When we eat, we can smell the aroma of food, and when flowers bloom, we can smell their fragrance. The sense of smell is one way we judge our likes and dislikes. Traditional Chinese Medicine (TCM) emphasizes the four diagnostic methods: observation, listening, inquiry, and palpation, where the method of smelling not only refers to hearing sounds but also includes the sense of smell. Here, I will discuss how to assess health through the sense of smell.
Smelling is primarily about detecting abnormal odors from the patient’s body, excretions, and the environment, which is one aspect of the diagnostic method of smelling. This involves smelling the patient’s body, mouth, and various excretions to understand the condition and assess the nature of the illness, whether it is cold or hot, deficient or excess.
The organs and blood of the human body require the nourishment of the essence from food and water to carry out normal metabolism without producing abnormal odors. When a person is ill, the organs and blood are disturbed by pathogenic factors, leading to metabolic disorders, improper elimination of waste, and the generation of foul odors.
1. Odors
First, let’s discuss the odors associated with patients, which can be categorized as follows:
① Halitosis
Refers to the foul odor emitted from the mouth when the patient opens it. This is often seen in individuals with oral diseases or those with heat in the gastrointestinal tract. Halitosis due to oral diseases can be seen in conditions like dental caries, gingivitis, or poor oral hygiene. Halitosis due to gastrointestinal heat is often associated with stomach fire, food stagnation, or damp-heat in the spleen and stomach.
② Sweat Odor
Due to different causes of sweating, the odor of sweat can vary. For example, when external pathogens invade, such as wind, or when the defensive yang is insufficient, the sweat may be odorless. In cases of excess heat in the qi level or prolonged illness with yin deficiency and excess fire, the sweat may have a sour and rotten odor. In cases of wind-damp obstruction, the sweat may be yellowish and have a peculiar foul smell. If a patient with edema sweats and has a “urine-like odor,” it indicates a critical condition.
③ Nasal Odor
Refers to the foul odor emitted when exhaling through the nose. There are three causes: first, nasal discharge that is yellow, thick, and foul-smelling, which is often chronic and recurrent, indicating nasal sinusitis. Second, nasal ulcers, such as those caused by syphilis, leprosy, or cancer, can produce foul odors. Third, internal organ diseases, where the breath has a “rotten apple smell,” indicating severe diabetes. If the breath has a “urine-like odor,” it is often seen in patients with edema, indicating a critical condition.
④ Body Odor
Body odor can arise from ulcers, abscesses, or conditions like hyperhidrosis.
2. Odors of Excretions
The odors of the body’s excretions can also help us understand health issues, which is quite fascinating. Patients can often perceive the odors of their excretions. Therefore, through inquiry, we can learn about the abnormal odors of excretions such as phlegm, urine, and menstrual discharge.
Generally, diseases caused by damp-heat or heat pathogens produce excretions that are turbid and foul-smelling; whereas diseases caused by cold or cold-damp pathogens produce excretions that are clear and without special odors.
① Vomit with Foul Odor
This is often due to excessive stomach heat. If the vomit has a sour and rotten smell, resembling undigested food, it indicates food stagnation.
② Vomit with Fishy Odor
This may contain pus and blood, indicating a gastric abscess. If the vomit is clear and thin without odor or fishy smell, it indicates cold in the spleen and stomach.
③ Belching with Sour Odor
This is often due to excessive heat in the stomach or food stagnation. Belching without odor is often due to liver qi invading the stomach or cold pathogens affecting the stomach.
④ Urine with Foul Odor
Its color is yellow and turbid, indicating a pattern of excess heat. If the urine is clear and long, with a slight fishy smell or no special odor, it indicates a deficiency or cold pattern.
⑤ Foul-Smelling Stool
Yellow, loose stools or those with red or white pus and blood indicate damp-heat in the large intestine. In children, sour-smelling stools with undigested food indicate food stagnation. Loose stools with a fishy odor indicate spleen and stomach deficiency and cold.
⑥ Flatulence with Foul Odor
This is often due to overeating, food stagnation in the middle jiao, or fecal impaction in the intestines. Continuous flatulence with sound but no odor is often due to liver qi stagnation and poor bowel movement. Foul odor during menstruation or postpartum discharge is due to heat pathogens invading the uterus. Vaginal discharge with foul odor and yellow color indicates damp-heat descending. Vaginal discharge with fishy odor and white color indicates cold-damp descending.
3. Odors in the Sickroom
The odors in the sickroom arise from the body and excretions of the patient.
In the early stages of an epidemic, there may be foul odors that can be felt, ranging from mild to overwhelming in the room.
A strong bloody smell in the room often indicates blood loss.
A putrid smell in the room often indicates purulent ulcers.
A corpse-like smell in the room indicates organ failure.
A urine-like smell in the room is often seen in late-stage edema.
A rotten apple smell in the room is often seen in diabetes.
(This content is compiled from the internet; please contact us for removal if there are any copyright issues.)
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