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Observation
The observation
portion of diagnosis begins the moment the patient appears before the
practitioner. In this step, the practitioner is forming an initial
impression of the patient, while assessing the seriousness of the condition
based on four main considerations:
Vitality: the
color, complexion and lustre of the skin, and the overall general impression
of the patient are key points in observation. The appearance of the
face is an excellent indicator of vitality as all the acupuncture meridians
flow to the face, by their primary or secondary pathways, and the state
of Blood and chi (qi) is very evident in this area.
As well, the color
of the face may reveal problems in the functioning of the organs. For
example, black circles under the eyes could indicate kidney weakness,
whereas red coloring (which relates to heat/fire) is linked with the
heart. Black or blue coloring is linked with the kidneys, blue-green
may involve the liver, and white implies a lung problem.
Body Appearance:
the appearance of the body can also provide the practitioner with good
information as to where the problems lie. At this point the practitioner
is mainly looking for the distribution of fat, type of build, appearance
of body hair, etc.. For example, it is difficult for yang qi to be
distributed in a body with excess fat, therefore an overweight person
is more susceptible to cardiac arrest and stoke.
Facial Features:
facial expressions tell the practitioner about the psychological status
of the patient, whether it be sad, happy, anxious or overjoyed, and
are a point of consideration prior to making a diagnosis. The features
themselves, including the eyes, nose, mouth and lips, can also provide
evidence of excess or deficient conditions causing imbalance in the
body.
The Tongue
and its Coating: the inspection of the tongue is a vital diagnostic
procedure in the practice of Traditional Chinese Medicine. The color,
coating, shape and texture of various parts of the tongue yield information
about the state of the organs.
A normal tongue
is moist and has an "appropriate" red color. A light red
or pale tongue is a sign of deficiency in both qi and blood. A thick,
purple colored tongue is often associated with alcoholism, while cracks
in the tongue show dryness, heat, and deficient yin.
Prior to an examination,
it is important not to eat or drink anything that will discolor the
tongue and give a misleading impression to the practitioner.
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