood.
• Identify possible organs or channels involved
• Establish a prognosis.

Question 9

What is an abnormal facial colour?

Answer 9

• Abnormal facial colour: colour reflects the type of pathology and location can reflect channel involvement
• Abnormal facial sheen: withered and dull indicates deficient Jing
• Observing facial colours

Question 10

What does a green complexion indicate?

Answer 10

Liver & Gall Bladder
Spring
Wind

Blue-green = wind
Dark blue/green = cold
Sudden blue/green = pain
Blue/green/purple = stasis

Question 11

What does a red complexion indicate?

Answer 11

Heart & small intestine
Summer
Heat

Red face = full heat
Red cheeks = empty heat
Red in a particular place indicates heat in the corresponding channel organ

Question 12

What does a yellow complexion indicate?

Answer 12

Spleen & stomach
Late summer
Damp

Pale yellow = spleen deficiency
Bright orange/yellow = damp heat (more heat)
Smoky hazy yellow = damp heat. (more damp)

Question 13

What does a white complexion indicate?

Answer 13

Lung & Large intestine
Autumn
Dryness

Pale dull white = qi or blood deficiency
Bright white = yang deficiency
Bluish white = cold
Pale with no sheen = bleeding

Question 14

What does a black complexion indicate?

Answer 14

Kidney & Bladder
Winter
Cold

Dark black = cold, kidney yang xu
Dry scorched black = kidney yin xu
Purple black = blood stasis