The olfactory diagnosis involves detecting abnormal odors from the patient’s body, excretions, and the environment to understand the condition and assess the nature of the disease, including its cold-heat and deficiency-excess patterns.

Body Odors

1. Halitosis:

This refers to foul odors emanating from the mouth when the patient opens it. It is often seen in cases of oral diseases or in individuals with gastrointestinal heat.

Halitosis due to oral diseases can be seen in conditions such as dental caries, gingivitis, or poor oral hygiene. Halitosis caused by gastrointestinal heat is often associated with stomach fire, food stagnation, or damp-heat in the spleen and stomach.

2. Sweaty Odors:

The odor of sweat varies depending on the cause of sweating. 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 be abundant and have a sour, rotten smell. In cases of bi syndrome with lingering wind-dampness, the sweat may be yellow and have a distinct foul odor. If a patient with edema sweats and has a “urine-like odor,” it indicates a critical condition.

3. Nasal Odors:

This refers to foul odors when exhaling through the nose. There are three causes: first, thick, yellow, and foul-smelling nasal discharge that is difficult to resolve, indicating nasal sinusitis. Second, nasal ulcers due to syphilis, leprosy, or cancer can produce foul odors. Third, internal organ diseases may cause exhaled breath to have 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, leading to foul smells.

Excretion Odors

Patients can also perceive the odors of their excretions. Therefore, abnormal odors from phlegm, urine, and feces, as well as women’s menstrual discharge, can be assessed through inquiry. Generally, damp-heat or heat pathogens lead to foul-smelling, turbid excretions, while cold pathogens result in clear, thin excretions without special odors.

Vomitus with foul odors is often due to excessive stomach heat. If the vomitus has a sour, rotten smell and appears undigested, it indicates food stagnation. Vomitus that is fishy and contains pus or blood may indicate a gastric abscess. If the vomitus is clear and thin without odor, it suggests cold in the spleen and stomach.

Sour belching is often due to excessive heat in the stomach or food stagnation. Odorless belching is usually caused by liver qi invading the stomach or cold pathogens affecting the stomach.

Foul-smelling urine that is yellow and turbid indicates excess heat. If the urine is clear and long, with a slight fishy smell or no special odor, it indicates deficiency or cold patterns.

Foul-smelling stools that are yellow and watery or contain red or white pus and blood indicate damp-heat in the large intestine. In children, sour-smelling stools with undigested food indicate food stagnation. Watery stools with a fishy smell suggest spleen and stomach deficiency and cold.

Foul-smelling flatulence is often due to overeating, food stagnation in the middle burner, or retained feces in the intestines. Continuous flatulence with sound but no odor often indicates liver qi stagnation and poor bowel movement.

Menstrual or postpartum discharge with foul odors is due to heat pathogens invading the uterus. Yellow, foul-smelling discharge indicates damp-heat downward transmission. Fishy discharge that is white indicates cold-damp downward transmission.

Room Odors

The odors in a sickroom arise from the patient’s body and their excretions. In the early stages of infectious diseases, foul odors can be overwhelming, filling the room. A bloody smell in the room often indicates blood loss. A putrid smell suggests the presence of necrotic ulcers. A corpse-like smell indicates organ failure. A urine-like odor is often seen in late-stage edema. A rotten apple smell is commonly associated with diabetes.

Disclaimer:This article is shared for the purpose of disseminating more information.If there are any errors in source attribution or infringement of your legal rights, please contact the author with proof of ownership, and we will promptly correct or delete it. Thank you.