observation portion of diagnosis begins the moment the patient
appears before the practitioner. In this step, the practitioner
is forming an initial impression of the patient, while assessing
the seriousness of the condition based on four main considerations:
the color, complexion and lustre of the skin, and the
overall general impression of the patient are key points
in observation. The appearance of the face is an excellent
indicator of vitality as all the acupuncture meridians flow
to the face, by their primary or secondary pathways, and
the state of Blood and chi (qi) is very evident in this
the color of the face may reveal problems in the functioning
of the organs. For example, black circles under the eyes
could indicate kidney weakness, whereas red coloring (which
relates to heat/fire) is linked with the heart. Black or
blue coloring is linked with the kidneys, blue-green may
involve the liver, and white implies a lung problem.
Appearance: the appearance of the body can also provide
the practitioner with good information as to where the problems
lie. At this point the practitioner is mainly looking for
the distribution of fat, type of build, appearance of body
hair, etc.. For example, it is difficult for yang qi to
be distributed in a body with excess fat, therefore an overweight
person is more susceptible to cardiac arrest and stoke.
Features: facial expressions tell the practitioner about
the psychological status of the patient, whether it be sad,
happy, anxious or overjoyed, and are a point of consideration
prior to making a diagnosis. The features themselves, including
the eyes, nose, mouth and lips, can also provide evidence
of excess or deficient conditions causing imbalance in the
Tongue and its Coating: the inspection of the tongue
is a vital diagnostic procedure in the practice of Traditional
Chinese Medicine. The color, coating, shape and texture
of various parts of the tongue yield information about the
state of the organs.
tongue is moist and has an "appropriate" red color.
A light red or pale tongue is a sign of deficiency in both
qi and blood. A thick, purple colored tongue is often associated
with alcoholism, while cracks in the tongue show dryness,
heat, and deficient yin.
to an examination, it is important not to eat or drink anything
that will discolor the tongue and give a misleading impression
to the practitioner.