Diagnosis Through Observation: Questions and Answers
The essence of the five organs and six bowels is reflected in the eyes. If the spleen qi is deficient, yang declines, failing to contain yin, leading to the scattering of spirit light outward, resulting in the spirit water becoming expansive, causing a double vision. The nourishment is in the liver, the master is in the kidney, and the harmony is in the spleen, which can combine the yin of the kidney and spleen, allowing the liver to reach it, thus returning essence to the eyes.
Clear eyes indicate cold;
Dark and turbid eyes indicate heat;
Cloudy eyes indicate dampness;
Dry eyes indicate dryness;
Dry and rough eyes indicate insufficient liver yin;
Red and swollen eyes indicate wind-heat in the liver channel;
Swollen eyeballs indicate liver fire and external wind-heat;
Pupil constriction often indicates blazing liver and gallbladder fire;
Dark eyelids indicate kidney qi deficiency;
Dark eyelids often indicate kidney deficiency;
Red and moist eyelid margins indicate damp-heat in the spleen;
Eyes open during sleep indicate spleen qi deficiency and insufficient blood;
Constantly open eyelids during sleep indicate weak spleen qi;
Inability to close eyelids when awake indicates kidney deficiency leading to eye failure;
Distinct upper and lower eyelids indicate phlegm-dampness disease;
Weak eyelid opening indicates deficiency of original qi;
Sunken eyelids with crying but no tears indicate severe injury to yin fluids;
Swollen eyelids resembling a sleeping silkworm, with yellow urine, indicate jaundice;
Swollen eyelids often indicate signs of edema;
Eye corners developing films indicate liver fire rising;
Red and painful eye corners indicate heart fire;
Pale white eye corners indicate blood deficiency;
Red sclera indicates lung fire;
Red sclera indicates external wind-heat;
Red sclera with red veins often indicates yin deficiency with excess fire;
Eyes slightly fixed indicate internal phlegm-heat obstruction;
Squinting eyes indicate internal liver wind movement;
Staring eyes that are not lively indicate internal liver wind movement;
Stagnant and dull eyes with slow movement indicate kidney essence deficiency;
Stagnant and dull eyes with slow movement indicate a precursor to wind stroke.
Eyes lacking brilliance and movement indicate deficiency of the essence of the organs.
Children sleeping with open eyes often indicate spleen qi deficiency and insufficient blood.
Diagnosis Through Observation of the Throat and Teeth: Questions and Answers
Deep red and swollen throat indicates excess heat syndrome;
Soft red throat with mild swelling indicates yin deficiency with excess fire syndrome;
Soft red throat with mild swelling indicates heat evil phlegm obstructing the lungs;
Red and swollen throat with pain indicates excess heat toxin in the lungs and stomach;
Pus and ulceration in the throat with yellow-white necrotic spots indicate severe heat toxin in the lungs and stomach;
Gray-white necrotic spots in the throat indicate diphtheria, with heat injuring the lungs and kidneys.
Dry teeth indicate injury to yin fluids;
Teeth dry and smooth as stone indicate extreme stomach heat;
Teeth color like dry bones indicate kidney yin deficiency.
Teeth tightly clenched or making noise indicate phlegm obstructing the channels;
Teeth tightly clenched or making noise indicate extreme heat causing spasms.
Diagnosis Through Observation of the Face: Questions and Answers
White complexion indicates cold syndrome, either yang deficiency or the onset of an external pathogen;
White complexion indicates yang deficiency, qi deficiency, and blood deficiency;
White complexion with virtual cold and blood coagulation indicates constricted meridians;
Pale complexion indicates lung disease;
White and swollen complexion indicates qi deficiency;
White and emaciated complexion indicates blood depletion;
White complexion like dry bones indicates severe lung disease;
White complexion with slight redness indicates sufficient qi and blood.
Yellow and red complexion indicates heat;
Yellow complexion indicates dampness;
Pale yellow complexion indicates cold dampness;
Yellow and floating complexion indicates wind-dampness;
Yellow and red complexion indicates wind-heat;
Pale yellow complexion without luster indicates spleen deficiency;
Yellow complexion like orange indicates damp-heat;
Yellow complexion like bitter orange indicates exhausted spleen qi;
Yellow and dark complexion indicates blood stasis with damp-heat;
Yellow complexion with a reddish hue indicates wind, pointing to wind-heat disease;
Yellow complexion with a bright and moist appearance indicates recovery from illness;
Yellow complexion with a greasy appearance indicates swelling and pus formation;
Slightly yellow complexion indicates presence of stomach qi;
Red complexion with fever and delirium indicates internal heat;
Bright red complexion indicates severe blood syndrome, either blood loss or local congestion;
Normal red complexion indicates yang qi stagnation on the surface, causing sweating without thorough resolution.
Blue complexion indicates cold stagnation, qi stagnation, and blood stasis;
Blue complexion indicates qi and blood stagnation, indicating cold and pain;
Blue complexion like grass indicates severe lung disease;
Blue-black complexion indicates pain-related diseases;
Blue-black complexion indicates severe cold and extreme pain;
Black complexion indicates kidney yang deficiency, internal cold, and poor circulation of qi and blood;
Black complexion indicates unprocessed water retention, blood losing warmth and nourishment, and constricted meridians;
Black and dry complexion indicates kidney yin deficiency;
Black complexion like stove soot indicates exhausted kidney qi;
Withered and dull complexion indicates chronic illness and deficiency syndrome;
Bright and moist complexion indicates superficial disease;
Dark and turbid complexion indicates deep-seated disease;
Both cheeks flushed indicates internal heat from yin cold;
Both cheeks with a rosy hue in the afternoon indicates water depletion and fire excess, indicating a fire-type lung condition.
Discussion on Limb Symptoms in TCM
The limbs include the upper limbs (shoulders, elbows, arms, wrists, palms, and fingers) and the lower limbs (thighs, hips, knees, shins, ankles, and toes). The heart governs the blood vessels of the limbs, the lungs govern the skin and hair, the spleen governs the muscles, the liver governs the tendons, and the kidneys govern the bones. The spleen has the closest relationship with the limbs. The upper limbs are where the three yin and three yang meridians of the hands circulate, while the lower limbs are where the three yin and three yang meridians of the feet circulate.
Observation of the limbs can diagnose changes in the five organs and the meridians circulating through the limbs:
1) Atrophy of the limbs or one limb indicates qi and blood deficiency or obstruction of the meridians.
2) Swelling of the limbs or one limb, if red and painful, indicates blood stasis or heat obstructing the meridians.
3) If the feet are swollen, or if the whole body is swollen, it often indicates edema. If the lower limbs are swollen with skin resembling elephant skin, it is often seen in blood vessel diseases.
The limbs are the foundation of all yang, and observing the limbs’ cold and warmth can provide insight into the rise and fall of yang qi, which is also significant for prognosis.
4) If the limbs show signs of external pathogens or internal injuries. For example, heat in the back of the hand indicates an external pathogen, while heat in the palm and lower abdomen indicates internal injury.
5) Heat in the palm can be correlated with heat in the forehead for mutual examination. If the heat in the palm is greater than that in the forehead, it indicates deficiency heat. Conversely, if the forehead heat is greater than that in the palm, it indicates exterior heat.
6) If a child has a high fever with cold fingertips, it is necessary to prevent convulsions. If fever, runny nose, and red eyes are accompanied by cold fingertips, it indicates the onset of measles.
7) If the hands and feet are twitching, it often indicates spleen and stomach qi deficiency, leading to insufficient nourishment of the tendons. If the feet cannot walk, are weak and painless, it indicates atrophy syndrome.
8) Trembling of the hands and feet often indicates blood deficiency, insufficient nourishment of the tendons, or excessive drinking, indicating a precursor to stroke. Generalized limb pain or localized pain indicates bi syndrome.
9) Numbness in the hands and feet, or numbness in one part of the body often indicates qi deficiency. Numbness in the hands and feet extending to the elbows indicates a precursor to stroke.
10) Pain in the muscles, tendons, and joints of the limbs often indicates invasion by wind, cold, and dampness. Alternatively, it may indicate wind-dampness transforming into fire or phlegm-stasis, causing heat-stasis obstructing the circulation of qi and blood. For upper limb pain, add Chuanxiong (Ligusticum chuanxiong), and for lower limb pain, use Niu Xi (Achyranthes bidentata) and Mu Xiang (Saussurea costus) with additional Frankincense and Myrrh for severe pain.
11) Fixed pain in the limbs indicates retention of cold and dampness, obstructing qi and blood. Pain that moves around indicates wind evil, or may be accompanied by wind evil. Coldness in the limbs indicates spleen yang deficiency.
12) Treatment for limb swelling and pain: (Luo Tianyi) Da Qiang Huo Decoction: Qiang Huo, Sheng Ma each 3 grams, Du Huo 2.1 grams, Cang Zhu, Fang Feng, Wei Ling Xian, Gan Cao, Dang Gui, Fu Ling, Ze Xie each 1.5 grams. Function: dispel wind, eliminate dampness, promote yang qi, and tonify spleen earth, allowing damp evil to dissipate.
Physician Li Zhongzi believes: “San Cai Decoction nourishes the yin of the lungs and stomach, allowing lung qi to descend, and the essence of food and water to be distributed to the extremities, thus allowing atrophy to recover.” Atrophy syndrome (wei syndrome) is caused by internal steaming of excess heat, with heart yang being overly vigorous, and is treated with Cheng Qi Decoction followed by Ren Shen Decoction, using bitter cold descending medicines. This follows the principle of treating atrophy in the “Inner Canon” by focusing on the yangming channel, removing excess heat, and then using San Cai.
Note: San Cai Decoction consists of Ren Shen (Ginseng), Tian Dong (Asparagus), and Gan Di Huang (Rehmannia glutinosa). Its function is to tonify qi and nourish yin, used for both qi and yin deficiency, fatigue, shortness of breath, and a red tongue with a dry mouth. Da Cheng Qi Decoction: strongly purges heat accumulation, drains fire, and detoxifies. Xiao Cheng Qi Decoction: lightly purges heat accumulation, reduces fullness.
Diagnosis Through Observation of Nails: Questions and Answers
Nail color white indicates both qi and blood deficiency;
Pale white nails indicate blood deficiency;
Light-colored nails indicate lung and stomach cold deficiency;
Pale nails indicate yang deficiency with cold, and both qi and blood deficiency;
Yellow nails often indicate jaundice;
Bright red nails with emaciation indicate excess yin fire;
Deep red nails often indicate internal heat;
Blue-purple nails often indicate blood stasis;
Black nails often indicate a terminal condition;
Pressing the nails turns them white, and they return to red after release, indicating a treatable condition;
Pressing the nails turns them white, and they do not return to red, indicating a difficult condition to treat.
Yellow-black ears indicate kidney deficiency.
Nostrils flaring often indicate lung heat or asthma. Rapid breathing with significant chest movement often indicates excess heat syndrome.
Diagnosis Through Sound: Questions and Answers
Low voice often indicates internal injury and deficiency syndrome.
Loud voice often indicates external pathogen and excess syndrome.
Delirious speech often indicates excess heat syndrome.
Low voice with few words often indicates deficiency syndrome and cold syndrome.
Sudden hoarseness often indicates wind-phlegm obstructing fire.
Rough and uneven breathing often indicates external heat excess. This often relates to the lungs and stomach.
Weak and shallow breathing often indicates internal injury and chronic illness.
Excessive wheezing with lung distension and rough breathing often indicates excess heat in the lungs and stomach.
Weak wheezing with a low voice and short breaths often indicates kidney deficiency.
Dry cough without phlegm, with cough being the main symptom, indicates treatment focused on the lungs.
Coughing with phlegm, with phlegm being the main symptom, indicates treatment focused on the spleen.
Sudden cough with hoarseness often indicates excess metal and fire evil.
Chronic cough with hoarseness often indicates deficiency of qi and injury to essence.
Coughing with much phlegm and nasal congestion often indicates a cold. This condition is easy to resolve.
Sudden onset of cough with continuous sounds often indicates a more difficult condition to resolve.
Diagnosis Through Mouth: Questions and Answers
Facial asymmetry indicates wind-phlegm obstructing the head and face meridians, with yangming storing phlegm and turbid, and taiyang being externally affected by wind. Wind-phlegm obstructing the head and face meridians leads to impaired meridian flow and loss of nourishment to the muscles, resulting in weakness and slowness. If there is no external pathogen, qi and blood can still circulate, and the relative urgency indicates that the slower side is being pulled by the urgent side, leading to facial asymmetry. Treatment should focus on dispelling wind-phlegm, unblocking the meridians, and stopping spasms, allowing the wind to dissipate and phlegm to clear, thus enabling recovery.
Sweet and greasy taste in the mouth indicates damp-heat in the spleen;
Salty taste in the mouth indicates kidney deficiency;
Bland taste in the mouth indicates damp turbidity in the stomach, often due to spleen and stomach deficiency;
Sour taste in the mouth indicates poor digestion and gastrointestinal accumulation;
Bitter taste in the mouth indicates fire in the liver and gallbladder, with gallbladder fire rising;
Smelly taste in the mouth indicates heat in the stomach, leading to poor digestion;
Ulceration in the mouth indicates heat accumulation in the heart and spleen, with severe cases leading to mouth sores;
Dry mouth and throat indicate yin deficiency with excess fire, with true yin being depleted;
White patches in the mouth indicate oral sores;
Chapped lips often indicate food accumulation;
Chapped and dry lips indicate food accumulation with spleen heat;
Red and swollen lips indicate severe heat;
Bright red lips indicate excess yin fire;
Pale and white lips indicate qi and blood deficiency;
Swollen white lips indicate wind in the lips;
Pale blue lips indicate wind-cold binding the surface;
Red and bright lips indicate severe heat;
Purple-red lips indicate blood stasis;
Bright red lips indicate excessive diarrhea damaging yin;
Asymmetrical lips indicate stroke;
Inability to speak indicates a spasm condition;
Closed mouth and difficulty opening indicate excess syndrome;
Pale skin around the mouth with flushed cheeks indicates a severe heat condition.
Diagnosis Through Tongue Observation: Questions and Answers
The “Formula Thinking Theory” states: “Even experienced doctors find it easy to understand the heart, but difficult to clarify the fingers. Tongue diagnosis is like a barometer, accurately reflecting the health status of the body and is easy to grasp.”
What is the method of tongue diagnosis? A tongue without coating indicates an exterior condition, a bright red tongue indicates heat, and a pale white tongue indicates cold.
Key points for tongue quality diagnosis depend on color and shape. The tip of the tongue reflects changes in the heart and lungs. The tongue is the sprout of the heart and is also the exterior of the spleen, with the heart meridian connecting to the tongue base. The spleen meridian connects to the tongue base, dispersing beneath the tongue. The lung meridian connects the throat to the tongue root. The kidney meridian runs through the throat, connecting to the tongue base. The liver meridian runs behind the throat, connecting to the tongue base. Changes in the organs, meridians, qi, blood, and body fluids can be reflected on the tongue.
What does a normal tongue look like?
A normal tongue is moist, light red, but due to individual differences, tongue quality varies. The “Tongue Diagnosis Guide” states: “A healthy tongue can vary in shape and color, with some being clean, some having a slight coating, some being bright red, and some being pale white, or having a tight and pointed shape, or being loose and soft, and may have teeth marks—this is due to individual differences when healthy, hence the variation in tongue quality.” Additionally, a normal tongue may show teeth marks, cracks, or peeling coating; in summary, a normal tongue is flexible, soft, light red, and has a thin white coating.
1) A thin and small tongue indicates deficiency syndrome;
2) A bright red tongue with a white slippery coating indicates heat in the nutrient level;
3) A pale and tender tongue with a white and moist coating indicates deficiency cold syndrome;
4) A pale, plump, and tender tongue with a yellow and slippery coating often indicates yang deficiency with water retention;
5) A tongue that is too pale or white indicates anemia and water retention, indicating deficiency cold syndrome;
6) A bright red and swollen tongue often indicates excess heat in the heart and spleen;
7) A crimson tongue indicates severe heat. A purple tongue indicates blood stasis;
8) A red tongue indicates heat, often dry with little or no coating, indicating severe heat injuring body fluids;
9) A red tongue with a white slippery coating indicates dampness in the qi level; yin deficiency with excess fire may also be present with phlegm-turbidity and food accumulation;
10) A red tongue is often seen in cases of internal heat syndrome and yin deficiency syndrome;
11) A crimson tongue is often seen in the extreme phase of external heat diseases and yin deficiency with excess fire;
12) A crimson tongue often indicates: external diseases with heat entering the nutrient and blood levels;
13) A crimson tongue with little coating but moist indicates blood stasis syndrome;
14) A pale red tongue with a thick yellow coating is often seen in cases of external wind-cold transforming into heat, or external damp-heat evil;
15) A red tongue with a yellow and greasy coating indicates liver and gallbladder damp-heat, which may present with rib and abdominal distension and pain;
16) A swollen tongue may indicate water retention or dampness, and may suggest hypothyroidism;
17) A trembling tongue is a precursor to stroke. Tongue diagnosis should be performed in the morning after waking, before brushing, for the most accurate observation;
18) A tongue without coating, like an oiled kidney, indicates loss of fluids and is untreatable.
Thorny protrusions on the tongue, resembling thorns, are red or yellow-black sharp particles, referred to as thorny protrusions. The presence of thorny protrusions on the tongue indicates excess heat in the qi level, with excessive yang heat in the organs; it indicates diseases related to excessive yang heat in the organs or extreme heat in the blood.
The “Observation of Diagnosis” states: “The presence of thorny protrusions on the tongue indicates severe heat accumulation.”
“Tongue Diagnosis in TCM” states: “Evil heat entering the nutrient level can occur regardless of whether it is in the middle or lower jiao, leading to thorny protrusions.”
Key points for diagnosing thorny protrusions on the tongue:
1) Thorny protrusions on the tip of the tongue often indicate excessive heart fire;
2) Thorny protrusions on the sides of the tongue often indicate excessive liver and gallbladder heat;
3) Thorny protrusions in the middle of the tongue often indicate extreme heat in the stomach and intestines;
4) A red tongue with thorny protrusions indicates heat in the yangming qi level;
5) A crimson tongue with thorny protrusions indicates heat deeply penetrating the nutrient and blood levels;
6) The more thorny protrusions on the tongue, the more severe the heat, indicating excessive heat in the qi level and organs;
Key points for critical tongue diagnosis:
1) A tongue resembling a mirror surface indicates a critical condition;
2) A tongue with a dry, scorched color indicates a critical condition;
3) A tongue resembling a peeled kidney indicates a critical condition;
4) A tongue with no coating indicates that the stomach qi has been exhausted and is untreatable;
5) A tongue with a rough, prickly texture, dry and cracked, indicates a critical condition;
6) A tongue that is tight and stiff, unable to move, with slurred speech indicates a critical condition.
Diagnosis Through Tongue Coating: Questions and Answers
Key points for observing tongue coating depend on the color and presence of the coating.
1) How is tongue coating produced? Tongue coating is produced by the stomach qi and stomach yin rising to the tongue surface. The “Essence of Cold Damage” states: “Tongue coating is the vital energy of the stomach, like the fine grass on the ground.” Tongue coating is a layer of coating on the tongue surface.
2) What does normal tongue coating look like? Normal tongue coating is moist, light red, with a slight white coating, not thick, with a balanced moisture level, neither slippery nor dry, but in summer, the coating may be thicker and slightly yellow, but not excessive or stagnant, which is still considered normal coating.
3) What is the method of tongue diagnosis? A tongue without coating indicates an exterior condition, a bright red tongue indicates heat, and a pale white tongue indicates cold. The thickness of the coating indicates the depth of the disease; the moisture level of the coating indicates the abundance or deficiency of body fluids; the texture of the coating indicates dampness or turbidity; the color indicates cold, heat, dampness, or dryness of the evil.
4) What causes thick coating? Thick coating is produced by stomach qi combined with dampness and turbid evil qi, steaming and condensing. All five organs derive qi from the stomach, thus it can be used to diagnose the cold and heat of the organs, the deficiency and excess, as well as the nature and depth of the disease. Since stomach qi arises from the heart and spleen, healthy individuals often have thin coating, which is the vital energy of the stomach, like fine grass on the ground.
1) Thin coating indicates a mild disease, with the evil being relatively superficial, often indicating an external pathogen;
2) Thick coating indicates a severe disease, with the evil penetrating deeply. Thick coating may indicate poor appetite, food accumulation, or phlegm-dampness. If yellow, it indicates damp-heat.
3) No coating (also known as peeling coating resembling flower peeling) generally indicates significant damage to both stomach qi and yin; depletion of stomach yin and deficiency of qi and blood; no coating, like an oiled kidney, indicates loss of fluids and is untreatable. Little or no coating indicates yin deficiency: a tongue surface that is smooth and shiny like a mirror is referred to as a chicken heart tongue, indicating severe yin injury.
4) White coating indicates exterior syndrome and cold syndrome; if damp-heat is internally abundant, the coating may be white; white coating indicates exterior syndrome and cold syndrome. If there is white coating, it indicates a half-exterior, half-interior condition, with moist coating indicating cold and dry coating indicating fire.
5) Yellow coating indicates internal heat syndrome. If damp-heat is steaming, the coating may be yellow; yellow coating indicates internal heat syndrome. Yellow coating indicates internal conditions, while black coating indicates deep yin conditions, often indicating a terminal condition.
6) Moist coating indicates wind-cold exterior syndrome, early damp syndrome, or blood stasis syndrome; moist coating indicates cold. Dry coating indicates high heat, excessive sweating, vomiting, diarrhea, or damp obstruction, or excessive use of warm-dry medicines;
7) Thin coating indicates high heat, excessive sweating, vomiting, diarrhea, or damp obstruction, or excessive use of warm-dry medicines;
8) Moist coating indicates wind-cold exterior syndrome, early damp syndrome, or blood stasis syndrome; moist coating indicates cold. Dry coating indicates high heat, excessive sweating, vomiting, diarrhea, or damp obstruction, or excessive use of warm-dry medicines;
9) Greasy coating: the coating is fine and dense, merging into sheets that are not easily scraped off, indicating dampness, phlegm, and food accumulation; greasy coating, thick coating indicates excessive dampness.
10) Putrid coating: the coating is coarse and loose, like tofu dregs, piled on the tongue surface, easily scraped off, indicating excess heat and turbid evil in the stomach; it can be divided into front, middle, and back sections, with the back indicating excessive heat in the kidneys, bladder, and lower jiao;
Putrid coating indicates damp-heat;
11) Black coating that is dry indicates excessive heat. Black coating that is moist indicates excessive cold. Black coating indicates deep yin conditions, often indicating a terminal condition.
Diagnosis of Headaches: Questions and Answers
Why observe the head and face? The head is the meeting point of all yang, with the governor vessel and the three yang meridians of the hands and feet all converging in the head and face, while the yin meridians include the ren vessel and the foot jueyin liver meridian, which also converge in the head. The head is the residence of the spirit, housing the brain marrow, and is the abode of the original spirit. The brain is the sea of marrow, governed by the kidneys, with the kidney essence manifesting in the hair, and the blood vessels nourishing the head and face. Therefore, observing the head and face, neck, and hair is primarily to understand the condition of the heart, kidneys, and the rise and fall of qi and blood.
All six meridians can cause headaches:
Headache in the back indicates the taiyang meridian (foot taiyang bladder meridian, hand taiyang small intestine meridian);
Headache on both sides indicates the shaoyang meridian (foot shaoyang gallbladder meridian, hand shaoyang sanjiao meridian);
Frontal headache indicates the yangming meridian (foot yangming stomach meridian, hand yangming large intestine meridian);
Vertex headache indicates the jueyin meridian (foot jueyin liver meridian, hand jueyin pericardium meridian);
Head and body pain indicates exterior evil;
Head heaviness often indicates damp-heat;
Head heaviness often indicates brain deficiency and heavy dampness;
Constant head shaking indicates internal liver wind movement;
Constant head shaking indicates qi and blood deficiency, leading to insufficient nourishment of the brain;
Continuous headache with cold and heat indicates an external pathogen;
Headache with dizziness indicates internal injury;
Head heaviness with cold often indicates phlegm-dampness obstructing the ascent of clear yang;
Head heaviness with deficiency often indicates kidney deficiency and excessive liver yang;
Wind-phlegm headache often indicates liver and spleen involvement.
Diagnosis of Hands and Feet: Questions and Answers
Numbness in the hands and feet, or numbness in one part of the body often indicates qi deficiency;
Numbness in the hands and feet extending to the elbows often indicates a precursor to stroke;
Worm-like movements in the hands and feet often indicate spleen and stomach qi deficiency, leading to insufficient nourishment of the tendons;
Trembling of the hands and feet often indicates blood deficiency, insufficient nourishment of the tendons;
Trembling of the hands and feet due to excessive drinking also indicates a precursor to stroke;
Inability to walk with weak and painless feet indicates atrophy syndrome;
Pain in the feet while walking often indicates spleen deficiency;
Weakness and fatigue in the limbs indicate that the spleen essence cannot be distributed;
Cold limbs, fatigue, and weakness indicate spleen yang deficiency. Heart disease often presents with pain in both arms; spleen disease often presents with pain in the feet; lung disease often presents with pain in the shoulders and back; kidney disease often presents with pain in the lower abdomen; liver disease often presents with pain in both sides, radiating to the lower abdomen;
Diagnosis of Diet: Questions and Answers
Abdominal distension and pain after eating indicate excess;
Relief of pain after eating indicates deficiency;
Preference for cold food indicates heat syndrome;
Preference for hot food indicates cold syndrome;
Generally, if a disease worsens after eating, it indicates excess syndrome;
Generally, if a disease improves slightly after eating, it indicates deficiency syndrome;
Feeling distended after eating indicates qi stagnation and food obstruction;
Good appetite with distension indicates a strong stomach and weak spleen;
Inability to eat due to stomach rumbling indicates phlegm-fire obstruction;
Good appetite with weight loss indicates internal heat.
Diagnosis of Urination: Questions and Answers
Clear urine indicates cold;
Yellow and red urine indicates heat;
Deep yellow urine indicates internal damp-heat;
Bright red urine indicates blood heat;
Short and yellow urine indicates excess syndrome;
Brownish-yellow urine resembling pus indicates damp-heat jaundice;
Yellow-red and turbid urine, with painful urination, indicates damp-heat;
Foul-smelling and turbid urine indicates damp-heat affecting the bladder;
Foul-smelling and turbid urine indicates bladder damp-heat;
Frequent urination with clear urine indicates deficiency cold;
Frequent clear urine with involuntary leakage indicates qi deficiency;
Dribbling urine with abdominal pain and fever indicates excess heat;
Little or no urination with cold in the lower back indicates deficiency syndrome;
Dribbling urine with sharp pain indicates a likely case of dysuria;
Frequent urination indicates kidney deficiency;
Painful urination with blood indicates blood dysuria;
Frequent, urgent, and painful urination with red urine often indicates bladder damp-heat or kidney deficiency;
Frequent urination with thirst and weight loss indicates diabetes;
Involuntary urination indicates kidney qi instability. In children, bedwetting indicates developmental immaturity;
In boys, a scrotum that is neither tight nor loose indicates kidney qi abundance;
In boys, a loose scrotum often indicates physical weakness or fever.
Diagnosis of Bowel Movements: Questions and Answers
Loose, thin, and clear stools indicate spleen yang deficiency;
Weak and loose stools indicate spleen qi deficiency;
Thick, sticky, and foul-smelling stools indicate heat;
Black, tarry stools indicate blood stasis;
Purple stools indicate damp-heat;
Putrid, foul-smelling stools indicate internal heat accumulation;
Pus and blood in stools indicate dysentery, often due to large intestine damp-heat;
Foul-smelling, thin stools indicate internal heat and poor digestion;
Foul-smelling, thin stools indicate cold in the intestines and spleen deficiency;
Thin, foul-smelling stools indicate spleen and stomach deficiency;
Frequent, urgent bowel movements with abdominal pain indicate excess syndrome;
Frequent, small amounts of stools indicate spleen and stomach weakness and insufficient qi;
Stools that are hard at first and then loose indicate spleen and stomach weakness and insufficient qi;
Natural diarrhea without abdominal pain indicates deficiency syndrome;
Diarrhea occurring before dawn (five morning diarrhea) often indicates spleen and kidney yang deficiency;
Diarrhea with undigested food indicates cold diarrhea;
Diarrhea with urgency and burning pain indicates heat diarrhea.
Constipation, accompanied by blood deficiency pulse syndrome, indicates blood depletion and dry intestines;
Constipation with new symptoms and abdominal fullness indicates excess syndrome;
Constipation with excess heat pulse syndrome indicates yang accumulation;
Constipation with excess cold pulse syndrome indicates yin accumulation;
Constipation in the elderly, chronic illness, or pregnant women often indicates fluid depletion and blood deficiency.
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