Observational Diagnosis in Traditional Chinese Medicine

1. Spots on the eyelids: Indicate hormonal imbalance or intrauterine congestion, irregular menstruation, or gynecological fibroids.

2. Spots at the outer corners of the eyes: Suggest decreased thyroid function, poor organ oxygenation, low psychological resilience, and sensitive skin.

3. Swelling of the eyelids due to spleen deficiency: Indicates kidney deficiency, dark eye bags, excessive vaginal discharge, heavy menstrual flow, early menstruation, and lower back pain.

4. Lung and stomach heat stagnation: Acne on the nose tip, blackheads, rosacea, enlarged pores, and bad breath.

5. Spots around the eyes: Indicate uterine diseases, progesterone deficiency, and pelvic congestion.

6. Spots on the cheeks: Suggest liver metabolic disorders, decreased gastrointestinal function, and allergic colitis.

7. Pimples around the mouth: Indicate poor gastrointestinal health, dietary imbalance, digestive disorders, bad breath, and dry stools.

8. Liver issues can lead to liver spots (i.e., below the corners of the eyes); yellow conjunctiva indicates hepatitis, pale lower eyelids suggest anemia, and dry eyes indicate excessive liver fire. Liver qi stagnation manifests as irritability, and liver spots may appear as small dots gradually merging into patches.

9. Spots below the nose: Indicate insufficient endocrine function of the bladder and ovaries, with clear or yellowish discharge having a foul odor.

10. Spots on the bridge of the nose are often related to liver and gallbladder metabolic disorders, commonly appearing alongside cheek spots, known as butterfly spots.

11. Lesions on the jaw: Indicate kidney qi deficiency and bladder damp-heat, resulting in large, pus-filled lesions with deep red color.

12. Spots on the hairline: Indicate poor qi and blood circulation, acne, and excessive oiliness due to overactive sebaceous glands.

13. Acne on the forehead: Indicates developed sebaceous glands, numerous whitehead pustules, and lung heat.

14. Spots around the eyes: Indicate uterine diseases, progesterone deficiency, and possible pelvic congestion.

15. Spots on the jaw: Acne is often related to the menstrual cycle, worsening before menstruation and improving afterward, with symptoms of yin deficiency, cold intolerance, excessive vaginal discharge, and rheumatic pain.

16. Acne on the chin: Indicates damp-heat in the lower jiao, excessive yellowish discharge, and vulvar itching.

Observing the complexion

1. Observing Qi:

This primarily involves observing the luster of the skin in the hand diagnosis area. The skin’s luster reflects the external manifestation of organ qi and blood, providing physiological or pathological information about the organs. Observing qi can give a preliminary understanding of the severity of the disease and prognosis. Bright and moist skin indicates “presence of qi,” while dull and dry skin indicates “absence of qi.”

The color of the skin on the palms being rosy and shiny is a sign of health and sufficient righteous qi. Even if there are some subjective symptoms or diseases, recovery is generally faster. Dull skin indicates poor health, a sub-healthy state, and if it appears dark and dry, it suggests potential latent diseases or serious conditions already present in the body.

2. Observing Color:

This refers to judging the health status of the body by observing the color and changes in various hand diagnosis areas. Color observation is based on the TCM theories of yin-yang and the five elements, analyzing the health of the five zang and six fu organs. Although the color of the hands may vary due to genetics, occupation, gender, age, race, and seasonal changes, there are still certain commonalities.

The ideal color is moist and bright. A normal person’s palms are light red or pink, bright and shiny. If the skin is bright yet reserved, the organs may be diseased, but the stomach qi is intact, indicating a good prognosis; if the skin is dull and exposed, it suggests significant damage to the stomach qi and severe organ changes, indicating a poor prognosis. The hands may temporarily change color due to labor, alcohol consumption, or emotional stress, which should not be considered pathological.

3. Five Colors Indicating Disease:

(1) White:

White indicates deficiency, cold, blood loss, inflammation, anemia, and pain. White reflects a lack of vitality; when yang qi is deficient, qi and blood circulation is weak, or qi is consumed due to blood loss, the corresponding hand diagnosis area appears white.

For example, if the kidney area appears white, it indicates kidney qi deficiency; if the spleen and stomach area is white, it indicates spleen and stomach deficiency; if it is pale and floating, it often indicates insufficient yang qi; pale and emaciated suggests deficiency of nutritive blood; alternating red and white indicates qi stagnation or inflammation; a completely white palm (including nails) symbolizes anemia and blood loss.

(2) Yellow:

Yellow indicates deficiency, dampness, and chronic illness. Yellow is a sign of spleen deficiency and warmth retention, often suggesting liver and gallbladder diseases or chronic conditions. Chronic diseases of various organs generally present yellow spots or callous nodules in the corresponding hand diagnosis areas. Obstructive jaundice due to liver and gallbladder diseases often presents yellowing of the face and body, and the fingers may also appear yellow. Bright yellow like orange indicates yang jaundice, often associated with damp-heat; dull yellow like smoke indicates yin jaundice, often associated with cold-dampness. Yellowing in the throat area suggests chronic pharyngitis, and yellowing and roughness in the stomach area indicate long-standing stomach issues; if the skin has raised areas, it suggests thickening of the gastric mucosa.

(3) Red:

Red indicates blood color and heat symptoms. When heat is excessive and the vessels are full, it appears red.

In observational diagnosis, pay attention to the following different shades of red:

Light red indicates weakened organ function, often seen in the early stages of illness or during recovery from a long-term illness with low fever.

Dark red often suggests significant inflammation; deep red spots in the trachea area indicate tracheitis or lung heat. If there are red spots with white in the throat area, it suggests purulent changes in the throat.

Bright red, except for red birthmarks on the hands, generally appears in spots and often indicates bleeding or ongoing bleeding in the corresponding organs.

Dark red suggests a long illness or indicates past ailments or healing wounds.

Brownish-red indicates recovery or recent healing from surgery.

Purple-red indicates blood stasis, poor circulation, or coagulation after bleeding.

(4) Blue:

Blue indicates cold, pain, blood stasis, and convulsions. Blue reflects cold stagnation and qi stagnation, and both qi stagnation and blood stasis or pain can appear as blue or even purple-blue in the corresponding areas of the palms. Blue palms are often seen in spleen and stomach deficiency with cold. Purple-blue indicates severe blood stasis.

For example, if there is insufficient blood supply to the brain, the corresponding vascular area will appear purple-blue. If there are visible blue-purple blood vessels throughout the palms, it indicates abnormal blood lipids and suggests high acidity in the blood, low oxygen content, and a tendency for blood to coagulate, increasing the risk of cerebral thrombosis.

Poor cardiac conduction can cause the palms to appear blue. Dark blue-purple palms suggest high blood lipids, poor elimination of metabolic waste, and accumulation in the body, often leading to fatigue. Greenish-blue indicates high blood viscosity, high acidity, or weakened elasticity of blood vessel walls, even leading to hardening.

(5) Black:

Black indicates kidney deficiency and blood stasis. Black reflects kidney yang deficiency and cold water accumulation. Black spots, except for age spots on the back of the hands, appearing on the palm side suggest chronic or severe diseases in the corresponding organs.

Observing Shape

Shape refers to the visual representation of a specific area on the palm. Observing shape is a further observation based on color and qi, supplementing color observation. Holistic hand diagnosis emphasizes observing subtle shape changes in various reflex zones.

There are eight types of shapes that reflect the body’s health status on the palm:

1. Protruding:

Refers to point-like or patchy changes that are raised compared to the surrounding skin, indicating a long disease course.

Pathological protrusions include localized exposure of superficial veins. Areas prone to calluses due to frequent friction, if without specific changes, are not considered pathological.

If the protruding area is light yellow, it indicates a long disease course; small yellow-brown protrusions near the mouth area suggest long-standing dental issues or healing marks after tooth extraction.

If the protruding area is pointed and light yellow, with a darker center and irregular or coffee-colored spots, it generally indicates tumors or cancer in the corresponding organs. If it is dark brown, withered leaf color, or shiny dark blue protrusions, the condition is more serious.

Protrusions that are white and red in patches generally indicate inflammation, often with secretions. For example, if there are red and white protrusions in the trachea or lung area, it suggests tracheal or lung inflammation with excessive phlegm. If in the reproductive area, it often indicates uterine fibroids. Initial protrusions are white spots; when they turn yellow, it suggests a long duration and serious or worsening condition.

2. Depressed:

Refers to point-like or patchy changes that are sunken compared to the surrounding skin, indicating qi and blood deficiency, suggesting organ atrophy or aging, or indicating that the corresponding area has undergone surgery.

3. Floating:

Spots of qi color seen on the skin surface are termed floating, indicating that the disease is superficial. Superficial veins may be visible but not protruding; this also belongs to the floating shape change, often indicating an external pathogen or an early stage of illness, which is mild and easy to recover from.

4. Deep:

Color spots or localized veins hidden beneath the skin are termed deep, indicating that the disease is internal, suggesting a chronic condition and more severe illness. A change from floating to deep indicates worsening of the condition, while the opposite suggests improvement and gradual alleviation.

5. Subtle:

Minor changes in the shape of the hand diagnosis area, with light color, are termed subtle, indicating insufficient righteous qi, reflecting deficiency of yin, yang, qi, and blood.

6. Severe:

Deep color spots or significant changes in shape are termed severe, indicating that evil qi is strong, and the disease is progressing or more severe.

7. Sparse:

Few qi color spots in the hand diagnosis area, dispersed distribution; superficial veins are small and unobstructed, termed sparse. This often indicates a mild condition or that the disease is recovering, or only functional changes are present without organic damage.

8. Dense:

Many qi color spots in the hand diagnosis area, densely distributed, even merging into patches, and superficial veins are twisted, enlarged, or deformed, termed dense. This indicates a more severe condition, or the disease is progressing, or there is organic damage in the organs.