Listening and smelling

Question 1

What do vocal sounds indicate in terms of excess and deficiency?

Answer 1

loud (heat, excess), quiet and vague (wind or damp), and quiet (cold, deficiency)

Question 2

What are we listening for?

Answer 2

Voice, speech, breathing, sighing, coughing, sneezing, hiccup, belching, vomiting, borborygmi

Question 3

How is the voice produced?

Answer 3

Lungs, larynx (lungs), nose (lungs), epiglottis (kidneys), tongue (heart), teeth (kidneys), lips (spleen).

Question 4

What does sound indicate in terms of heat and cold?

Answer 4

loud volume / strong = heat, excess, soft volume / weak: cold, deficiency

Question 5

What are the sounds of the 5 elements?

Answer 5

Laughing (fire), Singing (earth), Weeping (metal), groaning (water) and shouting (wood).

Question 6

What is a normal vocal sound?

Answer 6

Normal vocal sound: natural, clear and smooth. Change in accordance with constitution, age, gender and emotional status.

Question 7

What are pathological vocal sounds?

Answer 7

hoarseness, rasping, loss of voice, congestion, snoring.

Question 8

What does a nasal voice indicate?

Answer 8

excess = external wind, deficiency = qi.
Phlegm = excess, Lung qi deficiency, damp = excess and qi & blood will be deficient.

Question 9

What does a hoarse voice indicate?

Answer 9

acute external wind heat with dryness, chronic = lung and kidney yin deficiency, acute = liver qi stagnation, chronic = swelling of pharynx phlegm and blood stasis. Acute = stagnation of qi

Question 10

What does snoring indicate?

Answer 10

loud = phlegm and damp, weak = phlegm and damp with underlying qi deficiency.

Question 11

What should normal speech sound like?

Answer 11

o Listening to speech = normal speech should sound natural, clear and fluent.
o A person should be able to easily express and convey their thoughts and feelings.
o Heart is linking to speech and is an expression of our consciousness (shen)
o Stuttering, muttering and speech issues are linked with heart pathology and shen.
o The lungs provide to project speech.

Question 12

What are we listening for in respiration?

Answer 12

o Listening to respiration: respiration is governed by the lungs. Lung and kidney relationship is integral to healthy breathing.
o Lung descend qi to the kidneys and the kidneys anchor the qi down.
o The lung and kidneys exchange fluid. The lungs send fluids to the kidneys, kidney yang evaporates the fluid and creates a fine mist to moisten the lungs.
o Normal respiration: neither too rapid nor too slow, regular rhythm, smooth and even flow. Without audible sounds.

Question 13

What is abnormal respiration?

Answer 13

asthma, wheezing, upper stifling breath, shortness of breath, weak breathing.
o Sighing is diagnostically important. Status of the lungs and liver. Liver qi stasis (often from stress) can lock the diaphragm (inhibiting the movement of qi and air in the lungs).

Question 14

What does an acute onset of cough indicate?

Answer 14

o Acute onset cough indicates an exterior pathogenic attack such as wind cold, wind heat and wind dryness.

Question 15

What does a barking cough indicate?

Answer 15

o Barking cough could be phlegm heat in the Lungs

o Loud, rich, loose sound. Worse in the morning / after meals = damp-phlegm in the lungs

Question 16

What does a chronic persistent dry weak cough with scanty sputum indicate?

Answer 16

dry phlegm in the lungs

Question 17

What does Persistent dry weak cough that is worse at night indicate?

Answer 17

lung yin deficiency

Question 18

What does Chronic feeble cough with a low volume indicate?

Answer 18

lung qi deficiency

Question 19

What does Reoccurring barking loud violent cough, uninterrupted and possibly leading to vomiting (esp in children) indicate?

Answer 19

RED FLAG: whooping cough – refer to GP for testing

Question 20

What is Borborygmi?

Answer 20

Borborygmi refers to gurgling sounds in the abdomen. Reflects damp accumulation or qi obstruction in abdomen and intestines. It reflects the body struggling to transform and transport fluids.

Question 21

What are we smelling?

Answer 21

body odours, the odours of excreted materials and the odours in a patients room.
o Patients breath and sweat
o Strong foul odours are associated with heat or damp heat. This is linked with the fu such as stomach, GB and LI.
o A sweet or rotten apple smell is associated with diabetes and this is considered a red flag.

Question 22

What are the smells in relation to the 5 elements?

Answer 22

Scorched (fire), sweet (earth), Rotten (metal), Putrid (water), wood (rancid/sour).