There are four areas that are involved in making a diagnosis in
Traditional Chinese Medicine (TCM). These areas are Observation,
Listening and Smelling, Questioning and Palpation (touching).

Observation involves looking at the patient’s complexion, eyes, gait
(overall physical appearance), tongue, and also the openness and
overall emotional demeanor of the patient.

Listening and smelling involves paying attention to the sound of the
patient’s voice and breathing, noticing any body odors or breath
odor.

Questioning involves gathering of information both past and present
complaints that the patient may have as to appetite, bladder, bowel
movements, digestion, emotional status, history of family health,
pain, patterns of sleep, physical environment, sweating and work.

Palpation (touching) involves assessing body temperature, presence of
moisture or pain/sensitivity, and the taking of the patient’s pulse.
There are a total of twelve pulses that are taken by placing 3 fingers
on each wrist that correspond with each of the meridians. There are
fourteen pulse characteristics: empty, full, rapid and slow…. etc.).
These characteristics are compared to the 12 pulses to determine which
organ is not working.

The purpose of treatment is to restore the balance of Yin/Yang. The
common therapies used to restore balance are: acupuncture, exercise,
diet and herbal remedies.

Listening and smelling involves listening to the sound of the
patient’s voice and to his breathing.

If the patient has a loud assertive voice, he has a yang pattern. A
patient with a timid and weak voice suggests a yin pattern. A patient
who presents with a restless and heavy breathing pattern is in an
excess syndrome. A patient with a shallow breathing is in a deficient
condition.

The sound of a cough can also suggest either a yang or yin pattern by
being loud and sudden or weak and persistent.

Another important part of these aspects of diagnosis is the smelling
part. The odors given off by the body and the excretions of the body
are important clues in diagnosis. It takes many, many years of
experience to be able to accurately use this aspect of diagnosis.
There are two different classifications of smell. The first is Yang
(hot, excess), which includes rancid or rotten smells. The second is
Yin (cold, deficient), which includes the strong, fishy aromas.
Generally any unusual odor indicates an illness.

The diagnosis takes into consideration the entire body, seeking to
understand the flow of balance and to detect if that flow is
disrupted; where it is that that imbalance is occurring. The two
theories (yin and yang and the five elements) are used to make the
diagnosis. The four areas observation, listening and smelling,
questioning and palpation are excellent diagnosing aids.