If you visit a Chinese medicine practitioner for the first time, you might be overwhelmed with all the strange diagnostic methods. It is just a more holistic approach to understanding a patient's current state of health. It is also helpful to use these methods as a guide to check your health for any signs and symptoms that are out of the regular pattern.

Very different from Western Medicine, Traditional Chinese Medicine (TCM) evaluate a patient's health by checking tongue, pulse, and ask a lot of questions. There are 4 Diagnostics, meaning four different methods for a health evaluation. There is also a "10 questions" asking the patient about details such as urination, stool, sweat and so on. Here is a simplified explanation of how Chinese medicine evaluates a patient's health.

Tongue and Pulse

Tongue diagnosis

One of the most distinct diagnostic methods in Chinese medicine is looking at patient's tongue and taking the pulse. Patients are asked to stick out their tongues, and the doctor will check the color, coating, size and overall condition of the tongue. In a healthy person, the tongue should be light pink with thin white coating. If you have cracks in the tongue, it might be dryness or heat in the body. Toothmark indicates swollen or puffy tongue and often means too much dampness. A red color is a heat sign; purple means stagnation and pale white usually indicates blood or Qi deficiency. Depending on the location of the color or texture, it signifies different organ problems. For example, red tip of tongue means heart fire. The person might also feel restless and insomnia. 

Pulse diagnosis

There are at least 26 standard pulse types, including rapid, thready, rolling, big, wiry and so on. It is usually examed with three middle fingers placing around the pulse below the thumb. Three fingers represent top, middle and lower part of the body and its corresponding location of disease. The doctor will also check three levels of the pulse by pressing down deeper. When a pulse is strongest in the deep level means the disease is deeper in the body and more chronic. On the other hand, when the pulse is closer to the surface means the disease is on the exterior and acute (such as a cold or flu). Another way to read a pulse is its speed. Rapid pulse is a heat sign, and a slow pulse indicates a cold condition.

Pulse and tongue can be difficult to identify for most people. However, checking yourself on a regular basis can assist in determining any new patterns that are signs of imbalance. Even if you don't fully understand the Chinese medicine theory, you can pay more attention to any changes and prevent worse development.

4 Diagnostics

Four diagnostics include inspection, Auscultation-olfaction, interrogation, and Palpation. In another word, a Chinese medicine doctor exams patients by 1. looking, 2. smelling and listening, 3. asking questions, and 4. touching affected area of the body.

1. Inspection

By just looking, a doctor can observe how a patient walks, talks, and moves, and find much information about a patient's health. 

2. Auscultation and Olfaction

By listening to patient's speech, coughing or other sounds, an experienced Chinese medicine practitioner can learn more about patient's constitution and disease. By the smell from patients or their secretion, a doctor can find out more information about the current illness. 

3. Interrogation

Asking patients questions about disease history, onset, and other details is a primary method to evaluate patient's health just like in the modern days.

4. Palpation

Before the X-ray, MRI and advanced technologies, examine patients by touching affected areas with hand seems a straightforward and efficient manner to know more about the health problem. Patient's feedback and the reaction can confirm the suspected illness.

10 Questions

There are many variations of what consisting a "10 questions" in TCM diagnosis. But they all include the followings in different orders.

1. Hot and cold

Do you feel hot or cold all the time? Do you tend to feel cold hands and feet? Do you prefer hot or cold drinks? It indicates your body types and nature of diseases. 

2. Sweat

Do you sweat easily? Profuse sweating? Night sweat? Sweat in the palm and heat in the chest? Different sweating shows different Yin and Yang imbalance, or Qi deficiency. 

3. Head and face (hearing)

Do you have a headache? Location (corresponding to channels) and intensity of a headache? Dizziness? Any eyes, ears, throat problems? Tinnitus? A high or low pitch of ear ringing? They all indicate different pattern diagnosis. 

4. Diet, appetite, thirst and taste

What is your daily diet? What is your preferred food? Sweet, sour, bland, bitter, or pungent? (5 flavors corresponds to 5 elements). Do you have a healthy appetite and digestion? (indicating your stomach and spleen health). Do you feel thirsty and drink a lot or no desire to drink (indicating dampness)?

5. Pain

Do you have any pain in the body? What types of pain: sharp, dull? Intensity and duration? What makes it better and what makes it worse? Does the pain get worse in a particular time of the day, or under the rainy weather? What triggers it and what relieves it?

6. Thorax and abdomen

Any chest pain or abdominal pain? Pain or discomfort in different locations indicates its related organs, channels, and possible causes. All the pain questions above applies here too.

7. sleep

Do you get full 8-hour rest at night? What time do you go to bed and what time do you wake up? Do you have to wake up to use the restroom at night? Do you have repeated dreams or nightmare? They can be related to five elements too. 

8. Urine and stool

Is there anything unusual about urine and stool? Color, quantity, and frequency change? What triggers the change? Any constipation or loose stool? Early morning diarrhea?

9. History

What is your current health concern? When is the onset of the problem? Anything makes it worse? Anything makes it better? Any treatment you tried? Any family history related to the condition?

10. Gynecological

For the female, how is your monthly period? Is it profuse and bright red, or delayed, pale and scanty? Any pain and clot? How long does it last? Any mood change?

Check your health

Even though you can not fully understand the TCM pattern diagnosis behind all the questions, you can know your health better by checking all the signs mentioned above. Maintaining a holistic health usually involves a lifestyle change, diet change, and just be observant with any newly developed symptoms. Listening to your body is the best way to prevent disease and maintain balanced health.