TCM III - Diagnosis by Looking

Question 1

Diagnosis by looking

Answer 1

Diagnosis by looking takes into account a range of elements. Be present and discreetly observe:
* Spirit
* Body type
* Skin
* Face
* Hair and Ears
* Eyes
* Mouth and lips
* Demeanour
* Movements
* Colours

Question 2

Tongue

Answer 2

Tongue diagnosis is a skill of its own. We look at:
* Size
* Shape
* Colour
* Texture
* Coating
* Cracks
* Bumps
* Different areas

Question 3

Skin

Answer 3

The colour and texture of the skin reflects the state of Qi and Blood:
* Strong red = Excess heat
* Pale red or malar flush = Yin deficiency
* Purple = Blood stasis
* Blue = Cold
* Dull white = Blood deficiency
* Bright weight = Qi deficiency
* Puffy = Damp or Yang deficiency
* Dry = Blood or Yin deficiency, dehydration
* Itchy = Wind or Wind Heat
* Pitting Oedema = Kidney Yang deficiency
* Non-pitting oedema = Qi stasis
* Flakes and scales = Damp
* Oozing = Damp heat

Question 4

Facial areas: Eyes

Answer 4

• Red sclera = Heat
• Red and itching sclera = Wind heat
• Yellow and murky sclera = Dampness
• Under eyelid pale = blood deficiency
• Bright red eyelid = heat in the blood

Question 5

Facial areas: Nose

Answer 5

• Flaring and closing nostrils = Heat in the lungs
• Dry nostrils = Heat in the lungs
• Tip red = Heart disorder
• Clear runny mucus = damp cold
• Sticky mucus = damp heat or phlegm

Question 6

Facial areas: Ears

Answer 6

The kidneys open into the ears in TCM
* Long, full, free hanging earlobe = Good constitution, Strong essence (Jing)
* Small earlobe, joined to head = Poor constitution
* Small ears = poor constitution
* White ears = Cold
* Dry, withered or black earlobes = exhaustion of kidney Qi

Question 7

Facial areas: Chin

Answer 7

• A weak chin can donate kidney weakness

Question 8

Mouth lips and gardens

Answer 8

• Normal lips should be pale red, moist and shiny
• Dull white = Qi and Blood deficiency
• Purple or blue = cold, stagnant Qi and blood
• Deep red = Excess heat
• Dry = body fluids injured, spleen deficiency
• Green colour around mouth = liver and spleen disharmony
• Pale gums = blood deficiency
• Bleeding gums with pain = heat in the stomach
• Bleeding gums with no pain = empty heat

Question 9

Nails

Answer 9

• Ridged, thin or brittle = Blood deficiency
• Thickened = Blood stasis (Or a fungal infection)
• Yellow = damp heat
• White = blood deficiency
• Purplish = blood stasis
• Red = heat

Question 10

Hair

Answer 10

The kidneys govern the hair on the head, whilst hair generally as an extension of the blood
* Thin and dry = blood deficiency
* Falling out = blood deficiency
* Falls out in patches = blood deficiency and wind
* Poor Lustre = lung deficiency

Question 11

Shen Or Spirit

Answer 11

The vitality of the mental and emotional state might be assessed through observation:

• Spirit:
  o Healthy complexion
  o Firm muscles
  o Normal facial colour
  o Normal breathing
  o Spark in the eyes
• No spirit:
  o Unhealthy complexion
  o Withered muscles
  o Dark facial colour
  o Erratic or laboured breathing
  o Disturbed or dull eyes