Method of Clinic Practice in TCM Inquiring Inspection Auscultation & Olfaction Pulse-feeling & palpat

Method of Clinic Practice in TCM Inquiring Inspection Auscultation & Olfaction Pulse-feeling & palpation Heart (Ht); Liver (Liv); Spleen (Sp); Stomach (St); Lung (Lu); Kidney (Kid); Gallbladder (GB); Large Intestine (LI); Small Intestine (SI);

<A> Inquiring: Question 1: Fever or Cold <1> Interior Fever -- Deficiency: Pathology: due to internal disorders -- Excess: Pathology: Yang-Ming fever or Epidemic Qi fever <2> Exterior Fever: Pathology: Wind-cold: no sweating, chill, headache Wind-heat: sweating, less chill, Summer-heat: high fever, thirsty, constipation

<3> Interior Cold: -- Deficiency: long illness; yang deficiency -- Excess: Pathology: Mostly due to exterior cold attack Stomach directly Sym: Acute stomach pain; diarrhea; cold limbs; like hot drinking; Tongue: white coating Pulse: tight <4> Exterior Cold: -- Wind-cold

Four clinic types of “Fever & Cold” (I) Fever with aversion to cold ----------------------------------------------------------------------------------------------- ( A pointer symptom of exterior disease ) ----------------------------------------------------------------------------------------------- 1. Fever being mild but “Aversion to cold” being severe Pathology: Exterior cold invasion Sym: No sweating, headache, tight muscle, snuff… 2. Fever being mild and “Aversion to wind” Pathology: wind invade human body; Lung Qi or Wei Qi Def. Sym: 3. Fever being severe but “Aversion to cold” being mild Pathology: wind-heat invade people with ordinary or Yin-deficiency, or Yang-excess constitution Sym: sweating, no headache, dry throat with rapid pulse

(II) “Aversion to cold” but no fever Pathology: Exterior cold invade internal organs; Def. of Yang Sym: cold limbs, midsection cold, like warm package, diarrhea… Tongue: white coating Pulse: sink & tight (III) Fever only 1. Excessive fever Pathology: Wind-heat transform into interior heat; Yang-Ming fever; Sym: high fever (over 103 F), red face, thirsty, severer sweating, constipation… 2. Tidal fever Pathology: Yang-Ming fever; Yin Def. ; blood stasis cause fever Sym: fever happen in certern time everyday 3. Low fever Pathology: long illness; Qi Def. ; Blood Def. Yin Def.; Liver Qi Stag. Sym: red face; palm & feet fever

Question 2: Sweating ------------------------------------------------------------------------------------------------------- Purpose: Identify the character of evil factors; Judging body’s Qi strength ------------------------------------------------------------------------------------------------------- <1> Sweating or not Exterior disease: No sweating: wind-cold Sym. Sweating: wind-heat or wind sym. Interior disease: No sweating: fluid & blood Def. Or Yang Qi Def. Sweating: interior heat excess or (Yang) Qi def. or yin def. <2> Seven characters of sweating <a> Spontaneous sweating : Qi Def. Or Yang Def. Sleeping sweating : Yin Def. <c> Exhausted sweating : Yin exhausted or Yang exhausted <d> Chill sweating : exterior cold evil fight with Qi <e> Cold sweating : Yang Qi Def. or being scared <f> Heat sweating : interior heat excess <g> Yellow sweating : Dampness

Question 3: Pain <1> Character of Pain <a> Distension pain: Qi Stag. Mostly on stomach area except eye Prickling pain: Blood stag. <c> Cold pain: exterior cold invade joints & meridians or Yang def. <d> Heat pain: exterior fire invade joints & meridians or Yin def. <e> Heavy pain: Dampness or liver fire flow up to head <f> Sore pain: dampness invade joints or bad circulation of qi & blood or kidney def. <g> Empty pain: Qi & blood def. or kidney essence def. (head or abdomen) <h> Colic pain (true heart pain): physical evil or excess cold block Qi circulation; Secret anguish: yang Qi or blood or kidney essence def. <j> Fixed pain: blood stasis (abdomen& costal & hypochondriac regions); damp-cold or damp heat invade joints. <k> Moving pain: Qi Stag ( abdomen & costal & hypochondriac regions); wind cold invade joints

<2> Location of Pain: <a> Headache: Chest pain: <c> Costal pain: <d> Stomach pain: <e> Abdomen pain: <f> Back pain: <g> limb pain: <h> Whole body pain:

Question 4: Whole body abnormal Sym <1> Dizziness <2> Oppressed feeling in the chest <3> Palpitation <4> Costal oppressive feeling <5> Abdominal distension <6> Heaviness of body <7> Numbness of skin or limbs <8> Impotence <9> Spermatorrhoea

Question 5: Eye & Ear <1> Ear <a> Tinnitus & Deafness Acute: Excessive sym. Liver fire or damp-phlegm; Qi & blood stasis; Wind-heat; Medical side-affect Chronic: Def. sym. (kid. Sp. Liv. ) Hard of hearing Acute: Phlegm invasion & block the ear meridian Chronic: kidney essence def. <c> distention in the ear: Dampness or wind-heat <2> Eye <a> Itching of eye: liver fire or wind-heat (acute); Liver blood def. (chronic) Ache of eye: Liver fire ; wind-heat ; Yin Def. <c> Dazzle of eye: Liver Yang excess; Phlegm-damp; or Qi, blood Def. <d> blurring of eye: Liver & Kidney Def.

Question 6: Sleeping <1> Insomnia: Pathology: Heart blood def. ; Gallbladder Qi def.; Yin def.; Liver fire excess; phlegm heat… <2> Sleepyhead: Pathology: Spleen Yang Def. & dampness block the yang qi.. Prodrome of coma;

Question 7: Food & taste <1> Thirsty & Drinking water <a> No thirsty & no desire to drink water Pathology: Cold or Dampness diseases Thirsty & desire to drink * Thirsty & dryness of throat and nose * Thirsty & like cold water and high fever and big sweating * Thirsty & yin def symptoms * Thirsty & polydipsia, polyuria, polyorexia * Thirsty & less drinking * Thirsty & only gargle the water & black skin

<2> Diet & Appetite <a> Losing appetite: No appetite: Food stag in stomach; Damp-heat; Liver & GB dampness; Pregnant women <c> Excessive appetite: Stomach (St) Fire <d> Hungary but no appetite: St Yin def. <e> Being addicted to one food or one thing: <3> Taste <a> light taste : Sp yang def. sweet taste : Damp-heat; Sp Qi def. <c> sticky taste : Phlegm heat; Damp-heat or damp-cold <d> sore taste : Food stag; Liv & St heat <e> bitter taste : Heart fire up; Liv & GB fire <f> salty taste : Kid disease; <g> acerbity taste : Dryness damage fluid; excessive heat

 Observation of the nose * Appearance : flapping of the nose wing * Discharge -- Clear -- Whilst turbid -- Prolonged turbid discharge with stinking smell : chronic rhinitis or chronic sinusitis <c> Observation of the ear * Colour -- Pale -- Red & swollen: Liv. & GB. Damp-heat or fire evil -- Dry & withered auricles, burnt black color: Kid. Essence exhausted * Purulent Discharge * Shape <d> Observation of the gums, lips & mouth

Question 8: Stool & Urine <1> Stool <a> Times * Constipation * Diarrhea Quality * Dyspeptic * Dry & Soft * With puriform blood * blood <c> Feel of anus when defecate * Hot * Heaviness * Sticky * Incontinence * prolapse

<2> Urine <a> Times * Frequently * Retention of Urine Quantity of urine * clear & increased * descreased <c> Sensation of Urine * Acerbity & ache * Unclearly * Incontinence * Enuresis

Question 9: Menstruate & Secretion <1> Menstruate <a> Period * Advanced * Prolonged * Not fixed Quantity * Excessive quantity * Decreased quantity <c> Color & Quality <d> Dysmenorrhea <2> Secretion <a> White secretion Yellow secretion <c> Red & White secretion

 Inspection (1) Observation of the Vitality <a> Eyes Skin lustrous <c> Expression <d> Posture (2) Observation of the Colour <a> Red: malar flush; heat Pale: Def.; cold; lost blood <c> Yellow: Sp def. ; “bright orange” or “smoky dark” <d> Blue: Cold, Qi Stag.; Blood stasis; pain; <e> Black: Kid def.; cold; blood stasis; pain;

<3>Observation of the Appearance * Overweight with mental depression: Qi def. & phlegm damp * Thin with dry skin: Blood def. * Great loss of weight: Exhaustion of the essential qi * Active posture & movement: Yang Sym * Passive manner: Yin sym. * Violent movement of the four limbs: wind disease * Wei Syndromes: Weakness, motor impairment & muscular atrophy of limbs * Bi Syndromes: pain, soreness, heaviness & numbness in the tendons, bones & muscles with swelling & restricted movement

<4> Observation of the Five Sense Organs <a> Observation of the eye * Eye vitality * Eye shape : deep eye socket Eye ball pop out: Graves’ disease * Eye color --Red: Sclera: Lu. fire or wind-heat Corner: Ht. fire Eyelid: Sp. dampness Whole eye: Liv. fire or wind --Yellow Sclera: damp-heat or damp cold --Pale corner: blood def. --Black Eyelid: kid. Def. * Unconscious Eye movement: wind

<5>. Observation of the tongue ¤ Lower Jiao The Base of the tongue corresponds to the Kidney, Urinary Bladder, Large Intestine and Small Intestine Meridians. ¤ Middle Jiao The sides of the tongue correspond to the Liver and Gall Bladder meridians. Some theories place the Gall Bladder on the patients left side and the Liver on the patients right side.The Middle of the tongue corresponds to the Stomach and Spleen Meridians. ¤ Upper Jiao The Tip of the tongue corresponds to the Lung and the Heart Meridians.

Tongue Body Colors and Clinical Indications

Tongue Body Shapes and Clinical Indications

Tongue Coatings and Clinical Indications

<C>. Auscultation & Olfaction <1> Listening <a> Speech Respiration <c> Cough <2> Smelling <a> Breathing Sweating: body odor <c> Phlegm <d> Stools <e> Women’s secretion <f> vomiting

<D> Pulse-feeling & palpation Common Pulse Locations and Related Meridians

Writing of medical report in TCM Internal Medicine

Method of Clinic Practice in TCM Inquiring Inspection Auscultation & Olfaction Pulse-feeling & palpat